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FY 2015 US HUD Continuum of Care (CoC) ProgramFY 2015 United States Department of Housing and Urban Development (US HUD) Continuum of Care (C0C) Program Grantee: Miami -Dade County through its Homeless Trust And Subrecipient: City of Miami Beach, Florida Program Name: City of Miami Beach Outreach Grant #: FL0177L4D001508 Cover page ---page 1 Index --page 2 Whereas and preanible---page 3 1. Statement of Work a. Activities ---page 3 b. Time Schedule ---page 4 c. Budget ---page 4, 5, 6 2. Records and Reports a. Financial Management ---page 7 b. Records and Access to Records ---page 8 c. Public Itecords---page 9 INDEX d. Encouraging Efficient Use of Information Technology and Shared Services--- page 10 e. Reports: i) Progress Reports; ii) APR; Survey; iv) Participants' Application for Housing; v) Program Iriconie; vi) program Guidelines; vii) Audit; viii) Incident; ix) COOP through x) Mandatory Disclosures ---pages 10 through 13 3. Special andGeneal Conditions a. Staff Responsibility ---page 13 b. Client Referral Process ---page 13 c. Documents to facilitate the Reimbursement of services ---page 13 d. Compliance with rules, guidelines of CoC Rental Assistance items i) through v) ---page 13 e. VAWA Emergency Transfer Plan -2, -page 14 f. Performance Improvement Plans ---page 14 General Conditions 1. insurance; ii) Indeinnification;'iii) Certification and Representation; iv) Conflict of Interest; v) Affidavits--- pages 14 through 17 h. Civil Rights ---page 18 through 20 4. Suspension and Termination a. Suspension ---page 21 b. TerniinatiOnIT7-pge 21 through 2 PP 5. Future Funding A ications---page 23 6. Reversion ofAssets a. Term of Commitment ---page 24 " b. Repayment of Grant ---page 24 c. Prevention of Undue Benefit e.dDeeveloacraattii°onnooff Restrictive Covenant and4Declaration of Restrictions ---page 25 License or Permit ---page 25 7. Uniform Administrative Requirements a. Accounting Standards, Costs Principles and Regulations -7 -page 26 b. Retention of Records ---page 27 8. Additional Requirements Items a through gg ---pages 27 through 35 9. Religious Organizations ---page 36 10. Health Insurance Portability and Accountability Act (HIPAA)--- page 36,37 11. Proof of Licensure / Certification and Background Screening a. Licensure / Certification---page 37 b. Background Screening---page3e8 Signature ---page 39 Index of Attachments A through K ---page 40 g. CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach Page 2 Subrecipient Agreement between Miami -Dade County and City of Miami Beach, Florida for the FY 2015 US HUD CoC Program Grant #FL0177L4D001508 City of Miami Beach Outreach THIS AGREEMENT, entered this day of 201 by and between Miami -Dade County, on behalf of its Homeless Trust (HT) (hereinafter called the "Grantee"), and City of Miami Beach, Florida, (hereinafter referred to as the "Subrecipient") under this Agreement. WHEREAS, the Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH Act) amended the McKinney-Vento Homeless Assistance Act, consolidating three (3) separate reauthorized McKinney-Vento Homeless Assistance Programs, Supportive Housing Program (SHP), Shelter Plus Care (S+C) Program, and Section 8 Moderate Rehabilitation Single Room Occupancy (SRO) Program into a single grant program known as the Continuum of Care (CoC) Program. WHEREAS, the Grantee has applied for and received funds .from the United States Department of Housing and Urban Development (US HUD) under the McKinney-Vento Homeless Assistance Act as amended by The HEARTH Act of 2009 (42 U.S.C. 11301, et seq.). WHEREAS, the Grantee agrees to comply with all requirements of this Agreement and to • accept responsibility for such compliance by the Subrecipient to which it makes grant funds available; and NOW, THEREFORE, it is agreed between the parties hereto that; 1. Statement of Work a. Activities — The Subrecipient shall adhere to the "Continuum of Care Program Grant Agreement and Exhibit 1 Scope of Work for FY 2015 Competition", Attachment A, which is incorporated herein and governed by the Continuum of Care (CoC) Program rules and regulations (the "Rule"). The Subrecipient shall comply with all applicable federal, state and local laws, regulations and ordinances, including but not limited to 24 CFR Part 578, as may be amended, the McKinney- Vento Homeless Assistance Act (42 U.S.C. 11301 et seq.) (the "Act"), as maybe amended, the Consolidated and Further Continuing Appropriations Acts of 2013 and 2014 (The Consolidated Appropriations Act of 2014, Public Law 113-76, approved January 17, 2014 in the "FY 2014 HUD Appropriations Act") as .well as with any other terms and conditions as HUD may have established in the applicable Notice of Funds Availability (NOFA) and with any applicable guidance, requirements and directives provided by US HUD and with any applicable guidance, requirements and directives provided by Miami -Dade County Homeless Trust. The Subrecipient shall carry out the activities specified in the "Scope of Service and US HUD eSnaps Documents" Attachment B. The Subrecipient shall also adhere to the Standards of Housing and Services as set forth in the "Mimi -Dade County Homeless Trust Standards of Care", as may be amended from time to time and incorporated herein by reference. The Subrecipient shall adhere to all applicable CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 3 federal, state and local laws, regulations, rules and standards, as well as with the terms of this Agreement including all attachments. b. Time Schedule —. The. Grantee and: the Subrecipientagree that this Agreement shall become effective on lune 1, 2016. This Agreement shall expire on May 31, 2017, one (1) year from the effective date. Any cost incurred by the Subrecipient beyond this date will not be paid by the Grantee, except as specifically provided herein.Notwithstanding any provision herein to the contrary, certain requirements' imposed on the Subrecipient by this Agreement and federal regulations may continue for term of at least fifteen (15) years from the, date of initial occupancy or service, as provided in this Agreement or as specified by or" regulation: The requirements of this Agreement shall remain in' effect during any time' period that the Subrecipient has control over any funds generated or provided in connection with this Agreement, including program income. c. Budget — The Grantee agrees, subject to the availability of funds and payment of funds to the Grantee" by the United States Department of. Housing and Urban Development and subject to the. Subrecipient's compliance with all applicable laws and agreement terms as determined by the Grantee, to pay for contracted activities according to the terms and conditions contained within this Agreement, Subrecipient's application for the CoC Homeless Assistance Program, and the Subrecipients NOFA application documents as Project Sponsor and "Scope of Service and; US HUD eSnaps documents" including the Budget incorporated herein as Attachment B, in an amount not to exceed $0.00 for Rental Assistance, $0.00 for Leasing, $60,946.00 for Supportive Services, $0.00 for Operations, $0.00 for HMIS costs and $4.266.00 for overall Project Administration Costs which added together equals an amount of $65,212.00 in TOTAL BUDGET. If the Grantee, Miami -Dade County through its Public Housing and Community Development ;Department>(PHCD)".or such other department or party as may be selected,by Miami -Dade County Homeless Trust, is the Rental "Administrator; then the Grantee shall pay the "CoC Program HAP Contract" Attachment K payments directly to Landlord, owner(s): The total amount. awarded pursuant to, this Agreement; in amount up to $0.00 for Rental Assistance funds has been allocated for use as eligible rental assistance payments on behalf of the Subrecipient's program participants: Pursuant t� 24 CFR 578.59, the Grantee shall retain 50% of the Overall Project Administration Costs, except where limitations are imposed as may be applicable pursuant to 42 USC § 11383 (a). If applicable, f the Subrecipient ,shall; be reimbursed for capital funding on an incremental basis, based;on the . following completion benchmarks: 30%, 30%, 30% and 10% to be provided when a final Certificate of Occupancy is obtained from the developer, in accordance with any ,applicable laws and regulations. All other activities shall be paid on a reimbursement basis following the submission of a monthly invoice along with the appropriate supporting documentation. CoC Grant #FLO177L4D001S08, City of Miami Beach, Outreach Page 4 In accordance with federal requirements including 24 CFR Part 578.73, the Subrecipient agrees to provide match funds in an amount that represents no less than twenty-five percent (25%) cash or in-kind contributions on all eligible grant funds, except leasing. If in-kind services providedthrough a third party are used to fulfill part of the match, a fully -executed Memorandum of Understanding (MOH) between the Subrecipient and the third party that will provide the services must be submitted to the Grantee. The budget figures above represent the original line item totals as delineated in the "Continuum of Care Program Grant Agreement" Attachment A. The Subrecipient may propose to shift funds by less than 10% between eligible categories in the "Scope of Service and US HUD eSnaps Documents" Attachment B, if the appropriate match is provided, the administrative costs are not increased and the proposed shift is submitted in writing for the Grantee's consideration. The Grantee may, but is not required to, approve the proposed shift. Any approval must be in writing. As such, if Attachment B is modified as described above, the figures within the "eSnaps Application" may not match the contractee d figures delineated in the "US HUD Grant Agreement." In accordance with 24 CFR 578 the Subrecipient is prohibited from moving more than 10% from one budget line item in a project's approved budget to another without written "US HUD grant amendment" and amendment to this Agreement. This is a Performance-based Agreement to deliver housing and or services to Subrecipient's Continuum of Care (CoC) program participants. The Subrecipient shall provide three hundred fifty (350) outreach placements services through the Supportive Services Only for homeless persons under the Continuum of Care Program. This program with a main office located. at Walk In Center 555 17 Street, Miami Beach, Florida 33139. Service is located in Miami -Dade County, Florida. The Subrecipient shall provide services as outlined in the Attachments to this Agreement as required, pursuant to the FY 2015 US HUD CoC Program NOFA Competition as submitted in the project application, incorporated herein by reference. Availability of funds shall be determined in the Grantee's sole discretion. If this Agreement is for permanent supportive housing or permanent housing for eligible homeless individuals and /or homeless families; the Subrecipient agrees that, with some exceptions, no undocumented or illegal immigrants shall be eligible for services provided under this Agreement. Additionally, the Subrecipient shall comply with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), as may be amended and applicable law, in verifying citizenship, residency and immigration status of potential participants. The Subrecipient shall comply with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), as may be amended and applicable law, in verifying citizenship, residency and immigration status of potential participants. The Subrecipient hereby acknowledges that PRWORA prohibits housing or services provided under this Agreement to undocumented or illegal immigrants. CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 5 When the Grantee, Miami -Dade County through its Homeless Trust is the rental administrator of the CoC Program (also known as Tenant -Based, Sponsor - Based or Project Based Rental Assistance). If this Agreement' is for permanent supportive housing or permanenthousing for homeless participants, under the CoC Program and the Grantee, Miami -Dade County through its Homeless Trust is the rental administrator of payment,of Housing Assistance payment (HAP) Contracts the following rules, regulations, responsibilities apply: Agreement specifically for housing under Tenant -based or Sponsor -based, or Project -based Rental Assistance, it is the Subrecipient's responsibility to identify eligible rental units for eligible homeless program participants: in' partnership with the established CoC's :Coordinated, Outreach and Assessment System. The Landlord identified by the Subrecipient must enter into a "Housing Assistance Payment (HAP) Contract", Attachment.K attached to. this; Agreement __..... en the Subrecipient is the rental administrator of payments of Housing Assistance Payment': (HAP) Contracts for. the Permanent Housing Tenant -Based, Sponsor Based or Project' Based Rental Assistance or Rapid : Rousing CoC Program.` If this Agreement is ,for permanent supportive; housing or permanent housing for homeless participants, under the Legacy'SHPr or OK Rental Assistance Program and the Subrecipient is, the rental administrator of the "Housing Assistance Payments (HAP) ' Contracts" Attachment J, the' following rules, regulations, and responsibilities apply. It is the Subrecipient's sole responsibilityto identify eligible rental units for eligible homeless program` participants in partnership With the established CoC's Coordinated Outreach and Assessment. It is the Subrecipient's sole responsibility to enter into a "Housing Assistance Payment :(HAP)` Contract" Attachment J with the eligible owner of each'rental,unit' ("Landlord") The Subrecipient must use the HAP Contract template forms in Attachment J attached' to `this Agreement when the Subrecipient contracts'with the Landlord'. The Subrecipient_is responsible for ensuring the HAP; Contract complies with 'all program requirements, terms and conditions of this Agreernent;and applicable law: The Grantee, Miami -Dade County, shall not be a party' to the HAP Contract. Shahid the Subrecipient desire or require pthe shall advise any amendments to, the HAP Contract tem late form; , the Grantee of the proposed amendments) and explain why the is desired or required prior to, arnendingthe,HAP Contract template form. The. Subrecipient is solely responsible for paying rent to the Landlords on time. The .:Subrecipient shall develop forms. for Landlords'' use in collecting late fees arising from Subrecipieflt'S failure to pay a Landlord rept on.time. The Subrecipient shall be solely responsible for paynient.pf any late feearisingfrom any late rent payment(s) to landlord(s):-.-The; Subrecipient,shall indemnify tlle Grantee, Miami -Dade County, and pay all costs of defense, including attorneys' fees arising from or related to the HAP Contract and this provision. ; CoC Grant #FL0177L4D001S08, City of Miami Beach, Outreach Page`6 a. Financial Management - The Grantee and the Subrecipient shall adhere to the requirements for financial reporting as required pursuant to the Federal Office of Management and Budget (OMB) Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225, and 230 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as may be amended or updated from time to time; 24 CFR Part 578, as may be amended or updated from time to time; and any other applicable laws, regulations and standards. Requests for payment shall be submitted to the Grantee by the fifteenth (15th) of the month in the following manner. All requests shall include supporting documentation for each line item, including payroll reports, time sheets, invoices, leasing agreements and shall be signed by the Executive. Director, Financial Officer or other duly authorized fiscal agent of. the Subrecipient in the forms incorporated herein as combined "Consolidated Financial Record and Reports", Attachment E, Reimbursement shall be provided only for eligible costs associated with the activities outlined in the budget contained within the "Scope of Service and US HUD e -Snaps Documents" Attachment B. Any reimbursement may be withheld or reduced by the Grantee if missing receipt of documents verifying the in-kind or cash match expenditures or compliance requirements are not met. Cash match or in-kind contributions must be used for the costs of activities that are eligible in the governing regulations. Any reimbursement may be withheld pending the receipt of approval by the Grantee of all reports and documents required herein, including but not limited to the submission of an accurate and complete Annual Performance Report (APR) "Performance Reports (Monthly and Annual) HMIS and Fiscal Report" Attachment F. The Subrecipient shall provide a certification statement for all annual financial reports and requests for payment which states the following: "By signing this report, 1 (insert name here) certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the federal award. I am aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or other offense." In no event shall the Grantee funds be advanced to any of the Subrecipient's subcontractors hereunder. The parties agree that the Subrecipient may request a revision, amendment, or modification of the schedule of payments or line item budget. However, such revisions, amendments or modifications shall be, in writing and subject to review and approval by the Grantee and, if applicable, by US HUD. If there is a request to shift greater than 10% of funds between funding activities, such requests shall be submitted to the Grantee no later than one hundred twenty (120) calendar days prior to the expiration of the grant. If the request is a shift of less than 10% of funds between funding activities, a modification or revision, shall be submitted to the Grantee no later than sixty (60) calendar days prior to the expiration of the grant. CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 7 Failure to submit the appropriate supporting documentation in a timely manner may result in the inability of the Grantee to revise, amend or modify the budget. A final request for reimbursement from the Subrecipient will be accepted by the Grantee up to thirty (30) days after the expiration of this Agreement. If the Subrecipient fails to comply,all rights to payments will be forfeited if the Grantee so chooses. A final report of expenditures shall be submitted to the Grantee within thirty (30) calendar days from the termination or expiration of this Agreement. If after the receipt of such final report, the Grantee'deterriizles that the Subrecipient has been paid funds not in compliance with the Agreement, and to which the Subrecipient is not entitled, the_Subrecipient shall be required to return such funds. However, if the _ Subrecipient submits documentation `demonstrating that the expenditure was in compliance with this Agreement to the satisfaction of the Grantee, the funds shall not have 'to be returned. The Grantee' shall have the sole and absolute discretion to determine if the Subrecipient is entitled to such funds and the decision of the Grantee in this matter shall be final and binding. b. Records and Access to Records Agreement records are defined as any and all books, records, client files (including client progress reports, referral forms, case notes andother reports or work product), documents, information, data, papers, letters, materials, electronic storage data and media whether written, printed, electronic or electrical, however collected or preservedwhich is or was produced, developed, maintained, completed, received, or compiled by or at the direction of the Subrecipient or any subcontractor directly or indirectly related to the duties and 'obligations required by terms of this Agreement, including but not limited to financial books and records, ledgers, drawings, maps, pamphlets, designs, electronic tapes, computer drives, flash drives and diskettes or surveys. The Subrecipient shall maintain Agreement records that document all actions to comply with and that relate to this Agreement, including those on race, ethnicity, gender, disability and homeless status data; and those in accordance with generally accepted accounting principles, procedures, and,practices as required in OMB Omni or Super Circular Uniform AdministrativeE Requirements, Cost Principles and Audit Requirements for Federal Awards which shall sufficiently and properly reflect all revenues and expenditures of funds provided directly or, indirectly by the Grantee pursuant to the, terms of this Agreement which shall include but not limited to a cash receipt journal, cash disbursements journal, general ledger, and all such subsidiary ledgers as may be reasonably necessary. The Subrecipient shall provide to the Grantee, upon request by the Grantee, all Agreement records. The requested Agreement records shall become the property of the Grantee without restriction, reservation, or limitation of their use and shall be made available by the Subrecipient at any time upon request by the Grantee. The Granteeshall have unlimited rightsto all, books, articles, or other copyrightable materials developed in the performance of this Agreement. These,unlimited rights include' the rights of royalty -free,; nonexclusive, andirrevocable license to reproduce, publish, or otherwise use, and. to -authorize others to use the work for public purposes. F.. Page 8 CoC Grant #FL01.77L4D001508, City of Miami Beach, Outreach The Subrecipient shall ensure that the Agreement records shall at all times be subject to and available for full access and review, inspection, or audit by Grantee and Federal personnel and any other persons so authorized by the Grantee. The Subrecipient shall include in all the Grantee approved subcontracts, language outlining eligible substantive programmatic services, recordkeeping and audit requirements as detailed in this Agreement. This includes all subcontractors eligible to carry out substantive programmatic services as detailed in this Agreement. The Grantee shall, in its sole and absolute discretion, determine when services are eligible substantive programmatic services and subject to the audit and recordkeeping requirements described in this Agreement. These records shall be maintained pursuant to this Agreement. If the Subrecipient received funds from or is under regulatory control of other governmental agencies, and those agencies issue monitoring reports, regulatory examinations, or other similar reports, then the Subrecipient shall provide to the Grantee a copy of each report and any follow-up communications and reports immediately upon such issuance unless such disclosure is a violation of those agencies' rules. c. Public Records —Pursuant to Section 119.0701, Florida Statutes, the Subrecipient shall: i. Keep and maintain public records that ordinarily and necessarily would be required by the Grantee in order to perform the service; ii. Upon request from the Grantee's custodian of public records identified herein, provide the Grantee with a copy of the requested records or allow the public with access to the public records on the same terms and conditions that the Grantee would provide the records and at a cost that does not exceed the cost provided in the Florida Public Records Act, Miami - Dade County Administrative Order No. 4-48, 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 this Agreement's term and following completion of the services under this Agreement if the Subrecipient does not transfer the records to the Grantee; and iv. Meet all requirements for retaining public records and transfer to the Grantee, at no Grantee cost, all public records created, received, maintained and / or directly related to the performance of this Agreement that are in possession of the Subrecipient upon termination of this Agreement. Upon termination of this Agreement, the Subrecipient shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the Grantee in a format that is compatible with the information technology systems of the Grantee. CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach Page 9 For purposes of this Article, the .term "public records" shall mean all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data processing software, or other material, regardless of the physical form, characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection withthe transaction of official business of the Grantee. In addition to penalties set for in Section 119.10, Florida Statutes, for the failure of the Subrecipient to comply .with Section .119.0701, Florida Statutes, and this Article II, Section 2.1 (QQ) of this Agreement, the ._ avail itself " the remedies set forth in this Agreement. If the Subrecipient has questions regarding the application of Chapter 119, Florida: Statutes, to the Subrecipient's duty to provide public records relating to this Agreement, contact Miami -Dade County's Custodian of Public Records at: Miami -Dade County Homeless Trust 111 NW 1st Street, 27th Floor, Suite 310 Miami, Florida 33128. Attention: Victoria L. Mallette, Executive Director Email: .tririallette(@iniainidade.gov` d. Encouraging 'Efficient. Use of Information Technology and Shared Services - in accordance with the May 2013 Executive Order on Making Open and Machine Readable the New Default for Government; Information, OMB Omni or Super Circular2 CFR Chapters I,' Chapters II, Part 200). et al. Section 200.335 Methods for Collection, Transmission and Storage of Information; the Subrecipient is encouraged whenever practicable, _to. ,collect; transmit and store Federal award - related information in open and machine-readable formats. Reports - The Subrecipient shallsubmit: to. the Grantee the reports described below or any other document in whatsoever form, manner,, or frequency as may be requested by the Grantee. These reports will be used for monitoring the progress, performance, and compliance with applicable Grantee and Federal requirements Progress Reports The Subrecipient shall submit a "Homeless Management Information System (HMIS)` generated 'Performance Report", Attachment F, along with a ..summary and the specified forms attached hereto as "Consolidated Financial Record and Reports", Attachment E. These reports may be revised or updated, by the Grantee fromtime to time; and shall describe the progress made by the Subrecipient in achieving . each of the objectives identified in "Scope of. Service and US HUD,eSnaps Documents" Attachment B. The reports shall explain the Subrecipient's progress including comparison of actualversus planned progress for the period. The reports are due by the fifteenth (15th) day of the following month. The request for reimbursement, are also due by the fifteenth (159 day following the close of the prior month•. Subrecipients that are Domestic Violence Programs shall participate in a HMIS- equivalent system. Such Subrecipients shall provide proof to the Grantee of the utilization of an alternative system to compile all required data for the Performance Report. CoC Grant`#FL0177L4D001508, City of Miami Beach, Outreach Page 10 ii. Annual Performance Report - The Subrecipient shall submit a HMIS generated "US HUD CoC. Annual Performance Report (0625-HUD-CoC-APR)" Attachment F, in addition to a complete and accurate report using supplemental "eSnaps CoC APR Financial and Performance Questions" provided by the Grantee Attachment F. The complete and accurate APR is due to the Grantee no later than thirty (30) days after the end of each operating year. The above referenced report may be substituted for any other US HUD required Report if approved by US HUD. iii. A Program Rating and Satisfaction Survey Report shall be conducted and retained by the Subrecipient in a separate file and available for review and monitoring or as requested by the Grantee. The Program Rating and Satisfaction Survey forms, included herein by reference only may be substituted or updated by the Grantee with a comparable satisfaction survey. iv. When the Grantee, Miami -Dade County is the Rental Administrator: The Subrecipient shall submit a complete an accurate CoC Program "Participant Application for Housing" Package, Attachment K, including all supporting documentation for each eligible program participant accepted through the CoC's established Coordinated Outreach and Assessment HMIS system to Miami -Dade County Homeless Trust, 27th Floor, Suite 310, 111 NW First Street, Miami, Florida 33128. Pursuant to 24 CFR 578.77(c), the Subrecipient must examine program participants' income initially, and at least. annually thereafter, to determine the amount of the contribution toward rent payable by the program participants. Adjustments to program participants' contribution toward the rental payment must be made as changes in income are identified. The Subrecipient is required for each program participant receiving assistance to notify the Grantee in writing of changes in the participants' income or other circumstances that affect the program participants' eligibility or need for assistance. The Subrecipient shall submit "Re -certification of Participation Application for Housing" Package Attachment K, no later than one hundred - twenty (120) calendar days before the expiration of term of the Lease Agreement and HAP Contract. The Re -certification application shall include documented evidence of the program participants' continued lack of sufficient resources and support networks necessary to retain housing without assistance from the CoC Program. When the Subrecipient is the Rental Administrator: The Subrecipient shall complete and maintain an accurate CoC Program "Participant Application for Housing" Package, Attachment J, including all supporting documentation for each eligible program participant accepted through the CoC's established Coordinated Outreach and Assessment HMIS system. Pursuant to 24 CFR 578.77(c), the Subrecipient must examine program participants' income initially, and at least annually thereafter, to determine the amount of the contribution toward rent payable by the program participants. Adjustments to program participants' contribution toward the rental payment must be made as changes in income are identified. The Subrecipient is required for each program participant receiving assistance to retain records for the Grantee's review, changes in the participants' income or other circumstances that affect the program participants' eligibility or need for assistance. The Subrecipient shall CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 11 retain records of "Re -certification of Participation Application for Housing" Package Attachment J, no later than one hundred -twenty (120) calendar days before the expiration of term of the Lease Agreement and HAP Contract. The Re -certification application shall include documented evidence of the program participants' continued lack of sufficient resources and support networks necessary to retain housing without assistance from the CoC Program. v. Program Income -the income received by the Subrecipient directly generated by a grant -supported activity. Program income earned during the grant term shall be retained and may either be 1) added to funds committed" to the project by HUD and the recipient and used for eligible activities in accordance with the requirements pursuant to 24 CFR 578 or 2) used as match. Program Income is reported and submitted to thenHomeless Trust monthly in the "Consolidated Financial Record and. Reports E vi. A "CoC Homeless Assistance Program Guidelines" Attachment G shall be completed and retained by the Subrecipient This report must be available upon request during any site visit or comprehensive monitoring or inspection as requested by the Grantee. This report is an informational guideline to assist in compliance to the CoC Homeless Assistance Program policies procedures and requirements and regulations, ` vii. Audit Reports — Subrecipients shall submit an audit conducted in accordance 'with the provisions of Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225, and 230 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as applicable, and with 24 CFR 578.99(g) which provides that Subrecipients must comply with the audit requirements of OMB Circular A-133, "Audits` of States, Local Governments, and Non-profit Organizations.". The Subrecipient shall, provide such reports no later than one hundred -eighty (180)` calendar days following the end of the .Subrecipient's fiscal year, for each year during which this Agreement ";remains` in force or until all funds earned from this Agreement have been so audited, whichever is later, provided that the Subrecipient has such an opinion prepared. TheSubrecipient shall comply with any and all other applicable audit and reporting requirements. viii.Incident Reports — The Subrecipient must report to Miami -Dade County Homeless Trustinformation related to any critical incidents occurring during the administration of its programs, using" form, "Incident Report" Attachment H. Such notification shall occur, within twenty-four (24) hours of the incident occurring In addition, the Subrecipient shall report , this incident to the appropriate authorities as wellas submit in writing a detailed account of the incident::: This Incident Report should be addressed to Miami -Dade County Homeless. Trust's Disaster Coordinator, as well as the Subrecipient's assigned Contract Officer. The Subrecipient shall, comply with, the, privacy, security and electronic transfer standards in transmittal of any Incident Report to comply with. Health Insurance- Portability and Accountability Act (HIPAA) in using appropriate safeguards to preventnon-permitted disclosures. This Incident Report shall be addressed to Miami -Dade County, Homeless Trust, Suite 310, 27th Floor, 111; NW 15. Street, Miami, Florida, 3312.8, (305) 375-1490 and facsimile (305) 375-2722. CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach Page 12 ix. The COOP Report -- The Subrecipient shall submit a Continuity of Operations Plan (COOP), also known as an Agency Wide and Program Specific Disaster Plan in PDF format and emailed as an attachment to Miami -Dade County Homeless Trust's Disaster Coordinator and an original paper copy submitted no later than April 1St of each operating year. x. Mandatory Disclosure - The Subrecipient is required to disclose in a timely manner and in writing "all violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award". Failure to make the required disclosures can result in a number of actions, including suspension and or debarment. 3. Special and General Conditions - a. The Subrecipient's Staff members providing eligible services under this Agreement are listed in the budget section of the "Scope of Service, US HUD eSnaps Documents Attachment 13. The Subrecipient shall additionally submit job titles and job descriptions upon request. b. The Subrecipient shall follow the client referral process in the Scope of Service contained within the "Scope of Service and US HUD eSnaps Documents" Attachment 13 and through the Continuum of Care (CoC)'s Coordinated Outreach and Assessment system. The client referral process may be amended by the Grantee to meet changing priorities of the Continuum of Care. All referrals shall be made to the Subrecipient and accepted by the Subrecipient through the established HMIS system. c. The Subrecipient shall provide any documentation necessary, such as the "W-9 Form" Attachment C, to facilitate the reimbursement of services. d. The Subrecipient shall comply with all rules, guidelines and regulations governing the CoC Rental Assistance program under 24 CFR 578, and any other applicable law, rules and regulations. i. Rental assistance projects must serve eligible program participants, including but not limited to retaining records of disability and homeless verification as part of the recordkeeping requirements. ii. Rental assistance funds are to pay Landlord owner(s) in the community the difference between the contract rent amount of the unit and the homeless participants' or tenants' contribution toward rent. The program participants' or tenants' contribution toward rent is determined by the type of program. Under tenant -based rentalassistance, sponsor -based rental assistance, and project based rental assistance, program participants are required to pay rent to the landlord as determined under 24 CFR 578.77. It is important to note in all the US HUD CoC Programs, the program participants enter into a Lease with the Landlord. iii. The Subrecipient must consistently follow policies and procedures used by the CoC's established Coordinated Outreach and Assessment (HMIS) system CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 13 in accepting referrals of eligible program participants pursuant to 24 CFR 578.7(a)(8). iv. The Subrecipient shall establish referral protocols, policies and procedures subject, to approval by Miami -Dade County Homeless Trust in documenting rejection of program participants accepted from the CoC's established Coordinated Outreach and Assessment (HMIS) system, which must include at a minimum, assurances that such rejections are justified and thatthe program participants are able to access another suitable program within a reasonable amount of time.. v. The' Subrecipient shall establish protocols, policies and procedures subject to approval by Miami Dade County' Homeless Trust and consistent with Miami -Dade County Homeless-Triust's-COC "Standards of Care" pertaining to termination of assistance to program participants. The Subrecipient may terminate assistance_, to program,; participants ,who violates program requirements:' Termination does not bar the Subrecipient from providing further assistance at a later date to ,the ;same participants, individual or family (household). The protocol, policies,and procedures must include at a minimum a formal process that recognizes the rights of individuals receiving assistance under due process of law. This process must also consist of: (1) Providing the program participant with a writtencopy ofthe program rules and the termination, process before.. the program, participant begins to receive assistance; (2) Written notice to the program participant containing a clear statement of ,the ,reason(s) for termination; . (3) A review of the decision., in_,which `the, program participant is given the opportunity to present written or oral objections before a person other than the person (or a subordinate of that person)who made or approved the termination decision; and (4) Prompt written notice of the,final decision to the program participant.: The Subrecipient providing permanent supportive housing for hard -to -house populations of homeless persons must exercise judgment and examine allextenuating circumstances in determining when violations are serious enough ; to, . warrant termination so that program participants' assistance is terminated only in the most severe cases. The Subrecipient shall comply with the Violence against Women Reauthorization Act " (VAWA) "as well' as with 24 CFR 5.200, as , may' be amended, and with all applicable pi•ovisions"of24''CFR Parts 5, 92, 200, 574; 576; 578, 880, 882, 883, 884; 886, 891, 960, 966, 982, and 983 and with such administrative rules and policy guidance relating 'to .'VAWA as may exist, be adopted, or be amended from time to time, as may be applicable. The Subrecipient may be subject to a Performance Improvement Plan (PIP) at the discretion of the Grantee. -; General Conditions The Subrecipient shall comply with all applicable federal, state and, local laws,. regulations, and required policies, including but not limited to the; Continuum of Care (CoC) Program Final Interim Rule,. 