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South Miami
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
THE CITY OF PLEASANT LIVING
To:
FROM:
VIA:
DATE:
SUBJECT:
BACKGROUND:
GRANTOR:
The Honorable Mayor & Members of the City Commission
Steven Alexander, City Manager
Angelica Bueno, Planning & Sustainability Administrator ,.,
January 17, 2017 Agenda Item No.:--/-
A Resolution authorizing the City Manager to execute the grant
agreement with Miami-Dade County for the South Miami Tennis
Program.
Miami-Dade County by and through its Office of Grants Coordination
awarded the City of South Miami with a grant not to exceed $10,000
under the Community Development Block Grant (CDBG) Program. The
grant provided funding for the tennis lessons program for South Miami
residents living inside the Low-Mod Clientele (LMC) and Neighborhood
Revitalization Strategic Area (NSRA); through the City's Parks and
Recreation Department. The twice a week lessons program, was for
eleven (I I) low income children for the duration of seven (7) weeks.
The program was provided at Marshall Williamson Park, located at 6125
SW 68th Street, South Miami, FL., inside the NRSA area, in Miami Dade
County (MDC) District 7 as per grant requirements. Due to the delay of
the approval process, MDC will reimburse the City immediately upon
approval of the contract, since services have been provided.
The grant period began on October I S\ 2016 and ended on December
31 st
, 2016. The City's tennis program started November 7th
, 2016 and
ended on December 3 1st
, 2016; and has expended a total amount of
proximally $6,040.00.
Miami-Dade County Office of Grants Coordination -Local Granting
Agency
GRANT AMOUNT: $10,000
ATTACHMENTS: Miami-Dade Contract
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RESOLUTION NO. __ _
A Resolution authorizing the City Manager to execute FY2016 Community
Development Block Grant agreement with Miami-Dade County for the South
Miami Tennis Lessons Program.
WHEREAS, the City of South Miami was awarded a grant for the Tennis Lessons
Program from Miami-Dade County by and through its Office of Grants Coordination in the
amount of$10,000 with an expiration date of December 31th, 2016; and .
WHEREAS, the Mayor and City Commission authorize the City Manager to"execute the
Community Development Block Grant (CDBG) agreement with Miami-Dade County's Office of
Grants Coordination and accept the funding amount of $10,000 for the City of South Miami
Tennis Lessons Program.
NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY
COMMISSION OF THE CITY OF SOUTH MIAMI, FLORIDA THAT:
Section 1: The City Manager is hereby authorized to execute the CDBG agreement with
Miami-Dade County Office of Grants CoordinatioI;l for the South Miami Tennis Lessons
Program, with an expiration date of December 31 st, 2016 and accept the funding amount of
$10,000. The grant agreement is attached to this resolution.
Section 2: This resolution shall be effective immediately after the adoption hereof.
PASSED AND ADOPTED this __ day of _____ , 2017.
ATTEST:
CITY CLERK
READ AND APPROVED AS TO FORM
LANGUAGE, LEGALITY AND
EXECUTION THEREOF:
CITY ATTORNEY
APPROVED:
MAYOR
Mayor Stoddard:
Vice Mayor Welsh:
Commissioner Edmond:
Commissioner Harris:
Commissioner Liebman:
Resolution Number: R-853-16
Duns Number: 24628976
Awarded Amount: $10,000
CDBG2M~
Non-Profit
FY 2016 COMMUNITY DEVELOPMENT BLOCK GRANT
CONTRACT BETWEEN
MIAMI-DADE COUNTY
AND
CITY OF SOUTH MIAMI
This Agreement (hereinafter referred to as "Agreemenf' or "Contract"), by and between Miami-Dade County, a
political subdivision of the State of Florida, hereinafter referred to as "County" and City of South Miami hereinafter
referred to as "Awardee" and having offices at, 6130 Sunset Drive, South Miami, FL 33143, and telephone number of
of (305) 668-2514 states conditions and covenants for the rendering of Community, Economic or Housing activities
hereinafter referred to as "Activity or Activities" for the County through its Public Housing and Community
Development hereinafter referred to as "PHCD," and having its principal offices at 701 N.W. 1 Court, 14th Floor,
Miami, Florida 33136, collectively referred to as the "Parties."
WHEREAS, the Home Rule Charter authorizes Miami-Dade County to provide for the uniform health and
welfare of the residents throughout the County; and
WHEREAS, the Community Development Block Grant (CDBG) Program was authorized by the Housing and
Community Development Act of 1974, as amended, with the primary objective of promoting the development of viable
urban communities; and
WHEREAS, the Awardee provides it will develop activities of value to the County and has demonstrated an
ability to provide these activities; and
WHEREAS, the County is desirous of obtaining such activities of the Awardee, and the Awardee is desirous
of providing such activities; and
WHEREAS, the County has appropriated CDBG funds (plus any Program Income awarded by the Board of
County Commissioners, which may be added to the Contract by Amendment) to the Activity Community Programs,
located at 6125 SW 68th Street. South Miami, FL 33143. All CDBG funds, except those awarded to County
Departments and municipalties, are awarded in the form of a loan that is forgivable if the national objective is met
pursuant to the terms and conditions set forth herein, induding but not limited to Section II, W(2)(a)(1)-(2); and
WHEREAS, the Awardee shall carry out the Activities defined and set forth in Attachment A, "Scope of
Services", in Miami-Dade County or the focus area(s) of the county.
NOW, therefore, in consideration of the mutual covenants recorded herein, the parties hereto agree as
follows:
EFFECTIVE TERM
OF AGREEMENT:
AMOUNT OF AGREEMENT:
J. DEFINITIONS
PHCD
24 CFR Part 570 -CDBG
Regulations
Awardee
Community Development
This Agreement shall begin on October 1, 2016.
This Agreement shall expire on December 31, 2016.
Subject to the availability of funds, the amount of funds which may be disburse,
in accordance with this Agreement, may not exceed $10,000.
Public Housing and Community Developmentor its successor
Department
Federal regulations implementing Title I of the Housing and
Community Development Act of 1974, as amended -Community
Development Block Grant.
Recipient of CDBG funds from Miami-Dade County.
A local agency that is organized to meet community development
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Corporation
Local
Low-and Moderate-Income
Individual or Family
Very Low Income Individual
or Family
Contract Records or
Agreement Records
Effective Term
of Agreement
Federal Award
OMS A-133
Property
Policies and Procedures
Manual
Subcontractor or
Subconsultant
Subcontract
II. THE AWARDEE AGREES:
needs with particular emphasis on the economic development,
housing and revitalization needs of low-and moderate-income area
residents and which is receptive to the needs expressed by the
community.
Having headquarters in Miami-Dade County or having a place of
business located in Miami-Dade County from which the Contract or
Subcontract will be performed.
A person or family whose annual income does not exceed 80% of the
median income for the area, as determined by HUD with adjustments
for smaller and larger families and with certain exceptions as provided
in 24 CFR Part 570.
A person or family whose annual income does not exceed 50% of the
median income for the area, as determined by HUD with adjustments
for smaller and larger families and with certain exceptions as provided
in 24 CFR Part 570.
Any and all books, records, documents, information, data, papers,
letters, materials, electronic storage data and media whether written,
printed, electronic or electrical, however collected, preserved,
produced, developed, maintained, completed, received or compiled by
or at the direction of the Awardee or any subcontractor in carrying out
the duties and obligations required by the terms of this contract,
including but not limited to financial books and records, ledgers,
drawings, maps, pamphlets, designs, electronic tapes, computer
drives and diskettes or surveys.
The Effective Term of this Agreement is the duration of time listed
above as the "EFFECTIVE TERM OF AGREEMENT".
Any federal funds received by the Awardee from any source during the
period of time in which the Awardee is performing the obligations set
forth in this contract.
OMS A-133 shall mean as amended, replaced or supplemented from
time to time.
The real property as descibed by legal description in any loan
documents executed between Awardee and the County and any real
property of Awardee or Related or Affiliated Entities (as defined herein)
acquired or improved upon with funds awarded pursuant to this
Agreement or on which funds awarded pursuant to this Agreement are
anticipated to be used.
PHCD's Policies and Procedures Manual f/kla Contract Compliance
Manual may be viewed and downloaded at
http://www/miamidade.gov/housing/community-development.asp
Any individual or firm hired on a contractual basis by the Awardee for
the purpose of performing work or functions cited on the Action Step
Format (Attachment "A1) ofthis contract.
Any contractual agreement between a Subcontractor and the Awardee.
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A. The Awardee shall carry out the Activities defined and set forth in Attachment A, "Scope of
Services," which is incorporated herein and attached hereto, in the County or the focus area(s) of
the County. Awardee acknowledges and agrees that the purpose of CDBG funds is to benefit low-
and moderate-income persons. Therefore, Awardee shall carry out the Activities in such a manner
as to satisfy a National Objective.
B. Insurance Requirements
Upon PHCD's notification, the Awardee shall furnish to the Department's Community and Housing
Management Division (CHMD), 701 N.W. 1 Court, 14th floor, Miami, Florida 33136, relevant
certificate(s) of Insurance evidencing insurance coverage as detailed in Attachment B-1 (M). The
effective coverage start date of applicable insurances shall not be later than the date of the
Agreement execution and shall be approved by Miami-Dade County's Internal Services Department
prior to any reimbursement being processed. All certificates and insurance updates must identify
the names of the Awardee and the Activity being funded through this Agreement. The Awardee
shall provide Builder'S Risk Insurance and/or Flood Insurance (if applicable) upon the issuance of
the Notice to Proceed with an effective date for coverage commencing on .the Notice to Proceed
date.
Any changes to the required insurance policies, including coverage renewals, must be submitted to
PHCD through a formal notice immediately upon occurrence throughout the Agreement period.
If the Awardee fails to submit the required insurance documents in the manner prescribed in these
requirements within sixty (60) calendar days after the Board of County Commissioners' approval,
the Awardee shall be in default of the terms and conditions of the Agreement.
C. Certificate of Continuity
The Awardee shall be responsible for ensuring that the insurance certificates required in
conjunction with this subsection remain in force for the duration of the Agreement period, including
any and all option years, if applicable. In the case of construction and major rehabilitation activities,
the Awardee must have the coverage cited in Attachment B-1 (M) of this Agreement at the time
that it begins construction on the project. If the insurance certificates are scheduled to expire during
the Agreement period, the Awardee shall be responsible for submitting new or renewed insurance
certificates to the County at a minimum of thirty (30) calendar days before such expiration.
In the event that expiration certificates are not replaced with new or renewed certificates that cover
the Agreement period, the County shall suspend the Agreement until the new or renewed
certificates are received by the County in the manner prescribed in the requirements; provided,
however, that this suspended period does not exceed thirty (30) calendar days. If such suspension
exceeds thirty (30) calendar days, the County may, at its sole discretion, terminate the Agreement.
Prior to execution of the Agreement by the County and commencement of the contracted services,
the Awardee shall obtain all insurance required under this Section and submit same to the County
for approval. All insurance shall be maintained throughout the term of the Agreement.
D. Indemnification
The County shall not assume any liability for the acts, omissions to act or negligence of the
Awardee, its agents, servants or employees; nor shall the Awardee exclude liability for its own acts,
omissions to act, or negligence arising out of the Awardee's performance pursuant to this
Agreement. The Awardee shall indemnify and hold harmless the County and its officers,
employees, agents and instrumentalities from any and all liability, losses or damages, including
attorneys' fees and costs of defense, which the County or its officers, employees, agents or
instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings
of any kind or nature arising out of, relating to or resulting from the performance of this Agreement
by the Awardee or its employees, agents, servants, partners principals or subcontractors. The
Awardee shall pay all claims and losses in connection therewith and shall investigate and defend
all claims, suits or actions of any kind or nature in the name of the County, where applicable,
including appellate proceedings, and shall pay all costs, judgments, and attomey's fees which may
issue thereon. The Awardee expressly understands and agrees that any insurance protection
required by this Agreement or othelWise provided by the Awardee shall in no way limit the
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responsibility to indemnify, keep and save harmless and defend the County or its officers,
employees, agents and instrumentalities as herein provided. Nothing herein is intended to serve as
a waiver of sovereign immunity by the County nor shall anything herein be construed as consent by
the County to be sued by third parties in any matter arising out of this Agreement. Nothing herein
shall be construed to extend the County's liability beyond that provided in section 768.28, Florida
Statutes. The provisions of this section survive the termination or expiration of this Agreement. For
an Awardee which is a municipality, nothing herein shall be construed to extend the Awardee's
liability beyond that provided in section 768.28, Florida Statutes.
E. National Objective
In accordance with 24 CFR Section 570.208 of the federal regulations, the Awardee shall be
required to achieve the national objective of Benefit to Low and Moderate Income Persons or
Households (LMI). (See Attachment B-2). Awardee shall execute and deliver to the County,
simultaneous with this Agreement, a Promissory Note committing to repay the funds provided by
the County pursuant to this Agreement in the event that Awardee fails to meet the national
objective. In the event the CDBG fund!) subject to this Agreement are to be used for the acquisition
or improvement of real property, the Awardee shall also be required to give the County a mortgage
or other .sercurity instrument to be determined at the absolute and sole discretion of the County
Mayor or Mayor's designee in order to secure the loan described in this Agreement. Title work and
a title insurance policy, if so required in the absolute and sole discretion of the County Mayor or
Mayor's designee in order to adequately secure the loan set forth herein, shall be paid for by
Awardee. Awardee understands that the County may be liable to the United States Department of
Housing and Urban Development ("HUD") for repayment of the federal funds loaned to Awardee
pursuant to this Agreement in the event that HUD determines that Awardee has failed to meet the
national objective. AWARDEE WAIVES ANY RIGHT TO OBJECT TO THE REPAYMENT OF
FUNDS, PURSUANT TO THIS AGREEMENT AND/OR THE PROMISSORY NOTE, IN THE
EVENT THAT HUD DETERMINES THAT THE AWARDEE HAS NOT MET THE NATIONAL
OBJECTIVE. The County shall have all rights and remedies in law and equity to seek repayment
of funds loaned to Awardee pursuant to this Agreement.
F. Documents and Reporting Requirements
The Awardee shall submit documents to PHCD or report on relevant information to PHCD as
described below and provide any other documents in whatever form, manner, or frequency as
prescribed by PHCD. These will be used for monitoring progress, performance, and compliance
with this Agreement and for compliance with applicable County and Federal requirements.
1. Certificates of Insurance
The original certificate, as set forth in Attachment B-1{M) to be received by PHCD within
the first month of this Agreement period, and submitted with each payment request,
including any renewals, prior to payments made by the County. The effective date of the
coverage must coincide with the beginning date of this agreement.
2. Progress Reports
a. The Awardee shall submit each quarter a status report using the form attached
hereto as Attachment C, "Progress Report," as it may be revised by PHCD,
which shall describe the progress made by the Awardee in achieving each of the
Activities, objectives and action steps identified herein, including but not limited to
Attachment A and Attachment A-1.
The Awardee shall ensure that PHCD receives each report in triplicate (or as
indicated) no later than 10 days after the quarter ends.
The Awardee shall submit to PHCD a cumulative account of its activities under
this agreement by completing the following portions of the Progress Report Form:
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, 'I -'g.
Section I -General Information
Section II -Financial Information:
The Awardee must report expenditure information based on approved budgeted
line items to reflect all costs incurred during the reporting period. In addition, the
Awardee shall report on Program Income, depicting the twenty percent (20%) to
be paid to the County quarterly as well as Awardee's usage of Program Income
for each contracted activity.
Section III -Status of Contracted Activities:
The Awardee must report specific information regarding the status of the
contracted activities, including accomplishments and/or delays encountered
during the implementation of the project and an unduplicated count of clients
served during the reporting period (if applicable) for each federally defined ethnic
category. Awardees engaged in construction and/or housing rehabilitation
projects shall report on the progress of their activities including the number of
housing units completed and occupied by low-moderate and low income·
residents. The Awardee shall also report demographic informafiori.on each head
of household. Each goal and corresponding objective(s), as indicated in the
approved Scope of Services, must be addressed as part of this report. Awardees
engaged in job creation projects shall report on the progress of their activities
including the names of businesses assisted, the number of jobs created and the
income qualification of individuals holding the jobs created.
50% and 70% Benchmark Reporting: At the time Awardee has been paid or
otherwise received fifty percent (50%) and seventy percent (70%) of the
Agreement Funds, Awardee must report --on the next progress report due --and
submit documentation to show sufficient to show that Awardee has accomplished
50% and 70%, respectively, of the Activities described herein. For Awardees
engaged in construction and/or housing rehabilitation projects, Awardees shall
report on the progress of their activities including the number of housing units
completed and· occupied by low-moderate and low income residents. The
Awardee shall also report demographic information on each head of household.
Each goal and corresponding objective(s), as indicated in the approved Scope of
Services, must be addressed as part of this report. Awardees engaged in job
creation projects shall report on the progress of their activities including the
names of businesses assisted, the number of jobs created and the income
qualification of individuals holding the jobs created.
In conjunction with the progress reports submitted, Awardee shall submit the
Performance & Benefit Data Supplement (the "Supplement") to the Quarterly
Expenditure & Progress Report. The Supplement shall be considered a part of
the progress reports due pursuant to this Agreement.
Section III -Contract and Subcontract Activity Report:
Contract and Subcontract Activity Report (First and Third Quarter Progress
Report) -The Awardee shall report to PHCD the number of business activities
involving minority vendors, including subcontractors performing work under this
Agreement. The "Contract and Subcontract Activity Report" Section in
Attachment C, and when applicable Section 3 in the same Attachment shall be
completed semiannually by the Awardee and submitted to PH CD no later than 10
days after the first and third quarter.
Section IV -Contract and Subcontract Activity Report:
Contract and Subcontract Activity Report (First and Third Quarter Progress
Report) -The Awardee shall report to PHCD the number of business activities
involving minority vendors, including subcontractors performing work under this
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Agreement. The "Contract and Subcontract Activity Report" Section in
Attachment C, and when applicable Section 3 in the same Attachment shall be
completed semiannually by the Awardee and submitted to PHCD no later than 10
days after the first and third quarter.
Section V -Neighborhood Employment Opportunities:
a. Neighborhood Employment Opportunities Report (First and Third Quarter
Progress Report) -The Awardee shall report to PHCD the number of
target and service area residents who have received employment
opportunities from federally financed and assisted projects and activities.
The Neighborhood Employment Opportunities Report shall be submitted
using the Progress Report Form attached hereto as a Section in
Attachment C, as it may be revised. This section of the form shall be
completed semiannually by the Awardee and submitted to PHCD no later
than 10 days after the first and third quarter.
The Awardee shall submit to the County, in a timely manner, any other
information deemed necessary by the County to show Awardee has
performed its obligations set forth in this Agreement and to show U.S.
HUD that Awardee has met the national objective, and its presentation
shall comply with the format specified at the time of the request. Failure to
submit the Progress Reports or other information in a manner satisfactory
to the County by the due date shall render the Awardee in noncompliance
with this Agreement. The County may require the Awardee to forfeit its
claim to payment requests or the County may invoke the termination
provision in this Agreement by giving five (5) days written notice of such
action to be taken.
b. Quarterly Reporting when Subcontractors are Utilized
Awardees are advised that when Subcontractors or Subconsultants are
utilized to fulfill the terms and conditions of this Agreement, Miami-Dade
County Resolution No. 1634-93 will apply to this Agreement. This
resolution requires the Awardees to file quarterly reports as to the amount
of Agreement monies received from the County and the amounts thereof
that have been paid by the Awardee directly to Black, Hispanic and
Women-Owned businesses performing part of the contract work.
Additionally, the listed businesses are required to sign the reports,
verifying their participation in the contract work and their receipt of such
monies. For purposes of applicability, the requirements of this resolution
shall be in addition to any other reporting requirements required by law,
ordinance or administrative order.
c. Unspecified Site(s) Objective -If the Awardee has not yet identified a
location to carry out any of the activities described in Attachment A, the
Awardee shall submit, in triplicate, Progress Reports, using the form
attached hereto as part of Attachment C, on a monthly basis until such
time as the Awardee complies with the provisions contained within Section
II, Paragraph F.4. of this Agreement. Copies of the above described
Progress Report shall be received by PHCD no later than the tenth (10th)
day of each month and shall address the progress undertaken by the
Awardee during the previous month. This Progress Report shall not be
required if the Awardee is submitting the Progress Reports required by
Section II, Paragraph F.2.a and Paragraph F.3.
3. Annual Report (Fourth Quarter Progress Report) and Final Report -The Awardee shall
submit a cumulative status report (hereinafter referred to as "Annual Report") using the
"Progress Report" specified in Section II, Paragraph F.2.a. above, which shall describe the
progress made by the Awardee in achieving each of the National Objectives identified in
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Attachment A during the previous year. The "Annual Report" must cover the CDBG fiscal
year beginning on January 1 and ending on December 31 and shall be received by PHCD
no later than 10 days after the year ends. The Final Progress Report submitted by
Awardee shall include a summary of services and accomplishments Awardee performed
and achieved throughout the term of this Agreement and shall be accompanied by
sufficient documentation to show Awardee has met the CDBG National Objective. For
Activities where the National Objective is job creation, the Final Progress Report shall
include documentation sufficient to prove to U.S. HUD that Awardee met the National
Objective. Awardee shall report all Program Income earned during the year and shall pay
to the County all Program Income earned unless directed expressly, in writing, to
otherwise by the County.
4. Environmental Review -The Awardee immediately upon locating or determining a site for
each of the "Unspecified Site" activities to be carried out pursuant to this Agreement, shall
submit information detailing the location of each site for which a Site Environmental
Conditions Statement will be prepared. The Environmental Review is to be prepared on
information contained in Attachment D, "Information for Environmental Review Form."
Notwithstanding any provision of this Agreement. the parties hereto agree and
acknowledge that this Agreement does not constitute a commitment of funds or site
approval. and that such commitment of funds or approval may occur only upon
satisfactory completion of environmental review and receipt by the County of a release of
funds from the U.S. Department of Housing and Urban Development under 24 CFR Part
58. The parties further agree that the provision of any funds to the project is conditioned
on the County's determination to proceed with. modify or cancel the project based on the
results of a subsequent environmental review.
5. Audit Report -The Awardee shall submit to PHCD an annual audit report in triplicate as
required by Section II, Paragraph L of this Agreement, as set forth below. The Awardee
shall submit a written statement from its auditing firm to confirm that it has cleared any
non-compliance issues stated in the audit, and a written statement from the Auditor that
the audit complies with all applicable provisions of 24 CFR Part 84.26, Part 85.26 and
OMB A-133, as may be amended from time to time, and 2 CFR Part 200.
6. Personnel Policies and Administrative Procedures -The Awardee shall submit detailed
documents describing the Awardee's intemal corporate or organizational structure,
property management and procurement policies and procedures, personnel management,
accounting policies and procedures, etc. Such information shall be submitted to PHCD
within 30 days of the execution of this Agreement.
7. Inventory Report -The Awardee shall report annually all nonexpendable personal and real
property purchased with CDBG funds from this and previous agreements with the County
as specified in Section II, Paragraph W of this Agreement.
8. Affirmative Action Plan -The Awardee shall report to PHCD information relative to the
equality of employment opportunities whenever so requested by PHCD.
9. Disclosure of Related or Affiliated Parties -At the time of contract execution, or at any
other time at the request of the County, Awardee shall disclose to the County all Related
or Affiliated Parties. Related or Affiliated Parties shall mean persons, corporations,
partnerships, or other business entities (a) which have a direct or indirect ownership
interest in Awardee, (b) which have a parent or principal thereof which has a direct or
indirect ownership interest in Awardee, (c) whose members appointed by Awardee, or (d)
which the County deems in its sole discretion to be a Related or Affiliated Party of
Awardee. The Awardee shall report this information to the County upon forming the
relationship or, if already formed, shall report it immediately. Any supplemental information
shall be reported quarterly in the required Progress Report. This provision shall be
construed broadly to the benefit of the County. Non-compliance with these requirements
will be considered a default, which may result in the immediate termination of the
agreement, the recovery of the entire funding award, and the disqualification of funding
through PHCD for a period of three years.
Page 7
10. Reporting on financial Status, Bankruptcy, Real Property, or Personal Property -Awardee
shall notify the County in writing within ten (10) days of the occurrence of any of the
following as to Awardee or any Related or Affiliated Parties:
a. Any anticipated or pending lis pendens, foreclosure action, arrearage, default,
late payment regarding any property of Awardee or Related or Affiliated Parties,
including properties not related to this Agreement. Awardee shall also provide the
County with a copy of all court filings, notices of default, arrearage or late
payment, or any other documents relevant to the disclosures required herein.
b. Any legal encumbrance on the Property not permitted in writing by the County.
c. Any default or arrearage on any loan, Note or other debt or obligation for which
the Property is security.
d. Any anticipated or pending bankruptcy, restructuring, dissolution, reorganization,
appointment of a trustee or receiver.
e. Any action, activity, facts, or circumstances that would materially impair
performance by Awardee of all. the terms and conditions of this Agreement.
'\ . . .
Failure to comply with these reporting requirements shall constitute a default and shall
entitle the County to seek any and all remedies available at law, equity and pursuant to
this Agreement.
11. Pursuant to the Miami-Dade Board of County Commissioners' Resolution No. R-34-15, the
Awardee, its agents and/or representatives, shall provide written notice to the County
related to the availability of rental opportunities, including, but not limited to, the number of
available units, bedroom size, and rental prices of such rental units at the start of any
leasing activity, and after issuance of certificate of occupancy. The Awardee, its agents
and/or representatives shall also provide the County with the contact information for the
Awardee, its, agents and/or representatives.
G. Lobbying Prohibition
1. The Awardee shall certify that no federal appropriated funds have been paid or will be
paid, by or on behalf of the undersigned, to any person for influencing or attempting to
influence an officer or employee of any agency, a Member of Congress, an officer or
employee of Congress, or an employee of a Member of Congress in connection with the
awarding of any federal Agreement, the making of any federal grant, the making of any
federal loan, the entering into of any cooperative Agreement, and the extension,
continuation, renewal, amendment, or modification of any federal Agreement, grant, loan,
or cooperative Agreement.
2. The Awardee shall disclose to PHCD if any funds other than federal appropriated funds
have been paid or will be paid to any person for influencing or attempting to influence an
officer or employee of any agency, a Member of Congress, an officer or employee of
Congress, or an employee of a Member of Congress in connection with this federal
Agreement, grant, loan, or cooperative Agreement, on a Standard Form-LLL, "Disclosure
Form to Report Lobbying," in accordance with its instructions.
3. The Awardee shall ensure that the language in this Section II, Paragraph G.1. and G.2 be
included in the award documents for all subawards at all tiers (including subcontracts,
subgrants, and Agreements under grants, loans, and cooperative Agreements) and to
ensure that all subrecipients shall certify and disclose accordingly in connection with this
activity.
