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Continuum of Care Program CMB Outreach Program vim : zol-Hati 5- miAmion mai FY 2017 United States Department of Housing and Urban Development (US HUD) Continuum of Care (CoC) Program Grantee: Miami-Dade County through its Homeless Trust And Subrecipient: The City of Miami Beach Program Name: The City of Miami Beach Outreach Program Grant #: FL0177L4D001710 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 1 INDEX Cover page---page 1 Index---page2 Whereas and preamble---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 Records---page 9 d. Encouraging Efficient Use of Information Technology and Shared Services---page 10 e. Reports:i) Progress Reports;ii)APR;iii) Survey; iv) Participants'Application for Housing;v) Program Income;vi)Program Guidelines;vii)Audit;viii) Incident; ix)COOP through x) Mandatory Disclosures---pages 10 through 13 3. Special and General 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---page 14 f. Performance Improvement Plans---page 14 g. General Conditions i. Insurance; ii) Indemnification;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. Termination---page 21 through 23 5. Future Funding Applications---page 23 6. Reversion of Assets a. Term of Commitment---page 24 b. Repayment of Grant---page 24 c. Prevention of Undue Benefit---page 24 d. Revocation of License or Permit---page 25 e. Declaration of Restrictive Covenant and Declaration of Restrictions---page 25 7. Uniform Administrative Requirements a. Accounting Standards,Costs Principles and Regulations---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---page 38 Signature---page 39 Index of Attachments A through L---page 40 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 2 Subrecipient Agreement between Miami-Dade County and The City of Miami Beach for the FY 2017 US HUD CoC Program Grant#FL0177L4D001710 The City of Miami Beach Outreach Program 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 The City of Miami Beach, (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 2017 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 may be 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 "Miami-Dade County Homeless Trust Standards of Care", as may be amended from time to time and incorporated herein by reference. The Suhrecipient shall adhere to all applicable 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 Subrecipient agree that this Agreement shall become effective on June 1.2018. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 3 This Agreement shall expire on May 31.2019 one (1)year from the effective date. Any cost incurred bythe Subrecipient beyond this date will not be paid bythe 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 a term of at least fifteen(15)years from the date of initial occupancy or service, as provided in this Agreement or as specified by law 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 maybe 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 to 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, 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. 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 provided through a third party are used to fulfill part of the match, a fully- executed Memorandum of Understanding(MOU) 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 CoC Grant#3FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 4 propose to shift funds by less than 100/0 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 contracted 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 outreach and emergency placement services(Supportive Services Only(SSO)to three hundred and fifty(350)homeless individuals and families under the Continuum of Care Program. The program's main office is located at 1700 Convention Center Drive, 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 2017 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 dor 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 potentia] participants. The Subrecipient hereby acknowledges that PRWORA prohibits housing or services provided under this Agreement to undocumented or illegal immigrants. 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 permanent housing 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. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 5 When 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 Re-Housing CoC Program. If this Agreement is for permanent supportive housing or permanent housing for homeless participants, under the Legacy SHP or CoC 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 responsibility to 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 Agreement, and applicable law. The Grantee, Miami-Dade County,shall not be a party to the HAP Contract. Should the Subrecipient desire or require any amendments to the HAP Contract template form;the Subrecipient shall advise the Granteeof the proposed amendment(s)and explain why the amendment(s)is desired or required prior to amending the 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 Subrecipient's failure to pay a Landlord rent on time. The Subrecipient shall be solely responsible for payment of any late fee arising from any late rent payment(s)to Landlord(s). The Subrecipient shall indemnify the Grantee, Miami-Dade County, and pay all costs of defense, including attorneys' fees arising from or related to the HAP Contract and this provision. 2. Records and Reports 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 I1,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 amendedor 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 115 HUD e-Snaps Documents"Attachment B. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 6 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,l(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. 1 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 LIS 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 fifty(ISO) 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 ninety 190) calendar days prior to the expiration of the grant. Failure to submit the appropriate supporting documentation in a timely manner may result in the inability of the Grantee to approve, 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 he submitted to the Grantee within thirty 130) calendar days from the termination or expiration of this Agreement. If after the receipt of such final report,the Grantee determines 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 and other reports or work product), documents, information, data, papers, letters, materials, electronic storage data and media whether written, printed, electronic or electrical, however collected or preserved which is or was produced, developed, maintained, completed, received, or CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 7 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 Administrative 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 Grantee shall have unlimited rights to all books,articles,or other copyrightable materials developed in the performance of this Agreement. These unlimited rights include the rights of royalty-free, nonexclusive,and irrevocable license to reproduce,publish,or otherwise use,and to authorize others to use the work for public purposes. 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 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 8 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. 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 with the 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 Grantee shall avail itself of 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: vmallette(Wmiamidade.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 Circular 2 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. CDC Grant 5FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 9 e. Reports-The Subrecipient shall submit 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. i. 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 from time 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 actual versus planned progress for the period. The reports are due by the fifteenth 115th) day of the following month. The requests for reimbursement, are also due by the fifteenth (15th) 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. 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(301 days after the end of each operating year. The above referenced report maybe substituted for any other US HUD required Report if approved by US HUD and the Miami-Dade County Homeless Trust. iii. A Program Rating and Satisfaction Survey Report shall he conducted electronically utilizing a Miami-Dade County Homeless Trust generated survey tool. This tool will be issued in the month of May of each calendar year and survey results must be submitted to the Miami-Dade County Homeless Trust no later than forty-five (45) calendar days from the date of issuance. 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 (1201 calendar days before the expiration of term of the Lease Agreement and HAP Contract. The Re-certification CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 10 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 retain records of 'Re- certification of Participation Application for Housing' Package Attachment J, no later than one hundred-twenty (1201 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 the Homeless Trust monthly in the"Consolidated Financial Record and Reports",Attachment 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 (1801 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. The Subrecipient shall comply with any and all other applicable audit and reporting requirements. viii.Incident Reports—The Subrecipient must report to Miami-Dade County Homeless Trust information related to any critical incidents occurring during the administration of its CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 11 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 well as 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 prevent non-permitted disclosures. This Incident Report shall be addressed to Miami-Dade County, Homeless Trust, Suite 310, 27th Floor, 111 NW 1st Street, Miami, Florida, 33128; (305) 375-1490 and facsimile(305) 375-2722. 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 B. 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 B 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 Coordinated Outreach and Assessment and 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' CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 12 contribution toward rent is determined by the type of program. Under tenant-based rental assistance, 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 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 that the 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 Trust'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 written copy of the 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 all extenuating circumstances in determining when violations are serious enough to warrant termination so that program participants' assistance is terminated only in the most severe cases. e. The Subrecipient shall complywiththe Violence against Women Reauthorization Act(VAWA) as well as with 24 CFR 5.200, as may be amended, and with all applicable provisions of 24 CFR Parts 5, 92, 200, 574, 576, 578,580,882, 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. f The Subrecipient may be subject to a Performance Improvement Plan (PIP) at the discretion of the Grantee. g. GeneralConditions—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 Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 13 (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 D.S.C. 11301 et seq.) (the "Act") the 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. i. 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, anon 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 In 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#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 14 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. Or Compliance with the foregoing 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 of 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 shall 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 intended that 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, I(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 for fraud,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 Subrecipient'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 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. 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). Coc Grant#FLo177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 15 3. Miami-Dade CountyAffirmative Action/Non-Discrimination 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-Dade 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 be used 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) 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 maybe 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, CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 16 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 stalking. It is further hereby declared to be the policy of Miami-Dade County\o eliminate and prevent discrimination in housing based on source of income. Initials her • DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Parts , 92, 570, 574, 576, and 903 [Docket No. FR-5173-F-04] RIN 2501-AD33 Affirmatively urthering 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,discriminatio in the sale,rental,and financing of dwellings, and in other housing-related transactions b e of "race, color, religion, sex, familial status,national origin, or handicap."Initials her . See 42 U.S.C. 3604 and 3605. Section 808(d) of the Fai ousing Act requires all executive branch departments and agencies admi .stering housing and urban development programs and activities to administer these pro s in a manner that affirmatively furthers fair housing.See 42 U.S.C. 3608. Initials her . The Subrecipient agrees to abide and be overned by Title VI and VII, of the Civil Rights Act of 1964 (42 U.S.C. 2000 et.seq.) and Title Vlll of the Civil Rights 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,religious background, ancestry or national origin in performanc of this Agreement, in regard to persons served, or in regard to employees or applicants or employment or housing. It is expressly understood that upon receipt of evidence of sue crimination,the Grantee shall have the right to terminate this Agreement. Initials her . Executive Order 11063 prohibits discrimination in e sale, leasing, rental, or other disposition of properties and facilities 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 12898 requires 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 LEP persons can have meaningful access to them. Executive Order 13217 requires federal agencies to evaluate their p ivies and programs to determine if any can be revised or modified to improve the avail 15 of community-based living arrangements for persons with disabilities. Initials her Awareness of the Joint tette- f clarification dated August 5, 2017 from United States Department of Justice,United St es Department 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(i)are necessary CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 17 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 ublic benefits and must be made available to eligible persons without regard to citizenship a ionality, or immigration status.8 U.S.C.Section 1611(b)(1)(D); 1621(6)(4). Initials her It is further understood that the Subrecipient must submit affidavits attesti that it is not in violation of the American with Disabilities 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 enforcement agency, 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 Subrecipient violates any of the Acts during the term of any contract the Subrecipient has with Miami-Dade County, such contract shall be voidable by the Grantee, even if the S recipient was not in violation at the time the affidavit(s) were submitted. Initials here The Subrecipient agrees that it is in compliance with the Domestic Violence Leave, codified as (Article 8,Section 11A-60 et.seq.of the County Code),as maybe 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. Failur o comply with this local law may be grounds for voiding or terminating this Agree or for commencement of debarment proceedings against the Subrecipient. Initials he The Subrecipient agrees to abide and be governed by the Age Discrimination Ac f 1975, (42 U.S.C.6101 et seq.) and implementing regulations at(24 CFR Part 146),as may be ame ed, as well as with any applicable regulations, which provides in part that there shall b no discrimination against persons in any area of employment because of age.Initials her . The Subrecipient agrees to abide and be governed by Section 504 of the Rehabilitat o Act of 1973,as amended, (29 U.S.C. 794,et.seq.) as may be amended,as well as with any cable regulations,which prohibits discrimination on the basis of handicap. Initials her . he Subrecipient agrees to abide and he governed by the requirements of the Am cans with ability Act (ADA), as may be amended, as well as with any applicable law. Initials here Pursuant to 24 CFR 578.23,Subrecipient hereby certifies and agrees that: i. 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 or location of 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 to domestic violence centers; CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 18 iii. Subrecipient 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 the McKinney- Vento Homeless Assistance Act, as amended, and other laws relating to the provision of educational and related services to individuals and families experiencing homelessness; iv. In the case of programs 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 community 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 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 forth pursuant to 24 CPR 578.7(a) (8); vi. Subrecipient,its officers,and employees 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: i. 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, 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. Tocomply 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: COC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 19 I. Ineffective or improper use of any funds provided hereunder by the Subrecipient; u. 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,maybe 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 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. iv. 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 all 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 in its sole and absolute discretion that the Subrecipient is not making sufficient 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 but not limited to the following: 1. 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; CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 20 3. 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 final expenditure reports or submits incompletely or incorrectly; 5. The Subrecipient failed or fails to submit required reports or submits incompletely or incorrectly; 6. 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's program; 7. The Subrecipient discriminates under any of the laws outlined in this Agreement; 8. The Subrecipient failed or fails to provide Domestic Violence Leave to its employees pursuant to local law; 9. The Subrecipient falsifies or violates the provisions of a Drug Free Workplace Affidavit; 10. The Suhrecipient attempted or attempts to meet its obligations under this Agreement through fraud,misrepresentation or material misstatement; 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 he 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. S. 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. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 21 The Subrecipient agrees to timely notify the Grantee of the Subrecipient's intention not to be available to renew and continue operating orproviding 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) upon request 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 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. b. Repayment of Grant-If the Subrecipient does not provide supportive housing 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 Term of Commitment. The parties hereby agree this provision shall survive the expiration or termination of this Agreement. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 22 c. 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 to the Subrecipient by the Grantee. 