24 CFR Part 578, as may be amended from time to time, the McKinney-Vento Homeless Assistance Act, as may, be amended from time to time • (42 U.S.C. 11301. et seq.) (the "Act") the CoC Grant#FL0'177L4D001508, City of Miami Beach, Outreach Consolidated and Further Continuing Appropriations Acts of 2012, 2013, and 2014 the Homeless Definition Final Rule, published in the Federal Register on December 5, 2011, as may be amended from time to time; the "Continuum of Care Program Grant Agreement" Attachment A and all other federal requirements of this grant. The responsibility for knowledge of and compliance with all Federal and any other legal requirements is that of the Subrecipient. The Subrecipient shall also comply with any guidance provided by US HUD regarding this Agreement, program and the services offered hereunder, as well as with any guidance provided by US HUD applicable to this Agreement, program and the services offered hereunder. The Subrecipient shall abide and be governed by the requirements of the Americans with Disabilities Act (ADA), Subrecipient shall designate with its organization an ADA Coordinator to ensure -that all requirements of the ADA and any related applicable regulations and requirements are met by the Subrecipient. In addition, the Subrecipient agrees to comply with the following requirements. . Insurance If the Subrecipient is the State of Florida or an agency or political subdivision of the State as defined by Section 768.28, Florida Statutes, the Subrecipient shall furnish the Grantee, upon request, written verification of liability protection in accordance with Section 768.28, Florida Statutes. The written verification shall be submitted to Miami -Dade County Risk Management, Internal Services Division, located on the 23rd Floor, 111 NW 1St Street, Miami, Florida 33128. Nothing herein shall be construed to extend any party's liability beyond that provided in Section 768.28, Florida Statutes. If the Subrecipient is a non-governmental entity said Subrecipient shall maintain required liability insurance coverage as noted below during this contract period. The Subrecipient shall maintain required liability insurance coverage as noted below at all times during this contract period. Public Liability Insurance on a comprehensive basis in an amount not less than $300,000 combined single limit for bodily injury and property damage. The Grantee must be shown as an additional insured with respect to this coverage, as evidenced by a Certificate of Insurance. Automobile Liability Insurance coverage for all owned, non -owned and hired vehicles used in connection with this Agreement in an amount not less than $300,000 combined single limit for bodily injury and property damage. Workers' Compensation Insurance for all employees of the Subrecipient as required by Florida Statutes 440. Flood Insurance shall be maintained as per the requirements in 24 CFR Part 583.330(a). The insurance coverage required shall include these classifications, listed in standard liability insurance manuals, which most nearly reflect the operations of the Subrecipient. All insurance policies required above shall be issued by companies authorized to do business under the laws of the state of Florida, with the following qualifications: CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 15 The company must be rated no less than "B" as to management, and no less than "Class, V" as to financial strength by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent subject to the approval of Miami -Dade County Risk Management Division. Compliance with theforegoing requirements shall not relieve the Subrecipient of its liability and obligations under this section or under any other section of this Agreement. No modification or waiver of any of the aforementioned insurance requirements shall be made without thirty (30) days written advance notice to the Grantee, and is subject -to the -approval of Miami -Dade County Internal Services -Risk Management Division. ii. Indemnification -The Subrecipient shall indemnify and hold harmless the Grantee and its past, present, and future employees and agents from and against any and all claims, liabilities, losses, and causes bf action which may arise out of or relate to this Agreement, or which may arise out of actions or negligence, in whole or in part, of the Subrecipient, its officers, agents, employees, or assignees in the direct or indirect fulfillment of this Agreement. The Subrecipient sbaIl pay all claims and losses of any nature in connection therewith, and shall defend all suits, in the name of the Grantee when applicable, and shall pay' all costs and judgments which may issue thereon. It is expressly understood and intendedthat the Subrecipient is an independent contractor and is not an employee or agent of the Grantee. iii. Certifications and Representations -Pursuant to OMB 2 CFR Chapter I, Chapter II, Subpart C (200.208), the Subrecipient shall provide a certification statement for all annual financial reports and requests for payment that states the following: "By signing this report, 1 (duly authorized signature) certify to the best of my knowledge and belief that the report is true, complete and accurate.and the expenditures, disbursements and cash receipts, are for the purposes and objectives set forth in the terms and conditions of the Federal award. I' am aware that any false, fictitious, or fraudulent information or the omission of any material" fact, may subject me to criminal, civil or administrative penalties forfraud, false statements, false claims or other offense." iv. ; Conflicts of Interest, The Subrecipient shall disclose to the Grantee in writing any possible or actual conflicts of interest or apparent Improprieties relating to the Subrecipient under this Agreement. The Subrecipient shall make each disclosure in writing to the Grantee immediately upon the Sibrecipient's discovery of such possible conflict The Grantee :will then render an opinion which shall be binding on all parties. v. Affidavits The Subrecipient shall complete, notarize and provide one (1) original Affidavits set of "Miami Dade County Affidavits ; and , Declarations, 1 through 16", "Attachment D". One (1) original set of Affidavits will remain on file with Miami - Dade County Homeless Trust, two (2) full set of copies will be created and one (1) copy provided to Miami -Dade County Clerk of the Board and one (1) copy to the Subrecipient. CoC Grant' #FL0177L4D001508, City of Miami Beach, Outreach 1 Miami -Dade County Ownership Disclosure Affidavit (Section 2-8.1 of Miami -Dade County Code "County Code"). 2. Miami -Dade County Employment Disclosure Affidavit (County Ordinance 90-133, Amending Section 2-8.1; Subsection (d) (2) of the County Code). 3 Miami -Dade County Affirmative Action / Non-Discrirnination of Employment, Promotion and Procurement Practices (County Ordinance 98-30 codified at 2-8.1.5 of the County Code). 4. Miami -Dade County Criminal Record Affidavit (Section 2-8.6 of the County Code). 5. Sworn Statement Pursuant to §287.133 Florida Statutes on Public Entity Crimes. 6 Miami-ade Employment Family Leave Affidavit (County Ordinance 142-9 codified as Section 11A-29 et. seq of the County Code). 7. Miami -Dade County Disability Nondiscrimination Affidavit (County Resolution R-385-95). 8. Miami -Dade County Regarding Delinquent and Currently Due Fees or Taxes (Section 2-8.1(c) of the County Code). 9. Miami -Dade County Current on all County Contracts, Loans and Other Obligations. (County Ordinance 99-162). 10. Miami -Dade County Domestic Violence Leave (11A-60 et.seq of the County Code). 11. Miami -Dade County Employment Drug Free Workplace Affidavit (County Ordinance 92-15 codified as Section 2-8.1.2 of the County Code). 12 Attestation regarding due and proper acknowledgement Miami -Dade County funding support. 13. Miami -Dade County Affidavit pursuant to Board of Miami -Dade County Commissioners Resolution No. R-630-13. Pursuant to "Board of Miami -Dade County Commissioners the Subrecipient will also submit a detailed project budget, and sources and uses statement as contained within "Scope of Service and US HUD eSnaps Documents", incorporated into Attachment B, which shall be sufficiently detailed to show: i) the total project cost; ii) the amount of funds to beused for administrative and overhead costs; iii) whether the funds under this Agreement will be 'gap' funds meaning that they would be the last remaining funds needed to ensure funding for the total project costs; iv) any profit (program income) to be made by the Subrecipient; and v) the amount of funds devoted toward the provision of the desired services or activities. 14. Miami -Dade County certification not to use "Pink Slime" in food programs or related housing programs providing food (County Resolution No. R-478-12) 15. Affidavit of Miami -Dade County Lobbyist Registration for Oral Presentation (County Ordinance Section 2-11.1(s) of the County Code), Lobbyist specifically includes the principal, as well as any agent, officer, or employee of a principal, regardless of whether such lobbying activities fall within the normal scope of employment of such agent, officer or employee. 16. Subcontract/Supplier Listing (Ordinance 97-104) CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 17 The Subrecipient understands that the Grantee has relied on the Subrecipient's aforementioned representations in entering into this Agreement. h. Civil Rights The Subrecipient agrees to `abide by Chapter 11A of the Code of Miami - Dade County ("County Code"), as may be amended, in the exercise of its police power for the public safety, health and general welfare, to eliminate and prevent discrimination in employment, ` family leave, 'public accommodations, credit and financing practices, and housing accommodations because of race, color, religion, ancestry, "national origin, sex," pregnancy, age, disability, marital status, familial status, gender identity, gender expression, sexual orientation, or actual or perceived status as a victim'of domestic violence, dating violence' or stalk'ng. It is further hereby_.;declared to be the policy _of Miami Dade County to elimi and prevent discrimination in housing based on source of income. Initials here DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR rts 5, 91, 92, 570, 574, 576, and 903 [Docket No. FR -5173-F-04] RIN 2501-AD3 Affirmatively Furthering Fair Housing - The Fair. Housing Act. (title VIII of the Civil Rights Act of 1968, 42 U.S.C. 3601-3619) declares=that it is "the policy of the United States to provide, within constitutional limitations, for, fair housing throughout the United States, See 42 U.S.C. 3601: Accordingly, the Fair Housing Act prohibits, among other things, discrimination in the sale, rental, .nd,financing of dwellings, and in other housing -related transactions because of� . ce, color, religion, sex, familial status, national origin, or handicap." Initials her See 42 U.S.C. 3604 and 3605. Section 808(d) of tie Fair Housing Act requires all executive' branch; departments and agencies administering housi and urban development programs and activities to administer these programs n a manner that affirmatively furthers fair housing. See 42 U.S.C. 3608. Initials here' The Subrecipient agrees to abide and be governed by Title VI and VII, •` the Civil Rights Act of 1964 (42 U.S.C. 2000 et.seq.) and Title, VIII of the Civil Ri is Act of 1968, as amended, and Executive Order 11063, as may be amended, as well as with any applicable regulations, which provide in- part that there will be no discrimination 'of race, color, gender/sex; religiousbackground, ancestry or national origin in`perforrnance of this Agreeme t, in regard to persons served, or in regard to employees or applicants: for employme or housing. It is expressly understood that upon receipt of evidence of such'discri n.tion, the' Grantee shall have the right to terminate this Agreement. Initials heir`. Executive Order 11063 prohibits dis, 1 matron in the sale, leasing, rental, or other disposition of properties and fac es owned or operated by the federal government or provided with federal funds. Executive Order 12892, as amended, requires federal agencies to affirmatively further fair housing in their programs and activities, and; provides that the ; Secretary of HUD will be responsible for coordinating the effort. Executive Order 12898requires nondiscrimination in federal programs that affect; human health and the environment as well as provides minority and, low-income,: communities access to, public information and public participation. Executive Order 13166 requires federal agencies to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach Page 18 LEP persons can have meaningful access to them. Executive Order 13217 requires federal agencies to evaluate their policies and pr: rams to determine if any can be revised or modified to improve the availability e; community-based living arrangements for persons with disabilities. Initials herr t V i Awareness of the Joint Letter of clarification dated gust 5, 2016 from United States Department of Justice, United States Depart 1 '-nt of Health and Human Services, United States Department of Housing and Urban Development reminding recipients of federal financial assistance that they should not withhold certain services based on immigration status when the services are necessary to protect life or safety. In the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), Congress restricted immigrant access to certain public benefits, but also established a set of exceptions to these restrictions. - It is understood that recipients of federal funding that administer programs that (1) are necessary for the protection of life or safety; (ii) deliver in-kind services at the community level; and (iii) do not condition the provision of assistance, the amount of assistance, or the cost of assistance on the individual (participant's) recipient's income or resources, that such programs are not subject to PRWORA's restrictions on immigrant access to public benefits and m4lst be made available to eligible persons without regard to citizenship, national' or immigration status. 8 U.S.C. Section 1611(b)(1)(D); 1621(b) (4). Initials her It is further understood that the Subrecipient m t submit affidavits attesting that it is not in violation of the American with Di abilities Act, Section 504 of the Rehabilitation Act of 1973, as amended, (29 U.S.C. 794, et. seq.), the Federal Transit Act, (49 U.S.C. 1612), and the Fair Housing Act, (42 U.S.C. 3601 et.seq.), as may be amended, as well as with any applicable regulations. If the Subrecipient or any owner, subsidiary, or other firm affiliated with or related to the Subrecipient is found by the responsible enforcementagency, the Courts or Grantee to be in violation of these Acts, the Grantee shall conduct no further business with the Subrecipient. Any contract entered into based upon a false affidavit shall be voidable by the Grantee. If the Subrecipie :, violates any of the Acts during the term of any contract the Subrecipient has with ami-Dade County, such contract shall be voidable by the Grantee, even if the Subre Fent was not in violation at the time the affidavit(s) were submitted. Initials her The Subrecipient agrees that it is in con f+liance with the Domestic Violence Leave, codified as (Article 8, Section 11A-60 et.seq. of the County Code), as may be amended, which requires an employer, who in the regular course of business and has fifty (50) or more employees working in Miami-Dade County for each working day during each of the twenty (20) or more calendar work weeks to provide domestic violence leave to its employees. Failure to comply w' h this local law may be grounds for voiding or terminating this Agreement or fo ommencement of debarment proceedings against the Subrecipient. Initials her The Subrecipient agrees to abide and be governed by the Ag iiscrimination Act of 1975,(42 U.S.C. 6101 et seq.) and implementing regulations a 24 CFR Part 146), as may be amended, as well.with any applicable regulations, which provides in part that there shall be no disc ination against persons in any area of employment because of age. Initials her CoC Grant#FL0177L4D001508, City of Mia Beach, Outreach Page 19 The Subrecipient agrees to abide and be governed by Section SO4 of the Rehabilitation Act of 1973, as a ended, (29 U.S.C. 794, et.seq.) as may be amended, as well as, with any applicable egulations, which prohibits discrimination on the basis of, handicap. Initials here AL, The Subrecipient agrees to ab I ,. and be governed by the requirements of the Americans with Disability At 4,,ii A), as may be amended, as well as with any applicable law, Initialshere IN \Pursuant to 24 CFR 578 23 Su . ,0 ecipient hereby certifies and agrees that: 1. Subrecipient will maintain the confidentiality of records pertaining to any • individual or family that was provided family violence prevention or — - treatment services through the project / program. ii. The address orlocationof any family violence project / program assisted under this part will not be made public, except with written authorization of the person responsible for the operation of such program and in accordance with any ' applicable state and local laws that prohibit disclosure of information relating td domestic violence centers; iii. Subrecipient will establish polfcies and practices that are consistent with, and do nbt restrict the exercise of rightsprovidedby Subtitle B of Title VII of the MCI(iriney-Vento Homeless Assistance Act, as amended, and other laws relating to, the provision of educational and related services to individuals and farnilies experiencing homelessness; iv. In the case of programs that provide housing or services to families, that Snbrecipientswill designate a staff person, to be responsible for ensuring that children being served in the program are enrolled in school and connected to appropriate services in the community iricluding early childhood programs such as Head Start, Part C of the individualswl'th Disabilities Education Act, and programs authorized under Subtitle Bof Title,V1I ofthe McKinney-Vento Homeless Assistance Act as amended' ' v . The Subrecipient shall use the centralized or coordinated assessment • system established by the Continuum of Care as set orth pursuant to 24 • CFR 578.7(a) (B); . Subrecipient, its officers, ands are not debarred or suspended from doing business with the federal government; and •' vii. Subrecipient will provide information, such as data and reports, as required by US HUD. Additionally, Subrecipient agrees• : To establish such fiscal controls and accounting procedures as may be necessary to assure the proper disbursal of, and accounting for grant funds in order to ensure that all financial transactions are conducted, and records maintained' in accordance with generally accepted accounting principles. ii. To take the educational needs of children into account when families are placed in housing and will, to the maximum extent practicable, place families with children as close as possible to their school of origin so as not to disrupt such children's education. A Subrecipient that serves families with school-age children shall have at least one program staff member, CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 20 knowledgeable of the McKinney-Vento Education for Children and Youth Act requirements and shall comply with all requirements related to facilitation of educational opportunities consistent with Miami -Dade County Homeless Trust's Standards of Care incorporated herein by reference; iii. To comply with the provisions of 24 CFR 578.23(c) (9). iv. To follow the written standards for providing Continuum of Care assistance developed by the Continuum of Care, including the minimum requirements set forth in § 578.7(a)(9); and v. To operate the project(s) in accordance with the provisions of the McKinney-Vento Act and all requirements under 24 CFR part 578; and to comply with such other terms and conditions as US HUD may establish by NOFA (Notice of Funding Availability) 4. Suspension and Termination a. Suspension - The Grantee may, for reasonable cause, temporarily suspend the operation and authority to obligate funds of the Subrecipient, under this Agreement, or withhold payments to the Subrecipient pending necessary corrective action by the Subrecipient or both. Reasonable cause shall be determined by the Grantee in its sole and absolute discretion and may include: i. Ineffective or improper use of any funds provided hereunder by the Subrecipient; ii. Failure by the Subrecipient to materially comply with any terms, conditions, representations or warranties contained herein; iii. Failure by the Subrecipient to submit any documents required by this Agreement; or iv. Incorrect or incomplete document submittal by the Subrecipient. b. Termination - i. Termination at Will - This Agreement, in whole or in part, may be terminated by the Grantee upon no less than fifteen (15) working days' notice when the Grantee determines that it would be in the best interest of the Grantee and / or the Subrecipient materially fails to comply with the terms and conditions of the award. Said notice shall be delivered by certified mail, return receipt request, or in person with proof of delivery. The Subrecipient shall have. five (5) days from the day the notice was delivered to state why it is not in the best interest of the Grantee to terminate the Agreement. However, it is up to the discretion of the Grantee to make the final determination as to what is in its best interest. ii. Termination for Convenience The Grantee or Subrecipient may terminate this Agreement, in whole or 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 in writing upon the termination conditions, including the effective date and in the case of partial termination, the portion to be terminated. However, if the Grantee determines in the case of partial termination that CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 21 the reduced or modified portion of the grant will not accomplish the purposes for which the grant was made it may terminate the grant in its entirety. iii. Termination Because of a Lack of Funds — In the event funds to finance this Agreement become unavailable, the Grantee may terminate this Agreement upon no less than twenty-four (24) hours' notice in writing to the Subrecipient. Said notice shall be sent by certified mail, return receipt requested, or in person with proof of delivery. The Grantee shall be the final and sole authority in determining whether or not funds are available. Termination: for. Breach Upon terminating this Agreement under this section the Grantee, in its sole. discretion, may require the Subrecipient to pay the Grantee. 'any or.a11. costs associated • with termination of this Agreement, including but not 'limited to transfer of the Subrecipient's obligations under this Agreement and or selection of a new Project Sponsor. The Grantee may terminate this Agreement, in whole or in part, when the Grantee determines m its sole and absolute" discretion that the Subrecipient is not making sufflczerit progress in the performance of this Agreement as outlined in the "Scope of Services" contained within the "Scope of Service and US HUD eSnaps Documents Attachment B or is:not materially complying with any term or provision provided herein including b• + not limited to the following: The : Subrecipient ineffectively or improperly used or uses the Grantee funds allocated under this Agreement; 2. The: Subrecipient failed" or fails to furnish the Certificates of Insurance required. by this Agreement or as determined by Miami - Dade County Internal Services Risk Management Division; . The Subrecipient failed or fails to furnish proof of Licensure, proof of Certification or proof of Background Screening required by this Agreement; 4. The `Subrecipient failed or fails to, submit detailed reports of expenditures or finalexpe'nditure reports or submits incompletely or incorrectly•` . ` The Subrecipient ' failed or fails to submit required reports or submits' incompletely or incorrectly; The Subrecipient refused or refuses to allow the Grantee access to records or refused or refuses to allow the Grantee to monitor, evaluate' and review the Subrecipient'spz ogram; The Subrecipient discriminates under any ofthe laws outlined in this Agreement,'' ", The Subrecipierit failed or fails to provide Domestic Violence Leave to itsemployees pursuant to local law; The Subrecipient; falsifies or. violates the provisions of a Drug Free Workplace Affidavit; 10, The Subrecipient attempted or attempts to meet its obligations under this Agreement through fraud, misrepresentation or material misstatement; CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 22 11. The Subrecipient failed or fails within a specified period, to correct deficiencies found during a monitoring, evaluation or review; 12. The Subrecipient failed or fails to meet the terms and conditions of any obligation under this Agreement or otherwise of any repayment schedule to the Grantee or any of its agencies or instrumentalities; 13. The .Subrecipient failed or fails to meet any of the terms and conditions of the Miami -Dade County Affidavits; and 14. The Subrecipient failed or fails to fulfill in a timely and proper manner any and all of its obligations, covenants, agreements and stipulations in this Agreement. The Subrecipient shall be given written notice of the claimed breach and ten (10) business days to cure same. If the Subrecipient is not provided a written waiver of the breach by the Grantee, or if the Subrecipient remains in breach of this Agreement as determined by the Grantee, the Grantee shall initiate written notice to terminate and said notice will be to terminate effective within no less than twenty-four (24) hours. Said notice shall be sent by certified mail, return receipt requested, or in person with proof of delivery. Waiver of Breach or any provision of this Agreement shall not be construed to be a modification, or revisions of the terms of this Agreement. The provisions contained herein do not limit the rights to legal or equitable remedies or any other provision for termination by the Grantee under this Agreement. The Subrecipient shall be responsible for all direct and indirect costs associated with such termination or cancellation, including attorney's fees. Any individual or entity who attempts to meet its contractual obligations with the Grantee through fraud, misrepresentation or material misstatement may be disbarred from Miami -Dade County contracting for up to five (5) years. 5. Notice Regarding Future Funding Applications Funding under this Agreement is provided by US HUD. The parties understand the Grantee, as the US HUD funding recipient, is responsible for review and approval of the funding application and response submitted to US HUD through the annual US HUD CoC Program Notice of Funding Availability (NOFA) application process. The Subrecipient agrees to timely notify the Grantee of the Subrecipient's intention not to be available to renew and continue o u eratin or rovidin the program in its entirety as covered under this Agreement. Timely is defined as the earliest of either 1) six (6) months prior to this Agreement's expiration; or 2) uponrequest to confirm allocations in the Grant Inventory Worksheet (GIW) registration process of the anticipated annual application to US HUD CoC Program NOFA. If the Subrecipient is not available to apply for "renewal funding" or for the continuation of the program outlined in this Agreement, and failed to timely inform the Grantee as described herein, then the Grantee in its sole discretion may opt not to enter into future grant agreements with the Subrecipient. Further, in the event the Subrecipient will not be available to apply for renewal funding applicable to this Agreement, the Subrecipient agrees to ensure that housing is maintained CoC Grant #FL01.77L4D001508, City of Miami.Beach, Outreach Page 23 for persons served by the Subrecipient under this Agreement after the expiration of this Agreement so that those persons do not become homeless. Notice from Subrecipient to Grantee pursuant to this section shall be delivered in writing by certified mail, return receipt request, or in person with proof of delivery, to the attention of Miami -Dade County Homeless Trust Executive Director. 6. Reversion of Assets a. Term of Commitment — If the Subrecipient receives assistance for acquisition, rehabilitation, or new, construction, then the Subrecipient shall agree to operate the "McKinney-Vento Act housing" or provide "McKinney-Vento Act services" in accordance with this Agreement and applicable laws, and regulations for a term of at least twenty(20) years or if applicable fifteen (15). years -from the date of -initial occupancy or date of initial service provision. If the United States, Department of Housing and `Urban Development( US. HUD) determines a project is no longer needed `for use as, homeless assistance housing or _services, then US HUD may provide authorization to the Grantee on:behalf of the Subrecipient to convert the project to a project for the direct benefit of low-income persons pursuant to a request for such use by the Grantee on behalf of the. Subrecipient operating the project as Project Sponsor. The parties hereby agree to this provision shall survive the expiration or termination of this Agreement: pursuant to 24 CFR 578.81 - The request for authorization to US HUD from the Grantee on behalf of the Subrecipient must be made while the project is operating as homeless housing or supportive services for homeless individuals and families, must be in writing, and must include an explanation of why the project is no longer needed to provide transitional or permanent housing or supportive services. The. primary factor in US HUD`s decision on the proposed conversion is the unmet need for transitional or permanent housing or supportive services in the Continuum of Care's geographic area. Repayment of Grant — If the Subrecipient does not provide supportivehousing or supportive services for twenty (20) years or if applicable fifteen (15) years following the date of initial occupancy or date of initial service provision pursuant to this Agreement, then the Grantee shall require repayment of the entire amount of the grant or partial repayment of the grant used for acquisition, rehabilitation, or new construction, unless conversion of the project has been authorized by US HUD pursuant to the terms in the Tenn of Commitment. ,:The parties hereby agree this provision shall survive the expiration or termination: of this Agreement, Prevention of Undue Benefit — Upon the sale or other disposition of a project assisted with acquisition, rehabilitation or new construction funds occurring before the expiration of the twenty (20) years Or if applicable fifteen' (15) year period, the Subrecipient must comply with such terms and conditions as US HUD and the Grantee may prescribe to prevent the Subrecipient from unduly benefiting from such sale or. disposition, The Subrecipient shall return to the Grantee, upon the expiration or termination of the Agreement, any funds on hand, any accounts receivable attributable to those funds, and any overpayment due to unearned funds or costs disallowed pursuant to the terms of this Agreement that were disbursed tothe Subrecipient by the Grantee. CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach Page 24 d. Revocation of License or Permit - Notwithstanding any provision of this Agreement to the contrary, revocation of any necessary license, permit, or approval by a governmental authority may result in immediate termination of this Agreement upon no less than twenty-four (24) hours' notice. Said notice shall be certified by mail or hand delivery. e. Declaration of Restrictive Covenant, and Declaration of Restrictions -Where grant funds are used for acquisition, construction or rehabilitation under this Agreement, the Subrecipient shall record a Declaration of Restrictive Covenants, as well as a Declaration of Restrictions, in accordance with this section. The Declaration of Restrictive Covenants and the Declaration of Restrictions shall restrict_ theuse of properties located at _ in Miami Dade County, Florida such that the properties must be operated for the provision of homeless housing and services for homeless persons in accordance with the provisions of (24 CFR Part 578, Code of Federal Regulations) and any other applicable laws or regulations for a term of at least twenty (20) years or if applicable fifteen (15) year period or for such other purposes as may be approved by the Grantee and US HUD. The Subrecipient agrees that the Declaration of Restrictive Covenants and the Declaration of Restrictions shall be signed by the Subrecipient, as well as the title owner of the subject property and any other relevant property interest holders, including but not limited to a lessee of the title holder subleasing the property to the Subrecipient. If the Subrecipient is not the title owner of the subject property, the Subrecipient shall be responsible for obtaining execution of the Declaration of Restrictive Covenants and the Declaration of Restrictions by the title owner and by any other parties required by US HUD. The Subrecipient shall be responsible for ensuring that any signatories required by US HUD sign the Declaration of Restrictive Covenants and the Declaration of Restrictions whether US HUD requires such signatories by regulation or by guidance provided directly regarding the project and / or property covered under this Agreement. The Declaration of Restrictive Covenants executed by the Subrecipient and any other required parties and recorded by the Subrecipient must be approved by US HUD. The Subrecipient must provide US HUD with proof of recordation of the approved Declaration of Restrictive Covenants before funds for Rehabilitation or New Construction may be drawn down. Acquisition funds may be drawn down before proof of recordation is received by US HUD; however, no other grant funds will be available for draw down until US HUD is satisfied with the form and recordation of the Declaration of Restrictive Covenants. The Subrecipient agrees to inform any lender or grantor which has loaned or granted funds for the purchase of such properties or structure on the subject property or properties covered under this Agreement and obtain their consent to the recordation of and subordination to the "Declaration of Restrictive Covenants" and the "Declaration of Restrictions". Such consent shall be in a form acceptable to the Grantee. The parties hereby agree this provision shall survive the expiration or termination of this Agreement. CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 25 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards Accounting Standards, Cost Principles and Regulations. i. The Subrecipient shall comply with applicable provisions of applicable Federal, State and County laws, regulations; and rules such as OMB Circular A-110, OMB Circular A-21, and OMB Circular A-133 and with the Energy Policy and Conservation Act (Public' Law 94-163) which requires mandatory standards' and policies', related to energy efficiency. If any provision of this Agreement conflicts with any applicable law or regulation, only the conflicting provision shall be modified to be consistent with the law or regulation ; or be deleted` if modification is` impossible-:- However, the obligations ' under this Agreeirient, as modified, ' shall ' continue and all provisions of this Agreement shall remain in full force and effect. If the amount payable to the Subrecipient pursuant to the terms of this Agreement are` in excess of $100,000," or such other amount as required by applicable law or regulation; the Subrecipient shall comply with all applicable stands, orders, or regulations issued pursuant to Section 306 of the'Clean Air Act of 1970 (42 U.S.C. 1857(h), as amended: the Federal Water Pollution Control Act (33 U S.C. '1251), as amended: Section 508 of the Clean Water' Act{_ 33 U.S.C. 1368); the `environmental Protection Agency regulations (40 CFR Part '15), Executive Order :11738; and the Environmental Review Procedures and Regulations (24 CFR Part 58 and 24 CFR Part 583:230). The Subrecipient shall comply "with all applicable laws and regulations governing this Agreement The Subrecipient shall ''complyr with the .:federal uniform administrative requirements and accounting standards "cost: principles and audit requirements according to OMB Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225 and 230, "OMB Circular A-122, and 24 CFR 78 et.seq., as may be applicable and any other applicable laws and regulations. i Performance Measurements The "Subrecipient shall comply and report all performance objectives outlined in the "Scope' of Service and US HUD eSnaps Documents" Attachment'B and as outlined in the NOFA `application and in the manner specified and "outlined in this Agreement Internal Controls The Subrecipient. shall <comply, with internal control related federal statutes, regulations,. and the.terms"and",conditions of the federal award; evaluate andmonitor and take prompt action when instances of noncompliance are identifiedincluding'noncoXnphance identified in audit findings, aril take,' reasonable measures 'ted, safeguard legally protected personally identifiable information and other information. These internal controls' shall safeguard " assets and provide ` reasonable assurance of compliance with federal statutes and regulations. iii. Payment - The Subrecipient is required to report deviations from budget or project scope or objectives and request" prior approvals from federal CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach awarding agencies through the Grantee on any and all changes in scope or key persons and any other change to the program budget, in accordance with Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225 and 230 and any other applicable laws and regulations. iv. Cost Sharing or Matching - For all federal awards, any shared costs or matching funds and all contributions, including cash and third party in-kind contributions, must be accepted as part of the non-federal entity's cost sharing or matching and such contributions shall meet all of the following criteria: 1. Are verifiable from the non-federal entity's records; 2. Are not included as contributions for any other federal award; 3. Are necessary and reasonable for accomplishment of project or- - program. objectives; 4. Are allowable under Costs Principles of 2 CFR Part 200, et al. 5. Are not paid by the federal government under another federal award, except where the federal statute specifically provides that federal funds made available for such program can be applied to match or cost sharing requirements of other federal programs; 6. Are provided for in the approved budget when required by the federal awarding agency; and 7. Conform to 2 CFR Chapter II, Part 200.306, as applicable. c. Retention of Agreement Records i. The Subrecipient shall retain financial records, supporting documents, statistical records and all records pertinent to a federal award for a period of five (5) years from the date of submission of the final expenditure report or, for Federal awards that are renewed quarterly or annually, from the date of the submission of the quarterly or annual financial report, respectively, as reported to the federal awarding agency. 1. If any litigation, claim or audit is started before the expiration of the five (5) -year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken. If the Grantee or the Subrecipient has received or been given notice of any kind indicating any threatened 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 the Grantee, fully, completely and finally resolved. 2. Records for real property and equipment acquired with federal funds must be retained for a minimum five (5) years after final disposition. 