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Tania Perez for Youth Services o io - a 7q„Lc PROFESSIONAL SERVICES AGREEMENT BETWEEN THE CITY OF MIAMI BEACH, FLORIDA AND TANIA PEREZ FOR YOUTH SERVICES RELATED TO THE CITY'S SERVICE PARTNERSHIP INITIATIVE THIS AGREEMENT made and entered into this 1st day of November, 2010, by and between the CITY OF MIAMI BEACH, FLORIDA (hereinafter referred to as City), having its principal offices at 1700 Convention Center Drive, Miami Beach, Florida, 33139, and Tania Perez, (hereinafter referred to as Contractor), whose address is 7955 Hawthorne Ave. Miami Beach, FL 33141. SECTION 1 1.1 DEFINITIONS Agreement: This Agreement between the City and Contractor, and any exhibits and /or attachments hereto. City Manager: The Chief Administrative Officer of the City. Contractor: For the purposes of this Agreement, Contractor shall be deemed to be an independent contractor, and not an agent or employee of the City. Services: All services, work and actions by the Contractor performed pursuant to or undertaken under this Agreement, as described in Section 2 and Exhibit "A" hereto. Fee (Compensation): Amount paid to the Contractor to cover the costs of the Services. Risk Manager: The Risk Manager of the City, with offices at 1700 Convention Center Drive, Third Floor, Miami Beach, Florida 33139, telephone number (305) 673 -7000, Ext. 6435, and fax number (305) 673 -7023. 1 SECTION 2 SCOPE OF WORK (SERVICES) The Contractor will provide attendance tracking and truancy intervention services for up to Seventy Five (75) youth and their families in accordance with The Children's Trust Miami Beach Service Partnership Grant, dated November 1, 2010. The scope of work to be performed by Contractor is further detailed in Exhibit "A," entitled "Scope of Services." The Contractor shall report to the City of Miami Beach, Neighborhood Services Department, Office of Community Services, Division Director. SECTION 3 COMPENSATION 3.1 FIXED FEE Contractor shall be compensated for the Services, as set forth in Section 2 and Exhibit "A ", as follows: (a) Provision of attendance tracking, initial written communication, follow -up communication, school or home meeting, and assistance in development of Care Coordination Plan services for up to Seventy Five (75) youth and their families at Nineteen Dollars and Forty -Four Cents ($19.44) per each hour worked for up to one hundred forty four (144) hours, for a maximum not to exceed Two Thousand Seven Hundred Ninety -Nine Dollars and Thirty -Six Cents ($2,799.36). Contractor's compensation shall be further subject to and conditioned upon all or any portion of the Services to be provided herein being allowable and within the Scope of Services delineated in Exhibit "A ". Notwithstanding the preceding, Contractor's total compensation during the term of this Agreement shall not exceed the maximum allowable sum of Two Thousand Seven Hundred Ninety -Nine Dollars and Thirty -Six Cents ($2,799.36). 3.2 INVOICING Contractor shall submit bi- weekly invoices and bi- weekly time sheets, as set forth in Exhibit "B ", which includes an itemized, detailed description of the Services, or portions thereof, provided (including the clients served) and cost(s) for same. Invoices and supporting documentation shall be submitted to Maria Ruiz, Division Director, Office of Community Services, 1700 Convention Center Drive, Miami Beach, Florida, 33139. 3.3 METHOD OF PAYMENT Payments shall be made within thirty (30) days of the date of invoice, in a manner satisfactory to and as approved and received by the City Manager and /or his designee, who shall be the Division Director, Office of Community Services. 2 SECTION 4 GENERAL PROVISIONS 4.1 RESPONSIBILITY OF THE CONTRACTOR With respect to the performance of the Services, the Contractor shall exercise that degree of skill, care, efficiency and diligence normally exercised by recognized professionals with respect to the performance of comparable services. In its performance of the Services, the Contractor shall comply with all applicable laws, ordinances, and regulations of the City, Miami -Dade County, the State of Florida, and the federal government, as applicable. 4.2 PUBLIC ENTITY CRIMES A State of Florida Form PUR 7068, Sworn Statement under Section 287.133(3)(a) Florida Statute on Public Entity Crimes shall be filed with the City's Procurement Division, prior to commencement of the Services herein. 