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 Suhrecipient shall record a Declaration of Restrictive Covenants,as well as a Declaration of Restrictions,in accordance with this section. The Declaration of Restrictive Covenants a the Declaration of Restrictions shall restrict the use of properties located at / /9 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 maybe 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 he 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 maybe 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 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 23 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. 7. Uniform Administrative Requirements, Cost Principles,and Audit Requirements for Federal Awards a. 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 Agreement, as modified, shall continue and all provisions of this Agreement shall remain in full force and effect. ii. 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. b. The Subrecipient shall comply 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. ii. Additionally, the Subrecipient shall comply with the established United States Department of Housing and Urban Development's (USHUD) performance measures related to the Continuum of Care's (CoC) system performance. Specifically: 1. Measure 1: The Length of Time Persons Remain Homeless- 2. Measure 2: The Extent to which Persons who Exit Homelessness to Permanent Housing Destinations Return to Homelessness 3. Measure 3:Number of Homeless Persons CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 24 4. Measure 4: Employment and Income Growth for Homeless Persons in CoC Program-funded Projects 5. Measure 5: Number of Persons who Become Homeless for the First Time 6. Measure 6:Homeless Prevention and Housing Placement of Persons Defined by Category 3 of HUD's Homeless Definition in CoC Program-funded Projects 7. Measure 7: Successful Placement from Street Outreach and Successful Placement in or Retention of Permanent Housing HUD-funded agencies must have a minimum of 86% of the organization's total number of beds/units which are reported to HUD for the Miami-Dade County Continuum of Care (CoC)through the Housing Inventory Checklist, populated in the HMIS, regardless of whether the beds are funded by IIUD or the Homeless Trust, whether or not funded by HUD or the Homeless Trust. iv. Internal Controls-The Subrecipient shall complywith internal control related federal statutes,regulations,and the terms and conditions of the federal award; evaluate and monitor and take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings; and take reasonable measures to 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. v. Payment- The Subrecipient is required to report deviations from budget or project scope or objectives and request prior approvals from federal 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. vi. 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 151 years from the date of submission of the final expenditure report or,for Federal awards that CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 25 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. 4. Records for program income transactions after the period of performance: The Subrecipient must report program income after 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. 5. 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 to the Federal Award and this Agreement. 6. 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. 7. The Subrecipient shall obtain prior written approval by the Grantee for the disposal of any Agreement records before disposing of such records if it is within one(1)year after the expiration of the Retention Period. 8. 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 program or 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. b. 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. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 26 c. 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,site habitability, 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 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 responsihle 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 meetin•s ma 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 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 27 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 of Miami-Dade County Homeless Trust and or its Committees, as information relevant to their program or services may be discussed. g. 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 its own procurement procedures which shall comply with any and all applicable federal, state and local laws, ordinances and regulations including but not limited to 2 CFR 200.318 as applicable. The Subrecipient shall maintain oversight and ensure that its subcontracts perform in accordance with the terms, conditions, and specifications of their contracts or purchase orders. The Subrecipient shall make a positive effort to competitively procure supplies, equipment, construction and services necessary or related to carrying out the terms of this Agreement from minority and women owned businesses,as may be permitted by applicable law. If this Agreement involves the expenditure of$100,000 or more by Miami-Dade County, and the Subrecipient intends to use subcontractors to provide the services listed herein or suppliers to supply the materials,the Subrecipient shall provide Miami-Dade County with the names of the"Subcontractor/Supplier Listing",Attachment D. Subrecipient agrees that it will not change or substitute subcontractors or suppliers from those listed without prior written approval of Miami-Dade County. i. Involvement of HUD-assisted individuals and families - per 24 CFR 578.23 (c)(3), the Subrecipient agrees 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. Further,per the Housing and Urban Development Act of 1968,as amended, (12 U.S.C. 1701u) to the greatest extent feasible,opportunities for training and employment,for services or programs covered under this Agreement should be given to lower-income residents of HUD-assisted projects and contracts for work in connection with the project be awarded in substantial part to persons residing in the area of the project. j. Property - This section applies to equipment with an acquisition cost of greater than $5,000.00 per unit and all real property. 1) 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 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 28 $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 and, including land improvements, structures, and appurtenances 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 in the property records all equipment with an 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 Assetlnventoryn Attachment lin 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. I. 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 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 29 Miami-Dade County the race,gender and ethnic information as soon as reasonably available and 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, income tax withholdings, retirement 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 shall be responsible for monitoring the contractual performance of all subcontracts. The Subrecipient shall receive written documentation prior to entering into any subcontract which contemplates performance of substantive programmatic activities,as such is determined as provided herein. The approval of the Grantee shall be obtained prior to the release of any funds to the Subrecipient for the subcontract. The Subrecipient shall receive written approval from the Grantee prior to either assigning or transferring any obligations or responsibilities set forth in this Agreement or 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 in 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 Subrecipient for services rendered. The Grantee shall provide written notification to the Subrecipient of the name, address and employee representatives of the Grantee's Consultant. n. Participation in the Homeless Management Information System (HMIS) - The Subrecipient agrees to participate in a Homeless Management Information System selected and established by the Grantee. Participation will include, but not be limited to, input of client data upon intake, daily updates of bed availability information, as well as updates to current and prior client's records upon client contact, and maintaining current data for statistical purposes. Subrecipients of Domestic Violence Programs 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 for any ongoing costs to access the HMIS system. The Subrecipient agrees to abide by terms of any HMIS Agreements, which are incorporated herein by 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 or the HMIS system. o. Miami-Dade County Inspector General review- The Subrecipient understands that Miami- Dade County, Office of the Inspector General may, on a random basis, perform audits on all Miami-Dade County contracts,throughout the duration of said contracts. p. 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, CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 30 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. q. 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 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. t. 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. CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 31 u. No Third Party Beneficiaries - This Agreement has no intended or unintended third party beneficiaries. v. Construction of the Agreement-This Agreement 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 Executiv Director Mia -Dade Coun Hamel ss Tr st The Subrecipient's representativet m _ fo thi Agree .. t is _ .r � � - / r — . The project site location is ��l / .. . In e event that different representatives are designated by the S brecipient after this Agreement is executed, or the Subrecipient changes the address of either the program site or principal office,the Subrecipient must notify the Grantee prior to such relocation and obtain all necessary approvals. Notice 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. z. 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 Terrell T. Ellis within five (5) business days of execution of this Agreement. aa. Name and Address of Payee -When payment is made to the Subrecipient, it shall be directed to the name and address t.e paye- liste. here: / Subrecipignt's Na .-: Cf L / . . !// - / . / /"7 Address: ? 1(/ 17.0/ iate= 12 / '"Al i Pr . ! / e "' 33/65 bb. All Terms and Conditions Included - this Agreement and its Attachments A through K as referenced in the Index of Attachment, contain all the terms and conditions agreed upon by the parties. 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 Subrecipient in 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. CoC Grant#FLo177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 32 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) During the 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. 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 9. 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 provide homeless housing and services in a manner that is free from religious influences as described in section 24 CFR Part 578.87 and in accordance with the following principles; a. It will not discriminate against any employee or applicant for employment on the basis of religion and will not limit employment or give preference in employment to persons on the basis of religion; CoC Glant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 33 b. It will not discriminate against any person applying 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 c. It will provide no religious instruction or counseling, conduct no religious worship or religious services, engage in no religious proselytizing and exert no other religious influence in the provision of homeless housing and services funded hereunder. d. Alternative Provider-The Subrecipient shall incorporate into their policies and procedures, a written approved policy to refer, or transfer any program participant or prospective program participant of the Continuum of Care program who objects to the religious character of the provider. The policy and procedures shall be reviewed and subject to approval by Miami-Dade County Homeless Trust. At a minimum the policy and procedures shall include action to transfer or refer within a reasonably prompt time after the objection and undertake reasonable efforts to identify and refer the participant to an alternative provider to which the participant has no objection. Except for services provided by telephone, the Internet, or similar means, the referral must be to an alternative provider in reasonable geographic proximity to the organization making the referral. In making the referral,the Subrecipient shall comply with applicable privacy laws and regulations. The Subrecipient shall document 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 CFR Part 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 County with a function or activity involving the use or disclosure of Individually Identifiable Health Information (IIHI) and or Protected Health Information (PHI)shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as may be amended, and any applicable federal, state, county and local laws and policies, including by not limited to 24 CFR 578.103, 42 CFR Part 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-Dade 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). CoC Grant PFL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 34 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 1601 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 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 943.059, Florida Statutes, regarding court- ordered sealing of criminal history records,and Section 943.0585,Florida Statutes,regarding 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, CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 35 satisfactorily passed Level 2 background screenings pursuant to Chapter 435 Florida Statutes,as maybe 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 volunteering with or in the vicinity of a vulnerable person or vulnerable persons, Miami-Dade County shall not disburse any further funds and this Agreement may be subject to termination at the sole discretion of Miami-Dade County. SIGNATURES CONTINUE ON NEXT PAGE CoC Grant#FL0177L4D001.710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 36 IN WITNESS WHEREOF, the parties have caused this(38) thirty-eight nape Agreement to be executed by their respective and duly authorized officers the day and year first above written. WITNESSES: ENTITY: The City of Miami Beach 1. Y At I. / Subrecipient: (Si; -ture of Witness) (Pri full na e of Provider Agency) JUCy tIOAPSHELI (Print Name of Witness) I ✓ y� L. itvIke gLx�S (Signature) reit/ rn(Print Name of Authorized Agency Signatory) 0J raci /ig0 CI T`/ yvA Arif}GtEf2 (Print Name of Witness) (Print Title of Authorized Agency Signatory) Paell.ATEES ` SE P `L':7reO\ 16 ;INCORP ORATED/ * Rafael E.Grande., ity Clerk �;?i. h.p : h.' 6)72-6..;)\-P/ ATTEST: Miami-Dade County,a political subdivision of The State of Florida HARVEY RUVIN, CLERK BY: Deputy Clerk Carlos A.Gimenez, Mayor APPROVED AS TO FORM&LANGUAGE Date la FOR EXECUTION See attached memorandum dated(July 20 2018)approved as to form and legal suffigWhllrn eY �� ate Resolution #R-1067-17 CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 37 INDEX OF ATTACHMENTS Attachment A - Continuum of Care Program Grant Agreement & Exhibit 1 Attachment B - Scope of Service and US HUD eSnaps documents Attachment C - Form W-9 Request for Taxpayer Attachment D - Miami-Dade County Required Affidavits and Declarations Attachment E - Consolidated Financial Record and Reports - Excel Format Attachment F - Performance Reports (Monthly and Annual) Attachment G - CoC Internal Wellness Checklist and Guidelines Attachment H - "Incident Report" form Attachment I - "Real Property& Equipment Asset Inventory" form Attachment J - When Subrecipient is the Rental Administrator (Participant's Housing Application)f HAP &:LEASE Attachment K - When Miami-Dade County is the Rental Administrator (Participants Housing Application)* HAP & LEASE Attachment L- Place-setter - Leave Blank 4W 'THIT6CPaiiticipant Housing Application"contained therein,maybe updated and amended from tune'ro$frhe JAd re-issued administratively CoC Grant#FL0177L4D001710,The City of Miami Beach,The City of Miami Beach Outreach Program Page 38 FY 2017 Continuum of Care (CoC) GRANT AGREEMENT Between United States Department of Housing and Urban Development (US HUD). And Miami-Dade County Miami-Dade County Homeless Trust ATTACHMENT A"2017 US HUD CoC Grant Agreement' Tax ID No.: 59-6000573 CoC Program Grant Number: FL0177L4D001710 Effective Date: 7/30/2018 DUNS No.: 004148292 EXHIBIT I SCOPE OF WORK for FY2017 COMPETITION (funding 1 project in CoCs with multiple recipients) 1. The project listed on this Scope of Work is governed by the Act and Rule, as they may be amended from time to time. The project is also subject to the terms of the Notice of Funds Availability for the fiscal year competition in which the funds were awarded and to the applicable annual appropriations act. 2. HUD designations of Continuums of Care as High-performing Communities (HPCS) are published in the HUD Exchange in the appropriate Fiscal Years' CoC Program Competition Funding Availability page. Notwithstanding anything to the contrary in the Application or this Grant Agreement, Recipient may only use grant funds for HPC Homelessness Prevention Activities if the Continuum that designated the Recipient to apply for this grant was designated an HPC for the applicable fiscal year. 3. Recipient is not a Unified Funding Agency and was not the only Applicant the Continuum of Care designated to apply for and receive grant funds and is not the only Recipient for the Continuum of Care that designated it. HUD's total funding obligation for this grant is 5_65212_for project number_FL0177L4D001710 . If the project is a renewal to which expansion funds have been added during this competition,the Renewal Expansion Data Report including the Summary Budget therein, in e-snaps is incorporated herein by reference and made a part hereof In accordance with 24 CFR 578.105(b),Recipient is prohibited from moving more than 10%from one budget line item in a project's approved budget to another without a written amendment to this Agreement. The obligation for this project shall be allocated as follows: a. Continuum of Care planning activities $ 0 b. UFA costs 5 0 c. Acquisition 5 0 d. Rehabilitation S 0 e. New construction $ 0 11 Leasing $ 0 g. Rental assistance $ 0 It Supportive services $ 60946 i. Operating costs S 0 j. Homeless Management Information System S 0 k. Administrative costs $ 4266 www.hud.gov espanoLhudgov Paces I. Relocation Costs $ 0 m. IIPC homelessness prevention activities: Housing relocation and stabilization services $ 0 Short-term and medium-term rental assistance $ 0 4. The performance period for the project begins 06-01-2018 and ends 05-31-2019 No funds for new projects may be drawn down by Recipient until HUD has approved site control pursuant to §578.21 and §578.25 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. 5 If grant funds will be used for payment of indirect costs, the Recipient is authorized to insert the Recipient's federally recognized indirect cost rates on the attached Federally Recognized Indirect Cost Rates Schedule, which Schedule shall be incorporated herein and made a partof the Agreement. No indirect costs may be charged to the grant by the Recipient if their federally recognized cost rate is not listed on the Schedule.. 6. The project has not been awarded project-based rental assistance for a term of fifteen (15) years. Additional funding is subject to the availability of annual appropriations. Hrvrv.hndeov espanolhud-gov Page 6 Tax ID No.: 59-6000573 CoC Program Grant Number: FL0177L4D001710 Effective Date: 7/30/2018 DUNS No.: 004148292 FEDERALLY RECOGNIZED INDIRECT COST RATE SCHEDULE Grant No. Recipient Name Indirect cost rate Cost Base EL017YL4Da01 710 uns4_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 By: / /.. A .., Signature) 1r Ann D. Chavis, Director (T)ped Name and Title) July 30,2018 (Date) RECIPIENT Miami-Dade County (Name of Organization) By: (Signature of Authorized Official)°' " ri (Typed Name and Tit i �of Authorized Official) (Date) envwhudgov espanol.hud.gov PugcN FY 2017 Continuum of Care (CoC) Program Scope of Service eSnaps Budget and Performance Objectives ATTACHMENT B"FY 2017 Scope of Service" Miami-Dade County Homeless Trust Scope of Service FL0177L4D001710 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 2017 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 Participants 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 1 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 polities and procedures which ensure compliance with Further Fair Housing Act, Client Rights and 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 2017 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 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001609 6E. Supportive Services Budget Instructions: Enter the quantity and total budget request far 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. A quantity AND description must be entered for each requested cost. Enter the quantity in detail (e.g. 1 FTE Case Manager Salary+ benefits, or child care for 15 children)for each supportive service activity for which funding is being requested. Please note that simply stating"1FTE" is NOT providing'Quantity AND Detail" and limits HUD's understanding of what is being requested. Failure to enter adequate'Quantity AND Detail' may result in conditions being placed on an award and a delay of grant funding. Annual Assistance Requested: This is a required field. 