3. Any leases or mortgages or similar documents or contracts with a term longer than five (5) years, must be retained for five (5) years beyond the end of the document's full term. CoC Grant,#FL0177L4D001508, City of Miami Beach, Outreach Page 27 4. Records for program income transactions after theperiod performance: The Subrecipient must report program incomepafter the period of performance records pertaining to the earning of program income must be retained for five (5) years after the end of the non-federal entity's fiscal year in which the program income is earned. The Subrecipient shall allow the Grantee or any persons authorized by the Grantee full access to and the right to examine any of the records pertinent toithe Federal Award and this Agreement. The Subrecipient shall notify the Grantee in writing both during the pendency of this Agreement and after its expiration as part of the final Close out procedure -Of, the location and address where all the Agreement records will be retained.' The Subrecipient shall obtain.prior written approval by the Grantee for the disposal of any Agreement records before disposing of such records if it As within one (1) year after the expiration of the Retention Period. Additional Requirements The Subrecipient shall comply with the following additional requirements: a. Client Rules and Regulations - The Subrecipient shall submit to the Grantee a copy of the Client Rules and Regulations that apply, to all programor client participants referred to the Subrecipient.. pursuant to this Agreement. This copy is due within thirty (30) calendar days following the execution of this Agreement. Personnel Policies" and Administrative Procedure Manuals - The Subrecipient shall submit detailed documents describing all the Subrecipient's' policies and procedures for internal control, corporate, or organizational structure, property management, procurement, personnel management, accounting and fiscal information. This information shall be available to the Grantee upon request. Monitoring - The Subrecipient shall permit the Grantee and any other persons authorized by the Grantee to monitor, according to applicable regulations, all Agreement records, facilities, goods, services and activities of the Subrecipient which are in any way connected to the activities undertaken pursuant to the terms of this Agreement including interview of any participant, employee, subcontractor, or assignees of the Subrecipient The Grantee shall monitor both fiscal and programmatic compliance with all terms and conditions of this Agreement including a review of beneficiaries, supportive services, housing, operating costs, program and performance progress, sitehabitability, participant eligibility, documentation for required match, record keeping, and compliance; with circulars, . administrative costs, technical assistance visits, and environmental review. The Subrecipient shall permit the Grantee to conduct site visits, participant assessment surveys, and other techniques deemed reasonably necessary to fulfill the monitoring function. If the Grantee monitors and there is a finding of deficiencies report; said report may be delivered to the Subrecipient, and if so delivered, the Subrecipient shall rectify all deficiencies cited within the period of time specified in the report. Pursuant to CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 28 Board of Miami -Dade County Commissioners Resolution No. 630-13, Miami -Dade County Mayor or Mayor's designee may make unannounced, on-site visits during normal working hours to the Subrecipient's headquarters and / or any locations or site where the services contracted for are performed. d. Restrictions of Funds Use - The funds received under this Agreement (and any State or local government funds used to supplement -this Agreement) may not be used to replace State or local funds previously used, or designated for use to assist homeless persons (24 CFR Part 578.87). The Subrecipient shall notify the Grantee of any additional funding received for any activity described in this Agreement, other than funding already noted in the "Consolidated Financial Record and Reports", Attachment E. Such notification shall be in writing and received by the Grantee within thirty (30) calendar days of the Subrecipient's notification by the funding source. e. Related Parties - The Subrecipient shall report to the Grantee the name, purpose and any other relevant information in connection with any transaction conducted between the Subrecipient and a related party transaction. A related party includes, but is not limited to; a for-profit or nonprofit subsidiary or affiliate organization, and organization with overlapping boards of directors or any organization for which the Subrecipient is responsible for appointing members. The Subrecipient shall report this information to the Grantee upon forming the relationship or if already formed, shall report it immediately. Any supplemental information shall be reported in the Grantee required Agency Narrative and Progress Report which are addressed in Section 2 b. "Records and Access to Records". f. Required Meeting Attendance - From time to time, Grantee through Miami -Dade County Homeless Trust may schedule meetings and or training sessions to assist the Subrecipient in the performance of its contractual obligations or to inform the Subrecipient of new and or revised policies and procedures. Attendance at some of these meetings may be mandatory. The Subrecipient shall receive notice no less than three (3) business days prior to any meeting or training session that may require mandatory participation. A record of attendance shall be kept of meetings or training sessions where notice was given indicating the mandatory participation of the Subrecipient and the Subrecipient shall be monitored for compliance on that record of attendance. Failure to attend meetings or training sessions for which a mandatory notice has been provided can result in material non-compliance of the Agreement, up to and including Breach or Default. Proof of mandatory notice shall consist of fax record, certified mail, electronic confirmation and or verbal communication with the Agreement contact person or persons and other program administrative staff of the Subrecipient. The Subrecipient may select one or more employees from their Agency, directly involved in the Agreement program, as their representative at the meeting or training session; the participation of the Agreement contact person or persons is preferred. The Subrecipient may request waiver from a mandatory meeting. That waiver must be received no later than twenty-four (24) hours prior to the meeting date and time, and justification provided, including the reason the Subrecipient could not send any representative. The Grantee shall have absolute and final approval over any determination to waive mandatory attendance; and no more than two (2) mandatory attendance waivers shall be allowed during the term of this Agreement. The Subrecipient is encouraged to attend all meetings CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 29 of Miami -Dade County Homeless Trust and or its Committees, as information relevant, to their program or services may be discussed. Publicity and Advertisements — The Subrecipient shall` ensure that all publicity and advertisements` prepared and released by -the Subrecipient, such as pamphlets and news releases already or indirectly related to activities funded pursuant to this Agreement, and all events carried out to publicize the "accomplishments of any activity funded pursuant to this Agreement, recognize the Grantee as its funding source. • h. Procurement -The Subrecipient shall use shall comply with any;and all •applicable fe regulations including but not limited to 2 CFR 200.318,. as appl b Subrecipent shall"maintainoversght and ensureat its" subcontracts perform in accordance with the terms, conditions, and specifications, of their contracts or purchase or 1 t its own procurement procedures which deral,state and local laws, ordinances and ica Te. The purc 1 11 make a 1 e The " Subrecipient s is quipment, construction and services necess of this Agreeme " f i ority and women owned e permitted° by ap iture of $x.00,000 or mor to use 1 the positive eff ort` to competitive y procure supp ies, necessary or relate h s nt from m'n plicalile law. if this .Agreement involves' the expend e by "Miami -Dade County, and the Subrecipient intends ' s listed' herein or suppliers to sup o e d to carrying out t e term businesses, as may b pY aures f th agrees that it ted withou d h unty with the n ubrecipie nt ag s from those lis subcontractors to Pr 1-% e, the service brecipient shall provide Miami=Dade Co Subcontracto / Supp l' Listing'', Attachment D. S will not change or substitute `subcontractors or supplier Materials, the Su " rliter r writtenapprova1 of Miami -Dade County. rio Ink.olverrient of HUD' -assisted indvidiia7s"and farnilies `per' 24 CFR 578.23 (c)(3), the Subrecipent `agrees to' ensure to :the " maximum.- extent " practicable, that • • • individuals and families experierfcing homel"essness are•' involved, through employment,` provision of volunteer'; services, or otherwise, :in constructing, rehabilitating;`'rnaintaming and•operating facilities for the project and in providing supportive services for' the project. Further, perthe.'Housing and Urban Development <Act" of 1968; as amended, (12 U:S.C. 1701u) to the greatest extent feasible;` opportunities forei training :and employment, for "services or programs. covered under this Agreement, should lie given to lower-income" residents of HUD- asssted projects aril contracts for work in connection with he project be award th&nraa nft}1P T11 in substaptial part to pets°=4 ` Property This'section applies to .equipment with an acquisition cost of greater than $5,000;00 per unit and all,real property:.Any, real, property under the control`of the;Subrecipient that was acquired and or; improved in, whole or in part with funds :from Grantee; or. from Miami -Dade ,County; and any equipment or property purchased .for•greater than $5,000.00, shall, upon expiration or termination of this Agreement, be: disposed in accordance with instructions from the Grantee»Real Property'is defined as land, including land improvements, structures, and appurtenances , t thereto, including moveable machinery and equipment. equipment means tangible; non -expendable, personal property having a useful life of more than;one.(1)year and acquisition costs of greater than $5,000.00 per unit 2) The Subrecipient shall list m . the property. records all equipment with an CoC Grant #FL0177L4D001508, City of IMliaini Beach, Outreach Page 30 acquisition cost of greater than $5,000.00 per unit and all real property purchased in whole or in part with funds from the Grantee or from Miami -Dade County from this Agreement or from previous agreements. The property record shall include a legal description, size, date of acquisition, and value at time of purchase, owner's name if different than the Subrecipient, information on the transfer or disposition of the property, and map indicating where property is in parcels, Lots or blocks and showing adjacent streets and roads. Notwithstanding documents required for reimbursement purposes, an additional copy of the purchase receipt for any property described above which was purchased using Grantee or Miami -Dade County funds must also be included in the reimbursement package along with the "Real Property and Equipment Asset Inventory" Attachment I in the month it was purchased. 3) All equipment with an acquisition cost of greater than $5,000.00 per unit and all real property shall be inventoried annually by the Subrecipient and an Annual Inventory Report submitted to the Grantee. This report shall include the elements listed above. Pursuant to 2 CFR 200.94, if the cost of computing devices (inclusive of accessories) falls below the lesser of the capitalization threshold of the nonfederal entity or $5,000, regardless of the length of useful life, the asset is a supply. k. Management Evaluations and Performance Reviews - The Grantee may conduct formal Management Evaluations and Performance Reviews of the Subrecipient following this expiration of this Agreement. The Management Evaluations will reflect the compliance of the Subrecipient with generally accepted fiscal and organizational standards and practices. The Performance Reviews will reflect the quality of service provided and value received of the funds using monitoring data such as progress reports, site visits, and participants' surveys. 1. Subcontracts and Assignments — The Subrecipient shall not assign this Agreement without the Grantee's written consent to the assignment. The Subrecipient shall ensure that all subcontracts and assignments; 1) Identify the full, correct and legal name of the party; 2) Describe the activities to be performed; 3) Present a complete and accurate breakdown of all price components; and 4) Incorporate provisions requiring compliance with all applicable regulatory and other requirements of this Agreement with any conditions of approval that the Grantee deems necessary. This applies only to subcontracts and assignments in which parties are engaged to carry out any eligible substantive programmatic service as set forth in this Agreement. The Grantee shall in its sole and absolute discretion determine when services are eligible substantive programmatic services subject to the audit and record keeping requirements described above. The Subrecipient shall ensure that all subcontracts and assignments which involve the expenditure of one hundred thousand dollars ($100,000.00) or more, comply with (Miami -Dade County Ordinance 97-104, § 1, 7-8-97), which shall require the entity contracting with Miami -Dade County to list all first tier subcontractors who will perform any part of the contract and all suppliers who will supply materials for the contract work directly to such entity. The contract shall also require the entity contracting with Miami -Dade County to report to Miami -Dade County the race, gender, and ethnic origin of the owners and employees of all such first tier subcontracts. This Agreement shall require the Subrecipient to provide Miami -Dade County the race, gender and ethnic information as soon as reasonably available and CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 31 in any event prior to final payment under the contract. The Subrecipient shall not change or substitute subcontractors or suppliers from those listed except upon written approval of the County. The Subrecipient must provide the list of all first tier subcontractors and direct suppliers; see "Subcontractor, / Supplier Listing" Attachment D The Subrecipient shall incorporate into all consultant subcontracts this additional provision: "The Subrecipient is not responsible for any insurance or other fringe benefits for the consultant or its employees, (examples social security, i income tax withholdings, retireinent� or leave benefits): The consultants assume full responsibility for the provision of all insurance and fringe benefits for themselves and their employees retained by the, consultants in carrying out the Scope of Service provided in this subcontract"The Subrecipient shallbe responsible for monitoring the contractual perfornriance of all subcontracts 'The Subrecipient shall receive — -written-documentation prior to enter -mg mto-any subcontract which -contemplates performance . of substantive programmatic activities, as such is determined as provided herein The approval. of the Grantee shall be obtainedprior to the release of any funds to the Subrecipient for the subcontract The Subrecipient shall receiive written`approval from the Grantee prior` to either asslgnlng or transferring any obligations or responsibilities set forth in this Agreementor the right to receive benefits or payments resulting from this Agreement. Approval by the Grantee of any subcontract or assignment; shall not under any circumstances be deemed to provide for the incurring of any obligation by the Grantee m excess of the total dollar amount set forth in this Agreement. m Consultant to, the Grantee -'the parties understand; that in order to facilitate the implementation of this Agreement, the Grantee may from time to -time designate a development consultant to work with the. Subrecipient, The Grantee's Consultant shall be considered the Grantee's designee with' 'respect to all' portions of this Agreement,,with _the exception of those provisions relating to, payment to the Subrecipientfor services, rendered The Grantee shall provide Written notification to the Subrecipient of the name, address and. employee_ representatives of the Grantee's Consultant. F + " n. Participation in the Homeless Management Information' System (HMIS) The Subrecipient agrees' to participate in a,Horrieless Management Information System selected and established by the Grantee ' ' Participation' will include, but not be limited,to, input of cliont data upon intake; daily updates,`of bed availability information, as well as updates'to current and "prior client's records upon client n contact, ad maintaining'current data for statistical purposes.' Subrecipients of Domestic Violence Prograrns With heightened privacy and confidentiality concerns are required to participate in an HMIS equivalent system to include the necessary stricter privacy and confidentiality standards. The Subrecipient understands that they, .are responsible fore any,ongoing costs 'to access the HMIS system: The Subrecipient agrees to abide by terms of any HMIS 'Agreements, which are incorporated` hereinby "reference The Subrecipient shall indemnify and hold harmless the Grantee and Miami-Dade'County, its agents and instrumentalities from any and all liability,; losses and damages arising out of or relating to this Agreement orthe ,HMIS system. Miami -Dade County Inspector General review - The Subrecipient understands that Miarii -Dade` County, Office of the Inspector General may,'' on a' random basis, CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 32 P. q. perform audits on all Miami -Dade County contracts, throughout the duration of said contracts. Independent Private -Sector Inspector General review - The Subrecipient understands that Miami -Dade County Inspector General is also empowered to retain the services of Independent Private -Sector Inspector Generals, to audit, investigate, monitor, oversee, inspect and review operations, activities, performance and procurement processes including but not limited to project design, application and project specifications, proposals submittals, activities of the Subrecipient, its officers, agents and employees, lobbyists, Miami -Dade County staff, and elected officials to ensure compliance with contract specifications and to detect fraud and corruption. Renegotiation or Modification. The . Subrecipient agrees that modifications to provisions of this Agreement shall only be valid, when in writing and signed by duly authorized representatives of all parties. In addition, the Subrecipient may not make any significant changes to an approved program without prior written approval by the Grantee. Significant changes include, but are not limited to, changes in the Project Sponsor, changes in the project site location, additions or deletions in types of program or funding activities outlined in 24 CFR 578.37 - 578.63 and the Notice of Funding Availability (NOFA) process approved in the Technical Submission for this program, or a shift of greater than ten (10) percentage points between approved funding activities, or a change in the population served, the number of population served, or any other changes deemed significant by the Grantee. Depending upon the nature of the change, the Grantee may require a new certification of consistency with the Consolidated Plan Certification from the United States Department of Housing and Urban Development. Any approval for changes is contingent upon United States, Department of Housing and Urban Development Field Office approval of the continuation of the Subrecipient's renewal ranking in the CoC NOFA application process. The parties agree to renegotiate this Agreement if the Grantee determines, in its sole and absolute discretion, that changes are necessary for reasons including but not limited to changes in Federal, State, County laws or regulations, or increases or decreases in funding allocations. The Grantee shall have final authority in determining funding availability for this Agreement caused by changes listed above. Notwithstanding the foregoing, the Grantee retains all rights of suspension and termination set forth in other section(s) of this Agreement. r. Right to Waive - The Grantee may, for good and sufficient cause, determined by the Grantee in its sole and absolute discretion, waive provisions in this Agreement in writing or seek to obtain such wavier from the appropriate authority. All waiver requests from the Subrecipient must be in writing. Any waiver shall not be construed as a modification or revision to this Agreement. s. Disputes - In the event that an unresolved dispute exists between the Subrecipient and the Grantee, the Grantee shall 'refer the questions, including the views of all interested parties and the recommendation of the Miami -Dade County Homeless Trust, to the Miami -Dade County Mayor or the Mayor's designee for determination. The Mayor or Mayor's designee will issue a determination within thirty (30) calendar days of receipt and so advise the Grantee and the Subrecipient, or in the CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 33 event additional time is necessary, the Grantee will notify the Subrecipient within the thirty (30) day period that additional time is necessary. The Subrecipient agrees that the determination of the Mayor or the Mayor's designee shall be final and binding on all parties. Proceedings - This Agreement shall be construed in accordance with the laws of the State of Florida and any proceedings arising between the parties in any manner pertaining or related to this Agreement shall, to the extent permitted by law, be held in Miami -Dade County, Florida. u No Third Party Beneficiaries - This Agreement has no intended or unintended third party beneficiaries. v. Constructton-of die Agreemerit ThisAgreemerit shall not be construed against the-- 'drafter of this Agreement. w, -Sovereign Immunity Nothing in this Agreement shall be considered .a waiver of sovereign immunity. x Notice and Contact - The Grantee's representative for this Agreement is Victoria L. Mallette, Executive Director, Miami -Dade County Homeless Trust. The Subrecipient's representative for this Agreement is -31)0'4 1-4OA NSI -i -T . The project site location is Gly iF MIAMI ea -A c 14 ` • In the event that different representatives are designated by the Subrecipient after this Agreement is executed, or the Subrecipient changes the address of either the program site or principal office, the Subrecipient must notify the Granteeprior to suchrelocation and obtain all necessary approvals Nonce of the name of the new representative or new address, will be rendered in writing to the Grantee within five (5) business days of the proposed change:..; y. The Subrecipient shall provide to the Grantee, prior to execution of this Agreement, the Subrecipient's Board Approval or Board Resolution designated`authorizing signatories or their alternative to receive and expend funds, to execute agreements and subcontract agreements and to exercise modification, renewal, and termination clauses contain within this Agreement The resolution shall be updated and provided annually, The Subrecipient shall provide the Grantee with a current list of the Subrecipient's Board of Directors and a Program Specific Table of Organization, which includes all current job titles in PDF format and which shall be emailed as an attachment to Miami -Dade County Homeless,Trust's Contract Manager within five (5) •business days of execution of this Agreement. aa. Name and Address of Payee -When payment is madeto the Subrecipient, it shall be directed to the name and. address of the payee hsted here: Subrecipient's Name: Gid o;' M (A Address:` 1 oN CVEN�"!.otel, tvl f A M 1 GI -d c ENTe 1 t v E. 1= L 33139 819 bb. All Terms and Conditions Included 7 this. Agreement and its Attachments A through K asreferenced in the Index of Attachment, contain all the terms and conditions agreed upon by the parties. CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach cc. Autonomy - Both parties agree that this Agreement recognizes the autonomy of and stipulates or implies no affiliation between the contracting parties. The parties acknowledge that the relationship of Grantee and Subrecipient is that of independent contractors and that nothing contained in this Agreement shall be construed to place Grantee and Subrecipientin the relationship of principal and agent, employer and employee, master and servant, partners or joint ventures. Neither party shall have, expressly or by implication, or represent itself as having, any authority to make contracts or enter into any agreements in the name of the other party, or to obligate or bind the other party in any manner whatsoever. dd. Severability of Provisions - If any provision of this Agreement is held invalid, the remainder- of this Agreement shall not -be affected thereby if such remainder would then continue to conform to the terms and requirements of all applicable law. ee. Waiver of Trial Neither the Subrecipient, subcontractor nor any other person liable for the responsibilities, obligations, services and representations herein, nor any assignee, successor heir or personal representative of the Subrecipient, subcontractor or any other such persons or entities shall seek a jury trial in any lawsuit, preceding, counterclaim or other litigation proceeding based upon or arising out of this Agreement, or the dealings or the relationship between or among the parties to this Agreement.. ff. Counties and Municipalities outside Miami -Dade County - The Subrecipient agrees to provide homeless housing within Miami -Dade County and further agrees to abide by, as well as to post this notice: Notice that all firms, corporations, organizations or individuals desiring to transact business or enter into a contract with Miami -Dade County for the provision of homeless housing and or homeless services swears, verifies, affirms and agrees that 1) they have not entered into any current contracts, arrangements of any kind, or understanding with any county, or municipality outside of Miami -Dade County to provide housing and services for homeless persons in Miami -Dade County who are transported to Miami -Dade County by or at the behest of such counties and municipalities outside Miami -Dade County; and 2) Duringthe term of this contract, entities listed above will not enter into any such contract, arrangement of any kind or understanding provided however, Miami -Dade County Homeless Trust may, in its sole and absolute discretion, find and determine within sixty (60) days of an entity's request to waive the requirements of this section, that a proposed contract should not be prohibited hereby, as the best interests of the homeless programs undertaken by and on behalf of Miami -Dade County would be served and Miami -Dade County would not be negatively affected by such contract, arrangement, or undertaking. gg. Compliance with all applicable Laws, Regulations, Ordinances, Policies and Standards - The Subrecipient agrees to comply with all applicable Federal, State, and local laws, regulations, ordinances, and standards including but not limited to any applicable requirements regarding payment and performance bonds and other requirements for public works, competitive bid and bid bond requirements, if applicable, as well as with requirements contained in the Grantee's "Continuum of Care Program Grant Agreement", Attachment A. The Subrecipient also agrees to sign and provide the Grantee with any required affidavits. CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 35 Additionally, the Subrecipient shall comply with any and all guidance that Grantee receives, from US HUD regarding this Agreement, the program and / or services covered herein, .and clarification of existing laws and regulations Religious Organizations Pursuant to 24 CFR Part 578.87, a primarily religious organization is eligible to receive US HUD funding, if the organization agrees to p ovie homess housing and services desd ibed in sect o 24 CFR Part 578.87 1and n a manner that is free from religious influences in accordance with the following principles;: It will not discriminate against any employee or applicant for employment p ployinent to basis of religion and will not limit employment or give preference persons sr th -basis of religion, b. It will not discriminate against any personapplying for homeless housing or services on the basis of religion and will not limit such homeless housing or services or give preference to persons on the basis of religion; and It will provide no religious instruction or Counseling, religious coduCat o reeligious no worship or religious services, engage in no rel gi proselytizing religious.; influence in the provision of homeless housing and services funded hereunder. d. Alternative Provider The Subrecipient shall incorporate into th ir ram oliaciecs aand t procedures, a written approved policy to' refer, or transfer any program p or prospective program participant of the Continuum of Care program who objects to the. religious chai:,acter. of the ` provider Thepolicy and procedurs Trust all l be reviewed and `subject to approval by Miami-DadeCounty minimum the policy and procedures shall include action to transfer or refer within a reasonably prompt time after the objection and undertake twhichsonable the peff r pant ts to identify and refer the participant to an alternativeprovider has no objection Except fel.' services providedby telephone, the Internet, or similar means, the referral must be to an alternative provider in reasoab rgergrapal,thic proximity to the `organization making the referral. In making the,applicable rivac laws': and regulations. The Subrecipient shall comply- with :app privacy Subrecipient shall "docunent any objections from program ' participants and prospective program participants and any efforts to refer such participants to alternative providers in accordance with the requirements of 24 CFR 578.103(a)(13) The' Subrecipient shall comply with the provisions of this section and with 24 CFPart 578.87, as well as with any other applicable laws. or' regulations governing a primarily religious organization. 10. Health Insurance Portability and Accountability Act (HIPAA)' Any person or entity that performs or assists Miami -Dade In a function t o(II or)acat vity involving the use or disclosure of Individually Identifiable , Health or Protected Health Information (PHI) shall comply with the Health :I applicable su Insurance frderait astad Accountability Act of 1996 (HIM), as may be amended, and any pp county and local laws and policies, including by not limited to 24 CFR 578.103, 42 CFR Part Page 36 CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach 2, and Section 39.908, Florida Statutes, as may be applicable. HIPAA mandates for privacy, security and electronic transfer standards that include but are not limited to the following: a. Use of information only for performing services required by the contract or as required by law; b. Use of appropriate safeguards to prevent non -permitted disclosures; c. Reporting to Miami -Dade County of any non -permitted use or disclosure; d. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Subrecipient and provides reasonable assurances that IIHI and PHI will be held confidential; e Making PHI available to the customer; f. Making PHI available to Miami -Dade County for an accounting of disclosures; g. Making internal practices, books and records related to PHI and IIHI available to Miami -Dame County for compliance audits and- for other purposes as may be permitted by law; and h. PHI shall maintain its protected status regardless of the form and method of transmission (including paper and or electronic transfer of data). The Subrecipient must give its customers written notice of all privacy information practices including but not limited to description of the types of uses and disclosures that would be made with protected health. information. 11. Proof of Licensure / Certification and Background Screening a. Licensure. — If the Subrecipient is required by the State of Florida or Miami -Dade County or any federal, state or local law or regulation to be licensed or certified to provide the services or operate the facilities outlined in the Scope of Service contained within the "Electronic Review, Renewal Adjustment and HEARTH Renewal Application", Attachment B, the Subrecipient shall furnish to the Grantee a copy of all required current licenses or certificates. Examples of services or operations requiring such licensure or certification include but are not limited to childcare, day care, nursing homes, and boarding homes. If the Subrecipient fails to furnish the Grantee with the licenses, certificates or certifications required under this Section, the Grantee in its sole discretion, shall not disburse any funds until it is provided with such licenses or certifications. Failure to provide the required licenses or certification within sixty (60) days of execution of this Agreement may result in termination of this Agreement at the Grantee's discretion. b. Background Screening — The Subrecipient agrees to comply with all applicable federal, state and local laws, regulations, ordinances and resolutions regarding background screening of employees, volunteers, subcontractors and independent contractors. Subrecipient's failure to comply with any applicable laws, regulations, ordinances and resolutions regarding background screening of employees, volunteers, subcontractors and independent contractors is grounds for a material breach and termination of this contract at the sole discretion of Miami -Dade County. The Subrecipient agrees to comply with all applicable laws, (including but not limited to chapters 39, 402, 409, 394,408, 393, 397, 943, 984, 985, 1012 and 435, Florida Statutes, and Section 943.04351, Florida Statutes, as may be amended from time to time), regulations, ordinances and resolutions regarding background CoC Grant #FL0177L4D001508, City of Miami Beach, Outreach Page 37 screening of those who may work or volunteer directly, with or in the vicinity of vulnerable, persons as defined by Section 435.02 Florida Statutes, as may be amended from time to time. In the event criminal background screenings is required by law, the State of Florida and / or Miami -Dade County, the Subrecipient will' permit only employees, volunteers, subcontractors and independent contractors with a satisfactory national criminal background, check` through an appropriate; screening agency (i.e., the Florida Department of Juvenile Justice, Florida Department of Law Enforcement or Federal Bureau of Investigation) to' work or volunteer in direct contact with or in the vicinity of vulnerable persons: The Subrecipient shall also comply with Section 94-(39/ : Florida Statutes, regarding court ordered sealing of criminal history records, -and Section 9-43.05851Florida S,tatuteS,-rtgarcli court-ordered expunction' of criminal history records, as may be applicable: The Subrecipient agrees to , ensure that employees, volunteers, subcontracted personnel and independent contractors :who <. work with vulnerable persons satisfactorily complete and pass Level 2 background screenings before working or volunteering with any vulnerable persons. The Subrecipient 'Shall' furnish Miami- Dade County with proof that employees,` volunteers, subcontracted personnel, and independent contractors who work with vulnerable persons, 'satisfactorily passed Level 2 background screenings pursuant', to Chapter 435 Florida Statutes, as may be amended from time to time; If the Subrecipient fails to furnish to Miami -Dade County proof that an employee, volunteer, subcontractor or independent contractor's Level 2 `or other required background screening.. was satisfactorily passed and completed prior to that employee, volunteer, . subcontractor or independent contractor working or volunteermg,with orin the vicinity of a vulnerable person or,,Vulnerable persons, Miami -Dade County shallnot disburse any further funds and this Agreement may be subject to termination at the sole discretion of Miami -Dade County. IGNATURES CONTINUE ON NEXT PAG CoC Grant #FLO177L4D001508, City of Miami Beach, Outreach rt. IN WITNESS WHEREOF, the parties have caused this (40) forty -page Agreement to be executed by their respective and duly authorized officers the day and year first above written. ENTITY: Subrecipient: C.17-‘,/ aF MtE•'Ac.H jai L (Print s Name) ignature) (fret Authorized Signatory)ORKTEDi a.1 riY mAi4AGER .5 (Priiat Title of Authorized Signatory) (Print Witness Name) ATTEST: HARVEY RUVIN, CLERK BY: Deputy Clerk Date APPROVED AS TO FORM & LANGUAGE & FOR fr E UTION 4L1' Date Affix Incorporation SEAL here Miami -Dade County, a political subdivision of The State of Florida Carlos A. Gimenez, Mayor See attached memorandum dated ( ) approved as to form and legal sufficiency Resolution # R-408-16 CoC Grant #FL01.77L4D001508, City of Miami Beach, Outreach Page 39 Attachment A - Continuum of Care Program Grant Agreement & Exhibit 1 Attachment B Scope of Service and US HUD eSnaps documents Attachment C - Form \V-9 Request for Taxpayer Attachment D - Attachment' Attachment F - Miami -Dade County. Required Affidavits and Declarations "Consolidated Financial Record and Reports" "Performance Reports (Monthly and Annual)' "CoC Homeless Assistance Program Guidelines" Attachment I - "Real Property & Equipment Asset Inventory" form Attachment: J Attachment K s=:440ax When Subrecipient is the Rental Administrator (Participant's Housing Application)* HAP & LEASE When Miami -Dade County is the Rental Administrator * E ts Housing (Partrcipan ' H g Application) HAP &LEAS -31E- The "CoC Participant Housing Application" contained therein, may be updated and amended from time to time and re -issued administratively includes CoC Grant #FLO177L4D001S08, City ( Miami Beach, Outreach Page 40 Form W-9 Department of the Treasury Internal Revenue Service (IRS) Request for Taxpayer Identification Number and Certification ATTACHMENT C "W-9 Request for Taxpayer ID Number and Certification" Form (Rev. C Departs Interna "w9 'ecember 2014)requester. nentoftheTreasury Revenue Service Request for Taxpayer IdetiicatiAr! Number and Certification Give Form to the Do not send to the IRS. 1 Name (as shown CII' - Y oP on your income tax return), Name is required on this line; do not leave this line blank. MiAM I EACJ-! 