4.3 DURATION AND EXTENT OF AGREEMENT (TERM) The term of this Agreement shall commence upon execution of this Agreement by all parties hereto, and shall terminate on October 31, 2011. 4.4 TIME OF COMPLETION The Services to be rendered by the Contractor shall be commenced upon receipt of a written Notice to Proceed from the City subsequent to execution of the Agreement by the parties, and shall be completed no later than October 31, 2011. 4.5 INDEMNIFICATION Contractor agrees to indemnify and hold harmless the City of Miami Beach and its officers, employees and agents, from and against any and all actions, claims, liabilities, losses, and expenses, including, but not limited to, attorneys' fees, for personal, economic or bodily injury, wrongful death, loss of or damage to property, at law or in equity, which may arise or be alleged to have arisen from the negligent acts, errors, omissions or other wrongful conduct of the Contractor, its employees, agents, sub - consultants, or any other person or entity acting under Consultant's control, in connection with the Contractor's performance of the Services pursuant to this Agreement; and to that extent, the Contractor shall pay all such claims and losses and shall pay all such costs and judgments which may issue from any lawsuit arising from such claims and losses, and shall pay all costs and attorneys' fees expended by the City in the defense of such claims and losses, including appeals. The Contractor's obligation under this Subsection shall not include the obligation to indemnify the City of Miami Beach and its officers, employees and agents, from and 3 against any actions or claims which arise or are alleged to have arisen from negligent acts or omissions or other wrongful conduct of the City and its officers, employees and agents. The parties each agree to give the other party prompt notice of any claim coming to its knowledge that in any way directly or indirectly affects the other party. 4.6 TERMINATION, SUSPENSION AND SANCTIONS 4.6.1 Termination for Cause If the Contractor shall fail to fulfill in a timely manner, or otherwise violate any of the covenants, agreements, or stipulations material to this Agreement, the City shall thereupon have the right to terminate the Services then remaining to be performed. Prior to exercising its option to terminate for cause, the City shall notify the Contractor of its violation of the particular terms of this Agreement and shall grant Contractor seven (7) days to cure such default. If such default remains uncured after seven (7) days, the City, upon three (3) days' notice to Contractor, may terminate this Agreement and the City shall be fully discharged from any and all liabilities, duties and terms arising out of /or by virtue of this Agreement. Notwithstanding the above, the Contractor shall not be relieved of liability to the City for damages sustained by the City by any breach of the Agreement by the Contractor. The City, at its sole option and discretion, shall additionally be entitled to bring any and all legal /equitable actions that it deems to be in its best interest in order to enforce the City's right and remedies against the defaulting party. The City shall be entitled to recover all costs of such actions, including reasonable attorneys' fees. To the extent allowed by law, the defaulting party waives its right to jury trial and its right to bring permissive counter claims against the City in any such action. 4.6.2 Termination for Convenience of City NOTWITHSTANDING SECTION 4.6.1, THE CITY MAY ALSO, FOR ITS CONVENIENCE AND WITHOUT CAUSE, TERMINATE THIS AGREEMENT AT ANY TIME DURING THE TERM HEREOF BY GIVING WRITTEN NOTICE TO CONSULTANT OF SUCH TERMINATION, WHICH SHALL BECOME EFFECTIVE SEVEN (7) DAYS FOLLOWING RECEIPT BY THE CONSULTANT OF THE WRITTEN TERMINATION NOTICE. IN THAT EVENT, ANY FINISHED OR UNFINISHED DOCUMENTS AND OTHER MATERIALS PREPARED AND OR OTHERWISE COMPILED BY CONSULTANT PURSUANT TO ITS PROVISION OF THE SERVICES CONTEMPLATED IN SECTION 2 AND IN EXHIBIT "A ", SHALL BE PROMPTLY ASSEMBLED AND DELIVERED TO THE CITY, AT 4 CONSULTANT'S SOLE COST AND EXPENSE. IF THE AGREEMENT IS TERMINATED BY THE CITY AS PROVIDED IN THIS SUBSECTION, CONSULTANT SHALL BE PAID FOR ANY SERVICES SATISFACTORILY PERFORMED, AS DETERMINED BY THE CITY AT ITS SOLE DISCERTION, UP TO THE DATE OF TERMINATION; PROVIDED, HOWEVER, THAT AS A CONDITION PRECEDENT TO SUCH PAYMENT, CONSULTANT SHALL HAVE DELIVERED ANY AND ALL DOCUMENTS, MATERIALS, ETC, TO CITY, AS REQUIRED HEREIN. 