4THE CITY OF PLEASANT LIVING
To:
FROM:
DATE:
SUBJECT:
BACKGROUND:
GRANTOR:
GRANT AMOUNT:
GRANT PERIOD:
ATTACHMENTS:
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
The Honorable Mayor & Members of the City Commission
Steven Alexander, City Manager
Agenda Item NO.:-1 March 7, 2017
A Resolution authorizing the City Manager to execute Amendment Three to
extend the grant agreement with Miami-Dade County for the South Miami
Senior Meals Program.
Miami-Dade County by and through its Office of Grants Coordination
awarded the City of South Miami $18,400 to fund the South Miami Senior
Meals Program. The grant period began on October 1st, 2014 and ended on
September 30th , 2015. Amendment One to the agreement provided
additional funding for the Senior Meals Program's services in the amount of
$13,800 and extended the contract for nine (9) months to June 30th , 2016.
Amendment Two to the agreement provided additional funding for the
Senior Meals Program's services in the amount of $4,600 and extended the
contract for three (3) months, to September 30th , 2016.
Amendment Three to the agreement provides additional funding for the
Senior Meals Program's services in the amount of $12,267 and extends the
contract for eight (8) months, to May 31St, 2017.
The City of South Miami will be allocating the funds to help support the
City's Senior Meals Program by paying for two (2) pre-packaged meals for
residents at the HUD Senior Center every Friday, based on the current
contract; each meal will cost $2.19.
The contract is retroactive and the City will be reimbursed any expenses
accrued from October 1st, 2016 through May 31st, 2017.
Miami-Dade County Office of Grants Coordination (Formerly Known As
Department of Human Services) -local Granting Agency
$12,267
Extension October 1st, 2016 through May 31st, 2017
Draft Resolution for Amendment Three
Miam\i-Dade FY 2015 Contract Amendment Three
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RESOLUTION NO, ___ _
A Resolution authorizing the City Manager to execute Amendment Three to the
fiscal year 2015 grant agreement with Miami-Dade County for the South Miami
Senior Meals Program,
WHEREAS, the City of South Miami was awarded a grant for the Senior Meals Program from
Miami-Dade County by and through its Office of Grants Coordination in the amount of $18,400 with an
expiration date of September 30th , 2015; and.
WHEREAS, the City of South Miami was awarded the first grant amendment to the agreement
which provided additional funding for the Senior Meals Program's services in the amount of $13,800 and
extended the contract for nine (9) months to June 30th 2016; and
WHEREAS, the City of South Miami was awarded the' Amendment Two to the agreement
provided additional funding to the agreement for the Senior Meals Program's services in the amount of
$4,600 and extended the contract for three (3) months to September 30th 2016; and
WHEREAS, Amendment Three to the agreement provides additional funding to the agreement
for the Senior Meals Program's services in the amount of $12,267 and extends the contract for eight (8)
months, to May 31st, 2017; and
WHEREAS, the Mayor and City Commission authorize the City Manager to execute Amendment
Two to the agreement with Miami-Dade County's Office of Grants Coordination to extend the expiration
date to May 31st, 2017 and accept additional funding in the amount of $12,267 for the South Miami
Senior Meals 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 Amendment Three of the grant
agreement with Miami-Dade County Office of Grants Coordination for the South Miami Senior Meals
Program to extend the expiration date to May 31 st, 2017 and accept additional funding in the amount of
$12,267. The grant agreement and amendments are 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 Liebman:
Commissioner Harris:
MIAMI-...,,......., [ttonum
Carlos Gimenez, Mayor
February 22, 2017
Angelica Bueno
Planning and Sustainability Administrator
City of South Miami·
6130 Sunset Drive
Miami, FL 33143
Office of Management and Budget
Grants Coordination
III NW 1st Street
22 nd Floor
Miami, FL 33128
T 305-375-4742 F 305-375-4454
Re: FY 2014~2015 General Revenue Contract I Amendment to Extend Terms
Dear Ms. Bueno:
This letter accompanies the contract amendment extending the terms of your agency's FY 2014-
2015 contract supported with Miami-Dade County's General Fund for an additional eight months
from October 1, 2016 through May 31, 2017. Please return three (3) originals of the amendment,
and the attached scope and budget, and Updated Affidavit for Background Screening properly
completed and signed by the person designated by your Board to sign on behalf of your agency
to execute the agreement, and to approve the scopes and the budgets.