2 Business name/disregarded entity name, If different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes; El Individual/sole proprietor or ❑ C Corporation ❑ S Corporation Cl Partnership single -member. LLC El Ltmited liability company, Enter the tax classification (0=0 corporation, S=S corporation, P=partnership) Note. For a single -member LLC that is disregarded, do not check LLC; check the appropriate box in the tax classification of the single -member owner. CI Other (see lnstruotions) ► ❑ Trust/estate m 4 Exemptions certain entities, instructions Exempt payee Exemption code (If any) Mpllea to accounts (codes apply only to not in see on page 3): code (if any) from FATCA reporting the line above for maintained. inside the us.i 5 Address (number, street, and apt. or suite no.) I4.00 C0t'4VEiN ON CENTER 1oi?IYE Requester's name and address (optional) G City, state, and ZIP code MIAMI 13EAG14, FL 3313 7 List account number(s) here (optional) Taxpayer Identification Number {TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this Is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entitles, it is your employer identification number (EN). If you do nothave a number, see How to get a TIN onpage 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Part 1 Social security number or. Employer identification number 5 9 6ioiopi3 2. Part 11 Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer Identification number (or i am waiting for a number to be issued to me); and 2. I have not been ed the Internal Revenue Sam ervice(IRS)ect to backup withholding that 1 am subject to backupecause:p withholding as a resu1 am t of a failut from retoreport allllii terestbor dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (If any) indicating that I am exempt from FATCA reporting Is correct. Cortification instructions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have fated to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured • operty, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments other than Into est and dividends you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person ► General Instructions Section references are to the Internal Rev ue Code unless otherwise noted. Future developments. Information about evelopments affecting Form W-9 (such as legislation enacted after we release it) is at wwwirs,govlfw9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer Identification number (EIN),10 report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: • Form '1099 -INT (interest earned or paid) • Form 1099-DiV (dividends, Including those from stocks or mutual funds) • Form 1099-MISC (various types of Income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-9 (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) Dates it /i(((7 • Form 1098 (home mortgage interest), 1098-E (student Loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN, If you do not return Form W-9 to the requester with e TIN, you might be subject to backup withholding. See What Is backup withholding? on page 2. By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U,S. person, your allocable share of any partnership income from a U,S, trade or business Is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat, No. 10231X Form W^9 (Rev.12-2014) Miami -Dade Coun M lAN MADE s Affidavits and Declarations Miami -Dade County requires each party desiring to enter into a contract with. Miarni-Dade County to; (1) Sign an affidavit as to certain matters and (2) make a declaration as to certain other matters. This form contains both Affidavit forms for matters requiring the entity to sign under oath and Declaration forms for matters requiring only an affirmation or declaration for other matters. Each section of this form must be read, and initialed in the top right hand box indicating acceptance and/or compliance with the County's policy related to the particular affidavit. For affidavit sections that you do not believe are applicable to your organization, please indicate this by placing "Ei'' in the box next to N/A. ALL SECTIONS MUST BE COMPLETED THE FOLLOWING MATTERS REQUIRE THE ENTITY TO SIGN AlAFFIDAVIT UNDER OATH: STATE OF ( FL-ofR DA COONTY OF (NI IA iwt 1 — C>AIDE COUNTRY OF (USA J Before me the undersigned authority appeared (Print Name), -Xi MMI L.. MA LES who is personally known to me or who has provided as identification and who did swear to the follovving: That he or she is the duly authorized representative of (Name of Entity) C 1 CIP MIA M1 ESEAC, (Address of Entity) 14-0D CON Ne EN -11 ON C.E'N-reR tR IVET addresses are not acceptable 5 '9 0 0 0 5 2 Past Office Federal Employment Identification Number CITY OF Mt AMU I5EAc.1-1 (hereinafter referred to as the contracting "entity"), and that he or she is the entiVs (Sole Proprietor) (Partner) (President or Other Authorized Officer) CITY MA'ER NIA That he or she has full authority to make this affidavit, and that the information given herein and the documents attached hereto are true and correct; and That he or she says for the following fifteen (16) Affidavits and Declarations: ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 1 of 11 Miarni-Dade County's; Affidavits and Declarations. 1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT (SECTION 2-E.1. OF THE COUNTY CODE) Pertains 0 N/A If the contract or business transaction is with a corporation, the full legal name and business address shall be provided for each officer and director and each stockholder who bolds directly or indirectly five percent (5%) or more of the corporation's stock 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 -full legal rialto and address shall be provided for each trustee and each beneficiary. The foregoing requirements shall not pertain to contracts with publicly traded corporations or to contracts with. the United States or any department or ageriey thereof, the `State or any political subdivision or agency thereof or any municipality' of this :State, All such names and address are outlined below: Post Wee- addresses are not acceptable. (Full Legal Name, Address, %/o Ownership) (Full Legal Nance, Address, % Ownership) (Full Legal Dame, Address, % Ownership) (Full Legal Name, Address, % Ownership) The full legal names and business address of any other individual (other than subcontractorsone terial person, suppliers, laborers, or lenders) who have, or will have, any interest (legal, equitable beneficial or otherwise) in the contract or business transaction with Miami Dade County are: Post office addresses are not acceptable Any person who willfully fails to disclose the information required heroin, or who knowingly discloses false information in this regard, shall be punished by a fine of up to five hundred dollars ($50000) or imprisonment in jail for up to sixty (60) days or both. ATTACHMENT D "Miami -Made County Affidavits and Declarations" Page 2 of 11 Miami -Dade County's Affidavits and Declara MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT (COUNTY ORDINANCE 90.133, AMENDING SECTION 2.8-1 SUBSECTION (d)(2) OF THE COUNTY CODE) 0 s Except where precluded by Federal or State laws or regulations, each contract or business transaction o renewal thereof which involves the expenditure of then thousand dollars ($10,000) or more shall require the entity contracting or transaction business to disclose the following information. The foregoing disclosure requirements do not apply to contracts with the United States or any department or agency thereof, the State or any political subdivision or agency thereof or any municipality of this State. Does your firm have a collective bargaining agreementwith its employees? V Yes O No Does your firm provide paid health care benefits for its employees? Provide a current breakdown number of ersons of our firm's work force and ownership (below): White: Black, Hispanic: males 29 3 Males 285 ales 812 Asian Males 13 Americana Native: Males 2 Aleut (Eskimo): Males Females3 14 Females 5 Females Females ATTACH ENT D"Miami-Dade County Affidavits and Declarations" Pag 3 of 11 Miami -Dade County's Affidavits and Declarations MIAMI-DADE COUNTYAFFIRMATIVJ ACTION / NONDISCRIMINATfON OF EMPLOYMENT, PROMOTION AND PROCUREMENT PRACTICES (COUNTY ORDINANCE 98-30 CODIFIED AT 2-8.1.5 OF THE COUNTY CODE) Pursuantto Miami -Dade; County's Ordinance No. 98-30, Section 2'-8.z,5, entities with annual gross revenue in excess of $5,000,000 seeking to contract with the County shall, as a condition of receiving a County contract, have;, 1) a written affirmative action:Plan which sets forth the procedures the entity utilizes to assure that it does not discriminate in its employment and promotion practices and 2).a written procu einem policy which sets forth the procedures the entity utilizes to assure that it does not discriminate against minority and women -awned businesses in its own procurement et goods, supplies and services, Suchaffirmative action plans and procurement policies shall: provide for periodic review to determine their effectiveness in assuring the entity dues not discriminate in its employment, promotion and procurement practices. The foregoing, not withstanding, corporate entities whose board of directors are representative of thepopulationmalke-UP`of the nation, shallbe presumed to have non-discriminatory, employment and procurement policies,. and shall not be required to have'a written. affirmative action plan and procurement policy in order to receive a County contract The foregoing presumption may be rebutted. The requirements of this section ay be waived upon written recommendation of the County Manager that it is in the best interest. of the County to do so and approval of the County ComMission'by majority vote of the members present. Based on the above, please complete the affidavit as directed and return the completed affidavit alongwith a cover letter on your compaiiy's,tetterhead,.listing the company's address, phone and fax numbers, and any required documents, to: Miami -Dade County, Department of l i ocurement Management Affirniative Acton Plan Unit 111 NW lst Street,13th Floor Miami, FL 3312E My company has an affirziiative action plan and procurement policy and is available for review. My company has annual gross revenues in excess of $5,000,000. Therefore, our company's affirmative action plan and procurement policy is available for review. My company'has annual gross revenues less than $5,000,000. If at any time the Miami Dade County has reason to believe that any person or firm has willfully and lmowingly provided incorrect information or made false statements, the County inay refer the matter to the State Attorney's Office and/or other investigative agencies. The County may initiate debarment and/or pursue other remediesin accordance with Miami -Dade County policy and/or applicable federal, state and local laws. 4. MIAMI-DADE COUNTY CRIMINAL RECORD AFFIDAVIT (SECTION 2-8.6 OF THE COUNTY CODE) The individual or entity entering into a contract or receiving funding from Miami -Dade County 0 has h snot; as of the date of this affidavit, been convicted of a felony during the past ten (10) years. An officer, director, or executive officer of the entity entering into a contractor receiving funding from Miami -Dade. County 0 has 114 has not as of the date of this affidavit been convicted of a felony during the past ten (10) years. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 4 of 11 Miami -Dade County's Affidavits and Declaratio: s 5. PUBLIC ENTITY CRIMES AFFIDAVIT (SECTION 287133(3)(a), FLORIDA STATUTES) eirtai N/A Initial: i The individual or entity entering into a contract or receiving funding from Miami -Dade County understand ;the following; That "public entity crime" as defined in Paragraph 287.135 ,1) (g) Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or withan agency or political subdivision Of any other state ofthe United States ofAmerica, including but not limited to, any bid er contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States of America and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 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 any federal state trial court of record relating to charges brought by indict mens or information after July 1, 1989, as a result of a jury verdict, .non - hay trial, or entry of plea of guilty or, nolo contendere. That an "affiliate" 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; orb) an entity under the control of any natural person who is active in the management of the entity and who has keen.convicted ofa public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, merribers, 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 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 person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florlda during the preceding 36 months shall be considered an affiliate. That a "person" as defined in Paragraph 287.133 (1) (e) Florida Statutes means any. natural`persen or entity organized under the laws of any state or of the United States of America with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, inernbers and agents who are active it the nianagement of an entity. Based ori information and belief, the statement as marked below, is true in,relation to the entity subrnitting this sworn statement. (Please indicate which statement applies by applying the individual initials near thebox), Q Neither the entitysubmittng this sworn statement nor any'of its officers, directors, executives; partners, shareholders, employees, membersor agents who are active in the management of the entity, nor an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. Cl The entity submitting this sword 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 has been, charged with and convicted of a public entity crime within the past 36 months; and yes an additional statement is applicableor 0 no an additional statement is not applicable. 0 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 inanagement 01 the entity has been charged with and convicted of a public entity crime within the past 36 months. However, there.have been subsequent proceedings before a Hearing Officer ofthe 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 sworn statement on the "Convicted Vendor List". The individual or entity entering into a contract or receiving funding from Miami -Dade County understands that he or she is required to inform the public entity prior to entering into a contract in excess of the threshold amount provided in Section 287.017 Florida Statues. for Category 2 of any change in the information contained inthis form, ATTACHMENT D "Miami -Dade CotmtyAffidavits and Declarations" Miami -Dade County's Affidavits and Declarations 6. MIAMI-DADE EMPLOYMENT FAMILY LEAVE AFFIDAVIT (County Ordinance No.142=91 codified as Section 191-29 et. see of the County Code) That in compliance with Ordinance No. 142-91 of the Code of Miarrii Dade County, Florida, an employer withlifty (50) or more employees working in Dade County for each working; day during each of twenty (20) or More calendar work weeks, shall provide the following information in compliance with all items in the aforementioned ordinance; An employee who has worked for the above firm at least one (1) year shall be entitled to ninety (90) days of family leave during any twenty-four (24) month period; for medical reasons, for the birth or adoption of a child, or for the care of a child, spouse or other close relative who has a serious health condition without risk of termination of employment or employer retaliation. The foregoing requirements shall not pertain to contracts with the United States or any department or agency thereof, or the State of Florida or any political subdivision or agency thereof. It shall, however, pertain to municipalities of this State. 7. MIAMI-DADE COUNTY DISABILITY NONDISCRIMINATION AFFIDAVIT (County Resol,utio' H-385-95) Pertaiikts tit[a That the above named firm, corporation or organizationis in compliance with and agrees to continue to corn •ly with, and assure that any subcontractor, or third party contractor under` this project complies with all applicable requirements of the laws listed below including, bnt not limited to, those provisions pertaining to e?n.ployinent, provision ofprbgrams and services, transportation;;communications, access to facilities, renovations, and new construction in the following laws: 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 11I, Public: Accommodation and Services Operated by Private i ntfties; Title IV, Teiecommunication.s and Title V, Miscellaneous Provisions:: The RohabattationAct, of 1973, 29 U S C. Section 794; The Federal' Transit Act, as amended 49 U .S. C. Section 1612: The Fair Housing Act as. amended, 42 .USC Section 3601.3631. The foregoing requirements shall not pertain to contracts with the United States or any department or agency thereat or the State or any political subdivision or agency thereof or any .municipalityof this State. 8. MIAMI-DADE COUNTY REGARDING DELINQUENT AND CURRENTLY DUE FEES OR TAXES (Sec. 2-81(c) of the County Code) Except for small purchase orders and sole source contracts, that above named firm, corporation, organizatio individual desiring to transact business or enter intoa contract with the County verifies that all delinquent a currently due fees or taxes -- including but not limited to teal and property taxes, utility taxes and occupational licenses ,- which are collected in the nor mal_ course by the Dade County Tax Collector as well as Dade County issued parking tickets for vehicles registered in the name of the firm, corporation, organization or individual have been paid. AffigaiStgaggfittiffetarldiONSOWN ATTACHMENT D "Miami -Dade County Affidiaivi.ts and Declarations" Page 6 of 11 Mia i -Dade County's Affidavits and Declarations 9. CUR NT ON ALL COUNTY CONTRACTS, LOANS AND OTHER OBLIGATIONS The individual entity seeking to transact business with the. County is current in all its obligations to the Co t1 ty and is not otherwise in default of any contract, promissory note or other loan document with the County or any of its agencies or instrumentalities, 10. DOMESTIC VIOLENCE LEAVE (Resolution 185-00; 99-5 Codified At 11A- 60 Etta Seq. ofthe Miami -Dade County Code). Pertain NiA Initial:.( The firm desiring to do business with the County ist in corn fiance with. Domestic Leave Ordinance, Ordinare 99- 5, codified at 11A-60 et seq. of the Miami Dade County Code, which requires an employer which has in the regular course of business fifty (50) or more employees working in Mimi -Dade County for each worldrig day during each of twenty (20) or more calendar work weeks in the current or proceeding calendar years, to provide Domestic Violence. Leave to its employees. 11. MIAMI-DADE COUNTY EMPLOYMENT DRUG-FREE WORKPLACE AFFIDAVIT (County Ordinance No. 92-15 codified as Section 2- 8.1.2 of the County Code) That in compliance with Ordinance No. 92-15 ofthe Code cif Mianii-Dade County, Florida,,the above named erson or entity is providing a drug-free workplace. A Written statement to each erriployee 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 workplaces 3. availability of drug counseling, rehabilitation and employee assistance programs; 4. penalties that may be imposed upon employees for drug abuse violations. The person or entity shall also require an employee to sign a statement, as a condition of employinent that the employee Will abide by the terms and notify the employer of any criminal drug conviction occu00 rring no later than five (5) days after receiving notice of such conviction and impose appropriate personnel action against the employee up to and includingtermination. Compliance with Ordinance No, 9245 maybe waived if the special, characteristics of the product or service offered by the person or entity make it necessary for the operation of the County or for the health, safety, welfare economic benefits and well-being of the public. Contracts involving funding which is provided in whole or in part by the United States or the State of Florida shall be exempted from the provisions of this ordinance in those instances- where those provisions are in conflict with the requirements of those governmental entities. ATTACHMENT D "Miami -Dade County Affidavits and Declarations"-' Page 7 of 11 Miami -Dade County's Affidavits and Declarations 11 ATTESTATION REGARDING DU AND PROPER ACKNOWLEDGEMENTOF COUNTY FUNDING SUPPORT' Pertains ►l N/A 10 ia1;( By initialing this subsection and accepting County funds, the above named firm, corporaf on, organization or individual' agrees to abide by the grant contract requirement to recognize and acknowledge Miami -Dade County's. grant support in a manner commensurate with all contributors and sponsors of its activities at comparable dollar levels. 13.MIAMI-DA.DE COUNTY RESOi.UTION:NO R.630-13 REQUIRING ADETAILED PROJECT BUDGET, SOURCES AND USES STATEMENT, CERTIFICATIONS AS TO PAST DEFAULTS ON AGREEMENTS WITH NON -COUNTY FUNDING SOURCES, AND DUE DILIGENCE CHECK: Pursuant to Miami -Dade County Resolution No. R-630-13, requiring a detailed project budget, sources and uses statement, certifications as to past defaults on agreements with non -county funding sources and,due diligence check prior to the County Mayor or County Mayor's designee recommending a commitment of Miami -Dade County funds to Social Services, Economic Development, Community Development, and.Affordable Housing Agencies and Providers. Theundersigned entity c ertifies, to the best of his or her lnowledge and belief, that: 1. . - 'Within the past five (5) years, neither the Agency nor its directors, partners, principals, members or board members; (i) have been sued by a funding source forbreach of contractor failure to perforin obligations under a contracts (ii) have been cited by a funding source for non-compliance or default under a contract; (iii) have been;a defendant in at lawsuit based upon a contract • with a funding source. Please list any matters which prohibit the Agency from making the certifications required and explain how the matters are being resolved (use separate sheet if necessary). 14. MIAMI-DADj COUNTY RESOLUTION No. R478-12 NOT TO USE pommel's OR FOODS CONTAINING "PINK SLIME" Pursuant to Miami -Dade County Resolution No R-478;12, the undersigiaed certifies, not to us;e meatproducts` containing "Pink Slime" in food provided or served as part any food program; urging all who provide food services or operate a food program to immediately discontinue using meat products containing `pinkslime" in food provided or served in these programs. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 8 of'1 Miami -Dade County's Affidavits and Declarations 15. Mi I FDAD1 COUNTY: REQUIRED LOBBYIST REGISTRATION FOR ORAL PRESENTATION Section 2411.1(1)(2) CONFLICT OF INTEREST AND CODE OF ETHICS ORDINANCE Pertalns N/A Iflitial All lobbyists shall register with the Clerk of the Board of County Commissioners within five (5) business da o being retained as a lobbyist or before engaging in any lobbying activities, whichever shall come first Every t erson required to so register shall; 1. Register on forms prepared by the Clerk; 2. State under oath his or her name, business address and the name and business address of each person or entity which has employed said registrant to lobby. If the lobbyist represents a corporation, the corporation shall also be identified; Without limiting the foregoing, the lobbyist shall also identify all persons holding; directly or indirectly, a five (5) percent or more ownership interest in such corporation, partnership, or trust Registration of all lobbyists shall be required prior to January 15 of each year and each person who withdraws as a lobbyist for a particular client shall file an appropriate notice of withdrawal. 3. Prior to conducting any lobbying, all principals must file aforrn with the Clerk ofthe Board of County Commissioners, signed; by the principal or the principal's representative, stating thatthe lobbyist is authorized to represent the principal. Failure of a principal to file the form required by the preceding sentence may be considered in the evaluation of a bid or proposal as evidence that a proposer or bidder is not a responsible contractor, Each principal shall file a form with the Clerk of the Board at the point in time at which a lobbyist is no Longer authorized to represent the principal. ByInitialinghere, the principals orprincipal's representative have filed with the Clerk of the Board of County Commisioners stating that a lobyist authorized to represent the principal. 4. Any public officer, employee or appointee who only appearsin his or her official capacity shall not be required to register as a lobbyist. 5. Any person who only appears in his or her individual capacity for the purpose of self -representation. without compensation or reimbursement, whether direct, indirect or contingent, to express support of or opposition to any item, shall not be required to register as a lobbyist: 6; Any person who only appears as a representative of a not-for-profit corporation or entity (such as a charitable organization, or a trade association or trade union), without special compensation or reimbursement for the appearance, whether direct, indirect or contingent; to express support of or opposition to any item, shall register with the Clerk as required by the Ordinance subsection, but, upon request, shall not be required to pay any registration fees. The Clerk of the Board of County Commissioners shall notify the Commission on Ethics and Public Trust of the failure of a lobbyist or principal to file a report and/or pay the assessed fines after notification, A lobbyist or principal may appeal a fine and may request a hearing before the Commission on Ethics and Public Trust. A request for a hearing on the fine must be filed with the Commission on Ethics and Public Trust within fifteen (15) calendar days of receipt ofthe notification of the faiIure to filethe required disclosure form. The Commission or Ethics and Public Trust shall have the authority to waive the fine, in whole or part, based` on good cause shown. The Commission on Ethics and Public Trust shall have the authority to adopt rules of procedure regarding appeals from. the Clerk of the Board of County Commissioners. Except as otherwise provided in subsection ofthe Ordinance, the validity of any action or determination of the Board of County Commissioners or County personnel, board or committee shall not be affected by the failure of any person to comply with the provisions of this subsection(s). (Gird. No. 00-19, § 1, 2-8-O0; Ord, No. 01-93, § 1, 5-22- 01; Ord. No. 01462, § 1, 10-23-Q1; Ord. No. 03407, § 1, 516-03) MOINatem ATTACHMENT D' LVlianii-Dade County Affidavits and Declarations' Page 9 of "11 Mjami-Dade Count Affidavits and Declarations 1ti. disclosure SUBCONTRACTOR / SUPPLIER LISTING (ORDINANCE 97-.104) rtatti natal This form, or a comparable form meeting the r:equirernents of Ordinance 97404, Must be completedby all ers and proposers on Miami -Dade County contracts for purchase of supplies, Materials or services, including professional services which involve expenditures of $100,000.00 or more, and all bidders and proposers on County or Public Health Trust construction contracts which involve expenditures of $t00,000 00 tib' more. This form or a comparable form meeting the requirements of Ordinance- 97-104, 'must be completed and submitted even trough the bidder or proposer will not utilize subcontractors or suppliers. on the contract. The bidder or proposer should enter the word "NONE" under the appropriate heading; in those instances where no suiicontractors or suppliers will be used on the contract, A -bidder Or proposer 'who is awarded the contract, shall not change or substitute first tier subcontractors or direct suppliers or the portions of the contract work to be performed or materials to be supplied from those identified except upon written approval of the County. Business Name and Address. of First Tier Subcontractor/Subco.nsultat Principal Owner Scope of Ward to. he Performed liy •contractor/Suliconsttltant (Principal Owner) Csnder Race` Business Name and Address of Direct Supplier Principal Owner Supplies/Materials/Services to be Provided by Supplier (Princ Gender al Owner) Race I certify that the 'representations contained in this Subcontractor/Supplier Listing are to the best of my knowledge true and accurate. Signature of Authorized Representative. Date t Print Title Print Naxne (Duplicate if additional space is needed) ATTACHMENT D "Miami -Dade CouityAffidavits and Declarations Page. 10 of 11 Miami -Dade County's Affidavits and Declarations I have carefully read this entire 11 -page document entitled, "Miami -Dade County's Affidavits and Declarations" and agree to; (1) sign an affidavit as to certain matters and (2) make a declaration as to certain other matters. This form contains both Affidavit forms for matters requiring the entity to sign under oath and Declaration forms for matters requiririg only an affirmation or declaration for other matters. BY SIGNING AND NOTARIZING THIS PAGE YOU ARE ATTESTING TO AFFIDAVITS AND DISCLOSURES 1-16 MIAMI-DADE COUNTY AFFIDAVITS SIGNATURE PAGE By: .641 --rr:11544: GOCX:) , Federal -..Employer IdetitifieatIon. Nurnl)er , 20 0 k • IM L .MORAL1771- OF MIAMI 8EAC1--1 Printed arne of Affiant and Name of Agency 14-00 Cotaiv EINrin c)I•4 C.E 1°4 "TVE miAmi Address of Agency FL 33. I 3cI — I 8 I 9 SUBSCRIBED AND SWORN TO (or affirmed) before me this a day of , 20 He/She is personally known to me or has presented Type of Identification Serial Number Print or Stamp Name of Notary Expiration Date Notary Publio — State of County of MIA CARDILLO MY COMMISSION # FF 155322 EXPIRES: August 27, 2018 Bonded Thru Notary Public Undermilers • as identification. No/ay Seal ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 11 of 11 Agency Letterhead Date, Attention. Assigned Contracts Officer Miami -Dade County Homeless Trust Suite 310, 27th Floor 111 NW First Street Miami, Florida 33128 Subject: FY 2015 US: HUD CoC° Program 01,4D001500..PrOg1 Name ofA,gency is respectfully submitting for your review and release of payment`of the enelosed Consolidated Financial Record and Reports for the above subject program. We request reimburserrient and ericlose"d documents that support this request ar Mount as'well as documentation of match compliance. The following documents included in this report are outlined below: Li Cover Letter Li Pe'rforn ante Rej ort- 0625°HOO CoC Monthly I-IMIS.generated Report l l Homeless Trust Invoice C7 HUD form 27053-A SNAPS Request Voucher for Grant Payment [1 Summary and Compliance Report: Cl Snivelling documents for invoice requireinor is and match including invoices, cancelled checks, payroll, time arid effort logs, and if applicable: copy of Tenant paid utility bills cOriSistent With utility allowance, documentation ofmatch expenditure compliance, consistent with OMB Omni or Super Circular and 24 CFR 578. The amount requested is 1041,0 for the riaonch of Mati r . The value of the match demonstrated is solo. The amount of program?, income if applicable) is 10,,M This is an adjustment #, ) for the month Of l t On behalf of our homeless community members who benefit from this program, we thank you for your time and assistance. Please call (305) 000-000 extension 0 or email address with any concerns or:comments aboutttris reimbursement package. Sincerely, Naive Title Enclosures Attachment E "Consolidated Financial Record and Reports Cover Letter'' IAMi-DADE CO NT` O LESS TRUST:INVOICE Rental Assistance '• ermainentTenantBased RA Re al Assistance ° Permanent Sponse as i d RA 7.,Assessfilen t of S Needs' 2;Assistance'with rilow ng cos s,gase Management 4.Chi1 7 Cane TOTAL QUEST AMOUNT By signing this report, 1 certify to the best of my knowledge and belief that the, report is true, complete and accurate and the expenditures, df§bursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the federal award. l am aware that any false, fictitious, or fraudulent lnfrmatio or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or Other offense Prepared this (date) Miami -Dade County Homeless Trust LOCSNRS U. S, Department of Housing SNAPS Special Needs Assistance Program and Urban Development Request Voucher for Grant Payment Office of Community Planning and Development Soo Instruction§ and Pub5c Repotfingflurden Statement on back OMB Approval No, 2535-0102 Parma of Agoncy Warne of progrant 1. Voucher Number: ?st.Ocos nom 4BEA: PS HPAC IHP 3 Period Covered by this Request: (dates) 6, Voice ReSpense No. (5 .diglts, hyphenS, 5 niore 6. Grantee OrganizatIon'e Name 7. Grant No; F L0000 L4D001 508 0, Line Item no. 10. Type of Funds Requested 8: Grantee Organizatlede TIN: 4, Type of Disbursement: Partial Final A Antou0 (rqttnq to nearest dollar) 1010 Acquisition 1020 Rehabilitation 1021 New Construction 1022 Substantial Rehabilitation 1023 Moderate Rehabilitation 1030 Operating Cost 1040 Rental Assistance 1060 Supportive SOIVICOS 1051 HMIS Costs 1060 Administrative Cost 1062 CoC Planning Costs 1070 1080 Child Care Employment Assistance 1090 Relodation 1100 Leasing 1110 Repair & Maintenance Prevention (RH) 1112 Capacity Building (RH) 1120 Other: Voucher. Total: $ I hereby certify that alt the Information stated herein, as well senny information provided in the acOomPaphearkt fterevv1111, is true POO aeCeOtte. . _ Warning: HUt7wfl prosecute false claims and statements. Conviction innyissnit in criminal penalties. (lp 3p0.2). 11. Nems & Phone Num4er gm:lading area.codo) eftheAuthoaze,d. 12. Signature:. 13, Date -of Requasi; Person who called SNAPs System VRS; Privacy Statement: Public Law 97-266, Financial Integrity Aet, 31 1),S,C. 3512,-authoriZeS the Department Of Housing and Urban nnyeioninont (Hum to,cniteet all the InfortnetlOp (pxoept the, Social Security Number (SNN)) whleh will be used by HUO 10 protsst disbursement data:from fan:Outwit:actions, The1-leusinn:eadcernmunIty Development Act pt 1087,..42 1114C, 3643, authorizes to collect the ON, The data ale tiSad to ensure that IndiViddele who ne longer require-nocesst9 Lit ? nf t.rsditPirirni System (1,0POP) have theifaceeSS aaPabilliYProMPt deleted. Provision of the SSN is Mandatory. HUD uSetlt as.? unique identifier for safeguarding LOCOS froth unauthorized accees. Failure to provide the information requested may delay the processing of your approval for access to LOCCS: Thls'Inferiaation will riot be otherwise disclosed or releaied outside of HUD, extent as permitted by IOW, form HUD -27053-A Agency Name: Summary and Compliance Report IVIIAMI-DALIE COUNTY FY 201g IJS }1W COC SUIVIIVIARY ANT) COMPLIANCE REPORT Program Name: Grant #-'400.00L40001500 Month pf $ortriOegentillyrn.. 011ration: 00/00/2016 - 00/00/2017 ACTUAL Nit)NTHLY 1,TtOGRAIVI EXPENSE LSASING PitOORANi INCOME 'EtPEND.PfoRES- • - Leasing. Leasing Structures Leasing Unita Siebtotal TOTAL LEASING Units- Rental Assistaneo TRA SRA lJnits ToTAI,YEAll gMiNi* AMOUNT RENTAL .„ . SRO Pi -Omani Ineonte to Landlords Rental Administration costs Subtotal TOTAL RENTAt. ASSISTANCE 1. Annual AS§eSsIdellt staffSalary TaxeS & Pringe Subtotal $ 2. ASsistance Miiving Costa SUIPIIeS to transition moving expenses Subtotal$ 3 Cake Mainigenient FT staff :561aq TaxeS & Fine Obtaining benefits Subtotal, 4 Chid care Childcare vouchers Meals and Snacks in childcare Subtotal 5. EducatiOn Services VTR staff salary Taxes Sefringe education supplies Subtotal 6. Empleyment / Training FT1 staff salary % taxes tie fringe • Computer training Eligible job Stipends Subtotal 7. itood Providing meals Groceries Subtotal Sum ary and Compliance Report FY 2015 COG Pl'ograin ACTUAL MONTHLY prtoratAm EXPENSE INVOICE MATcH PROGRAM INCOME EXPENDITURES MONTHLY BUNCHMAHH AMOUNT TOTAL YEAH ORANT AMOUNT 8, Housing search FTE $ staff salary Taxes & Fringe Landlord mediation Rental application fee Credit counseling Subtotal 9. Legal services FTE $ $ $ staff salary Taxes & Fringe Subtotal 10. Ufe Skills Training FTE staff salary Taxes & Fringe $ Subtotal $ 11. Mental health services FTE staff salary Taxes & Fringe Subtotal 2, Outpatient heal TE staff salary Taxes & Fringe Subtotal 3, Outreach Services. FTE s aff salary Taxes &Fringe Subtotal 14, Substance Abuse FTE staff salary Taxes & Fringe supplies Subtotal 5. Transportation Van/ gas/ maintenance Bus Tokens Subtotal 16. Utility deposits $ one-time fee Subtotal 17. Direct provisions of Operational costs for SSO only Subtotal $ TOTAL SUPPORTIVE SERVICES Summary and Compliance Report ACTUAL MONTHLY PROGIUM EXPENSE INVOICE OPERATIONS PROGRAM INCOME EkEENOITTIEES: NtoN:i'n.tv AMOUNT TOTAL Wit GRANT AmOUNT 1- Maintenance & Repair staff salary Taxes & Fringe supplies VTR Subtotal 7 Z. Property taxes, insurance tax insurance • Subtotal 3 Reserve lteltlacentent major systems reserve 4. Building security staff salvo Taxes & Pringe subcontracted security Subtotal .,t. 'Electricity gas and water utilities Subtotal 6. Furniture $ FTE $ fOrniture Subtotal 7. Etptipment operational equipment Subtotal TOTAL, OPERATION HMIs HINIIS ataff salary TOTAL HMIS COSTS ProjectAdroinistration FTE PROIECTADMINISTRATION staff salary staff salary Taxes & Rringe Travel to monitor 3rd Ratty Administration Audit $ $ Adminlatrativa office space CoC Training TOTAL ADMINISTRATION TOTAL Auto/a, MONTHLY PROGRANMENSE INVOICE MATCH - $ $ 'PROEIbilvt INCOME EXPENITITtlItES MONTH OstiCiltiittta AvieRRT Term. 11P,Alt GIANT AMOUNT By signing this report, I certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, diSburSementa and cash receipts are Or the purposes and objectives set forth in the tetras and conditions of the federal award, I are awere that any false, fictitiotts, Or fraudulent inforthatiOn er omission of any Material fact, may subject me to criminal, civil or administrative penalties forfraud, false statements, false claimor other offenso. Prepared this ( Certified by: ( ) mm/dd/yyyy signature Print Name and Title ( • 416 0 .C; A") a d 1041 etet- A 0 0 -;" a ,-. 0 0 0 0 0 ity 0 0 0 .o 0 0 0 0 0 0 te44,,) VP0 0 0 tr3 .0 I-, oN 4 q' t f: ar HO Or 450511§555h'illil 0 1-t 0 .9 g 0 0 Gettipa Miami -Dade County Ho eless Trust income Income excIusi` 7jr Annual Gross Income ;,lse roof pony t lae Number of .Dependents Multiply line 4 by$40 (Child Ca Allawctrr C l are Alloivauce.' rater anticipated unreirnbur°secl Clrilcl Care r3,v . . .. o 7 Disabled Assistance Expenses Multiply Line 3 by 0.0 Subtract Line 8 from Line Arrraunt earned by hnusehohl nrernla4s rlelrendent:'upon Disabled a :sistcirce ex rrsej 11) Enter tlw Lesser Amount ofLi e or 10 ly .ors hold lltleclh'pe<175e5 if Zine 9 is less than ero, eIn;er the amni:rrit fa it ling :I 13) otherwise crdcl lines 7 and 12 and subtract line 8 -14� E1derrlyor'Dis (bled Family Allowance enter $ 00 drat 15) Total lncomeAdjustment s cc c1(1lirres Adjusted Income (subtract orrt,lin a> j Reszrlc r7 Rent Determination eterYaaaa tri 3i % oAdjusted Tricot-ne (D vide Line 16 by 12 . Multiply by 0.3) 10/ a - Monthly Grass Income (Divide Line 3 by 12 and Multiply by a 10) 9) A Welfare rent, not applicable in State of Florid i Pis°i leaf l ciit Icir-ilest of line 17 or 18 opnyA Volt, Unlit (Allowance (lrubIisltecll yPI/CD) Resident Occupancy Charge % Prvgr-ctnr Income Utilities Reimbusement ** Ifthe amount on line 22 is less than 0, change the mints to a plus. This is the amount that iny be paid on behalf of the resident as a utility re mbursirrtent, pad. to the Utility Company d1r ctly or provide docurnentattoiri ofpJcI ixtilities. o CD c ©CDaCi CaCDC20 0 0o0 ct co PC:IPP. AeAApAo4 ALaPAAO 44 44 44 44 44 144=:x# 4#' 44 44444# A14 En o - 6-4 4,4 to 4,4 4413, 'l r 113 t1� .64 CD 0 0 4a4 411, 0 b 8 0 4.4 LY, F Go 4.4 to N EN EN EN tN as ai d; aj ai aS ai ai as tiro vim �d 0 tai N m m d` d' in ttn 53 s -I N en., c{' CJ) td IIs- CD C b N -1 N M c}! td') k[) tt"-: Co. (J? O cs c) co 0 n o r tr.)a(4"d+0 Cs air � cCi raw o. o a k13 %C5 t tin 1 co 01. ty9 ter. c Co cJ q Ln Lb m L�f7 ) ,5 m N Ln 134 ri O 0 C o a 1.4 0 co 0 rn 0 • 44, do z c) a. t Information. 0 0 w 0 0 0 0 e$ 0 0 0 0 0 H H 1-0 a -a 1.0 10 t-0 hl e-1 - vd t -i g v v- d rz oPt m Request for ForSHUD Grant Funded Continua of Care CoC) rograrns Includes I.,egacy Programs under the CoC Supportive Hosing Programs (SHP) Shelter Plus Care Progras (S+C) Single. Room Occupancy for the Homeless (SRO) 24 CFR ,S 578:105 rar e anal Project i ranges _ i lie rocipio t or subi ecipicrrts May riot lig cltaanges to a without prior US WJI) approval, evidenced by a by HUDand the i ecipient. Si rrlficar t change geile change of recipient, a change of project site, additions or deltypes of eligible le activftics approved foga project, a si i 't of more than 10% from one approved eligible activity to all re action in the number of heft, and a change i.t the s bpopu at'on served; By signing this repor4 the duly .author i?ed Project Sponsor/ Provider / SuJrr'eciph Ht Official signature below certifies to the best of their knowledge and belief that the repart, istrue, complete and accurate and is, for thepurposes and objectives set forth in the terms and conditions of the federal award; and are aware that any false, fictitious, or fraudulent information or the orntssion ofany material fact, may subject the duly authorized official to criminal, civil or administrative penalties forfrarrd, false stateinerits, false claims or other offense: Print Name and Tide of Authorized Project c or Provid i Vit} re i lerrtQfficial:: Signature & nate: Reviewed by lvirani US HUD for Reque e Cour ily anti forwarr led to rove (greater• lrarl q%shift regi"categdr1es), Reviewed au inforrtiatiou forward in funds:be D (less.tf een categories:) im/dd/yyyy) Rev iewed and Nofi' Approved by Miami.