4.6.3 Termination for Insolvency The City also reserves the right to terminate the remaining Services to be performed in the event the Contractor is placed either in voluntary or involuntary bankruptcy or makes an assignment for the benefit of creditors. In such event, the right and obligations for the parties shall be the same as provided for in Section 4.6.2. 4.6.4 Sanctions for Noncompliance with Nondiscrimination Provisions In the event of the Contractor's noncompliance with the nondiscrimination provisions of this Agreement, as applicable, the City shall impose such sanctions as the City or the State of Florida may determine to be appropriate, including but not limited to, withholding of payments to the Contractor under the Agreement until the Contractor complies and /or cancellation, termination or suspension of the Services and /or the Agreement. In the event the City cancels or terminates the Services and /or the Agreement pursuant to this Subsection the rights and obligations of the parties shall be the same as provided in Section 4.6.2. 4.7 CHANGES AND ADDITIONS Any changes and additions to the terms of this Agreement shall be by a written Y 9 9 Y amendment, signed by the duly authorized representatives of the City and Contractor. No alteration, change, or modification of the terms of this Agreement shall be valid unless amended in writing, signed by the parties hereto, and approved by the City. 4.8 OWNERSHIP OF DOCUMENTS Any changes and additions to the terms of this Agreement shall be by a written amendment, signed by the duly authorized representatives of the City and Contractor. No alteration, change, or modification of the terms of this Agreement shall be valid unless amended in writing, signed by the parties hereto, and approved by the City. 5 4.9 AUDIT AND INSPECTIONS Upon 24- hour's written notice, the City Manager (on behalf of the City) and /or such authorized representatives as the City Manager may deem to act on the City's behalf, may, during Contractor's normal business hours, audit, examine and make audits of all contracts, invoices, materials, payrolls, records of personnel, conditions of employment, and any and all other data and /or records and /or documents relating to all matters covered by this Agreement. Contractor shall maintain any and all such records, as necessary to document compliance with the provisions of this Agreement. 4.10 ACCESS TO RECORDS Contractor agrees to allow access during normal business hours to all records including, without limitation, Contractor's financial records, to the City and /or its authorized representatives, and agrees to provide such assistance as may be necessary to facilitate audit by the City and /or its representatives, when and as the City Manager, in his sole and reasonable discretion, may deem necessary to ensure compliance with the provisions of this Agreement including, without limitation, as they pertain to any financial audits (with applicable accounting and financial standards). Contractor shall allow access during normal business hours to any and all records, forms, files, and documents which have been generated in performance of this Agreement, by the City and /or its authorized representatives. 4.11 INSURANCE REQUIREMENTS The Contractor shall not commence any work and /or Services pursuant to this Agreement until all insurance required under this Section has been obtained and such insurance has been reviewed and approved by the City's Risk Manager. Contractor shall maintain and carry in full force during the term of this Agreement the following insurance: 1. Contractor General Liability, in the amount of $1,000,000. 2. Contractor Professional Liability, in the amount of $200,000. 3. Workers Compensation & Employers Liability, as required pursuant to Florida Statutes. All insurance required hereunder must be furnished by insurance companies authorized to do business in the State of Florida. Original certificates of insurance for the above coverage must be submitted to the City's Risk Manager at the Office of the Risk Manager of the City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139. The Contractor is solely responsible for obtaining and submitting all insurance certificates for its sub - contractors. 