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 CoC's HUD-approved FY 2016 GIW. Total Annual Assistance Requested: This field is automatically calculated based on the sum of the annual assistance requests entered for each activity. Grant Term:This field is populated with the value"1 Year"and will be read only. Total Request for Grant Term:This field is automatically calculated based total amount requested for each eligible cost multiplied by the grant term. All total fields will be calculated once the required field has been completed and saved. Additional Resources can be found at the HUD Resource Exchange: https:1/www.hudexcha nge.infoi e-snaps/g a id es icoc-program-com petition-resources/ A quantity AND description must be entered for each requested cost. Eligible Costs Quantity AND Description Annual Assistance (max 400 characters) Requested 1.Assessment of Service Needs 2.Assistance with Moving Costs 3.Case Management 4.Child Care 5.Education Services 6.Employment Assistance 7.Food B.Housing/Counseling Services 9.Legal Services J 10.Life Skills 1 11.Mental Health Services 12.Outpatient Health Services 13.Outreach Services 12 FTE Outreach Case Workers-Salary and Fringe Benefits $60,948 Renewal Project Application FY2016 Page 1 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001609 14.Substance Abuse Treatment Services 15.Transportation 16.Utility Deposits 11.Operating Costs Total Annual Assistance Requested $60,946 Grant Term 1 Year Total Request for GrantTerm $60,946 Click the 'Save' button to automatically calculate totals. Renewal Project Application FY2016 Page 2 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 Before Starting the Project Application To ensure that the Project Application is completed accurately, ALL project applicants should review the following information BEFORE beginning the application. Things to Remember -Additional training resources can be found on the HUD Exchange at https://www.hudexchange.info/e-snaps/guides/coc-program-competition-resources/ - Program policy questions and problems related to completing the application in e-snaps may be directed to HUD via the HUD Exchange Ask A Question. - Project applicants are required to have a Data Universal Numbering System (DUNS) number and an active registration in the Central Contractor Registration (CCR)/System for Award Management(SAM)in order to apply for funding under the Fiscal Year(FY)2017 Continuum of Care (CoC) Program Competition. For more information see FY 2017 CoC Program Competition NOFA. -To ensure that applications are considered for funding, applicants should read all sections of the FY 2017 CoC Program NOFA and the FY 2016 General Section NOFA. -Detailed instructions can be found on the left menu within e-snaps. They contain more comprehensive instructions and so should be used in tandem with onscreen text and the hide/show instructions found on each individual screen. -Before starting the project application, all project applicants must complete or update (as applicable)the Project Applicant Profile in e-snaps. -Carefully review each question in the Project Application. Questions from previous competitions may have been changed or removed, or new questions may have been added, and information previously submitted mayor may not be relevant. Data from the FY 2016 Project Application will be imported into the FY 2017 Project Application; however, applicants will be required to review all fields for accuracy and to update information that may have been adjusted through the FY 2016 post award process or a grant agreement amendment. Data entered in the post award and amendment forms in e-snaps will not be imported into the project application. - Expiring Shelter Plus Care projects requesting renewal funding for the first time under 24 CFR part 578, and rental assistance projects can only request the number of units and unit size as approved in the final HUD-approved Grant Inventory Worksheet(GIW). -Expiring Supportive Housing Projects requesting renewal funding for the first time under 24 CFR part 578,transitional housing, permanent supportive housing with leasing, rapid re-housing, supportive services only, renewing safe havens, and HMIS can only request the Annual Renewal Amount(ARA)that appears on the CoC's HUD-approved GIW. If the ARA is reduced through the CoC's reallocation process,the final project funding request must reflect the reduced amount listed on the CoC's reallocation farms. -HUD reserves the right to reduce or reject any renewal project that fails to adhere to 24 CFR part 578 and the application requirements set forth in the FY 2017 CoC Program Competition NOFA. Renewal Project Application FY2017 Page 1 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 1A. SF-424 Application Type 1. Type of Submission: Application 2. Type of Application: Renewal Project Application If "Revision", select appropriate letter(s): If"Other", specify: 3. Date Received: 10/19/2017 4. Applicant Identifier: 5a. Federal Entity Identifier: 5b. Federal Award Identifier: FL0177 This is the first 6 digits of the Grant Number, known as the PIN, that will also be indicated on Screen 3A Project Detail. This number must match the first 6 digits of the grant number on the HUD approved Grant Inventory Worksheet (GIW). Check to confrim that the Federal Award X Identifier has been updated to reflect the most recently awarded grant number 6. Date Received by State: 7. State Application Identifier: Renewal Project Application FY2017 Page 2 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project:City of Miami Beach Outreach FL0177L4D001710 1B. SF-424 Legal Applicant 8. Applicant a. Legal Name: Miami-Dade County b. Employer/Taxpayer Identification Number 59-6000573 (EIN/TIN): Ic.Organizational DUNS: 004149292 PLUS 4 d. Address Street 1: 111 N.W. 1st Street Street 2: 27th floor, Suite 310 City: Miami County: Miami-Dade State: Florida Country: United States Zip / Postal Code: 33128 e. Organizational Unit (optional) Department Name: Homeless Trust Division Name: none f. Name and contact information of person to be contacted on matters involving this application Prefix: Ms. First Name: Victoria Middle Name: L. Last Name: Mallette Suffix: Title: Executive Director Organizational Affiliation: Miami-Dade County Telephone Number: (305) 375-1490 Renewal Project Application FY2017 Page 31 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 Extension: Fax Number: (305) 375-2722 Email: vmallette@miamidade.gov Renewal Project Application FY2017 Page 4 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 1C. SF-424 Application Details 9. Type of Applicant: B. County Government 10. Name of Federal Agency: Department of Housing and Urban Development 11. Catalog of Federal Domestic Assistance CoC Program Title: CFDA Number: 14.267 12. Funding Opportunity Number: FR-6100-N-25 Title: Continuum of Care Homeless Assistance Competition 13. Competition Identification Number: Title: Renewal Project Application FY2017 ] Page 5 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L40001710 1D. SF-424 Congressional District(s) 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 (for multiple selections hold CTRL key) b. Project: FL-023 (for multiple selections hold CTRL key) 17. Proposed Project a. Start Date: 06/01/2018 b. End Date: 05/31/2019 18. Estimated Funding ($) a. Federal: b. Applicant: c. State: d. Local: e. Other: f. Program Income: g. Total: Renewal Project Application FY2017 Page 6 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 1E. SF-424 Compliance 19. Is the Application Subject to Review By b. Program is subject to E.O. 12372 but has not State Executive Order 12372 Process? been selected by the State for review. If"YES", enter the date this application was made available to the State for review: 20. Is the Applicant delinquent on any Federal No debt? If"YES," provide an explanation: Renewal Project Application FY2017 Page 7 08/17/2018 _� Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 1F. SF-424 Declaration By signing and submitting this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete, and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) I AGREE: X 21. Authorized Representative Prefix: Mr. First Name: Carlos Middle Name: A. Last Name: Gimenez Suffix: Title: County Mayor Telephone Number (305) 375-1490 (Format: 123-456-7890) Fax Number: (305) 375-2722 (Format: 123-456-7890) Email: cgimenez@miamidade.gov Signature of Authorized Representative: Considered signed upon submission in e-snaps. Date Signed: 10/19/2017 Renewal Project Application FY2017 Page 8 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 1G. HUD 2880 Applicant/Recipient Disclosure/Update Report - Form 2880 U.S. Department of Housing and Urban Development OMB Approval No. 2510.0011 (exp.11/30/2018) Applicant/Recipient Information 1. Applicant/Recipient Name, Address, and Phone Agency Legal Name: Miami-Dade County Prefix: Mr. First Name: Carlos Middle Name: A. Last Name: Gimenez Suffix: Title: County Mayor Organizational Affiliation: Miami-Dade County Telephone Number: (305) 375-1490 Extension: Email: cgimenez@miamidade.gov City: Miami County: Miami-Dade State: Florida Country: United States Zip/Postal Code: 33128 2. Employer ID Number (EIN): 59-6000573 3. HUD Program: Continuum of Care Program 4. Amount of HUD Assistance $65,212.00 Requested/Received: (Requested amounts will be automatically entered within applications) Renewal Project Application FY2017 Page 9 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLJI77L4D001710 5. State the name and location (street City of Miami Beach Outreach 111 N.W. 1st address, city and state) of the project or Street Miami Florida activity: Refer to project name, addresses and Coo Project Identifying Number(PIN)entered into the attached project application. Part I Threshold Determinations 1. Are you applying for assistance for a Yes specific project or activity? (For further information, see 24 CFR Sec. 4.3). 2. Have you received or do you expect to Yes receive assistance within the jurisdiction of the Department (HUD), involving the project or activity in this application, in excess of $200,000 during this fiscal year (Oct. 1 -Sep. 30)? For further information, see 24 CFR Sec. 4.9. Part II Other Government Assistance Provided or Requested/Expected Sources and Use of Funds Such assistance includes, but is not limited to, any grant, loan,subsidy, guarantee, insurance, payment,credit,or tax benefit. Department/Local Agency Name and Address Type of Assistance Amount Expected Uses of the Funds Requested/ Provided N/A Part III Interested Parties You must disclose: 1.All developers,contractors,or consultants involved in the application for the assistance or in the planning,development, or implementation of the project or activity and 2. any other person who has a financial interest in the project or activity for which the assistance is sought that exceeds$50,000 or 10 percent of the assistance(whichever is lower). Alphabetical list of all persons with a Social Security No. Type of Financial Interest Financial Interest L Renewal Project Application FY2017 Page 10 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 reportable financial interest in the. or Employee ID No. Participation In Project/Activity in ProjecVActivity project or activity ($) (%) (For individuals,give the last name first) See detailed attachment placed in 59-6000573 CA $31,640,189.00 100%, "Other Attachment" Certification Warning: If you knowingly make a false statement on this form, you may be subject to civil or criminal penalties under Section 1001 of Title 18 of the United States Code.In addition, any person who knowingly and materially violates any required disclosures of information, including intentional nondisclosure, is subject to civil money penalty not to exceed $10,000 for each violation. I certify that this information is true and complete. I AGREE: X Name/Title of Authorized Official: Carlos Gimenez, County Mayor Signature of Authorized Official: Considered signed upon submission in e-snaps. Date Signed: 08/28/2017 L Renewal Project Application FY2017 Page 11 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 1H. HUD 50070 • HUD 50070 Certification for a Drug Free Workplace Applicant Name: Miami-Dade County Program/Activity Receiving Federal Grant CoC Program Funding: Acting on behalf of the above named Applicant as its Authorized Official, I make the following certifications and agreements to the Department of Housing and Urban Development(HUD) regarding the sites listed below: I certify that the above named Applicant will or will continue to provide a drug-free workplace by: a. Publishing a statement notifying employees that the unlawful e. I Notifying the agency In writing,within ten calendar days after I manufacture,distribution,dispensing,possession,or use of a receiving notice under subparagraph d.(2)from an employee or controlled substance Is prohibited in the Applicants workplace otherwise receiving actual notice of such conviction.Employers and specifying the actions that will be taken against employees of convicted employees must provide notice,including position for violation of such prohibition. title,to every grant officer or other designee on whose grant activity the convicted employee was working,unless the Federalagency has designated a central point for the receipt of such notices.Notice shall include the identification number(s) of each affected grant; b. Establishing an on-going drug-free awareness program to f. Taking one of the following actions,within 30 calendar days of inform employees-- receiving notice under subparagraph d.(2),with respect to any S1 The dangers oPomg abuse In the workplace employee who is so convicted-- 21TM1eApplicant'spolicy maintaininga drug-free workplace; (1)Taking appropriate personnel action against such an 3 Any available drug counseling,rehabilitation,and employee employee,up to and Including termination,consistent with the assistance programs;and requirements of the Rehabilitation Act of 1973,as amended;or (4)The penalties that may be imposed upon employees for drug (2)Requiring such employee to participate satisfactorily in a abuse violations occurring In the workplace. drug abuse assistance or rehabilitation program approved for such purposes by a Federal,State,or local health,law enforcement,or other appropriate agency; c. Making It a requirement that each employee to be engaged in g. Making a good faith effort to continue to maintain a drugfree the performance of the grant be given a copy of the statement workplace through implementation of paragraphs a.thru f. required by paragraph a.; d. Notifying the employee in the statement required by paragraph a.that,as a condition of employment under the grant,the employee will--- (1)Abide by the terms of the statement;and (2)Notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction; Sites for Work Performance. The Applicant shall list(on separate pages)the site(s)for the performance of work done in connection with the HUD funding of the program/activity shown above: Place of Performance shall include the street address,city,county, State,and zip code. Identify each sheet with the Applicant name and address and the program/activity receiving grant funding.) Workplaces, including addresses, entered in the attached project application. Refer to addresses entered into the attached project application. I hereby certify that all the information stated X herein, as well as any information provided in the accompaniment herewith, is true and Renewal Project Application FY2017 Page 12 08/17/2018 -J Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 accurate. J Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802) Authorized Representative Prefix: Mr. First Name: Carlos Middle Name A. Last Name: Gimenez Suffix: Title: County Mayor Telephone Number: (305) 375-1490 (Format: 123-456-7890) Fax Number: (305) 375-2722 (Format: 123456-7890) Email: cgimenez@miamidade.gov Signature of Authorized Representative: Considered signed upon submission in e-snaps. Date Signed: 10/19/2017 Renewal Project Application FY2017 Page 13 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies, to the best of his or her knowledge and belief, that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. 2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form- LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Statement for Loan Guarantees and Loan Insurance The undersigned states, to the best of his or her knowledge and belief, that: If any funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this commitment providing for the United States to insure or guarantee a loan, the undersigned shall complete and submit Standard Form-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. Submission of this statement is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file Renewal Project Application FY2017 Page 14 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 the required statement shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. I hereby certify that all the information stated X herein, as well as any information provided in the accompaniment herewith, is true and accurate: Warning: HUD will prosecute false claims and statements. Conviction may result in criminal and/or civil penalties. (18 U.S.C. 1001, 1010, 1012; 31 U.S.C. 3729, 3802) Applicant's Organization: Miami-Dade County Name / Title of Authorized Official: Carlos Gimenez, County Mayor Signature of Authorized Official: Considered signed upon submission in e-snaps. Date Signed: 10/19/2017 • r Renewal Project Application FY2017 Page 15 08117/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 1J. SF-LLL DISCLOSURE OF LOBBYING ACTIVITIES Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352. Approved by OMB0348-0046 HUD requires a new SF-LLL submitted with each annual CoC competition and completing this screen fulfills this requirement. Answer"Yes"if your organization is engaged in lobbying associated with the CoC Program and answer the questions as they appear next on this screen. The requirement related to lobbying as explained in the SF-LLL instructions states: "The filing of a form is required for each payment or agreement to make payment to any lobbying entity for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress,or an employee of a Member of Congress in connection with a covered Federal action." Answer"No"if your organization is NOT engaged in lobbying. Does the recipient or subrecipient of this CoC No grant participate in federal lobbying activities (lobbying a federal administration or congress) in connection with the CoC Program? Legal Name: Miami-Dade County Street 1: 111 N.W. 1st Street Street 2: 27th floor, Suite 310 City: Miami County: Miami-Dade State: Florida Country: United States Zip / Postal Code: 33128 11. Information requested through this form is authorized by title 31 U.S.C. section 1352. This disclosure of lobbying activities is a material representation of fact upon which reliance was placed by the tier above when this transaction was made or entered into. This disclosure is required pursuant to 31 U.S.C. 1352. This information will be available for public inspection. Any person who fails to file the required disclosure shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. I certify that this information is true and X complete. Renewal Project Application FY2017 Page 16 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L40001710 Authorized Representative Prefix: Mr. First Name: Carlos Middle Name: A. Last Name: Gimenez Suffix: Title: County Mayor Telephone Number: (305) 375-1490 (Format: 123-456-7890) Fax Number: (305) 375-2722 (Format: 123-456-7890) Email: cgimenez©miamidade.gov Signature of Authorized Official: Considered signed upon submission in e-snaps. Date Signed: 10/19/2017 Renewal Project Application FY2017 Page 17 1 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 Additional Information Now that you have completed Part 1 of the application, please review Parts 2-7, which are in Read Only mode. Screen 3C, which is mandatory for all PH-PSH projects and screens 6D, 7A and 7B which are mandatory for all projects will be editable and must be answered prior to submission. Once you are done reviewing, you will be guided to a "Submissions without Changes" screen. At this screen if you decide no edits or updates are required to any screens other than the mandatory questions for 3C and/or 6D,7A and 7B, you are allowed to submit the application without ever needing to edit the rest of the application. However, if you determine that changes need to be made to the application, we have given you the ability to open up individual screens for edit, instead of the entire application. Once you select the screens you want to edit via checkboxes, you will click "Save", and those screens will be available for edit. An important reminder, once you make those selections and click "Save", you cannot uncheck those boxes. You are allowed to select additional boxes even after saving your initial selections. Again, you must click"Save" for those newly selected screens to be available for edit. If your project is a First Time Renewal, your project will not be able to utilize the "Submit Without Changes" function. The Submissions Without Changes page will be automatically set to "Make Changes" and you will be required to input data into the application for all required fields relevant to the component type. Renewal Project Application FY2017 Page 18 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 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. Total Expected Sub-Awards: $65,212 Organization Type Type Sub- Awar d Amo tint City of Miami C. City or Township Government C. City or Township Government $65,2 Beach 12 Renewal Project Application FY2017 Page 19 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 2A. Project Subrecipients Detail a. Organization Name: City of Miami Beach b. Organization Type: C. City or Township Government 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 Renewal Project Application FY2017 Page 20 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 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 Fax Number: 786-394-4675 Renewal Project Application FY2017 L Page •21 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 2B. Recipient Performance This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select "Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. 