-Dade,Coun' see attached lcirrerrfot reasons for disapproval:" 00 Agency, Program Name Fit andal mati for HUD_CoC Pro ra s hIstructions for budget amendment [modification request: L Attach the eSnaps Word documents previously provided; for the applicable budget chart, supportive services, operations, rental assistance, leasing. Reformat the far right -side colturin in the chart to reflect the budget requested. The far left -side column will reflect the original budget. 2. Attach the eSnaps Word document for summary of progratn, budget. Reformat the far right -side column in the chart to reflect the budget request. 3 Type in the body of the eSnaps Word document below the applicable chart with the budget narrative or explanation for the change only. Answer or justify why your agency requesting an increase or a decrease in that item? Lt. Asserrthle and attach page one of this document. S. Review, sign and submit paper original to Miami -Dade County Homeless Trust 27th Floor, Suite 310, 111 NW First Street, Miami, Florida 33128 Grant 4 PLO ,L40001 Agency, Program Name An Cont1 . - iffuly,00titfiadOgr 10.044es Legacy Pi ograIns under the GOC Supportive Housing Programs (Slip) Shelter.Plus Care Programs (S --C). Single Rotnn: Occupancy for the tl meles.s (SRO) This template is designed to assist grantees and subrecipients required to complete the Full CoC APR. It is a model of the data collected in <e -Snaps. It is no l intended to replace electronic, data collection in e -Snaps. Field layout in e -Snaps may differ from the layout presented in this document. By signing this report, the duly authc the just of their knowledge and belie objectives set forth in the terms and fraudulent information or the omission of any nrrr administrative pen fraud, false statement cl Project sponsor/ Pr report is tr Project Name Print Name and Title of Authorized on o Provide� cilse clahns o r/'irlrecipint Officio! ,t ct)trrplete and acurLr' cart o ucird; and are awctt'e .tht tiiljjeat t•Iue duly a ttItcrrl ed + ether o Tense. nature be f any fa! lagal to fair Project Grant Nuinle:., Signature & Date (rnm/dd/yyyy)i, F; int Na o & Title ofAuthorized Pr fficial. ive Director o Supervisory i eview and Entry. Print Name & Title. Attachment F "AnnualProgress Report (APR) Suppleiucntal' Updated .September 3, 2015 Guidance was provided for e -snaps changes that were irrii)lenlented to improve processing time; completing an 'Applicant Profile"; and en. 3, 5 f 23, 24, and 81 lease subinit the l'IMISLEnerated APR as well. US ANNUAL Pt FOltIVIA CE" - P itT" APR) R N . CONTiN Ql. CootAct Information Project Natite Reel') ent/Agency Name Grant Nrimber Prefix (Mr, Mrs, Ms, Dr, etc.) First Name Middle Name La,st Name Suffix (LCSW, MSW, Etc,) Tit Street Address 1 Street Address 2 City State Zip Code E-mail address Phone Number •Extension Fax Number - ... . . Q3. Project Inforination: Choolc tile component for the program' on vv. hich:you are reporting C ontinuuni of Care Program (COO.ASSs -.Rental itancelitA. , - Sec. ,t1 06.$ Moderate • . . , . .. .. , • RehabilitatlOa .. 0 Transitional Housin 0Tenant-hasetillental Assistance (TRA) 0: Single Room Occupancy 0 Project -based Rental Assistance (PRA) 0 (Sec. 8 SRO) 0 Permanent Housing for Homeless Persons with Disabilities O Safe liaven 0 Innovative Supportive Housing Su' ortive Services Onl 0 Single Room Occupancy (SRO) 0 HMIS OSponsor-based Rental Assistance (SRA) Is this APR fulfilling the repotting Obligation associated with a 20 -year use recluirethent?. (Lb Nutriber of Years in Operation: (0) Contract Ot erating term or duration is from /20 ) to ( / /20 Project Information continued: is this a Domestic - Violence Program (Yes or No) Was this project funded under a special. initiative? If yes, what type? (Samaritan Bonus, Permanent Housing Bonus, Reallocation, Etc.) Amount of Contract or Award $ CoC Number and Name FL -600 Miami -Dade County Is this an APR for a grant that received a HUD- approved grant extension? (Yes or NO) Is this a final APR? (Yes or No) Attachment F "Annual Progress Report (APR) Supplemental° Q ti mnrt VVf! fnr VAWA/[)V iroviders place administrative office address: .r,, p ., Luutrausfm,ivw,1 I Address/PO Box City State Fled da Zip Code 1, Site. Infotmation continued: identify the program site configuration type - Designate single site or single building or trtultiple buildings or sites identify the site type for the principal service site - iiiontip typo- of house, Tonly services select "not applicable or non- residential" Is this a grant that only funds the services that are provided to a CoC Program -funded housing grant(s)? ..... 8icplain any changes made inthiS section from the.Jnforination.proddcd in the original application: 2000 ChoroctemmoximOrn. QS Bed and Unit Inventory Explanation of Changes Explain any difference in the actual inventory from the inforniatico provided in the application/contractual Agreement MUX,M$0112 affiractorm 200 Attachment P "Annual Progress Report (APR) Supplonental" Q3 Fna ia nfo a%n o CoC Pro 'as CoC Final ciai Deyeleptneot Expenditure Type Coe Programfunds Expenthtures Acquisition Rehabilitatlan New Construction Development - Subtotal Q31a2 CoC ExpendituresSupportive Services Report on all CoC Program hinds expended during the operating year on suppo items or these items ere. not included in our : ant a. iicatie ent ve:services. Ifyou have no expense for these eac e oiit the question. 1. Assessment of Service Needs 2. Assistance With Moving Costs 3. Case Management 4. Child Care 5. Education Services 6. IrnpleymentAssistrance 7, l+'ood 8. Housing/CounselingServices 9. Legal Services 10, Life Skills Mental Health Services 12. Outpatient Health Services 13.Outreach Se vices 14. Substance Abuse Treatment Services 5. Transportation 16. Utility Deposits Supportive Services Subtotal$, Attachment 1 "Annual Progress Report (APR) Supplemental" Q31a4 CoC ancia easing, As nice, Opera ti ag, and Ad] istraiaion Total Expenses COC Funds Development Supportive Services Real Property Leasing Short. /Medium Term Rental Assistance.: Long-term Rental Assistance. Operating Costs MTS SUBTOTAL' Administration - Provider. Administration - Homeless Trust TOTAL Expenses plus Administration Cash Match In -Kind. Match. TOTAL Match. Match %. TOTAL Expenditures and Match Program .Income Attachment F "Annual Progress Report (APR) SupplexnentaE Perforinance for CoC Programs Refer to the HMIS. generated APR Questions 36 6aa Permanent Housin Pro rams / Rapid .e -Housing Prog.Niras Performance Measure Actual.# of person lit the Actual # ofpersoes program for sures are Mond in the eSn<aps whoom the accompliished'this Mbit 2)) of the UD applikatioit m+fa sure is appropriate date ttieas'ure Csltlhlt ri A•C) Actual% ofpersons who accolniplished this measure L Housing Stability measure 2a. Total incorne Measure 2b, Earned Income Measure ,36b: Transitio TransitionalHousing Frog Performance Measure toeS are oudin the'e€taps; of the nlofl appia atiott tA,C: i.HousirigStaliilit tmeasure Actual # ofperson in the program for Cvhont the measure is appropriate Actual # of persons who accomplished fills measure Actual %, ofpersons who accomplished this measure 2a, Total; Income;Measure 2b. Earned Irmome Measure Q36c: Street Outreach. Pro v l'erfdrmance Measure surs lir fou.it it the eSneps ` heir2)+;Ritet Ul7appllrattloit gsltlitit A•C) Housing Stability measure. Actual # of person in rise Actual t''efpersons onto: program for whom the _ accoruplished this measrire is appropriate measure • Actual filo of persons who accomplished 'this oneasure 2a.Physical Disabili 2b,Developmental Disability 2c.Chronic Health 2d,l-Ily/;ACRS 2e,Mental Health 2f Siil stanteAbuse Attactllilent `Annual Progress Report (APR) Supplemental" Q3 6 d: Su pr 0. iV Sery es Only (SSO) Programs Actual'# ofperson in th program for whom the measureis appropriate mance Measure )ai ilia e$rali pplicatiou t6A- Actual # of persons who accomplished this measure Actual°/a oi'persons who accouipltshed this ineasrare 1. }dousing Stability measure 2a. Total Tnconte Measure 2b. Earned tncorne Measure Q36e: Safe Haven Pregi 1 Performance Measure ;Are fotrntd h the eSuaps U application 1.Housing Stability measure Actual # of per, programfor;W measure is appropriate Actual of pewho w # accoptlPlisheii this' meastu e Actuai % ofpersons who; accomplished this measure 2a, Total Income Measure Q37: Additional Pei" 1'erformanee Measure uiesarefound in the eSiial s ieatttiiblt2) of the kii11 uplattcatiuir 6 A- irniance Meas (Target) _# of Persons WhO Were effected td acconiplish this measure (Sijaps tftidget tx.Iiibit 2) # of total (Utttversat) persons who are is expected to accomplish this meaure; (eSria.tt Cti etlixtrlh!t 2) ' % expectedto accotnplrsh,this• irreasure ip' Btt+lh t A;ctiial Target # of persons who;, accomplis)ied this mea ore. teportetd in. iii43ta� Actual, # of total' (urttversaq persom to, achieve this rnrasure i=par%d iii !S' Actiial % o f prions to achieve this; measure epctried in HMIs, *Utilization Rate or Vacancy Report Q40: Significant Program A corn l Describe in a brief narrative form (no in project during the reporting period: hments ?,OOtil:chd t alt any significant accomplishments achieved by your Q42: Additional Comments Describe in a brief narrative form. Ow mord, thct;t2F00a,etivrr ct as) based on your experience during the last year any problems or explanations and or changes Or need for technical advice or assistance. Attachment F „Annual Progress Report (APR) Supplemental" HUD CoC APR Annual Performance Report Additional Information User Prompt Field 1. Select Provider Group(s): 1, Select Provider(s): .2, Enter Start Deter 3. Enter End Date PLUS 1 Day: Value(s) Selected 1 -None Selected - !Bowmen Systems, LLC(0) ...i9/1/2016 11011./2'016 j4, Seleot Entry Type: !HUD 8. Enter Adult Age: 118 ;EDA Provider -Default Provider Enter Effective Date i10/1/2018 its using the Disability Determination field part of your lYes !workflow for HUD reporting? is using the Receiving Income Source field part of your ;workflow for HUD reporting? IIs using the Receiving Benefit field part of your workflow ;for HUD reporting? Is using interim Reviews part of your workflow for HUD reporting? !Yes `Yes Nes 1 Provider Reporting Inforfnation Client Count Based on Uid. Unduplicated Court. 0 2015 Bowman Systems L.L.C. At Rights Reserved, This document and the information contained herein should be considered business sensitive, Bowman Systems® and the Bowman Systems® Logo are trademarks of Bowman Systems L.L.C. All other brand or product names are trademarks or registered trademarks of their respective holders. Bowman Systems 333 Texas Street, 300 Shreveport, IA 71101 Toll Free: (844) 213-8780 Direct: (318) 213-8780 Fax: (318) 213-8784 http://www.bowmaneystems.com Bowman Systems 0625 HUD CoC APR - v27 Tab 0 -Additional information Page 1 of 1 v27 Printed: 9/07/2016 2:12:40 PM HUD Coe APR Annual Performance Report Question 7 7. HMIS or Comparable Database Data Quality Total number of records for All Clients Total number of records for Adults Only Total .number of records for Unaccompanied Youth Total number of records for Leavers Data Element .............. First Name Last Name SSN Date of Birth Race Ethnicity Gender Veteran Status ............. Disabling Condition Residence Prior to Entry Zipof Last Permanent Address ane Housing Status (at entry) Income (at entry) Income (at exit) Non -Cash Benefits (at entry) Non-Cesh Benefits (at exit) Physical Disability (at entry) Developmental Disability (at entry) Chronic Health Condition (at entry) HIV ! AIDS (at entry) Mental Health (at entry) Substance Abuse (at entry) Domestic Violence (at entry) Destination Don't Know or Refused Missing Data 0 0 0 0 Bowman Systems 0626 - HUD CoC APR - v27 TabA-Q7 Page 1 of 1 v27 Printed: 9/07/2016 ' 2:12:40 PM HUD CoC APR Annual Performance Report Questions 8-9 8. Persons Served During the Operating Year by Type Number of Persons in Households Served During the Operating Year Total Without ' With Children With Only Unknown Children ' and Adults Children HEI Type 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 Adults Children ..... bon't Know/Refused Missing Information TOTAL 0 0 0 0 Average Number of persons Served Each Night Average Number of Persons Total . _ Children and Adults 1 Children HH Type 0 0 ; 0 0 Without With Children i With Only Unknown Point -in -Time Count of Persons an the Last Wednesday in „....,.. . January ......................... i 0 0 f 0 , f . : 0 0 •, April 1 0 0 0 0 0 , July i 0 0 0 0 0 ...., ...... .... ................... ....... October 1 i 0 0 : 0 0 0 Without With Children With Only ; Unknown Total Children i and Adulth Children . HN Type 9. Households Served During the Operating Year Number of Households Served During the Operating Year ! HoushoLd Without With Children With Only Unknown Total Children and Adults Children Type 0 0 0 0 0 Point -in -Time Count of Households Served on the Last Wednesday in • 1' Without With Children With Only Unknown January April .„,._ July October Total Children and Adults Children , HH Type 0 0 o 0 0 0 0 0, L 00 0 Bowman Systems 0625 - HUD CoC APR - v27 Tab B 8-9 Page 1 of 1 v27 Printed: 9/07/2016 2:12:40 PM HUD Coe APR Annual Performance Report Question 12 12, Client Contacts and Engagements Number of Persons Contacted Rates During the Operating Year „ . Once . . . 2-6 Times ... ._.....,... 6-9 Times 10+ Times First contacted First contacted First contacted First contact at place not Total at non -housing at housing place was meant for human , serviCe site location missing habitation I 0 0 , 0 0 ; 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 TOTAL; 0 0 0, 0 0 0 Number of Persons Engaged by Number of Contacts During the Operating Year First contacted .. - First contacted First contacted Flrst contact at place not at non -housing at housing place was meant for human habitation service site • location missing Total 1 Contact ... • . 2-5 Contacts 0 6-9 Contacts 0 • 10+ Contacts TOTAL 1 0 0 0 0 0 0 0 0 0 . 1 0 • ... 0 0 0 0 00 0 0 0 0 Rate of Engagement 0 0 Bowman, Systems 0625 - HUD CoC APR - v27 Tab -Q 12 Page 1 ofl v27 Printed: 9107/2016 2:12:40 PM HUD CoC APR Annual Performance Report Question 15 15a. Gender.. Adults Gender of Adults Number of Adults In Households Male Female Transgendered Other Don't Know/Refused Information Missing Subtotal Total Without Children i and Adults I Fill Type ...... ............. 0 0 0 0 0, 0 0 0 With Children Unknown 0 0 6 ,i 0.,.,.... L .................0 0 0 0 0 i 0 0 0 10 0 0 0 0 0 15b. Gender - Children Male Female Transgendered .._.., Other Don't Know/Refused information Missing Subtotal Gender of Children Number of Children In Households With Children With Only Unknown Total and Adults . Children HH Type 0 0 0 0 0 0 0 0 0 ! 0 0 o 0 0 0 0 0 i 0 0 0 0 0 0 lac. Gender - Missing Age Male Female Transgendered Other Don't Know/Refused Information Missing Subtotal Gender of Persons IVIIssing Age Information Number of persons In Households • Total Without Children 0 0 0 0 0 0 0 f0 0 0 ! 0 .... .i........ ,..0 L..... ..,0 0 0 0 With Children With Only I,,,...and Adults I Children 0 0 0 0 Unknown HH Type 0 0 0 0 0 °.... Q.. 0 Bowman Systems 0625 d HUD CoC APR - v27 Tab D -Q15 Page 1 of 1 v27 Printed: 9/07/2016 2:12:40 PM HUD Coe APR Annual Performance Report Questions 16-17 16. Age Age Number of Persons in Households Viiithout With Children With Only Unknown Total ; Children and AdultsChildren HHy Type I 0 0 0 0 00 0 Under5 5 12 ............ . 13-17 18-24 25 - 34 35.44 .................. 45 - 54 55-61 62+ Don't Know/Refused Information Missing Age Error (Negative Age or 100+) Total 0 0 0 0 17a. Ethnicity 0 0 0 0 0 0 .0 0 Ethnicity Number of Persons in Households Total Without With Children With Only Unknown Childrenand Adults Children HH Type 0 0 0 i 0 ................•..........1,,....::;._•..,0: Q 0 ,. p i 0 0 0 . Non-Hispanic/Non-Latino Hispanic/Latino Don't Know/Refused Information Missing Total 17b. Race Race Number of Persons in Households Total Without 1 With Children i With Only Children and Adults' Children Whits _....... { :.. � Stack or African-American ,... ...a i 0 Asian . 0 0 0 1. 0 American Indian or Alaska Native 0 • i � 0 0 j Native Hawaiian or Other Pacific Islander 0 •• •-• •• • ••-• : Multiple Races• :... _•........ • ..... Don't Know/Refused 0 0 0 0 0 � o •Q a information Missing ....• Total 0 0 0 Unknown HHType ,.......1 ....... 0 0 0 ........... 0 0 .... 0 ................ 0 0 Bowman Systems 0625 -'HUD CoO APR - v27 Tab E - Cl 16-17 Page 1 of 1 v27 Printed: 9/07/2016 2:12:40 PM HUD CoC APR Annual Performance Report Questions 18-19 18a. Physical and Mental Health Types of Conditions at Entry Known Physical and Mental Health Conditions Number of Persons in Households Mental Illness Alcohol Abuse Drug Abuse Chronic Health Condition HIV/AIDS and Related Diseases Developmental Disability Physical Disability Total Children and Adults 0 0 Without • With Children 0 0 0 • • With Only Unknown Children HH Type 0 0 0 0 0 ! 0 0 0 0 18b, Physical and Mental Health Known Conditions at Entry Number of Known Conditions Number of Persons None I Condition 2 Conditions 3+ Conditions - Condition Unknown Don't Know / Refused Information Missing Total 0 0 0 0 0 J. TOTAL:': 0 Without Children 0 0 0 0 0 0 0 With Children and Adults 0 0 0 0 0 With Only Children 0 0 0 0 0 a Unknown HH Type__.. 0 0 0 0 0.., 0 0 0 0 19a. Victims of Domestic Violence Past Domestic Violence Experience Number of Adults and Unaccompanied Children in Households Yes No Don't Know/Refused Information Missing TOTAL. 19b. When Past Domestic Violence Experience Occurred Number of Adults and Unaccompanied Children in Households Total Without With Children With Only Children and Adults Children Unknown HH Type 0 0 0 ..... 0 0 0 a 0 D. 0 Less than 3 Months 3 to 6 Months Ago 6 to 12 Months Ago More than a yearAgo Don't Know/Refused Information Missing TOTAL Total Without With Children ' Children I „ and Adults , i 0 0 0 0 0 0 0 0 0 0 0 0 0 With Only Unknown Children Hid Type 0 0 0 0 0 0 0 0 0 0 0 bowman Systems 0625 - HUD CoC APR - v27 Tab F - Q 18-19 Page 1 of 1 v27 Printed: 9/07/2016 2:12:40 PM MUD Coe APR Annual Performance Report Question 20 2Oat Residence Prior to Program Entry - Homeless Situations Residence Prior to Program Entry - Homeless Situations Number of Persons in Households Total Without ' With Children i With Only Unknown Children and Adults • Children HH Type 0 0 i i] ' U I 0 I 0 0 i n f1 0 0 Emergency Shelter.._ ................ Transitional housing for homeless persons Place not meant for. habitation Safe Raven TOTAL 0 0 0 2Qa2. Residence Prior to Program Entry M Institutiolnai Settings Residence Prior to Program Entry - institutional Settings Number of Persons in Households Total Without With Children With Only Unknown Children and Adults l Childreni HH Type Psychiatric hospital or other psychiatric facility 0 j... •..• , 0 ........, .,0, ,_• .... Substance abuse treatment facility or detox center 0 0 . • 0 00 0 0 Hospital (Non -psychiatric) Jail, prison , or juvenile detention facility Foster Care • TOTALI 0 0 0 0 0 0 0 00 20a3. Residence Prior to Program Entry . Other Locations Residence Prior to Program Entry - Other Locations Number of Adults and Unaccompanied Youth in Households Total Without i With Children Children and Adults PSH for Homeless persons 0 Owned by Client, no Subsidy Owned by Client, with Subsidy 0 Rental by Client, no subsidy 0 Rental by Client, with VASH Subsidy i 0 Rental by Client, with other ongoing Subsidy 0 Hot0 el/Motel, Paid by Client I . Staying or Living with Family ............. ? 0 Staying or Living with t'riend(s) j 0 Other 0 Don't Know/Refused .. • , i 0 information Missing0 TOTAL:... 0 0 0 ,. .. .•..�• ...... . •... 0 i 0 0 0 0 0 0 0..... 0 0 0 0 0 0 0 0 0 0 0 0 0 With Only Unknown Children HH Type _..,. 0.•....... i 0 0 0 0 0 0 0 0 0 0 0 0 0 ! 0 0 0 0 Bowman Systems 0626 - HUD Coe APR v27 Tab G -' Q 20 Page 1 of 1 v27 Printed: 0/07/2016 2:12:40 PM 21. Veteran Status HUD Coe APR Annual Performance Report Questions 21-22 Veteran Status Number of Adults in Households Veteran Not a Veteran Don't Know/Refused Information Missing Total Total Without Children With Children and i Unknown j..... Adults ......i.... ...HHType,. 0 0 0 0 0 0 0 0 0 ; 0 0 0 22a1. Physical and Mental Health Condition Types at Exit w Leavers Known Physical and Mental Health Conditions Leavers - Total Number by Type Mental illness Alcohol Abuse Drug Abuse Chronlo Health Condition HIV/AIDS and Related Diseases Developmental Disability Physical Disability • Ali Persons .. .. . Adults 0 0 Children Unknown 0 0 0.. 0 22a2. Known Physical and Mental Health Condition at Exit - Leavers Number of Known Conditions Leavers - Total Number by Type 0 0 None 1 Condition 2 Conditions 3+ Conditions Condition Unknown Don't Know / Refused information Missing All Persons Adults 0 i 0 0 0 0 0 0 0 0 TOTAL: 0 0 0 0 0 0 Children Unknown 0 0 0 0 Bowman Systems 0625. HUD CoC APR - v27 TabH-Q21-22 Page 1 of 2 v27 Printed; 9/07/2016 2;12;40 PM HUD CoC APR Annual Performance Report Questions 21-22 22b1. Physical and IUlsntal Health Condition Types at Exit Stayers Known Physical and Mental Health Conditions Stayers • Total Number by Type Unknown 0 0 0 0 0 0 0 Mental .Illness Alcohal Abuse Drug Abuse Chronic Health Condition HtV/AIDS and Related Diseases Developmental Disability Physical Disability All Persons ; Adults 0 0 0 0 0 0 0 a 0 221x2, Known Physical and Mental Health Condition at Exit — Stayers Number of Known Conditions Stayers - Total Number by Type All Persons j Adults 0 i 0 None 1 Condition 2 Conditions 3+ Conditions Condition Unknown Don't Know / Refused Information Missing Children 0 Unknown 0 0 0 0 OI Bowman Systems 0625 - HUD CoC AIR v27 Tab H - Q 21-22 Page 2 of 2 v27 Printed: 9/07/2016 2:12:40 PM HUD CoC APR Annual Performance Repot Question 23-24 23. Cash Income Ranger No income $1 $150 $161 $260 $2,51 _ $600 601 = $1,000 $1,001 -$1,600 $1,601 -$2,000 $2,001 + Don't Know/Refused Information Missing Income. Entry Number of Adults Income at lucerne. at Latest Fallow. Exit up for Stayers for Leaver's 0 0 0 0 0 24.a Nuntber of Adults Sy` income Category Adults with Only Earned Income Adults with Only. Other Income Adults with Both Earned Income and Other Incotne Adults with No Income ..o Adults with DIJIi income. Information Adults with Missing income Infortnatldn Total Adults Adults with home infonnat)on at Entry acid Fallow-up/Exit AdUttsat Adults at Mutts at t Latest Follow- !Exit Entry I an (stercus) (Leavers) )_ 24.0.1 Incerne Change by Income Category (Utdvoreet Adult Stayers with Income Info Entry and follow-up) Adults with Earned Income Avg Change In Earned Income Adults with Other Income Average Change In Other Income Adults Any Morrie AVg Change in Overall Income Had income Categotyat Entry and Not at Follow -tip 0 Retained lucerne category Fut Had Less $ At Follow-up 0 0 0 0 0 0 Retained Inaorne Category and sante $ at Follow-up 0 atdbidlNot Nava. tad Did Not Have ncohte ncgminIffie'innome eetegery and ; Category et Categirry at Entry and IncreaeFsd $ at Entry, or a: Forlgw-up , oainedltat Fo(inw:up Ftsllnvrup 0 0 Total Adults (titdludtng thasewithrio i ineoTne)_ - 24.b,2 income Change by income Category (Universe: Adult Leavers with income Info at Entry and Exit) Adults With Earned Income Avg Change in Earned Income Adults with Other Income AvgChangeIn Other iriconto Adults Any Income Avg Change In Overall Income Hat( lrtcome. Category at Entry and bid Not Have at Eidt Retained incorna Category But Had Lasa $tai Exit 0 Retained Income Category and Sante $'at Exit 0 ed Did Not Have lncome Income Category and ` Categorypt increased $ at Entry end Exit Gained it ataxil0 0 Did Not Have fatal 9ddlls the Inooma (Including those: r try er ry r♦t with Iso Inconie) Entry oai EXit 0 24.h.3 Income Change by i Had Income I Retained Income Category (Universe: category at ' lucerne Total Adults with Income Info at 1 Entry and Old Category .But Entry and Either Follow tip ! flat it Follow- ! Had less $ar (Stayers) or Exit (Leavers)) up/Esq Fnilow.uptEiit Adults with Earned Moats 0 0 Avg Change to Earned income o 0' Adults with Other Incetite Avg Chango-lti Other Income Adults Any Income Avg 'Change, in Overall Income. Bowman Systems 0626 - HUD CoO APR - v27 Tab..I - r 23-24 Retained Retained Did Not Have Did Not Nave Income !declineincOpte the Income Total Adults Category at Category and Category and C {egoty at• (inciudleg those Same $ et I Inoroaaed $ at i Entty and Eritry or et with no hicorne). Gained it at Fallow-up/Exit renew-up/ExitI Fo low up/Exit Fellow-up/Eat J 0 0 0 0 Page 1 of 1 v27 Printed: 9/07/2016 2112:40PM HUD Coe APR Annual Performance Report Question 25 25a1,, Cash Income Types by Exit Status - Leavers Cash -Income Sources Type of Cash-incorne Sources by Number of Persons - Leavers Total ' Adults ' Children ! Age Unknown 1. Earned Income 0 , 0 0 0 _.. . .. . Unemployment Insurance , 0 ;. ; 0 i , 0 581 0 i i , 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 i 0 0 0 0 0 0 i 0 0 0 ,.,,.. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o 0 0 SSD] 0 Veteran's Disability 0 Private Disability Insurance , . 0 Worker's Compensation ; 0 TANF or Equivalent , 0 , .... .. . General Assistance 0 Retirement (Social Security) 0 Veteran's Pensioni 0 , . Pension from Former Job , 0 Child Support : 0 Alimony (Spousal Support) ) 0 _. .. . . . . Other Source , 0 , . . . .. . TOTAL. , 0 25a2. Cash -Income by Exit Status - Leavers Cash -Income Sources Number of Cash -Income Sources by Number of Persons - Leavers Total • Adults Children No Sources 0 0 0 1+ Souroe(s) 0 0 • • I . • I I . • • Pont Know 1 Refused , 0 0 l. 0 •• ••.•.•.....•.•...••,••••• • . .•. „ Missing this Information 0 0 ! 0 n 0 0 •_••,.• ...• • • • TOTAL, Ago Unknown 0 0. 0 0 0 Bowman Systems 3625 - HUD CoC APR - v27 Tab J Q 25 Page 1 of 2 v27 Printed: 0/07/2016 2:12:40 PM HUD CoC APR Annual Performance Report Question 25 25b1. Cash -Income Sources - Stayers Cash-lncome Sources Type of Cash -Income Sources by Number of Persons - Stayers Total j Adults 1.......... 9 Q 0 0 0 0 0 Earned Income .0 Unemployment Insurance 0 SSI 0 SSD1 0 Veteran's Disability 0 Private Disability Insurance 0 Worker's Compensation 0 TANF or Equivalent 0 General Assistance 0 Retirement (Social Security) 0 Veteran's Pension 0 Pension from Former Job 0 Child Support 0 Alimony (Spousal Support) 0 Other Source . 0 TOTAL; 0 Children Age Unknown 0 0 • 0 0 0 0 0 ........... 0 0 a 0 0 0 25b2. Cash Income Number of Sources - Stayers Cash -Income Sources Number of Cash•Income Sources by Number of Persons - Stayers Total Adults �.Children .. No Sources 0 0 0 1+ Sources) Q 0 0 Don't Know/ Refused 0 Missing this Information 0 0 0 TOTAL: 0 0 0 Age Unknown 0 0 0 0 b Bowman Systems 0625 - HUD CoC APR - v27 Tab J a25 Page 2 of 2 v27 printed; 9/07/2016 2:12:40 PM MUD CoC APR Annual Performance Report Question 26 260. Non -Cash Benefit Types by Exit Status » Leavers Non -Cash Benefits Non -Cash Benefits by Number of Persons - Leavers Adults Supplemental Nutritional Assistance Program MEDICAID Health Insurance MEDICARE Health Insurance State Children's Health Insurance WIC VA Medical Services TANF Child Care Services TANF Transportation Services Other TANF-Funded Services 0 Temporary Rental Assistance 0 • Section 8, Public Housing, Rental Assistance 0 Other Source 0 TOTAL. 0 .I Total 0 0 0 0 0 Children 0 0 0 Age Unknown 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26a2, Non -Cash Benefits by Exit Status y Leavers Client Non -Cash Benefits by Exit Status Number of Non -Gash Benefits by Number of Persons - Leavers No Sources 1+ Source(s) Don't Know / Refused Missing this Information • TOTAL] Total Adults Children 0 0 0 0 0 0 0 0 e Unknown 0 0 0 0 0 Bowman Systems 0625 - HUD CoC APR - v27 Tab K - Q 26 Page 1 of2 v27 Printed: 9/07/2016 2,12:40 PM HUD CoC APR Annual Performance Report Question 26 26b1, Non -Cash Benefit Sources - Stayers Non -Cash Benefits Non -Cash Benefits by Number of Persons - Stayers I. Total AdultsChildren Supplemental Nutritional Assistance Program . 0 0 0 MEDICAID. Health Insurance 0 0 0 MEDICARE Health insurance 0 0 0 State Children's Health Insurance 0 0 0 WIC 0 Age Unknown 0 0 VA Medical Services o 0 TANP Child Care Serv.lces . 0 0 0 TANF Transportation Services 0 0 0 Temporary Rental Assistance 0 0 0 Section 8, Public Housing, Rental Assistance 0 0 0 Other Source 0 0 TOTAL 0 0 0 26b2, Number of Non -Cash Benefit Sources - Stayers Client Non -Cash Benefits by Exit Status Number of Non -Cash Benefits by Number of Persons - Stayers Total. ...• Adults, Children No Sources 0 1+ Source(s) 0 Don't Know 1 Refused 0 Missing this Information 0 TOTAL,':, 0 .Age Unknown„ 0 0 0 0 0 0 0 0 0 0 I 0 0 0 0 Bowman Systems 06266 - HUD CDC APR - v27 Tab K - Q 26 Page 2 of 2 v27 Printed: 9/0712016 2:12:40 PM HUD COC APR Annual Performance Report Question 27 27. Length of Participation by Exit Status Length of Participation by Exit Status Number of Persons Less than 30 days 31 to 60 days 61 to 180 days 181 to 365 days 366 i0.7.30 days (1-2 Yrs) 731 to 1095 days (273 Yrs) 1096 to 1460 days (3-4 Yrs) 1461 to 1825 days (4-5 Yrs) More than 1825 Days (>5 Yrs) Information Missing Total Total 0 0 0 Stayers 0 0 0 0 0 0 0 0 0 Average and Median Length of Participation in Days Leavers Stayers Average Length 0 Median Length 0 0 Bowman Systems 0625 - HUD CoC APR ., v27 TabL-Q27 Page 1 of 1 v27 Printed: 9/07/2016 2,12:40 PM HUD CoC APR Annual Performance Report Question 29 29a1. Destination by Household Type and Length of Stay (All Leavers who Stayed More than 90 Day Number of Leavers in Households Permanent Destinations Total Owned by Client, no Ongoing Subsidy ! 0 Owned by Client, with Ongoing Subsidy . . .. .. 0 Rental by Client, no Ongoing subsidy 0 Rental by Client, with VASH Subsidy 0 Rental by Client, with other Ongoing Subsidy 0 PSH for Homeless Persons 0 Living with Family, Permanent Tenure 0 Living with Friends, Permanent Tenure 0 Subtotal 0 Without ' With Children ' With Only UnknToyw pen Children i• and Adults Children i 0 . H. 0 0 0 : 0 0 0 0 : 0 i 0 0 H 0 0 0 1-* 0 0 0 0 0 0 o o ;. 0 0 0 0 0 0 0 ; 0 0 0 :. .. .0 0 ; 0 0 Temporary Destinations Emergency Shelter ........ ..... . „ TH for Homeless Persons Staying with Family, Temporary Tenure ..,....... . ..... Staying with Friends, Temporary Tenure Place Not Meant for Human Habitation. Safe Haven Hotel or Motel, Pald by Client Subtotal 0 1 0 1 0 ; 0 0 0 1 0 1, 0 i 0 0 0 0 0 I. ....0 .0 0 0 0 ; 0 I 0 0 0 0 I 0 ! .,.., ..... ° 0 ; 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Institutional Seftings Foster Care Psychiatric Facility Substance Abuse or Detox Facility ....... . . . , . Hospital (non-Psychiatrlo) Jail or Prison . Subtotal : 0 , 0 0 0 0 ; 0 0 0 0 0 0 0 , 0 1 0 0 0 0 0 1 0 0 , .. 0 0 0 0 0 0 0 0 0 0 Other Destinations Deceased Other Don't Know/Refused ......... , . . Information Missing Subtotal 0 I- 0 0 1 0 0 1, 0 0 ; 0 0 i , 0 0 0 1 • ••• 0 0 0 0 0 0 0 0 0 0 0 0 Bowman Systems 0625 - HUD CoC APR - v27 Tab M Q 29 Page 1 of 2 v27 Printed: 0/07/2016 2:12:40 PM HUD CoC APR Annual Performance Report Question 29 29a2. Destination by Household Permanent Destinations Type and Length of stay (All Leavers who Stayed 90 Days or Less) Number of Leavers in Households Owned by Client, no Ongoing Subsidy Owned by Client, with Ongoing Subsidy Rental by Client, no Ongoing subsidy Rental by Client, with VASH Subsidy Rental by Client, with other Ongoing Subsidy PSH for Homeless Persons Living with Family, Permanent Tenure Living with Friends, Permanent Tenure Subtotal Temporary Destinations mergeney Shelter TH for Homeless Persons Staying with Family, Temporary Tenure Staying with Friends, Temporary Tenure Place Not Meant for Human Habitation Safe Haven Hotel or Motet, Paid by Client Subtotal Total Without Children 0 With Children j With Only and Adults i Children 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Institutional Settings Foster Care Psychiatric Facility Substance Abuse or Detox Facility Hospital (non -Psychiatric) Jell or Prison Subtotal Other Destinations Deceased Other Don't Know/Refused information Missing Subtotal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Unknown HH Type 0 0 0 a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Bowman Systems 0625 - HUD CoC APR -v27 Tab M CI 29 Page 2of2 v27 Printed: 9/07/2016 2:12:40 PM HUDCoCAPR Annual Performance Report Question 36 36a. Permanent Housing Programs / Rapid Re -Housing Programs Performance Measure 1. Housing Stability Measure 2a. Total income Measure 2b. Earned Income Measure Exhibit 2 Target # of persons who s were expected to accomplish this measure Exhibit 2 Actual # of Target % of person in the persons who program for were expected ' whom the to accomplish ; measure is this measure appropriate 36b. Transitional Housing Programs % Difference Actual # of Actual % of between persons who persons who Exhibit accomplished accomplished Target and this measure this measure Actual Performance 0 0 0.00% 00 0.00% _ _,.....,..... Q ............. _........_ ....,........ 0.._...,., ..,...........,. , 0.00%.. Performance Moasure 1. Housing Stability Measure 2a, Total Income Measure 2b. Earned Income Measure Exhibit 2 Exhibit 2 Actual # of Target # of Target % of person in the persons who , persons who program for were expected, were expected whom the to accomplish i to accomplish measure is this measure j this measure appropriate 0 0 % Difference Actual #of 1 Actual % of between persons who : persons who Exhibit 2 accomplished ± accomplished ; Target and this measure ' this measure i Actual I Performance 0 0,00% 0.00% 0.00% 36c, Street Outreach Programs Exhibit 2 Target # of Performance Measureparsons who were expected to accomplish this measure 1. Housing Stability Measure 2a, Physical Disability 2b. Developmental Disability 2c, Chronic Health 2d. HIV/AIDS 2e. Mental Health 2f. Substance Abuse Exhibit 2 Target % of persons who were expected to accomplish this measure Actual # of person in the Actual # of Actual % of program for persons who persons who whom the accomplishedi accomplished measure is this measure i this measure appropriate 00.00% 0 0 0.00% 0 0 0 0 0 0 0 0.00% 0.00% 0,00% 0,00% 0.00% % Difference between Exhibit 2 Target and Actual Performance Bowman Systems 0625 - HUD CoC APR - v27 Tab Q36 Page 1 of 2 v27 Printed; 9/07/2016 2:12;40 PM HUD CoC APR Annual Performance Report Question 36 36d. Supportive Services Only (SSO) Programs Exhibit 2 Exhibit 2 . Actual # of ! 1 % Difference I Target # of Target % of i person in the Actual # cif i Actual % of 1 between 1 persons who persons who 1 program for persons who . Exhibit 2 P rfonnence Meas um i were expected were expected : whom the accomplished accomplished • Target and persons whG to accomplish to accomplish , measure is this measure thActual .1 measure I this measure Performance this measure i appropriate 11 1 . I i • Housing.Stability Measure : i 0 0 0.00% 0.00% 2a, Total Income M .0 2b ; , 0 0 i. . 6,D.. . ,... .... , . 2b, Earn0.64 ed Income Measure 0 0 i 36e, Safe Haven Programs Performance Measure 1. Housing Stability Measure 2a. Total Income Measure Exhibit 2 Target # of persons who were expected to accomplish this measure Exhibit 2 . Actual # of 1 % Difference Target % of person in the Actual # of Actual % of I between persons who . program for persons who persons who Exhibit 2 were expected ' whom the accomplished accomplished i Target and to accomplish measure Is ; this measure this measure ; Actual this measure , appropriate i Performance 0 i 0• . . . ... . 0 00% ,.. 0 I 0 ! 0,00% Bowman Systems ' 0626 - HUD CoC APR - v27 Tab N Q 36 Page 2 of 2 v27 Printed: 9107/2016 2:12:40 PM Attachment G "CoC Program Guidelines" Page 1 of 14 Miami -Dade County Homeless Trust Monitoring Team information Staff: Date of Visit: CoC Program Subrecipient: Agency and Program Information Suhrecipient: Program Name: Subrecipient staff consulted: Grant Amount: Grant Number: Program Type: 0 PSH RRH 0 Til 0 SH LII SSO C1 Legacy SPC 0 RRH Number to be served: Number of chronic beds/units: Program serves: 0 Individuals 0 Families 0 Both CoC PrograM grant funds are used for: Leasing (no Inatcli.required) 0 Rental Assistance 0 Operations 0 Supportive Services 0 HMIS Administration Is the Subrecipient a faith -based organization? 0 Yes E No CoC Matching funds (25%) required are Li Cash/Cash Equivalent 0 In Kind 0 N/A Is there an active restrictive covenant on one or more of the project's properties? 0 Yes 0 No Attachment G "CoC Program Guidelines" Page Z of 14 PART 1; PROGRAM MONITORING: SUBRECIPIENT OPERATIONS: POLICIES.AND PROCEDURES: Conflict of Interest 1. There are written standards of conduct governing the performance of covered personsengaged in the award and administration of contracts. 24 CFR § 578,95(a); 24 CFR §578.103(a)(11) 0 Yes O NO 2, The Subrecipient has a general conflict-of-interest policy for staff and Board members 24 CFR § 578.95(c); 24 CFR § 578.103(a)(11) 0 Yes 0 lid. 3, If the Subrecipient iss an approved exception to the conflict of interest policy the agency has dace mented the exception 24 CFR §-578.103(a)(11) 0 Yes 0 No Involvement of homeless ", ersons 1. There is atleastone homeless/fortner1yhomeless 0 Yes person is on the Board of Directors or equivalent 0 No poll akin! enti . 24 CFR §.578.75 >0 1 2. The Subrecipient involves homeless individuals 0 Yes and families through employment; volunteer' 0 No services; or otherwise; in constructing, rehabilitation, maintaining, and operating the project, and in providing supportive services for the project. 24 CFR § 57875 (g) (2) Confidentiality 1, The Subrecipient has written policies to ensure, Records containing protected <identifying information: of any individual / family receiving assistance will be kept confidential; The location of any family violence project will not be made public, except with the written permission of the person resppnsible for operating the project; and • The location of any housing of any program participant willnot be made public, except as provided in a preexisting privacy and as provided by law, 24 CFR § 578.103(b) (These policies are in addition to HMIS, related confidentiality / security requirements) U Yes 0 No Fair Rousing and Equal Ojp;portunityy 1; The Subrecipient has written nondiscrimination and equal opportunity policies that apply to housing and employment. 24 CFR § 57893 0 Yds 0 No 2. The Subrecipient has policies and procedures for providing reasonable accommodations and reasonable modifications for persons with disabilities, 24 CPR § 100.204(a), 28 CFR § 35,130(b)(7) 0 Yes' 0 No Attachment G ?"CoC Program Guidelines" Page 3 of 14 3. The Subrecipientrnaintains copies of marketing, outreach, and other materials used to inform eligible persons of the program and these materials show that the agency markets their housing and supportive services to those least likely to apply in the absence of special outreach. 24 CFR §578,93(c)(1) 0 Yes 0 No 4, The Subrecipienthas policies'and procedures in place to provide meaningful access for Spanish- speaking and other Limited English Proficiency persons to access the Subrecipient's programs and services. 72 federal regulation 2732 0 Yes 0 No 5. The Sul recipient provides program participants with information on rights and remedies available under applicable federal,. State and local; fair housing and civil rights laws, 24 CFR §578.93(c)(3) 0 Yes 0 No Pm -Free Workplace 1, The Subrecipient has a drug-free workplace policy statement which includes the requirement of notification to HUD if an employee is convicted for a criminal drug offense. 