H. Federal, State, and County Laws and Regulations
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Rules, Regulations and Licensing Requirements
1. The Awardee shall comply with all laws, ordinances and regulations applicable to the
services contemplated herein, especially those applicable to conflict of interest and
collusion. Awardees are presumed to be familiar with all Federal, State and local laws,
ordinances, codes, rules and regulations that may in any way affect the goods or services
offered, especially Executive Order No. 11246 entitled "Equal Employment Opportunity"
and as amended by Executive Order No. 11375, as supplemented by the Department of
Labor Regulations (41 CFR, Part 60), the Americans with Disabilities Act of 1990 and
implementing regulations, the Rehabilitation Act of 1973, as amended, Chapter 553 of
Florida Statutes and any and all other local, State and Federal directives, ordinances,
rules, orders, and laws relating to people with disabilities. The Awardee will also comply
with OMB A-122, OMB A-110, OMB A-21, OMB A-133, and with the applicable
procedures specified in PHCD's Policies and Procedures Manual found at
http://www/miamidade.gov/housing/community-development.asp, which are incorporated
herein by reference, receipt of which is hereby acknowledged, and as they may be
revised.
2. The Awardee agrees to abide by Chapter II-A, Code of Miami-Dade County ("County
Code"), as amended, applicable to non-discrimination in employment, housing and public
accommodation on the basis of race, color, religion, ancestry, national origin, sex,
pregnancy, age, disability, marital status, familial status, gender identity, gender
expression, sexual orientation, actual or perceived status as a victim of domestic violence,
dating violence or stalking, or source of income, as amended; and applicable to non-
discrimination in employment, housing and public accommodation; and 24 CFR 570.607.
3. Awardee shall comply with, and cause all subcontracts to require compliance with, Florida
Statutes, the Miami-Dade County Code of Ordinances, and all applicable building codes,
including the Miami-Dade County Building Code and any applicable municipal building
code. Failure of Awardee or any subcontractor of Awardee to so comply with these
requirements, which includes but is not limited to engaging in construction or repairs
without proper building permits or unlicensed professionals engaging in work which
requires a license, shall cause this Agreement to be voidable by the County at the
County's absolute and sole discretion. In the event the County voids this Agreement for
failure to comply with the requirements of this section, Awardee" shall forfeit any right to
payment pursuant to this Agreement, regardless of when Awardee's or the subcontractor's
noncompliance becomes known to the County.
4. The Awardee shall comply with Section 504 of the Rehabilitation Act of 1973, as amended,
which prohibits discrimination on the basis of handicap and requires a minimum number of
units to be accessible to persons with disabilities; Title VI of the Civil Rights Act of 1964,
as amended, which prohibits discrimination on the basis of race, color, or national origin;
the Age Discrimination Act of 1975, as amended, which prohibits discrimination on the
basis of age; Title VIII of the Civil Rights Act of 1968, as amended, and Executive Order
11063 which prohibits discrimination in housing on the basis of race, color, religion, sex, or
national origin; Executive Order 11246, as amended which requires equal employment
opportunity; and with the Energy Policy, amended and Conservation Act (Pub.L 94-163)
which requires mandatory standards and policies relating to energy efficiency. The
Awardee also agrees to comply with the Domestic Violence Leave codified as 11A-60 et
seq. of the Miami-Dade County Code, which requires an employer, who in the regular
course of business has fifty (50) or more employees working in Miami-Dade County for
each working day during each of twenty (20) or more calendar work weeks to provide
domestic violence leave to its employees. Failure to comply with this local law may be
grounds for voiding or terminating this Agreement or for commencement of debarment
proceedings against the Awardee.
5. If the amount payable to the Awardee pursuant to the terms of this Agreement is in excess
of $100,000, the Awardee shall comply with all applicable standards, orders, or
regulations, issued pursuant to Section 306 of the Clean Air Act of 1970 (42 U.S.C.A. Ch.
85) as amended; the Federal Water Pollution Control Act (33 U.S.C. 1251), as amended;
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Section 508 of the Clean Water Act (33 U.S.C. 1368); Environmental Protection Agency
regulations; and Executive Order 11738.
6. Assurance of Compliance with Section 504 of the Rehabilitation Act -The Awardee shall
report its compliance with Section 504 of the Rehabilitation Act whenever so requested by
PHCD within the term of this Agreement or the Affordability Period.
7. Americans with Disabilities Act (ADA) of 1990 -The Awardee shall attest to; and submit
the required Disability Non-discrimination Affidavit assuring compliance with all applicable
requirements of the laws listed below including but not limited to, those provisions
pertaining to employment, provIsions and program services, transportation,
communications, access to facilities, renovations, and new construction.
8. Affirmative Action/Non-Discrimination of Employment, Promotion, and Procurement
Practices (Ordinance #98-30) -All firms with annual gross revenues in excess of $5
million, seeking to contract with Miami-Dade County shall, as a condition of award, have a
written Affirmative Action Plan and Procurement Policy on file with the Regulatory and
Economic Resources Department. Said firms must also submit, as a part of their
proposals/bids to be filed with the Clerk of the Board, an appropriately completed and
signed Affirmative Action Plan/Procurement Policy Affidavit. Firms whose B'oards of
Directors are representative of the population make-up of the nation are exempt,from this
requirement and must submit, in writing, a detailed listing of their Boards of Directors,
showing the race or ethnicity of each board member, to the County's Regulatory and
Economic Resources Department. Firms claiming exemption must submit, as a part of
their proposals/bids to be filed with the Clerk of the Board, an appropriately completed and
signed Exemption Affidavit in accordance with Ordinance 98-30. These submittals shall
be subject to periodic reviews to assure that the entities do not discriminate in their
employment and procurement practices against minorities and women-owned businesses.
It will be the responsibility of each firm to provide verification of their gross annual
revenues to determine the requirement for compliance with the Ordinance. Those firms
that do not exceed $5 million annual gross revenues must clearly state so in their
bid/proposal.
Any bidder/respondent which does not provide an affirmative action plan and procurement
policy may not be recommended by the County Mayor for award by the Miami-Dade
Board of County Commissioners.
9. Domestic Violence Leave Affidavit -Prior to entering into any contract with the County, a
firm desiring to do business with the County shall, as a condition of award, certify that it is
in compliance with the Domestic Leave Ordinance, 99-5 and Section 11A-60 of the Miami-
Dade County Code. This Ordinance applies to employers that have, in the regular course
of business, fifty (50) or more employees working in Miami Dade County for each working
day during each of twenty (20) or more calendar work weeks in the current or preceding
calendar year. In accordance with Resolution R-185-00, the obligation to provide domestic
violence leave to employees shall be a contractual obligation. The County shall not enter
into a contract with any firm that has not certified its compliance with the Domestic Leave
Ordinance. Failure to comply with the requirements of Resolution R-185-00, as well as the
Domestic Leave Ordinance may result in the contract being declared void, the contract
being terminated and/or the firm being debarred.
10. Code of Business Ethics -In accordance with Section 2-8.1 (1) of the Code of Miami-Dade
County each person or entitiy that seeks to do business with Miami-Dade County shall
adopt a Code of Business Ethics ("Code") and shall submit an affidavit stating that the
Awardee has adopted a Code that complies with the requirements of Section 2-8.10) of
the Miami-Dade County Code (Form A-12). Section 2-11.1(d) of Miami-Dade County Code
as amended by Ordinance 00-1, also requires any county employee or any member of the
employee's immediate family who has a controlling financial interest, direct or indirect,
with Miami-Dade County or any person or agency acting for Miami-Dade County from
competing or applying for any such contract as it pertains to this solicitation, must first
request a conflict of interest opinion from the County's Ethic Commission prior to their or
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their immediate family member's entering into any contract or transacting any business
through a firm, corporation, partnership or business entity in which the employee or any
member of the employee's immediate family has a controlling financial interest, direct or
indirect, with Miami-Dade County or any person or agency acting for Miami-Dade County
and that any such contract, agreement or business engagement entered in violation of this
subsection, as· amended, shall render this Agreement voidable. For additional
information, please contact the Ethics Commission hotline at (305) 579-9093.
11. Public Entity Crimes -Pursuant to Paragraph 2(a) of Section 287.133, Florida Statutes, a
person or affiliate who has been placed on the convicted vendor list following a conviction
for a public entity crime may not submit a proposal for a contract to provide any goods or
services to a public entity; may not submit a proposal on a contract with a public entity for
the construction or repair of a public building or public work; may not submit proposals on
leases of real property to a public entity; may not be awarded or perform work as a
Awardee, supplier, subcontractor, or consultant under a contract with any public entity;
and, may not transact business with any public entity in excess of the threshold amount
provided in Section 287.017 for Category TWO ($10,000) for a period of thirty-six (36)
months from the date of.bein.g placed o.n the convicted vendor list. The Awardee warrants
and represents that it has not been placed on the convicted vendor list The Awardee
agrees that should Miami-Dade County discover that the Awardee's representations
regarding the list are false, this Agreement shall be terminated on the discretion of Miami-
Dade County. Further, should the Awardee be placed on the list at any time during this
Agreement Miami-Dade County shall have the right to terminate this agreement
12. Criminal Conviction -Pursuant to Miami-Dade County Ordinance No. 94-34, "Any
individual who has been convicted of a felony during the past ten years and any
corporation, partnership, jOint venture or other legal entity having an officer, director, or
executive who has been convicted of a felony during the past ten years shall disclose this
information prior to entering into a contract with or receiving funding from the County."
Failure of the Awardee to disclose this information as required may lead to the
termination of this agreement by Miami-Dade County.
If Awardee, or any owner, subsidiary, or other firm affiliated with or related to the Awardee,
is found by the responsible enforcement agency, the Courts or the County to be in
violation of the Acts, the County will conduct no further business with Awardee. Any
contract entered into based upon a false affidavit, as listed below, and submitted pursuant
to this resolution shall be voidable by the County:
1. Miami-Dade County Vendor Affidavit Form
2. Criminal Record Affidavit
3. Public Entity Crime Affidavit
4. Related-Party Disclosure Information
5. Miami-Dade County Affidavit Regarding Delinquent and Currently Due Fees or
Taxes
6. Affirmative Action Affidavits
7. Current on all County Contracts, Loans, and Other Obligations Affidavit
8. Financial and Conflicts of Interest Affidavit
9. Collusion Affidavit
If any attesting firm vioJatesany of the Acts below during the term of any contract such firm has
with the County, such contract shall be voidable by the County, even if the attesting firm was not in
violation at the time it submitted its affidavit.
The applicable Acts are as follows:
1. The Americans with Disabilities Act of 1990 (ADA), Pub. L. 101-336, 104 Stat
327,42 U.S.C. 12101-12213 and 47 U.S.C. Sections 225 and 611 including Title
I, Employment; Title II, Public Services; Title III, Public Accommodations and
Services Operated by Private Entities; Title IV, Telecommunications; and Title V,
Miscellaneous Provisions.
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2. The Rehabilitation Act of 1973, 29 U.S.C. Section 794;
3. The Federal Transit Act, as amended 49 U.S.C. Section 1612;
4. The Fair Housing Act as amended, 42 U.S.C. Section 3601-3631.
In addition to the requirements in the Agreement, the Awardee agrees to comply with all the
provisions of 24 CFR 570.502, 24 CFR 570.503, and 24 CFR Part 570,Subpart K (24 CFR 570.600
-570.614), including the following: '
Public Law 88-352 and Public Law 90-284; affirmatively furthering fair housing; Executive
Order 11063.
Section 109 of the Housing and Community Development Act (24 CFR 6)
Labor standards (24 CFR 570.603; 29 CFR Part 5).
Environmental standards.
National Flood Insurance Program.
Uniformed Relocation Act.
Employment and contracting opportunities.
Lead-based paint regulations.
Eligibility of contractors or sub recipients.
Uniform administrative requirements and cost principles.
Conflict of interest.
Executive Order 12372.
Eligibility of certain resident aliens.
Architectural Barriers Act and the Americans with Disabilities Act.
13. CDBG-Related Requirements
1. National Objective -Awardee must perform the Activities described herein in a
manner in which Awardee meets the national objective of benefit to low-
and moderate-income persons. Awardee shall ensure and maintain
documentation, acceptable to the County in its sole and absolute discretion, that
conclusively demonstrates that each activity assisted in whole or in part with
CDBG funds is an activity which provides benefit to low-and moderate-income
persons, as defined in the CDBG Regulations.
2. The Awardee shall comply with all applicable provisions of 24 CFR Part 570 and
shall carry out each activity in compliance with all applicable federal laws and
regulations described therein. If the Awardee is a primarily religious entity, it shall
comply with all provisions of 24 CFR 570.200 0).
3. The Awardee agrees to comply with (a) the Uniform Relocation Assistance and
Real Property Acquisition Policies Act of 1970, as amended (URA), and
implementing regulations at 49 CFR Part 24 and 24 CFR 570.606(b):(b) the
requirements of 24 CFR 570.606(c) governing the Residential Antidisplacement
and Relocation Assistance plan under section 104(d) of the HCD Act; and (c) the
requirements in 570.606(d) governing optional relocation policies. (The County
may preemept the optional policies). The Awardee shall provide relocation
assistance to persons (families, individuals, businesses, non-profit organizations
and farms) that are displaced as a direct result of acquisition, rehabilitaion,
demolition or conversion for a CDBG assisted project. The Awardee also agrees
to comply with applicable County ordinances, resolutions and policies concerning
the displacement of persons from their residences.
4. For each activity or portion of activity described in Attachment A hereto for
which a location has not yet been identified, the Awardee shall obtain,
immediately after a site is identified by the Awardee, PHCD's written
environmental clearance statement and shall agree in writing to comply with any
and all requirements as may be set forth in the Site Environmental Clearance
Statement.
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5. The Awardee shall cooperate with PHCD in informing the appropriate CDBG
citizen participation structures, including the appropriate area committees, of the
activities of the Awardee in adhering to the provisions of this Agreement.
Representatives of the Awardee shall attend meetings of the appropriate
committees and citizen participation structures, upon the request of the citizen
participation officers, PHCD, or the County.
6. The Awardee shall make a good faith effort to address the concems of the
residents of the affected area. The Awardee shall cooperate with PHCD in
informing the appropriate CDBG citizen participation structures, including the
appropriate area committees, of the activities of the Awardee in adhering to the
provisions of this Agreement. Representatives of the Awardee shall attend
meetings of the appropriate committees and citizen participation structures, upon
the request of the citizen participation officers, PHCD, or the County.
7. For activities involving acquisition, rehabilitation and/or demolition of property and
which require the relocation of families, individuals, businesses and/or industries,
the Awardee shall submit a written notification to the Community Planning and
Outreach Division of PHCD prior to relocating, evacuating, and/or dispersing any
and all legal occupants who reside at this property on the basis of a long or short .
term lease. When the legality of an occupant (individual, family, business, and/or
industry) is in question, the Awardee shall contact the above mentioned unit prior
to making a determination. Awardees receiving CDBG funds shall adhere to 24
CFR part 50 and/or part 58 and to the rules and regulations of the Uniform
Relocation Assistance and Real Property Acquisition Act of 1970, as
amended.The Awardee shall adopt Affirmative Marketing Procedures and
requirements for CDBG assisted projects. These procedures must consist of
actions to provide information and attract eligible persons from all racial, ethnic
and gender groups to the available services. The Awardee shall annually assess
its affirmative marketing program to determine if the procedures used to comply
with the requirements specified in Public Law 88-352 and Public Law 90-284
successfully meet these requirements. The Awardee shall submit to PHCD its
Affirmative Marketing Plan no later than 60 days from the date this Agreement is
executed.
8. For Housing, Rehabilitation, and Construction activities all conditions in this
section will apply throughout the regulatory period identified in the national
objective. Throughout that period, the Awardee will be required to submit an
annual report regarding their compliance with the national objective, and PHCD
will have the right to monitor the activity.
9. The Awardee shall comply with all applicable uniform administrative
requirements as described in 24 CFR 570.502
10. For Special Economic Development projects, Awardee is reponsible for
understanding 24 CFR 570.209, which describes HUD's underwriting and
project anlaysis requirements. These requirements include, but are not limited to,
the analysis of Awardee's financing gap or rate of return gap, project feasibility,
and the reasonableness of costs and Awardee's or owner's equity return.
Awardee agrees to defer to the County's analysis of the Activity as conducted in
compliance with the CDBG Regulations, including but not limited to 24 CFR
570.209, including Appendix A, as well as OMB guidance on using federal funds.
Awardee understands that in the event that the Activity fails the analysis
conducted pursuant to 24 CFR 570.209, Awardee shall have the opportunity to
renegotiate this Agreement by modifying the Activity to improve the Activity to the
County's satisfaction or to terminate this Agreement with each party paying their
own costs, fees and damages (as applicable).
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If Awardee is a municipality, the Awardee acknowledges that the County will
perform an underwriting and project analysis to determine the financing gap or
rate of return gap, project feasibility, and the reasonableness of costs and
Awardee's or owner's equity return. Awardee agrees to defer to the County's
analysis. Awardee shall have the opportunity to renegotiate this Agreement by
modifying the Activity to improve the Activity to the County's satisfaction or to
terminate this Agreement with each party paying its own costs and fees (as
applicable).
I. Conflicts with Applicable Laws
If any provision of this Agreement conflicts with any applicable law or regulation including but not
limited to, 24 CFR 570, only the conflicting provision shall be deemed by the parties hereto to be
modified to be consistent with the law or regulation or to be deleted if modification is impossible.
However, the obligations under this Agreement, as modified, shall continue and all other provisions
of this Agreement shall ·remain in full force and effect. The County's determination on whether a
provision conflicts shall be final and binding.
J. Board of Directors
If the Awardee is a Community Development Corporation (CDC), PHCD shall have the option to
appoint a representative to the Awardee's board of directors. This representative shall not be
considered in the counting of a quorum and shall have no voting privileges.
K. Construction
If the Awardee engages in, procures, or makes loans for construction work, the Awardee shall:
1. Contact the PHCD representative noted in Section IV, Paragraph M of this Agreement,
prior to taking any action, to schedule a meeting to receive compliance information.
2. Comply with the Awardee's procurement and pre-award requirements and procedures
which, at a minimum, shall adhere to all applicable federal standards.
3. Comply with the Davis-Bacon Act; Copeland Anti-Kick Back Act (18 U.S.C. 874 et seq.);
Contract Work Hours and Safety Standards Act (40 U.S.C. 327 Et Seq.); and Lead-Based
Paint Poisoning Prevention Act as amended on September 15, 1999; and other related
acts, as applicable.
4. Submit to PHCD for written approval all proposed Solicitation Notices, Invitations for Bids,
and Requests for Proposals prior to publication.
5. Submit to PHCD all construction plans and specifications and receive PHCD's approval
prior to implementation.
6. Contact the PHCD representative noted in Section IV, Paragraph M, prior to scheduling a
pre-construction conference. In accordance with industry standards, PHCD will hold ten
percent (10%) of the total grant award as a retainer until the construction work is
determined by PHCD, in its sole discretion, to be seventy-five percent (75%) completed,
At the time that the construction work is determined by PHCD to be seventy-five percent
complete, the retainer will be reduced to 5% until the work is completed, Completion shall
occur when a Certificate of Occupancy is issued.
7. The County shall have the right to assign Professional Staff and Technical Assistance
from the Public Housing and Community Developmentto assist the project if the County's
staff determines that the Awardee has been unable to consistently achieve the work and
units described within the time frames of the action step format of this agreement. Such
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involvement may result in a reduction of a maximum of 5% of the Agreement's award to
cover the cost of the technical assistance. The Awardee shall cooperate and comply with
all requests made by such staff.
8. Execute and record, at the County's request, any of the following documents in order to
ensure the Property is used as defined and described in Attachment A of this Agreement:
a. Promissory Note
b. Mortgage
c. Loan Agreement
d. Restrictive Covenant
e. Rental Regulatory Agreement
f. Collateral Assignment of leases, rents and Contract Rights
g. UCC-1 Rider
h. Title Insurance Policy
9. Comply with County Resoltuion No. R-346-15, establishing that the Maximum
Development Cost per Unit (as defined below) to construct, rehabilitate or acquire
Affordable Housing with these funds shall be $225,000.00, except for construction of High-
Rise projects for which the Maximum Development Cost per Unit shall be $250,000.00.
"High-Rise" shall mean Affordable Housing structures which are seven or more stories in
height. This Maximum Development Cost per Unit shall apply to projects constructed,
rehabilitated or acquired by the County or by private or public entities using County funds,
including, but not limited to, Community Development Block Grant, Home Investment
Partnership, State Housing Initiative Program, Documentary Surtax, Building Better
Communities General Obligation Bond, or general revenue funds. The "Maximum
Development Cost per Unit" means the Total Development Cost, as defined herein,
looking at all funding sources and not just County funds, divided by the total number of
units. For the purposes of determining the Maximum Development Cost per Unit on
construction or rehabilitation projects, the 'Total Development Cost" shall mean the total
cost of completing the entire project, from acquisition to the issuance of Certificate of
Occupancy, including, but not limited to, the costs for design, planning, zoning, variances,
financing costs, legal costs, construction, and permitting. For construction and
rehabilitation projects, the cost of land acquisition shall be deducted from the Total
Development Cost. In addition, construction costs associated with non-housing features
included in a project or those not deemed by PHCD to be amenities expected of, typically
provided with or appurtenant to affordable housing units, may be deducted from the Total
Development Cost by the Mayor or Mayor's designee.
10. Awardee shall comply or provide the County with bonds sufficient for the County to comply
with Florida Statutes, Section 255.05.
L. Audits and Records
1. Nonprofit organizations that expend $750,000 or more annually in federal awards shall
have a single or program specific audit conducted in accordance with OMB A-133.
Nonprofit organizations expending federal awards of $750,000 or more under only one
federal program may elect to have a program-specific audit performed, in accordance with
OMB A-133. Awardees who will be receiving, or who have received, federal awards for
loans or loan guaranteed programs may be required to conduct audits of those programs
in accordance with regulations of the federal agencies providing those guarantees or
loans.
2. Nonprofit organizations that expend less than $750,000 annually in federal awards shall
be exempt from an audit conducted in accordance with OMB A-133, although their records
must be available for review (e.g., inspections, evaluations). Such agencies that receive
less than $750,000 in combined Federal awards must submit to the County annual
compilation reports that describe their performance. To achieve uniformity regarding the
reporting format, such documents must comply with the accounting industry standards by
communicating an independent accountant's (1) expression of limited assurance on
FINANCIAL STATEMENTS as a result of performing inquiry and analytic procedures
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(Review Report); (2) results of procedures performed (Agreed-Upon Procedures Report);
(3) non-expression of opinion or any form of assurance on a presentation in the form of
financial statements information that is the representation of management (Compilation
Report); or (4) an opinion on an assertion made by management in accordance with the
Statements on Standards for Attestation Engagements (Attestation Report).
3. When the requirements of OMS A-133 apply, an audit shall be conducted for each fiscal
year for which federal awards attributable to this Agreement have been received by the
Awardee. Each audit shall include a fiscal review, which includes a validation of all
program generated income and its disposition, especially attributable to CDSG funds, an
internEIl control review, and a compliance review as described in OMS A-133. A copy of
the audit report in triplicate must be received by PHCD no later than six months following
the end of the Awardee's fiscal year.
4. If an audit is required by Paragraph L of this Agreement, but the requirements of OMS A-
133 do not apply the Awardee may choose to have an audit performed either on the basis
of the Awardee's fiscal year or on the basis of the period during which PHCD-federal
assistance has been received. In either case, each audit shall cover a time period of not
more than twelve (12) months and an audit shall be submitted covering each assisted,
period until all the assistance received from this Agreement has been reported on. Each
audit shall adhere to all other audit standards of OMS A-133, as these may be limited to
cover only those services undertaken pursuant to the terms of this Agreement. A copy of
the audit report in triplicate must be received by PHCD no later than six months following
each audit period.
5. The Awardee shall maintain all Contract Records in accordance with generally accepted
accounting principles, procedures, and practices which shall sufficiently and properly
reflect all revenues and expenditures of funds provided directly or indirectly by the County
pursuant to the terms of this Agreement.
6. The Awardee shall maintain all Contract Records that document all actions undertaken to
accomplish the "Scope of Services" outlined in Attachment A in this Agreement and in
accordance with 24 CFR 570.506; 570.503.
7. The Awardee shall ensure that the Contract Records shall be at all times subject to and
available for full access and review, inspection, or audit by County and federal perl)onnel
and any other personnel duly authorized by the County.
8. The Awardee shall include in all PH CD approved subcontracts used to engage
subcontractors to carry out any eligible substantive programmatic services, as such
services are described in this Agreement and defined by PHCD, each of the record-
keeping and audit requirements detailed in this Agreement. PHCD shall, in its sole
discretion, determine when services are eligible substantive programmatic services and
subject to the audit and record-keeping requirements described above.
9. The County reserves the right to require the Awardee to submit to an audit by Audit and
Management Services or other auditor of the County's choosing at the Awardee's
expense. The Awardee shall provide access to all of its records, which relate directly or
indirectly to this Agreement at its place of business during regular business hours. The
Awardee shall retain all records pertaining to this Agreement and upon request make
them available to the County for four years following expiration of the Agreement. The
Awardee agrees to provide such assistance as may be necessary to facilitate the review
or audit by the County to ensure compliance with applicable accounting and financial
standards.
10. The Awardee shall ensure that its auditors share their audit results with and must submit
the audit report to PHCD within six months after the conclusion of the audit period.
11. Pursuant to County Ordinance No. 03-2, the Awardee will grant access to the Commission
Auditor to all financial and performance related records, property, and equipment
purchased in whole or in part with government funds. The Awardee agrees to maintain an
accounting system that provides accounting records that are supported with adequate
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documentation, and adequate procedures for determining the allow ability and allocability
of costs.
M. Protected Records and Documents
Any person or entity that performs or assists Miami-Dade County with a function or activity
involving the use or disclosure of "Individually Identifiable Health Information (IIHI) and/or
Protected Health Information (PHI) shall comply with the Health Insurance Portability and
Accountability Act (HIPAA) of 1996 and the Miami-Dade County Privacy Standards Administrative
Order. HIPAA mandates privacy, security and electronic transfer standards including but not
limited to:
1. Use of information only for performing services required by the Agreement or as
required by law;
2. Use of appropriate safeguards to prevent non-permitted disclosures;
3. Reporting to Miami-Dade Coun,ty of any non-permitted 'use or disclosure;
4. Assurances that any agents and subcontractors agree to the same restrictions
and conditions that apply to the Contractor and reasonable assurances that
IIHIIPHI will be held confidential;
5. Making Protected Health Information (PHI) available to the customer;
6. Making PHI available to the customer for review and amendment, and
incorporating any amendments requested by the customer;
7. Making PHI available to Miami-Dade County for an accounting of disclosures;
and
8. Making internal practices, books and records related to PHI available to Miami-
Dade County for compliance audits.
PHI shall maintain its protected status regardless of the form and method of transmission (paper
records, and/or electronic transfer of data). The Contractor must give its customers written notice
of its privacy information practices including specifically, a description of the types of uses and
disclosures that would be made with protected health information.
N. Retention of Records
1. The Awardee shall retain all Contract Records for a period of at least seven (7) years
following the final Close-Out of the Activity/Project (hereinafter referred to as "Retention
Period") subject to the limitations set forth below. The final Close-Out of the
Activity/Project is the date when PHCD provides written notification of such. Under no
circumstances shall Awardee dispose of any Contract Records prior to Awardee providing
the County sufficient documentation to show that the HOME Regulations were fully
complied with in Awardee's performance of its obligations under this Agreement and has
received confirmation from PHCD that the Activity/Project has been finally Closed-Out in
the U.S. HUD lOIS system. Upon Awardee's request in writing for confirmation of said final
Close-Out, PHCD shall provide Awardee in writing either confirmation of final Close-Out or
a list of documentation required in order to proceed toward final Clos~-Out.