We are asking that you return the signed agreements to our office within seven (7) days from the
date of this letter so that we may expedite the processing of the contract agreement. You also
have the option to include with the agreement package an original signed letter requesting an
advance payment of 25% of your agency's award for the eight-month period ending May 31,
2017. Intended to offset any potential cash flow problems, that payment request will be processed
after the final execution of the agreements by the Mayor or his designee.
Please contact your assigned Contracts Officer by telephone or bye-mail if you have any
questions regarding the final processing of your agency's agreement or the advance payment
request.
AMENDMENT# 3
TO FY 2014-2015 CONTRACT BETWEEN
MIAMI-DADE COUNTY
AND
CITY OF SOUTH MIAMI
15-SMIA~CB
Miami-Dade County by and through its Office of Management and Budget -Grants
Coordination located at 111 N.W. 1st Street, 22 nd Floor, Miami, FL 33128 (hereinafter called "the
County") and City of South Miami located at 6130 Sunset Drive, South Miami, Florida 33143
(hereinafter called "the Provider") hereby agree on this __ day of , 2017 to
amend the Grant Agreement dated July 27, 2015 between the County and the Provider (hereinafter
called "the Agreement").
WHEREAS, the County and the Provider entered into the Agreement for the provision of
Human and Social Services; and
WHEREAS, the Agreement allows for amendment by written consent of the County and the
Provider; and
WHEREAS, on April 14, 2016 the Agreement was extended for an additional nine month
period until June 30, 2016 upon written consent of the County and the Provider; and
WHEREAS, the Board of County Commissioners voted on January 20, 2016 to provide
additional funds to Provider pursuant to this Agreement for an additional three (3) month period from
July 1,2016 through September 30,2016; and
WHEREAS, the Board of County Commissioners voted on September 22, 2016 to provide
additional funds to Provider pursuant to this Agreement for an additional four (8) month period from
October 1,2016 through May 31,2017; and
WHEREAS, pursuant to the Agreement, Provider provides the following programs:
Program A: Elderly Services ~ South Miami Senior.Meals
Program B: The Afterschool House (Tutoring)
WHEREAS, the parties wish to attach and incorporate herein a new Attachment(s) A, Scope of
Service, an Attachment B, Budget, an Attachment B-1 -detailed project budget anq sources and uses
statement, and Attachment B-2 Agency-Wide Budget, all of which said new attachments shall pertain
to the period of time from October 1, 2016 through May 31, 2017, in order to reflect the additional
,'}(> services and funds provided pursuant to this Amendment,
NOW, THEREFORE, in consideration of the mutual covenants recorded herein and made part
of this Amendment and incorporated herein by reference as if fully set forth herein, the County and the
Provider agree to amend the Agreement as follows:
I. The 'whereas' clauses above are fully incorporated and adopted herein as if fully set forth
herein.
Page 1 of 4
15-SMIA-CB
II. Article 2. AMOUNT PAYABLE is hereby amended to add the additional amounts payable for
the services rendered during the extended period of the agreement as follows: .
Elderly Services -South Miami Senior Meals is awarded the additional amount of $12,267.
The Afterschool House (Tutoring) is awarded the additional amount of $16,065.
The additional funds authorized by this agreement shall only reimburse authorized
expenditures made and expenses incurred during October 1, 2016 through May 31, 2017.
The rest of Article 2 shall remain unchanged.
III. Article 3. SCOPE OF SERVICES is hereby amended as follows:
Attachments A(A3) and A(B3) Scope of Services shall be attached hereto and incorporated
herein and shall pertain to the period of time from October 1,2016 through May 31,2017,
The rest of Article 3 shall remain unchanged.
IV. Article 4. BUDGET SUMMARY is hereby amended as follows:
The following shall be attached hereto and incorporated herein and shall pertain to the period
of time from October 1, 2016 through May 31, 2017:
(1) Attachments B(A3) and B(B3) Budget for funds allocated under this Agreement as
amended; and
(2) Attachments B1 (A2) and B1 (B2) detailed project budget and sources and uses statements;
and
(3) Attachment B-2(C), Agency-wide Budget, which shall reflect the Provider's projected
revenues by funding source and by type of expense, including direct and indirect
expenses.