24 CPR § 84.13 0 Yes O No POLICIES AND PROCEDURES FOR COC GRANT FUNDED PROGRAM Number Served I. The Subrecipient serves at least as many program 0 Yes participants as show in its application for assistance. 0 No 24 CFR§ 578,51(h)(3) Termination Process 1, The Subrecipient has a written policy for termination of participation for violation of program policies or occupancy agreements. 24 CFR § 578.91(b) O Yes 0 No Services Related CO Housing Stabilit 1. The Subrecipient has a written policy for Yeas termination of participation forviolati,on of program: 0 No policies Or Occupancy agreements. 24 CFR, § 578.91(b) Residential Supero sign 1. The Subrecipient provides adequate residential supervision, 24 CFR § 578,75(f) 0 Yes O No Progra 1. The Subrecipient does not charge participant's program fees, 24 CFR § 578.87(d) Program fees are not the same as rent or occupancy rent; program. participants may be charged, rent for housing) Fees Cl Yes 0 No Attachment G "CaC Program Guidelines" Page 4 of 14 Recordkeeping Eligibility: Ho r teiessness 1. The Subrecipient has systems in place to ensure CD Yes that records related to CoC-funded programs are [�No maintained for a 5-yeaLperiod, 24 CFR § 578.1.03 1. 1 program provides PSM, each participant file contains verification of participant's disability. 24 CFR § 578.37(a:)(1)(i)1) Verification frons a professional who is Iicensed to diagnose and treat Condition OR 2) Disability verified by the Social Security Administration (VA disability cheek or an SSD1 check) REVIEW OF Coe PROGRANI PARTICIPANT FILES Eligibility: Ho r teiessness 1. Each participant file contains -verification of homelessness status at the time of program entry. 24 CPR § $75:103(a)(3)_24 CFR §`576.50000) [ .7 Yes CD No 2. The Subrecipient'has written policies and, procedures for documenting homelessness. Intake staff document eligibility at intake; documentation is required for all persons seeking assistance; written policies state the evidence that maybe relied upon to establish and verify homeless status. The Subrecipient makes efforts to establishand verify homeless status and get the appropriate documentation,. Uses Miami -Dade County's homeless verification forms. In order of preference: 1) Homeless coordinated outreach and assessment, 2) Third party documentation, 3) Intake worker observations, 4) Certification from the person seeking assistance. tom. Yes 0 No Eligibility: Disability 1. 1 program provides PSM, each participant file contains verification of participant's disability. 24 CFR § 578.37(a:)(1)(i)1) Verification frons a professional who is Iicensed to diagnose and treat Condition OR 2) Disability verified by the Social Security Administration (VA disability cheek or an SSD1 check) [] Yes ('~]` leo Eligibility: Chronic hoi ielessness 1. If the program has units dedicated to persons who are chronically homeless, participant files contain verification of chronic homelessness. 0 Yes ❑ No Service Assessment 1. The file contains participant assessments and service plans, updated at least annually. 24 CFR§ 578.53(a) 0 Yes 0 No Services Provided and Costs 1. The file contains documentation of services provided and the agency tracks the amounts spent on those services. 24 CFR§ 578.103(a)(9) 0 Yes L -j, No Duration of Services 1, The file reflects that supportive services are made e available throughout resident's entire time in the project 24 CFR § 578,53(b) 0 Yes C] Na 2. Rapid rehousing: The file reflects that program participant meets with case manager not less than once per month. 24 CFR §578.53(b)(4) 0 Yes Ci No Attachment G "CoC Program Guidelines" Page 5 of 14 Participants Terminated from Program 1. If a participant: has been terminated from: the LI Yes program, file includes documentation that the 0 No Subrecipient followed its written procedure for termination of assistance. 24 CFR,§ 578.10363(7)(M; 24 CFR § 578.91 RENTAL ASSISTANCE OR LEASING (complete this section if the Subrecipient pays yenta assistance or leasing costs for a unit that the, pragrain participant lives in) Rental Agreement / Lease 1. The program participant has an occupancy CJ Yes' agreement or lease with the Recipient/Subrecipient 0 No or Landlord. 24 CFR §_578.77(a) For tenant and project based assistance; the program participant must be the tenant on the lease. For sponsor based assistance, lease between the Subrecipient and the. Landlord, sub -Lease between participun t and Subrecipient 2, For project -based, sponsor -based, or tenant -based. permanent housing (PH) rental assistance; initial lease must be at least one year, terminable for cause. The leases Must be auton aticallyrenewable upon expiration for terms that are a minimum, of one -monthlong, except on prior notice by either party, up to a maximum term of 24 months. 24, CFR § 578.51(1)(1) 3, For transitional housing; initial lease term mustbe. at least one month. The lease must be automatically renewable tipop, expiration, except,on prior notice by either patty; up to a'rumximurn term of 24 months, 24 CFR -§-579.51(T) (2) 0Yes Q No. L; Yes 0 No Habitability 1. File includes documentation that -units passed E Yes housing quality standards inspection prior to initial 0 No client move -in. 24 CFR §578.75[b); and 24 CFR § 578.103(a)(8) 2, File includes documentation that unit has passed 0 Yes annual housing quality standards inspections, O No including an inspection within the last 12 months. 24 CFR § 578.7$ (b) 3, Dwelling unit is correct size; The dwelling unit must have at least one bedroom or living/sleeping room for each two persons. Children of opposite sex, other than very young children, may not be required to occupy the same bedroom or living / sleeping room. 24 CFR § 578.(c) O Yes O No 4. For supportive housing for persons with disabilities; the Subrecipient must macre available meal preparation facilities for residents or provide meals 24 GFR 578,75(d) O Yes i� No Attach erit G "CoC Program Guidelines" Page 6 of 14 Unit Rents 1. Documentation that rents are reasonable in relation to rents charged in the same geographic area for comparable space 24 CFR§ 578.49{b) 0 Yes 0 No 2. Rents do not exceed the HUD-detetinined Fair Market Rents (FMRs): This documentation must include chart show current year's Mils. 24 CFR §578,49(b)(4) 0 Yes 0 No 3, Security deposit does not exceed two months' rent; in addition to the security deposit, the Subrecipient may also pay the final months' rent in advance 24 CFR § 578.49(b) (4) El Yes 0 No Annual lnconie 1, The file contains an income evaluation form. completed by program participant and source documents verifying income and assets (or, if source documentation not available, 3rd party verification; or if 3rd party verification not available, written certification by'program participant 24 CFR ,§ 578.103(a)(6) 0 Yes 0 No 2. The file contains documents demonstraung that income is re-examined annually. 24 CFR § 578.77(c)(2) 0 Yes 0 No Rent Calculation 1. The file contains the annual rent calculation, and the calculation is accurate. BEST PRACTICE: The file contains a printout of the HUD rent calculation 24 CFR § 578,103 O Yes 0 No 2. Is the participant charged rent (unless $0 income) and isthe rent treated as program income? (required) L1 Yes 0 No 3. Is rent calculated initially, annually, and when there is any change in income? 0 Yes 0 No 4. Is there documentation of compliance of an eligible "utility allowance" The Subrecipient has received a copy of the Tenants paid utility bill for compliance. .0 yes 0 No Vacancies 1, The Subrecipient does not pay rent for more than ' 0 Yes 0 No 30 days for any unit that has been vacated. Rent may not be paid on the vacated unit again until there is a new occupant, (NOTE,; Erief periods of stays in institutions, not to exceed 90 daysfor each occurrence, are not considered vacancies). 24 CFR § 578.1:(9) Attachment G " Cat Program Guidelines" Page 7 of 14 LEASING (complete this section if the Subrecipient leases bulldings for the purpose of providing program services or if there is a unit lease agreement with .a landlord) Rent Reasonableness (applies to rent for buildings or ous%ng units) 1, Documentation that rents aroreasonable in Ct Yes relation to rents charged lathe same geographic area ; Ci No for comparable space. 24 CFR § 578.490 2, Rents do not exceed rents chargedfor comparable units rented bythe Subrecipient 24 CFR § 578.4901 3, Security deposit does not exceed two months' rent; in additionto the security deposit, the Subrecipient may also pay the final months' rent in advance. 24 CFR § 578,49(0)(4) 4. The Subrecipient must have an occupancy greement, and if applicable a sublease. 5. Is rent calculated initially and when, the tenant requests? 0 Yes c�Ne 0 Yes 0 No 0 Yes Cl No >. 0 Yes 0 No 6, Is the participant charged rent? (not required) (DYes C: No 7. Has an occupancy charge been imposed? (not required) If so, the charge cannot exceed the highest of 1) 30% of the households monthly adjusted income; 2) 1O% of the households' monthly income, or; 3) The portion of the households' welfare assistance, if any that is designated for housing costs., (not applicable in the State of Florida) Ci Yes U No 8. Leasing funds are not used to lease units or structures owned by the Recipient, Subrecipient, their parent organization(s) or organizations that are members ofa partnership where the partnership owns the structure. (Doesn't apply to rental assistance). 0 Yes 0 No REQUIRED POLICIES AND PROCEDURES FOR SPECIFIC PICOGRAMS/ IRCUMSTANCES Participant Household Policies (coin/Vete this section for any program that,serves families with children) i;:: The age and gender of a child under age 18 must: 0 Yds not be used as a basis for: denying any participant household's admission to a project that receives funds under this part. Faith -based Activities (complete this section if the $ubreciplent is a faith based orgcinizatio i) 0 Yes 0 No 0 Yes Cl No 0 No 1. The Subrecipient serves all potential participants without regard to religious' belief, refusal to hold'a_ religious belief, or refusal to attend or participate in religious services; 24 CFR § 578.87(b)(1), 2. If the Subrecipient provides explicitly religious activities (including worship, religious instruction, or proselytizing), these activities are separate from HUD funded activities and beneficiaries.ef HUD - funded activities are not required to participate, Attachment G "CoC Program Guidelines" Page 8 of 14 24 CFR§ 578.87 b)(2) construction, and rehabilitation Projects involving acquisition, new 1. Records for acquisition, new construction, and rehabilitation must be retained for 15 years following the date the project is first occupied, or used, by program participants. 24 CFR § 578.103 (c) (2) O Yes O No 2. If the project resulted in dislocation of any persons, the Subredpient complied with the obligations of the Uniform Relocation Act? .24 CFR 578.13 O Yes O No 8. For projects including new construction or rehabilitation, do the Recipient's records show that Section 3 reports have been completed and submitted timely? 24 CFR § 578.99(1) O Yes O No Rousing Transitional 1. Participants do not regularly exceed 24 months in the program. 24 CFR § 578.79 O Yes _ O No .. 2. When,a participant is in the program for longer than 24 months, the file documents the need for extended participation. 24 CFR § 578.79 0 Yes 0 No 0 Yes 0 No 3. If participants stay longer than 24 months, is the number of participants with longer stays less than 50% of the total number served by the project? 24 CFR § 578.79 Transfer Due'to Domestic Violence 1 . If a program participant receiving tenant -based rental assistance has moved to a different CoC due to threat of imminent harm, the file must contain documentation of the domestic violence and imminent threat 0 Yes 0 No PART 2 FISCAL MONITORING INTERNAL REVIEW Audit 1. Is the SubrecSubredpient subject tothe OMB A-188 single audit requirement? (Required if $5000,000 or more in aggregate Federal funds expended) 2, If subjectto A-133 audit,,has the Subrecipient provided its most recent auditand management. letter? 3. If not bound by A-133 requirement, has the agency provided financial statements audited by a CPA? Board of 1. Has the Subrecipient provided Miami -bade County a list of the members of its Board of Directors? 0 Yes O No. 0 Yes 0 No 0 Yes 149 ctors (1) Yes O No Authorized Check Signers 1. Has the Subrecipient provided Miami -Dade County with a list of authorized check signers? 0 Yes O No Attachment G "CoC Program Guidelines" Page9of14 Invoicing_ 1. The Subrecipient submits invoices on a monthly Yes 0 No Procurement 1, The Subrecipient has a written procurement policy 0 Yes that ineets the requirements of Miami -Dade County 0 No competitive procurement standards. 2, The SubreelPlent retains copies of all procurement contracts and documentation of compliance with federal procurement requirements 24 CFR § 578.103(a) (16)(iii) basis (on time or within time)? 0 Yes 0 No atch 1. The Subrecipienthas documentation of thesource 0 Yes and use of contributions made to satisfythe 25% Ci No match requirements (match may be cash or in kind)., Records must indicate the grant and fiscal year for which each matching contribution is counted. The records must show haw the value placed on 3rd party in kind contributions was derived. Costs incurred by a partnering organization to provide "in kind" services to the program participants must be documented by a MOU. Cash or any in kind contribution used as Match for another grant is not ari eligible in kind contribution used as match for another grant is not an eligible Match, 24 CFR 578,73, 24 CFR § 578.103(a)(1-0), 24 CFR4 84.23 and 24 CFR § 57£3.23 -(c) (6 2. Match must be spent on eligible project costs (in the budget) 3. Where match is documented by MOU, the MOO must; establish the unconditional commitment identify the service, to be provided; identify the profession of the persons providing the service; and Identify the cost of the service to be provided Internal Controls 0 Yes 0 No 0 Yes 0 No 1, The Subreelpient has written job descriptions for all HOP -funded positions 2. The Subrecipient has written fiscal policies and procedures specifying approval authority for all financial transactions and guidelines for controlling expenditures 3. The Subrecipient has written procedures for recording financial transactions, and an accourith* manual and chart of accounts 0 Yes 0 No QY00-:- ,ONo 0 Yes 0 No Program Income 1. Is all program income spent on eligible costs? Rent' n Yes and Occupancy charges are considered program L) No income as is any utility allowances in rental programs 2. Is program income part of your match? Program income is not an eligible source of match. 0 Yes - 0 No PINACONNEUMffeiVINNWHOMEO,, Vt00aggffiEnEliFIDOMEMMEIMO' StIEggriinWiliaral Attachment G "CoC Program Guidelines" .Pagel0 of Irtclirect Costs 1. Does the organization use grant funds for indirect costs? 2. Are the costs consistent with OMB Super Circulars as applicable. 0 Yes c No 0 Yes 0 No O M NTATION REVIEW Salary Documentation 1.Original tirneshe'ets - signed. grant dutics identified, if split time (copy in reimbursement `package) 2. Payroll sheets C2 Yes 0 No C Yes 0 No 3. Cancelled checks to the employee C� Yes 0 No 4. If time is divided between the CoC Programs and 0 Yes another funding source, review time distribution ❑ No records supporting the allocation of charges among: the sources. Staff time breakdown allocation chart Space / Docurnentailon / Lease s 1. Rental or lease agreement - signed by participant;' valid lease period; correct rental amount 0 Yes 0 N 2, Original invoices 0 Yes CI No 3. Cancelled checks to the landlord/rnortgagee; utility company, etc: Cl Yes o No 4,Unitinspection report(s); nolongerthan J. year old 0 Yes 0 No 5, Verification of what payment was used for (e.g. first month's rent, security deposit, etc:) Supplies 1.. P urchase. orders. 0Yes 0 No 2. Requisitions Cl Yes 0 No 3. Cancelled. checks 0 Yes C. J No 4, Determine where supplies are being kept 0 Yes 0 No 5, Determine what Cost objective is being used 0 Yes 0 No Review inventory list -,any equipment shall be labeled as property of Miami -Dade County through its floineless °frust 0 Yes 0 No Attachment G "CoC program Guidelines Page 11 of 14 INTERNAL CONTROLS 1. Internal control questionnaire O Yes 0 N 2. Review organizational. chart O Yes I No 3. Review job descriptions/definitions of employees' duties O Yes CJ Na 4, Review Subrecipient`s system of authorization and supervision 0 Yes. Nci 5, -Ensure that there is a separation of duties (authorizing, recording and custody should be separate) 6. Review control over assets: O Yes 0 No OYes 0 N EVALUATION OF SELECTED TRANSACTIONS is the expenditure allowable a. Is the expenditure necessary, reasonable and O,Yes directly related to the grant? ONo b. Is the expenditure authorized by the grant? 0 Yes O No Source documentation evaluation, a. Were the expenditures incurred during the term of 0 Yes the grant? 0 No. b. Was themoney actually paid out? 0 Yes ONo c. Were the expenditures approved by the responsible Subrecipiientofficials d. Is there adequate documentation to supportthe expenditures? OYes 0 No; 0 Yes O No a, Chart ofaccounts Does the Subrecipient maintain the appropriate records? Does the Subrecipient maintain the: following? O Yes 0 N Cash receipts journal • OYes O Na c, Cash dlsbursei7ents journal O Yes ONo d. Payroll. journal O Yes 0 No e. General. ledger OYes; 0 N 1. Does the Subrecipientt-maintain documentation concerning its sources of funding D Yes LINO Attachment G "CoC Program Gtd del les" Page 12 of 14 PART 3s HMIS MONI'T'ORING HMIS HOMELESS MANAGEMENT INFORMATION SYSTEMS HMIS Operations: Poiicy and Procedures Q Yes 0 No 1, The Subrecipient has signed an HMMMJS Participation Agreement to use the HMIS license 2. Are the Subrecipient's HMIS Administers" registered and approved to enter the data into the HMIS system C...) Yes 0 No 3. The Subrecipient has designated an HMIS site Administrator(s), who is the Point of Contact for Miaini-Dade County through°its Homeless Trust as HMIS Lead Agency. 0 Yes 0 No 4. the Subrecipient has ensured that each HMIS user within itss Organization has signed a user agreement stating full understanding of user rules, protocols and confidentiality. [ i Yes [0 No Privacy 0 Yes 0 No 1. The Subrecipient has a Data Collection / Privacy Notice posted in English and Spanish at each intake location z. The Subrecipient has a written Privacy Policy or uses the. CoC's written. Privacy Policy o Yes Cl No 3. If the Subrecipient has a web site, the Privacy Policy is posted to the web site. LJ Yes CJ No 4. The Subrecipient has 'a signed authorization for release; of information; form that it uses for any client for which the Subrecipientuses HMIS for data sharing C3 Yes. [—I No 5, The Subrecipient ensures that all signed.forms are locked in a designated location with Iimited access to staff 0 Yes QNo 6. The Subrecipient has:executed the Agency Sharing Data Agreement, if applicable (MOH?) 0 Yes [) No 7. The Subrecipient has a written client complaint policy 0 Yes CD No 8. The Subrecipient has established a process of tracldng all filed complaints and can provide copies of complaints and resolutiohs.to the HMIS Lead Agency if requested. 0 Yes 0 No Security 1. The Subrecipient maintains a list of active, HMIS users 0 Yes Cj No 2. The Subreelpient regularly contacts the HMIS Lead. when an employee leaves the Organization, in order to Inake sure that the person's HMIS accountis disabled. [1 Yes 0 No 3. Are the Subr ecipient's HMIS workstations located in secure locations or, if not, are the workstations manned at all times? 0 Yes d No 4. Has the Subrecipient Identified a person who will serve as the Organization's HMIS security officer? [1] Yes Attavhmen.t G "CaC Programa Guidelines" Page la of 14 No 5. Has the HMIS security officer completed an HMIS security self -certification within the last 12 months? Cl Yes Q No 6. Does the 8ubrecipienthave in place policies and. procedures to protect hard copies (paper) with personal identifying information?_ (� `,Yes 0 N at Quality At a minimum, the Subreciplent collects the Universal Pata Elements for every client entered and Minimum data quality standards are meta The Subrecipient enters cliont Basic Demographic Data into the HMIS system at a minimum within one week of intake The Subrecipient-staff review monthly reports received from HIVIIS Program Administrator and addresses any issues noted. JYes Q•No• 0 Yes No 0 Yes NO Attachment G "CoC Program Guidelines" page 14 of 14 INCIDENT REPORT IDENTIFYIN G MORMATION Repordng Party Phone 11 Reporting Party Name Contract Provider Name Prograrn Name Provider Location Specific Program: (check all that apply) Cl Miami -Dade County 0 Primary Care 0 CoC Program 0 Emergency 0 Challenge 0 Other Specflic location/ address where incident occurred: Date of Incident Time of 'incident am/pm TYPE OF INCIDENT 0 ALTERCATION 0 CLIENT DEATB 0 CLIENT 1N,ITIRY 01?ILLNESS 0 TITEFT 0 SEKLML 13AFIERY 0 SUICIDE ATTEAPT 0 PROTERTY DAMAGE 0 OTBER INCIDENT SpeOify PARTICIPANT (S) / WITNESS (E$) (Please mark W or P for either Witness or PartiCiPailt) LAST NAME, FIRST IDENTIFIER # CLIENT EMPLOYEE OTHER W / P 0 0 0 DESCRIPTION OF INCIDENT Give detailed account who, what, where, when, why, how — itdd pagesitntcessary ATTACHMENT H "MDC -HT incident Report Forni" Page 1 of 2 tatipAti CORRECTIVE ACTION AND FOLLOW UP Iiiimediate corrective action taken Is follow up action needed? 0 Yes 0 No If yes, specify INDIVIDUALS NTOTIF+'I.Fi) Abuse Registry 1-800-962-2873 *App !cab e Law En orcernent Department Indicate person contacted, if report was accepted, the date and the tisane, and, if by telephone or if copy of report. available, Incident Reports — The Srrbrecipient must report to Miarn-Dade County Homeless Trustinformation related to axi critical incidents occurringduring the administration term of its programs. In addition to reporting this incident to the ;appropriate authorities the Subreoipient must, within twenty-four (24) hours of any incident, submit in writing a detailed account of the incident, This ittcdent report should be addressed to the Contract Q .ft'Ieer Or Administrative .Officer assigned, This incident report should be addressed; to MIiami-Dade County Homeless Trust, 11,1 NW First; Street, 27th Floor, Suite 310, Miami, Florida 33128; telephone (305) 3754490 and faasmllie (305) 375-2722. Definitions of Reportable Incidents a. Altercation. A physical confrontation .occurring 1)Qtween a client and employee or two or more clients at the time services ate being rendered, Or when a client is in trio physical custody of the department, which results in one or more clients or employees :roeeiv..ingmedical treatment by a licensed health care professional Client Death. A person whose life terminates due to or allegedly due to an accident, act of abuse, nogiect or other incident occurring While ur the presence of an employee, inHomeless Trust contracted program ,facility. c. Client Injury or Illness. A medical condition of a•client requiring medical treatment by a Reprised health care professional:sustained, or allegedly sustained due to an accident, act, of abuse, neglect or other incident occurring while in the presence of an employee,, in a homeless Trust contracted program. d. Other incident. An unusual occurrence or circumstance initiated by something -other than natural causes or. out of the ordinary such as a tornado, kidnapping ilott or hostage situation, which jeopardizes the health, safety and welfare of clients. e, Sexual Battery. An allegation of sexual battery by a client on a client, employee on a client, or client on au employee as evidenced: by medical evidence or law enforcement involvement. f. Suicide Attempt. An act which clearly reliects the physical attempt by a client to carise his oilier own death' while h the physical custody of the department or a, departmental, contracted or certified provider, which results in bodily injury requiring'niedical treatment by a licensed health care professional. Property damage an incident involving damage to any property procured with Miami -Dade County 'Homeless Trust funding. g, Print Name of Person Submitting Report Signature ATTACHMENT %I "MDC -HT Incident Report Form" a Real Property and Equipment Asset Inventory Equipment with an acquisition cost of greater than $5,000.00 per unit and all real property must be inventoried. Ileal property includes land, land improvements, structures and appurtenances, moveable machinery and equipment, Property and Property Improvement Record: Legal description: Size: Date of Acquisition: Value at time of purchase: Owner's name (if different than the Subrecipient): Map: (attach map) indicate: where property is inparcels, lots or blocks and show adjacent streets and roads Equipment 1: Description of Property: Serial / TD Number: Acquisition Date: Cost: Vendor Nance: % of Purchase Cost from Grant: Location of Property:; Use and Condition of Property: Who Holds Title? Equipment 2:° Description of Property: Serial / ID Number: Acquisition Date: Cost: Vendor "Name % of Purchase Cost from Grant: Location of Property: Use and Condition ,of Property: Who Holds Title'? Equipment 3: Description. OfProperty: Serial / ID Number: Acquisition Date: Cost: Vendor Name of Purchase Cost from Grant: Location of Property: Use and Condition of Property: Who Holds Title? *(please create additional pages as required) ATTACHMENT I "Miami -Dade County Real Property and Equipntent Asset Inventory" ;1 United States Department of Housing and Urban Development (US HUD) FY2015 Continuum of Care (CoC) Program GRANT AGREEMENT ATTACHMENT A "2015 US HUD CoC Program Grant Agreement" U.S. Department of Housing and Urban Development Office of Community Planning and Development 909 SE First Avenue Miami, FL 33131 Tax ID No.: 59-6000573 CoC Program Grant Number: FL0177L4D001508 Effective Date: 8/3/2016 DUNS No.: 004148292 CONTINUUM OF CARE PROGRAM GRANT AGREEMENT This Grant Agreement ("this Agreement") is made by and between the United States Department of Housing and Urban Development ("HUD") and Miami -Dade County (the "Recipient"). This Agreement is governed by title IV of the McKinney-Vento Homeless Assistance Act 42 U.S.C. 11301 et seq. (the "Act") and the Continuum of Care Program rule (the "Rule"). The terms "Grant " or "Grant Funds" mean the funds that are provided under this Agreement. The tem]. "Application" means the application submissions on the basis of which the Grant was approved by HUD, including the certifications, assurances, and any infoitnation or documentation required to meet any grant award condition. All other teuuns shall have the meanings given in the Regulation. The Application is incorporated herein as part of this Agreement, except that only the project listed, and only in the amount listed on the Scope of Work exhibit, are funded by this Agreement. In the event of any conflict between any application provision and any provision contained in this Agreement, this Agreement shall control. Exhibit 1, the FY2015 Scope of Work, is attached hereto and made a part hereof, If appropriations are available for Continuum of Care grants; if Recipient applies under a Notice of Funds .Availability published by HUD; and, if pursuant to the selection criteria in the Notice of Funds Availability, HUD selects Recipient and one or more projects listed on Exhbit 1 for renewal, then additional Scope of Work exhibits may be attached to this Agreement. Those additional exhibits, when attached, will also become a part hereof. The effective date of the Agreement shall be the date of execution by HUD and it is the date use of funds under this Agreement may begin. Each project will have a performance period that will be listed on the Scope of Work exhibit(s) to this Agreement. For renewal projects, the period of performance shall begin at the end of the Recipient's final operating year for the project being renewed and eligible costs incurred for a project between the end of Recipient's final operating year under the grant being renewed and the execution of this Agreement may be paid with funds from the first operating year of this Agreement. For each new project funded under this Agreement, Recipient and HUD will set an operating start date in eLOCCS, which will be used to track expenditures, to establish the project performance period and to determine when a project is eligible for renewal. Recipient hereby authorizes HUD to insert the project performance period for new projects into the exhibit without Recipient signature, after the operating start date is established in eLOCCS. This Agreement shall remain in effect until termination either: 1) by agreement of the parties; 2) by HUD alone, acting underthe authority of 24 CFR 578.107; 3) upon expiration of the final performance period for all projects funded under this Agreement; or 4) upon the expiration of the period of availability of funds for all projects funded under this Agreement. www.hud.gov espanol.hud.gov Page 1 Recipient agrees: 1. To ensure the operation of the project(s) listed on the Scope of Work in accordance with the provisions of the Act and all requirements of the Rule; 2. To monitor and report the progress of the project(s) to the Continuum of Care and ITUD; 3. To ensure, to the maximum extent practicable, that individuals and families experiencing homelessness are involved, through employment, provision of volunteer services, or otherwise, in constructing, rehabilitating, maintaining, and operating facilities; for the project and in providing supportive services for the project; 4. To require certification from all subrecipients that: a. Subrecipients will maintain the confidentiality of records pertaining to any individual or family that was provided .family violence prevention or treatment services through the project; b. The address or location of any family violence project assisted with grant funds will not be made public, except with written authorization of the person responsible for the operation of such project; c. Subrecipients will establish policies and practices that, are consistent with, and do not restrict, the exercise of rights provided by subtitle B of title VII of theAct and other laws relating to the provision of educational and related services to iAndividuals and families experiencing homelessness; d. In the caseof projects that provide housing or services to families, that subrecipients will designate a staff person to be responsible for ensuring that children being served in the program are enrolled in school and connected to appropriate services in the oomrnunity,, including early childhood programs.such as Head Start, part C of the. Individuals with Disabilities Education Act, and programs authorized under subtitle B of title VII of the Act; e. The subrecipient, it officers, and employees are not debarred or suspended from doing business with the Federal Government; and £ Subrecipients will provide information, such as data and reports, as required by HUD; and 5. To establish such fiscal control and accounting procedures as may be necessary to assure the proper disbursal of, and accounting for grant funds in order to ensure that all financial transactions are conducted, and records maintained in accordance with generally accepted accounting principles, if the Recipient is a Unified Funding Agency; 6. To monitor subrecipient match and report on match to HUD; 7. To take the educational needs of children into account when families are placed in housing and will, to the maximum extent practicable, place families with children as close as possible to their school of origin so as not to disrupt such children's education; 8. To monitor subrecipients at least annually; 9. To use the centralized or coordinated assessment system established by the Continuum of Care as required by the Rule. A victim service provider may choose not to use the Continuum of Care's centralized or coordinated assessment system, provided that victim service providers in the area use a centralized or coordinated assessment system that meets HUD's minimum requirements and the victim service provider uses that system instead; www,hud.gov espanol.hud.gov Page 2 10. To follow the written standards for providing Continuum of Care assistance developed by the Continuum of Care, including those required by the Rule; 11. Enter into subrecipient agreements requiring subrecipients to operate the project(s) in accordance with the provisions of this Act and all requirements of the Rule; and 12. To comply with such other terms and conditions as HUD may have established in the applicable Notice of Funds Availability. HUD notifications to the Recipient shall be to the address of the Recipient as stated in the Application, unless HUD is otherwise advised in writing. Recipient notifications to HUD shall be to the HUD Field Office executing the Agreement. No right, benefit, or advantage of the Recipient hereunder may be assigned without prior written approval of HUD. The Agreement constitutes the entire agreement between the parties hereto, and may be amended only in writing executed by HUD and the Recipient. By signing below, Recipients that are states and units of local government certify that they are following a current HUD approved CHAS (Consolidated Plan). www,hud.gov espanol,hud.gov Page 3 This agreement is hereby executed on behalf of the parties as follows: UNITED STATES OF AMERICA, Secretary of Housing and Urban Development By: Signature) Ann D. Chavis, Director (Typed Name and Title): August 3, 2016 (Date) RECIPIENT Miami -Dade County (Name of Organization) By: (Signature of Authorized ficial) (Typed Name and Title of uthor d fficial) RO(U0 (Date) Victoria L. 1V1allette Executive Director Miami -Dade County Homeless Trust Telephone: (305) 375-1490 Fax: (305) 375-2722 Einail eam10v www.hud.gov espanoLhud.gov Page 4 Tax ID No.: 59-6000573 CoC Program Grant Number: FL0177L4D00.1508 Effective Date: 8/3/2016 DUNS No.: 004148292 EXHIBIT 1 SCOPE OF WORK for FY2015 COMPETITION 1. The project listed on this Scope of Work is governed by the Continuum of Care program Interim Rule attached hereto and made a part hereof as Exhibit la. Upon publication for effect of a Final. Rule for the Continuum of Care program, the Final Rule will govern this Agreement instead of the Interim Rule. The project listed on this Exhibit at 4 below, is also subject to the terms of the Notice of Funds Availability for the fiscal year listed above. 2. The Continuum that designated Recipient to apply for grant funds (has/has not) been designated a high performing community by HUD for the applicable fiscal year. 3. Recipient is not the only Recipient for the Continuum of Care. HUD's total funding obligation for this grant and project is $__65212, allocated between budget line items, as indicated in 4. below. 4. HUD agrees, subject to the terms of this Agreement, to provide the Grant funds for the project application listed below in the amount specified below to be used during the performance period established below. However, no funds for new projects may be drawn down by Recipient until HUD has approved site control pursuant to the Rule and no funds for renewal projects may be drawn down by Recipient before the end date of the project's final operating year under the grant that has been renewed. Project No. Performance Period FL0177L4D001508 06-01-2016- 05-31-2017 Allocated between budget line items as follows: a. Continuum of Care planning activities $ 0 b. UFA costs $ 0 c. Acquisition $ 0 d. Rehabilitation $ 0 e. New construction $ 0 f. Leasing $ 0 g. Rental assistance $ 0 h. Supportive services $ 60946 i. Operating costs $ 0 j. Homeless Management Information System $ 0 k. Administrative costs $ 4266 www.hud.gov espanol.hud.gov Page 5 In accordance with the Rule, Recipient is prohibited from moving more than 10% from one budget line item in a project's approved budget to another without written amendment to this Agreement. 5. If grant funds will be used for payment of indirect costs, pursuant to 2 CFR 200, Subpart E Cost Principles, the Recipient is authorized to insert the Recipient's federally recognized indirect cost rates (including if the de minimis rate is charged per 2 CFR §200.414) on the attached Federally Recognized Indirect Cost Rates Schedule, which Schedule shall be incorporated herein and made a of the'Agreemente N6 indirect costs May be charged to the grant by the Recipient if their federally recognized cost rate is not listed on the Schedule. ",Do not include indirect cost rates for Subrecipients, however, Subrecipients may not charge indirect costs to the grant if they do not also have a federally recognized indirect cost rate. 6. The project has/has not been awarded project -based rental assistance for a term of fifteen (15) years. Funding is provided under this Scope of Work for the perfolinance;period stated in paragraph 4. Additional funding is subject to the availability of annual appropriations. 7. Program income earned during the grant term shall be retained and may either be 1) added to funds committed to the project by HUD and the recipient and used for eligible activities;_ or 2) used as match:' www.hud.gov espanol.hud.gov Page 6 Tax ID No.: 59-6000573 CoC Program Grant Number: FL0177L4D001508 Effective Date: 8/3/2016 DUNS No.: 004148292 FEDERALLY RECOGNIZED INDIRECT COST RATE SCHEDULE Grant No. Recipient Name Indirect cost rate Cost Base www.hud.gov espanol.hud.gov Page 7 This agreement is hereby executed on behalf of the parties as follows: UNITED STATES OF AMERICA, Secretary of Housing and Urban Development Ann D. Chavis, Director (Typed Name and Title) August 3, 2016 (Date) RECIPIENT Miami -Dade County (Name of Organization) By: (Signature of (Typed Name and Titl (Date) '34 61) flicidl` of Authorized� ) N((,0 Victoria L. Mallette Executive Director Miami -Dade County Homeless Trust Telephone: (305) 375-1490 Fax: (305) 375-2722 Email: vmalletteAmiamidade.gov www.hud.gov espanoLhud,gov Page 8 FY 2015 Continuum of Care (CoC) Program Scope of Service eSnaps Budget and Performance Objectives ATTACHMENT B "FY 2015 Scope of Service" Miami -Dade County Homeless Trust Scope of Service FL0177L4D001508 City of Miami Beach Outreach The Subrecipient shall provide at least three hundred fifty (350) CoC Program eligible persons placed in emergency shelters from outreach contacts through the Supportive Services Only (SSO) Program during the one (1) year grant term. The Subrecipient shall provide services as proposed in the application to United States Department of Housing and Urban Development (US HUD) pursuant to the 2015 NOFA (incorporated herein by reference), and pursuant to 24 CFR 578 including but not limited to: 1. Accept eligible homeless persons as defined by US HUD and through Miami -Dade County Homeless Trust CoC's established Coordinated Outreach and Assessment HMIS referral process; 2. Comprehensive assessment and case management; 3. Residential stability; 4. If applicable, locate and match eligible program participants with eligible Landlords with units in the community; 5. If Miami -Dade County is the Rental Administrator, provide, complete and submit to the assigned staff all documentation, records and reports, including but not limited to, Attachment K Participant's Housing Application; 6. If Miami -Dade County is not the Rental Administrator, provide, complete and maintain all documentation, records and reports, including but not limited to, Attachment J Participant's Housing Application. Provide, maintain and complete all documentation and supporting information for HQS Inspections, verify compliance with federal rules and regulations, verify Program Participants' Income Calculation and Rent Determination including any applicable utility allowances, review Lease Agreement, Lease Addendum if applicable, and Housing Assistance Payment (HAP) Contracts, issue move -in authorization, and issue payments to Landlords; 7. Provide policies and procedures which ensure compliance with Further Fair Housing Act, Client Rights arid Grievance Procedures specifically regarding terminations of housing, termination from program, evictions, and Landlord Tenant issues and appeals; 8. Provide directly, or refer to all appropriate mainstream services (as applicable) including psychiatric or psychological evaluations, medical clearances, mental health treatment, substance abuse treatment, social rehabilitation, legal services, life skills training, family reunification, counseling services, benefits applications, veteran services, employment, vocation and job assistance services; 9. Provide at a minimum, an annual assessment of the services needs of the program participants and adjust services accordingly; and 10. Discharge planning to other types of mainstream positive housing. Conditions: The Subrecipient shall adhere to the "Continuum of Care Program Grant Agreement", which includes the "Exhibit 1 Scope of Service FY 2015 Competition" and which is governed by the Continuum of Care (CoC) program rules and regulations. The Subrecipient shall comply with all applicable federal, state and local laws, regulations and ordinances, including but not limited to 24 CFR Part 578, as may be amended, the McKinney- Vento Homeless Assistance Act (42 U.S.C. 11301 et seq.) (the "Act") as may be amended, the Consolidated and Further Continuing Appropriations Acts of 2013 and 2014 as well as with any other terms and conditions as HUD may have established in the applicable Notice of Funds Availability and with any applicable guidance, requirements and directives provided by Miami -Dade County Homeless Trust. .._.