2. If the County or the Awardee have received or given notice of any kind indicating any
threatened or pending litigation, claim or audit arising out of the services provided
pursuant to the terms of this Agreement, the Retention Period shall be extended until such
time as the threatened or pending litigation, claim or audit is, in the sole and absolute
discretion of PHCD, fully, completely and finally resolved.
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3. The Awardee shall allow the County, federal personnel, or any person authorized by the
County full access to and the right to examine any of the Agreement records during the
required Retention Period.
4. The Awardee shall notify PHCD in writing, both during the pendency of this Agreement
and after its expiration as part of the final closeout procedure, of the address where all
Agreement records will be retained.
5. The Awardee shall obtain written approval of PHCD prior to disposing of any Agreement
records within one year after expiration of the Retention Period.
o. Provision of Records and Proprietary Rights and Information
1. The Awardee shall provide to PHCD, upon request, all Agreement records. These records
shall become the property of PHCD without restriction, reservation, or limitation of their
use. PHCD shall have unlimited rights to all books, articles, or otner copyrightable
materials developed for the purpose of this Agreement. These unlimited rights shall
include the rights to royalty-fees; nonexclusive, and irrevocable license to reproduce,
publish, or otherwise use, and to authorize 9thers to use, the information for public
purposes.
2. If the Awardee receives funds from, or is under regulatory control of, other governmental
agencies, and those agencies issue monitoring reports, regulatory examinations, or other
similar reports, the Awardee shall provide a copy of each report and any follow-up
communications and reports to PHCD immediately upon such issuance unless such
disclosure is a violation of the rules or policies of the regulatory agencies issuing the
reports.
3. Proprietary Information
As a political subdivision of the State of Florida, Miami-Dade County is subject to the
stipulations of Florida's Public Records Law.
The Awardee acknowledges that all computer software in the County's possession may
constitute or contain information or materials which the County has agreed to protect as
proprietary information from disclosure or unauthorized use and may also constitute or
contain information or materials which the County has developed at its own expense, the
disclosure of which could harm the County's proprietary interest therein.
During the term of the Agreement, the Awardee will not use directly or indirectly for itself
or for others, or publish or disclose to any third party, or remove from the County's
property, any computer programs, data compilations, or other software which the County
has developed, has used or is using, is holding for use, or which are otherwise in the
possession of the County (hereinafter "Computer Software"). All third-party license
agreements must also be honored by the Awardees and their employees, except as
authorized by the County and, if the Computer Software has been leased or purchased by
the County, all hired party license agreements must also be honored by the Awardees'
employees with the approval of the lessor or Awardees thereof. This includes mainframe,
minis, telecommunications, personal computers and any and all information technology
software.
The Awardee will report to the County any information discovered or which is disclosed to
the Awardee which may relate to the improper use, publication, disclosure or removal from
the County's property of any information technology software and hardware and will take
such steps as are within the Awardee's authority to prevent improper use, disclosure or
removal.
4. Proprietary Rights
a) The Awardee hereby acknowledges and agrees that the County retains all rights, title
and interests in and to all materials, data, documentation and copies thereof furnished
by the County to the Awardee hereunder or furnished by the Awardee to the County
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and/or created by the Awardee for delivery to the County, even if unfinished or in
process, as a result of the Services the Awardee performs in connection with this
Agreement, including all copyright and other proprietary rights therein, which the
Awardee as well as its employees, agents, subcontractors and suppliers may use
only in connection of the performance of Services under this Agreement. The
Awardee shall not, without the prior written consent of the County, use such
documentation on any other project in which the Awardee or its employees, agents,
subcontractors or suppliers are or may become engaged. Submission or distribution
by the Awardee to meet official regulatory requirements or for other purposes in
connection with the performance of Services under this Agreement shall not be
construed as pUblication in derogation of the County's copyrights or other proprietary
rights.
b) All rights, title and interest in and to certain inventions, ideas, designs and methods,
specifications and other documentation related thereto developed by the Awardee
and its subcontractors specifically for the County, hereinafter referred to as
"Developed Works" shall become the property of the County.
c) Accordingly, neither the Awardee nor its employees, agents, subcontractors or
suppliers shall have any proprietary interest in such Developed Works. The
Developed Works may not be utiliied, reproduced or distributed by or on behalf of the
Awardee, or any employee, agent, subcontractor or supplier thereof, without the prior
written consent of the County, except as required for the Awardee's performance
hereunder.
d) Except as otherwise provided in subsections a, b, and c above, or elsewhere herein,
the Awardee and its subcontractors and suppliers hereunder shall retain all
proprietary rights in and to all Licensed Software provided hereunder, that have not
been customized to satisfy the performance criteria set forth in the Scope of Services.
Notwithstanding the foregoing, the Awardee hereby grants, and shall require that its
subcontractors and suppliers grant, if the County so desires, a perpetual, irrevocable
and unrestricted right and license to use, duplicate, disclose and/or permit any other
person(s) or entity(ies) to use all such Licensed Software and the associated
specifications, technical data and other Documentation for the operations of the
County or entities controlling, controlled by, under common control with, or affiliated
with the County, or organizations which may hereafter be formed by or become
affiliated with the County. Such license specifically includes, but is not limited to, the
right of the County to use and/or disclose, in whole or in part, the technical
documentation and Licensed Software, including source code provided hereunder, to
any person or entity outside the County for such person's or entity's use in furnishing
any and/or all of the Deliverables provided hereunder exclusively for the County or
entities controlling, controlled by, under common control with, or affiliated with the
County, or organizations which may hereafter be formed by or become affiliated with
the County. No such License Software, specifications, data, documentation or related
information shall be deemed to have been given in confidence and any statement or
legend to the contrary shall be void and of no effect
5. Public Records Law
a. Awardee acknowledges that the County is subject to Chapter 119 of the Florida Statutes,
known as the "Public Records Law". As such, items considered to be public records under
the Public Records Law related to this Agreement shall be disclosed by the County upon a
public records request in accordance with law.
b. IF THE AWARDEE HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119, FLORIDA STATUTES, TO THE AWARDEE'S DUTY TO
PROVIDE PUBLIC RECORDS RELATING TO THIS AGREEMENT, CONTACT
THE PHCD CUSTODIAN OF PUBLIC RECORDS AT 786-469-4192,
csalina@miamidade.gov, 701 NW 1st Court, 16th Floor, Miami, FL 33136.
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c. Many agencies contracting for COBG funds are not considered "contractors" as defined in
Florida Statutes, Section 119.0701. However, where Awardee is a "contractor," as defined
in Florida Statutes, Section 119.0701, meaning that Awardee has entered into a contract
for services with the County and is acting on behalf of the County as provided under
Florida Statutes, Section 119.011 (2), the following shall apply:
d. Contractor shall comply with the Florida public records law, specifically to:
i. Keep and maintain public records required by the County to perform the service.
ii. Upon request from the County's custodian of public records, provide the County
with a copy of the requested records or allow the records to be inspected or
copied within a reasonable time at a cost that does not exceed the cost provided
in this chapter or as otherwise provided by law.
iii. Ensure that public records that are exempt or confidential and exempt from
public records disclosure requirements are not disclosed except as authorized by
law for the duration of the contract term and following completion of the contract
if the contractor does not transfer the records to the County.
iv. Upon completion of the Agreement, transfer, at no cost, to the County all-public
records in possession of the contractor or keep and maintain public records
required by the County to perform the service. If the contractor transfers all public
records to the County upon completion of the Agreement, the contractor shall
destroy any duplicate public records that are exempt or confidential and exempt
from public records disclosure requirements. If the contractor keeps and
maintains public records upon completion of the Agreement, the contractor shall
meet all applicable requirements for retaining public records. All records stored
electronically must be provided to the County, upon request from the County's
custodian of public records, in a format that is compatible with the information
technology systems of the County.
e. A request to inspect or copy public records relating to this Agreement for services must be
made directly to the County. If the County does not possess the requested records, the
County shall immediately notify the contractor of the request, and _ the contractor must
provide the records to the County or allow the records to be inspected or copied within a
reasonable time.
i. If a contractor does not comply with the County's request for records, the County
shall enforce these requirements in accordance with the Agreement.
ii. A contractor who fails to provide the public records to the County within a
reasonable time may be subject to penalties under Florida Statutes, Section
119.10.
f. The contractor shall be liable in any civil action brought due to contractor's violation of
Florida's public records laws, and shall indemnify the County as described in this
Agreement.
-P. Audits and Inspectors General
Nothing in this Agreement shall impair any independent right of the County to conduct audit or
investigate activities. The provisions of this section are neither intended nor shall they be construed
to impose any liability on the County by the Awardee or third parties.The provisions in this section
shall apply to the Awardee, its officers, agents, employees, subcontractors, suppliers and Related
or Affiliated Parties. The Awardee shall incorporate the provisions in this section in all subcontracts
and all other Agreements executed by the Awardee in connection with the performance of the
Agreement.
Miami-Dade County Inspectors General Review
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According to Section 2-1076 of the Code of Miami-Dade County, as amended, Miami-Dade County
·has established the Office of the Inspector General which may, on a random basis, perform audits
on all County contracts, throughout the duration of said contracts, except as otherwise provided
below. The cost of the audit of any Contract shall be one quarter (1/4) of one (1) percent of the
total contract amount which cost shall be included in the total proposed amount. The audit cost will
be deducted by the County from progress payments to the selected Awardee. The audit cost shall
also be included in all change orders and all contract renewals and extensions.
Exception: The above application of one quarter (1/4) of one percent fee assessment shall not
apply to the following contracts: (a) IPSIG contracts; (b) contracts for legal services; (c) contracts
for financial advisory services; (d) auditing contracts; (e) facility rentals and lease agreements; (f)
concessions and other rental agreements; (g) insurance contracts; (h) revenue-generating
contracts; (I) contracts where an IPSIG is assigned at the time the contract is approved by the
Commission; 0) professional service agreements under $1,000; (k) management agreements; (I)
small purchase orders as defined in Miami-Dade County Administrative Order 3-2; (m) federal,
state and local government-funded grants; and (n) interlocal agreements. Notwithstanding the
foregoing, the Miami-Dade County Board of County Commissioners may authorize the inclusion of
the fee assessment of one quarter (1/4) of one percent in any exempted contract at the time of
award.
Awardee consents to the. powers of the Inspector Ge~eral. The Miami-Dade CountY Inspector
General is authorized and empowered to review past, present and proposed County contracts,
transactions, accounts, records and programs. In addition, the Inspector General has the power to
subpoena witnesses, administer oaths, require the production of records and monitor existing
projects and programs. Monitoring of an existing project or program may include a report
concerning whether the project is on time, within budget and in compliance with plans,
specifications and applicable law.
Upon ten (10) days prior written notice to the Awardee from the Inspector General or IPSIG
retained by the Inspector General, the Awardee shall make all requested records and documents
available to the Inspector General or IPSIG for inspection and copying. The Inspector General and
IPSIG shall have the right to inspect and copy all documents and records in the Awardee's
possession, custody or control which, in the Inspector General or IPSIG's sole judgment, pertain to
performance of the Agreement, including, but not limited to original estimate files, worksheets,
proposals and Agreements from and with successful and unsuccessful subcontractors and
suppliers, all project-related correspondence, memoranda, instructions, financial documents,
construction documents, proposal and Agreement documents, back-charge documents, all
documents and records which involve cash, trade or volume discounts, insurance proceeds,
rebates, or dividends received, payroll and personnel records, and supporting documentation for
the aforesaid documents and records.
Independent Private Sector Inspector General Reviews
Pursuant to Miami-Dade County Administrative Order 3-20, the Awardee is aware that the County
has the right to retain the services of an Independent Private Sector Inspector General (hereinafter
"IPSIG"), whenever the County deems it appropriate to do so. Upon written I)otice from the County,
the Awardee shall make available to the IPSIG retained by the County, all requested records and
documentation pertaining to this Agreement for inspection and reproduction. The County shall be
responsible for the payment of these IPSIG services, and under no circumstance shall the
Awardee's prices and any changes thereto approved by the County, be inclusive of any charges
relating to these IPSIG services. The terms of this provision herein, apply to the Awardee, its
officers, agents, employees, subcontractors and assignees. Nothing contained in this provision
shall impair any independent right of the County to conduct an audit or investigate the operations,
activities and performance of the Awardee in connection with this Agreement. The terms of this
Article shall not impose any liability on the County by the Awardee or any third party.
Commission Auditor Access to Records
Pursuant to Ordinance No. 03-2, Awardee shall grant access to the Commission Auditor to all
financial and performance related records, property, and equipment purchased in whole or in part
with government funds, including funds awarded tp Awardee pursuant to this Agreement.
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Q. Prior Approval
The Awardee shall obtain written approval from PHCD prior to undertaking any of the following:
1. The engagement or execution of any subcontract(s) or Agreement assignments, wherein
CDBG funds will be used to pay for goods or services. The Awardee must submit all
proposed agreement documents to PHCD at least thirty (30) days prior to the start date of
the agreement. PHCD shall have no obligation to approve payment of any expenditure
(resulting from an agreement or subcontract) which was incurred prior to the approval by
PHCD of such agreement or subcontract.
2. The addition of any positions not specifically listed in the approved budget.
3. The modification or addition of all job descriptions for existing staff.
4. The purchase of all nonexpendable personal property not specifically listed in the
approved budget.
5. The disposition of all real, expendable personal, and nonexpendable personal property as
defined in Section II, Paragraph W.1. of this Agreement.
6. Out-of-town travel not specifically listed in the approved budget.
7. The disposition of Program Income not specifically listed in the approved Program Income
budget.
8. The publication of proposed Solicitation Notices, Invitations for Bids and Requests for
Proposals as provided for in Section II, Paragraph K of this Agreement.
9. The disposal of all Agreement records as provided for in Section II, Paragraph N of this
Agreement.
10. In the event the Awardee wishes to substitute personnel for the key personnel identified
by the Awardee's Proposal, the Awardee must notify the County in writing and request
written approval for the SUbstitution at least ten (10) business days prior to effecting such
SUbstitution.
R. Monitoring
The Awardee shall permit PHCD and other persons duly authorized by PHCD to inspect all
Agreement records, facilities, equipment, materials, and services of the Awardee which are in any
way connected to the activities undertaken pursuant to the terms of this Agreement, and/or to
interview any clients, employees, subcontractors, or assignees of the Awardee. Following such
inspection or interviews, PHCD will deliver to the Awardee a report of its findings, and the Awardee
will rectify all deficiencies cited by PH CD within the specified period of time set forth in the report, or
provide PHCD with a reasonable justification for not correcting the deficiencies. PHCD will
determine, in its sole and absolute discretion, whether or not the Awardee's justification is
acceptable or if the Awardee must, despite the justification, rectify the deficiencies cited by PHCD
in its report.
S. Conflict of Interest
The Awardee agrees to abide by the provisions of 24 CFR 84.42 (24 CFR Part 85.36 for Public
Agencies) and 24 CFR 570.611, all as may be amended from time to time, with respect to conflicts
of interest,' and covenants that it presently has no financial interest and shall not acquire any
financial interest, direct or indirect, which would conflict in any manner or degree with the
performance of services requried under this Agreement. The Awardee further covenants that in the
performance of this Agreement no person having such a financial interest shall be employed or
retained by the Awardee hereunder. These conflict of interest provisions apply to any person who
is an employee, agent, conSUltant, officer, or elected official or appointed official of the County, or of
Page 22
any designated public agencies or subrecipients which are receiving funds under the CDBG
Entitlement program. The Awardee certifies and represents that no officer, director, employee,
agent, or other consultant of the County or a member of the immediate family or household of the
aforesaid has directly or indirectly received or been promised any form of benefit, payment or
compensation, whether tangible or intangible, in connection with the grant of this Agreement.
The Awardee shall abide and be governed by Miami-Dade County Ordinance No. 72-82 (Conflict
of Interest Ordinance), as amended, which is incorporated herein by reference as if fully set forth, in
connection with its Agreement obligations hereunder.
The Awardee shall disclose any possible conflicts of interest or apparent improprieties of any party
that are covered by the above standards. The Awardee shall make such disclosure in writing to
PHCD immediately upon the Awardee's discovery of such possible conflict. PHCD will then render
an opinion which shall be binding on all parties.
The Awardee shall submit to PHCD, within five business days of execution this Agreement, all
updated Conflict of Interest affidavits, Related Party Disclosure statements, list of current Board
members, and list o!all business associations with the following documents:
> Original Agreement or its subsequent amendments.
> Requests for budget revisions.
> Requests for approval of subcontracts.
Non-compliance with the above requirements will be considered a breach of Agreement, which will
result in the immediate termination of the agreement, the recovery of the entire funding award, and
the disqualification of funding through PHCD for a period of three years.
a) Awardee certifies and represents that there are no undisclosed persons or entities
interested with the Awardee in this Agreement. This Agreement is entered into by the
Awardee without any connection with any other entity or person making a proposal for
the same purpose, and without collusion, fraud or conflict of interest. No elected or
appointed officer or official, director, employee, agent or other consultant of the
County, or of the State of Florida (including elected and appointed members of the
legislative and executive branches of government), or a member of the immediate
family or household of any of the aforesaid:
i} is interested on behalf of or through the Awardee directly or indirectly in any manner
whatsoever in the execution or the performance of this Agreement, or in the services,
supplies or work, to which this Agreement relates or in any portion of the revenues; or
ii) is an employee, agent, advisor, or consultant to the Awardee or to the best of the
Awardee's knowledge any subcontractor or supplier to the Awardee.
b) Neither the Awardee nor any officer, director, employee, agency, parent, subsidiary, or
affiliate of the Awardee shall have an interest which is in conflict with the Awardee's
faithful performance of its obligation under this Agreement; provided that the County,
in its sole discretion, may consent in writing to such a relationship, provided the
Awardee provides the County with a written notice, in advance, which identifies all the
individuals and entities involved and sets forth in detail the nature of the relationship
and why it is in the County's best interest to consent to such relationship.
c) The provisions of this Article are supplemental to, not in lieu of, all applicable laws with
respect to conflict of interest. In the event there is a difference between the standards
applicable under this Agreement and those provided by statute, the stricter standard
shall apply. '
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d) In the event Awardee has no prior knowledge of a conflict of interest as set forth above
and acquires information which may indicate that there may be an actual or apparent
violation of any of the above, Awardee shall promptly bring such information to the
attention of the County's Project Manager. Awardee shall thereafter cooperate with the
County's review and investigation of such information, and comply with the instructions
Awardee receives from the Project Manager in regard to remedying the situation.
T. Intentiona"y Left Blank
U. Publicity, Advertisements and Signage
The Parties agree that the Awardee is funded by the County for CDBG Activities. Further, the
Awardee agrees that a" events funded by this Agreement shall recognize the County and the
United States Department of Housing and Urban Development (US HUD), as funding sources and
that the Awardee shall ensure that a" publicity, public relations, advertisements and signs
recognize the County and US HUD for the support of a" contracted activities. This is to include, but
is not limited to, a"· posted signs, pamphlets, wall plaques, cornerstones, dedications, notices,
flyers, brochures, news releases, media packages, promotions, and stationery. The use of the
official County logo is permissible. The Awardee shall ensure that all media representatives, when
inquiring about the activities funded by this Agreement, are informed that the County and US HUD
are the funding sources. The Awardee shall notify the County of a" events and activities involving
the Project ten (10) days prior to the activity or event.
When the Awardee obtain(s) the building permit(s), the CHMD Project Manager at the Department,
must be notified in order to request the project sign from Miami-Dade County Internal Services
Department (ISD). Within thirty (30) days of the erection of the sign, the CHMD Project Manager
will submit an invoice to the Awardee for payment of the project sign cost. The Awardee is
responsible for a" costs for replacing any amended, lost, defaced or missing sign. The sign shall
remain on the premises at least ninety (90) days after the issuance of the Certificate of Occupancy
(CO) or Certificate of Completion (CC).
NO WORK SHALL COMMENCE UNTIL THE PROJECT SIGNS ARE SECURED IN PLACE. THE
SIGNS SHALL BE IN ACCORDANCE WITH THE DETAIL SHOWN IN ATIACHMENT F. Payment
for fumishing, installing and maintaining the sign shall be under the bid amount for mobilization.
v. Procurement
The Awardee must take affirmative steps to procure supplies, equipment, construction, or services
to fulfill this Agreement from minority and women's businesses, and to provide these sources the
maximum feasible opportunity to compete for subcontracts to be procured pursuant to this
Agreement. To the maximum extent feasible, these businesses shall be located in or owned by
residents of the Community Development areas designated by PHCD in the CDBG application
approved by the supervising federal agency.
The Awardee shall assure that a" subcontracts or third party agreements contain provisions with
stated goals, that low-income residents from Community Development Target and Service Areas
be provided with opportunities for employment and training in contracted activities.
In conformance with Section 3 of the Housing and Community Development Act of 1968, the
Awardee must direct federal financing assistance towards Target Area residents and ensure that
employment and economic opportunities be given to low and very low-income persons, particularly
those who are recipients of government assistance for housing according to the guidelines
mentioned below:
1. The work to be performed under this Agreement is subject to the requirements of Section
3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701
(Section 3). The purpose of Section 3 is to ensure that employment and other economic
opportunities generated by HUD assistance or HUD-assisted projects covered by Section
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3, shall, to the greatest extent feasible, be directed to low-and very low-income persons,
particularly persons who are recipients of HUD assistance for housing.
2. The parties to this Agreement agree to comply with HUD's regulations in 24 CFR part 135,
which implement Section 3. As evidenced by their execution of this Agreement, the
parties to this Agreement certify that they are under no contractual or other impediment
that would prevent them from complying with the part 135 regulations.
3. The Awardee agrees to send to each labor organization or representative of workers with
which the Awardee has a collective bargaining agreement or other understanding, if any, a
notice advising the labor organization or workers' representative of the Awardee's
commitments under this Section 3 clause, and will post copies of the notice in
conspicuous places at the work site where both employees and applicants for training and
employment positions can see the notice. The notice shall describe the Section 3
preference, shall set forth minimum number and job titles subject to hire, availability of
apprenticeship and training positions, the qualifications for each; and the name and
location of the person(s) taking applications for each of the positions; and the anticipated
date the work shall begin.
4. The Awardee agrees· to include this Section :3 clause in every subcontract subject to
compliance with regulations in 24 CFR part 135, and agrees to take appropriate action, as
provided in an applicable provision of the subcontract or in this Section 3 clause, upon a
finding that the subcontractor is in violation of the regulations in 24 CFR part 135. The
Awardee will not subcontract with any subcontractor where the Awardee has notice or
knowledge that the subcontractor has been found in violation of the regulations in 24 CFR
part 135.
5. The Awardee will certify that any vacant employment positions, including training
positions, that are filled (1) after the Awardee is selected but before the Agreement is
executed, and (2) with persons other than those to whom the regulations of 24 CFR part
135 require employment opportunities to be directed, were not filled to circumvent the
Awardee's obligations under 24 CFR part 135.
6. Noncompliance with HUD's regulations in 24 CFR part 135 may result in sanctions,
termination of this Agreeinent for default, and debarment or suspension from future HUD
assisted contracts.
7. With respect to work performed in connection with Section 3 covered Indian housing
assistance, section 7(b) of the Indian Self-Determination and Education Assistance Act
(25 U.S.C. 450e) also applies to the work to be performed under this Agreement. Section
7(b) requires that to the greatest extent feasible (i) preference and opportunities for
training and employment shall be given to Indians, and (ii) preference in the award of
contracts and subcontracts shall be given to Indian organizations and Indian-owned
Economic Enterprises. Parties to this Agreement that are subject to the provisions of
Section 3 and section 7(b) agree to comply with Section 3 to the maximum extent feasible,
but not in derogation of compliance with section 7(b).
8. Fair Subcontracting Policies (Ordinance 97-35)
All Awardees on County contracts in which subcontractors may be used shall be subject
to and comply with Ordinance 97-35 as amended, requiring Awardees to provide a
detailed statement of their policies and procedures for awarding subcontracts which:
a) notifies the broadest number of local subcontractors of the opportunity to be awarded
a subcontract;
b) invites local subcontractors to submit bids/proposals in a practical, expedient way;
c) provides local subcontractors access to information necessary to prepare and
formulate a subcontracting bid/proposal;
d) allows local subcontractors to meet with appropriate personnel of the Awardee to
discuss the Awardee's requirements; and
e) awards subcontracts based on full and complete consideration of all submitted
proposals and in accordance with the Awardee's stated objectives.
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All Awardees seeking to contract with the County shall, as a condition of award, provide a
statement of their subcontracting policies and procedures (see Attachment G). The County will not
execute this Agreement with Awardees who fail to provide a statement of the Subcontractors
Policies and Procedures.
The County reserves the right to either approve or withdraw its consent to a subcontract if it
appears to the County, in its discretion and authority, that the subcontract will delay, prevent, or
otherwise impair the performance of the Awardee's obligations under this Agreement.
W. Property
1. Definitions
a. Property. As defined on page 2 herein.
b. Real Property: Land, land improvements, structures, fixtures and appurtenances
thereto, excluding movable machinery and equipment.
c. Personal Property: Personal property of any kind except real property.
1) Tangible: All personal property having physical existence.
2) Intangible: All personal property having no physical
existence such as patents, inventions, and copyrights.
d. Nonexpendable Personal Property: Tangible personal property of a
nonconsumable nature, with a value of $750 or more per item, with a normal
expected life of one or more years, not fixed in place, and not an integral part of a
structure, facility or another piece of equipment.
e. Expendable Personal Property: All tangible personal property other than
nonexpendable property.
2. The Awardee shall comply with the real property requirements as stated below:
a. Any real property under the Awardee's control that was acquired or improved by
Awardee or PHCD in whole or in part with CDBG funds received from PHCD in
excess of $25,000 shall be either:
1) Used to meet one of the three (3) CDBG national objectives until five
(5) years after the expiration or termination of this Agreement, or for
such longer period of time as determined by PHCD in its sole and
absolute discretion; or
2) Not used to meet one of the three (3) CDBG National Objectives. In the
event the property is not used to meet one of the national objectives for
five (5) years following the expiration or termination of this Agreement or
such longer period as determined by PHCD, the Awardee shall, in the
sole discretion of PHCD, either pay to PHCD an amount equal to the
market value of the property as may be determined by PHCD in its sole
and absolute discretion, less any proportionate portion of the value
attributable to expenditures of non-CDBG funds for acquisition of, or
improvement to, the property or transfer the property to PHCD at no
cost to PHCD. Reimbursement is not required after the period of time
specified in Paragraph W.2.a.1., above.
b. Any real property under the Awardee's control that was acquired or improved in
whole or in part with CDBG funds from PHCD for $25,000 or less shall be
disposed of, at the expiration or termination of this Agreement, in accordance
with instructions from PHCD.
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c. All real property purchased or improved in whole or in part with funds from this
and previous Agreements with PHCD, or transferred to the Awardee after being
purchased in whole or in part with funds from PHCD, shall be listed in the
property records of the Awardee and shall include a legal description; size; date
of acquisition; value at time of acquisition; present market value; present
condition; address or location; owner's name if different from the Awardee;
information on the transfer or disposition of the property; and map indicating
whether property is in parcels, lots, or blocks and showing adjacent streets and
roads. The property records shall describe the programmatic purpose for which
the property was acquired and identify the CDBG national objective that will be
met. If the property was improved, the records shall describe the programmatic
purpose for which the improvements were made and identify the CDBG national
objective that will be met.
d. For awards involving the purchase or improvement of real property, the Awardee
agrees to execute a mortgage, loan document, or restrictive covenant for the
CDBG award with PHCD within 180 days after the execution of this agreement.