The rest of Article 4 shall remain unchanged.
V. Article 5. EFFECTIVE TERM is hereby amended as follows:
VI.
Both parties agree that the effective term of this Agreement shall commence on October 1,
2014 and terminate at the close of business on May 31,2017.
The rest of Article 5 shall remain unchanged.
Article 7. INSURANCE, Section B(J):is hereby amended as follows:
The Provider shall be responsible for assuring that the insurance certificates required in
conjunction with this Section remain in force for the duration of the effective term of this
Agreement (October 1, 2014 through May 31, 2017).
The rest of Article 7 shall remain unchanged.
VII. Article 24, Section (J) is hereby amended as follows.
Page 2 of 4
15-SMIA-CB
"Attachment K: Updated Background Screening Affidavit" is hereby listed beneath
"Attachment J: Authorized Signature Form."
The rest of Article 24 shall remain unchanged.
Attachment K, Updated Background Screening Affidavit, attached hereto, is hereby added
and incorporated as if fully set forth in this Agreement as amended.
VIII. All Provider's obligations pursuant to the Agreement remain ongoing, including but not limited
to the following: The Provider hereby agrees to maintain and to submit to the County updated
and current licenses, permits, background checks and insurance coverage, as applicable,
during the extended term of this Agreement, pursuant to Article 7. INSURANCE and to
Article 8. PROOF OF LICENSURE AND BACKGROUND SCREENING; and to provide
updated disclosures and notifications pursuant to Article 9 CONFLICT OF INTEREST and
Article 12. NOTICE REQUIREMENTS. Additionally, the Provider agrees to submit to the
County updated Attachment(s), including updated sworn, notarized Affidavit(s), within ten (10)
days of the occurrence of any material change to the information contained in the following
Attachments to the Agreement:
Attachment C:
Attachment D:
Attachment D-1:
Attachment E:
Attachment I:
Attachment J:
Collusion Affidavit
Miami-Dade County Affidavits
Due Diligence Affidavit
State Public Entities Crime Affidavit
List of Subcontractors and Suppliers
Authorized Signature Form
IX. All references in the Agreement to:
(1) Attachments A(A) and A(8) and the Scope of Services shall refer both to
Attachments A(A) and A(B), Attachments A(A 1) and A(B1), Attachments A(A2) and
A(B2), and Attachments A(A3) and A(B3).
(2) Attachments B(A) and B(B) shall refer both to Attachments B(A) and 8(B),
Attachments 8(A 1) and 8(B1), Attachments B(A2) and B(82), and Attachments
8(A3) and B(B3).
(3) Attachment B-2 shall refer both to Attachment B-2, Attachment 8-2(8), and
Attachment 8-2(C). .
X. Other than as expressly amended herein, all other terms and conditions of the Agreement shall
remain in full force and effect. If any conflict in language exists between the Agreement and this
Amendment # 3, the language in this Amendment # 3 shall prevail.
Xl. This Amendment # 3 is hereby made a part of the Agreement and is binding upon the County
and the Provider. This Amendment·# 3 shall be effective as of October 1, 2016, once it has. been
signed by both parties, and shall expire on May 31,2017. . ..
Page 3 of 4
15~SMIA-CB
IN WITNESS WHEREOF, the parties hereto have caused this Amendment # 3 to the Agreement to be
executed by their officials thereunto duly authorized.