6 All insurance policies must be issued by companies authorized to do business under the laws of the State of Florida. The companies must be rated no less than "B +" as to management and not less than "Class VI" as to strength by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. Compliance with the foregoing requirements shall not relieve the Contractor of the liabilities and obligations under this Section or under any other portion of this Agreement, and the City shall have the right to obtain from the Contractor specimen copies of the insurance policies in the event that submitted certificates of insurance are inadequate to ascertain compliance with required overage. All of Contractor's certificates, as required in this Section 4.11, shall contain endorsements providing that written notice shall be given to the City at least thirty (30) days prior to termination, cancellation or reduction in coverage in the policy. The Contractor shall not commence any work and /or Services pursuant to this Agreement until the City's Risk Manager has received, reviewed and approved, in writing, certificates of insurance showing that the requirements of this Section (in its entirety) have been met and provided for. 4.12 ASSIGNMENT, TRANSFER OR SUBCONTRACTING The Contractor shall not subcontract, assign, or transfer any work under this Agreement without the prior written consent of the City Manager which consent, if granted at all, shall be at the Manager's sole and absolute discretion. 4.13 SUB - CONTRACTORS The Contractor shall be liable for Contractor's services, responsibilities and liabilities under this Agreement, and the services, responsibilities and liabilities of sub - contractors, and any other person or entity acting under the direction or control of Contractor. When the term "Contractor" is used in this Agreement, it shall be deemed to include any sub - contractors and any other person or entity acting under the direction or control of Contractor. All sub - contractors must be approved, in writing by the City Manager, or his designee, prior to their engagement by Contractor (which approval, if granted at all, shall be at the Manager's sole discretion and judgment). 4.14 EQUAL EMPLOYMENT OPPORTUNITY In connection with the performance of this Agreement, the Contractor shall not discriminate against any employee or applicant for employment because of race, color, religion, ancestry, sex, age, and national origin, place of birth, marital status, or physical handicap. The Contractor shall take affirmative action to ensure that applicants are employed and that employees are treated during their 7 employment without regard to their race, color, religion, ancestry, sex, age, national origin, place of birth, marital status, disability, or sexual orientation, as applicable. 4.15 NO CONFLICT OF INTEREST The Contractor agrees to adhere to and be governed by the Metropolitan Miami -Dade County Conflict of Interest Ordinance, as same may be amended from time to time; and by City of Miami Beach Code, as same may be amended from time to time. The Contractor covenants that it presently has no interest and shall not acquire any interest, direct or indirectly which should conflict in any manner or degree with the performance of the Services. The Contractor further covenants that in the performance of this Agreement, no person having any such interest shall knowingly be employed by the Consultant. No member of or delegate to the Congress of the United States shall be admitted to any share or part of this Agreement or to any benefits arising there from. 4.16 PATENT RIGHTS; COPYRIGHTS; CONFIDENTIAL FINDINGS Any patentable result arising out of this Agreement, as well as all information, design specifications, processes, data and findings, shall be made available in perpetuity to the City, for public use. No reports, other documents, articles or devices produced in whole or in part under this Agreement shall be the subject of any application for copyright or patent by or on behalf of the Contractor or its employees or subcontractors. 4.17 NOTICES All notices and communications relating to the day -to -day activities shall be exchanged between a project manager appointed by the Contractor and the program coordinator designated by the City Manager, who shall be Neighborhood Services Department, Office of Community Services, Division Director. The Contractor's project manager shall be designated following execution of this Agreement by the parties and prior to commencement of the Services. All other notices and communications in writing required or permitted hereunder may be delivered personally to the representatives of the Contractor and the City listed below or may be mailed by registered mail. Until changed by notice in writing, all such notices and communications shall be addressed as follows: 