Failure to comply with this requirement may result in the retraction of the CDBG
award for the project and termination of this agreement.
e. All real property shall be inventoried annually by the Awardee and an inventory
report shall be submitted to PHCD. This report shall include the elements listed in
Paragraph W.2.c., above.
Nothing in this section shall be construed to limit the County's right to collect from
Awardee the entire amount of CDBG funds awarded pursuant to this Agreement in the
event Awardee fails to meet a national objective.
3. Inventory -Capital Equipment and Real Property
All capital items acquired for the project by the Awardee with funds allocated in this
Agreement shall be assets of the Awardee and may be secured by a mortgage delivered
to the County. A capital item shall be defined as an item that: (1) has a service life in
excess of one year; (2) is either complete within itself or is a major component of another
item of property; (3) by definition cannot be described either as supplies or materials;
(4) will not be consumed or lose its identity; and (5) has a unit cost of $500 or more.
Awardee shall notify the County immediately upon acquiring any capital items with funds
allocated in this Agreement
The County shall allow the Awardee to retain possession of capital equipment after
expiration of this Agreement as long as the Awardee continues to provide the service
described in the Scope of Services (Attachment A). If the Awardee disbands, becomes
defunct or in any way ceases to exist or if the Awardee ceases to provide the service
described in the Scope of Services or another service of value, Awardee shall notify the
County immediately and provide instructions describing how the County may take
possession of the capital equipment. Awardee shall deliver to the County all documents of
title or ownership and shall transfer or assign such ownership rights to the County.
Foreclosure of the County mortgage or enforcement of other documents shall not be
required in order for the County to claim and take possession of capital equipment.
4. The Awardee shall comply with the nonexpendable personal property requirements as
stated below:
a. All nonexpendable personal property purchased or improved in whole or in part
with funds from this and previous Agreements with PHCD shall be listed in the
property records of the Awardee and shall include a description of the property;
location; model number; manufacturer's serial number; date of acquisition;
funding source; unit cost at the time of acquisition; present market value;
property inventory number; information on its condition; and information on
transfer, replacement, or disposition of the property.
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b. All nonexpendable personal property purchased or improved in whole or in part
with funds from this and previous Agreements with PHCO shall be inventoried
annually by the Awardee and an inventory report shall be submitted to PHCD.
The inventory report shall include the elements listed in Paragraph W.3.a.,
above.
c. Title (ownership) to all nonexpendable personal property purchased in whole or
in part with funds given to the Awardee pursuant to the terms of this Agreement
shall vest in the County and PHCO.
5. The Awardee shall obtain prior written approval from PHCD for the disposition of real
property, expendable personal property, and nonexpendable personal property purchased
or improved in whole or in part with funds given to the Awardee or subcontractor pursuant
to the terms of this Agreement. The Awardee shall dispose of all such property in
accordance with instructions from PHCO. Those instructions may require the retum of all
such property to PHCO.
X. Program Income
1. Program Income as defined in 24 CFR Part 570.500' (a) means gross income received by
the Awardee directly generated from activities supported by CDBG funds. When Program
Income is generated by an activity that is only partially assisted with COBG funds, the
income shall be prorated to ref/ect the percentage of CDBG funds used.
2. The Awardee shall not, under any circumstances, use Program Income to pay for charges
or expenses that are specifically not allowed pursuant to the terms of this Agreement and
applicable federal regulations or rules, or any County rules or ordinance.
a. The Awardee shall comply with the Program Income provisions in PHCO's
Policies and Procedures Manual. If any Program Income provisions of the
Policies and Procedures Manual conflict with any Program Income provisions of
this Agreement, the provisions of this Agreement shall rule.
b. The Awardee shall report to PHCO all cumulative Program Income generated
from activities financed in whole or in part by funds from this Agreement, for as
long as it receives and/or has control over Program Income generated from this
and any previous Agreements with PHCO. The Awarded must submit the
information for the generated Program Income to PHCD guarterly as part of the
Fiscal Section of the Awardee's Progress Report as outlined in Section II.
Paragraph F.2.a.
The County may expressly permit Awardee to use Program Income in the Scope
of Services. If such permission is not expressly set forth in the Scope of Services,
then Awardee must request permission from the County to use Program Income
for eligible activities. The County may in its sole discretion grant such permission.
but such permission may require the approval of the Board of County
Commissioners.
c. If the Awardee requests to use Program Income, the Awardee shall provide to
PHCD a written explanation of the activities to be assisted with Program Income
and shall obtain PHCO's written approval prior to implementing those activities.
All provisions of this Agreement shall apply to any activity performed using
Program Income.
d. Should Awardee be granted permission to use Program Income, Awardee's use
of Program Income shall be subject to the limitations set forth in this Agreement
and as set forth in the COBG regulations, 24 CFR Part 570.504. Awardee
acknowledges that the CDBG Regulations require that Awardee spend Program
Income before further COBG funds are drawn down. Therefore, in the event that
the County permits Awardee to use Program Income, Awardee agrees that
Awardee shall expend the Program Income funds prior to seeking payment of
CDBG funds from the County. Twenty percent (20%) of the Program Income
Page 28
Awardee makes, retains or receives shall be paid to the County on a quarterly
basis and reported in Awardee's quarterly Progress Report. At the conclusion of
the contract period or upon termination of this Contract, Awardee shall
immediately pay/return all Contract funds and Program Income to the County.
e. Should Awardee be granted permission to use Program Income from a revolving
loan activity, Program Income must be used only for the same revolving loan
activity.
f. Should Awardee be granted permission to use Program Income, Program
Income from a revolving loan activity, such as loan repayments, interest eamed,
late fees, and investment income, shall be substantially disbursed to eligible
loans, loan-related programmatic costs, and operational costs for the same
revolving loan activity before the Awardee may request additional CDBG funds
for that activity.
g. Should Awardee be granted permission to use Program Income, all Program
Income from activities other than a revolving loan activity shall be substantially
disbursed to carry out other PHCD-approved CDBG eligible activities, and to
cover operational costs before requesting additional CDBG funds.
h. Any proceeds from the sale of property as detailed in Section II, Paragraph WA.,
above, shall be considered Program Income.
i. The Awardee shall obtain, as part of the required audit report, validation by a
certified auditor of all Program Income and its disposition.
3. Upon expiration or termination of this Agreement or at the end of any program year, the
Awardee shall transfer to the County any Program Income funds on hand, and any
Program Income accounts receivable to any CDBG funded activities. PHCD may require
remittance of all or part of any Program Income balances (including investments thereof).
4. PHCD, in its sole and absolute discretion, reserves the right to pursue other courses of
action in the retention and use of Program Income generated by the Awardee, and such
action shall not require an amendment to this Agreement.
Y. Travel
The Awardee shall comply with the County's travel policies. Documentation of travel expenses
shall conform to the requirements of PHCD's Policies and Procedures Manual.
Z. Subcontracts and Assignments
1. Unless otherwise specified in this Agreement, the Awardee shall not subcontract any
portion of the work without the prior written consent of the County. Subcontracting without
the prior consent of the County may result in termination of the Agreement for breach.
When Subcontracting is allowed, the Awardee shall comply with County Resolution No.
1634-93, Section 10-34 of the County Code and Section 2-8.8 of the County Code.
The Awardee shall ensure that all subcontracts and assignments:
a. Ensure that no contractor, subcontractor or assignee is listed on the U.S. HUD's
debarred, suspended, or ineligible contractors list; Awardee shall use, at a
minimum, US HUD's Excluded Parties List System to confirm clearance of
contractors. The system may be accessed at https:/lwww.sam.gov/ Awardee
shall provide to PHCD a copy of the site page that indicates the name and the
date it was checked. Awardee shall further ensure that no contractor,
subcontractor, or assignee is listed on Miami-Dade County's debarred
Contractor's List; Awardee shall, at a minimUm, check at
http://www.miamidade.gov/smallbusiness/business-development-reports.asp to
determine if a person or entity is on Miami-Dade County's debarred contractor's
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f
list. Awardee shall provide PHCD with a printout copy of the site page that
indicates the name and the date it was checked.
b. Comply with all CDBG requirements, as applicable, as well as the regulations
specified in PHCD's Policies and Procedures Manual.
c. Identify the full, correct, and legal name of the party.
d. Describe the activities to be performed.
e. Present a complete and accurate breakdown of its price component.
f. Incorporate a provision requiring compliance with all applicable regulatory and
other requirements of this Agreement and with any conditions of approval
that the County or PHCD deem necessary.
This applies only to subcontracts and assignments in which parties are engaged
to carry out any eligible substantive programmatic service, as may be defined by
PHCD, set forth in this Agreement. PHCD shall in its sole discretion determine
when services are eligible substantive programmaticserviGes and subject to the·
audit and record-keeping requirements described above, and;
Result from an open competitive bid process generating a minimum of three bids.
Such competitive process shall be described in writing, approved by the Board of
Directors and a copy of which submitted to PHCD. In such circumstances that
open, competitive bids are not feasible or that \a minimum of three bids are
unobtainable, permission to use other methods of award must be requested in
writing and approved by PHCD prior to the assignment or award of subcontract.
The Awardee agrees that no assignment or sub-contract will be made or let in
connection with the Agreement without the prior written approval of PHCD, which
approval shall not be unreasonably withheld, and that all such sub-contractors or
assignees shall be governed by the terms and intent ofthis Agreement.
g. Incorporate the language of Attactlment E, "Certification Regarding Lobbying."
h. Indude language stating that the Subcontractor understands and agrees that the
County is not a party to the subcontract and has no obligation to the
subcontractor.
i. The Awardee shall maintain, and shall require that its subcontractors and
suppliers maintain, complete and accurate records to substantiate compliance
with the requirements set forth in the Scope of Services. The Awardee and its
subcontractors and suppliers, shall retain such records, and all other documents
relevant to the Services furnished under this Agreement for a period of three (3)
years from the expiration date of this Agreement and any extension thereof.
2. The Awardee shall incorporate in all consultant subcontracts this additional provision:
The Awardee is not responsible for any insurance or other fringe benefits, e.g., social
security, income tax withholdings, retirement or leave benefits, for the Consultant or
employees of the ConSUltant normally available to direct employees of the Awardee. The
Consultant assumes full responsibility for the provision of all insurance and fringe benefits
for himself or herself and employees retained by the Consultant in carrying out the Scope
of Services provided in this subcontract.
3. The Awardee shall be responsible for monitoring the contractual performance of all
subcontracts and their progress toward meeting the approved goals and objectives
indicated in the attached Scope of Services. Regardless of any approvals by PHCD of
subcontracts or subcontractors, the Awardee shall bear all risks associated with
subcontracting performance of the Activities to a subcontractor.
Page 30
4. The Awardee shall receive from PHCO written prior approval for any subcontract engaging
any party who agrees to carry out any sUbstantive programmatic activities as may be
determined by PHCO as described in this Agreement. PHCO's approval shall be obtained
prior to the release of any funds to the subcontractor.
5. The Awardee shall receive written approval from PHCO prior to either assigning or
transferring any obligations or responsibility set forth in this Agreement or the right to
receive benefits or payments resulting from this Agreement.
6. Approval by PHCO of any subcontract or assignment shall not under any circumstance be
deemed to provide for the incurrence of any obligation by PHCO in excess of the total
dollar amount agreed upon in this Agreement.
7. If the subcontract involves $100,000 or more to provide services listed in the Scope of
Services or suppliers to supply the materials, the Awardee shall provide the names of the
subcontractors and suppliers to PHCO (Attachment H).
8. The Awardee agrees that it will not change or SUbstitute subcontractors or suppliers from
the list (Attachment H) without prior written approval from PHCO.
9. The Awardee shall not hire any of the Awardee's staff members or employees as
subcontractors.
AA. Additional Funding
The Awardee shall notify PHCO of any additional funding received for any activity described in this
Agreement. Such notification shall be in writing and received by PHCO within thirty (30) days of the
Awardee's notification by the funding source.
BB. Method of Payment
The Awardee shall be paid as described below:
1. The Awardee shall be paid for those expenses allowed pursuant to the provIsIons
provided below only when the Awardee submits to PHCO adequate proof, as determined
by PHCO in its sole and absolute discretion, that the Awardee has incurred the
expenditures. It shall be presumed that the Awardee has provided adequate proof of
having incurred expenses if the Awardee submits to PHCO canceled checks or original
invoices approved by the Awardee's authorized representative which show performance of
the Activities described in Attachment A and conformance with the laws, rules and
regulations set forth in this Agreement. When original documents cannot be presented,
the Awardee must adequately justify their absence in writing and furnish copies of those
documents to PHCO. The Awardee shall be paid only for those expenditures contained
within Attachment B, "Budget," to this Agreement as it may be revised with the prior
written approval by PHCO.
2. Requests for payment (reimbursement) shalf be assembled by calendar month and
submitted to PHCO no less frequently than monthly. Expenditures incurred by the
Awardee must be submitted to PHCO, along with alf original invoices, copies of front and
back of cancelled checkspaid to all subcontractorsand suppliers, all release of liens from
aliI subcontractorsand suppliers, and all final approved permits, for payment within 30
days after the month in which the expenditures were incurred. Failure to comply will result
in rejection of invoices. In no event shall the County be obligated to pay any invoices for
expenses which were incurred more than 60 days prior to the date the request for
payment is submitted to PHCO.
3. In no event shall the County provide advance COBG funding to the Awardee or to any
subcontractor hereunder, nor shalf the Awardee advance COBG funds to any party.
Page 31
4. Any payment due under the terms of this Agreement may be withheld pending the receipt
and approval by PH CD of all reports and documents which the Awardee is required to
submit to PHCD pursuant to the terms of this Agreement or any amendments thereto.
5. All payments will be limited to the quarterly payment schedule that accompanies the
action step chart in the scope of services. Payment is contingent on the achievement by
the Awardee of the quarterly accomplishment levels identified in the scope of services
portion of this agreement -Attachment A, which shall be submitted with all payment
requests and shall clearly identify the completed level of accomplishments met. This shall
also apply to soft costs associated with project delivery.
6. No payment(s) will be made without evidence of appropriate insurance required by this
Agreement. Such evidence must be on file with PHCD and the County's Internal Services
Department. PHCD must receive the final request for payment from the Awardee no more
than thirty (30) calendar days after the expiration or termination of this Agreement. If the
Awardee fails to comply with this requirement, the Awardee will forfeit all rights to
payment(s) if PHCD, in its sole discretion, so chooses.
7. All monies paid to the Awardee which have not been used to retire outstanding obligations
of this Agreement must be refunded to PHCD in accordance with PHCD's Policies and
Procedures Manual.
8. Any unexpended funds remaining after the completion of the services under this
Agreement, or after termination of this Agreement, shall be recaptured in full by the
County.
9. In the event the County determines that the Awardee has breached the terms of this
agreement and that the County is entitled to return of any or all of the funds awarded
under this Agreement, Awardee agrees to and shall assign any proceeds to the County
from any Agreement between the County, its agencies or instrumentalities and the
Awardee or any firm, corporation, partnership or joint venture in which the Awardee has a
controlling financial interest in order to secure repayment of this award. "Controlling
financial interest" shall mean ownership, directly or indirectly to ten percent or more of the
outstanding capital stock in any corporation or a direct or indirect interest of ten percent or
more in a firm, partnership or other business entity.
10. For special economic development projects: Notwithstanding any other provision herein,
payments to Awardee shall be restricted in the following manner: payment by the County
of expenditures contained within Attachment B, "Budget," to this Agreement shall be on a
pro rata basis in accordance with the level of development progress and percentage of
construction completed by Awardee using funds from Awardee's equity contribution
toward the project.
CC. Reversion of Assets
The Awardee shall return to PHCD, upon the expiration or termination of this Agreement, all assets
owned or held by Awardee as a result of this Agreement, including, but not limited to any CDBG
funds on hand, any accounts receivable, any overpayments due to unearned funds or costs
disallowed pursuant to the terms of this Agreement that were disbursed to the Awardee by the
County, other than reasonable operating and deficit reserves established by Awardee and which
are connected with the real property. In the case of activities involving real property, such reserves
shall not be distributed to any partner or subcontractor prior to repayment to PHCD of the CDBG
Loan. The Awardee shall at the request of the County execute any and all documents, including but
not limited to, mortgages securing the property, UCC financing statements, and restrictive
covenants, as required by the County to effectuate the reversion of assets.
DD. Restriction on the Use of Funds
The funds received pursuant this Agreement shall be used for the purposes set forth herein and
shall not be used to supplant other funds. In no event shall funds received pursuant to this
Agreement be used for:
Page 32
1. Adverse Actions or Proceedings. The Awardee shall not utilize County funds to retain
legal counsel for any action or proceeding against the County or any of its agents,
instrumentalities, employees or officials. The Awardee shall not utilize County funds to
provide legal representation, advice or counsel to any client in any action or proceeding
against the County or any of its agents, instrumentalities, employees or officials.
2. Religious Purposes. County funds shall not be used for religious purposes.
3. Commingling Funds. The Awardee shall not commingle funds provided under this
Agreement with funds received from any other funding sources, but may be included in a
Development Bank Account permitted by the first mortgage lender at the discretion of the
County.
III. THE COUNTY AGREES:
Subject to the availability of funds, to pay for contracted Activities according to the terms and conditions
contained within this Agreement in an amount not to exceed the appropriated amount as stated on page 1 of this
contract.
IV. THE AWARDEE AND PHCD AGREE:
A. Effective Date
1. This Agreement shall begin on the effective start date as stated on page 1 of this contract
. Any costs incurred by the Awardee prior to this date will not be reimbursed by the
County.
2. This Agreement shall expire on the end date as stated on page 1 of this contract. Any
costs incurred by the Awardee beyond this date will not be reimbursed by the County.
The term of this agreement and the provisions herein may be extended by the County to
cover any additonal time period during which the Awardee remains in control of the CDBG
funds or other assests, including Program Income to support CDBG eligible activites. Any
extension made pursuant to this paragraph shall be accomplished by a writing by the
County to the Awardee. Such notice shall automatically become a part of this Agreement.
3. This Agreement may, at the sole and absolute discretion of the County and PHCD, remain
in effect during any period that the Awardee has control over Agreement funds, including
Program Income. However, the County shall have no obligation or responsibility to make
any payment, except those described within Section II, Paragraph Y, or provide any type
of assistance or support to the Awardee if this Agreement has expired or been terminated.
4. Management Evaluation and Performance Review
The Department may conduct a formal management evaluation and performance review
of the Awardee, if in the Department's sole discretion it is deemed necessary and
applicable. The management evaluation shall reflect the Awardee's compliance with
generally accepted fiscal and organizational standards and practices. The performance
review should reflect the quality of service provided and the value received using
monitoring data, such as progress reports, site visits, and client surveys.
B. Default or Breach
1. The Awardee shall be in default or breach of this Agreement if any of the following acts,
omissions or conditions occur:
a. The Awardee fails to fulfill each and every provision of this Agreement and the
Attachments and fails to provide the services outlined in the Scope of Services
(Attachment A) within the effective term of this Agreement, including but not
Page 33
limited to failure to meet the National Objective, as determined by the County and
U.S. HUD.
b. Awardee fails to disclose all Related or Affiliated Parties and all matters required
to be disclosed as to Related or Affiliated Parties to the Co.unty as requried
herein.
c. Filing of a lis pendens, foreclosure action, or other legal action against the
Property, any property of Awardee or Related or Affiliated Party, or against
Awardee or Related or Affiliated Party which the County determines, in its sole
discretion, threatens the Property or the ability of Awardee to fulfill the provisions
of this Agreement and the services outlined in the Scope of Services.
d. Any arrearage, default, or late payment on any loan, Note or other debt or
obligation for which the Property is security or regarding any property of Awardee
or Related or Affiliated Party, including properties not related to this Agreement.
e. Any legal encumbrance on the Property not permitted in writing by the County.
f. Any anticipated or pending bankruptcy, restructuring, dissolution, reorganization,
appointment' of a trustee or receiver.
g. Any action, activity, facts, or circumstances that the County determines in its sole
discretion would materially impair performance by Awardee of all the terms and
conditions of this Agreement.
h. Awardee fails to report to the County within ten (10) days any bankruptcy,
reorganziation, dissolution, liquidation, appointment of a trustee or receiver, lis
pendens, foreclosure action or legal encumberance related to the Awardee,
Related or Affiliated Party or the Property, or any action, activity, facts, or
circumstances that would materially impair performance by Awardee of all the
terms and coditions of this Agreement.
i. Failure to comply strictly with Section W(2)(a)(1)-(2) of this Agreement.
j. Failure to meet the fifty percent (50%) or seventy percent (70%) Benchmarks, as
set forth in this Agreement, or to submit documentation (via Progress Reports
and applicable supporting documentation) sufficient to show Awardee has met
said Benchmarks.
C. Suspension
1. The County may suspend payment in whole or in part under this Contract by providing
written notice to the Awardee of such suspension and specifying the effective date thereof,
at least ten (10) days before the effective date of suspension. If payments are suspended,
the County shall specify in writing the actions that must be taken by the Awardee as
conditions precedent to resumption of payments and shall specify a reasonable date for
compliance. The County may also suspend any payments in whole or in part under any
other Agreements entered into between the County and the Awardee. The Awardee shall
be responsible for its own direct and indirect costs associated with such suspension,
including attorney's fees. Reasonable cause shall be determined by PHCD, in its sole and
absolute discretion, and may include, but is not limited to:
a. Ineffective or improper use of these Agreement funds by the Awardee or any of
its subcontractors;
b. Failure by the Awardee to materially comply with any term or provision of this
Agreement;
c. Failure by the Awardee to submit any documents required by this Agreement; or
Page 34
, ,
~
d. The Awardee's submittal of incorrect or incomplete reports or other required
documents.
e. Failure to meet the fifty percent (50%) or seventy percent (70%) Benchmarks, as
set forth in this Agreement, or to submit documentation (via Progress Reports
and applicable supporting documentation) sufficient to show Awardee has met
said Benchmarks.
2. In the event of a default by the Awardee, PHCD may at any time suspend the Awardee's
authority to obligate funds, withhold payments or both. These actions may apply to only
part or all of the activities funded by this Agreement.
3. PHCD will notify the Awardee of the type of action to be taken in writing by certified mail,
return receipt requested, or in person with proof of delivery. The notification will include
the reason(s) for such action, the conditions of the action, and the necessary corrective
action(s).
D. Termination
1. Termination at Will
This Agreement, in whole or in part, may be terminated by PHCD upon no less than ten
(10) working days notice when PHCD determines that it would be in the best interest of
PHCD and the County. Said notice shall be delivered by certified mail, return receipt
requested, or in person with proof of delivery. In the event of termination, the County may:
(a) request the return of all finished or unfinished documents, data studies, surveys,
drawings, maps, models, photographs, reports prepared, and capital equipment secured
by the Awardee with County funds under this Agreement; (b) seek reimbursement of
County funds allocated to the Awardee under this Agreement; and/or (c) terminate or
cancel any other Agreements entered into between the County and the Awardee. The
Awardee shall be responsible for its own direct and indirect costs associated with such
termination, including attorney's fees.
2. Termination for Convenience
PHCD may terminate this Agreement, in whole part when both parties agree that the
continuation of the activities would not produce beneficial results commensurate with the
further expenditure of funds. Both parties shall agree upon the termination conditions.
PHCD, at its sole discretion, reserves the right to terminate this Agreement without cause
upon thirty (30) days written notice. Upon receipt of such notice, the Awardee shall not
incur any additional costs under this Agreement.
3. Termination Because of Lack of Funds
In the event of a funding short-fall, or a reduction in federal appropriations, or should funds
to finance this Agreement become unavailable, PHCD may terminate this Agreement
upon no less than twenty-four (24) hours written notification to the Awardee. Said notice
shall be delivered by certified mail, return receipt requested, or in person with proof of
delivery. PHCD shall be the final authority to determine whether or not funds are available.
PHCD may at its discretion terminate, renegotiate and/or adjust the Agreement award
whichever is in the best interest of the County.
4. Termination for Substantial Funding Reduction
In the event of a SUbstantial funding reduction of the allocation to the Awardee through
Board of County Commissioners' action, the Awardee may, at its discretion, request in
writing from the Director of PHCD a release from its contractual obligations to the County.
The Director of PHCD will review the effect of the request on the community and the
County prior to making a final determination.
Page 35
5. Termination for Default or Breach
PHCD may terminate this Agreement upon no less than twenty-four (24) hours written
notification to the Awardee for breach or default.
6. Termination for Failure to Make Sufficient Progress.
PHCD may terminate this Agreement, in whole or in part, when PHCD determines, in its
sole and absolute discretion, that the Awardee is not making sufficient progress thereby
endangering ultimate Agreement performance, or is not materially complying with any
term or provision of this Agreement, PHCD may treat such failure to comply as a
repudiation of this Agreement;
7. Termination for Bankruptcy
The County reserves the right to terminate this Agreement, if, during the term of any
Agreement the Awardee has with the County, the Awardee becomes involved as a debtor
in a bankruptcy proceeding: or becomes ··involved: iri a reorganization·, dissolution, or"
liquidation proceeding, or if a trustee or receiver is appointed over all or a sUbstantial
portion of the property of the Awardee under federal bankruptcy law or any state
insolvency law.
8: General to Termination and Breach
Unless the Awardee's breach is waived by the County in writing, the County may, by
written notice to the Awardee, terminate this Agreement upon no less than twenty-four
(24) hours notice. Said notice shall be delivered by certified mail, retum receipt requested,
or in person with proof of delivery.
Waiver of breach of any provision of this Agreement shall not be deemed to be a waiver of
any other breach and shall not be construed to be a modification of the terms of this
Agreement. The provisions herein do not limit the County's right to legal or equitable
remedies. The County may resort to any remedy for breach provided herein or at law,
including but not limited to, taking over the performance of the Services or any part thereof
either by itself or through others.
In the event the County shall terminate this Agreement for default or breach, the County
or its designated representatives, may immediately take possession of all applicable
equipment, materials, products, documentation, reports and data.
9. Penalties for Fraud, Misrepresentation, Material Misstatement, or Criminal Conviction
In accordance with the Code of Miami-Dade County, Section 2-8.4.1, and other County
policies, if Awardee or any individual, corporation, firm, partnership, joint venture or other
business entity in which Awardee or its principals has a Controlling Financial Interest
attempts to meet its contractual obligations with the County under this Agreement or any
other County agreement or County program through fraud, misrepresentation or material
misstatement, or is convicted of fraud, bribery or any other corrupt or criminal act in
connection with any County program or County agreement, the County shall have the sole
and absolute discretion to terminate this Agreement and may terminate or cancel any
other agreements which Awardee or such individual, corporation, firm, partnership, joint
venture or other business entity in which Awardee or its principals has a Controlling
Financial Interest has with the County. Such individual or entity shall be responsible for its
own direct and indirect costs associated with such termination or cancellation, including
attorney's fees. The foregoing notwithstanding, any individual, corporation, firm,
partnership, joint venture or other business entity who attempts to meet it contractual
Page 36
obligations with the County through fraud, misrepresentation or material misstatement
may be disbarred from County contracting for up to five (5) years. For the purposes of this
section, "controlling financial interest" shall mean ownership, directly or indirectly to ten
percent or more of the outstanding capital stock in any corporation or a direct or indirect
interest of ten percent or more in a firm, partnership or other business entity.