By:
Name:
Title:
Date:
Attest:
CITY OF SOUTH MIAMI
Authorized Person OR
Notary Public
Print Name:
Title:
Corporate Seal OR Notary Seal/Stamp:
MIAMlwDADE COUNTY
By:
Name: Jennifer Moon
Title: Mayor or Mayor's Designee
Date: ------------------------
Attest: HARVEY RUVIN, Clerk
Board of County Commissioners
By:
Print Name:
Page 4 of 4
ATTACHMENT A (A3)
MIAMI-DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET
GRANTS COORDINATION
SCOPE OF SERVICE NARRATIVE
SECTION I: GENERAL INFORMATION
Name of Orgqnization: City of South Miami, Parks and Recreation Department
Address: 6130 Sunset Drive, South MiamL Florida 33143
Program Contact Person: Angelica Bueno, Planning & Sustainability Administrator
15~SMIA-CB~A
Phone Number: 305-668-2514 Fax Number: 305-663-6345
E-mail Address: abueno@southmiamifl.gov
Fiscal Contact Person: Alfredo Rivero!, CFO
Phone Number: 305-663-6343 Fax Number: 305-668-7388
E-mail Address: ariverol@southmiamifl.gov
Board President/Chair: N/A
Phone Number: N/A Fax Number: N/A
E-mail Address: N/A
') Non-Profit Entity 0 For-Profit Entity D
Contract Amount: $ 12,267 Contract Period: October 1, 2p16 -May 3l 2017
SECTION II: PROGRAM NARRATIVE
Descriptive Program Name: Elderly Services -South Miami Senior Meals
Describe the program goals:
The Senior Meals Program will provide positive social, cultural; educational, and recreational
opportunities for seniors residing in the City of South Miami. In addition, the program will create a
healthy environment for our senior population by encouraging physical activities, and providing
nutritional meals, which will lead to a healthier lifestyle for the targeted popUlation. Services will be
provided to residents at the HUD Senior Center for participants regardless of race, religion, gender, or
family income level that are 60 years and older.
Describe the program and services and how program funding will be used:
Page 1 of 3
ATTACHMENT A (A3)
Through our Parks and Recreation Department, the City of South Miami will provide prepared meals
to sixty-nine (69) residents that participate in activities at the HUD Senior Center located in South
Miami.
Identify what Commission District(s) will be served: District 7.
Identify the target population that will be served (Le., children/students, seniors, adults, families,
general population, businesses etc.): Seniors.
Identify the total number of the target population served (if more than one service, define for each):
69 Seniors.
SECTION III: PROFILE OF SERVICES
Annual workload measures (for each type of service to be provided including the number of clients to
be served in the program) [I.e., 3 hours of after school care for twenty-five (25) children ages 5 -10,
one home delivered meal for 50 seniors every day (18,250 meals)]:
The Senior Meals Program will provide two (2) pre-packaged meals (cantina-style) to a minimum of
sixty-nine (69) residents at the HUD Senior Center every Friday. The program will provide a minimum .
of 138 meals per week (69 seniors X 2 meals per week) for 34 weeks, for a maximum of 4,692 meals
. ($12,267/$2.45 per meal) during the 8 month ~ontract period.
Unit Cost (Define the unites) of service and detail the unit cost(s) for the service):
$ 12,267/69 c1ients:= $ 177.78 per client for the 8 month period.
Identify the period of service delivery for program component(s) that WILL NOT be provided year-
round: N/A.
Total number of unduplicated clients that will be served during the program year is: 69.
Total number of clients receiving ongoing services: 69.
Total number of new clients will be: O.
A typical client will be in the program for: -.JLday(s)..JL month(s) ~week(s) ...Q.,.hour(s)
What is the defined workload measure (meals provided, therapy, tutoring, or after-school care hours,
program completion, employment, etc.): meals provided. .
The total'number of workload measures that will be provided during the 8 months contract period:
Up to 5,006 meals.
Location of Service Site(s) and Hours of Service at each Site: (Ust all administrative and program
sites including the physical street address with zip codes, contact information and the hours of
operation for each site): '
The City of South Miami Senior Center is located at 6701 SW 62nd Avenue, South Miami, Florida
33143. The hours of operation are Monday-Friday from 7:00 am -3:00 pm.
Page 2 of 3
ATTACHMENT A (A3)
The service site phone number is: (305) 663-6319; email: qpough@southmiamifl.gov.
SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives.
Please quantify and note timeframe for completion of each objective [i.e.,75% of children attending
after school tutoring program will increase their reading score by a full letter grade as measured by
pre and post-testing during the contract year]).
• One hundred percent (100%) of the elderly participants that receive weekend meals will satisfy
one of their basic needs.
e Ninety percent (90%) of the elderly participants will gain sufficient nutrition from the meals
provided which will be measured by the type of menu provided.