8 TO CONTRACTOR: Tania Perez 7955 Hawthorne Ave. Miami Beach, FL 33141 (786) 797 -5051 TO CITY: City of Miami Beach Office of Community Services Attn: Maria L. Ruiz, Director 1700 Convention Center Drive Miami Beach, Florida 33139 (305) 673 -7491 4.18 LITIGATION JURISDICTION/VENUE This Agreement shall be governed by, and construed in accordance with, the laws of the State of Florida, both substantive and remedial, without regard to principles of conflict of laws. The exclusive venue for any litigation arising out of the Agreement shall be Miami -Dade County, Florida, if in State court, and the U.S. District Court, Southern District of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, CONTRACTOR AND CITY EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY OR ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS AGREEMENT. 4.19 ENTIRETY OF AGREEMENT This writing and any exhibits and /or attachments incorporated (and /or otherwise referenced for incorporation) herein embody the entire Agreement and understanding between the parties hereto, and there are no other agreements and understandings, oral or written, with reference to the subject matter hereof that are not merged herein and superseded hereby. 4.20 LIMITATION OF CITY'S LIABILITY The City desires to enter into this Agreement only if in so doing the City can place a limit on the City's liability for any cause of action for money damages due to an alleged breach by the City of this Agreement, so that its liability for any such breach never exceeds the sum of $1,000. Contractor hereby expresses its willingness to enter into this Agreement with Consultant's recovery from the City for any damage action for breach of contract to be limited to a maximum amount of $1,000. Accordingly, and notwithstanding any other term or condition of this Agreement, Contractor hereby agrees that the City shall not be liable to the 9 Contractor for damages in an amount in excess of $1,000 for any action or claim for breach of contract arising out of the performance or non - performance of any obligations imposed upon the City by this Agreement. Nothing contained in this paragraph or elsewhere in this Agreement is in any way intended to be a waiver of the limitation placed upon the City's liability as set forth in Section 768.28, Florida Statutes. [REMAINDER OF THIS PAGE LEFT INTENTIONALLY BLANK] 10 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their appropriate officials, as of the date first entered above. FOR CITY: CITY OF MIAMI BEACH, FLORIDA ATTEST: By: (17,Pod,(A. 1/4. • City Clerk Mayor FOR CONTRAC R: 0 d _ Tania Perez, ontractor ATTEST: B ii r" , , : Aa . 4- 416 'Vi " vfiii 0'1.2 It wit -s J0111'109 elho,,� ��� T MY 11 Print Nam Print Name u APPROVED AS TO FORM & LANGUAGE & FnR EXECUTION i - . t ti `/ ' & • me i 1 Date 11 EXHIBIT "A" "SCOPE OF SERVICES" The Contractor agrees to provide the following services to youth referred to the Success University program: Service Documentation of Service Letter to Parent for each child Copy of letter to Parent (attached) j missing five unexcused school ;..._ .............._.. _ -- ! — - -. _ { School or Home Meeting Sign -in sheet (attached) following letter to parents Assistance with completion of ! Care Coordination Plan (attached) Care Coordination Plan for eligible clients and their families Follow -up communication with Status Update Form (attached) parents and students Weekly Attendance Tracking School Attendance Report Contractor further agrees to the terms and conditions established by The Children's Trust, the primary source of funds for Success University, as delineated in its Core Contract with the City of Miami Beach, Contract Number 903 -109, dated August 1, 2009. Related Definitions: School or Home Meeting — School or Home Meeting must be attended by the youth student, parent or guardian of the youth, Community Involvement Specialist and one representative from the City of Miami Beach; it is documented by sign -in sheet. Weekly Attendance Tracking — Weekly attendance tracking is documented by the School Attendance Report and clearly indicates the dates and classes from which the youth was absent or present. Letter to Parent — Letter to parent is prepared from a set template and documented as a copy of the signed letter. Care Coordination Plan — The Care Coordination Plan is a tool that provides a comprehensive, individualized proposal that addresses the holistic needs of clients and their families. Follow -up Communication — Follow -up