__........._ Attachment B "Miami -Dade County Homeless Trust Scope of Service" Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FLO177L4D001508 Project and Recipient Information 1. Awarded Grant Number: 2. Project Name: 3. CoC Number and Name: 4. Recipient Legal Name: 5. EIN/TIN: FL0177L4D001506 City of Miami Beach Outreach FL -600 - Miami -Dade County CoC Miami -Dade County 59-6000573 6a. DUNS Number: 004148292 6b. DUNS Extension: HUD Award Information Budget Summary Eligible Activities Renewal Applicant Submission DO Review DD Review HUD Award 7. Component Type: SSO SSO la. Leased Units SSO 8. Grant Term: 1 Year 1 Year 1 Year 9. Will the PH project provide PSH or RRH? 1b. Leased Structures 10. Reduced through Reallocation: No No 1 1r ar No 11. Indirect Cost Rate: No No 2. Rental Assistance No Budget Summary Eligible Activities Annual Amount Requested (Renewal Applicant Submissio n) Annual Amount Requested (HUD Award) Grant Term (Renewal Applicant Submissio n) Grant Term (HUD Award) Total Requested for Grant Term (Renewal Applicant Submission) Total Requested for Grant Term (HUD Award) la. Leased Units 1b. Leased Structures 6 $0 $0 (Year z 1 1r ar 2. Rental Assistance 3. Supportive Services$6,94660 "t946 1 Yeal 1 Year 946r yy 4. Operating 5 HMIS ��-�� :�� $o '1Ya�r �t1�Ye�r 6 Soli {b#aos Req es ed $6D946 7. Admina$4,266 (Up to 10%) i at it Tota! A`asWstance Plus Acjn ih iRequest�d t $65212 $65212` 9. Cash Match $545L05 -` $ii45 654 HUD Conditional Award Summary Page 1 08/03/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 10. In -Kind Match 2,4, 1§3. 60 �L�6= r{ ��6266; HUD Conditional Award Summary Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L40001508 'ID. Congressional District(s) Instructions: All fields on this screen will populate with inforrnation from the project application. These fields can be adjusted. Areas Affected By Project: This field is required. Select the State(s) in which the proposed project will operate and serve the homeless. Descriptive Title of Applicant's Project: This field is populated with the narne entered on the Project screen when the project application was created. To change the project name, click Back to the Submission List and click on "Projects" on the left hand menu. Click on the magnifying glass next to the project name to edit. Congressional District(s): a. Applicant: This field populates from the Project Applicant Profile. Project applicants cannot modify the data in this field. However, project applicants may modify the Project Applicant Profile in e -snaps to correct an error. b. Project: This field is required. Select the congressional district(s) in which the project operates. For new projects, select the district(s) in which the project is expected to operate. Proposed Project Start and End Dates: In this required field, indicate the operating start date and end date for the project. For new project applications, indicate the estimated operating start and end date of the project. Estimated Funding: Fields intentionally left blank, cannot edit. Additional Resources: https://www. h udexchange. info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 14. Area(s) affected by the project (State(s) Florida only): (for multiple selections hold CTRL key) 15. Descriptive Title of Applicant's Project: City of Miami Beach Outreach 16. Congressional District(s): a. Applicant: FL -027, FL -026, FL -024, FL -025, FL -023 b. Project: FL -023 (for multiple selections hold CTRL key) rApplicant Renewal Issues and Conditions J Page 1 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 17. Proposed Project a. Start Date: 06/01/2016 b. End Date: 05/31/2017 Applicant Renewal Issues and Conditions Page 2 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 2A. Project Subrecipients This form lists the subrecipient organization(s) for the project. To add a subrecipient, select the icon. To view or update subrecipient information already listed, select the view option. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. Total Expected Sub -Awards: $65,212 Organization ., . �.. �.,.._ ., bunt City of Miami Beach C. City or Township Government $65,212 Applicant Renewal Issues and Conditions Page 3 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FLO177L40001508 2A. Project SUbrecipients Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Enter the contact information for the person designated by the subrecipient who has the authority to act on the subrecipient's behalf. Organization Name: This field is required: Enter the legal name of the organization that will serve as the subrecipient. Organization Type: This field is required. Select the type of business organization that best describes the subrecipient. Nonprofit applicant types (both public and private) are required to submit to HUD one of the following sources documenting nonprofit status: (1) IRS letter or ruling showing 501(c)(3) status; (2) Documentation showing certified United Way agency status; (3) Certification, from a licensed CPA (see 24 CFR part 578); or (4) Letter from an authorized state official showing that the applicant is organized and in good standing as a public nonprofit organization. If Other, please specify: Enter the other type of business organization that best describes the subrecipient. Employer or Tax Identification Number: This field is required. Enter the Employer or Taxpayer Identification Number (EIN or TIN) as assigned by the Internal Revenue Service. If your organization is not in the US, enter 44-4444444. Organizational DUNS: This field is required. Enter the organization's DUNS or DUNS+4 number received from Dun and Bradstreet. Information on obtaining a DUNS number may be obtained at http://www.dnb.com. Physical Address: Enter the street address, city, state, and zip code (required); county, province, and country (optional). If the mailing address is different from the street address, enter the mailing address. Congressional District(s): This field is required. Select the congressional district(s) in which the subrecipient is located. Faith Based Organization: This field is required. Select "Yes or "No if the subrecipient is a faith based organization. Prior Federal Grant Recipient: This field is required. Select "Yes" or "No" to indicate if the subrecipient has ever received a federal grant. Expected Sub -Award Amount: This field is required. Enter the expected sub -award amount. Contact person: Enter the prefix, first name, last name, and title (required); middle name and suffix (optional). Enter the person's organizational affiliation if affiliated with an organization other than the subrecipient. Enter the person's telephone number and email (required); alternate number, extension, and fax number (optional). Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ a. Organization Name City of Miami Beach b. Organization Type C. City or Township Government Applicant Renewal Issues and Conditions Page 4. 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 If "Other" specify: c. Employer or Tax Identification Number: 59-6000372 * d. Organizational DUNS: 020546289 PLUS 4 e. Physical Address Street 1 1700 Convention Center Drive Street 2 City Miami Beach State Florida Zip Code 33139 f. Congressional District(s): FL -023 (for multiple selections hold CTRL key) g. Is the subrecipient a Faith -Based No Organization? h. Has the subrecipient ever received a Yes federal grant, either directly from a federal agency or through a State/local agency? i. Expected Sub -Award Amount: $65,212 j. Contact Person Prefix Ms. First Name Judy Middle Name Last Name Hoanshelt Suffix Title Grants Manager E-mail Address judyhoanshelt@ci.miamibeach.fl.us Confirm E-mail Address judyhoanshelt@ci.miamibeach.fl.us Phone Number 305-673-7000 Extension 6,183 Applicant Renewal -issues and Conditions Page 5 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 Fax Number 786-394-4675 Applicant Renewal Issues and Conditions 1 Page 6 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 2B. Recipient Performance Instructions: The selections made on this screen by completing all of the mandatory fields marked with an asterisk (*), will provide information on capacity of the project applicant. The screen asks the Project Applicant questions about capacity performance as a HUD grant recipient; in terms of: timely submission of required reports, quarterly eLOCCS drawdowns, addressing HUD monitoring and/or OIG audit findings and the recapture of any funds from the most recently expired grant term of the project. APR Submission: Select "Yes" or "No" from the dropdown menu to indicate whether you have successfully submitted the APR on time for the most recently expired grant term related to this renewal project request. If "No" is selected, an additional question will appear, in which you must provide an explanation in the textbox; as to why the APR was not submitted in a timely manner. HUD Monitoring Findings: Select "Yes" or"No" from the dropdown menu to indicate whether your organization has any unresolved HUD Monitoring and/or OIG Audit findings concerning any previous grant term related to this renewal project request. If "Yes" is selected, two new questions will appear, in which the applicant will enter the date of the oldest unresolved finding(s) and explain why the findings remain unresolved in the textbox provided. Quarterly Drawdowns: Select "Yes" or "No" from the dropdown menu to indicate whether your organization maintained consistent Quarterly Drawdowns from eLOCCS for the most recent grant terms related to this renewal project. If "No," is selected, one new question will appear in which the applicant must explain, in the textbox provided, as to why the recipient has not maintained consistent Quarterly Drawdowns for the most recent grant terms related to this renewal project request. Recaptured Funds: Select "Yes" or "No" from the dropdown menu to indicate whether any funds have been recaptured by HUD for the most recently expired grant term related to this renewal project request. If "Yes," is selected, one new question will appear, in which the applicant must explain why HUD recaptured funds from the most recently expired grant term. Additional Resources: https://www. hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Has the recipient successfully submitted Yes the APR on time for the most recently expired grant term related to this renewal project request? 2. Does the recipient have any unresolved No HUD Monitoring and/or OIG Audit findings concerning any previous grant term related to this renewal project request? 3. Has the recipient maintained consistent Yes Quarterly Drawdowns for the most recent Applicant Renewal Issues and Conditions Page 7 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L40001508 grant terms related to this, renewal project request? 4A Have any Funds been recaptured by HUD No for the most recently expired grant term related to this renewal project request? Applicant Renewal Issues and Conditions Page 8 07/14/2016 Applicant; Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508. 3A. Project Detail Instructions: The majority of the fields on this screen are for reference only. Questions 5 and. 6 may only be adjusted to resolve identified issues and conditions. Additional Resources: https://www.hudexchange.info/e-snaps/gu ides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Expiring Grant Number: FLO177L4D001508 (e.g., the "Federal Award Identifier" indicated on form 1A, Application Type) 2a. CoC Number and Name: FL -600 Miami -Dade County CoC 2b. CoC Applicant Name: Miami -Dade County 3. Project Name: City of Miami Beach Outreach 4. Project Status: Standard r 6. Does this project use one or more No properties that have been conveyed through the Title V process? Applicant Renewal Issues and Conditions Page 9 07/14/2016 l Renewal Project Application HUD Award Adjustment 5. Component Type: SSO SSO SSO r 6. Does this project use one or more No properties that have been conveyed through the Title V process? Applicant Renewal Issues and Conditions Page 9 07/14/2016 l Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L44D001508 3B. Project Description Instructions: All fields on this screen will populate with information from the project application. Many fields, can be adjusted directly.. For others, data can only: be entered under the Adjustment column. Data under the New Submission column populates from the project application. Data under the HUD Award column populates from the HUD conditional award. Provide a description that addresses the entire scope of the proposed project: This field populated with the information from the project application. It cannot be adjusted. Provide changes, if required, to:the description that addresses the entire scope' of the.proposed project:, This:field populates;m . with information frothe, project application. It can. be: adjusted: ='A project description should be complete and concise, It must address the; entire scope of the amended project, including the details from Terminating grants under a grant consolidation. The project description should address the entire scope of the project, including a clear picture of the target population(s) to be served, the plan for addressing the identified needs/issues of the CoC target population(s), projected outcome(s), and coordination with; other source(s)/partner(s). The narrative is expected to describe the project at full operational capacity. The description should be consistent with and make reference to other parts of this application: Does your project participate in a CoC Coordinated Assessment System: This is a required field. Select "Yes" if the project is currently participating in a coordinated assessment; system. If a coordinated assessment system does not exist in the CoC or if the project does not participate, select "No" and the following question will be visible; - Please explain why your project does not participate in a CoC Coordinated Entry Process as required by 24 CFR part,578. Does your project have a specific population focus: This is a required field. Select "Yes" if your project has special capacity in its facilities, program designs, tools, outreach or methodologies for a specific subpopulation or subpopulationst This does not necessarily mean that the project exclusively serves that subpopulation(s), but rather that they are uniquely equipped to serve them. If "Yes" is selected, select the relevant checkbox(es) to identify the project's population focus. PH, TH and SSO PROJECTS ONLY Does the project follow a "Housing First" approach: The following three questions, are required for PH, TH, and some SSO projects and does not apply to SSO Coordinated Entry and HMIS projects. Confirm whether the project quickly moves participants into permanent housing and select all applicable checkboxes that indicate whether ,the p, articipants are not screened out or terminated from the program based on the listed reasons Does the project quickly move participants into permanent housing?; This is a required field. The recipient must select "Yes" or "No" from the dropdown. Has the project removed the following barriers to accessing housing and services? (Check all that apply): The recipient must select at least one checkbox and should select "None of the above:" if all of the listed reasons are used to screen out participants. Has the project removed the following as reasons for program termination? (Check all that apply) The recipient must select at least on checkbox and should select "None of the above:" if all of the listed reasons are used to terminate participants from the program. Does the project follow a "Housing First" approach? This is auto -scored based upon the responses to the questions above and 'Yes" or "No" will indicate whether the project is using the Housing First approach to house program participants. Applicant Renewal Issues and Conditions Page 10 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 r PH PROJECTS ONLY Does the PH project provide PSH or RRH: This is a required field if PH. Select" PSH" if the project will operate according to a permanent supportive housing model as defined by 24 CFR 578. Select "RRH" if the project will operate according to a rapid rehousing model as defined by 24 CFR 578. PH AND TH PROJECTS ONLY Does the project request costs under the rental assistance budget line item? This is a required field if PH or TH. If requesting rental assistance, select "Yes" from the dropdown menu. If not requesting rental assistance in this project application, select "No". TH AND SSO PROJECTS ONLY Do you plan on serving homeless households with children and youth defined as homeless under other federal statutes (Paragraph 3 of the definition of homeless found at 24 CFR 578.3)? Please note that no project is permitted to serve this population unless the CoC has requested and is approved to do so: This is a required field. Projects are only permitted to serve households with children and youth defined as homeless under other federal statutes (Paragraph 3 of the definition of homeless found at 24 CFR 578.3), if the CoC has requested and is approved to use funds for such a purpose. CoCs that wish to request that projects within the CoC be permitted to use funds to serve this population had to identify the specific project(s) that would use funding for this purpose (up to 10 percent of CoC total award) by submitting an attachment with the CoC Application. HUD will only consider TH and SSO projects for approval under the above conditions. PH AND TH PROJECTS ONLY Does the project request costs under the rental assistance budget line item?: This is a required field. If requesting rental assistance, select "Yes" from the dropdown menu. If not requesting rental assistance in this project application, select "No". RENTAL ASSISTANCE PROJECTS ONLY Is this a CoC Program leasing or former SHP project that had been approved by HUD to revise the renewal project budget from leasing to rental assistance? (This change must have been listed on the final HUD -approved GIW. See 24 CFR 578.49(b)(8))This is a required field. "Yes" should only be selected if the change from leasing to rental assistance was approved by HUD during the GNI/ process. Additional Resources: https://www.hudexchange. info/e-snaps/guides/coc-program-com petition -resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. la. Application description that addresses the entire scope of the proposed project. The City of Miami Beach conducts street outreach Monday through Friday to identify, engage and offer services to homeless persons with the City of Miami Beach. Via its outreach efforts and walk-in center (located at 555 -17th Street), the City seeks proactively reaches out to homeless persons with a variety of services including: intake and assessment for services, shelter placement, replacement of identification documents, application for entitlements, relocation services and referral services to providers within the County's Continuum of Applicant Renewal Issues and Conditions Page 11 07/14/2016 1 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000. FL0177L4D001508 Care. Goals and Objectives: The City's goal is to end homelessness in the City by providing prevention and intervention services to participants who are homeless o n or at risk of homelessness, As one of the City's intended outcomes, the City has prioritized ending homelessness by investing in support services including shelter beds and transportation services,to enable relocation for thosewith support networks elsewhere as a means of augmenting our outreach efforts. Eligibility The City serves homeless persons within its municipalboundaries who seek to end their cycle of homelessness. Clients and Population Served: The City anticipates serving 700 homeless 'persf thesemilies and individuals) via its outreach services during the grant period. Of these, we expect to place:350 participants in emergency shelter, housing first`and other housing with supportive services. Hours of Operation: The City's walk-in center operates 8:30am -12:00 pm and f pm -3:30 pm daily, Street outreach is conducted during walk,in center operating hours as well as early. morning outreach (com'mencing at4arn)"in conjunction with -the Miami" Beach Police. Department; lb, Provide changes, if required, to the description that addresses the entire scope of the proposed project. The City of Miami Beach conducts street outreach Monday through Friday to identify, engage and offer services to homeless persons with the City of Miami Beach. Via its outreach efforts and walk-in center (located at 555 -17th Street), the City seeks proactively reaches out to homeless persons with a variety of services: including: intake, andassessment for services, shelter placement, replacement of identification documents, application for entitlements, relocation services and referral services to providers within, the County's :Continuum .of Care. Goals and Objectives: The City's goal is to end homelessness in; the City by Providing prevention and intervention services :to participants Who are. homeless or at risk of homelessness As ope of the City's intended. outcomes, the City" has prioritized: ending homelessness by investing in support services including. shelter beds and transportation'services to enable relocation for those with support networks elsewhere as a means of augmenting our outreach efforts. Eligibility: The City serves homeless persons within its municipal boundaries who seek to end their.; cycle of homelessness. Clients and'Population Served: The City anticipates serving 700 homeless persons (families and individuals) via its outreach services during the grant period. Of these, we expect to place 350 participants in emergency shelter, housing first and other housing with supportive services,; Hours of Operation The -City s walk in center operates 8:30am -12:00 pm and .1 pm -3 30 pm daily street outreach is conducted during walk-in center operating hours as well as early morning outreach (commencing at 4am) in conjunction with the Miami Beach Police Department. 2. Does your project participate in a CoC Yes Coordinated Assessment System? 3. Does your project have a specific Yes population focus?' Applicant Renewal Issues and Conditions Page 12 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L40001508 3a. Please identify the specific population focus. (Select ALL that apply) Chronic Homeless — X' Domestic Violence Active or history of substance X J 9 X J Veterans FX Having a criminal record with exceptions for state -mandated restrictions Substance Abuse History of domestic violence (e.g. lack of a protective order, period of seperation from abuser, or law enforcement involvement) X X Youth (under 25) None of the above L___J Mental Illness X Families HIV/AIDS X X Other (Click 'Save' to update) X Other: All individuals and families in need of services 4. Housing First a. Does the project quickly move participants Yes into permanent housing be Has the project removed the following barriers to accessing housing and services? (Check all that apply) Having too little or little income — X' X Active or history of substance � — X abuse LX FX Having a criminal record with exceptions for state -mandated restrictions LXI History of domestic violence (e.g. lack of a protective order, period of seperation from abuser, or law enforcement involvement) X Any other activity not covered in a lease agreement typically found in the project's geographic area I `_ X J None of the above L___J c. Has the project removed the following as reasons for program termination? Failure to participate in supportive services — X' Failure to make progress on a service plan � — X Loss of income or failure to improve income FX Domestic violence X Any other activity not covered in a lease agreement typically found in the project's geographic area X None of the above Applicant Renewal Issues and Conditions Page 13 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FLO177L4D001508 d. Does the project follow a "Housing First" Yes approach? 8. Please select the type of SSO project: Street Outreach Applicant Renewal Issues and Conditions Page 14 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 4A. Supportive Services for Participants Instructions: AH fields on this screen will populate with information from the project application. These fields can be adjusted. Are the proposed project policies and practices consistent with the laws related to providing education services to individuals and families: This is a required field. Select "Yes," "No," or "N/A" to indicate whether the project policies provide for educational and related services to individuals and families experiencing homelessness, and if the policies are consistent with local and federal educational laws, including the McKinney-Vento Act. Only projects that do not serve families with children or unaccompanied youth should select "N/A." If "No" is selected, the project applicant will be required to answer an additional question. Does the proposed project have a designated staff person to ensure that children are enrolled in school and receive educational services, as appropriate: This is a required field. Select "Yes," "No," or "N/A" to indicate whether the project has a designated staff person responsible for ensuring that children and youth are enrolled in school and connected to the appropriate services within the community, including early childhood education programs such as Head Start, Part C of the Individuals with Disabilities Education Act, and McKinney-Vento education services. Only projects that do not serve families with children or unaccompanied youth should select "N/A." If "No" is selected, the project applicant will be required to answer an additional question. Describe the manner in which the project applicant will take into account the educational needs of children when youth and/or families are placed in housing: This is a required field if a response of "No" is given for either one of the two preceding questions. Use this space to explain how the project will plan to meet the educational needs of children and youth participants according to the requirements specified under section 426.6.4 of the McKinney-Vento Act as amended by HEARTH. For all supportive services available to participants, indicate who will provide them, how they will be accessed, and how often they are provided. This field is required and at least one value must be entered. Complete each row of drop down menus for supportive services that will be available to participants, using the funds requested through the application, and funds from other sources. If more than one Provider or mode of Access is relevant for a single service, please select the provider and mode of access that corresponds to the highest frequency. - Provider: select one of the following: "Applicant" to indicate that the applicant will provide the service directly; "Subrecipient" to indicate that a subrecipient will provide the service directly; "Partner" to indicate that an organization that is not a subrecipient of project funds but with whom a formal agreement or MOU has been signed will provide the service directly; or, "Non -Partner" to indicate that a specific organization with whom no formal agreement has been established regularly provides the service to clients. If more than one provider offers the service at the same frequency, choose the provider according to the following: Applicant, then Subrecipient, then Partner, and lastly, non -Partner. - Frequency: Select the most common interval of time for which the service is accessible to participants. If two frequencies are equally common, choose the interval with the highest frequency. Applicants may leave dropdown menus as "—select—" when services are not applicable. To what extent are most community amenities available to project participants: This field is required. Select the answer that best fits the accessibility of community amenities such as: Schools, libraries, houses of worship, grocery stores, laundromats, doctors, dentists, parks or recreation facilities. If accessibility varies significantly by amenity, choose the level that best describes most of the amenities or the average accessibility of amenities. Please identify whether the project will include the following activities: Applicant Renewal Issues and Conditions Page 15 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 Transportation assistance to clients to attend mainstream benefit appointments, employment training, or jobs: This is a required field. Select "Yes" if the project provides regular or as requested transportation assistance to mainstream andcommunity resources, including appointments, employment training, or jobs. Select "No" if transportation is not regularly provided or cannot be provided consistently as requested. Use of a single application form for four or more mainstream programs: This is a required field. Select Yes" if the project uses a single application form that allow participants to sign up for four or more mainstream programs. Select "No" if mainstream forms are fora or fewer programs. At least annual follow-ups with participants to ensure mainstream benefits are received and renewed: "This is a required field. Select "Yes" if the project regularly follows -up with participants to ensure that they are receiving their mainstream' benefits and to renew benefits when required. Select"No" if there isare no follow-ups or the follow-ups are irregular concerning mainstream benefits. Will project participants have access to SSI/SSDI technical assistance provided by. the, applicant, a subrecipient, or partner agency: This is a required field. Select "Yes" if project participants have access to SSI/SSDI technical assistance. The assistance can be provided by the applicant; a subrecipient, or a partner agency through a formal or informal relationship. Select"No" if there is no or significantly limited access to SSI/SSDi"technical assistance. Additional Resources: https://www. hudexchange.info/e-snaps/guides/coc-program-competition To edit this screen, click "Adjustments" on the left menu, select `'Yes from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. la. Are the proposed project policies and Yes practices consistent with the laws related to providing education services. to individuals and families? lb. Does the proposed project have a designated staff person to ensure that the children are enrolled` in school and receive educational s, as appropriate? 2. For all supportive. services available to participants,.indlcate who will provide them, how theyYwill be accessed, and how often they will'be"; provided. - Click'Save'to. update. Supportive Services Provider Frequency Assessment of Service Needs Assistance with Moving Costs Case Management Child Care Education Services Employment Assistance and Job Training Subrecipient Daily :. Subrecipient Daily Partner As needed Applicant Renewal Issues and Conditions Page 16 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FLO177L40001508 Food Housing Search and Counseling Services Legal Services Life Skills Training Mental Health Services Outpatient Health Services Outreach Services Substance Abuse Treatment Services Transportation Utility Deposits Subrecipient Daily Subrecipient Daily Partner As needed Partner As needed Subrecipient Daily Partner As needed Subrecipient Daily 3. Please identify whether the project includes the following activities: 3a. Transportation assistance to clients to Yes attend mainstream benefit appointments, employment training, or jobs? 3b. Use of a single application form for four Yes or more mainstream programs? 3c. At least annual follow-ups with Yes participants to ensure mainstream benefits are received and renewed? 4. Do project participants have access to Yes SSI/SSDI technical assistance provided by the applicant, a subrecipient, or partner agency? 4a. Has the staff person providing the Yes technical assistance completed SOAR training in the past 24 months. Applicant Renewal Issues and Conditions Page 17 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L40001508 5A. Project Participants - Households Instructions: ALL PROJECTS EXCEPT HMIS All fields on this screen will populate with the most current grant information. These fields can be adjusted. In each non -shaded field list the number of households or persons served at maximum program capacity. The numbers here are intended to reflect a single point in time at maximum • occupancy and not the number served over the course of a year or grant term. Dark grey cells are not applicable and light grey cells will be totaled automatically• Households: Enter the number of households under at least one of the categories: Households with at least One Adult and One Child, Adult Householdswithout Children, or Households With Only Children. - Households with at least One Adult and One Child: Enter the total number of households with at least one adult and one child. To fall under this column and household type, there must be at least one person at or above the age of 18, and at least one person under the age of 18. Adult Households without Children: Enter the total number of adult households without children. To fall under this column and household type, there must be at least one person at or above the age of 18, and no persons under the age of 18, - Households with Only Children: Enter the total number of households` with only children. ' To fall under this column and household type, there may not be anypersons at'or `above the age of 18, and only persons under the age of 18. Characteristics: Enter the total number of homeless that fall under one of the characteristics listed. - Persons in Households with at least One Adult and One Child; Enter the nurrlber"of persons, in households with at least one adult and on child for each' demograph!c row To fall under this column and household type, there must be at least one person at or above the age of 18; and at least one person under the age of 18.' - Adult Persons in Households without Children: Enter the number of persons in -households without children for each demographic row. To fall under this column and household type, there must be at least one person at or above the age of 18, and no persons under the age of,18. - Persons in Households with Only Children: Enter the number of persons in households with only children for each demographic row. To fall under this column and household type, there may not be any persons at or above the age of 18, and only persons under the age of 18. Totals: All fields in the "Total Number..." and "Total Persons" rows will automatically calculate when the "Save" button is clicked. Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click' Adjustments on the. left menu, select "Yes" from the dropdown menuand briefly explain the adjustments that you would like to request in the text box provided. Households Total Number of Households Households with at Least One Adult and One Child 25 Adult Households without Children 355 Households with Only Children Total Applicant Renewal Issues and Conditions Page 18 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 Characteristics Persons in Households with at Least One Adult and One Child Adults over age 24 Adults ages 18-24 25 3 Adult Persons in Households without Children 310 45 Persons in Households with Only Children Accompanied Children under age 18 32 Unaccompanied Children under age 18 T Click Save to automatically calculate totals Applicant Renewal Issues and Conditions Page 19 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 5B. Project Participants - Subpopulations Instructions ALL PROJECTS EXCEPT HMIS All fields on this screen will populate with:' can be adjusted. In each non -shaded field enter the number of person's served at maximum program capacity according to their age group, disability status, and the extent in which persons served fit into one or more of the subpopulation categories. The numbers here are intended to reflect a single point in time at maximum capacity and not the number served over the course of a year or grant term. Dark grey cells are' not applicable. and light grey cells will be totaled automatically. Complete each of the three charts on the screen according to household types. Persons in Households with at Least One Adult and One Child chart: Enter only persons in households with at least one adult and one child. To be listed on this chart, a person must be part of a household with at least one person at or above the age of 18, and at least one person under the age of 18. Persons in Households without Children chart: Enter only persons in adult households without children. To be listed on this chart, a person must be part of a household with at least one person at or above the age of 18, and no persons under the age of 18. Persons in Households with Only Children chart: Enter only persons in households with only children. To be listed on this chart, a person must be part of a household with no persons at or above the age of 18, and only persons under the age of 18. Total Persons: All fields in the "Total Persons" rows will calculate automatically when the "Save" button is clicked, Describe the unlisted subpopulations referred to above: This field is visible and mandatory if a number greater than 0 is entered into the column "Persons not represented by listed subpopulations." Enter text that describes the person(s) identified in this column and explains how they do not fall under the other categories in columns 1 through 9. Additional Resources: https://www.hudexchange,info/e-snaps/guides/coc-program-competition-resources/ information from the project application. These fields To edit this screen, click from the drop d wn menu"Adjustments"explain e left mnu, select "Yes" the adjustments that you would like to request in the text box provided. Persons in Households with at Least One Adult and One Child Adults ages 18-24 Applicant Renewal Issues and Conditions Page 20 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041432920000 FL0177L4D001508 Children under age 18 0 0. 