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 grant term related to this renewal project request? 4. Have any Funds been recaptured by HUD No for the most recently expired grant term related to this renewal project request? L_ Renewal Project Application FY2017 Page 22 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 3A. Project Detail 1. Expiring Grant Number: FL0177 (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 Collaborative Applicant Name: Miami-Dade County 3. Project Name: City of Miami Beach Outreach 4. Project Status: Standard 5. Component Type: SSO 6. Does this project use one or more No properties that have been conveyed through the Title V process? Renewal Project Application FY2017 Page 23 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001710 3B. Project Description 1. Provide a description that addresses the entire scope of the proposed project. The City of Miami Beach conducts street outreach as a part of the Coordinated Assessment process, 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 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 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 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 1pm-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 have a specific Yes population focus? 2a. Please identify the specific population focus. (Select ALL that apply) Chronic Homeless Domestic Violence x x Veterans Substance Abuse X X Youth(under 25) Mental Illness X Families with Children HIV/AIDS X x Other (Click'Save'to update) X Other: All individuals and families in need of services CRenewal Project Application FY2017 Page 24 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 3. Housing First 3a. Does the project quickly move Yes participants into permanent housing 3b. Does the project ensure that participants are not screened out based on the following items? Select all that apply. Having too little or little income X Active or history of substance use I I X Having a criminal record with exceptions f x'i for state-mandated restrictions History of victimization X (e.g.domestic violence,sexual assault,childhood abuse) None of the above 3c. Does the project ensure that participants are not terminated from the program for the following reasons? Select all that apply. • • Failure to participate in supportive services X Failure to make progress on a service plan X Loss of income or failure to improve income X Any other activity not covered in a lease agreement typically found for unassisted persons in the project's geographic area X None of the above 3d. Does the project follow a "Housing First" Yes approach? 4. Please select the type of SSO Project: Street Outreach Renewal Project Application FY2017 Page 25 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L40001710 4A. Supportive Services for Participants This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select"Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. 1. For all supportive services available to participants, indicate who will provide them and how often they will be provided. Click'Save' to update. Supportive Services Provider Frequency Assessment of Service Needs Subrecipient Daily Assistance with Moving Costs Case Management Subrecipient Daily Child Care Education Services 'Employment Assistance and Job Training Partner As needed Food Subrecipient Daily Housing Search and Counseling Services Subrecipient Daily Legal Services Life Skills Training Mental Health Services Partner As needed Outpatient Health Services Partner As needed Outreach Services Subrecipient Daily Substance Abuse Treatment Services Partner As needed Transportation Subrecipient Daily Utility Deposits 2. Please identify whether the project includes the following activities: 2a. Transportation assistance to clients to Yes attend mainstream benefit appointments, employment training, or jobs? 2b. Use of a single application form for four Yes or more mainstream programs? 2c. At least annual follow-ups with Yes participants to ensure mainstream benefits L Renewal Project Application FY2017 Page 26 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 are received and renewed? 3. Do project participants have access to Yes SSIISSDI technical assistance provided by the applicant, a subrecipient, or partner agency? 3a. Has the staff person providing the Yes technical assistance completed SOAR training in the past 24 months. Renewal Project Application FY2017 Page 27 08117/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 5k Project Participants - Households This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select "Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. Households Households with at Adult Households Households with Total Least One Adult without Children Only Children and One Child Total Number of Households 25 355 0 380 Characteristics Persons in Adult Persons in 1 Persons in Total Households with at Households without Households with Least One Adult Children Only Children and One Child Adults over age 24 25 310 335 Adults ages 18-24 3 45 48 Accompanied Children under age 18 32 0 32 Unaccompanied Children under age 18 0 0 Total Persons 60 355 0 415 Click Save to automatically calculate totals Renewal Project Application FY2017 I Page 28 I 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 5B. Project Participants - Subpopulations This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select "Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. Persons in Households with at Least One Adult and One Child 7` ''°>:"'' Persons < I gif` �y not f IC o�1 C rd. Chronic Victims -° p1e]sq, m!Q! Substan Persons Severely of Physical Develop represen Characteristics Ho e1 ks a with Mentally Domesti Dlsabilit ental ted by I Vol �3 s Abuse HIV/AID III c y Dlsabilit listed Wier S Violence y subpopu x=:. 42a`av' 4101'.V talions Adults over age 24I 5 3 0 0 0 3 5 0 0 10 Adults ages 18-24 I 3 D 0 0 1 0 0 0 0 0 1 0 Children under age 18 0 0 0 0 1 0 3 28 Total Persons 8 3 0 0 0 3 6 0 3 1 38 Click Save to automatically calculate totals Persons in Households without Children i� 9 , Personsnot n1 y Ch n Chronic VI<olms t a p,,. males Itia1N Substan Persons Severely of Physical Develop represen Characteristics • ees, orne("es„ 1��o>rr'•"ei les' ca with Mentally Domesti Drsabllit mental ted by `st{-••; .rir11 ra Abuse HIVIAID III c y Disabilit listed V 1teellaann44..11[[�eetaera8 Vefp�� s S Violence y subpopu 1,1!",,,n . S Se 07,( , tabuns Adults over age 24 75 1 16 46 50 54 5 60 1 5 48 Adults ages 18-24 0 0 4 0 25 1 0 0 15 Total Persons 75 1 16 50 50 79 6 60 5 63 Click Save to automatically calculate totals Persons in Households with Only Children u Persons C r nc;.#4F3/4,1\ Chronic Victims not r„ 1 1Substan Persons Severely of Physical Develop represen Characteristics e Ione esales ce with Mentally Domesti Dlsabilit mental ted by fiat -477-tris trr Abuse HIV/AID III c y Dlsabilit listed 1T W eters s rens S Violence y subpopu lations i Accompanied Children under age 18 L Renewal Project Application FY2017 1 Page 29 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 'Unaccompanied Children under age 18 Total Persons 0 0 0 0 0 0 0 0 Describe the unlisted subpopulations referred to above: N/A Renewal Project Application FY2017 Page 30 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 5C. Outreach for Participants This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select "Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. 1. Enter the percentage of project participants that will be coming from each of the following locations. 100% !Directly from the street or other locations not meant for human habitation. Directly from emergency shelters. 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 Pojects Only) Directly from safe havens. Persons fleeing domestic violence. Directly from transitional housing. Directly from the TH Portion of a Joint TH and PH-RRH Component project. Persons receiving services through a Department of Veterans Affairs)VA)-funded homeless assistance program. 100% Total of above percentages Renewal Project Application FY2017 Page 31 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 6A. Funding Request This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select "Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. 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. Does this project propose to allocate funds No according to an indirect cost rate? 4. Renewal Grant Term: 1 Year 5. Select the costs for which funding is being requested: Leased Structures Supportive Services X HMIS • Renewal Project Application FY2017 Page 32 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 6D. Sources of Match The following list summarizes the funds that will be used as Match for the project. To add a Matching source to the list, select the icon. To view or update a Matching source already listed, select the icon. Summary for Match Total Value of Cash Commitments: I $1,181.891 Total Value of In-Kind Commitments: SO "[Total Value of All Commitments: 51,181.891 1. Does this project generate program income No as described in 24 CFR 578.97 that will be used as Match for this grant? Match Type Source Contributor Date of Value of Commitment Commitments Yes Cash Government City of Miami 08/01/2017 $1,181,350 Bea... Yes Cash Government Miami-Dade 08/30/2016 $541 County._ Renewal Project Application FY2017 Page 33 08/17/2018 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001710 Sources of Match Detail 1. Will this commitment be used towards Yes Match? 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, Emergency shellter beds, other office or grant program as applicable) supportive services 5. Date of Written Commitment: 08/01/2017 6. Value of Written Commitment: $1,181,350 Sources of Match Detail 1. Will this commitment be used towards Yes Match? 2. Type of Commitment: Cash 3. Type of Source: Government 4. Name the Source of the Commitment: Miami-Dade County Homeless Trust (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 08/30/2016 6. Value of Written Commitment: S541 Renewal Project Application FY2017 Page 34 08/17/2018 FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program Form W-9 Department of the Treasury Internal Revenue Service (IRS) Request for Taxpayer Identification Number and Certification ATTACHMENT C Request for Taxpayer ID Number and Certification" Fon) W-9 Request for Taxpayer Give Form to the requester.Do not (Paan December 2014) Identification Number and Certification send to the IRS. Department Revenue Treasury ca lme-�al1Nane(as b N t � N /e�gNon 1this lino-,do H vel sfina blank . t FU- 1 I. l �XCcPN 20. s itlsre arded entry name, f different fabove id li 3 Check appropriate box for federal t ;chef thtollewino seven boxes: 4 Exemptions(codes apply only to certain [[ t ind itl I 'see ❑Individualisole proprietor or 5 C Corporation ❑ S Corporation ❑ Partnership ❑ I mst' state instructions on page Si:, singiermember LUC - payee wJe(fanti ❑Limited liability company.Enter classification - . e above l Exemption from ting Not .For single-member LLC t - disregarded, o k ' ek appropriate . _ codehe (it any) the tax classification of The single-member owner. - • ro .,,,a. .was nits Aa d 5Other _instructions) - Requester's�am. and address(optional) Address(number.anon,and oat orcarte bo tl00 @onven4,on, �n er bf. - th 6 Cly,stab,and ZIP coda 7-7Lact u rn e FL 3 3 135 -- b r(a) (optional) Taxpayer Identification Number(TIN) Social scantily number Enter your TINn Neappropriate box.TheTINprovided must match the namei line toavoidaF-1 _ backupwithholding.For-clad thisy r social security number(SSN).H ever, for resident alien,sole pr ,p for - r garded entity,see the Part I instcto s on page 3.For other I entities,it s your employer ti number(EIN).If you do not have a number,see How tget a - TIN onpage3. or Employer identification number 7 Note.If the account is in more than one name,see the instructions for line l and the chart on page 4 for I i guidelines on whose number to enter. iSSI1, _I/0 "°II /Cc) 3 9-i2. Part II Certification l � 7 4 Under penalties of perjury,I certify that: 1- Th1. The number shown this form is my correct taxpayer tl t n number(or Ian)waiting for a number[ be issued tmel;and 2. am nt subject to backup withholding because:(a)l amei pt from backup viithholding,or(b)i haven t been notified by the InternalR ue Service;IRS)that I am subject to backup withholding as a result of a-allure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3. I am a U.S.cttizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(i any)indicating that I am exempt from FATCA repoging is correct. Certification instrrlctlons.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 failed ro repo all interest and di ends yourtax r to For realestate acid item 2 toes not apply.For mortgage interest paid,acquisition b prurient of e property,cancellation of - btcontributionst individual retirement arrangement(IRA),and generally,payments other than i est and divide ,you are not. 2 ured to sign the certification,but you must provide your correct TIN.See the insruc.lens on page a Signsignature of c Here I u.s. person. Date. tn'L1 I6 General Instruction •Fri')1098(home mortgage mferes). OO8-E(student ba.interest),1099-T (tuition) Section references are to the Internal eve ue Code unless otherwise noted. •form-10.93-Clca,wred debt) FIRure developments.Information ab developments is afecing Form W-9(such •Form tooa-A taciptisition or abandonment of secured property) slegislation enacted atter we release s at wwwiregovine Y. Use Form W-9 onlyfyou are a U.S.person iIdlg a resident aien),to Purpose of Form provide your correct TIN. al or entity(Form Wrequester) quired t13s an information guru dot return Form 1O-9ton requester witty TIN,you neigh(b t return h the IRS must obtain yourdtaxpayer [fi b atobackup h o 9 See(ADP' q k p hh I - g- page 2. which mayuber(SSindividual oat identification signingte filled-outyou: nu (ITNadoption p rnumberrod I ), employer1. ssthat= eTIN you ate giving is correct(or you 3_ziating tor enumber identfication number( Iv) report on an information returnthe amount paidtoto be suetl), you, N amount reportable onen information return.Examf f ' i"ion returns - but at dr the 0 7 2.0_rtty teat you are not suect to backupwithhold:lg.or •Form 109 3nterest earned or paid) 3.Claim frombackupwithholdingl) U.S. payee.II pp: lel you are t U.S 9 lel of •FormOIV(dMtl dincluding l o incfromstocks igrfunds) any axincome,om a.U.s.Dade or business is subject M •Form 1099 (C(v types prizes,awards, oproceeds) withholding tax partners'shareofeffectivelycond d ntl •Form 1039-B(stock 03s B(stbck or mutual fdsLes and certain other ansaotlons by eCertify T )entered ( anti indicatingNat youn brokers) exempt from the FALLA reporting,is correct See Jha4's FAR'A reporting?or re •Form 19999(proceeds from real estate transactions) page 2 for further information.•Form 1099-1((merchant card end third party network transactions) Cat.No.102313 Form W-9(Rey.12-2014) Form W-9(Rev.12-2014) Page 2 Note.If you are a U.S.person and a requester gives you a form other than Form 3.The IRS tells the requester that you furnished an incorrectTRN, W-9 to request your 11N,you must use the requesters form bit is substantially 4,The IRS tells you that you are subject backup withholding because you did similar to this Form W-9. not report all your interest and dividends on your tax return(for reportable interest Definition Ma U.S.person.For federal tax purposes,you art considered a U.S. and dividends only),or person If you are: 5.You do not certify to the requester that you are not subject to backup •An individual who is a U.S.citizen or U.S.resident alien: withholding under 4 above(for reportable interest and dividend accounts opened •A partnership,corporation,company,or asociaton created or organized lel the oyer 1889 only). United States or under the laws of the United States, Certain payees and payments are exemptfrom backup withholding.See Exempt •An estate(other than a foreign estate);or payee code on page 3 and the separate Instructions for the Requester of Form W-9 for more iniormation. •A domestic trust(as defined in Reguations section 3017701-7). qlm see Special atlas for partnerships¢hove. Special rules for partnerships.Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section What is FATCA reporting? 1946 on any foreign partiers'share of effectively connected taxable income from The Foreign Account Tax Compliance Act(FATG)requires a oartidpating foreign such business.Further,ioincertaincases pwhereaptoa'reuM1etnot burrner is atl, financal insihutlen to report all United States account hoitlers Mat are specred fofoe ign p exon,andtipa 1 hese46 tion 1 46rwxhoild in pax.Theme efthor e,ifpyou e a United Stales persons.Certain payees are exempt from FATCA reporting.See U.S..gnpemohis ptnesnca pntnerhip conductingldlax.Thxefor business in Exemption from FATCA reporting code on 3 and the Instructions for the Uperson that partner Ilia;the part atase or your U.S. she Requester of Form W-9 for more information. ed United avoid provideon 4Form W-i to the partnership ofo establish your m.e. status and the ecaees belowaswrahmtligpersonng on share oef partners;i they. Updating Your Information Inure cases below,tie following person must give Form V'9 to the partnership for purposes of estastet fishing Rs U.S.status and avoitlinwithholdingen its You must provide updated information toany person fo whom you'claimed to be allocable share of mmm=_from the partnership conducting atrade o business an exempt payee if you are o longer an exempt payee and example,you ICnt united States: provideblppayments the nRorefrom this Cooroa Foor'that elects to may need to •InMsd aofatlard not h entity w;tlle U.S ew,aq the U.S.owner of • provide updated informationonif you are a ompt.In addition, you mus beans disregarded entityand not entity: corporation,re or name you nolongerctax orthe al untiforyxamplesf the a new eg ommW9r the name or TIN changes for the acmue:;for example, grantorbf`;e •In Mecase rhter trust S.ownrLLS.grantor ratrrust ar S.not the y, ofe9rm;Nrtrust dies_ •I U.S.grantor ofor.other sty.owner of grantor a and not trst((th;and •Inthe case afdns_he beneficiaries of a the trutrust),Meustruaryemer than Penalties grantor oeigt per)ontlfytthersoner trust. Failure to famishTIN.ofCyou lelth schfarure unless:TIN to a reqdue to are that has eected.o you are esaforeignpersonor not Forms a-9.Iistadnk,u reasont to able aupeserydn50 ettor;UMWM1eale fafure unless your failure is tlue[e `heshas elected totreated ora U.S.U. . (see useP,blintiForm W-9. ilio reasonable for alse netto;UMW nre thea. appropriate Form W-8 or ONTO E233(see Publication 515.