E. Other Remedies
In addition to other provisions set forth herein, in the event of default by the Awardee, the
County shall have the right to exercise any and all of the following remedies:
1. Awardee shall be liable for all damages, including but not limited to:
a. the difference between the cost associated with procuring Services hereunder and
the amount actually expended by the County for reprocurement of Services, including
procurement and administrative costs; and
b. such other direct damages.
2. The Awardee shall remain liable for any liabilities and claims related to the Awardee's
performance of this Agreement or any breach or default, notwithstanding the expiration or
termination of this Agreement.
3. Seek enforcement of this Agreement including but not limited to filing an action with a
court of appropriate jurisdiction. The Awardee shall be responsible for its own direct and
indirect costs associated with such enforcement, including attomey's fees.
4. Debar the Awardee from future County contracting.
5. Any other remedy available at law or equity.
Damages Sustained. Notwithstanding the above, the Awardee shall not be relieved of liability to
the County for damages sustained by the County by virtue of any breach of the Agreement, and the
County may withhold any payments to the Awardee until such time as the exact amount of
damages due the County is determined. The County may also pursue any remedies available at
law or equity to compensate for any damages sustained by the breach.
Payment Settlement. If termination occurs for reasons other than breach or default, Awardee shall
be paid only for reasonable, allowable costs incurred by Awardee prior to notice of termination.
"Reasonable, allowable costs" are those costs which are necessary in order to perform Awardee's
obligations under this Agreement and specifically exclude expenses incurred prior to the execution
date of this Agreement, personal expenses, travel expenses, expenses related to additional phases
of the Project not specifically and expressly incorporated into this Agreement. PHCD shall be the
sole judge of "reasonable, allowable costs." All compensation pursuant to this Article is subject to
an audit at the County's discretion. Awardee shall not receive payment for lost future revenues, lost
developer fees or lost profits,
E-1. Limitation of Liability and Limitation of Remedies
Awardee acknowledges that the County is providing substantial funds to Awardee at low or no cost
to Awardee, and that these CDBG funds are for the purpose of providing a benefit to the
community health and welfare.
Therefore, notwithstanding any other provision herein, the Parties agree to the following limitations
on liabilities for any and all claims of any kind arising from or in connection with performance or
breach of this Agreement, which limitations shall apply equally to both Parties:
1. Both Parties' cumulative liability for damages, if any, is limited to the amount of the CDBG
Page 37
I ..; .)-,.
funds set forth in Section III, above.
2. Neither party shall be liable for lost revenues, lost profits, lost program income, or lost
developer fees.
3. Each party shall bear its own attorney's fees and costs.
4. Neither party shall be liable for costs incurred by the other party prior to the execution of
this Agreement.
F. Renegotiation, Modification and Right to Waive
1. Modifications of provisions of this Agreement shall be valid only when in writing and
signed by duly authorized representatives of each party, which for the County is the
County Mayor or Mayor's designee. The parties agree to renegotiate this Agreement if
PHCD determines, in its sole and absolute discretion, that federal, state, and/or County
revisions of any applicable laws or regulations, or increases or decreases in budget
allocations make changes in this.Agreement necessarY. PHCD shall be the final authority
in determining whether or not funds for this Agreement are available due to federal, state
and/or County revisions of any applicable laws or regulations, or increases in budget
allocations.
2. The County shall have the right to exercise an option to extend this Agreement beyond the
current Agreement period and will notify the Awardee in writing of the extension. This
Agreement may be extended beyond the initial extension period upon mutual agreement
between the County and the Awardee, upon approval by the County Mayor or Mayor's
designee.
3. The County may, for good and sufficient cause, waive provisions in this Agreement.
Waiver requests from the Awardee shall be in writing. No waiver shall be valid unless in
writing and signed by the County Mayor or Mayor's designee. Any waiver shall not be
construed to be a modification of this Agreement.
4. The County's failure to exercise any of its rights under this Agreement, or the County's
waiver of a provision on anyone occasion, shall not constitute a waiver of such rights or
provision on any other occasion. No failure or delay by the County in the exercise of any
right shall operate as a waiver.
G. Budget Revisions and Changes to the CDBG Eligibility Activity Title
1. Revisions to the Budget (Attachment B) shall be requested in writing and must comply
with PHCD's Policies and Procedures Manual. All budget revisions shall require an
amendment of this Agreement, which the County shall have no obligation to execute. The
County shall not be obligated to make payments for expenditures incurred prior to the
approval of the budget revision related to such expenditures.
2. Budget Revisions Through County Resolution
Should a portion of the funding allocation to the Awardee be rescinded by action from the
Board of County Commissioners, written notification via certified mail to the Awardee
advising of the funding reduction shall be sent by PHCD no later than five (5) working
days of the action; written notification will constitute a Agreement amendment. The
Awardee will have five working days upon receipt of certified return receipt notification to
submit a revised budget reflecting funding adjustments. Should the modified budget not
be received within the specified time, The County will revise the budget at its discretion.
The County in its sole and absolute discretion will determine whether substantial
reductions will necessitate revision and resubmittal of the Scope of Service (Attachment
A). Revisions to the Scope of Services, when required, will be negotiated to the mutual
satisfaction of both parties.
Page 38
3. Revisions to the CDBG eligibility activity titles under which this Agreement's objectives are
classified as noted in the Scope of Services shall not require a Agreement amendment.
H. Compliance
The County shall have the right to inspect, monitor, and inquire of Awardee , at the sole and
absolute discretion of the County, remain in effect during any period that the Awardee is obligated
to complete a National Objective or has control over Agreement funds, including Program Income,
in order to ensure compliance with the CDBG Regulations. However, the County shall have no
obligation or responsibility to make any payment or provide any type of assistance or support to the
Awardee if this Agreement has expired or been terminated.
The Awardee agrees to comply with all applicable State and County laws, rules and regulations,
which are incorporated herein by reference or fully set forth herein.
Any alterations, variations, modifications, extensions or waivers of provisions of this Agreement
shall only be valid when· they have been reduced to writing, duly approved and signed by both
parties and attached to the original of this Agreement.
This contract may be executed·.in counterpart copies, and these counterparts shall together
constitute an original of this Agreement.
I. Disputes
In the event an unresolved dispute exists between the Awardee and PHCD, PHCD shall refer the
questions, including the views of all interested parties and the recommendation of PHCD, to the
County Mayor for determination. The County Mayor, or an authorized representative, will issue a
determination within thirty (30) calendar days of receipt and so advise PHCD and the Awardee, or
in the event additional time is necessary, PHCD will notify the Awardee within the thirty (30) day
period that additional time is necessary. The Awardee agrees that it shall not bring any legal action
or against the County until thirty (30) days from the County Mayor issuing his/her determination.
J. Headings
The section and paragraph headings in this Agreement are inserted for convenience only and shall
not affect in any way the meaning or interpretation of this Agreement.
K. Minority Participation
In order to gain greater Black business participation, the Awardee may submit its Agreements to
the County Mayor for bidding and award in accordance with County policies and procedures.
L. Proceedings
This Agreement shall be construed in accordance with the laws of the State of Florida. Any dispute
arising under, in connection with or related to this Agreement or related to any matter which is the
subject of this Agreement shall be subject to the exclusive jurisdiction of the state and/or federal
courts located in Miami-Dade County, Florida.
M. Notice and Contact
All notices between the Parties shall be in writing and sent by registered or certified mail and
addressed as follows:
TO AWARDEE: City of South Miami
6130 Sunset Drive
South Miami, FL 33143
Attn: Angelica Bueno, Planning and
Sustainability Administrator
Page 39
COPY TO:
TO COUNTY:
COPY TO:
COPY TO:
COPY TO:
Attn: ________________ __
Miami-Dade County
111 N. W. 1 st Street
Miami, Florida 33128
Attn: Russell Benford, Deputy Mayor
Public Housing and Community Development
701 NW 1st Court, 14th Floor
Miami, FL 33136
Attn: Michael Liu, Director
Public Housing and Community Development
701 NW 1st Court, 14th Floor
Miami, FL 33136
Attn: Letitia Goodson, PHCD Project Manager
Assistant County Attorney
County Attorney's Office
111 N. W. 1 st Street, Suite 2810
Miami, Florida 33128
Attn: Brenda Kuhns Neuman, Esquire
Such addresses may be changed by written notice to the other party.
In the event that different representatives are designated by either party after this Agreement is
executed, or the Awardee changes its address, notice of the name of the new representative or
new address will be rendered in writing to the other party and said notification attached to originals
of this Agreement.
In the event that any of the information required by the provisions of this Article is changed by
either of the Parties after the execution of this Agreement, the affected Party shall give notice in
writing within five (5) days to the other Party of the amended pertinent information, which shall be
attached and incorporated into this Agreement.
N. WAIVER OF JURY TRIAL
NEITHER THE AWARDEE, SUBCONTRACTOR, NOR ANY OTHER PERSON LIABLE FOR THE
RESPONSIBILITIES, OBLIGATIONS, SERVICES AND REPRESENTATIONS HEREIN, NOR ANY
ASSIGNEE, SUCCESSOR, HEIR OR PERSONAL REPRESENTATIVE OF THE AWARDEE,
SUBCONTRACTOR OR ANY SUCH OTHER PERSON OR ENTITY SHALL SEEK A JURY TRIAL
IN ANY LAWSUIT, PROCEEDING, COUNTERCLAIM OR ANY OTHER LITIGATION
PROCEDURE BASED UPON OR ARISING OUT OF THIS AGREEMENT, OR THE DEALINGS
OR THE RELATIONSHIP BETWEEN OR AMONG SUCH PERSONS OR ENTITIES, OR ANY OF
THEM. NEITHER AWARDEE, SUBCONTRACTOR, NOR ANY SUCH PERSON OR ENTITY WILL
SEEK TO CONSOLIDATE ANY SUCH ACTION IN WHICH A JURY TRIAL HAS BEEN WAIVED.
THE PROVISIONS OF THIS PARAGRAPH HAVE BEEN FULLY DISCUSSED BY THE PARTIES
HERETO, AND THE PROVISIONS HEREOF SHALL BE SUBJECT TO NO EXCEPTIONS. NO
PARTY HAS IN ANY WAY AGREED WITH OR REPRESENTED TO ANY OTHER PARTY THAT
THE PROVISIONS OF THIS PARAGRAPH WILL NOT BE FULLY ENFORCED IN ALL
INSTANCES.
O. Assignment
The Awardee shall not assign, transfer, hypothecate or otherwise dispose of this Agreement,
including any rights, title or interest therein, or its power to execute such Agreement to any person,
company or corporation without the prior written consent of the County.
Page 40
( ~, l.,
P. Third Parties
This agreement is intended for the sole and exclusive benefit of the parties and is not intended to
benefit any third party nor shall it be deemed to give rise to any rights in any third party.
Q. Survival
The parties acknowledge that many of the obligations in this agreement, including but not limited to
Awardee's obligation to indemnify the County, maintain Contract Records, and provide sufficient
evidence of CDBG Regulation compliance for the duration of the period in which Awardee is
obligated to meet a National Obje.ctive or has control over CDBG funds as well as the County's
right to inspect and monitor the Project and Awardee for complaince with the HOME Regulations,
will survive the term, termination, and cancellation hereof. Accordingly, the respective obligations of
the Awardee and the County under this agreement, which by nature would continue beyond the
termination, cancellation or expiration thereof, shall survive termination, cancellation or expiration
hereof.
R. Autonomy
The Parties agree that this Agreement recognizes the autonomy of and stipulates and implies no
affiliation between the contracting parties. It is expressly understood and intended that the
Awardee is only a recipient of funding support and is not an agent, employee, servant or
instrumentality of the County.
The Awardee is, and shall be, in the performance of all work services and activities under this
Agreement, an independent contractor, and not an employee, agent or servant of the County. All
persons engaged in any of the work or services performed pursuant to this Agreement shall at all
times, and in all places, be subject to the Awardee's sole direction, supervision and control. The
Awardee shall exercise control over the means and manner in which it and its employees perform
the work, and in all respects the Awardee's relationship and the relationship of its employees to the
County shall be that of an independent contractor and not as employees, servants or agents of the
County.
The Awardee does not have the power or authority to bind the County in any promise, Agreement
or representation other than specifically provided for in this Agreement.
S. All Terms and Conditions Included
This Agreement and its attachments as referenced (Attachment A -Scope of Services; Attachment
A1 -Action Steps; Attachment B -Budget; Attachment B-1(M) Idemnification and Insurance
Requirements; Attachment B-2 -CDBG Program Requirements (Housing Only); Attachment C -
Progress Report,Set-Up Forms, Performance & Benefit Data Supplement to Quarterly Expenditure
& Progress Report; Attachment D -Information for Environmental Review; Attachment E -
Certification, Statements and Affidavits; Attachment F -Publicity, Advertisements and Signage;
Attachment G -Fair Subcontracting Policies; Attachment H -Subcontractor/Supplier Listing);
Attachment I -Agreement to Authorize Examination of Records and Adhere to Records Retention
Requirements) contain all the terms and conditions agreed upon by the parties. No other
Agreement, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to
exist or bind any of the parties hereto.
T. Conflict
In the event that a conflict arises between any prior funding documents and/or agreements
governing this development, the terms, provisions and definitions included in this Agreement shall
prevail.
In the event that the Subsidy Layering Review (SLR) or Underwriting analysis determine the
project's true "gap" financing needs to be less than the maximum award allocated by the Board of
County Commissioners, the SLR amount shall prevail and the amount of CDBG funds described in
Page 41
•
, .; . .
this Agreement shall be subsequently reduced. "Gap" financing means the difference between the
amount of financing available for the Project from other sources and the total project cost. In the
event Awardee applies for and is awarded by the Board of County Commissioners ("BCC")
additional funding for the same Project, as described in this Agreement, a separate Agreement or
amendment to this Agreement must be negotiated and executed between Awardee and the County
Mayor or Mayor's designee. Any differences between the terms and conditions set forth in this
Agreement and the subsequent funding award: shall require a negotiation between the Parties in
order to resolve those differences. Awardee understands and acknowledges that changes to the
Project or Activities described in this Agreement may not be accomplished by applying for and
being awarded subsequent funds by the BCC. In the event that Awardee applies for and is
awarded by the BCC funding for an additional phase of the same Project, a separate agreement
must be negotiated and executed between the Parties. Under no circumstances shall Awardee
assert that a subsequent application for and award of funds for the same project constitutes and
amendment of this Agreement. Awardee expressly assumes any and all risk of loss or damage
associated with a subsequent application for and award of funds for the same Project where such
subsequent application by Awardee includes terms which conflict with the terms of this Agreement.
U. Interpretation
Paragraph headings are for convenience only and are not intended to expand or restrict the scope
or substance of the provisions of this Agreement. Wherever used herein, the singular shall inclode
the plural and plural shall include the singular, and pronouns shall be read as masculine, feminine
or neuter as the context requires.
V. Survival
The parties acknowledge that any of the obligations in this Agreement, including but not limited to
the Awardee's obligation to indemnify the County, will survive the term, termination and
cancellation hereof. Accordingly, the respective obligations of the Awardee and the County under
this Agreement, which by nature would continue beyond the termination, cancellation or expiration
thereof, shall survive termination, cancellation or expiration hereof.
w. Corporate Governance
A Not-for-Profit Awardee shall abide by and be governed by Chapter 617, Florida Statutes,
particularly Sections 617.0830 through 617.0835 as amended, which are incorporated herein by
reference as if fully set forth herein in connection with its Agreement obligations hereunder.
A For-Profit Awardee shall abide by and be governed by Chapter 607, Florida Statutes, particularly
Sections 607.0830 through 607.0833, as amended, which \s incorporated herein by reference as if
fully set forth herein in connection with its contractual obligations hereunder.
X. Miami-Dade County Implementing Order: 104-132 will apply to this Agreement. This Implemeting
Order requires the County to charge Awardee applicable fees as outlined below:
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT SERVICE RATE SCHEDULE
Fee Name Proposed Fee (FY 2015 -16) Fee Due
Construction Inspection Fee $1,500.00 At Loan Closing
Contract Extension/Modificaiton Fee $2,500.00 At Time of Request for
(Multi-Family Development Loans Extension
Only)
Page 42
IN WITNESS THEREOF, the parties hereto have caused this contract to be executed by their undersigned officials as duly
authorized, this ___ day of 2016.
AWARDEE: MIAMI-DADE COUNTY
City of South Miami
BY: BY:
NAME: NAME: Carlos A. Gimenez
TITLE: TITLE: Mayor
DATE: DATE:
BY: ATIEST
BY:
NAME:
TITLE: Clerk, Board of County Commissioners
TITLE:
DATE: DATE:
Witnesses:
BY:
(Signature)
Type or Print Name
BY:
(Signature)
Type or Print Name
FederallD Number: 59-6000431
Resolution #: R-853-16
Awardee's Fiscal Year Ending Date: September 30th
CORPORATE SEAL:
Page 43
, .'
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
FY 2016 Scope of Services
October 1, 2016 through December 31,2016
Agency Name: City of South Miami
1.
2.
3.
4.
-ACTIVITY TITLE:
IDIS #:
RESOLUTION #:
DlJNS#:
-ACTIVITY DESCRIPTION:
2a -Activity Category:
2b. -Objective:
2c. -Outcome:
-APPROVED BY BCC:
Other Funding Source and Amount:
-FY 2013 FUNDING REQUESTED:
5. -HUD INFORMATION:
5a. -HUD matrix code:
. 5b. -HUD Activity Type:
5c. -HUD National Citation
6. -ACCOMPLISHMENTS:
6a. -Number of Units:
6b. -Type:
7. -NATIONAL OBJECTIVE:
Total # ofLowlMod in Service Area:
Census Tract:
Block Group:
8. -ACTIVITY ADDRESS:
9. -LOCATION:
NRSA (Activity located in):
District (Activity located in):
Youth Tennis Program
TBD
R-853-16
Tennis program for youth
Public Services
Sustainable Living
A vaiJabilityl Accessibility
Amount: $10,000 Source: CDB
$10,000
05D-Youth Services
LMC
570.208(a)(2)
30
People
1,360
76.03
1
6125 SW 68 Street, Miami, FL 33143
South Miami
7
ATTACHMENT A
MIAMI'.DAD [;.IWii'.
10. -LABOR STANDARD applicable _N;...;I""A"--______________________ _
Type of Work:
o Building [8J Residential o Highway o Heavy
11. Set aside units different from total units
12. INSURANCE REQUIREMENTS:
Project Manager: Letitia Goodson
Worker's Compensation Insurance, Commercial General Liability Insurance,
Auto mobility Liability Insurance and Professional Liability Insurance. See .'.,
Attachment for deta' re uirements.
Cordelia Ingra .. ~,,_~Y-__7'-:-7""\_---=-.::c--_+<_~-_/f_--'-
Planner
TENNIS PROGRAM -FY 16 -Public Service
Enter in the % of Enter in the Start Calculated End ID Task Name Required Resource Task Completed Date of Task Date of Task Notes:
(as of today)
11',<>.:" Contract Development phase'>,::" .' ~.:' ' .. ;.; .. ' > < ",,:,' <,"-.;.' :--> ,-:,.
".0:00'., -, ,-.</.': :{ .' ....... ;~'>'.~·,:2·· ' '.::.~ .. ". -". ~ " . !~
1.1.1 submit requirement documents for application Agency 0.00 N/A
1.1.2 submittal of scope and budget Agency 0.00
1.1.3 scope and budget review by Public Housing and Project Manager 0.00 Community Development (PH CD) Project Manager (PM)
1.1.4 review eligibility of activity Planner,IDIS Specialist,Project 0.00 Information used from Consolidated Plan
Manager
1.1.5 prepare and assemble CDSG contract with Attachments A
to H Project Manager 0.00
1.1.6 submit CDSG contract for agency signature to execute Project Manager 0.00
1.1.7 return signed CDBG contract to PHCD for final processing Agency 0.00 9/13/16
1.1.8 submit CDSG contract to Miami-Dade County Mayor's'
PM Supervisor and PM Manager 0.00 Office
1.1.9 receive and distribute executed CDSG Contract Project Manager 0.00
Milestone Review
1.2:' Marketing Phase~' '. ," , . ' ..... ~:. , 0.00 ,-.
...: ,':'
1.2.1 Registration program Agency 0.00 09/01/16 09/15/16
1.2.2 Submit copy of registrations to PHCD Agency 0.00 09/30/16 12/31/16
1.2.3 Identify potential recipients -name, addresses, telephone
Agency 0.00 10/01/16 10/01/16 number & income
Milestone Review
1.3· Eligibility and Programmatic Phase @: 0.00 .. :
1.3.1 Human Resources Department to select Instructors Agency 0.00 8/30/16 9/1/16
1.3.5 Execute contract with instructors Agency 0.00 9/15/16 9/17/16
1.3.6 submit copy of client in-take form to PHCD for approval Agency 9/15/16 12/31/16
1.3.7 determine that each participant is income eligible by
Agency 0.00 10/1/16 10/5/16 determining the family's annual income.
1.3.8 review and approve accounting polices Project Manager 0.00 10/1/16 10/6/16
1.3.9 Milestone Review
1A., . programExecu5loriPhase .. " .:'. , ,: ' ..... .'
1.4.1 2 session (45 min. ea.) 2 twice a week for 3 months. Total
Agency 0.00 10/1/16 12/31/16 of 72 hrs for 15 children
1.4.2 submit payments request to PHCD-Quarterly Agency 0.00 10/1/16 12/31/16 I
i ...
1.4.3
submit quarterly progress report (Due no later than 10
Agency 0.00 1/10/17 1/10/16
days after the end of the quarter)
-----------------.. ~-------_._ .. L-___ -------'--.. ____
.. . 16
Copy of Tab 06 -Scope of Tennis Program by Activity Rev1 Dec2016 (3)rev. 12-7-2016
Enter in the % of I
10 Task Name Required Resource Task Completed Enter in the Start Calculated End Notes:
(as oftoday) Date of Task Date of Task
1.4.4 Examine the source documents 1/10/17 3/31/17
1.4.5 Milestone Review I
l.Si~~-;; Close'Out:Phase::)'C,' . ;e;,;' ;,:. ':e:; "'&': ;ee,c :, <";"~' :;:i, ,.i;., .. ;."", ';' ..... :/ '·c'< :<:. "., .:',,>',::';,;';;:"!' ~ •• ,i "'O.OO,'i', " " .. :";';;~. ':.", .. .{; "' ,~,:'~';-:{-;:.'~-, .'~:-~'.:~ ".: ";' :'. ii.:.;··':;:;,U.:·~~::<.";:'~::;:'.:::,{; (:> '. ::'.. '
1.5.1 submit final progress report Agency 0.00 01/01/17 03/31/17
1,5.2 submit final payment Agency 0.00 01/01/17 01/31/17
1.5.3 submit LMI information to PHCD's Complaince Unit Project Manager 0.00 01/01/17 03/31/17
1.5.4 review LMI information Compliance Unit 0.00 01/01/17 03/31/17
1.5.5 print out copy of Finance balance Project Manager . 0.00 01/01/17 03/31/17
1.5.6 report accomplishment in IDIS lOIS Specialist 0.00 01/01/17 03/31/17
Milestone Review -.. ~---..
'0
/I • 17
TENNIS PROGRAM -FY 16 -Public Service
Enter in the % of Enter in the Start Calculated End ID Task Name Required Resource Task Completed Notes:
(as of today) Date of Task Date of Task
i
1:>';" ContractDevelopmenfpnase.:'.<·· .. .:~ . <;'-,:.;> .. '. .:\ .... ; .. :."::;: .. ;
: -, .':; ":: @;. : 0;00 :: . . ; r::.Y ':. ··.·c •.• ':-., . :"" ':.;' .' . '.':';~: ...
' .. '
1.1.1 submit requirement documents for application Agency 0.00 N/A
1.1.2 submittal of scope and budget Agency 0.00 i
1.1.3 scope and budget review by Public Housing and Project Manager 0.00
Community Development (PHCD) Project Manager (PM)"
Planner,IDIS Specialist,Project ,
1.1.4 review eligibility of activity 0.00 Information used from Consolidated Plan i
Manager
1.1.5 prepare and assemble CDBG contract with Attachments A
to H Project Manager 0.00
1.1.6 submit CDBG contract for agency signature to execute Project Manager 0.00 i
1.1.7 return signed CDBG contract to PHCD for final processing Agency 0.00 9/13/16
1.1.8 submit CDBG contract to Miami-Dade County Mayor's PM Supervisor and PM Manager 0.00 Office
1.1.9 receive and distribute executed CDBG Contract Project Manager 0.00
Milestone Review
1.2 Marketing Phase •.... . @ 0.00 . '"; ~, . ~ .. '
1.2.1 Registration program Agency 0.00 09/01/16 09/15/16
1.2.2 Submit copy of registrations to PHCD Agency 0.00 09/30/16 12/31/16
1.2.3 Identify potential recipients -name, addresses, telephone Agency 0.00 10/01/16 10/01/16 number & income
Milestone Review
1.3.,,' Eligibility.and'Programmatic Phase !@:. 0.00 .: .... .,' ~ ,'-'-"., <.c'.:'. :.,:' ". . '. .,
1.3.1 Human Resources Department to select Instructors Agency 0.00 8/30/16 9/1/16
1.3.5 Execute contract with instructors Agency 0.00 9/15/16 9/17/16
1.3.6 submit copy of client in-take form to PHCD for approval Agency 9/15/16 12/31/16
1.3.7 determine that each participant is income eligible by Agency 0.00 10/1/16 10/5/16 determining the family's annual income.
1.3.8 review and approve accounting polices Project Manager 0.00 10/1/16 10/6/16
1.3.9 Milestone Review
1.4: .. :: Program ExeclisionPhase , : ::' " .'... ····1 ,. . ' ... . ... ' ....... < . ", ," . .. . ...
1.4.1 2 session (45 min. ea.) 2 twice a week for 3 months. Total Agency 0.00 10/1/16 12/31/16 of 72 hrs for 15 children
1.4.2 submit payments request to PHCD-Quarterly Agency 0.00 10/1/16 12/31/16
"
1.4.3 submit quarterly progress report (Due no later than 10
Agency 0.00 1/10/17 1/10/16
days after the end of the quarter)
---_.-_._------------_ .. -----
16
Copy of Tab 06 -Scope of Tennis Program by Activity Rev1 Dec2016 (3)rev. 12-7-2016
Enter in the % of Enter in the Start Calculated End 10 Task Name Required Resource Task Completed Notes:
(as of today) Date of Task Date of Task
1.4.4 Examine the source documents 1/10/17 3/31/17 I
1.4.5 Milestone Review
1~5,;tn CloseOufPliasif><, :\' , "~, :",','!,; ";' ,: r, <'<;",:;,:,: ." ·i., L"::,.' >::"::<:.'" ::;:, i:' .'>., '":':,,, ~:::,:;?O;OO,;:: ,~":: h;::"./ :,!,' ~c; I~F::::)::::,':,>'~': ,":;' ';;,' ,::,":-::;,;;:::":.:y>::"::.~,,,;;:,:,:,:,:(, >Y~'L
1.5.1 submit final progress report Agency 0.00 01/01/17 03/31/17
1.5.2 submit final payment Agency 0.00 01/01/17 01/31/17
1.5.3 submit LMI information to PHCO's Complaince Unit Project Manager 0.00 01/01/17 03/31/17
1.5.4 review LMI information Compliance Unit 0.00 01/01/17 03/31/17
1.5.5 print out copy of Finance balance Project Manager 0.00 01/01/17 03/31/17
1.5.6 report accomplishment in 1015 1015 Specialist 0.00 01/01/17 03/31/17
Milestone Review
---------
i
17
, ; .'