Communication with parents and students includes the submission of the Care Coordination Plan to the client and their family by e -mail or mail and at least one phone conversation during which details of the Care Coordination Plan are explained. Services will be deemed as provided when the following documentation is provided within the noted timeframes: Service Documentation ' Submission Deadline 1, Letter to Parent Copy of letter 72 business hours from 12 identification of eligibility School or Home Meeting Sign -in sheet 72 business hours from provision of service Assistance with Completion I Care Coordination Plan 10 business days from of Care Coordination Plan completion of Intake & Assessment Follow up Communication Status Update Form 10 business days from completion of Intake & Assessment Weekly Attendance ` School Attendance Report Weekly during school year Tracking excluding spring and winter ! break Service Deliverables Service Unit of Service j Service Location Timeframe Letter to Parent Up to 500 youths Miami Beach All eligible clients will Senior High School I have letters mailed within 72 business hours of receipt of referral School or Home One each for up to Miami Beach All eligible school Meeting 500 youths; follow -up Senior High School meetings will be meeting for up to 200 I completed within thirty youths 1 ; (30) days of receipt of referral Assistance with One each for up to Miami Beach All eligible clients will Completion of Care 400 youths Senior High School ; have Care Coordination Coordination Plan Plan completed within 5 business days of the Family Group Conference Follow up One each for up to Miami Beach All clients for whom Communication 400 youths Senior High School Care Coordination Plans are developed will receive follow -up services within 72 business hours from completion of Care Coordination Plan Weekly Attendance Up to 400 youths Miami Beach , All enrolled youth will Tracking Senior High School ' have attendance records checked weekly Failure to meet contracted service units within the allocated timeframe may result in the City subsequently reducing the Contractor's service level and allocated funding accordingly. 13 If the Contractor is unable to fulfill the contracted service level within the allocated timeframe for each service component, the City reserves the right reduce service t t e t o t to educe sery P � Y 9 levels accordingly across the funded service spectrum. If the Contractor is unable to fulfill the contracted service level and the City subsequently reduces service and funding levels, the City reserves the right to select another vendor to fulfill the remaining service units. The City will select the alternate vendor at its sole discretion. Reporting Requirements The Contractor will provide the City with a bi- weekly reimbursement request and by- weekly time sheets utilizing the City's Reporting Forms (attached). Monthly reports and reimbursement requests will be submitted via any of the following methods: • Electronic mail • Facsimile • Standard mail • Hand delivery Monthly reports will not be considered acceptable unless the following is met: • Forms are completely and accurately filled • Necessary back -up materials are included (client documentation, expense receipts, time logs, etc.) • Reports bear the signature of the person submitting the report on behalf of the Contractor The City will document Contractor service level data and monthly reports via Active Strategy software for inclusion in the monthly report to the Miami Beach Governing Board as well as the City's website. The failure to submit required monthly reports and invoices in a timely manner for two consecutive months will result in the forfeiture of one (1%) percent of the combined billed total for the two months in question. These forfeited funds will be used exclusively for client incentive materials as approved by the Miami Beach Service Partnership Governing Board. These forfeited funds will be submitted to the City by the Contractor via check within 30 days. Engagement Strategies The Contractor will adhere to the following engagement strategies in the delivery of services: 14 • Advise the client and his /her parents and /or guardians of the scheduled appointment for Intake & Assessment. • Provide client and his /her parents and /or guardians information regarding tutoring and other available services. Evaluation In the continuing effort to ensure programming excellence, clients will be provided with evaluation forms at the end of