\Nkh]oltlino of Tax Civil penalty false information with that results withholding.G you make a onNonresidentMewsand Foreign Entities). false statement towith 350 reasonablenalty. baslsthat resul6ln no backup withholding, Nonresidentalien use becomes a at ix tretlito. only a nU.S. aro you re l nafoSSeepenalty. individual thetermsof most ex treatreduceaty to ies or eliminate known as Criminalaborispenalty y subject lou to infmmationalties incfa!ingifnean/oricns or alien aiotylcea sen e.Now ed in t traavincong ta in eaypermit mi known n ar maysun]ectyou to criminal Venakls lndoNggfinsantl/or avingdau tax to contiuefons r specifiedintye pes of even hp imprisonment. aso• therise from become to continue forent alien types of income even after the pays es or usesin has otherwise becomeaUSresident forfax purposes. Misuse esterNell the requester discloses "Nsviolation of federal law, IfU.S.resident alien who is relying os an exception contained in the the requester may be subject to civil and alminS penalties. :anyouclauseauof a tax treaty to claim an exemption from U.S.tax on certain types Specific Instructions ,you must attach a statement to Form W.9 that specifies the following P five nems: 1.The treaty county.Generally,this must be the same treaty under which you Line claimed exemption from tax nonresident alien. must enter one ofthe follovmg on this line;do not leave this line blank.The 2' The treaty article addressing the income. name should match the name on your tax return. 3.The article number or tocation)in the tax treaty that contains the saving If this Form W-9 is tore joint account,list first,and then circle,the name of the cause and,Us exceptions. person or entity whose number you entered in Part I of Form W-9. 4.The type and amount of income that qualifies for the exemption from tax. a Individual.Generally.enter the name shown on your tax return.II you have changed your last name without informing the Social Security Administration(554) 5.sufficient facts to justify the exemption from tax under the terms of the treaty of the name change,enter your firstname,the last name as shown on your social afiva security card,and your new last name. Example.Article 20 of the US:Chinancme t treaty allows aneemption . Note.MN applicant Enter your Individual name as it was entered on your Form from tax for tedscholarshipfUnder leromelaw,received stdetlwti studentcomtrmpoatayen for the Form line 1 4OEZ shouldalsowith the ourameesthe name you entered on tthe if hiso erst in thUnited itdtState exceedsS amsar t yarsn for Fprm t']4'Llo9owto4e¢yon filed with your apPg®rtn. o epara rahr her staythintheUnilol States U.S.-China (doted r ped Ap n. Sole proprietor or single-member Lia Enter your individual name as However,984paragmrozCfffi°flAicle tolcmeueE-0pply event'(fer the shown shown on your t 040/1040A/l 040EZon line 1.You may enter your business,trade, Chinesestuent provisions ofArticle20 to oche UnteaSptys.Aven afterrsredoing businessas"(USA)name on line 2. whogsalifes for becomes a tion(undsrparofap Un of protocol)tstates.roChinese ° who quolthifexcep exception atlerempgapfoofaxen Nsor rsandhot istcorat on.EiteLLC enols beta as s shownmberLLQOOax return on ons reor fin9 on fellowship income exception claim an exemptionForm - fmmtexen 91st includes the aany busiess,Enterentity's or RBA a onbue tn on the ererry's tax return on liner oripIncome above vato attach to ht exemption statement that inolutlesMe and Other entitisaEntrour mesnhon2 informationrzonrsdenween support feign nxemgiiedentities.This nave shoed matchtctnamegei shred wa on the Ghee Iprouare crmplenonresident W-8 ofForm23give the requester the documentsdocument nTrtnthe entity. the snobuenMecadeor or appropriate completed Form W-8 or Form 8233. other legal do cum^R creating entiTy-You may enter any business,trade,or D8name on lidsd 2.e Backup Withholding e.disregarded entrysForafom its tax wpurposes,tdosned as a"disregarded is What isbackupco diionslwinand PersonsmakingIRS certain payments cto you ymen .t entity. ee as Regulations separate301m dsownerrstr Enterthe owner's amd ce'laeckup ihho withhold lits toamaye0%oectoM1acupnb.This lineit1,," See mf iytion enteel]IDYe(1) namesIu.Eneverbodisreon underis tliney The name of theIentered on name shouldwnever in a omertaareetl called'backup withholding." Payments that may be subject to backupentity exchange gtrinsaci Ins,rent,.axcaempf nonemployee yee payEbroker menand made entry.The name omosMe1 shouldpate .the oaxaspov+n on fore income tax is treaed of payment rents.a d thirdprty netwlork transactions,pvy,paymean marten a a dire iardedestey d for e U.epedera Fax epurpose,ifa asingLLcaner treated sa paaymmes[olpaymeg bot opdator,Hea nest to aenotd subject Urea disregarded entfty name is tax irdto provdedo owner if the backup wthomdsgngboetepera'm2 Heal estate transactions are notsub]sctfo diect owner the thee owner'sbega .edfoenteiddrt onIr the backup wWot beg idi of fediey Is aim a fax posesaNttl thetdi reg enter dthe first ewnname on You will not be suhecf to backup withholding on payments you receive if you not disregarded"Business Bfor federal entity name."he of to disregarded ve the r estercorrect TIN,make thecertifications,and report all line s ureon, he ow eoat . can pprordIDFoimag-S 9 requester yourpropertur. noforeign FoW-g. hTes ermesemmptheorArson has a U.S.your taxable interest and dividends onyw[fat realm. instead eta Form W-g. is the case even if the foreign person M1asa U.S.TIN. Payments you receive will be subject to backup withholding it 1.You do not furnish your TIN to the requester, 2.You do not certify your TIN when required(see the Part H instructions on page 3 for details), Form lar-9(Rev.12-2011i Peaa3 Line 2 `Hov The following Payments rade ma corpormion aid,reportable on Form. If you nave a business name Made name,DBA nmeo-dames-elided dames-elidederfity nu re 109MISC are 1 exempt. baccup witnnold tic:medical and In - nn care yo y enter.A onIre_2 payments attorneys fees ds paid ttoY rePortame sect on 60.5(8,ern oaymentsnses paid by a federal .- Line 3 Exemption from FATCA reporting Code me following codes identify payees Bieck thp, 3 Mr the U.S.federal ticafon of she Mat am exempt from-eporting under FATCA.These ds apply tpersons hose names enteree on line L G_ck only one box in line 3 b Kling H form far accounts maintained outAde of the United Stby Limited Liability Company(LLC).'I me name on ite 1i an LLC treated as an faoreign tri nt.Th_ form onlyb ld g this form for anpart .bip for US.federal ax purposes,check the'Umfed Liability Company" o the person In request qu g cs form 1 youty f i Inefi k boxand enterri p provided.It IncILC', fl dF m 8832 or 255,7 to institution Rs.thesubjec[ t1requirements BNirequester yindicate that a code is r f be taxed as a corporation -1."Jolie]Lao Fty Company'box and in the not required by protlg y t a For W-Bw Lb NotAppl S for ap space provided t 'C C corporation or IS"tor S corporation If is a s rn ar indication)wY p mod on the line for a FATCA ept d . single-membersingle-member LLCthat disregarded entity,do check[ tM1 L d LiabilityCompany' L insteadcheckthfirst box in ine3 Ind rdualsue proprietor or AA B - 1 eiotfrom tax under section 501(a)or any ix'cry single member LLC' ent plan as dxe n section 770'4)(21B-The United States or any of ds agencies or instrumentalities Line 4,Exemptions c A state,theDistrict of Columba, U.S.S commonyealin or possesson-o offrom backup w'dn✓Jng armor FATCA reporting, .iter in the of loam oomcal dvsom or instrumentalities eppvoniexempt. e pamin Saoany oodels)Mat.may apprymyou . ao-A corporation the stoea of which recelarly hadec on one or more Exempt payee code established sec-ties mikes,as o3dued in Heg..'Ietiens section • BaidMg. m'rvafas(ntiaain3 sole pvonaorsl are not exempt sacxdCm 1.Imrq)por •Ex eat as E-or :pnpdeslrn that is aa member of the enure expanded affiliated group axe •r cera ap�wldsdnclud no interest uream exemptnds. tauter mina ---i, corpora-eon , a commodes, tatieIflanO Corporn payments,s e exempt plMom oackup dividends F—A dealereoadws conctfutirsor s,anotons)tl hat • Cup . not p4 , aksewithholdinganl Penmen's made in ( Ie notional palcontracts.h forwards, )ihaPs settlement of payment card r:Mtn p.M fear. +. osee[o.s. .,area as such under theaws e' ,e United States orahy state • Corporations are not exempt fromb k p win-Molding tat.-especn to attorneys G-A reel estate MaieStMarart tt fees or gross proceeds paid tH. and comorations that may de medical or H-A regulated afiestment company as definedi.section 551 or an entity neaith careem not exempt with to payments reportable on Form registered at all times ug tine tan year end_ Imes :mem Imem_mCmpany Act o` I hefollC1346 servIces Know ngcoose tpayeestate exempt from becalmweFt:ding. -A common 3u4Sm fund as fn= ^.:Eon 584 a1 Etre"Ina appropriate cooP thes eta in line 4 1 A g t exempt sectionD ( .iaany'RA J-A as drl sl'.section6 custodial a ntund r sexton 403Tyg T hour Isles the _q iecens K A broker of Section 4011012) L-A tt exempt from tax under section 654 or descnbed in section 4347;a)1; 2-The United States or any of its agencies r inremertaldies Id-A tax exempt trust ender a section 403(b)oar or section 457(g)Pan 3-A Rate,thep strict of Columbia a U.S.commonwealth or possession.or Note.Yoe may w:sn to Consult with- firancialinsritutio.ng min fo reit any of tne.r palRcal subdivisions or insnumensaltes determ ne whetner f_FATCA ode andior exempt payee saie should be 4-A foreign government or any of its political subdisions,agencies,cy completed. insrnmenta°rias Line 5 5-A Enter your address Memnon street and apartment or suae number).Mils s wmine A dler in securities or commodities required tregister is the United tha requester of its Fara u9 will mail yrnorraon returns ▪ toe District ac U.S.LI S commonwealth orpossession A futures commission merchant registered with the Commodity Futures Line 6 Trading Commission Enter your cty,state,aid ZIP code 8-A seal state lmestment bust 9-emend registered at al:times curing tri tax year under me Investment Part I.Taxpayer Identification Number cation NEnteryourthet alien and) do 1 10-A common✓ust fund operated bye bark under section 58e fa) have and are not eligible to t an SSN,your TIN is your IRS individual- p ayer identification nee ;ITN.Enterisnd "I seCsq numberx-bYou.donor 11-A middleman nsKNEon have an IN,see How ri get a TM'below. 12-A middlerman Knownin the Investment comment,as a nominee or C you area sole proprietor and you have an EIN,you may enter either you-SSN custodian m EIN.However,tae IRS prefers that you use your SSN. 19-Aru9ocrvnpt from tux under section 564 or describes'in section 1947 If you are a singimmeember LLD inch is disregarded as an mRyseparate SSits Thef I ng chart showseste of paymt that y bmeth ' b ek L'. nN bas abintyCompere,(LC :' p ), thesSRN w nn loryr.'M1e chart p' the exemptpearlistedabove.lMoe9h 15 (or slats ifed as a core ownerpoam,orr partneronp Do not enter the the entry's FINentryElN. "e lie iIF the payment is for... THEN the payment is exempt for... Note.See the chat on page 4 for&ller caNPcation of name and l'IN combinations Interest and diidendpymers All exempt payees except How to get a TIN ifyout he a TIN applyf tl ly PP:' try for en SSN,get Form,555,Application for a Soc al Security Gard from yourioea: _ SSA officeget this torn at You may also get[ form by Broker nan.ac[ons Exempt payees l through 4 and callingl-S0o772 213 Use Form W-7 Application'or IRS individual Taxpayer through 14 and a C corporations.5 identlication Number,to apply for an MN or Form 554,Application Employe' corporations must not enter an exempt Identi2Len Number,to gopl tor en SIN.you can apply for an SN on le by eayee code because mph accessing the IRS tveloste at ,Kw Ms govitusineSSeS an0 Clicung an EmPlMeii on y for sales of noncovered securities Identification Number EIN)under Starting a Business You caget Forms 01-/and acquired prior to 2012. SS-4 fm the IRS by visiting IRS egwo by aI g1-800-TAXFCRM (1-800-8295576). Eater exenagetransctocs and IExempt payees`through4 If you are asked to compete Form W-9 but do not have a LN,apply for allN patronage di.Mends and write'Applied Foe in the space for tee TIN,sicn and date t,e form,and give it to n ents ado Payments over$500,reguirec to be Generally, wtheeq'. 1 'rF y1 at .tldd dividend payments, tl ' i ' ey -exempt p . readily tradable '.,youwill haveyD days nto cat repotted and direct saes over S5,CD01 1 eiroegn 5 a T N and - tc.theben me yoe are subjectct to backup M Id. g o'i paymentsTati 60-day dces aoply to other types ofpayments You will P y.ents made in set ement of E.- pt payees l:Impugn 4 sebieurt backup withhotcling on anre t .til to provide ur 1 IN to payment a or thid party oomph Ire a' mer. transactions Note.Enter g"Applied For"means that yhave already appiod for a TIN or bei you - d to apply for r. rSea Form 10.99 bIS',MiscellaneousIncome d . .uee..ns. C C :A dsre edUS entry that has fotetgr,omiarmust use the ePPmmlafe Form a-a Form W-9(Rev.12-2014) age 4 BA Part II.Certification »Business yanmcnaduadea and youamay also may use ocheryourss name r�on Toestablisht the withholding agent that youU.S.person, resident is ), the IRS youyourSEN. signFormW-9.Ymay be requested to '9 by Me YM1 iding agent event L first t 1 - estate. pension (Dc f TN t ne terns l 4 below indicate b personal representative or Trustee erasethelead entity itself is not designated n t For joint nt ly the person Y eTN is shownPall should sion trialA. Special I far pun hF s on seine a rm vas to trustee of trust marequired),p the pae faxemptpaede rythe v identified ,rna1 more name mastsign.Exempt quiremento,see 6te the cyeemden asB cNons.ere to beharo the when [ oneis listed,tha numberwll be Signature requirements.Complete the certification Ttllcaled lnBen's l considered to be that of thafirst name listed, through 5 below. Secure Your Tax Records from Identity Theft 1.Interest,dividend,and barter exchange accounts opened before 1984 and broker accounts considered active during 1983.You must give your Identitytheft occurs when someone your personal information such as your name, mne SSN,or other identifying information,on,without your permissionto commit correct TIN,but you do not have to sign the certification. fraud or other crimes.An identity thief may use your SSA to get a job or may file a t.Interest,dividend,broker,and barter exchange accounts opened after tax return using your SSD to re a refund. 1983 and broker accounts considered inactive during 1933.You must sign the certification or backup withholding will apply.if you are subject to backup To reduce your Csrt withholding and you are merely providing your correct TIN to the requester,you •Protect your SBN, must coce out item 2 in the certification before signing toe form. •Ensure your employer is protecting your Saw,and 3.Real estate transactions.You must sign the certification.You may crsou[ .ge careful when choosing afax prepare. he 4. thecertification. ce If your tax records are affected by identity theft and you race a nonce from 0.etlfictan unlessnss You haveveenyotied that you previouslyhIvyprvousM1iven0nign the IRS,respond right away to the name and phone number printed on the IRS thecertification youinclude notifiedtlengiven an noticeletter. incorrect TIN. Orb payments" payments tl ' the than course 0l the e requester's e), businessis royalties,goods(other bills ofor e yourtax duet a arenot len currentlyaffected by identity ah er youcard k you merchandise),medical and health ayervarsen dpymetstm at rilostrdugt0octor e IRS purse wallet,questionable t Icreditactivity corporations),paymerrts to nt card n0 d third party networkranp�mnstmade in F14r39ert,onlas[MeIRS Identity Theft Hotline a[b80o 908-4W3 orsubmit sertameshing of boat crew tlmbersrtlparryermen,and noceeds mato Formo 14039, more certain fishing boat crew members and fishermen,and gross proceeds paid to For more information,see Publication 45351tlentMTheR Prevention and Vk`m attorneys(ocwde8 paymientss to oou, ons). Assistance. 5.Mortgageinterestacquisitionpaidbyyou, or abandonment of secured problem, of identitye theft who are experiencing economic harm 0r a system property, g),IRA,ation of debt,A,Archer tuition program payments(under throug_n',or are nel help in resorting tax problems that have not been resolved section 52g), Coveroeil ESA.Aroher MSA or HBA contributions or through normal You channels,may be eligible for Taxpayer Advocate ntaNce(lat distributions,nand pensioncrtmoatribu[ions.You must give your rorteG TlN,but you 1-877-ace.You can reach TAS by calling Ne TAS toll-Tee case intake line at do not have to sign the cefAca]en. ^,20]-]?T-4273 or TTY/TIDO 1-800-829-4059. What Name and Number To Give the Requester Protect yourself from suspicious emaila orphishing schemes. Plashing is he creation and use of email and website designed t0 mimic legitimate business Fru-this type of account Give name and SSP of reals and websites.The most common act is endinggan email to a userfalsely g to be anestablishedlegitimate P an attempt to sun the ser t la. 'duai The individual iclainunnto surrenderingP ate infot that will be usedf identitytheft 2.Two or more e individuals 0lolnt m ^tea owner the account or, TheIRS does not initiate contacts wig taxpayerseml -h theIRS es account) if combined funds,the first request personal detailed information through email 0r ask taxpayers for the individual on the account' not numbers,passwords,or similar secret access information for their credit card, 3.Custodian account of a minor Tne minor' bank,or other financial accounts. If S,forward trts (UniformGiftto Minors savingsActesyou receive an unsolictted email sage topgishingOirs.gov.You may also9to be hom the report misuse of a IRS name,logo, 4.e.Therantorevocable trustee) The9anM-trus:ae mor other IRS property to the Treasury Inspector General for Tax Adminisbefion trust(grantor sat account (TIG-FA)at 1.800-366-4484.You can forward suspicious emals to the Federal nota-maeotrud accst under is The actual owner' Trade Commission atspam@ucwgov or contact them at www.RegQthdTeft or not a iagal or valid trust under 1-827]-IDTHEFT 0-877.438-43301- state lw 5.Sole proprietorship or dtsregarded The owner Visit 1RS.gov to learn m0re about identity theft and now to reduce your risic entity owned by an individual 6.Granter trust filing underoptonal The grantor' Privacy Act Notice Form 1099 Fling Method 1(see Section 6109 of the Internal Revenue Code requires you to provide your correct Regulations section l.671-4(o)(2)() TIN to persons(including federal agencies)who are required to file inbrmat'on (W) TIN with tie IRS to report interest,dividends,or certain other income paid to For this type of account Give name and EIN of you:mortgage interest you paid;the acquisition or abandonment of secured 7,Disregarded entity not owned by an The owner popery;the oancellabon of debt,or contributions you made to an IRA,Archer MSA,or HSA.The person collecting his form uses the information on the form to individual file information returns with the IRS,reporting the above information.Routine uses B_Avalid trust,estate,or pension trust Legal entity' of his information include giving itto the Department of Justice for call and 9.Corporation or LLC electing The corporation criminal litigation and to oities,states,the DlsMtl of Columbia,and U.S. corporate status on Form 8832 or commonwealths and possessions for use in adnmm5ering their laws.The Form 2553 information also may be disclosed to other countries under a treaty,to federal and 10.Association,club,religious, The organization state agencies to enforce civil and criminal laws,or to federal law enforcement end Intelligence agencies to combat terrorism.You must provide your T,N whether or ch eatlucaiional,or oHeriv- not you are required to file atax return.Under section 3406,payers must generally cmpreptt o,r9anlzstion withhold a percentage of taxable interest,dividend,and certain other payments to 11.Parhlership or mulmember LLC The par era hip a payee who does not give a 11N to the payer.Certain penalties may also apply for 12.A broker or registered nominee The broker or nominee providing false orfraudu;ent information. 13.Account with the Department of The public entity Agriculture in the name of a public entity(sum as a state or local government,school district.or prison)that receives agricultural program payments 14.Grantor trust filing under the Form The trust 1041 Filing Method or the Optional Form 1099 Filing Method 2(see Regulations sectiont671-4(b)(2)[) 1 (B)) List first and calete name of he person whosedumber you�mish.,icnly one personona point amount has en SSP,Mat pe must ed. 