CATEGORIES
I. Personnel
II. Contractual Services
III. Operating Services
IV. Capital Outlay
TOTAL BUDGET
SOURCES OF OTHER FUNDING
City of South Miami -Budget
CITY OF SOUTH MIAMI
After School Tennis Programming Support
CDBG FY2016
Summary Budget
October 1, 2016 -December 31, 2016
PRIOR YEAR
FUNDING
$
$
$
$
$
FY2016 PHCD
FUNDING
$ 7,920.00
$ 2,080.00
I $ 10,000.00 I
TOTAL AMOUNT
$
19
NON-PHCD FUNDING
ATTACHMENT B
Tab 7
TOTAL
$
$ 7,920.00
$ 2,080.00
$
1$ 10,000.00 I
. )
CITY OF SOUTH MIAMI
CDBG FY 2016
Tennis Programming Support
DETAIL BUDGET
ATTACHMENT B
Tab7
October 1, 2016 thru December 31, 2016
PP
0410 PERSONNEL -Employee
Regular-Salaries
Sub-Total Salaries
4010 Fringe Benefits
FICA (salaryX7.65%)
Sub-Total Fringe
Total Personnel
Contractual Services
Instructors 2
Building Rental
Total Contractual
Operating Expenses
Sport supplies
Support supplies
Total Operating Expenses
I TOTAL BUDGET
SOURCES OF OTHER FUNDING
City of South Miami -Budget
18
Non-PHCD PHCD 16 Total All Sources
$ -
$ -$ -$ -
$ -$ -
$ -$ -
$ -$ -
$ 7,920.00 $ 7,920.00
$ -$ -
$ -$ 7,920.00 $ 7,920.00
$ 2,080.00
$ -
$ -
$ 2,080.00 $ 2,080.00
1$ I $ 10,000.00 I $ 10,000.00 I
TOTAL AMOUNT
$
"
INDEMNIFICATION AND INSURANCE
INDEMNIFICATION AND INSURANCE REQUIREMENTS -B-l(M)
City of South Miami, Parks and Recreation Department shall indemnify and hold harmless the
County and its officers, employees, agents and instrumentalities from any and all liability, losses
or damages, including attorney's fees and costs of defense, which the County or its officers,
employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of
actions or proceedings of any kind or nature arising out of, relating to or resulting from the
performance of the Agreement by City of South Miami, Parks and Recreation Department or its
employees, agents, servants, partners, principals or subcontractors. City of South Miami, Parks
and Recreation Department shall pay all claims and losses in connection therewith, and shall
investigate and defend all claims, suits or actions of any kind or nature in the name of the County
, where applicable, including appellate proceedings, and shall pay all costs, judgements, and
attorney's fees which may issue thereon. Provided, however, this indemnification shall only be to
the extent and within the limitations of Section 768.28 Florida Statutes, subject to the provisions
of the Statute whereby City of South Miami, Parks and Recreation Department shall not be held
liable to pay a personal injury or property damage claim or judgment by anyone person which
exceeds the sum of $200,000, or any claim or judgement or portions thereof, which when totaled
with all other claims or judgments paid by City of South Miami, Parks and Recreation Department
arising out of the same incident or occurrence, exceed the sum of $300,000 from any and all
personal injury or property damage claims, liabilities, losses or causes of action which may arise
as a result of the negligence of City of South Miami, Parks and Recreation Department.
City of South Miami, Park and Recreation Department shall require that all its subcontractors
performing work under this contract name Miami Dade County as an additional insured with
respect to their Commercial General liability policy.
. :
Public Housing and Community Development
Attachment B-2
Community Development Block Grant (CDBG) Program
Not App.licabl-e
• 4
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
QUARTERLY EXPENDITURE AND PROGRESS REPORT
FY20 ---
,-Rep()!iin g Pe~iod: _I _ th '. . .' . _ _ . . __ .
10 1st Quarter [Jan:"Mar] 0 2nd Quarter [Apr-Juh].D 3rg Quarter [Jul~Sept] 04 :Quarter [Oct-Dec]! ~n'nual Report.!
I'section 1:'Generallnformation
Recipient Name (Organization): ______________________________ _
Contact Person (Name & Title): Telephone Number:' ---------------
Activity Name (Project Title):
Activity Address:
Activity Description: ___ ~ ______________________________ _
IDIS#: Index Code: Funding Source: Funded Amount: $ ---------------~--------
Activity category:
o Administration 0 Capital Improvement 0 Economic Development 0 Historic Preservation 0 Public Service
o Housing 0 Homebuyer Assistance 0 Tenant-Based Rental Assistance (TBRA) 0 Homeless Housing
Objective: 0 Create suitable living environments 0 Provide decent affordable housing 0 Create economic opportunities
Outcome: 0 Availability/Accessibility 0 Affordability 0 Sustainability
I'Sectio n":ll: ·fin an cia 1.1 nformation..,At _thejjme.jhe~Award~!Lh-'!J~.J>eer.LQ?il:LQ[:Q.t!ierwlse~e.jved JL.f!Y.~perc::~~U§p.!;t!!nd seventy I
perc.e.i1t (70%) of the Ag~eef!1ent Fun'!s, the -Awar-dee:S .r~B0rting ~hese-eXJl.enditures illust submit documentation' to show thatAwardees' has-,
I accomplished50%and 70%, respectively, of the ActJvmes described herem. -. . . ..... . .
A B C o E F ·G H
Actual Reimbursed Projected
Approved Total Expenditures Cumulative
Cumulative Projected Cumulative
Category Budget Expended Cumulative [Through end of Percentage Expenditures Expenditures
[This Quarter] [Through end of this quarter] [8&0] [Next Quarter] [By end of Contrad
this quarter] Period]
Personnel $ $ $ $ % $ $
Contractual $ $ $ $ % $ $
Operating $ $ $ $ % $ $ Costs
Commodities $ $ $ $ % $ $
Capital $ $ $ $ % $ $ Outlay
TOTAL $ $ 1$ 1$ % $ $
Program Income The disposition of Program Income not specifically listed in the approved Program Income
budget requires prior written approval from PHCD. ,
1. Does this activity generate Program Income? 0 Yes 0 No
2. If yes, indicate the amount generated this quarter. -'$'--________ _
3. If yes, was written approval granted by PHCD to use the Program Income generated from this activity?
DYes 0 No 0 N/A
4. If yes, @ attach copy of approval letter and related documents. If no, a written request for approval to use the
Program Income must be submitted to PHCD.
CD114151712
10f3
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
QUARTERLY EXPENDITURE AND PROGRESS REPORT
FY20 --
ACTIVITY STATUS AND ACCOMPLISHMENT INFORMATION
1. Activity Status: 0 Cancell.ed 0 Underway 0 Completed
2. Environmental Status: 0 A=Exempt 0 C=Completed D D=Underway
3. Is this activity still in compliance with the origilwl project schedule? 0 Yes 0 No
I Sec:tion fu: 0 Work in Progress JOn-going Activities] +Q Accomplishment Narrative [Activity C0f"0pleted] ~
I Check appropriate. box and .refere~ce .th.e· Scope ; of-Services, included in your contract, as the .basis for reporting the II
. work in progress or accomplished In a brief narrative format. [lID Attach Scope of Services] . . '. . '. I
I s~ction:IV.: '?t~~r Supporting Efforts . .1 . . . . . ". . .... '" •
II prciV"id~'~ &s~riptio.n, usi~g quantifiable data;o! all othersupporting efforts that .have beg'un, partially impleme~ted,. or
. completed dunng thiS penod. . ...... '.. . ". .
I Section V: Problems Encountered'
i Provide·:i;Lb[ietda~cJjptian._Qtgny_ prQblenis.Qr.g~!gy;:; .. e!lcquntered. dllring thIs .. pE:lf:ioq qr_ClnJi~ipated __ ~ .. _ .. _ .. _ ............. _. ,
il Section VI: Technical Assistance '. I
If you i-organization has a need or antici pat'-e-:-a-n-e-e-:-d:-~:-o-r -:-te-c-:-h-=n i-ca-=I-:-a-s""-si-:-s=-ta-n-ce---:d-u-=-rin-g--:-:-th-=-is-pe-r:-io-:d-:-,' -pl~e-:-as-e-'~de-s-c-ri-be-th-e---'! I nature of the assistance required. '. .' '. . '. I
Section VI.,I:: P~rformance Measurement .1 . .
*'i'llotes: A,Supplemental Performance & Benefit' Data Report must be suomitted if any actual achievement$ are I
.. ' repo'rted duringihis reporting period and .all HOME funded projects. must submit applicable' activity set-:up form. I
Accomplishment Type: 0 People [01] D Households [04] D Businesses [08] D Organizations [09]
o Housing Units [10] D Public Facilities [11] 0 Jobs [13]
National Objective: 0 Area Wide Benefit [e.g. LMA, LMAFI, LMASA, SBA] -or-D Direct Benefit [e.g. LMC, LMH, LMJ]
, PeopleorHoU'seholds'" Achievements:' D Yes'D No' -.
If yes,' what is the accomplishment type? 0 People -:or-0 Hous'eholds .'
'", ,.'
People Households (LMH activities only)
Total People Low/Mod Total Households Low/Mod Female Headed
Projected Goal
Actual This Quarter
Actual Cumulative
Supplemental Report Attached YIN Performance & Benefit Data:
o Housing -or-0 Public Service & Administration -or-0 Capital Improvement & Public Facilities
CDI14151712
2of3
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
QUARTERLY EXPENDITURE AND PROGRESS REPORT
FY20 ---
I Housing Units· Achievements: 0 YesD No , .
wner en a o R t I 8 uyer Tot I a
Projected Goal
Actual This Quarter
Actual Cumulative
Supplemental Report Attached YIN ___ _ o Performance & Benefit Data: Housing
I Jobs'orBusinesses •. Achievements: DYes 0 No' .'
!Ifyes,.what isthe accompiishment type? D Jobs -or-:-o Businesses
Total Job Count Total Weekly Hours
Jobs Created Full-Time (FT) FT Low I Mod Part-Time (PT) PT Low I Mod
Projected Goal
Actual This Quarter
Actual Cumulative
Assistance to 8 usmesses rOJec e oa c ua IS ua e c ua P . t d G I A t I ThO Q rt rAt I C If" umua Ive
New Businesses
Existing Businesses
Total
Percent
Low I Mod Jobs
Supplemental Report Attached YIN ___ _ o Performance & Benefit Data: Economic Development
I
PERFORMANCE CERTIFICATiON: O.This certifies that No· Accomplishments occurr-ed during this Quarter. --
. Initials
NOTE: Submittal of Supplemental Form -Performance & Benefit Data is not required: at this time based on the
certification that no accomplishments occurred during this quarter.
. CERTIFICATION
This is to certify that the data and other information provided in this Report is correct, based on official accounting
system and records, and that expenditures and obligations shown have been made for the purpose of and in
accordance with applicable Terms and Conditions of the Contract and Funding Requirements.
Report Prepared by: Title: --------------------------------------------------Date: --------Print Name
Signature of Certifying Official: ___________ Title: ____________ _ Date: --------
![QroBB~9[5TII[EToNLYZ~.';~!;~~s{f~::;1f.E2;QE;~F;f~;t~f:¥~\?~~1~1~;~I&tt01£~ Activity IDIS Number: _____ _
Report D is lOis not complete + Report D is I D is not accurate
Initial review for completeness and accuracy completed by -Name: _____ -;:;--;--.,-;-: ________ _
Project Manager
Name: Date: ------------------------------Supervisor
Warning: Title 18, US Code Section 1001, states that a person who knowingly and willingly makes false or fraudulent statements to any Department or
Agency of the United States is guilty of a felony. State law may also provide penalties for false or fraudulent statements.
ti)
,,;;;:;;,",;:;i,' This material is available in an accessible format upon request. CD114151712
30f3
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
PERFORMANCE & BENEFIT DATA: PUBLIC SERVICES -OR-ADMINISTRATION
Supplement to Quarterly Expenditure & Progress Report
FY20
Recipient Name:
Activity Name: ____________________ _
IDIS#: Activity Category: _____ _
HUD Activity Matrix Code: __ _ Accomplishment Type: ____ _
HUD Matrix Code Description:
o Public Service
o Administration
(Fair Housing Activities)
o People -or-0 Households
Low & Moderate Income
Reporting Period·
1st Quarter [Jan-Mar]
2 na Quarter rApr-JunJ
3rCl Quarter [Jul-Sept]
4tn Quarter [Oct-Dec] / Annual Report
# of Persons Served ---
# of Households Served ---
___ # of Low & Moderate Income
Instructions & Applicability: National Objectives include LMA, LMC, LMH, SBA, SBR, ~BS or URG
0
0
0
0
1. Total benefiting for program year: 2. Counts by Households (H) -or-Persons (P): -----
3. Of those assisted, enter the number that:
a) Now have New Access to this service or benefit
b) Now have Improved Access to this service or benefit
c) Now receive a service or benefit that is No Longer Substandard ..... Tot,1I ----.-. _ .. _-_. _ .. -_ .. _-_.. ...--._-
-----
1. Complete the Direct Benefit Information in the table below for the service or benefit provided for this activity.
t·· . .DIRECT.BENEFIT DATA: 0 PERSONS -OR.'.;; 0 8.Q:.I}SEHbU~~_. _._:._._ .. __ .-,-__ .~_ .. _._J
RACE & ETHNICITY CATEGORY
Instructions: (1) Indicate the total number of persons or households served in each Racial Category for this reporting
period and the cumulative total. (2) From the total number depicted in each Racial Category, indicate the numbers that are
of Hispanic Ethnicity for this reporting period and the cumulative total.
Re art Period Totals
Race Ethnicity
Racial Cate ories Total # # His anic
White [11]
Black / African American [12]
Asian [13]
American Indian / Alaskan Native [14]
Native Hawaiian I Other Pacific Islander [15]
American Indian I Alaskan Native & White [16]
Asian & White [17]
Black / African American & White [18]
American Indian or Alaskan Native & Black / African
American 19
Other / Multi Racial [20]
Totals
1 of3
CD118151712V
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
PERFORMANCE & BENEFIT DATA: PUBLIC SERVICES -OR-ADMINISTRATION
Supplement to Quarterly Expenditure & Progress Report
FY20
OTHER DIRECT BENEFIT INFORMATION
Report Period Totals '. Cumi.Hati\j~/YTbTotals .... '.1:.( ····TOt~rNlJmher-<.· •.• ',. ". Income Levels Total Number
Extremely Low (30% or less)
Low (31 % -50%)
Moderate (51% -81%)
Non Low/Mod (81% or greater
Totals
I Number of Female Headed Households
" .......... .
AREABENEFIT INFORMATION [if applicable] .... . ~ -. .... ' ..
, .. ' . :;~ " "
-.:':.i,,"";' ,;'"
Census ( C) or Survey (S) Data Used: If (S), enter # of Low/Mod & Total Population:
Total # of Low/Mod in Service Area: Total Low/Mod Universe Population in Service Area:
Percent of LowlMod in Service Area:
Census Tract: Block Groups:
Census Tract: Block Groups:
Census Tract:
Is this activity located in a NRSA? 0 Yes 0 No
If yes, the NRSA must be identified, as applicable, using the maps provided via Miami-Dade County's website -Services Near
You: http://gisweb.miamidade.gov/CommunityServicesi. A copy of the printout must be included with this report
Provide the following information:
NRSA # of Clients Served # of Clients Served
Location / Project Address:
Street / City / Zip Code
Location / Project Address:
Street / City / Zip Code
Location / Project Address:
Street / City / Zip Code
fr " ,-, . -PART 4 .. LEVERAGING OF FUNDS [Oth~r Funding Sources] ',-':,' .' ' . :,',' -. :
$ 1. CDBG Funds -"-------$ 5. Other Federal Funds -'------
$ 2. HOME Funds --'-------$ 6. State / Local Funds --'------
$ 3. ESG Funds -"'--------$ 7. Private Funds -'-------
$ 4. Section 108 Loan Guarantee --'-------$ 8. Othe~ --'------
Name of Funding Source
$ Total Funds -'---------
CD 18JS1712 V
2of3
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
PERFORMANCE & BENEFIT DATA: PUBLIC SERVICES -OR-ADMINISTRATION
Supplement to Quarterly Expenditure & Progress Report
FY20
r &J'R-EciU"RED ATTACHMENTS [!f app'licablej-:{1 )[)ata\JeritYingfamIly~iie anl:~nn~al i~yome.ofeadl pers~n recei;i~gl
I.
t .. he b~nf;fit;(2~_ printout ~f N.RSAma p, ifapplicable;c~ (3) anyo. t. ~erh=jqu. ired. document a. s described in' the Contract or i
,Scope ~_Servlces, or asmstructed b~_!he Co~~ty. _~ .. ________ ~c:~:_:",, __ ~ ___ .. _. ____ -__ .. ______ ._. -____ .:. __ . _______ 1
Report Prepared by: Title: Date: ------------------------------------------------------------Print Name
Signature of Certifying Official: Title: Date: --------------------------------------------
Warning: Title 18, US Code Section 1001, states that a person who knowingly and willingly makes false or fraudulent statements to any Department or
Agency of the United States is guilty of a felony. State law may also provide penalties for false or fraudulent statements.
tar i:,~j:'T;;:N: This material is available in an accessible fOlTllat upon request. CDI181S1712V
30f3
.. '
PH CD SUBMITTAL OF PUBLIC SERVICE CHECKLIST
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••• III ••••••••••••• It •••••••••••••••••• · Agency · · · Activity Name · · · Funding Source I Year · · · Amount IIDIS # · · · Project Location · · · . . ........................................................................................................... -
LMI Limited Clientele Criteria (Must check one below & Provide documentation as required)
o 1. Low-Mod Clientele (LMC) -Documentation showing that the activity is designed for and used by a segment
of the population presumed by HUD to be LMI persons; for example:
o Abused children,
o Battered spouses,
o Elderly persons (family whose head, spouse, or sole member is a person aged 62 or older),
o Severely disabled,
o Homeless persons,
o Illiterate adults,
o Persons living with AIDS,
o Migrantfarm workers
o 2. Neighborhood Revitalization Strategy Area (NRSA) -Be of such a nature and in a location that it may be
concluded that the activities clientele located in an NRSA:
----------------.Obtain-documentation-thatshows -the client lives-aUhe. address which is .Iocated inan-NRSA:-
* Proof of location:
* Child(ren) School Records (showing home address)
* Driver License
* Utility Bill (FPL, Water & Sewer, etc)
REQUIRED DOCUMENTATION-NO EXCEPTIONS
* PHCD General CDBG Intake Eligibility Form (Must be Attached)
*Services Near Y9U Print Out (Must be Attached)
(http://gisweb.miamidade.gov/CommunityServices/
1. Biscayne North
2. Cutler Ridge
3. Goulds
4. Leisure City/Naranja
5. Model City
6. Opa-Locka
7. Perrine
8. South Miami
9. West Little River
Yes No
o 0 o 0 o 0
Yes No
o 0
o 0
NOTE: SHOULD ANY OF THE ABOVE NOT BE PROVIDED, QUARTERLY PROGRESS REPORTS WILL BE RETURNED TO
THE AGENCY AND WILL BE CONSIDERED NON-COMPLIANT
Page 1 of2
• 0(' r,1I
PHCD SUBMITTAL OF PUBLIC SERVICE CHECKLIST
o 3. Required Documentation: -Data showing the size and annual income for the family of each person receiving
the benefit and that at least 51 % of those served are LMI.
REQUIRED DOCUMENTATION A MUST -NO EXCEPTIONS Yes No
* PHCO General COBG Intake Eligibility Form (Current Income Must be Attached) D D
Select One Form of Proof to Provide:
* Pay Stub(s} D D
* Aid to Families with Dependent Children (AFDC) or
Temporary Assistance to Needy Families (TANF) D D
* Food Stamp Official Print out Letter D D
* Unemployment Benefits Letter with Amount D D
* Proof of Child Support or Alimony D D
* Proof of SSAISSI or Veteran's Benefits D D
* Proof of Retirement Income (Must be attached for Senior Programs) D D
* Other Income D D
_ .. _-----_.-._-_. -----------
Prepared by (Print) Agency Official Signature and Date
NOTE: SHOULD ANY OF THE ABOVE NOT BE PROVIDED, QUARTERLY PROGRESS REPORTS WILL BE RETURNED TO
THE AGENCY AND WILL BE CONSIDERED NON-COMPLIANT
Page 2 of2
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
GENERAL CDBG IN-TAKE ELIGIBILITY FORM
LIMITED INCOME (LMI) LIMIT EO CLIENTELE (LMC) I LIMITED JOBS (LMJ) I LIMITED HOUSING (LMH)
NAME: _________________________________________ PHONE: ____________________ __
ADDRESS: ________________________________________________ ~ZIP: ________________ _
Gender:. 0 Male 0 Female Ethnicity: 0 Hispanic o Not Hispanic
Race (Please check the race category which applies to you): o White 0 Black/African American o American Indian/Alaskan Native
o Asian 0 Black/African American & White o American Indian/Alaskan Native & White o Asian & White 0 Native Hawaiian/Other Pacific Islander o Other: Multi Racial
o American Indian or Alaskan Native &Black/African American
List Yourself and all Other Persons Occ Home Relatinnc,h in
1. elf
2.
3.
4.
6.
7.
8.
INCOME VERIFICATION DATA .. '
The assistance you receive is determinedif1-part-by: .the:size~of your household and .your income. All inc;.:Jme andass.ets will_require.
verification before eligibility will be granted. Income indudes all money caming into the household from all persons over 18 years old.
Wages, salaries, tips, commissions; Self-employment income; R~tiFemen~ Survivor, or Disability pensions; Social Security or
Railroad retirement; Supplemental Security-lp.come,Aid to Families with Dependent Children (AFDC), Temporary Assistance to
Needy Families (T ANF), Food Stamps,. or other ptlb!ic assistance, or public welfare programs; Interes~ dividends, net rental' income,
or income from estates or trusts; and any other sources of income received regularly, induding Veterans' (VA) payments,
unemployment compensation, alimony, and child support must be disdosed.
Household Member Source of Income Gross Monthly Amount Received
1. $
2. $
3. $
4. $
5. $
Income Eligibility Acceptable Documentation: Copy of Pay Stubs (from previous employer), Aid to Families with Dependent
Children (AFDC) or Temporary Assistance to Needy Families (TANF) Official Printout/Jetter, Food Stamp Official Printout/letter,
Letter confirming amount of unemployment b~nefi!s received, proof of child support, or alimony, proof of SSNSSI or Veteran's
Benefits, or proof of retirement income. MUST ATTACH A 'COpy: OF DOCUMENTS -NO EXCEPTIONS.
I, the undersigned applican~ do hereby authorize to verify my personal records, induding
(Name ri Agency)
wages, pensions, and investments. It is understood that this authorization is granted for the sole purpose of certifying my eligibility
for federal financial assistance, and that all information acquired in this regard will remain confidential.
BY MY SIGNATURE, I ACKNOWLEDGE THAT ALL INFORMATION I HAVE PROVIDED IS TRUE AND CORRECT TO THE BEST
OF MY KNOWLEDGE. I AM AWARE THAT IF I MAKE ANY WILLFUL FALSE STATEMENT IN THIS CERTIFICATION OR ANY
OTHER DOCUMENTATION THAT I PROVIDE FOR PROGRAM EUGIBIUTY, I MAY BE PUNISHED WITH FINES OR
IMPRISONMENT OF UP TO FIVE (5) YEARS, OR BOTH, UNDER SECTION 1001 OF TITLE 18, UNITED STATES CODE, AND I
ALSO MAY BE SUBJECT TO CML AND/OR AOMINISTRATIVE PENALTIES AND SANCTIONS.
Signature of Applicant Date
Page 1 of2 CD/17/51712fV3
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
GENERAL CDBG INTAKE ELIGIBILITY FORM
COBG INCOME ELIGIBILITY 24 CFR 570.208
Activity classified under family size and income 24 CFR 570.208(a)(2)(i)(8)
Activity is classified based on income eligibility requirements 24 CFR 570.208(a)(2)(i)(C)
that restrict it exclusively to low-and moderate-income persons
I DEFINITIONS 124 CFR 570.3
24 CFR 570.506(b)(3)(iii)
24 CFR 570.506(b)(3)(iii)
I Family means all ·persons living in the same household who are related by birth, marriage or adoption.
I Household means all the persons who occupy a housing unit The oCcupants may be a single family, one person living alone,
i two or more families living together, or any other group of related or unrelated persons who share living arrangements~ I Income. For the purpose of determining whether a family or household is low-and moderate-income under subpart C of this
I part, grantees may select any of the three definitions listed below for each activity, except that integrally related activities of the I same type and qualifying under the same paragraph of 570.208(a) shall use the same definition of income. The option to
I choose a definition does not apply to activities that qualify under 570.208(a)(1) (Area benefit activities), except when the
I recipient carries out a survey under 570.208(a)(1)(vi). Activities qualifying under 570.208(a)(1) generally must use the area I income data supplied to recipients by HUD. The three definitions are as follows: I
(i) Annual income as defined under the Section 8 Housing Assistance Payments program at 24 CFR 813.106 (except that if
the CD8G assistance being provided is homeowner rehabilitation under 570.202, the value of the homeowner's primary
residence may be excluded from any calculation of Net Family Assets); or
Estimate the annual income of a family or household by projecting the prevailing rate of income of each person at the time
, assistance is provided for the individual, family, or household (as applicable). I Estimated annual income shall include income from all family or household members, as applicable. Income or asset
I enhancement derived from the CDBG-assisted activity shall not be considered in calculating estimated annual income.
i Low-and moderate-income household means a household having an income equal to or less than the Section 8 low-
I income limit established by HUD. I Low-and moderate-income person means a member of a family having an income equal to or less than the Section 8 low-! .. incomeJimiLestablished:byHUD.UnFelatedindividuals wiILb.econsidElreda_s.one:.-p~fSOn families for this purpose. I Low-income. household means a household Raving an income equal to or less than the Section 8 very low-income limit
i established by HUD. I Low-income person means amembei:-dr a-family th.at r.as-anincome equal to or less than the Section 8 very low-income
I limit established by HUG. Unrelated individuals shall be considered as one-person families for this purpose.
INSTRUCTIONS FOR IMPLEMENTING AGENCY
ryou must first seek third party verification. This is a verification that is received directly from the source of income. The request can I be by mail, fax, or email. It must be clearly evidenced that it was received from the source.
Income Limits for Fiscal Year 2016-17 (Effective 03/28/2016)
Please check the size and income.
Warning: Title 18, US Gode Section 1001, states that a person who knowingly and willingly makes false or fraudulent statements to any Department or
Agency of the United States is guilty of a felony. State law may also provide penalties for false or fraudulent statements.
This material is available in an accessible format upon request.