• Ninety percent (90%) of the elderly participants will be satisfied with the services provided
which will be measured by surveys.
BACKGROUND SCREENING INFORMATION
The program(s) is serving "at-risk" population: Yes ... X... No .... ,. N/A. ........ .
The minimum age for a client is: 60 years.
The maximum age for a client is: N/A years.
Staff or volunteers working directly with seniors for more than 10 hours: Yes ... ZS; ••. No .... N/A .......
SECTION V: ORGANIZATIONAL SUPPORT ACTIVITIES
Describe how your organization will do outreach and public awareness of program activities:
Public announcements will made during televised City Commission meetings, and on the City's Web.
Describe how your organization will complete a self-assessment of its services throughout the
program year (Le., client satisfaction questionnaires, online surveys, independent organization audit
review, etc.): Annual survey.
SECTION VI: CERTIFICATION
I certify that the Scope of Services of the program will be carried out as described above. I also
understand that I must receive prior formal approval from Miami-Dade County Office of Management
and Budget-Grants Coordination for any variations from the operations and performance described
abov~,.
Signature and Title of Person Completing Form
Page 3 of 3
Angelica Bueno
Planning & Sustain ability Administrator
Print Name and Title
15-SMIA-CB-A
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Ci of South Miami
Requested By: _________ ~-_:_-~---_
Executive Director I Agency Designee Name
Executive Director I Age~lIY Designee Signature
Reviewed By: _____________________ _
OMS Contracts Officer Signature
Date
Date
Attachment B{A3)
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2116/2017
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TOTAL: I. -V.
Approved By:
~B~o-a-rd~P-re-s~id~e-n~tl~\Ii~I~ce-=P-~-s~id~e-n~t~N-am-e----------------------------
Soard President I Vice President Signature
Approved By: :-:-:::-c::_-:---:--::;::-c~__::__:__:_::_:_--_:_::__:_
OMS Contracts & Grants Administrator Signature Date
Charged to
This Award
Date
Fiscal Approval (if needed)
Accountant
Supervisor.
15-SMIA~CB~A
DIRECT COSTS
Contractual Services
City of South Miami
Elderly Services ~ South Miami Senior Meals
Miami~Dade County
October 1, 2016 -May 31,2017
I .
Senior Meals ($12,267):
Attachment 81 (A3)
1 .
Beginning October 1, 2016 through May 31, 2017, the City of South Miami Parks and
Recreation Department staff will distribute every Friday, two (2) prepackaged meals (cantina-
style) to a minimum of sixty-nine (69) residents at the HUD Senior Center every Friday. These
meals will be prepared by the catering company Montoya Holdings, Inc. at a cost of $2.45 per
meal. In total, the program will provide a minimum of 138 meals (69 residents x 2 meals
distribute every Friday, one for both Saturday and Sunday) to residents at the HUn Senior
Center for 34 weeks; for a maximum of 5,006 meals ($12,267/$2.45 per meal) during the 8
month contract period.
The Senior Site Manager and Recreational Leaders are the responsible staff for the
administrative functions related to this program. Their salaries and all other costs related to the
program are covered by the City of South Miami.
TOTAL AWARD: $12,267
'. "(,
Page 1 of 1
ATTACHMENT A (83)
MIAMI-DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET
GRANTS COORDINATION
SCOPE OF SERVICE NARRATIVE
SECTION I: GENERAL INFORMATION
Name of Organization: City of South Miami, Parks & Recreation Department
Address: 6130 Sunset Drive, South Miami, Florida 33143
Program Contact Person: Angelica Bueno, Planning & Sustainab,ility Administrator
1.~ .'
Phone Number: 305-668-2514 Fax Number: 305-663-6345
E-mail Address: abueno@southmiamifl.gov
Fiscal Contact Person: Alfredo Rivero!, CFO
phone Number: 305-663-6343 Fax Number: 305-668-7388
E-mail Address: Ariverol@southmiamifl.gov
Board President/Chair: N/A
Phone Number: N/A Fax Numb~r: N/A
E-mail Address: N/A
Non-Profit Entity 0 For-Profit Entity 0
Contract Amount: $16,065 Contract Period: October 1, 2016 -May 31 J 2017
SECTION II: PROGRAM NARRATIVE
Descriptive Program Name: The Afterschool House (Tutoring)
Describe the program goals:
The goal of the Afterschool Hous~ (Tutoring) Program is to provide positive social, ",cultural,
educational, and recreational opporttinities for children residing in the City of South Miami. The
program will also create a friendly environment and essential after-school services to participants
regardless of race, religion, gender, family income, and/or ability to pay for children ages 5 -14 years
(kindergarten to eighth grade).