'Chia the minorsaai name and turn-an the ors SEN. FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program "Affidavits and Declarations" ATTACHMENT D "Affidavits and Declarations" Miami-Dade County's Affidavits and Declarations MIAMI•DADE COUNTY Miami-Dade County requires each party desiring to enter into a contract with Miami-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"0" in the box next to N/A. ALL SECTIONS MUST BE COMPLETED THE FOLLOWING MATTERS REQUIRE THE ENTITY TO SIGN AN AFFIDAVIT UNDER OATH: STATE OF ( [Kt'LIC� COUNTY.OF ( ��CUh1[ - 2. COUNTRY OF [ Pc( S ) Before me the undersigned authority appeared (Print Name), CT Mir MCrlx\-.'S who i personally known o me or who has provided as identification aid who did swear to the following: r That he or she is the duly authorized representative of[Name of Entity) Ci"H Lt ned (Address of Entity) L1t6 ( *ice'v C L r1Y. Ei ; 3^'(-1:1 331 C1 Post Office addresses are not acre a table. _ 1 Federal Employment Identification Number _(hereinafter referred to as the contracting "entity"), and that he or she is the entity's (Sole Proprietor)(Partner)(President or Other Authorized Officer) 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 Miami-Dade County's Affidavits and Declarations Pertains 1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT(SECTION 2-8.1 N/A OF THE COUNTY CODE) Initial •:a4 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 holds 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 contractor business transaction is with a trust,the full legal name 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 agency 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 Office addresses are not acceptable. (Full Legal Name,Address,%Ownership) (Full Legal Name,Address,%Ownership) (Full Legal Name,Address,°A Ownership) it (Full Legal Name,Address,%Ownership) ,. The full legal names and business address of any other individual(other than subcontractors,material person,-1 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 herein,or who knowingly discloses false information in this regard, shall be punished by a fine of up to five hundred dollars ($500.00) or imprisonment in jail for up to sixty(60) days or both. L. J ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Paget of 11 Miami-Dade County's Affidavits and Declarations 2. MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT (COUNTY li Pertai s ❑ ORDINANCE 90-133,AMENDING SECTION 2.8-1; SUBSECTION (d)(2) OF THE N/A ❑ COUNTY CODE) j Initial - ) 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 he entity contracting or transaction business to disclose the following information. The foregoing disclosure I� 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 agreement with its employees? A`I Yes El No Does your firm provide paid health care benefits for its employees? 'Yes C. No LProvide a current breakdown (number of persons) of your firm's work force and ownership (below): White: Males 3014. Females " C1 Black: Males 2 Females lI9 Hispanic: Males Q�/' Females S b Asian: i Males ' Females American Native: Males 3 Females / — Males 9 Females � Aleut(Eskimo): p ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 3 of 11 Miami-Dade County's Affidavits and Declarations 3. MIAMI-DADE COUNTY AFFIRMATIVE ACTION/ Pertai,s O NONDISCRIMINATION OF EMPLOYMENT,PROMOTION AND N/A O PROCUREMENT PRACTICES (COUNTY ORDINANCE 98-30 CODIFIED Initial I ) L ._ AT 2-8.1.5 OF THE COUNTY CODE) It Pursuant to Miami-Dade County's Ordinance No.98-30,Section 2-8.1.5,entities with annual gross revenue; excess of$5,000,000 seeking to contract with the County shall,as a condition of receiving a County contract,have: i 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 procurement policy which sets forth the procedures the entity utilizes to assure that it does not discriminate against minority and women-owned businesses in its own procurement of goods,supplies and services.Such affirmative action plans and procurement I policies shall provide for periodic review to determine their effectiveness in assuring the entity does not discriminate in its employment,promotion and procurement practices.The foregoing,not withstanding,corporate N entities whose board of directors are representative of the population make-up of the nation shall be 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 may be waived upon written recommendation of the County li 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 i completed affidavit along with a cover letter on your company's letterhead,listing the company's address,phone and fax numbers, and any required documents,to:Miami-Dade County,Department of Procurement Management Affirmative Action Plan Unit 111 NW 1st Street, 13th Floor Miami,FL 33128 1. Yes pk No ❑ My company has an.affirmative action plan and procurement policy and is / �1 available for review. My company has annual gross revenues in excess of$5,000,000. Yes U No O I Therefore,our company's affirmative action plan and procurement policy is available for review. .1 Yes O No CJ My company has annual gross revenues less than $5,000,000. i Ii If at any time the Miami Dade County has reason to believe that any person or firm has willfully and knowingly provided incorrect information or made false statements,the County may refer the matter to the State Attorney's Office and/or other investigative agencies.The County may initiate debarment and/or pursue other remedies in I. accordance with Miami-Dade County policy and/or applicable federal,state and local laws. • 4. MIAMI-DADE COUNTY CRIMINAL RECORD AFFIDAVIT Pertai* M (SECTION 2-8.6 OF THE COUNTY CODE) II N/A Initial 1 , ) SThe individual or entity entering into a contractor receiving funding from Miami-Dade County G has t "hal iot, 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 contract or receiving funding from Miami-Dade II County O has'has not as of the date of this affidavit been convicted of a felony during the past ten (10)years. hI • ATTACHMENT D "Miami-Dade County Affidavits and Declarations" Page 4 of 11 Miami-Dade County 's Affidavits and Declarations 1 Pertai ❑ 5. PUBLIC ENTITY CRIMES AFFIDAVIT (SECTION N/A ❑ 287133(3)(a), FLORIDA STATUTES) Initial hit ) i■ The individual or entity entering into a contract or receiving funding from Miami-Dade County understand• I e following: That a"public entity crime" as defined in Paragraph 287.133 (1) (g) Florida Statutes,means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state of the United States of America, including i but not limited to,any bid or 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. GThat"Convicted" or"conviction" as defined in Paragraph 287.133 [1] (b)Florida Statutes means a finding of guilt I 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 indictment or information after July 1, 1989,as a result of a jury verdict,non- jury 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 been convicted of a public entity crime. The term"affiliate"includes those officers, directors, executives,partners,shareholders, employees,members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person,or 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 Florida 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 person 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,members and agents who are active in the management of an entity. Based on information and belief;the statement as marked below,is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies by applying the individual initials near the box). Neither the entity submitting this sworn statement nor any of its officers,directors, executives,partners, shareholders, employees,members or 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. ❑The entity submitting this sworn statement or one or more of its officers,directors,executives,partners, shareholders, employees,members or agents who are active in the management of the entity, 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 applicable or C]no an additional statement is not applicable. U The entity submitting this sworn statement, or one or more of its officers,directors,executives,partners, li shareholders, employees,members,or agents who are active in the management of 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 of the State of Florida,Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting ,, this sworn statement on the"Convicted Vendor List". 1 • 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 Category2 of any change in the information contained in this form ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 5 of 11. Miami-Dade County's Affidavits and Declarations 6.MIAMI-DADE EMPLOYMENT FAMILY LEAVE AFFIDAVIT Perta'i s O �I (County Ordinance No.142-91 codified as Section 11A-29 et. N/A O seq of the County Code) Initial(a That in compliance with Ordinance No.142-91 of the Code of Miami-Dade County,Florida,an employer with fty (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. Pe ' S O 7. MIAMI-DADE COUNTY DISABILITY NONDISCRIMINATION N/A AFFIDAVIT (County Resolution R-385-95) Initial ) That the above named firm,corporation or organization is in compliance with and agrees to continue to co i ly with,and assure that any subcontractor,or third party contractor under this project complies with all appli ble requirements of the laws listed below including,but not limited to,those provisions pertaining to employment, provisionof programs 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. 327,4Z U.S. C. 12101-12213 and 47 U.S.C.Sections 225 and 611 including Title I, Employment;Title II,Public Services; Title III,Public Accommodation and Services Operated by Private Entities;Title IV,Telecommunications; and Title V, Miscellaneous Provisions:The Rehabilitation Act of 1973, 29 U.S.C. Section 794:The Federal Transit Act,as amended 49 U.S.C.Section 1612:The Fair Housing Act as amended,42 U.S.C.Section 3601-3631.The foregoing requirements shall not pertain to contracts with the United States or any department or agency thereof or the State or any political subdivision or agency thereof or any municipality of this State. Pe s 8. MIAMI-DADE COUNTY REGARDING DELINQUENT AND CURRENTLY DUE N/A \ FEES OR TAXES (Sec.2-8.1R) of the County Code) Initial l l ) Except for small purchase orders and sole source contracts,that above named firm,corporation, organizatioor individual desiring to transact business or enter into a contract with the County verifies that all delinquent a0/ currently due fees or taxes--including but not limited to real and property taxes,utility taxes and occupational licenses --which are collected in the normal 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. J. ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 6 of 11 Miami-Dade County's Affidavits and DeclaratioIns it Pertain) ❑� :• 9. CURRENT ON ALL COUNTY CONTRACTS, LOANS AND OTHER OBLIGATIONS N/A Initial ! ) The individual entity seeking to transact business with the County is current in all its obligations to the Coul 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. ) _ _. ' Pertai C 10. DOMESTIC VIOLENCE LEAVE (Resolution 185-00; 99-5 Codified At 11A- N/A 60 Et.Seq. of the Miami-Dade County Code). Initial 1. • ) I The firm desiring to do business with the County is in compliance with Domestic Leave Ordinance, Ordinal e 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 Miami-Dade County for each working day during each of twenty[20) or more calendar workweeks in the current or proceeding calendar years,to provide Domestic . Violence Leave to its employees. • L . 11. MIAMI-DADE COUNTY EMPLOYMENT DRUG-FREE WORKPLACE Pertai s ❑ AFFIDAVIT(County Ordinance No. 92-15 codified as Section 2- '' N/A 0 8.1.2 of the County Code) i Initial( ) That in compliance with Ordinance No.92-15 of the Code of Miami-Dade County, Florida,the above named rson or entity is providing a drug-free workplace.A written statement to each employee shall inform the employ 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 employment that the employee will abide by the terms and notify the employer of any criminal drug conviction occurring no later than five(5) days after receiving notice of such conviction and impose appropriate personnel action against the employee up to and including termination. Compliance with Ordinance No.92-15 maybe waived if the special characteristics of the product or service offered 1 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. . 11 ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 7 of 11 Miami-Dade County's Affidavits and Declarations Pertain. ❑ 12. ATTESTATION REGARDING DUE AND PROPER ACKNOWLEDGEMENT OF N/A COUNTY FUNDING SUPPORT Initial( , ) i II By initialing this subsection and accepting County funds,the above named firm, corporation, organization o, 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-DADE COUNTY RESOLUTION NO,R-630-13 REQUIRING A DETAILED PROJECT BUDGET,SOURCES AND USES STATEMENT,CERTIFICATIONS AS Pertai i ❑ TO PAST DEFAULTS ON AGREEMENTS WITH NON-COUNTY FUNDING N/A 1 ❑ SOURCES,AND DUE DILIGENCE CHECK Initial ) Pursuant to Miami-Dade County Resolution No.R-630-13,requiring a detailed project budget,sources and u es 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. II The undersigned entity certifies,to the best of his or her knowledge and belief,that: 1. Within the past five (5) years,neither the Agency nor its directors,partners,principals,members or board members: it (i) have been sued by a funding source for breach of contract or failure to perform obligations under a contact; (ii) have been cited by a funding source for non-compliance or default under a contract; ' (iii) have been a defendant in a 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): Pertains ❑ SII 14.MIAMI-DADE COUNTY RESOLUTION No.R-478-12 NOT TO USE PRODUCTS N/A • OR FOODS CONTAINING"PINK SLIME" Initial( ) Pursuant to Miami-Dade County Resolution No. R-478-12,the undersigned certifies,not to use meat product 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"pink slime"in food provided or served in these programs. ATTACHMENT D "Miami-Dade County Affidavits and Declarations" Page 8 of 11 Miami-Dade County's Affidavits and Declarations 15.MIAMI-DADE COUNTY REQUIRED LOBBYIST REGISTRATION FOR Pertai C ORAL PRESENTATION Section 2-11.1(i)(2) CONFLICT OF INTEREST N/A C AND CODE OF ETHICS ORDINANCE InitialY ) All lobbyists shall register with the Clerk of the Board of County Commissioners within five (5)business d. of being retained as a lobbyist or before engaging in any lobbying activities,whichever shall come first. Ever {. rson 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 a form with the Clerk of the Board of County Commissioners,signed by the principal or the principal's representative,stating that the 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. By initialing here,the principals or principal's representative have filed with the Clerk of the Board of County Commissioners stating that a lobbyist is authorized to represent the principal. 4.Any public officer,employee or appointee who only appears in 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 of the notification of the failure to file the required disclosure form.The Commission on 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 of the 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). (Ord.No.00-19,§1, 2-8-00; Ord. No. 01-93,§1, 5-22- 01; Ord. No.01-162,§ 1, 10-23-01; Ord.No. 03-107, §1, 5-6-03) • ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 9 of 11 Miami-Dade County's Affidavits and Declarations - - - Pertain O 16. Disclosure SUBCONTRACTOR/SUPPLIER LISTING(ORDINANCE 97-104) N/A O i Initial ) This form, or a comparable form meeting the requirements of Ordinance 97-104,must be completed by all bi ers and I proposers on Miami-Dade County contracts for purchase of supplies, materials or services, including pro essional 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$100,000.00 or more. This form or a comparable ' form meeting the requirements of Ordinance 97-104, must be completed and submitted even though 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 subcontractors 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 Principal Owner Scope of Work to be Performed by (Principal Owner) I of First Tier Subcontractor/Subcousultant Gender Race i Subcontr ct� Subconsultant Business Name and Address Principal Owner Supplies/Materials/Services to be (Principal Owner) of Direct Supplier I. Provided by Supplier Gender Race • �I�OnrP • • I cert that the repfsentations contained in this Subcontractor/Supplier Listing are to the best of my knowledge true an accurate. io/yb/(S 'gnatnre •f•uthorized Representative Date i I l".l 1I . ; ) ( _ 1 /1.3M r . d IV YS ) Priv Name P Title (Duplicate if additional space is needed) ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 10 of 11 Miami-Dade County's Affidavits and Declarations MIAMI-DADS COUNTY 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 fou ins for matters requiring the entity to sign under oath and Declaration forms for matters requiring 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: f 20 Signa e of With-. or Secretary Seal Date -a Z S-`7- 6coo39 Siena ,n of A"i. a • Federal Employer Identification Number . i M 1' . IiL9rot lu3 0(-4i_o_i_gAstni Reim Printed Nazre o' Affiant and Name of Agency Agency 1 0 eon en-{ior < g en{.er 6 is 2mt. k ac& . Address of Agency SUBSCRIBED AND SWORN TO (or affirmed) before me thisaE'Fday of CL rbDr,20 t ' Ile/She i, personally known II me or has presented as identification. IS. \ \`yy111101114i,//, Type of identification I " ulte,0"41........ i' I _ Sigeltu4r;',,. < , Serial Number m 110.ZZ22718 aIva Primp otary Expiration Date Notary Public— State of A 0YLL6/`--) County of_9141.S_Th 1 — hLGeIt I Notary Seal • ATTACHMENT D"Miami-Dade County Affidavits and Declarations" Page 11 of 11 FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) Consolidated Financial Records Performance Reports ATTACHMENT E"Financial Records&Performance Reports" 0 o GI 0 0 Pi. N N - r, en 0 M m Co ' V m fiA Yt ; AAAA * e Aaa Asw y G G o A� o f E Ho o O O ag 0o m > > - m m > > >>> > >> > > > > > >>> o p L' o o o ox o o o p 110 0 o o o o o o o O N ZZ s s2xo ia. tu 3 'e O -es C C 0 c p o 2 Y 22 , (-2 OO .. CE 0 R Z F Z GL Ally. TA AA NAA LAA A d va o < al , 4 0 0 � . .� . o 0 F v o 22 E 6 0 E- 'z 0 < A A AA, i49 n 4, sx r. w » r.» v » AA '_, p. II Ez El � com of CP LEE Pi EG�� 0 w � �s w -ter A s s PI D 5 Q� 2 ca rtu a. �° 9u a¢ 2.0 E a.u I E � r u < °- I I kc F A A AAAA A A A A - AA A A AA A A A A A ° g' PE 00 0e o 0 C " _ p = < o or or oir - .°2 ‘ N Li dqj EA AO1 AA -8p0.t AiA A sAs » AA .. xv. As .P. it i - _ _ a a a = 0 cI E g g E - v E ig g g E v e = S E E C c c c 0. 2 _ 2._ _ - _ jp EP N g -F I T _ - Er Ai 0P- C F v n Hi re a 6 r o cm 4 11-4 0I � Ic7� P. w , -no S► , R r I \ U o \.arc z. V Z O Z io gz Fuz 74 c AImo m ¢ m I I 5 U O V Z¢ > 'P. SIA I I I I o a. 0u w 5 5 - m e ., .0 > o1-� - nI,G Al N N 0, Agency LetterheadS. `1 J.. ll Date L k� Attention:Assigned Contracts Officer Miami-Dade County Homeless Trust Suite 310,27th Floor 111 NW First Street Miami,Florida 33128 Subject: FY 2017 US HUD CoC Program #FL000014D0017 ,Program Name Name of Agency is respectfully submitting for your review and release of payment of the enclosed Consolidated Financial Record and Reports for the above subject program. We request reimbursement in amount requested is$0.00 for the month of Month.vvvy. The following documents are included in this checklist outlined below: ;RI Cover Letter J Performance Report-0625 HUD CoC Monthly HMIS generated Report =1 Homeless Trust Invoice Ri HUD form 27053-A SNAPS Request Voucher for Grant Payment 171 Summary and Compliance Report O Attachment E-Program Income Report Supporting documents for invoice requirements and match including invoices,cancelled checks,payroll,time and effort logs,and if applicable copy of Tenant paid utility bills. consistent with utility allowance,documentation of match expenditure compliance consistent with OMB Omni or Super Circular and 24 CFR 578. The value of the match demonstrated is$0.00. The amount of program income (if applicable) is$0.00. This is an adjustment# ( ) for the month of Month,yvvy 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 xvsexys.eom with any concerns or comments about his reimbursement package. Sincerely, Name Title Enclosures Attachment E"Consolidated Financial Record and Reports Cover Letter" MIAMI= COUNTY Request for Amendment/ Modification / for US HUD Grant Funded Continuum of Care (CoC) Programs Includes Legacy Programs under the CoC Supportive Housing Programs (SHP) Shelter Plus Care Programs (S+C) Single Room Occupancy for the Homeless (SRO) 24 CFR 578.105 Grant and Project Changes - The recipient or subrecipients may not make any significant changes to a project without prior US HUD approval, evidenced by a grant amendment signed by HUD and the Recipient Significant changes include a chae recipient, hneeof project site,additions oelanotthe eligible aupr a roject,a f of no than 10% from oapproved eligible titawr he, areduction in the number ofunits,ved and a change in the subpopulation served. By signing this report,the duly authorized Project Sponsor/Provider/Subrecipient Oficial signature below certifies to the best of their knowledge and belief that the report is true,complete and accurate and is for the purposes and objecdves set forth in the terms and conditions of the federal award;and are aware that any false.fctidous,or fraudulent information or the omission of any material fact,may subject the duly authorized officio! to criminal,civil or administrative penalties for fraud,false statements false claims or other offense. Print Name and Title of Authorized Project ponsor/Provider/Subrecipient Official: Signature&Date[mm/dd/yyyy): • Reviewed by Miami-Dade County and forwarded to Do Not Sign-for Miami-Dade County ONLY 1 US HUD for Request to Approve(greater than 10%shift in funds between categories or significant change) CHANGE IN PROJECT SPONSOR Signature&Date(mm/dd/yyyy): I Reviewed and Approved by Miami-Dade County; Do Not Sign-for Miami-Dade County ONLY information forwarded to US HUD(less than 10%shift in funds between categories). Signature&Datemmdd YYYY)' Reviewed and NOT Approved by Miami-Dade County- Do Not Sign-for Miami-Dade County ONLY see attached letter for reasons for disapproval. Signature&Date(mm/dd/yyyy) j Program Name:f Grant Number: { 1 Financial Information for CoC Programs Instructions for budget amendment/ modification request: 1. Attach the eSnaps documents in Word Format previously provided for the applicable budget chart. The charts should include a Summary chart; and all applicable detailed supportive services, operations, leasing, rental assistance and project administration charts. Reformat the far right-side column in the chart to reflect the budget modified or amendment requested. Please outline and clearly identify the changes to the budget. 