2of2
CD/17/51712N3
VIVIENDA PUBLICA Y DESARROLLO COMuNITARIO
FORMULARIO GENERAL DE ADMISION PARA CDBG
INGRESOS (LMI*, por sus siglas en JOg",S), CLIENTES (LM.C**, p.or s:s siglas en IngleS), EMPLEOS (LMJ***, porsus siglas en JOgles)
VIVIENDAS (LMH****, porsusslgJasen mgJes) BAJOS Y MODERADOS
TELEFONO: NOMBRE: ---------------------------------------------C~O~'D~I~G~O---------
POSTAL: DIRECCION: ______________________________________________ __ --------
Genera:
Origen
OMasculino DFemenino etnico: o Hispano 0 No Hispano
Raza (Por favor, marque la categoria de raza que Ie corresponde): o Blanco 0 Negro/Afro Americano o Indfgena Estadounidense/Nativo de
Alaska o Asiatico o Negro/Afro Americano y Blanco o Indfgena Estadounidense/Nativo de Alaska
y Blanco o Asiatico y Blanco 0 Nativo de Hawaii Otras Islas del Pacifico o Otros: Multi Racial o Indigena Estadaunidense I Nativo de Alaska / Afro Americano
Menci6nese a Usted mismo y a todas las personas que
oc . la Vivienda Parentesco leado?
1. Autonomo
2.
3.
4.
5.
6.
7 ..
8.
DAros DE LA VERIFICACION DE INGRESOS .....
.. '
La ayuda que Usted recibe se determina en parte por el numero de miembros en su nuc/eo familiar y de sus ingresos. Todos los
ingresos y los bienes deberan ser verificados antes de que la elegibilidad sea concedida. EI ingreso incluye todas las sumas de
dinero que reciben todos los miembros del nucleo familiar mayores de 18 arias. Los sa larios, sueldos, propinas, comisiones; los
ingresos como trabajador par cuenta propia; Pensiones de jubilacion, de supervivencia, por discapacidad; la jubilacion del Seguro
Social 0 del Ferrocarril, el Ingreso Suplementario de Seguridad, la Ayuda a las Familias con Ninos Dependientes (AFDC, por sus
siglas en ingles), la Ayuda Temporaria a las Familias Necesitadas (TANF, por sus siglas en ingh§s), los Sellos para Alimentos, u
. otro tipo de ayuda publica, 0 de programas publicos de ayuda social, 0 de ingresos provenientes de patrimonios 0 fideicomisos;
asf como otras fuentes regulares de ingresos, incluyendo los pagos a los Veteran os (VA, por sus siglas en ingles), la
compensacion por desempleo, la pension alimenticia la manutencion de menores deberan ser declarados.
Miembro del Nucleo Familiar Fuente de Ingresos Manto dellngreso Bruto
Mensual Recibido
1. $
2. $
3. $
4. $
5. $
Documentaci6n Aceptable para verificar la Elegibilidad a partir de los Ingresos: Copia de las colillas de pago (del empleador
anterior), la Ayuda a las Familias con Ninos Dependientes (AFDC, por sus siglas en ingles) 0 la Ayuda Temporaria a las Familias
Necesitadas (TANF, por sus siglas en ingles) la Impresion 0 la Carta Oficial de las Estampillas de Nimentos, la Carta confirmando
Pagina 1 de 3
C0/17/51712N3
, '
VIVIENDA PUBLICA Y DESARROLLO COMUNITARIO
FORMULARIO GENERAL DE ADMISION PARA COBG
la cantidad de beneficios percibidos par desempleo, la prueba de la manutencion de menores 0 del pago de la 'pe_n~!on ~limenticia,
la prueba del SSNSSI 0 de los Beneficios de los ~ete:~~os 0 la prueba de los ingresos por jubilacion. DE!3ERA ADJUNT ARSE
UNA COPIA DE LOS DOCUMENTOS -SIN EXCEPCION.
Quien suscribe, el solicitante, por medio de la presente autorizo a ____________ a fin de que verifique mis
antecedentes personales, incluyendo:· (NombredelaAgencia)
los salarios, pensiones e inversiones. Se entiende que esta autorizacion se otorga con el unico proposito de certificar mi elegibilidad
para la ayuda financiera federal, y que toda la informacion adquirida en este sentido seguira siendo confidencial.
CON MI FIRMA, RECONOZCO QUE TODA LA INFORMACION QUE HE PROPORCIONADO ES VERDADERA Y CORRECTA A
MI LEAL SABER Y ENTENDER. SOY CONCIENTE DE QUE SI HAGO ALGUNA DECLARACI6N FALSA INTENCIONALMENTE
EN ESTA CERTIFICACION 0 EN CUALQUIER OTRA DOCUMENTACION QUE PROPORCIONE PARA LA ELEGIBILIDAD DEL
PROGRAMA, PUEDO SER CASTIGADO CON MULTAS a CON LA CARCEL DE HASTA CINCO (5) ANOS, 0 AMBOS, BAJa LA
SECCION 1001 DEL TITULO 18, DEL COOIGO DE LOS ESTADOS UNIDOS, Y QUE TAMBIEN POD RIA ESTAR SUJETO A LAS
MULTAS Y SANCIONES CIVILES Y/O AOMINISTRATIVAS PERTINENTES.
Firma del Solicitante Fecha
ELEGIBILIDAD DE LOS INGRESOS PARA EL SUBSIDJO EN 24 CFR 570.208
BLOQUE PARA EL DESARROLLO COMUNIT ARlO (CDBG,
por sus siglas en ingles)
Actividad c1asificada bajo los ingresos y la composicion del 24 CFR 570.208(a)(2){i)(B) 24 CFR 570.506(b)(3)(iii)
grupo familiar
La actividad se clasifica a partir de los requisitos de elegibilidad 24 CFR 570.208(a)(2)(i)(C) 24 CFR 570.506(b)(3)(iii)
de los ingresos que se Iimitan exclusivamente a las personas
de ingresos bajos y_moderados
i DEHNICJONES I 24 CFR-570.3 I' I Fami.lia: ~e refi.ere ~_ todas las personas que vivan en fa misma casa, que estan relacionadas par nacimiento,
I matnmOf.T10 0 aaopclon. I
I.Nucleo .Familiar; Se refiere a todas las personas que ocupan la vivienda. Los ocupantes podrian ser una sola familia, una I
I persona viviendo sola, dos 0 mas familias viviendo juntas 0 cualquier otro grupo de personas relacionadas 0 no que i
I compartan las condiciones en materia de vivienda. I
Iingresos: Con el fin de determinar si los ingresos de una familia 0 de un nucleo familiar son bajos 0 moderados dentro de la ;
Subseccion C de esta seccion, los beneficiarios podrian seleccionar cualquiera de las tres definiciones enumeradas abajo
para cada actividad, salvo que las actividades integralmente relacionadas que sean del mismo tipo y que califiquen dentro del
mismo apartado del 570.208(a) deban utilizar la misma definicion de los ingresos. La opci6n de elegir una definicion no se
aplica alas actividades que califican con el 570.208(a)(1) (Actividades de beneficio del area), salvo cuando el beneficiario
lIeve a cabo una investigaci6n de acuerdo con el 570.208(a)(1)(vi). Las actividades que califican de acuerdo con el
570.208{a)(1) generalmente deberan utilizar los datos de ingresos del area provistos por HUD a los beneficiarios. Las tres
definiciones son las siguientes: .
(i) Los ingresos anuales tal como se los define en el programa de Pagos de Ayuda para la Vivienda de la Secci6n 8 en el
Titulo 24 del Codigo Federal de Regulaciones 813.106 (salvo que la ayuda para la CDBG que se proporcione tenga
relaci6n con la rehabilitaci6n al propietario de acuerdo con el 570.202, el valor de la residencia principal del propietario se
pod ria excluir del calculo de los Activos Netos de la Familia); 0 bien
Calcular los ingresos anuales de una familia 0 de un nucleo familiar efectuando una proyecci6n de la tasa predominante de
ingresos de cada persona al momenta de proporcionarsele la ayuda a la persona, a la familia 0 al nucleo familiar (segun
corresponda).
Ellngreso anual estimado deberaIncluir los ingresos de toda la familia 0 de los miembros del nucleo familiar, segun sea el
caso. La mejora en los ingresos 0 en los bienes derivada de la actividad de la ayuda del CDBG no se considerara para
calcular los ingresos anuales. -
Hogar de ingresos bajos y moderados se refiere a un nucleo familiar que tiene un ingreso igual 0 inferior allfmite de bajos
ingresos de la Seccion 8 establecido por HUD. (LMH, por sus siglas en ingles)
Advertencia: EI Titulo 18, Articulo 1001 del C6digo de los Estados Unidos establece que una persona sera hal/ada culpable de un delito penal grave
cuando intencionalmente haga declaraciones falsas 0 fraudulentas ante cualquier departamento 0 agencia de los Estados Unidos. La ley estatal
podrfa prever sanciones para las dec/araciones falsas 0 fraudulentas.
til Este material esta dispenible en un formate accesible a petici6n. ~~tl''''''1 CD/17I51712N3
2de 3
VIVIENDA PUBLICA Y DESARROLLO COMUNITARIO
MtAH· H,:j':h~'i FORMULARIO GENERAL DE ADMISION PARA CDBG
i Persona de ingresos bajos y moderados se refiere a un miembro de la familia cuyo ingreso es equivalente 0 inferior al I limite de ingresos bajos de la Secci6n 8 establecido por HUD. Los individuos no emparentados se considerarim familias
"
unipersonales para este prop6sito. (LMI, por sus siglas en ingles)
Hogar de ingresos bajos se refiere a un hogar con un ingreso igual 0 inferior al limite de ingresos muy bajo de la Secci6n 8
/
' establecido por HUD. (LMH, por sus siglas en ingles)
Persona de Baios Ingresos se refiere a un miembro de una familia cuyo es un ingreso igual 0 inferior al limite de ingresos
I muy bajos de la Secci6n 8 establecido por HUD. Los individuos no emparentados deberan considerarse como familias I unipersonales para este prop6sito. (LMC, por sus siglas en ingles) I
INSTRUCCIONES PARA LA AGENCIA DE EJECUCION
Usted debera pedir primeramente la verificaci6n de terceros. Se trata de una verificaci6n proveniente directamente de la fuente de 'I
ingresos. La solicitud puede ser env.iada por correo, por fax 0 por correo electr6nico. Debera quedar bien claro. que fue recibida de I
la fuente. .
Limites de los Ingresos para el Ano Fiscal 2016-17 (Vigente desde el28 de Marzo, 2015)
Par favor rriarque la cajita correspondiente al tamafio de su grupo familiar y a la cantidad de su ingreso
~~~iilirii~j 1:[~«~~'~I~iil81 ~1~!~fIIfl ~r~tli~~ll~t~i~!t
1 $14,950 $24,850 $39,800
2 $17,050 $28,400
3 $20,160 $31,950
4-$24,300 $35,500
5 $28,440 $38,350
6 $32,580 $41,200
7 $36,730 $44,050
8 $40,890 $46,900
Note:
LMI* (LOW-MODERATE INCOME): Ingresos bajos 0 moderados
LMC** (LOW-MODERATE CLIENTELE): Clientela de Ingresos bajos 0 moderados
LMJ*** (LOW-MODERATE JOBS): Empleos de Ingresos bajos 0 moderados
LMH**** (LOW-MODERATE HOUSING): Vivienda de Ingresos bajos 0 moderados
$45,450
$51,150
$56,800
$61,350-
$65,900
$70,450
$75,000
Advertencia: EI Titulo 18, Artfculo 1001 del C6digo de los Estados Unidos establece que una persona sera hal/ada culpable de.un delito penal grave
cuando intenciona/mente haga declaraciones fa/sas 0 fraudulentas ante cualquier departamento 0 agencia de los Estados Unidos. La ley estatal
podrfa prever sanciones para las declaraciones falsas 0 fraudulentas.
tir t:v;~,~\"";. Este material esta dispanible en un fannata accesible a petici6n. CD/17/51712N3
3 de3
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Date:
Recipient Name: Activity
Name:
lOIS Number:
1. Persons Assisted
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
List of Persons Assisted (Public Service)
Supplement to Quarterly Expenditure and Progress Report
2. Status
""';::?' ,'\;?:;!:;1~iReporting"F'eriod!;ii~';;}:;f'§'1'!';);r>':
1 st Quarter [Jan -Mar] D
2nd Quarter [Apr -Jun] D
3rd Quarter [Jul -Sept] D
4th Quarter [Oct -Oec]/Annual Report D
3. Address 4&5.NR:SA
htte:L!gisweb.miamidade.gov!Communi!1:Services!
Last Name First Name New Existing House Number Direction street Name Street Type Lives in a NRSA? Name ofNRSA
0 0 DYes DNO
D D DYes DNO
D D DYes DNO
D 0 DYes DNo
D 0 DYes DNO
0 0 DYes DNO
0 D DYes DNO
0 0 DYes DNO
0 0 DYes DNO
0 0 DYes DNO
D 0 DYes DNO
0 0 DYes DNO
0 0 DYes DNO
0 0 DYes DNO
0 D DYes DNO
INSTRUCTIONS
1. Fill in name of the person for which Public Services were provided.
2. Enter a check mark in the column that matches the person's status [New -or-Existing].
3. Enter the complete address of the person assisted, e.g., House Number, Direction, Street Name, & Street Type.
4. Enter Yes or No as applicable if the person lives in one of the NRSAs.
5. If yes, view NRSA map at http://gisweb.miamidade.govICommunityServices/ to determine correct NRSA location and fill in the name of the NRSA: Goulds, Leisure City, Melrose, Model City,
Opa-Locka, Perrine, South Miami, West Little River, Biscayne North or Cutler Ridge.
Warning: Title 1 B, US Code Section 1001, states that a person who knowingly and wl11ingly makes false or fraudulent statements to any Departm ent or Agency of the United States is gu11ty of a felony. State law may also provide penalties
for false or fraudulent statem ents.
® J.......:.i·.·,.;. This material is available in an accessible format upon request. PageUofD CD/23/12513N3
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HJAMJ.. ~
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
INFORMATION FOR ENVIRONMENTAL REVIEW FORM
INSTRUCTIONS: Per 24 CFR Part 58, the purpose of the environmental review procedures is
to foster the implementation of environmentally compatible activities. As a grant or loan
recipient, Miami-Dade County will not. fund projects that will negatively impact clients,
communities, or the environment.
Part I. AGENCY AND PROJECT DETAIL
-
1. Indicate Funding Source:
~ COBG 0 HOME o HOPE VI
0 HOMELESS (SRO/SHP) 0 EDI o NSP
2. Indicate Fiscal Year. FY20_16_
3. Name of SubrecipientJAgency:
City of South Miami
4. Name of Proposed Activity:
-Tennis Lessons
5. Location (Address with Clty. ST and Zip) of Activity Of Project:
6125 SW 68th Street, South Miami FL 33143 Tennis Lessons
6. Site Folio Number(s):
7. Commission District(s): 7
8 O· t C t t· f f 'fec on ac In orma Ion 0 fl I .. t oanlgran reclplen:
Name: Angelica Bueno
Address: 6130 Sunset Drive
City: South Miami I State: Florida I Zip: 33143
Phone: 305 668-2514 I Fax:
9. Oetailed description of activity or project:
City of South Miami Parks and Recreation Department will provide an instructional tennis
program for a minimum of thirty (30) low income children, residents of the Community
Redevelopment Agency (eRA) for the duration of contract period. The program will be at
. '
Marshall Park located in the NRSA area within the City of South Miami.
10. What is. the purpose of the activity or project? For example, Public Service, Econom ic
Development, Historic Preservation, Capital Improvement, Housing, etc.
Public Service
11. What is the status -of activity or project? For example, Pre-Development Phase,
Rehab/Construction Underway, Rehab/Construction Completed, etc.
Program has not started yet
Part II. PROJECT OUTCOME
Wil the activity or project resu t In teo owinq? -I· h f II
YES NO
X 1. Change in use
x 2. Sub-surface alteration (Le. excavations)
I·x 3. New construction
x 4. Renovation or demolitiun·
x 5. Site improvements (utilities, sidewalk, lalldscaping, storm
drainage, parKing ·areas, drives, etc.}
x 6. Building improvements (windows, doors, .etc.)
x 7. Displacement of persons, households or business
x 8. Increase in population working or living on site
x 9. Land acquisition
x 10. Activity in 10D-yearfloodplain
X 11. A new nonresidential use generating at least 1,375,000
gallons of water or 687,500 qallons of sewaqe per day.
x 12. Use requiring operating permit {Le. for hazardous waste,
pretreatment of sewaqe, etc.}
x 13. A sanitary landfill or hazardous waste disposal site
x 14. Tree removal or relocation
x 15. Street improvements
X 16. The impounding of more than 10 acre feet of water (e.g.
diqqinq a lake or divertinq or deepeninQ of a body of water).
Part III. SITE SPECIFIC INFORMATION
1. Land Use:
Describe the existing and proposed land use:
• Existing?
N/A
2
• "" t I
N/A
• Proposed?
• Does the site have any known contaminants?
DYES !2J NO
• If there are known contaminants, has a Phase I audit been completed? If yes, a copy
of Phase I Environmental Audit certified to Miami-Dade County must be submitted to
determine-the likely presence of either a release or threatened release of hazardous
sUbstance.
DYES
2. Site Plan:
~ NO
Does the proposed activity include a new structure(s) or site improvements on a site of one
(1) acre or more?
DYES !2J NO
If yes, a site plan must be provided. Project's) will not be enVironmentally reviewed without a
site plan.
3. Photographs:
Does the activity include R€W construction, renovation. or rehabilitation?
DYES I2J NO
If yes, photographs must be provided of each side (front, rear and sides) of the structure(s)
proposed for assistance and the buildings on the adjacent lots. The photographs shall be
identified by address. In addition, provide for each existing structure on the site, the following
information:
• Existing structure(s) on site? DYES ~ NO
• Estimated age of structure(s)? _N/A __
4. Value of Improvements:
Does the proposed activity include rehabilitation or renovation of structure(s)?
DYES !2J NO
If yes, what is the estimated cost of rehabilitation or renovation? N/A _____ _
What is the amount sought for funding? _$ 10,000.00
In addition, indicate if the estimated value of the improvement represents:
o 0 to 39.9 percent of the market value of the structure(s)
3
, .
1.
2.
3.
4.
5.
6.
7.
o 40 to 49.9 percent of the market value of the structure(s)
o 50 to 74.9 percent of the market value of the structure(s)
o 75 percent or more of the market value of the structure(s)
5. Phase I Environmental Audits:
Does the proposed activity involve the transfer of any property, new construction, major
renovations of 75% or more of the structures' market value, or a securing of a loan for
nonresidential parcel?
DYES 181 NO
If yes, a copy of Phase I Environmental Audit certified to Miami-Dade County must be
submitted to determine the likely presence of either a release or threatened release of
hazardous sUbstance.
An audit is a review of a site and adjacent properties and involves preparing a history of
ownership, land use and zoning for the last 50 years; researching environmental records for
information on hazardous waste sites, hazardous facilities, solid waste/landfill facilities and
underground storage tanks (available through the Department of Permitting Environment and
Regulatory Affairs (DPERA), Florida Department of Environmental Protection (FDEP) and
U.S. Environmental Protection Agency (EPA»; and site inspection for physical evidence of
contamination such as damaged vegetation or stains in the soil.
Has a Phase I been performed? DYES [gJ NO
6. Env-ironmentalJiealth Information:
• If a residential. site and-fhe-activity iITc/tldes or involves rehabilitatio!l,.has it -been inspected
for defective .paint surfaces?
DYES [gj NO
If yes, please submit the results.
• Have any child under the age of six at the site been tested for elevated levels of lead in the
body?
DYES [gI NO
If yes, please submit the results.
7. Other Site Information:
YES NO
Flood insurance required? x
Public water available on site? x
Public sewer available on site? x
Children under 6 years of age residing on x
site or relocating to site (including day care
facility)?
Hazardous waste disposal facility? x
Storage of hazardous materials on site? x
Abandoned structure(s) on site? x
4
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Part IV. SUPPLEMENTAL REQUIRES DOCUMENTS
Required Submittal Documents:
1. For aU projects: Submit street/plat maps that depict 10cation of property in the County and10r C:ity
with the location or lot clearly pointed out.
2. For new construction projects: Submit a scope of service, an itemized budget, and a site plan.
3. For housing/building rehabilitation projects only: Submit a scope of service, an itemized
budget describing the-major components-of the rehabilitation program planned, and a photograph
of the property.
4. For historic proprieties, include: Submit photographs of the property, and a description of any
adjacent historic properties that may be affected by your activity.
Part V. CERTIFICATION
I certify to the accuracy of the information provided. I understand that all funded activities must
have an approved environmental review clearance prior to the commencement of projects. I
clearly understand that any omitted and/or incorrect information will delay the initiation of the
environmental review process by the PHCD staff. As such, I am aware that omitted information
could delay the commencement of my organization's project. I understand all approved
environmental reviews are valid for one (1)
A..ngelica Bueno
. Print Name Title
Planning & Sustainabilit~ Ad.
City of South Miami Date: 912212016
Unless otherwise indicated, return completed form and attachments to:
Project Management Division
Public Housing and Community Development
701 NW 1st Court -14tti Floor
Miami, Florida 33136
TYPES OF ACTIVITIES AND ENVIRONMENTAL GUIDELINES TRIGGERED:
Type of Activity EXEMPT" CENST** CEST***
Economic Development
New Construction
Rehab X'
Non-Construction/Expansion X
Housing
Single Family Rehab X
Multi-Family Rehab X'
New Construction
Homeownership Assistance X
Affordable Housing Pre-Dey. X
5
EA****
X X2
X2
X
· '
Capital Improvement
Handicapped-Access X
Public Facilities X'
Infrastructure X'
Public Services
Employment X
Crime Prevention X
Child Care X
Youth or Senior Services X
Supportive-Services X
Type of Publication No Puolic No Public No Public Notice/No
Notice/No Notice/No HROF (No Statutory
RROF RROF Requirement
Triggered)
Or
Publish NOIIRROF
Estimated Time Frame (Excluding 30-45 Days 30-45 Days
Tri ered Statutes)
X1 If for continued use and change in density (or size) of less than 20%
X2 Change in crensity (or-size)-of moreJhan 20%
***
****
fiI
Exempt
CENST
CEST
EA
CD/38/10412
Exempt Activities
"Gateg-orically Excluded and-Not Subject to 58.5
Categoricall}l EXclu.ded -Subject to 58.5
Environmental Assessment (Format /I)
6
(Statutory
Requirement
Triggered)
45-90 Days
X 2
X 2
Publish
FONSI and
NOIIRROF
90 Days
Minimum
.. . .
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCO)
ATTACHMENT E
UNIFORM AFFIDAVITS
Federal Employer Identification Number (FEIN) Dun & Bradstreet Number (D-U-N-S"'j
A) Name of Entity, Individual(s), Partners or Corporation B) Doing Business As (If same as line A, leave blank)
street Address (P. O. Box Number is not permitted) City State (U.S.A) Country Zip Code
1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT
(Sec. 2-8.1 of th9 Miami-Dade County Code)
Firms registered to do business with Miami-Dade County, shall require Iheperson contracting or transacting such business with
the County to disclose under oath his or her full legal name, and business addres~ Such contract or transadion shall also require
the disclO$ure under oath of the full legal name and business address of all Individuals having any interest (legal, equitable,
beneficial or otherwise) in the contract other than subcontractors, materialmen, suppliers, laborers or lenders. Post office box
addresses shall not be accepted hereunder. If the contract or business transaction is with a corporation the foregoing information
shall be provided for each officer and director and each stockholder holding, directly or indirectly, five (5) percent or more of the
outstanding stock in the corporation. If the contract or business transaction Is with a partnership, the foregoing information shall
be provided for each partner. If the contract or bUsiness transaction is with a trust, the foregoing information shall be provided for
the trustee and each beneficiary of the trust The foregoing disclosure requirements shall not apply to contracts with publicly-
. traded corporations, or to contracts with the United States or any department or agency thereof, the State or any political
subdivision or agency thereof, or any municipaliiy of this State. Use duplicate page if needed for additional names.
Jf nnofficer, director or stockholder owns (5%) or more of stock. please write "None" below.
PRINCIPALS I
FULL LEGAL NAME nTLE ADDRESS
OWNERS I CHECK BOXES BELOW
GENDER RACE I ETHNIc/TY
!!: :c
tJ) -0::
W .g .~! FULL LEGAL NAME TITLE ~ ADDRESS M F '0 ... "'''' 0 .E "-.... EZ
IL e:
_ m «e:
0 ~ x '" .::'0 ~~ 0 a. ",e:
~ ~ '" '" U)~ ~~ iii :r: «~
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 tL 0 0 0 0
If a percentage of the t1rm Is owned by a publicly traded corporation, Indicate befow In the space 'Other Corporations·.
OTHERcORPORAnONS 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Page 1 of9 CD/52131413N
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:5
0
0
0
0
0
0
0
0
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PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCO)
ATTACHMENT E
UNIFORM AFFIDAVITS
2. MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFRDAVIT
(County Ordinance No. 90-133, amending Section 2.8-1 (d) (2) ofrhe Miami-Dade County Code)
The following information is for compliance with all items in the aforementioned Section:
1. Does your firm have a collective bargaining agreement with its employees? Yes 0
2. Does your firm provide paid health care benefits for its employees? Yes 0
No 0
No 0
3. Provide a current breakdown (number of persons) In your firm's work force indicating race, national origin and gender.
NUMBER OF EMPLOYEES
Males
White
Black
Hispanic
Asian I Pacific Islander
Native American I Alaskan Native
Other
Total Number of Employees
3. MIAMJ..DADE EMPLOYMENT DRUG-FREE WORKPLACE AFFIDA VlT
(Section 2-8. 1.2(b) of the Miami-Dade County Code)
Females
I
TofaJ Employees
AII·persons and entities that contract with Miaml-Dade County are required to certify that they will maintain a drug-free workplace
and such persons and entities are required to provide notice to employees and impose sandions for drug violations occurring in
the workplace.
In compliance with Ordinance·No....92-15 of the Code of Miami-Dade County, the above named firm is providing a drug-free
workplace. A written statement to each employee shall inform the employee about:
1. Danger of drug abuse In the workplace
2. The firm's policy of maintaining a drug-free environment at all work places
3. Availability of drug counseling, rehabilitation and employee assistance programs
4. Penalties that may be imposed upon employees for drug abuse violations
The firm shall also require an employee to sign a statement, as a condition of employment that the employee wJll abide by the
terms of the drug-free workplace policy and notify the employer of any criminal drug conviction occurring no later than five (5)
days after receiving notice of such conviction and impose appropriate personnel action against the employee up to and including
termination. Arms may also comply with the County's Drug Free Workplace Certification where a person or entity is required to
have a drug-free workplace policy by another local, state or federal agency, or maintains such a policy of its own accord and such
policy meets the intent of this ordinance.
4. MJAMI-IJADE COUNTY DISABIUTY AND NON-D/SCRfMINAnON AFFIDAVIT
(Mcle 1, Section 2-8.1.5 Resolution R-182-o0 Amending R-385-95 of the Miami-Dade County Code)
Firms transacting business with Mlami-Dade County shall provide an affidavit indicating compliance with all requirements of the
Americans with DisabilitiesAd (ADA).
I, state that this firm, Is in compliance with and agrees to continue to comply with, and assure that any subcontractor, or third party
contrador shall comply with all applicable requirements of the laws including, but not'limited to, those provisions pertaining to
employment, provision of programs and servIces, transportation, communications, access to fadlitfes, renovations, and new
constructloll.