Describe the program and services and how program funding will be used:
The Afterschool House Program operates from October 2016 -May 2017. Funding will be used to
provide tutoring services which will include reading and math curricula, as well as homework
assistance.
Page 1 of 3
ATTACHMENT A (83)
Identify what Commission District(s) will be served: District 7
Identify the target population that will be served (i.e., children/students. seniors. adults. families,
general population, businesses etc.): Children, ages 5 -14.
Identify the total number of the target population served (if more than one service, define for each):
One hundred (100) children for the Afterschool House Program.
SECTION III: PROFILE OF SERVICES
Annual workload measures (for each type of service to be provided including the number of clients to
be served in the program) [Le., 3 hours of after school care for twenty-five (25) children ages 5 -10,
one home delivered meal for 50 seniors every day (18,250 meals)]:
The program takes place 39 weeks throughout the year and one hundred (100) children grades K
through 8th grade will participate in the program.
Unit Cost (Define the unites) of service and detail the unit cost(s) for the service):
The unit cost to serve one hundred participants (100) is $160.65 per period.
Identify the period of service delivery for program component(s) that WILL NOT be provided year-
round: Winter Recess (December 26 -January 6)
Total number of unduplicated clients that will be served during the program year is: 100.
Total number of clients receiving ongoing services: 100.
Total number of new clients will be: 0
A typical client will be in the program for: _day(s) _ month(s) ~ weekes) _hour(s)
What is the defined workload measure (meals provided, therapy, tutoring, or after-school care hours,
program completion, employment, etc.): After-school care hours/tutoring 1.5 hours per day (1 hour of
homework, 30 minutes reading).
The total number of workload measures that will be provided during the 8 month contract period:
24,000 hours of after-school care/tutoring assistance (100 children x 1.5 hours per day x 5 days per
week x 32 weeks).
Location of Service Site(s) and.,/::Iours of Service at each Site: (List all administrative .. and program
sites including the physical street"address with zip codes, contact information and the hours of
operation for each site):
• The Afterschool House (Tutoring) Program is located at the Gibson-Bethel Community Center,
Murray Park -5800 SW 66th Street, South Miami, Florida 33143.
• Hours of Operation for the Center are Monday -Friday, 5:00 am -10:00 pm, Saturday, 9:00
am -6:00 pm, and Sunday, 10:00 am. -2:00 pm and services will be provided from 2:00 pm-
6:00 pm, Monday -Friday.
Page 2 of 3
ATTACHMENT A (83)
D Afterschool House (Tutoring) Program hours of operation: Monday -Friday, 2:00pm -6:00pm,
excluding holidays.
The service site phone number is: (305) 663-6319; email: qpough@southmiamifl.gov.
SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives.
Please quantify and note timeframe for completion of each objective [Le.,75% of children attending
after school tutoring program will increase their reading score by a full letter grade as measured by
pre and post-testing during the contract year]).
•
"
•
Eighty percent (80%) of the childr~h will increase their reading fluency and comprehension as
measured by various tests.
Ninety percent (90%) of the students will complete their homework assignments as measured
by report cards. .
Ninety-five percent (95%) of the children will participate in educational activities as measured
by the participation log.
BACKGROUND SCREENING INFORMATION
The program(s) is serving "at-risk" population: Yes ~ No-'.!.!.!.!..O..N/A. ........ .
The minimum age for a client is: 5 years.
The maximum age for a client is: 14 years.
Staff or volunteers working directly with children for more than 10 hours: Yes ... X... No !.!.!..:....N/A~
SECTION V: ORGANIZATIONAL SUPPORT ACTIVITIES
Describe how your organization will do outreach and public awareness of program activities:
Public awareness and outreach will be communicated through public announcements during televised
City Commission meetings, City's website, and flyers.