2. Attach the eSnaps documents in Word format for summary of program. Reformat the far right-side column in the chart to reflect the budget request. 3. Type below or within the applicable Word-formatted eSnaps budget chart - a detailed budget narrative- the justification for the line-item change. Also if there is a change in match amount - a new letter of match commitment is required. 4. Assemble and attach page one of this document. 5. Review, sign and submit the paper original to Miami-Dade County Homeless Trust, 111 NW 1st Street, 27th Floor, Suite 310, Miami, Florida 33128 Attention: Terrell Ellis, Contracts Manager. FY 2017 Continuum of Care (CoC) Miami-Dade County Miami-Dade County Homeless Trust Annual Progress Report (APR) ATTACHMENT F"2016 Annual Progress Report APR" FY 2017 Continuum of Care (CoC) Miami-Dade County Miami-Dade County Homeless Trust Annual Progress Report (APR) ATTACHMENT F"2017 Annual Progress Report APR" MIAMI= COUNTY Annual Progress Report (APR) for US HUD Grant Funded Continuum of Care (CoC) Programs On April 1, 2017 Continuum of Care (CoC)Program grant recipients report their CoC Program Annual Performance Reports (APRs)in Sage HMIS Reporting Repository(Sage). Recipients will be required to upload CSV data from their HMIS to fulfill the APR reporting requirement in Sage. All Subrecipients are required to continue to submit the hard copy of the HMIS report as well as the supplemental pages until further notice. By signing this report,the duly authorized Project Sponsor/Pro vider/SubreciPleflt Official signature below certifies to the best of their knowledge and belief that the report is true, complete and accurate and is for the purposes 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 omission of any material fact may subject the duly authorized official to criminal, civil or administrative penalties for fraud,false statements,false claims or other offense. Project Name Project Grant Number Print Name and Title of Authorized Proiect Sponsor/Provider/Subrecipient Official: Signature&Date (mm/dd/yyyy): Print Name&Title of Authorized Project Grant Do Not Sign-for Miami-Dade County ONLY Official (MDCHT Executive Director or Designee): Signature&Date(mm/dd/yyyy): Supervisory Review and Entry- Do Not Sign-for Miami-Dade County ONLY Print Name&Title Signature&Date(mm/dd/yyyy): Updated March 31,2017 Attachment F"Annual Progress Report(APR) Supplemental" Guidance was provided for e-snaps changes that were implemented to improve processing time;completing an"Applicant Profile";and on Q3,Q5,023,Q24,and Q 31-please submit the HMIS generated APR as well. US HUD-ANNUAL PERFORMANCE REPORT(APR) CONTINUUMbF C•ARE (CoC) • Ql.Contact Information Project Name Recipient/Agency Name Grant Numbe Prefix(Mr.,Mrs.,Ms.,Dr.,etc.) First Nam-1 Middle Name Last Name Suffix(LCSW,MSW,Etc.) Title Street Address 1 Street Address 2 City State Zip Code E-mail address Phone Number Extension Fax Number] Q3.Project Information:Check the coni*anent for the program on which you are reporting Continuum of Care Program(CoC) 1 Rental Assistance(RA) Section 8 Moderate Rehabilitation o Transitional Housing I (]Tenant-based Rental Assistance(TRA] El Single Room Occupancy ❑ Permanent Housing for Homeless OProiect-based Rental Assistance(PRA) O (Sec.B SRO) Persons with Disabilities ❑Safe Haven 0 Single Room Occupancy(SRO) 0 HMIS ❑Innovative Supportive Housing OSponsor-based Rental Assistance(SRA) ❑ Supportive Services Only_ -- Is this APR fulfilling the reporting obligation associated with a 20 or 15-year use requirement? ( ) Number of Years in Operation: (I ) Contract operating term or duration is from( / /20 )to ( / /20 ) Q3.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" Financial Information for CoC Programs Q31a1 CoC Financial -Development Expenditure Type CoC Program funds Expenditures Acquisition $ Rehabilitation • $ New Construction • $ Development-Subtotal $ Q31a2 CoC Expenditures-Supportive Services Report on all CoC Program funds expended during the operating year on supportive services. If you have no expense for these items or these items were not included in your grant application enter"0"in each field on the question. Expenditures type CoC Program Funds Expenditures 1.Assessment of Service Needs $ 2.Assistance with Moving Costs $ 3. Case Management $ 4.Child Care $ 5.Education Services $ 6.EmploymentAssistance $ 7.Food $ 8.Housing/CounselingServices 9. Legal Services 10.Life Skills 11.Mental Health Services 12.Outpatient Health Services �$ 13.Outreach Services 14.Substance Abuse Treatment Services $ I i 15.Transportation $ 16.Utility Deposits $ Supportive Services - Subtotals Attachment F"Annual Progress Report(APR)Supplemental" Q31a4 CoC Financial-Leasing,Rental Assistance,Operating,and Administration Total Expenses COC Funds Development $ Supportive Services $ Real Property Leasing $ Short-/Medium Term Rental Assistance $ Long-term Rental Assistance $ Operating Costs $ HMIS $ 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) Supplemental" Performance for CoC Programs Q36: Standard Performance Measures ( Performance Measure (Target) of ' a of total T %expected to Actual Target Actual of total Actual%of Persons ctwere (Universal) accomplishmesofcpersons hed (Universal) persons to (Measuresare(fxhexpected to personswed to thismeasureaccos mplished person achieve achieve this in the eSnaps(Exhibit accomplishureenap c expected sh (eSnaps Report d in this measureHMIS the HUD measure(Budges accomplish this Budget Reported in Reported in HMIS Re HMIS in application Budget Exhibit 2) measure (eSnaps Exhibit 2) HMIS Exhibit 6 A-C) I Budget Exhibit 2) 1 Persons exiting to0 20 q$% permanent housing 11 16 69 /o 19 J (subsidized or unsubsidized)during the operating year. � ' Housing Stability. Measure Reported in HMIS T Q36 - — Total Income Measure Reported in HMIS 1 Q36 Earned Income Measure Reported in HMIS Q36 I _, Other—Specify Reported in HMIS J Q37:Additional Performance Measures (Target)#of #of total %expected to Actual Target Actual #of Actual%owl Performance Measuretotal ersons to Persons who (Universal) accomplishmeasurethis #ofpersons (Universal) achieve this (Measures arefound2i0n were accomplishpisd personsexpected to are whoperson to the the HUD (ppMblton thisto measure c om lish this (eSnaps ibis2)Budget thacis measure measure HUD at 6 A-C)C)ion (eSnaps BudgetBe pea ure (eSnaps Exhibit 2) thismeasure achieve measurereis Reported in Reported In Exhibi[6 � (es Ex Exhibit 2) Budget hHMIS Reported in £xhibi[2) Budget Exhibit 2) I— HMIS 7- 'Utilization Rate or Vacancy Report Other Q40: Significant Program Accomplishments Describe in a brief narrative form(no more than 2,000 characters)all significant accomplishments achieved by your project during the reporting period: Q42:Additional Comments Describe in a brief narrative form(no more than 2,000 characters)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" FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) CoC Monitoring Guidelines Internal Wellness Checklist & Internal Wellness "Top Ten" List ATTACHMENT G"Internal Wellness Checklists" Internal Wellness Checklist for the Continuum of Care (CoC) Program The Internal Wellness Checklist was developed in an effort to assist homeless providers to proactively implement its FY CoC grant(s),thereby ensuring compliance with applicable regulations codified at 24 CFR Part 578. It is also designed to assist with determining the current"health"status of this CoC grant. Grant recipients are strongly encouraged to utilize this checklist prior to submitting the required APR to the U. S.Depth anent of Housing and Urban Development. Recipient Name: Project Name: _ _Grant Term: I or 2 Yrs. Grant Number: Grant Amt: Expiration Date: Date APR is Due to HUD: _ Date APR Submitted: (Not more than 90 days after the end of each CoC grant's performance period) General Recordkeepinv I. Executed Grant Agreement 24 CFR 578.23(c) 2. Documentation of Grant Amendment(request and approval, if applicable) 24 CFR 578.105 3. Executed Grant Agreements with Subrecipients 24 CFR 578.23(c)(ii) _4. Documentation subrecipients are not debaned 24 CFR 578.23(c)(4)(v) 5. Documentation of annual monitorin g of Subrecipients li 24 CFR 578.23(c)(8) 6. Executed Memorandum of Understanding with Service Providers 24 CFR 578.73(c)(3) Project Application should he maintained- ensure costs charged against the grant are consistent with the approved budget items identified in the application 24 CFR 578.59(a) 8-Documentation that Annual Performance Report was submitted timely 24 CFR 578.103(e) 9. Written CoC Program Policies and Procedures to include: 24 CFR 578.103(a) Intake/screening procedures 24 CFR 578.103(a)(3)and(4) Internal Wellness Checklist Page 2 Grant A: Personnel Policies and Procedures 2 CFR 200.303,and 24 CFR 578.103(a) Termination Policy 24 CFR 578.91 Grievance Policy 24 CFR 578.91 _Policy Privacy/Confidentiality Policy 24 CFR 578.103(b) Drug-Free Workforce Policy 24 CFR 5.105(d),24 CFR 2424,24 CFR 225 Policy identifying the involvement of homeless/formerly homeless individuals 24 CFR 578.23(c)(3) _ _Domestic Violence Policy 24 CFR 578.23(c)(4)(i)(ii),24 CFR 578.103(a)(17) Housing First Policy, if applicable HUD CPD Notice 14-02 10. Documentation of participation of homeless/formerly homeless individuals in policymaking 24 CFR 578.75(g)(1) 11.Documentation of compliance with environmental review requirements 24 CFR 578.99,24 CFR 578.31 12. Documentation of compliance with fair housing requirements 24 CFR 578.87(b),24 CFR 578.103(a)(14) and (17),24 CFR 578.93(c)(1) 13. Documentation of other federal requirements (i.e.lead based paint, Section 3, Section 504), if applicable 24 CFR 578.99,24 CFR 35,24 CFR 578.99(b) Financial Files 1. Written Financial Policies 2 CFR 200.302,24 CFR 578.23(c)(5),24 CFR 578.103(a) 2.Written Procurement Procedures 2 CFR 200.318 and 2 CFR 200.319 _3.Written Conflicts of Interest Policy 2 CFR 200.317 and 2 CFR 200.318,24 CFR 578.95(a) 4. Documentation of match(25%of total Grant Amount less leasing) 24 CFR 578.73(a) 5.Documentation of Grant Expenditures(during grant term and for approved items in application) 24 CFR 578.37,24 CFR 578.103 6. Documentation of Indirect Cost Rate Proposal,if applicable 24 CFR 578.63(b),24 CFR 578.103(a)(17) Internal Wellness Checklist Page 3 Grant 4: 7-Documentation showing compliance with the Single Audit Act 24 CFR 578.99(g),2 CFR 200 subpart F _8. Documentation showing quarterly draw requests 24 CFR 578.85(c)(3) 9. Documentation showing program income was expended prior to HUD draw requests, if applicable 24 CFR 578.97(6) Participant Program Files _ 1.Documentation participants are entered into HIVES or a comparable database • 24 CFR 578.103(a)(3) • 2. Documentation participant was screened via centralized or coordinated assessment systems 24 CFR 578.23(c)(9) 3. Documentation of Homelessness at intake 24 CFR 578.103(a)(3) 4. Permanent Supportive Housing-Documentation of disability 24 CFR 578.37(a)(i) 5. Transitional Housing- No more than 24 months of services provided except under documented - extenuating circumstances 24 CFR 578.79 6. Documentation of ongoing assessment of services 24 CFR 578.75(e) 7.Documentation of examination of income(initial and recertification) 24 CFR 578.103(a)(7)(i) 8. Documentation of initial and follow-up Housing Quality Standards inspections 24 CFR 578.75(6)(2) 9.Leasing-Documentation that the unit/structure is not owned by recipient or subrecipient 24 CFR 578.49(a) 10.Leasing-Documentation lease is between agency and landlord 24 CFR 578.49(6)(5) 11. Leasing-ls there an occupancy agreement,lease or sublease in the file(for individual units)? 24 CFR 578.103(a)(17) • 12.Leasing-Documentation of rent reasonableness for the period of approval for an assisted unit 24 CFR 578.49(6)(1) 13. Rents charged(including utilities) do not exceed HUD-Fair Market Rents 24 CFR 578.49(6)(2) 14. Documentation supporting the correedcurrent utility allowance schedule is used 24 CFR 578.103(a)(17),24 CFR 578.49(a)(3) • Internal Wellness Checklist Page 1 Grant 4: 15.Leasing-Documentation of occupancy charges with annual income calculations 24 CFR 578.77,24 CFR 578.99(b)(6) 16. Rental-Documentation the participant has a an executed lease agreement with the landlord 24 CFR 578.77,24 CFR 578.51(d)(e) 17.Rental-Documentation of rent reasonableness for the period of approval for an assisted unit 24 CFR 578.51(g) NOTE: For additional guidance,please refer to the following resource materials: (1)Homeless Emergency Assistance and Rapid Transition to Housing: Continuum of Care Program CoC regulations at 24 CFR Part 578, and • (2)Monitoring handbook 6509.2 REV-6 CHG-2 that can be accessed at: http://portal.hud.gov/hudportal/HUD?src=/program offices/ad ministration/hudclips/handbooks/cpd/6509.2. Completed by: Signature: _. .. Date: Typed/Printed Name:_ Title: This document is to be maintained in the applicable CoC project file. MIAMI-DADE COUNTY Attachment G"CoC Program Guidelines' Page 1 of 14 Miami-Dade County Homeless Trust CoC Program Guidelines • MIAMI COUNTY Miami-Dade County Homeless Trust Monitoring Team Information Staff: Date of Visit: CoC Program Subrecipient Agency and Program Information Subrecipient: Program Name: Subrecipient staff consulted: Grant Amount: Grant Number: Program Type: O PSH L] RRH O TH O SH O S50 LJ Legacy SPC O RRH Number to be served: Number of chronic beds/units: Program serves: EI Individuals O Families O Both CoC Program grant funds are used for: O Leasing(no match required) O Rental Assistance O Operations O Supportive Services LJ HMIS O Administration Is the Subrecipient a faith-based organization? O Yes O No CoC Matching funds (25%) required are: O Cash/Cash Equivalent O In Kind O N/A Is there an active restrictive covenant on one or more of the project's properties?O Yes O No Attachment G"CoC Program Guidelines" Page 2 of 14 PART 1: PROGRAM MONITORING: • SUBRECIPIENT OPERATIONS: POLICIES AND PROCEDURES: Conflict of Interest 1.There are written standards of conduct governing O yes the performance of covered persons engaged in the O No award and administration of contracts.24 CFR§ 57B.95(a);24 CFR§573.103(a)(117) 7 2.The Subrecipient has a general conflict-of-interest O Yes policy for staff and Board members 24 CFR§ O No 578.95(c);24 CFR§578.103(a)(11) 3.If the Subrecipient is an approved exception to the O Yes conflict of interest policy,the agency has documented i 0 N the exception 24 CFR§578.103(a)(11J - - � LInvolvement of homeless persons — 11.There is at least one homeless/formerly homeless El Yes person is on the Board of Directors or equivalent [3 No olic making entity.24 CFR§578.75(g)(1) --I 2.The Subrecipient involves homeless individuals O Yes and families through employment volunteer I C No services;or otherwise;in constructing rehabilitation, maintaining,and operating the project,and in providing supportive services for the project 24 CFR : §578.75(g)(2) I - Confidentiality '. 1.The Subrecipient has written policies to ensure: iii Yes ' • Records containing protected identifying O No 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 responsible for operating the project;and • The location of any housing of any program participant will not be made public,except as provided in a preexisting privacy and as provided by law. 24 CFR§578T 03(b) (These policies are in addition • to IHMIS related confidentiality/security requirements) - _1 - - — -- Fair Housing and Equal Opportunity 1.The Subrecipient has written nondiscrimination 1 O Yes and equal opportunity policies that apply to housing O No and em loyment.24 CFR§578.93 ' 2.The Subrecipient has policies and procedures for O Yes providing reasonable accommodations and O No i reasonable modifications for persons with disabilities, 24 CFR§ 100.204(a),28 CFR§ 35.130[b)(7) -- Attachment G"CoC Program Guidelines" Page 3 of 14 3.The Subrecipient maintains copies of marketing, O Yes outreach,and other materials used to inform eligible O No persons of the program and these materials show that the agency markets theirhousing and supportive services to those least likely to apply in the absence of special outreach.24 CFR §578.93(c)(1) 4.The Subrecipient has policies and procedures in O Yes place to provide meaningful access for Spanish- Li No speaking and other limited English Proficiency persons to access the Subrecipient's programs and services.72 federal regulation 2732 5.The Subrecipient provides program participants O Yes with information on rights and remedies available O No under applicable federal,State and local fair housing and civil rights laws.24 CFR§578.93(c)(3) `— Drug-Free Workplace 1.The Subrecipient has a drug-free workplace policy O Yes statement which includes the requirement of 0N notification to HUD if an employee is convicted for a criminal drug offense.24 CFR§84.13 POLICIES AND PROCEDURES FOR COC GRANT-FUNDED PROGRAM Number Served 1.The Subrecipient serves at least as many program O Yes participants as show in its application for assistance. O No 24 CPR§578.51(h)(3) Termination Process 1.The Subrecipient has a written policy for O Yes termination of participation for violation of program O No policies or occupancy agreements.24 CER§ 578.91(b) Services Related to Housing Stability I.The Subrecipient has a written policy for O Yes termination of participation for violation of program O No policies or occupancy agreements.24 CFR§ 578.91(b) Residential Supervision 1.The Subrecipient provides adequate residential O Yes supervision.24 CFR§578.75(£) O No Program Fees 1.The Subrecipient does not charge participants O Yes program fees.24 CFR§578.87(d)Program fees are ' O No I not the same as rent or occupancy rent;program amici ants may be charged rent for housing) J Attachment G"CoC Program Guidelines" Page 4 of 14 Recordkeeping --_ 1.The Subrecipient has systems in place to ensure C Yes that records related to CoC-funded programs are IT No maintained for a 5-year period.24 CFR§578.103 REVIEW OF COG PROGRAM PARTICIPANT FILES ] Eligibility:Homelessness 1.Each participant file contains verification of I C Yes homelessness status at the time of program entry.24 C No CFR§578.103(a)13) 24 CFR§ 576.500[b] 2.The Subrecipient has written policies and C Yes procedures for documenting homelessness. Intake I cu, No staff document eligibility at intake;documentation is required for all persons seeking assistance;written policies state the evidence that may be relied upon to i establish and verify homeless status. The Subrecipient makes efforts to establish and 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. Eligibility: Disability _ _1,If the program provides PSH,each participant file I C Yes 11 contains verification of participants disability.24 E No I I CFR§578.37(a)(1)(i) 1]Verification from a professional who is licensed to diagnose and treat condition OR 2] Disability verified by the Social Security Administration(VA disability check,or an I SSDIcheck) Eligibility: Chronic homelessness • 1.If the program has units dedicated to persons who ' E. Yes are chronically homeless,participant files contain f_`No verification of chronic homelessness. Service Assessment 1.The file contains participant assessments and C Yes service plans,updated at least annually.24 CFR§ C No 'L578.53(a) Services Provided and Costs 1.The file contains documentation of services I ❑Yes I provided and the agency tracks the amounts spent on U No those services.24 CFR§ 578.103(a)(9) Duration of Services P1.The file reflects that supportive services are made C Yes available throughout resident's entire time in the [] No ro�ject24 CFR§578.53(b) 2.Rapid rehousing:The file reflects that program [71 Yes participant meets with case manager not less than -]No , once per month.24 CFR§578.53(b)(4) Attachment G "CoC Program Guidelines" Page 5 of 14 Participants Terminated from Program 1.If a participant has been terminated from the D Yes program,file includes documentation that the LJ No Subrecipient followed its written procedure for termination of assistance.24 CFR§ 578.103(a)(7)(ii); 24 CFR§578.91 . RENTAL ASSISTANCE OR LEASING(complete this section if the Subrecipient pays rental assistance or leasing costs for a unit that the program participant lives in) Rental A_ eement Lease 1.The program participant has an occupancy Li Yes agreement or lease with the Recipient/Subrecipient D 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 Sub recipient and the Landlord,sub-Lease between participant and Subrecipient 2.For project-based,sponsor-based,or tenant-based U Yes permanent housing(PH) rental assistance;initial D No lease must be at least one year,terminable for cause. The leases must be automatically renewable upon expiration for terms that are a minimum of one month long,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 must be L.Yes at least one month. The lease must be automatically ❑ND renewable upon expiration,except on prior notice by either party,up to a maximum term of 24 months. 