The Amerfcan with DisabirttiesAct of 1990 (A.DA), Pub. L. 101-336, 104 Stat 327,42 U.S.C. Sections 225 and 611
including Trtles I, II, III, IV and V.
The Rehabilitation Act of 1973, 29 U.S.C. Section 794
The Federal Transit Act, as amended, 49 U.S.C. Section 1612
The Fair Housing Ad as amended, 42 U.S.C. Section 3601-3631
I, hereby afftrm that I am in compliance with the befgw seC#ons:
See lion 2-10.4(4)(a) of the Code of Miami-Dade County (Ordinance No. 82-37), which requires that all properly licensed
architectural, engineering, landscape architectural, and land surveyors have an aflilmative action plan on file with Miami-Dade
County
Page2of9 CD/521314131V
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PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
ATTACHMENT E
UNIFORM AFFIDAVITS
Section 2-8.1.5 of the Code of Miami-Dade County, which requires that firms that have annual gross revenues in excess of five
(5) million dollars have an affirmative action pran and procurement poricy on fife with Miami-Dade County. Firms thai have a
Board of Directors that are representative of the population make-up of the nation may b9 exempt.
5. MIAMI-DADE COUNTY DEBARMENT DISCLOSURE AFFIDAVIT
(Section 10.38 of the Miami-Dade County Code)
Firms wishing to do business with Miami-Dade County must certify that it's contractors, subcontractors, officers, principals,
stockholders, or affiliates are not debarred by the County before submitting a bid.
I, confirm that none of this firms agents, officers, principals, stockholders, subcontractors or their affiliates are debarred by Miami-
Dade County.
6. MIAMI-DADE COUNTY AFFlDAVrr RELATING TO INDIVIDUALS AND ENTITIES A nESTING BEING CURRENT IN maR
DBUGATIONS TO MIAMI-DADE COUNTY
(Ordinance 99-162, amending Section 2-8.1; O{f1jnance 00-30, amending Section 2-8.1 (c), and Ordinance 00-67, amending 2-8. 1
(h), of the Miami-Dade County Code)
Firms wishing to transact business with Miami-Dade County must certify that all delinquent and currently due fees, taxes and
parking tickets have been paid and no individual or entity in arrears in any payment under a contract, promisso!)' note or other
document with the Counly shall be allowed to receive any new business.
I, confirm that all delinquent and currently due fees or, taxes including, but not limited to, real and pelSonal property taxes,
convention and tourist development taxes, utifily taxes, and-tocal Business Tax Receipt collected in the normal course by the
Miami-Dade County Tax Collector and County issued parking tickets for vehicles registered in the name of the above finn, have
been paid.
7. MIAMI-DADE COUNTY CODE OF BUSINESS ETHICS AFRDAVIT
(Article 1, Section 2-8.1(1] of the Miami-Dade County Code through (6) and (9) of the County Code and County Ordinance No 00-1
amending Section 2-11.1(c) of the County Code)
Firms wishing to transact business with Miami-Dade County must certify that it-has adopted a Code that comprleS with the
requirements of Section 2-8.1 of the Counly Code. The Code of Business Ethics shall apply to all business that the contractor
does with the County and shall, at a minimum; require the contractor to comply with all applicable govemmental rules and
regulations.
I confirm that this firm has adopted a Code of business ethics which complies with the reqUirements of Sections 2-8.1 of the
County Code, and that such code of business ethics shall apply to all business that this firm does with the Counly and shall, at a
minimum, require the contractor to comply with all applicable govemmental rules and regulations.
8. MIAMI-DADE COUNTY FAMIL Y LEAVE AFFIDAVIT
(Article V of Chapter 11, of the Miami-Dade County Code)
Firms contracting business with Miami-Dade County, which have more than fifty (50) employees for each working day during
each of twenty (20) or more work weeks in the current or preceding calendar year, are required to certify that they provide family
leave to their employees.
Firms with less than the number of employees indicated above are exempt from this reqUirement, but must indIcate by letter
(signed by an authorized agent) that it does not have the minimum number of employees required by the County Code.
I confirm that if applicable, this firm complies with Article V of Chapter 11 of the County Code, which requires that firms
contracting business with MiamI-Dade County which have more than fifty (SO) employees for each working day during each of
twenty (20) or more work weeks in the current or preceding calendar year are required to certify that they provide family ieave to
their employees.
9. MIAMI-DADE COUNTY UViNG WAGE AFFIDAVIT
(SecUon 2-8.9 of the of the Miami-Dade County Code)
All applicable contractors entering into a contract with the County shall agree to pay the prevailing living wage required by this
section oftha County Code.
I confirm that if app6cable, this firm complies with Section 2-8.9 of the County Code, which requires that all applicable employers
entering a contract with Miami-Dade County shaD pay the prevailing living wage required by the section of the County Code.
Page 3 of9 CD/52131413N
, ..
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT {PH CD)
ATTACHMENT E
UNIFORM AFFIDAVITS
10. MIAMI-DADE COUNTY DOMESTTC LEA VE AND REPORTING AFFIDAVIT
(Article 8, Section 11A-60-11A-67 of the of the Miami-Dade County Code)
Firms wishing to transact business With Miami-Dade County must certifY that it is in compliance With the Domestic Leave
Ordinance.
I confirm that if applicable, this firm complies With the Domestic leave Ordinance. This ordinance appJies to employers that have,
in the regular course of business, fifty (50) or more employees working in MiamHJade County for each working day during the
current or preceding calendar year.
11. MIAMI-DADE COUNTY CRIMINAL RECORD AFFIDA VlT
(Section 2-8.6 of the Miami-Dade County Code)
The individual or entity entering into a contract or receiving funding· from the County 0 has 0 has not as of the date of this
affidavit been convicted of a felony during ttie past ten (10) years:
An officer, director, or executive of the entity entering into a contract or receiving funding from the County 0 has 0 has not as of
this date been convicted of a felony during the past ten (10) years.
(Signature)
Sworn to and-subscribed before me this _____ "day of ___________ ,. 20 __ "
Personally known _____________________________ _
Or produced identification __________ Notary Public State of ______ _
_______ --:-_-::-----:-___________ My commission expires _______ _
(Type of identification)
(Print, type or stamp commission name of notary public)
Page 4 of9 CD/52131413N
, . , • ,
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
UNIFORM AFFIDAVITS
SWORN STATEMENT PURSUANT TO SECTION 287.133 (3) (a)
FLORIDA STATUTES ON PUBLIC ENTITY CRIMES
A IT ACHMENT E
THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
1.-This form statement is submitted to ____________________ _
by ________________ ~~~~~~------~~---------------------
(Print individual's name and title)
fur ___________ ~---~~~--~---~--~-------
(Print name of entity submitting swam statement)
whose business address is _________________________ _
and if applicable its Federal Employer Identification Number (FEIN) is __________ --.;
If the entity has no FEIN, indude the Social Security Number (SSN) of the individual signing this sworn
statement: SSN __ -__ ' _-___
2.-I understand that a "public entity crime" as defined in paragraph 287.133 (1) (g), Florida Statutes, means a
violation of any state or federal law by a person with respect to, and directly related to the transactions of
business with any pl:lblic entity or with an agency or political subdivision of any other state or with the United
states, including, but not limited to any bid or contract for goods or services to be provided to public entity or
agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft,
bribery, collusfon, racketeering, conspiracy, or material misinterpretation.
3.-I understand that ·convicted" or "conviction" as defined in Paragraph 287.133 (1 )(b), Florida Statutes, means
a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in a federal or
state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result
of a jury verdict. non-jury trial. or ,entry of a plea of guilty or nolo contendere.
4.-I understand that an "AffiliateU as defined in paragraph 287.133 (1)(a), Florida Statutes means:
a) A predecessor or successor of a person convicted of a public entity crime or;
b) An entity under the control of any natural person who is active in the management of the entity and who
has been convicted of a public entity crime. The term "affiliate" includes those officers, directors,
executives, partners, shareholders, employees, members, and agents who are active in the
management of an affiliate. The ownership by one person of shares constituting a controlling interest in
another person, or a pooling of equipment or income among persons when not for fair market value
under an arm's length agreement, shall be a prima facie case that one person controls another person.
------A-l'ler-sGlR-wHGl-k-R9wingly--er:Jters-iRtO-a-jgir:Jt-v.enfur-e--witf:t-a-per.sort-who-has-been-convicted-Qf-a-public------
entity crime in Florida during the preceding 36 moths shall be considered an affiliate.
5.-I understand that a "person" as defined in paragraph 287.133 (1)(e), Florida Statutes, means any natural
person or entity organized under the laws of any state or of the United States within the legal power to enter
into a binding contract and which bids or applies to bid on contracts for the provision of goods or entity. The
term "person" includes those officers, executives, partners, shareholders, employees, members, and agents
who are active in management of an entity.
6.-Based on information and belief, the statement which I have marked below is true in relation to the entity
submitting this sworn statement (Please indicate which statement applies)
Page50f9 CDf52f31413N
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT {PH CD)
'A IT ACHMENT E
UNIFORM AFFIDAVITS
__ Neither the entity submitting swom statement, nor any of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate
of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989,
__ The en'tity submitting this swom statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of
the entity, or an affiliate of the entity had been charged with, and convicted of a public entity crime subsequent
to July 1, 1989, AND (please indicate which additional statement applies),
__ The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate
of the entity has been charged with and convicted of a public entity crime subsequent proceeding before a
Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the
Hearing Officer determined that it was not in the public interest to place the entity submitting this swom
statement on the convicted vendor list (attaGh a copy of the final order).
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND
THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED.
I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THAT PUBLIC ENTITY PRIOR TO ENTRING
INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287,017
FLORIDA STATUTES FOR A CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN
THIS FORM.
(Signature)
Sworn to and subscribed before me this ____ day of __________ , 20 __ .
Personally known ___________________________ _
Or produced identification __________ Notary Public-State of~. ____ -,--__
___________________ My commission expires ______ _
(Type of identification)
(Print, type or stamp commission name of notary public)
Page 6 ef9 CD152131413N
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
ATTACHMENT E
UNIFORM AFFIDAVITS
AFFIDAVIT OF FINANCIAL AND CONFLICTS OF INTEREST
1.-Do you have any past due financial obligations with Miami-Dade County?
Single Family House Loans
Multi-Family Housing Rehab
COBG Commercial Loan Project
U.S.HUD Section 108 Loan
Other HUD Funded Programs
Other {liens, fines, loans, occupational licenses, etc.}
If YES, please explain:
Yes 0
Yes 0
Yes 0
Yes 0
Yes 0
Yes 0
NoD
NoD
NoD
NoD
NoD
NoD
2.-Do you have any past due financial obligations with Miami-Dade County?
YES 0 NoD
If YES, please explain:
3.-Are you a relative of or do you have any business or financial interests with any elected Miami-Dade County
official, Miami-Dade County Employee, or Member of Miami-Dade County's Advisory Boards?
YES 0 NoD
If YES, please explain:
Any false information provided on this affidavit will be reason for rejection and disqualification of your project-funding request to Miami-Dade
County
The answers to the foregoing questions are correctly stated to the best of my knowledge and belief.
________ By_:~~~](~~Si~n-a7tu-re-O~f~AP_-m~lica~~nt:)~~~~~~~ ________________ ~(Daml ________________________________________ _
Sworn to and subscribed before me this ____ day of ___________ ...J. 20 __ .
Personally known, ____________________________ _
Or produced identification __________ Notary Public-State of ______ _
_____ ~__,=_~~------------My commission expires ______ _
(Type of identification)
(Print, type or stamp commission name of notary public)
Page 7of9 CD152131413N
••
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PH CO)
ATTACHMENT E
UNIFORM AFFIDAVITS
COLLUSION AFFIDAVIT
(Code of Miami-Dade County Section 2-8.1.1 and 10-33.1) (Ordinance No. 08-113)
BEFORE ME, A NOTARY PUBLIC, personally appeared _____ -'--_______ _
(Insert Name of Affiant)
who being duly sworn states:
I am over 18 years of age, have personal knowledge of the facts stated in this affidavit and I am
an owner, officer, director, principal shareholder andlor I am otherwise authorized to bind the bidder of
this contract.
I state that the bidder of this contract: .
o is not related to any of the other parties bidding in the competitive solicitation, and that the
contractor's proposal is genuine and not sham or collusive or made in the interest or on behalf of
any person not therein named, and that the contractor has not, directly or indirectly, induced or
solicited any other proposer to put in a sham proposal, or any other person, firm, or corporation to
refrain from proposing, and that the proposer has not in any manner sought by collusion to secure
to the proposer an advantage over any other proposer.
o is related to the following parties who bid in the solicitation which are identified and listed below:
Note: Any person or entity that fails to submit this executed affidavit shall be ineligible for contract
award. In the event a.recommended contractor identifies related parties in the competitive solicitation its
bid shall be presumed to be collusive and the recommended contractor shall be ineligible for award
unless that presumption is rebutted by presentation of evidence as to the extent of ownership. control
and management of such related parties in the preparation and submittal of such bids or proposals_
Related parties shall mean bidders or proposers or the principals, corporate officers, and managers
thereof which have a direct or indirect ownership interest in another bidder or proposer for the same
agreement or in which a parent company or the principals thereof of one (1) bidder or proposer have a
direct or indirect ownership interest in another bidder or proposer for the same· agreement. Bids or
proposals found to be collusive shall be rejected.
By:
Signature of Affiant
Print Name of Affiant and Title
==-"="7....,..,..,=====::=-:.2_0 __ . _____ . __ ._ .. .-Date"
-'---'-'_'_'_1_'_'
Federal Employer Identification Number
Print Name of Finn
Address of Firm
Page 8 of9 CD/52131413N
.. , '
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
ATTACHMENT E
UNIFORM AFFIDAVITS
SUBSCRIBED AND SWOR~ TO (or affirmed) before me this __ day of ___ • 20_
He/She is personally known to me or has presented ______________ as
identification. Type of identification
Signature of Notary Serial Number
Print or Stamp Name of Notary Expiration Date
Notary Public State of __ _
Notary Seal
Page 90f9 CDJ52131413N
'. '
to
MfAtif-,.t,:qili PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
DEVELOPER'S AFFIDAVIT THAT MIAMI-DADE COUNTY TAXES,
FEES AND PARKING TICKETS HAVE BEEN PAID
(Section 2-8.1 (c) of the Code of Miami-Dade County, as amended by Ordinance No. 00-30)
and
THAT DEVELOPER IS NOT IN ARREARS TO THE COUNTY
(Section 2-8.1 (h) of the Code of Miami-Dade County, as amended by Ordinance No.OD-B7)
I, • being first duly sworn, hereby state and certify
that the foregoing statements are true and correct:
By:
1. That I am the Developer (if the Developer is an individual), or the _______ (fill in the title of
the position held with the Developer) of the Developer.
2. That the Developer has paid all delinquent and currently due fees or taxes (including but not limited
to, real and personal property taxes, utility taxes. and occupational taxes) collected in the normal
course by the Miami-Dade County Tax Collector, and County issued parking tickets for vehicles
registered in the name of the above developer. have been paid.
3. That the Developer is not in arrears in excess of the enforcement threshold under any contract
final non-appeasable judgment. or lien with Miami-Dade County. or any of its agencies or
instrumentalities, including the Public Health Trust, either directly or indirectly through a firm,
corporation, partnership or joint venture in. which the Developer has a controlling financial interest
For purposes hereof, the term "enforcement threshold" means any arrearage under any individual
contract, non-appeal able judgment, or lien with Miami-Dade County that exceeds $25,000 and has
been delinquent for greater than 180 days. For purposes hereof, the term "controlling financial
interesf' means ownership, directly or indirectly, of ten percent or more of the outstanding
capitai stock in any corporation, or a direct: or indirect interest of ten percent or more in a firm,
partnership, or other business entity.
Signature of Affiant
Printed Name of Affiant and Title
__________ -.~----~20~----
Date
Federal Employer Identification Number
Printed Name of Firm
Address of Firm
SU BSCRIBED AND SWORN TO (or affirmed} before methis _____ day of ____ -:20, __ ---'
by _______________ ' He/She is personally known to me or has presented
------------------------,-.,-----,-,
-----:;:-----;,.-,-.--T-F::--."' __ ---as identification,
Type of Identification
Signature of Notary Serial Number
Print or Stamp Name of Notary Expiration Date
Notary Public-State of ______ _ Notary Seal
,~ ,
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
CONTRACTOR DUE DILIGENCE AFFIDAVIT
Per Miami-Dade County Board of County Commissioners (Board) Resolution No. R-63-14, County Vendors and
Contractors shall disclose the following as a condition of award for any contract that exceeds one million dollars
($1 ,000,000) or that otherwise must be presented to the Board for approval:
(1) Provide a list of all lawsuits in the five (5) years prior to bid or proposal submittal that have been filed against the
firm, its directors, partners, principals and/or board members based on a breach of contract by the firm; include the
case name, number and disposition;
(2) Provide a list of any instances in the five (5) years prior to bid or proposal submittal where the firm has defaulted;
include a brief description of the circumstances; .
(3) Provide a list of any instances in the five (5) years prior to bid or proposal submittal where the firm has been
debarred or received a formal notice of non-compliance or non-performance, such as a notice to cure or a
suspension from participating or bidding for contracts, whether related to Miami-Dade County or not.
All of the above information shan be attached to the executed affidavit and submitted to the Procurement Contracting
Officer (PCO)! AE Selection Coordinator overseeing this solicitation. The Vendor/Contractor attests 10 providing aU of the
above information, if applicable, to the PCO.
Contract No. :
Federal Employer
__________ Identification Number (FEIN):
Contract Title:
Printed Name of Affiant Printed Title of Affiant
Name of Rnn
Address of Firm Stale
NotarvPublic Information
Signature of Affiant
Date
Zip Code
Notary Public-State; ____________ _ Coun~of ___________________ _
Subscribed and sworn to (Dr affirmed) before me this ________ day of, __________ 20 __
----_._-------_._._._-------------_ .. _--.
By ____________________ He orshe is personally known to me D or has produced identification 0
Type of identification produced
Signature of Notary Public Serial Number
Print or Stamp of Notary Public Expiration Date Notary Public Seal
212014
, • •
CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
L No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the maldng of any Federal loan,
the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal contract, grant, loan, or
cooperative agreement
2. If any of the funds other than Federal appropriated funds have been paid-or will be
paid to any person for influencing or attempting to influence an officer or employee
of any agency, a Member of Congress, an officer or employee of Congress, or an
employee of a Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall complete and submit Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its
instructions.
3. The undersigned shall require that the language of this certification be included in
-the award documents for aU subawards at all tiers (including subcontracts, subgrants,
and contracts under grants, loans, and cooperative agreement in excess of $100,000)
and that all sUbrecipients shall certify and disclose accordingly.
4. This certification is a material representation of fact upon which reliance was placed
when this transaction was made or yntered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352,
title 31, U.S. Code. Any person who fails to file the required certification shall be
subject to a civil penalty of not less than $10,000 and not more than $100,000 for
each such failure.
By:
(Signature of Autborized Representative)
Print: ____________________________________________________ __
(print NlUJle of Firm and Authorized Representative)
---------------------------------------------------------'-----
Title:
Date:
• P' ... • 'f
MIAMI·
~
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
ETHICS COMMISSION DISCLOSURE STATEMENT FOR ALL PHCD PROGRAMS
Applicant:
Co-Applicant:
In accordance with Section 2-11.1 Subsection (c), and (d) of the Miami-Dade County Conflict of Interest
and Code of Ethics Ordinance, covered persons defined under 2-11.1 (b) are required to request an Ethics
Opinion if they are seeking to participate in housing assistance programs administered by the PHCD.
Check if any of the following applies to you:
o
o
o
o
IIwe do not currently work for Miami-Dade County (no additional action is requrred).
l!we am/are a School Board or Federal Employee. These employees are not covered under
Section 2-11.1 offhe Miami-Dade County Conmct of Interest and Code of Ethics Ordinance (no additional
action is required).
Ifwe am/are an appointed or elected County Official (Ethics Opinion must be sought ~
http://ethics.miamidade.govlfrequently-used-foTTTls.asp)
IIwe am/are a Miami-Dade County Employee (Ethics Opinion must be sought-
htfp:llethics.miamidade.govlfrequently-used-foTTTls.asp).
• Please provide the department and division nam.e below:
o IIwe am/are immediate family to a Miami-Dade County employee, appointed or elected official.
(*) Immediate family is defined as spouse, domestic partner, parents, stepparents, children and
stepchildren (Ethics Opinion must be sought -http://ethics.miamidade.gov/frequently-used-forms.asp).
• Please provide the following information regarding the County employee, appointed or elected
official:
Name of employee,
appointed or elected
official:
Department,
Division, or Board:
Signature of
Applicant
Signature of
--------Co-Applfcaft-t
Date:
Warning: Title 1 B, US Code Section 1001, states that a person Who knowingly and willingly makes false or fraudulent statements to any Department or
Agency of the United States Is guilty of a felony. State law may also provide penaltfes for false or fraudulent statements.
ALC/AMlCAlCDI1/62414N
Agency's letterhead
SAMPLE
AGENCY NAME
DISCLOSURE ABOUT RELATED PARTIES
(DATE)
THERE ARE NO BOARD MEMBERS OF THE _--,(",-,A:..=-GE=N~C=-...:.Y--,-N-==--A:.:...:.;M=E..L..-) __ _
WHO HAVE ANY RELATIONSHIP OR HAVE MADE ANY TRANSACTION WITH
OTHER ENTITIES THAT MIGHT RESULT IN A CONFLICT WITH (AGENCY
NAME) OPERATIONS.
-----------------------------------. --------------------------._----------------------------------------------------
.... ~
, . '
County Construction Sign
(Only areas circled are subject to change)
DGOB DNON GOB
Din Ground 1 Sided DIn Ground 2 Sided
DA-Frame 1 Sided DA-Frame 2 Sided
This Form to be Email to:
Makingston Chery: cmakin@miamidade.gov
and Hernan lopez: lopezh@miamidade.gov
Sign is 4' X 8' with 12' post
C:arI05 A. GlmimDX
Mayor
Je:lln MonestitnB
Chairman
Estaban Bovo, Jr.
VIC9 Chairman
a:u'~r:t J. Jor~n
Distria1
• Project Managerto mark location of
sign(s) on site .
• Installer to call Uncle for underground
inspection before digging.
Services Ticket
Index code
GOB Capital Project Number
Project Name
Project Number
Quantity required LI ______ -.l
Project Manager
Name: __________________________ _
Department: ____________________ _
. Address: ____________________ _
Phone Number: ----------
District Commissioner
. . .. other Funding Source(s) (Max 3-logos)
• For GOB Projects only
~~
Sign location address
Plus specific location of sign placement
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
ATTACHMENT G
FAIR SUBCONTRACTING POLICIES
(Ordinance 97-35)
FAIR SUBCONTRACTING PRACTICES
In compliance with Miami-Dade County Ordinance 97-35, the Developer submits the following
detailed statement of its policies and procedures of awarding subcontracts:
I hereby certify that the foregoing information is true, correct and complete_
Signature of Authorized Representative: ________________________ _
_______ _ _______ IitIe:_ _____ __ _________ _ ____________________ _ _ ______ D~.t~~ __ ~_ ~~~===-__ = __ = ___ = ___ = _____ = __ =
Firm Name: -------------------------FEIN: ________ _
Address: ___________________ _ City: ________ State: _______ _
Zip Code:
Telephone: _______________ _ Fa~ ______________ ___
CD/51/31313N -
rtfAhl
\2i t:hu ATTACHMENT H
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT (PHCD)
SUBCONTRACTOR/SUPPLIER LISTING
(Ordinance 97-104)
Firm Name of Prime Contractor/Developer -----------------------------------------
This form, or a comparable listing meeting the requirements of Ordinance No. 97-104, MUST be completed
by the developers on County contracts for purchase of supplies, materials or services, including professional
services which involve expenditures of $100,000 or more, and aff developers on County or Public Health
Trust construction contracts which involve expenditures of $100,000 or more. This form, or a comparable
listing meeting. the requirements of Ordinance No. 97-104, must be completed and submitted even
though the developer will not utilize subcontractors or suppliers on the contract The developer
should enter the word "NONE" under the appropriate heading on this form in those instances where
no subcontractors or suppliers will be used on the contract. The developer who is awarded the contract
shall not change or substitute first tier subcontractors, direct suppliers or the portions of the contract work to
be performed, or material!i to be supplied from those identified, except upon written approval of the County.
~ll'ilt~l)}~l.i~~f;~\~~~~~ltllill~f.~~
. -----------------------------------_._--_ .. _--._---_. -_. __ . ----_.-------_._-_ .. _---_. __ ._---_._-------------._._---_. __ ._--------------------------_. ---.. ---... _---_ ... -_ .. --_._-----. -_ .. -.
I certify that the representations contained in this Subcontractor/Supplier Listing are to the best of my knowledge
true and accurate.
Signature Developer(s)
Date
Print Name Print TItle
Authorized Representative
(Duplicate if additional space is needed)
Page 1 of1 CD/53/31413N
..
" "
PUBLIC HOUSING AND COMMUNITY DEVELOPMENT
Agreement
ATTACHMENT I
To Authorize Examination of Records and Adhere to Records Retention Requirements
The undersigned agrees to the stipulations noted below for all work, materials, and services provided under
this agreement dated and/or for a/l other third-party agreements/contracts for labor, materials,
and services related to the work covered by this agreement for the ____________ _
projecUactivity .
The undersigned shall ensure, and shall require all parties with whom it contracts to ensure, that Miami-Dade
County, the Department of Housing and Urban Development, or Comptroller General of the United States, or
any of their duly authorized representatives shall, have access to and the right to examine any of the following
records from the awardee, suh-recipient, developer, contractor, subcontractor, suppliers and/or any other
entity involved in any capacity in the above-referenced projecVactivity, for seven (7) years after final payment
under contract Records shall include, but are not limited to, the following:
Contracts, sub-contracts, audits, financial books, ledgers, copies of canceled checks (front
and back), wire transfer confinnations, payment requests (draws), invoices, receipts,
drawings, maps, pamphlets, designs, electronic tapes, computer drives and diskettes,' other'
media storage, pertinelit books, documents, papers, or other records-whether physical;,
electronic, or in any form-involving transactions related to this contract for the purpose of
making audits, examinations, excerpts, and transcriptions.
The awardee, sub-recipient, developer, contractor, sub-contractor, sub-tier, suppliers and or any other entity
involved in any capacity in the above-referenced project shall adhere to the following records retention
requirements:
-a) Maintain, and require that its sub-contractors and suppliers maintain complete and accurate records to
SUbstantiate compliance with the requirements set forth in the contracVagreement documents for this
project.
b) The undersigned shall retain such records, and all other documents related to the services and
materials fumished for this project, for a period of three (3) years from the completion of the activity or
project.
Other information:
a) The County may conduct unannounced visits to offices, satellite offices, work sites, supplier
warehouse, etc. of all entities involved in any capacity in the above-referenced project.
b) Pursuant to the contrac~ there may be additional records requirement not listed in this agreement.
'Entity Name: Employer ID #lFID #:
Fu" Address (including City, ST and Zip) and Email Address
------------------------SigIjatufe-:------------------------
Print Name: Date:
I rltle:
Check one, as applicable:
Developer Prime-Contractor = Sub-contractor or sub-tier sub-contractor _ other (specify) ________ _
if This material is available in an accessible fannat upon request. CD/61131616