Describe how your organization will complete a self-assessment of its services throughout the
program year (Le., client satisfaction questionnaires, online surveys, independent organization audit
review, etc.): Parent Surveys which are conducted once a year and report cards which are collected
four (4) times a year.
SECTION VI: CERTIFICATION
I certify that the Scope of Services of the program will be carried out as described above. I also
understand that I must receive prior formal approval from Miami-Dade County Office of Management
and Budget-Grants Coordination for any variations from the operations and performance described
above.
Signature and Title of Person Completing Form Print Name and Title
Page 3 of 3
15-SMIA-CB-B
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Cit of South Miami
Requested Ely: _________________ _
Executive Director I Agency Designee Name
Executive Director I Agency Designee SignaflJre
Reviewed By: =:__:--------::.,-----------
OMS Contracts Officer Signature
Date
Date
Attachment 8(83)
I')' :!)ij>!';!';'i';1{,J%!;;~fX'ii!NETITEM;'B8PG€f.fFORMiD:0i0D: i}';;:,:i01 rf5smJ;~:T::~'~;lij[f;;:q;;;cl
.~~ ~::~.~.;~:S:::/.~}):/ ::";':':'.;.~:'/;'; :(:i
III. TOTAL: I. -V.
Approved By:
~B~o-a-rd~P-~-s~id~e-n~t/~VJ~I~ce-=P-re-s~id~e-~7t~N-am~e---------~-------
Board President I Vice President Signature
Approved Ely:
OMS Contracts & Grants Administrator Signature Date
Date
Fiscal Approval (if needed)
Accountant:
Supervisor:
DIRECT COSTS
Personnel: Salaries
City of South Miami
The Afterschool House (Tutoring)
Miami-Dade County
October 1, 2016 -March 31, 2017
Teachersllnstructors ($16,065):
Attachment 61 (83)
These line items represent the salaries of three (3) part-time instructors. These instructors will
dedicate 100% of their time to students enrolled in the Afterschool House (Tutoring) program.
These instructors will provide tutoring and homework assistance for children participating in the
program. Grant funds are being charged 100% of the positions' salaries for the period up to 32
weeks, depending on the hours worked per week. After County funds are expended, the City of
South Miami will continue to pay for their salaries until the program is completed.
The staff person responsible for the administration of this program is the Director of Parks and
Recreation and his salary and all other additional costs (i.e. utilities) are covered by the City of
South Miami and participant fees.
TOTAL AWARD: $16,065
I.
Page 10f1
"
ATTACHMENT K
UPDATED BACKGROUND SCREENING AFFIDAVIT
Affidavit Attesting Compliance with Both Contractual and Any and All Legally Applicable Background
Screening Requirements for Provider Personnel, Subcontracted Personnel and Volunteers
The undersigned affiant makes the following statements under oath, under penalty of perjury, which is a
first degree misdemeanor, punishable by a definite term of imprisonment not to exceed one year and/or a
fine not to exceed $1,000, pursuant to Sections 837.012, 775.082 and 775.083, Florida Statutes.
STATE OF FLORIDA
COUNTY OF MIAMI-DADE
Before me, the undersigned authority, personally appeared _________ --:--_____ --:--_
Authorized Provider Representative
of _________________ , who being by me first duly sworn, deposes and says:
(Name of Contracted Provider)
I swear and affirm that the above-named contracted Provider is compliant with the background screening
requirements contained in Article 8 of the Contract attached hereto and incorporated herein by reference.
I further swear and affirm that the above-named contracted Provider is compliant with any and all
background screening requirements pertaining to its personnel, subcontracted personnel and volunteers
that may be required pursuant to applicable federal, state or local laws or regulations.
Date: _______________ _
(Signature of CEO/Exec. Dir.)
Sworn to and subscribed before me in' Miami-Dade County, Florida this the _____ day of
____________________ ,20 .
_ Who is personally known to me
_ Who has produced identification: ____ ----, ______ _
Type of Identification
Signature of Notary Public
State of Florida at Large
Print, type or stamp name of Notary Public
My Commission Expires:
OMB Rev. 10/1/15 ~