24 [CFR§578.51(1)(2) - Habitability 1.File includes documentation that units passed ' D Yes housing quality standards inspection prior to initial D No client move-in.24 CFR§578.75(b);and 24 CFR§578.103(a)(8) 2.File includes documentation that unit has passed D Yes annual housing quality standards inspections, Li No including an inspection within the last 12 months.24 CFR§578.75(b) - - - - 3.Dwelling unit is correct size:The dwelling unit D Yes must have at least one bedroom or living/sleeping 0N 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) - -- —' 4.For supportive housing for persons with D Yes disabilities; the Subrecipient must make available D No meal preparation facilities for residents or provide meals 24 CFR§ 578.75(d) Attachment G"CoC Program Guidelines" Page 6 of 14 - r Unit RentsF. Documentation that rents are reasonable in C Yes relation to rents charged in the same geographic area C No for comparable space 24 CFR§578.49(b) _ 2.Rents do not exceed the HUD-determined Fair O Yes Market Rents(FMRs). This documentation must 0 N include chart show current years FMRs. 24 CFR§578.49(11)[4) 3.Security deposit does not exceed two months'rent; ' C Yes in addition to the security deposit the Subrecipient O No may also pay the final months'rent in advance 24 CFR§ 578.49(b)(4) Annual Income 1.The file contains an income evaluation form C Yes completed by program participant and source O No document verifying income and assets(or,if source documentation not available,3i1 party verification; I or if 3rd party verification not available,written certification by program participant 24 CFR§578.103(a)[6) _ 2.The file contains documents demonstrating that O Yes income is re-examined annually. C No 24 CFR§578.77(c)[2) Rent Calculation 1. file contains the annual rent calculation,and C Yes the calculation is accurate.BEST PRACTICE:The file No contains a printout of the HUD rent calculation 24 CFR§578.103 _ -1 2.1s the participant charged rent(unless$0 income) C Yes and is the rent treated as program income? C No hrequired) _ 3.Is rent calculated initially,annually,and when C Yes 1(there is any change in income? No 4.is there documentation of compliance of an eligible E yes "utility allowance"The Subrecipient has received a CNo I copy of the Tenants paid utility bill for compliance. _ I Vacancies -i 1.The Subrecipient does not pay rent for more than 0 Yes 30 days for any unit that has been vacated. Rent may 0 N not be paid on the vacated unit again until there is a new occupant (NOTE:Brief periods of stays in i institutions,not to exceed 90 days for each occurrence are not considered vacancies). 24 CFR§578.51(9] Attachment G"CoC Program Guidelines" Page 7 of 14 LEASING (complete this section if the Subrecipient leases buildings 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 housing units) 1.Documentation that rents are reasonable in O Yes relation to rents charged in the same geographic area O No for comparable space.24 CFR§578.49(b) 2.Rents do not exceed rents charged for comparable O Yes units rented by the Subrecipient.24 CFR§578.49(h) O No _ 3.Security deposit does not exceed two months'rent; O Yes in addition to the security deposit,the Subrecipient O No may also pay the final months'rent in advance. 24 CFR§578.49(6)14) 4.The Subrecipient must have an occupancy O Yes agreement,and if applicable a sublease. O No S.Is rent calculated initially and when the tenant O Yes requests? O No 6.Is the participant charged rent?(not required) OYes O No 7.Has an occupancy charge been imposed? (not O Yes required) If so,the charge cannot exceed the highest O No of 1) 30%of the households monthly adjusted income;2) 10%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) 8.Leasing funds are not used to lease units or O Yes structures owned by the Recipient,Subrecipient, O No their parent organization(s) or organizations that are members of a partnership where the pal mership owns the structure. (Doesn't apply to rental assistance). J REQUIRED POLICIES AND PROCEDURES FOR SPECIFIC PROGRAMS/ CIRCUMSTANCES Participant Household Policies(complete this section for any program that serves families with children) 1.The age and gender of a child under age 18 must O Yes -T not be used as a basis for denying any participant O No household's admission to a project that receives funds under this part Faith-based Activities(complete this section if the Subrecipient is a faith-based organization) 1.The Subrecipient serves all potential participants ' O Yes without regard to religious belief,refusal to hold a O No religious belief,or refusal to attend or participate in religious services.24 CFR§578.87(b)(1) 1 2.If the Subrecipient provides explicitly religious O Yes activities[including worship,religious instruction,or j7 No proselytizing),these activities are separate from HUD-funded activities and beneficiaries of HUD- funded activities are not required to participate. - — Attachment G"CoC Program Guidelines" Page 8 of 14 24 CFR§578.87(b)(2) 1 � H- _Projects involvingacquisition new construction,and rehabilitation 1.Records for acquisition,new construction,and O Yes rehabilitation must be retained for 15 years 0N 11 following the date the project is first occupied,or used,by program participants.24 CFR§ ' 578.103(c)(2) _ I — 2.If the project resulted in dislocation of any ' O Yes persons,the Subrecipient complied with the O No obligations of the Uniform Relocation Act?.24 CFR§ 578.83 _I 3.For projects including new construction or 1 El Yes 1 rehabilitation,do the Recipient's records show that O No ' Section 3 reports have been completed and submitted timely? 24 CFR§578.99(i) Transitional Housin ' i.Participants do not regularly exceed 24 months in OYes � the program.24 CFR§578.79 O No '. 2.When a participant is in the program for longer O Yes than 24 months,the file documents the need for O No extended participation.24 CFR§578.79 3.If participants stay longer than 24 months,is the O Yes number of participants with longer stays less than O No 50%of the total number served by the project? 24 CFR§578.79 Transfer Due to Domestic ViolenceH 1.If a program participant receiving tenant-based O Yes rental assistance has moved to a different CoC due to O No threat of imminent harm,the file must contain documentation of the domestic violence and imminent threat - "—� PART 2: FISCAL MONITORING INTERNAL REVIEW Audit .- 1.Is the Subrecipient subject to the OMB A-133 1 O yes single audit requirement?(Required if$5000,000 or i [j No more in aggregate Federal funds expended) 1 r 2.If subject to A-133 audit,has the Subrecipient . OYes provided its most recent audit and management O No letter? - - - - 3.If not bound by A-133 requirement has the agency O Yes provided financial statements audited by a CPA? i O No Board of Directors 1.Has the Subrecipient provided Miami-Dade County OYes a list of the members of its Board of Directors? 0N I Authorized Check Signers -! 1.Has the Subrecipient provided Miami-Dade County O Yes 1 with a list of authorized check signers? O No - _ - Attachment G"CoC Program Guidelines' Page 9 of 14 Invoicing 1.The Subrecipient submits invoices on a monthly O Yes basis(on time or within time)? O No Procurement — 1.The Subrecipient has a written procurement policy O Yes that meets the requirements of Miami-Dade County ❑ No competitive procurement standards. 2.The Subrecipient retains copies of all procurement O Yes contracts and documentation of compliance with O No federal procurement requirements 24 CFR§578.103(a)(16)(iii) Match 1.The Subrecipient has documentation of the source I O Yes and use of contributions made to satisfy the 25% O 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 how the value placed on 3r1 party in kind contributions was derived. Costs incurred by a partnering organization to provide"in land" 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 an eligible in kind contribution used as match for another grant is not an eligible match. 24 CFR§ 578.73,24 CFR§578.103(a)(10),24 CFR§84.23 and 24 CFR§578.23(±)(6) 2.Match must be spent on eligible project costs (in ❑Yes the budget) O No 3.Where match is documented by MOO,the MOU O Yes must;establish the unconditional commitment O No identify the service to be provided;identify the profession of the persons providing the service;and identi the cost of the service to be provided _ Internal Controls _1.The Subrecipient has written job descriptions for O Yes all HUD-funded positions O No 2.The Suhrecipient has written fiscal policies and O Yes procedures specifying approval authority for all O No financial transactions and guidelines for controlling expenditures 3.The Subrecipient has written procedures for ❑Yes recording financial transactions,and an accounting Li No manual and chart of accounts _Program Income — 1.Is all program income spent on eligible costs? Rent O Yes and Occupancy charges are considered program O No income as is any utility allowances in rental aro: ams 2.Is program income part of your match? Program O Yes income is not an eligible source of match. No Attachment G"Cot Program Guidelines" Page 10 of 14 Indirect Costs 11.Does the organization use grant funds for indirect 0 Yes I costs? 0 No • 2.Are the costs consistent with OMB Super Circulars0 Yes as applicable I 0 No L_ _ 1kDOCUMENTATION REVIEW Salary Documentation ' 1. Original timesheets-signed;grant duties ' D Yes identified,if split time(copy in reimbursement i 0N acka el • 2.Payroll sheets ' D Yes 00. No [ 3.Cancelled checks to the employee G Yes I 0 No 4.If time is divided between the CoC Programs and ' C]Yes another funding source,review time distribution 0 No records supporting the allocation of charges among ' the sources. Staff time breakdown allocation chart - .- Space /Utilities Documentation/Leases I.Rental or lease agreement-signed by participant; I []Yes valid lease period;correct rental amount El No _ 2.Original invoices [Ti Yes ❑No 3.Cancelled checks to the landlord/mortgagee; [Ti Yes utility company,etc. Ij G No _ —_I I-4.Unit inspection report(s); no longer than 1 year old [l Yes LT No j 5.Verification of what payment was used for(e.g 0 Yes first month's rent,security deposit,etc.) ❑ No Supplies __I Purchase orders 0 Yes E1 No 2.Requisitions O Yes ` LCNo _ 3.Cancelled checks El Yes CNo �r4.Determine where supplies are being kept [Ti Yes ONo 5.Determine what cost objective is being used [Ti Yes 1 INo • Review Inventory list-any equipment shall be _l Yes labeled as property of Miami-Dade County through i O No • its Homeless Trust _ _ _I_ Attachment G "CoC Program Guidelines" Page 11 of 14 INTERNAL CONTROLS 1.Internal control questionnaire U Yes U No 2 Review organizational chart L,Yes D No 3.Review job descriptions/definitions of employees' iii)Yes duties D No 4.Review Subrecipient's system of authorization and U Yes supervision LI No J. 5.Ensure that there is a separation of duties U Yes (authorizing,recording and custody should be U No separate) Yes 6.Review control over assets D No EVALUATION OF SELECTED TRANSACTIONS Is the expenditure allowable a.Is the expenditure necessary,reasonable and D Yes directly related to the grant? LB No —— b.Is the expenditure authorized by the grant? I D Yes j O No L Source documentation evaluation a.Were the expenditures incurred during the term of D Yes the rant? D No b.Was the money actually paid out? D Yes 0 N I c.Were the expenditures approved by the 102 Yes ' responsible Subrecipient officials U No d.Is there adequate documentation to support the 10 Yes Iexpenditures? D No Does the Subrecipient maintain the appropriate records? Does the Subrecipient maintain the followin ? -- —� a.Chart of accounts 1 DYes D No b.Cash receipts journal DYes I D No c.Cash disbursements journal I D Yes U No d.Payroll journal D Yes D No e.General ledger D Yes L - -- (i No -- _ 1.Does the Subrecipient maintain documentation DYes concerning its sources of funding U No Attachment G"CoC Program Guidelines" Page 12 of 14 PART 3: HMIS MONITORING HMIS HOMELESS MANAGEMENT INFORMATION SYSTEMS HMIS Operations:Policy and Procedures [ 1.The Subrecipient has signed an HMIS Participation U Yes 1 AgreementtousetheHMISlicense HI No 2.Are the Subrecipient's HMIS Administers O Yes registered and approved to enter the data into the 5 No HMIS system LL 3.The Subrecipient has designated an HMIS site G Yes Administrator(s),who is the Point of Contact for O No Miami-Dade County through its Homeless Trust as HMIS Lead Agency. _ 4.the Subrecipient has ensured that each HMIS user U Yes within its Organization has signed a user agreement LI No stating U understanding of user rules,protocols and confidentiality. —_ Privacy — 1 1.The Subreclpien[has aData Co11eC,ion/Privacy I H Yes Notice posted in English and Spanish at each intake Ui No I location - 2.The Subrecipient has a written Privacy Policy or U Yes Loses the CoC's written Privacy Policy O No — 3.If the Subrecipient has a web site,the Privacy 1 C Yes Policy is posted to the web site. I U No _ � 4.The Subrecipient has a signed authorization for • (i Yes release of information form that it uses for any client 1 CNo for which the Subrecipient uses HMIS for data — H I sharing _ — 5.The Subrecipient ensures that all signed forms are U Yes locked in a designated location with limited access to • 0 No ( staff _ 6.The Subrecipient has executed the Agency Sharing I ID Yes Data Agreement,if applicable(MOOD) ! 0 No — riT-The Subrecipient has a written client complaint 1 O Yes • policy 1 Li No He.The Subrecipient has established a process of U Yes tracking all filed complaints and can provide copies G No of complaints and resolutions to the HMIS Lead Agency if requested. — L _ Security � I.The Subrecipient maintains a list of active HMIS 5 Yes T users — U No 2.The Subrecipient regularly contacts the HMIS Lead U Yes when an employee leaves the Organization,in order Li No to make sure that the person's HMIS account is disabled 33.Are the Subrecipient's HMIS workstations located LT Yes 1 in secure locations or,if not,are the workstations O No , manned at all times? I_ 4.Has the Subrecipient identified a person who will O Yes F Lerve as the Organization's HMIS security o=ficer? I - Attachment G"CoC Program Guidelines" Page 13 of 14 C•No 5.Has the HMIS security officer completed an HMIS O Yes security self-certification within the last 12 months? No 6.Does the Subrecipient have in place policies and O Yes procedures to protect hard copies(paper)with O No lersonal identifying information? Data Quality - At a minimum the Subrecipient collects the Universal O Yes Data Elements for every client entered and minimum O No data suality standards are met. The Subrecipient enters Client Basic Demographic O Yes Data into the HMIS system at a minimum within one IJ No week of intake The Subrecipient staff review monthly reports O Yes received from HMIS Program Administrator and .0 No addresses any issues noted. • Attachment G"CoC Program Guidelines" Page 14 of 14 FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program "Incident Report" ATTACHMENT H"2017 Incident Report" MIAMI �dw 64vdlma[^T Dq INCIDENT REPORT IDENTIFYING INFORMATION Reporting Party Phone# Date of Incident _ Time of Incident_amdpm Reporting Party Name Contract Provider Name Program Name Provider Location - - - Specific Program:(check at]that apply) ❑Miami-Dade County ❑Primary Care ❑CoC Program ❑ Emergency U Challenge❑ Other Specific location/address where incident occurred: TYPE OF INCIDENT 0 ALTERCATION ❑CLIENT DEATH ❑ CLIENT INJURY OR ILLNESS 0 THEFT 0 SEXUAL BATTERY ❑SUICIDE ATTEMPT 0 PROPERTY DAMAGE 0 OTHER LvCIDEd'T Specify — • PARTICIPANT(S) /WITNESS (ES) (Please mark W of P for either Witness or Participant) LAST NAME,IIRST IDENTIFIER# CLIENT EMPLOYEE OTHER W!P 0 ❑ -- ❑ ❑ ❑ -- ❑ ❑ DESCRIPTION OF INCIDENT Give detailed account-who,what,where,when,why,how—add pages if necessary ATTACHMENT H "MDC-HT Incident Report Form" Page 1 of 2 MIMIC MIAjIY .1.y£mL.m rrq'Ag CORRECTIVE ACTION AM)FOLLOW UP Immediate corrective action taken Is follow up action needed? ❑ Yes ❑ No If yes, specify INDIVIDUALS NOTIFIED *Abuse Registry 1-800-962-2873 *Applicable Law Enforcement Department Indicate person contacted,if report was accepted,the date and the time,and if by telephone or if copy of report available. Incident Reports—The Subrecipient must report to Miami-Dade County Homeless Trust information related to env critical incidents occurring during the administration term of its programs. In addition to reporting this incident to the appropriate authorities the Subrecipient must within twenty-four(24)hours of any incident,submit in writing a detailed account of-the incident This incident report should be addressed to the Contract Officer or Administrative Officer assigned. This incident report should be addressed to Miami-Dade County Homeless Trust, 111 NW First Street,271h Floor,Suite 310,Miami,Florida 33128;telephone(305)375-1490 and facsmilie(305)375-2722. Definitions of Reportable Incidents a Altercation. A physical confrontation occurring between a client and employee or two or more clients at the time services are being rendered,or when a client is in the physical custody of the department,which results in one or more clients or employees receiving medical treatment by a licensed health care professional. b. Client Death. A person whose life terminates due to or allegedly due to an accident,act of abuse,neglect or other incident occurring while in the presence of an employee,in Homeless Tmstcontracted program facility. c. Client Injury or Illness. A medical condition of a client requiring medical treatment by a a r liicensednsed health care are professional sustained or allegedly sustained due to an accident,act of abuse,neglect while in the presence of an etnployee,in aHomeless 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, riot, 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 an employee as evidenced by medical evidence or law enforcement involvement. Jr Suicide Attempt. An act which clearly reflects the physical attempt by a client to cause his or her owh cd results in n death while in the physical custody of the department or a departmental contracted or certified provider, bodily injury requiring medical treatment by a licensed health care professional. g. p .ry d aRe—an incident involving damage to any property procured with Miami-Dade County Homeless Trust funding Print Name of Person Submitting Report Date Signature ATTACHMENT H "MDC-HT Incident Report Form" Page 2 of 2 FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program "Real Property and Equipment Asset Inventory Report" ATTACHMENT I"2017 Real Property and Equipment Asset Report" miAM D cou r-A^--e"7.15, Real Property and Equipment Asset Inventory Equipment with an acquisition cost of greater than$5,000.00 per unit and all real property mustbe inventoried. Real property includes land,land improvements,structures and appurtenances, moveable machinery and equipment. Property and Property Improvement Record: r Legal description Size: Date of Acquisition: Value at time of purchase: Ovmer's name[if different than the Subrecipient): Map: (attach map)indicate where property is in parcels,lots or blocks and show adjacent streets and roads Equipment 1: Description of Property: Serial/ID Number: Acquisition Date: Cost: Vendor Name: Ws of Purchase Cost from Grant: I Location of Property: Use and Condition of Property: Who Holds Title? Equipment 2: 7 Description of Property: Serial/ID Number: Acquisition Date: ICost: I Vendor Name: of Purchase Cost from Grant: Location of Property: Use and Condition of Property: Who Holds Title? _Equipment 3: I Description of Property: Serial/1D 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 Equipment Asset Inventory" FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) When the Subrecipient is the Housing Administrator (Leasing or Rental Assistance) ATTACHMENT J"2017 Rental Assistance Forms" FY 2017 Miami-Dade County Homeless Trust Continuum of Care (CoC) When Miami-Dade County is the Rental Administrator ATTACHMENT K 2017 Rental Assistance Forms'