0 0 1 0 3 28 `TaniMri x 8 d 0 0 3 6 08 Adults over age 24 Adults ages 18-24 Click Save to automatically calculate totals Persons in Households without Children rs 75 Click Save to automatically calculate totals Persons in Households with Only Children Accompanied Children under age 18 Unaccompanied Children under age 18 Describe the unlisted subpopulations referred to above: N/A Applicant Renewal Issues and Conditions Page 21 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 5C Outreach for Participants Instructions: ALL PROJECTS EXCEPT,HMIS All fields on this screen will populate with information from the project application. These fields can be adjusted. Enter the percentage of project participants that will be coming from each,of the following locations: This isa required field.Enter the percentage (between (1%o and 100%) of participants that will be coming from each of the following locations: - Directly from the street or other locations not meant for human habitation - Directly from emergency shelters - Directly from safe havens - From transitional housing and previously resided in a place not meant for human habitation or emergency shelters, or safe havens - Persons at imminent risk of losing their night time residence within. 14 days, have no subsequent housing identified, and lack the resourcesto obtain other housing (only applicable to TH and SSO projects) - Homeless persons as defined under other federal statutes (TH and SSO only and HUD approval REQUIRED) .. - Persons fleeing domestic violence * If the project has entered a value into the row "Homelesspersons asdefined.,. that valu e has been set to zero as no projects have been approved to serve persons coming from these locations. ** If the project is not a TH or SSO project and has entered a value into the row "Persons at imminent risk..." that value, has been n.setto zero as no other project type may serve persons from these locations. Total of above percentages: The percentages entered will automatically sum, when all required fields are entered and the "Save" button is clicked. A warning message will appear if the total is greater than 100%. If the total is less than 100 percent, identify how the persons meet HUD's definition of homeless and the project type eligibility requirements. AND/OR If "Persons at imminent risk..." is greater than 0 percent, identify the project as either an SSO or TH project and verify that persons served will be within 14 days of losing their housing and becoming literally homeless: This field is required if the total percentage calculated above is less than 100 percent or if a number greater than 0 was entered in the "Persons at imminent risk of losing their nighttime residence" field. If both apply, the project applicant must provide a response to both questions in this field. If the total percentage calculated above is less than 100 percent, explain where the unaccounted for participants will come from. All participants served in CoC Program funded projects must meet eligibility criteria set forth in 24 CFR Part 578 and the FY 2015 CoC Program NOFA. Applicant Renewal Issues and Conditions Page 22 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 If the field for "Persons at imminent risk of losing their nighttime residence within 14 days, have no subsequent housing identified, and lack the resources to obtain other housing" contains a percentage greater than 0, the project applicant must indicate how these persons meet the eligibility criteria for the project component being requested (may only be TH or SSO). Additional Resources: https://www. hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Enter the percentage of homeless person(s) who will be served by the proposed project for each of the following locations. 100% Directly from the street or other locations not meant for human habitation. Directly from emergency shelters. Directly from safe havens. From transitional housing and previously resided in a place not meant for human habitation or emergency shelters, or safe havens. Persons at imminent risk of losing their night time residence within 14 days, have no subsequent housing identified, and lack the resources to obtain other housing (TH and SSO projects only) Persons fleeing domestic violence. 1lionf ` 4 Total of above percentages 2. If the total is Tess than 100 percent, identify how the persons meet HUD's definition of homeless and the project type eligibility requirements. AND/OR If "Persons at imminent risk..." is greater than 0 percent, identify the project as either an SSO or TH project and verify that persons served will be within 14 days of losing their housing and becoming literally homeless." Applicant Renewal Issues and Conditions Page 23 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508, 6A. Standard Perforrnance Measures Instructions:, SSO STREET OUTREACH PROJECTS ONLY All fields on this screen will populatewithinformationfrom the project, application, These fields can be adjusted. Persons placed into housing (ES'TH,"SH, .or PH) as a result of the street outreach program during the operating year: Count every participant who has moved into any shelter or housing situation after the initial street outreach intervention. Among persons who entered with an unmet need associated with a condition listed below, indicate how many received the services forthat condition by the time they exited? Consider all participants that your project might serve over the next 12 months. Fill out each row as each condition is applicable for the project's population. Leave fields blank in rows for conditions that are not applicable to the population being served, For each measure, enter a number in the blank cells according to the following instructions: Universe (#): Enter the total number of persons about whom the measure is expected to be reported: The Universe is the total pool�f persons that could be affected. Target (#): Enter the number of applicable clients frormthe universe Who are expected to achieve the measure within the operating year: The Target is the total number of persons from the pool that are affected. Target (%): This field will be calculated automatically when all required fields are entered a`nd saved. For example, if 80 out of 100 clients are expected to be placed into housing, the target should be80%. Additional Resources. https://www.hudexchange info/e=snaps/guides/coc-program-competition-resources/ fl 11 To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown. menu and briefly explain the adjustments that you virouid�`like to request•in,the text'box provided.` 1. Specify the universe and target for the housing measure. Housing Measure Target (#) Universe (#) Target % (calculated) 1a. Persons exiting to any destination that is not a place not 350 700 meant for human habitation; jail, prison or juvenile detention facility; or other destination. Recipients should exclude from their calculation, including their universe, persons they are expecting with exits to hospital or other residential non- psychiatric medical facility, residential project or halfway house with no homeless criteria, and deceased. Applicant Renewal Issues and Conditions Page 24 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 2. Among persons who entered with an unmet need associated with a condition listed below, indicate how many received the services for that condition by the time they exited. Measure Target (#) Universe (#) Target (%) (calculated) Physical Disability Developmental Disability Chronic Health HIV/AIDS Mental Health Substance Abuse Applicant Renewal Issues and Conditions Page 25 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 6B. Additional Performance Measures To edit this screen, click, Adjustments on the left menu, select"Yes from the dropdown menuand briefly explain the adjustments that you would like to request in the text box provided. Specify at least one measure on which the project will report performance in the Annual Performance Report (APR). The outreach team... Applicant Renewal Issues and Conditions Page 26 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 3. Specific data elements and formula proposed for calculating results Data element reports will be generated via the HMIS system. The number of client encountered divided by the number of clients placed. 4. Rationale for why the proposed measure is an appropriate indicator of performance for this program Emergency shelter placement is the first step in the process of ending homelessness in our community. Applicant Renewal Issues and Conditions Page 28 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 6B. Additional Performance Measures Detail Instructions: ALL PROJECTS EXCEPT HMIS All fields on this screen will populate with information from the project application. These fields can be adjusted. For each additional measure, fill in the blank cells according to the following instructions; Performance Measure: Provide a name for the additional performance measure. This name will populate the list on the parent additional performance measures screen. Universe (#): Enter the total number of persons/units/items about whom/which the measure is expected to be reported. The Universe is the total pool of persons/units/items that could be affected. Target (#): Enter the number of applicable persons/units/items from the universe who/that are expected to achieve the measure within the operating year. The Target is the total number of persons/units/items from the pool that are affected. Target (%): This field will be calculated automatically when all required fields are entered and saved. For example, if 80 out of 100 clients are expected to remain in the permanent housing program or exit to other permanent housing, the target % should be "80%." Data Source: (e.g., data recorded in HMIS) and method of data collection (e.g., data collected by the intake worker at entry and case manager at exit) proposed to measure results: This is a required field. Use the text box provided to provide as much detail concerning the data systems and methods as possible. Specific data elements and formula proposed for calculating results: This is a required field. Use the text field provided and be specific. Rationale for why the proposed measure is an appropriate indicator of performance for this program: This is a required field. Use the text field provided to describe the appropriateness of the measure given the nature of the program. Additional Resources: https://www. hudexchange.info/e-snaps/guides/coc-program-competition-resources/ 1. Specify the universe and target goal numbers for the proposed measure. a. Proposed Measure b. Target (#) c. Universe (#) d. Target (%) (Calculated) The outreach teams will place at least 50% of their homeless population into emergency shelter 350 700 2. Data Source (e.g., data recorded in HMIS) and method of data collection (e.g., data collected by the intake worker at entry and case manager at exit) proposed to measure results Participants information will be entered into the Service Point Homeless Management Information System (HMIS). Case management staff will also monitor progress in this area. Applicant Renewal Issues and Conditions Page 27 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 7A. Funding Request Instructions: For some fields on this screen data can only be entered under the Adjustment column. Data under the New Submission column populates from the project application. Data under the HUD Award column populates from the HUD conditional award. Questions with only one field and no columns can be adjusted directly. Do any of the properties in this project have an active restrictive covenant? Select "Yes" of "No" to indicate whether one or more of the project properties are subject to an active restrictive covenant. As a reminder, any project awarded capital cost funds (new construction, acquisition, or rehabilitation) has a 20 year or if initially awarded under the CoC Program (FY 2012 capital costs and beyond) a 15 year use restriction. Was the project awarded as either a Samaritan Bonus or Permanent Housing Bonus project? Select "Reallocation" if the project was created through the use of funds reallocated from one or more eligible renewal projects. Select "Permanent Housing Bonus" if this project was awarded using permanent housing bonus funds. Are the requested renewal funds reduced from the previous award as a result of reallocation? Select "Yes" or "No" to indicate whether the renewal project is reduced through the reallocation process. The response will be compared to the CoC Reallocation forms. Does this project propose to allocate funds according to an indirect cost rate? Select "Yes" or "No" to indicate whether the project either has an approved indirect cost plan in place or will propose an indirect cost plan by the time of conditional award. For more information concerning indirect costs plans, please 2 CFR Part 200.56, Part 200.413 and Part 200.414, FY 2015 NOFA and contact your local HUD office. The following questions become visible if "Yes" is selected: - Please complete the indirect cost rate schedule below: Applicant must complete at least one row in the grid. - Has this rate been approved by your cognizant agency?: Select "Yes" or "No" from the dropdown menu. - Do you plan to use the 10% de minimis rate?: Select "Yes" or "No" from the dropdown menu. Select a grant term: This field cannot be edited. Select the costs for which funding is being requested: These checkboxes should only be adjusted when HUD has either removed or created a new budget line item for the project during its review of the project application. Review the budget summary for information concerning the HUD conditional award and then select or deselect budget line items from this chart only if necessary. There are three columns with check boxes. The "New Submission" column is for reference only and represents the budget costs selected by the recipient on the new grant application. The check boxes in this column cannot be edited. The "HUD Award" column is for reference only and represents the budget costs awarded by HUD. The check boxes in this column cannot be edited. The "Adjustment" column represents the amendment request. These check boxes are available for edit. Depending on the project type, the following eligible costs may be listed: new construction/acquisition/rehabilitation, leased units, leased structures, rental assistance, supportive services, operating, and HMIS. Additional Resources: https://www.hudexchange. info/e-snaps/guides/coc-prog ram -competition -resources/ Applicant Renewal Issues and Conditions Page 29 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000, FL0177L4D001508 To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustmentsthat you would like to request in the text box provided. 1. Do any of the properties in this project No have an active restrictive covenant? 2. Was the original project awarded as either No a Samaritan Bonus or Permanent Housing Bonus project? 3. Are the requested renewal funds reduced from the previous award as a result of reallocation? 4. Does this project propose to allocate funds No according to an indirect cost rate? 5. Select a: grant term: ,1 • Year 6. Select the costs for which funding isbeing requested:. Renewal Application Adjustment Leased Units Leased Structures Rental Assistance Supportive Services Operations Applicant Renewal Issues and Conditions Page 30 07/14/201, 6 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 7E. Supportive Services Budget Instructions: Data can only be entered under the Adjustment column. Data under the Renewal Submission column populates from the project application. Data under the HUD Award column populates from the HUD conditional award. The total amount for this budget line item cannot be adjusted during the resolution ofissues and conditions, and so the total value under the Adjustment column must equal the total value under the HUD Award column. Enter the Quantity AND Description and total budget request for each supportive services cost. The request entered should be equivalent to the cost of one year of the relevant supportive service. Eligible Costs: The system populates a list of eligible supportive services for which funds can be requested. The costs listed are the only costs allowed under 24 CFR 578.53. Quantity AND Description: This is a required field. Enter the quantity and detail (e.g. 1 FTE Case Manager salary+ benefits, on-site child care with 1.5 FTE child care specialist for 15 children) for each supportive service activity for which funding is being requested. Please note that simply stating "1 FTE" is NOT providing "Quantity AND Description" and limits HUD's understanding of what is being requested. Failure to enter adequate"Quantity AND Description" may result in conditions being placed on an award and a delay of grant funding. Annual Assistance Requested: This is a required field. For each grant year, enter the amount of funds requested for each activity. The amount entered must only be the amount that is DIRECTLY related to providing supportive services to homeless participants. The request should match the budget amounts identified on the HUD -approved GIW. Total Annual Assistance Requested: This field is automatically calculated based on the sum of the annual assistance requests entered for each activity and is read only. The amount calculated in the Adjustments column must equal the amount in the HUD Award column in order to submit this screen. Grant Term: Read only Total Request for Grant Term: Read only All automatic fields will be calculated once the required field has been cornpleted and saved. Additional Resources: https://www. hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. A quantity AND description must be entered for each requested cost. Eligible Costs Quantity AND Description (max 400 characters) (Renewal Submission) Annual Assistance Requested (Renewal Submission) Annual Assistance Requested (HUD Award) Quantity AND Description (max 400 characters) (Adjustment) Annual Assistance Requested (Adjustment) 1. Assessment of Service Needs Applicant Renewal Issues and Conditions Page 31 07/14/2016 J Applicant: Miami -Dade County Project: City of Miami Beach Outreach 2. Assistance with Moving Costs 3. Case Management 4. Child Care 5. Education Services 6. Employment Assistance 7. Food 8. Housing/Counseling Services 9. Legal Services 10. Life Skills 11. Mental Health Services 12. Outpatient Health Services 13. Outreach Services 14. Substance Abuse Treatment Services 15. Transportation 16. Utility Deposits 17. Operating Costs 0041482920000 FL0177L4D001508 2 FTE Outreach Case Workers- Salary and Fringe Benefits ' $60,946 Click the 'Save' button to automatically calculate totals. Applicant Renewal Issues and Conditions Page 32 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach FL0177L4D001508 0041482920000 7H. Sources of Match/Leverage The following list summarizes the funds that will be used as Match or Leverage for the project. To add a Matching/Leverage source to the list, select the icon. To view or update a Matching/Leverage source already listed, select the icon. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. Total Value of Cash Commitments: Summary for Match Total Value of In -Kind Commitments: Total Value of All Commitments: Total Value of Cash Commitments: Total Value of In -Kind Commitments: Total Value of All Commitments: Summary for Leverage $o $728,357 $728,357 Levera ge Levera ge Levera ge Applicant Renewal Issues and Conditions Page 33 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 Levera ge In -Kind Government City of Miami Bea.,. 10/12/2015 $54,000 Levera ge In -Kind Government Miami -Dade County... 11/07/2015 $541 Levera ge In -Kind Government City of Miami Bea... 10/12/2015 $22,000 Levera ge In -Kind Government City of Miami Bea... 10/12/2015: $19,000 Applicant Renewal Issues and Conditions Page. 34 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-grog ram -competition -resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Match Match or Leverage? 2. Type of Commitment: Cash 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Cash for salaries/Outreach (Be as specific as possible and include the Workers office or grant program as applicable) Applicant Renewal Issues and Conditions Page 35 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 5. Date of Written Commitment: 10/12/2015 6. Value of Written Commitment: $545,054 Sources of Match/Leverage Detail Instructi ons: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. ":Match (cash or in-kind) must be,used for eligible. program costs only and must be equal to or greater than' 25% of the total grant; request for all eligible costs under theCoC Program interim rule with the+exception of leasing costs. Leverage funds can be used for any program related costs: and there. is no minimum requirement, however, the determination of the CoC's leveraging score will be calculated using data from this. screen. Please' review 24 CFR Part` 578 and the FY 2015 CoC Program NOFA.formore detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered." Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Neighborhood Stabilization=PrograType of source: Select Private or Government to denote the source of the contribution The. m (NSP)'and HUD-VASH (VA Supportive Housing. program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible; Name the Source of the Commitment: Be as -specific as possible (e.g. HHS PATH Grant," Community Service Block Grant, Hilton Foundation Grant to End.Chronic Homelessness) and include the: office or grant Program cas"applicablet.;Enter the name`of the entity providing the .' contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculatedand applied. Additional- Resources https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" 'on the left Menu, select "Yes" from the dropdown menu and briefly. explain the adjustments that you would like to request in the text, box provided. 1. Will this commitment be used towards Leverage Match or Leverage?' Applicant Renewal Issues and Conditions Page 36 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Internet Service for I -Pads (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 10/12/2015 6. Value of Written Commitment: $5,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g: HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange. info/e-snaps/guides/coc-program-competition-resources/ Applicant Renewal Issues and Conditions Page 37 07/14/2016 Applicant: Miami -Dade County Project: City of Miarni Beach Outreach 0041482920000 FL0177L4D001508 To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Co imitment: City of Miami Beach -Shelter Beds, relocation (Be as specific as possible and include the assistance and Identification assistance office or grant program as applicable) 5. Date of Written Cornrnitment:. 10/12/2015 6. Value of Written Commitment: $536,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match(cash or in-kind) must be used for eligible program costs" only and. must be equal�to or"greater than 25%'of the total grant request for all eligible costs under the CoC Program interim rule with the exception of easing -costs. 'Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated` using data"from this screen. Please review 24 CFR Part`578 and" the FY 2015 CoC Program'NOFA for- more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage,to.": categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program'(NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e>gHHS PATH Grant, Community Service Block Grant,' Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary Applicant Renewal Issues and Conditions Page 30 07/14/2016. Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Copier Rental (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 10/12/2015 6. Value of Written Commitment: $816 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can Applicant Renewal Issues and Conditions Page 39 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange:info/e-snaps%guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" ori the, left menu, select"Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Printing (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment 10/1 2/2015 6. Value of Written Commitment: $1,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted., Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all: eligible costs under the CoC Program interim rule with the exception of leasing costs, Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination, of the CoC's leveraging score will be calculated using data from this screen, Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or, Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and 1-IUD-VASH (VA Supportive Housing program) Applicant Renewal Issues and Conditions Page 40 07/14/2016 Applicant: Miami -Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001508 funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Insurance (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 10/12/2015 6. Value of Written Commitment: $30,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to Applicant Renewal Issues and Conditions 1 Page 41 07/14/2016 Applicant: Miami -Dade County Project: City of, Miami Beach Outreach 0041482920000 FL0177L4D001508 categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabillzation.Program .(NSP) and ,HUD-VASH (VA Supportive Housing program), funds may be considered Government sources., Project recipients are encouraged to include funds from these sources, whenever possible Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program` as applicable. Enter the name of the entity providing the contribution. It is important to provide as, much detail as possible so that the local HUDffi office can quickly identify and approve ofthe commitment source. Date of written commitment: Enter the date of the written contribution. Value of written. commitment; Enter the total dollar value of the contribution: The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where'the 25% match minimum will be calculated, and applied. . Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text, box, provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miarni Beach -Utilities (Be as specific as possible and include the office or grant program as applicable) 5. Date of Wratten Commitment: 10/12/2015: 6. Value of Written Commitment: $11,000 Sources of Match/Leverage Detail Instructions: All fields on this screen willpopulate with information from the project application;, These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request: for all Applicant Renewal Issues and Conditions Page 42 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach FL0177L4D001508 0041482920000 eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed inforrnation concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment, Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen, The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Staff Training (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 10/12/2015 6. Value of Written Commitment: $2,000 Sources of Match/Leverage Detail Applicant Renewal Issues and Conditions Page 43 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverageare two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing; costs. Leverage funds can be used for any prograrn related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program"NOFA for more detailed information concerning Match and„Leverage. Will this commitment be used towards Match, or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment Select Cash ($) or:In kind:(non-cash) to denote the type of contnbution that describes this match or leveraging commitmeni Type of source:. Select Private or ;Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VASupportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution.; It' is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the: commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the ' dollar The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also "automatically populate the., Summary budget where the 25% match minimum will be calculated and applied,' Additional Resources: https://www. hudexchange.info/e-snaps/guides/cocprogram-competition resources/ To edit this screen, click "Adjustments on” the'left menu;: select "Yes" from the dropdown menu adjustments that you would Like"to request in the "text box` provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Staff Uniforms, tolls, (Be as specific as possible and include the ambulance services office or grant program as applicable) 5. Date of Written Commitment. 10/12/2015 6. Value of Written Commitment: $41,000 Applicant Renewal Issues and Conditions Page 44 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach FL.0177L4D001508 0041482920000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Comrnitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www. hudexchange. info/e-snaps/guides/coc-prog ram -competition -resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Office Supplies (Be as specific as possible and include the office or grant program as applicable) Applicant Renewal Issues and Conditions Page 45 07/14/2016 Applicant: Miami -Dade County Project: City of. Miami Beach Outreach 004148292.0000 FLO177L4D001508 5. Date of,Written Commitment: 10/12/2015 6. Value of Written Commitment: $6,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from 'the project application: These fields can be adjusted. Match`and`Leverage are two distinct categories of funds from other sources thafwill be used in conjunction with this project, if awarded. Match (cash or in' -kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs tinder the CoC Program interim rule with the exception of leasing costs, Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. ` Please review 24 CFR Part 578' and the FY 2015 CoC Program' NOFA for more. detailed information concerning Match and Leverage. Will this commitment be used towards Match or 'Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source Select Private or Government to denote the source of the contribution. The Neighborhood Stab!llzatlon Program (NSP) and HUD-VASH (VA'Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged"to include funds from these sources, whenever possible: Name the Source of the Commitment: Be` as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source: Date of written commitment: Enter the date of the written contribution: Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www hudexchange.info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? Applicant Renewal Issues and. Conditions Page 46 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L40001508 2. Type of Commitment: 3. Type of Source: 4. Name the Source of the Commitment: (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 6. Value of Written Commitment: In -Kind Government City of Miami Beach -Transportation Vehicles, IT, Property Management 10/12/2015 $54,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted. Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ Applicant Renewal Issues and Conditions Page 47 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 To edit this screen, click ".Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: Miami -Dade County Homeless Trust -Admin. (Be as specific as possible and include the Cash office or grant program as applicable) 5. Date of;Written'Commitment: ''11/07/2015` 6. Value of Written Commitment: $541 Sources of Match/Leverage Detail Instructions: All fields on this screen will4populate with information from the project application. These can be adjusted. Match and Leverage are two distinct categories of funds fromother sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible programcostsonly and must be equal to orgreater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination, of the CoC's.leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and. the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be usedtowards Match or Leverage? categorize 'each'commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash that describes this match or leveraging commitment. Select Match or Leverage,to to denote the type of contribution Type of source: Select Private or Government to denote the source of the contribution. ,The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA;Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment:. Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and; include the office or grant program as applicable. Enter the name of the entity providing the contribution: It is important to provide as much detail as possible>so that the local HUD office can quickly identify and approve of the commitment source. Date of written commitment: Enter the date of the written contribution. Value of written commitment: Enter the total; dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary Applicant Renewal Issues and Conditions Page 48 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L40001508 screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied. Additional Resources: https://www.hudexchange. info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments"' on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Leverage Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Software applications, (Be as specific as possible and include the hardware office or grant program as applicable) 5. Date of Written Commitment: 10/12/2015 6. Value of Written Commitment: $22,000 Sources of Match/Leverage Detail Instructions: All fields on this screen will populate with information from the project application. These fields can be adjusted, Match and Leverage are two distinct categories of funds from other sources that will be used in conjunction with this project, if awarded. Match (cash or in-kind) must be used for eligible program costs only and must be equal to or greater than 25% of the total grant request for all eligible costs under the CoC Program interim rule with the exception of leasing costs. Leverage funds can be used for any program related costs and there is no minimum requirement; however, the determination of the CoC's leveraging score will be calculated using data from this screen. Please review 24 CFR Part 578 and the FY 2015 CoC Program NOFA for more detailed information concerning Match and Leverage. Will this commitment be used towards Match or Leverage? Select Match or Leverage to categorize each commitment being entered. Type of Commitment: Select Cash ($) or In-kind (non-cash) to denote the type of contribution that describes this match or leveraging commitment. Type of source: Select Private or Government to denote the source of the contribution. The Neighborhood Stabilization Program (NSP) and HUD-VASH (VA Supportive Housing program) funds may be considered Government sources. Project recipients are encouraged to include funds from these sources, whenever possible. Name the Source of the Commitment: Be as specific as possible (e.g. HHS PATH Grant, Community Service Block Grant, Hilton Foundation Grant to End Chronic Homelessness) and include the office or grant program as applicable. Enter the name of the entity providing the contribution. It is important to provide as much detail as possible so that the local HUD office can Applicant Renewal Issues and Conditions Page 49 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FI0177L4D001508 quickly identify and approve of the commitment source. Date of written commitment: tinter the date of the written contribution. Value of written commitment: Enter the total dollar value of the contribution. The values entered on each detailed Match/Leverage screens will populate the summary screen. The Cash, In -Kind, and Total Match will also automatically populate the Summary budget where the 25% match minimum will be calculated and applied, Additional Resources;,. https;//www,hudexchangeinfo/e=snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments on .the left menu, select "Yes" from the dropdown menu and briefly ezplarn th'e ad�ustmehts that yo would like to request in ' 1. Will this commitment be used towards= Leverage , Match or Leverage? 2. Type of Commitment: In -Kind 3. Type of Source: Government 4. Name the Source of the Commitment: City of Miami Beach -Budget and Performance (Be as specific`as possible'and include the Improvement office or grant program as applicable); 5. Date of Written Commitment: ;,10/12/2015 6. Value of Written Commitment: $19,000 Applicant Renewal Issues and Conditions Page 50 07/14/2016 Applicant: Miami -Dade County Project: City of Miami Beach Outreach FL0177L4D001508 0041482920000 71. Summary Budget Instructions: Data can only be entered under the Adjustment column. Data under the Renewal Submission column populates from the project application. Data under the HUD Award column populates from the HUD conditional award. The total requested amount for this summary budget cannot be adjusted during the resolution of issues and conditions. The system populates a summary budget based on the information entered into each preceding budget screen. Review the data in each preceding screen and, if necessary, in both the HUD Conditional Award Summary and the Project Application accessed through the "Reference Submissions", and return to the screens to correct any inaccurate information. All fields are read only with exception to field "8. Admin (Up to 10%), Admin (Up to 10%): This value cannot be increased above the amount that appears under the HUD Award column. It can however be reduced. The grant will not fund greater than 10% of the request listed in the field "Sub -Total Eligible Costs Request." If an amount above 10% is entered, the system will report an error and prevent application submission when the screen is saved. Total Assistance plus Admin Requested: This field is automatically populated based on the amount of funds requested on the various budgets completed by the project applicant and Admin costs requested. This is this is the total amount of funding the project applicant will request in the FY 2015 CoC Program Competition. Cash Match: This field is automatically populated based on the amount of Cash Match entered on Screen 7H. Sources of Match/Leverage. In -Kind Match: This field is automatically populated based on the amount of In -Kind Match entered on Screen 7H. Sources of Match/Leverage. Total Match: This field will automatically calculate the total combined value of the Cash and In - Kind Match. The total match must equal 25% of the request listed in the field "Total Eligible Costs Request" minus the amount requested for Leased Units and Leased Structures. There is no upper limit for Match. If an ineligible amount is entered, the system will report an error and prevent application submission. To correct an inadequate level of match, return to Screen "7H. Sources of Match/Leverage" to make changes. The Total Budget automatically calculates when you click the "Save" button. Additional Resources: https://www.hudexchange. info/e-snaps/guides/coc-program-competition-resources/ To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. The following information summarizes the funding request for the total term of the project. However, the appropriate amount of administrative costs must be entered in the available fields below. Eligible Costs Annual Assistance Requested (Renewal Annual Assistance Requested (HUD Annual Assistance Requested (Adjustment) Grant Term (Rene wal Grant Term (HUD Award) Grant Term (Adjust ment) Total Assistance Requested for Grant Total Assistance Requested for Grant Total Assistance Requested for Grant Budget Chang e (Adjust and Conditions Page 51 J 07/14/2016 rApplicant Renewal Issues Applicant: Miami -Dade County Project: City of Miami Beach Outreach 0041482920000 FL0177L4D001508 Submission) Award) Submi ssion) Term (Renewal Submission) Term (HUD Award) Term (Adjustment) la. Leased Units lb. Leased Structures 2. Rental Assistance 3. Supportive Services 4. Operating. 5. HMIS 7. Admin (Up to 10%) 10. In -Kind Match Applicant Renewal Issues and Conditions Page 52 07/14/2016