each programming component to gauge their satisfaction with services provided. The evaluation forms will be provided by the City and must be administered at the following time: • Completion of Home Visit Monitoring & Performance Reviews The City of Miami Beach reserves the right to inspect, monitor and /or audit the Contractor to ensure contractual compliance. This includes, but is not limited to: • Review of on -site service delivery • Inspection and review of client, budgetary and employee files (for those employees providing services under this contract) The monitoring tool provided by The Children's Trust, "Community and Neighborhood Services System of Care Programmatic Site Visit Form ", will be used to guide inspections and monitoring visits. (Copy included herein.) Master Calendar The Contractor will notify the City of any client appointment or anticipated service delivery at least 72 hours in advance of the appointment or service delivery for inclusion in the Success University Master Calendar that is distributed to all members of the Miami Beach Service Partnership via Community OS Software. The Master Calendar will be updated daily and distributed to the Partnership via Community OS Software. Training Requirements Frontline personnel (those conducting trainings) will be required to complete the following trainings prior to service provision: 15 Intake & Assessment Services ❑ Program Overview Training ❑ Intake & Assessment Training ❑ Community OS Software Training ❑ Client Evaluation Survey Training ❑ Care Coordination Plan Training While initial training expenses are covered by the City, the Contractor agrees to reimburse the City for the early departure (termination) of any trained staff member prior to this contract's termination on a pro -rated basis as follows: Training Cost Program Overview Training $66.56] Intake & Assessment Training $133.121 1 .1 2 Community OS Training $133.121 Client Evaluation Survey Training $16.64 , 16 EXHIBIT "B" INVOICING The Contractor agrees to provide the invoicing and services documentation as indicated in the bi- weekly Reimbursement Form and bi- weekly Time Sheets, as attached to this Exhibit. 17 "C" EXHIBIT C ATTACHMENTS The following documents are attached: • School Meeting Sign -in Sheet (1 page) • Care Coordination Plan (1 page) • Bi- weekly Time Sheet (1 page) • Bi- weekly Invoice (1 page) 18 u) w L w t MIC (1i • d 0 Q d ■i CD 0 w, s 0 • m 0 z 0 c 0 mi •.. c 0 c/ • 4) w ° c) a) r riArstr tIkAiltni Q) d ci 0 s d a a) _c � '2 Op E Q Q U C V < 1 — N . a) E a) i 3 m m a) w • _ 0) L. Z . O F x N x ^"€ r` (fl ti U -c CD a) s 6 ' CO C (B c a) u) ^' a) "0 a) a) � Ems . C L( - U %- (0 - `'t . . T aj 0 1 [ . a) a) a) La cn "O O d a) Q) Q (� c 0) GI M N ▪ U C N . cn C 'O (/) C p "- a) C Q W (0 u) O - C O (C a c N U a) +. w Q U � C CD ` g O L fa . 0 Ca ▪ c) U U) N c c a) 5 i. � U) cn O L ui ai ai C U . � m ci i L N E Ci p N (a 0 - 0 O (n d p, (-) C c6 ku Q a) V a) •O O E 0 a) 0 > a) .— O 0) 0 > • O C (B a) ca. 0) a) Tal C 0 .0 0 C C c i O 1, .,s a)' O < -" O • 0 U w T e O C CO (6 C 0 C 0 p 0) 41111111111111111111k 12 O C • _ o • C 0 ~y� U U 0 U 7 d (a < , R • N Q "". a V E N N a) CD • U (a "O 0 as m Z ., O a) C d U a) a) C p j o u) i C e 0 > >' ~ U C c (,) o C E U T . E — c CI _oo "- U v Success University S HEET ° EET Community Involvement Specialist - $19.44 per hour 1700 Convention Center Dr. Miami Beach, FL 33139 305 - 673 -7491 Employee Name: Title: Department: Supervisor: Date Start Time End Time Total Hrs. WEEKLY TOTALS: Employee Signature: Date: Supervisor Signature: Date: Office of Community Se Grant Name rvices /Grant Reimbursement quest Funder Success University The Children's T rust - Contract Number Awarded Amount Reporting Period Initials Expended Thus Far I $ - 1 Available Balance $ This Request $ - Balance Remaining $ - Fiscal Su mmary �,. }„ err s y � " '. �d,o.�:�:_ m.. .ro .ar.�,�.,,. "% - ., ..,.w. _,,,,, 4AF.,P,,,,v..,,,. � �.._„ .x,,, � .-_, MDCPS Contractor $ $ - $ - $ $ $ $ $ $ $ $ $ $ $ $ $ - $ $ $ $ $ - $ - TOTALS $ - $ $ $ Documentation Checklist Not Documentation submitted Submitted Service delivery documentation List of clients served and services provided I cert ify that t information provided above is accurate to the best of m y knowledge and that I have included all documentation required to ascertain the delivery of services as d elineated i n our contract with the City of Miami Beach. Signature Date Date Received by City of Miami Beach Amount Authorized for Reimbursement