Loading...
US HUD Continuum of Cara Program MIAMFDADE COUNTY FY 2018 United States Department of Housing and:Urban Development (US HUD) Continuum of Care (Co C) 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 #: FLO177L4D001811 { INDEX Cover page---page 1 Index---page 2 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 . L .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#FL0177L4D,001811,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. FY2018 US HUD COC Program Grant#FLO17714D.001811. The City of Miami.Beach Outr-eacirPrograni. THIS AGREEMENT,entered t s. day-of ,201 ,byand'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 McKinnney Vento Homeless Assistance Programs,. Supportive Housing Program (SHP), Shelter Plus Care ,(S-1C) 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 far and received funds from the United States Department of Housing and Urban Development(US HHD)under theMcKinney.Vento Homeless Assistance-Act as amended.by The HEARTH Act-0200%M if.S.C.11301,;etseq). 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 makei 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 Workfor FY 2018 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 withall applicablefederal,state and local Iaws,,regulations and ordinances,including but not limited to 24 CFR Part 578,as may, be amended, the McKinney-Vento Homeless Assistance Act.(42'USC: 11301 et seq.) (the "Act"),as may be amended,the.Consolidated and Further ContinuingAppropriations Acts of 2013 and 2014(The Consolidated Appropriations;Act of 2014,Public Law.113-76,approved January 17;2014.in the FY ZG14.FUD.Appropriations Act") aswell 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 an d directives provided by US HUD and with any applicableguidance, requirements and directives provided by Miami-Dade County Homeless Trust The Subrecipient shall carry out theactivities specified in the"Scope of Service and US HUD eSnaps Documents"Attachment B. The-Subrecipient shall also adhere>to the Standards of Housingand Services as setforth in the."Miami-Dade County Homeless Trust Standards of Care", as may be amended from time to time and incorporated herein by reference. The Subrecipient shall adhere to all applicable federal,state and local laws,regulations,rules and standards,as well as with the terms of this.Agreement including all attachments. COC Grant#FL0177L4DOO1811,The City of Miami Beach,The City of Miami Beach Outreach Program Page.3 b. Time Schedule-The Grantee and the Subrecipient agree thatthis Agreement shall become effective on June 1,2019. This Agreement shall expire on May31 2020,one(1)year from the effective date. Any cost incurredby theSubrecipient,beyondthis date will not be paid by the Grantee,except as specifically provide d herein..NotwithstandiriganyproVision 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 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;subjectto the availability of funds and payment of funds to the Grantee by the toted:States-Department of Housing'and Urban Development and subject to the Shbredipient'S compliance with all applicable laws and agreement terms as determined by the Grantee; to:pay for:contracted activities according to the, teems and conditions contained within this Agreement,Subrec:ipietit's application for the CoC Homeless Assistance Program,and the Subrecipients NOFA application documents:as Project Sponsor and of Service and 05 HUD eSnaps documents"including the Budget,incorporated herein as - Attachment B, in an amount iftit to exceed 0.1io for RentalAssistance, $6.0 for Leasing, $60.94 .60 for Supportive Services, $0,06 fpr Operations, $flflfl for HMIS costs and $4266.00 for overall Project Administration Costs which added together equals an amount Of$6500'in'TOTAL.BOGEta If the Grantee,Miami-Dade County through its Public Housing and Community Development Department (PHCD) or such other department or party as May be selected by Miami-Dade County Homeless Trust, is the Rental Administrator; then the Grantee shall pay the "CoC Program HAP Contract"Attachment K payments directly to Landlord,-owner(s). The total amount awarded pursuant to this Agreement,in amount up to.$0 00 for Rental Assistance fUnds..has been allocated for use: as eligible rental assistance payments on behalf of the .. Subredipienes program particiPants. Pursuant to 24 CFR S78.5% the Grantee shall retain. 50% of the Overall Project Admiiiigration Costs,excePt WherelimitatiOnS are imposed as maybe applicable pursuant to:42IISCI.11383(a):. • If aPpliCable, the Siibretipient shall be reimbursed for capital funding on an incremental basis, based on the following completion.benchmarks 30%, 30%, 30% and 10% to be provided when a final Certificate of Occupancy is obtained from the developer,in accordance With any applicable laws and regtilatiOns. All•other activitiesshallbe paid on a reimbursement basis following the submission of a monthly invoice along with the appropriate supporting documentation. : In accordance with federal requirements including 24-CFR Part 578:73, the Subrecipient agrees to. provide match funds in an amount that represents no less than twenty-five percent(25%)cash or in-kind contributions on all eligible grant funds,except leasing If in- . • kind services provided through a third party are used to fulfill part of the match, a fully- executed Memorandum of thicletstindifig1M0U)between the Subrecipient and the third party that will provide the services must be submitted to the'Grantee. Cot Grant#FL0177L4D00.8,11,TheCity of Miarnii.$ach;The City ofSjan0each,Otiii,eadi'POgrairi Page 4 The budget figures above represent the original line item totals as delineated in the "Continuum of Care Program Grant Agreement"Attachment A. The Subrecipient may propose to shift funds by less than 10%between eligible categories in the"Scope of Service and US HUD eSnaps Documents"Attachment B, if the appropriate match is provided, the administrative costs are not increased and the proposed shift is submitted in writing for the Grantee's consideration, The Grantee may,but;is not required to,approve the proposed shift. Any approval must be in.writing As such,if Attachment.B is modified as described above, the figureswithin 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 emergenc lacement services((Su ortive Services Onl (SSO)to three YP PP Y hundred and fifty `(350) homeless individuals and families,, including chronically • homeless:persons under theContinuum of Care Program. The program's main office is located at 1700 Convention Center Drive,`Miami Beach, Florida 33139. Services are located in and provided-in Miami=Dade County, Florida: The Subrecipient shall provide services as outlined in the Attachments to this Agreement as required, pursuant to the FY 2018. 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'ssole discretion. • If this Agreement is for,permanent:supportive housing-or permanent housing for eligible homeless individuals and /or homeless families; the Subrecipient agrees that,:with some exceptions;.no undocumented or illegal immigrants shall'be eligible;for services provided under this Agreement. Additionally,::the Subrecipient shall comply with The Personal' Responsibility_and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), as may be amended and applicable law,in verifying citizenship,residency and immigration status of potential participants. • The Subrecipient shall comply;with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"),, as may be amended .and applicable law,. in :verifying citizenship, residency and immigration status: of potential participants. . The Subrecipient hereby acloowledges: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 CoC Grant#FL0177L4D0018'11,The City-of Miami Beach,The.City of Miami Beach Outreach Program Page 5 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. When the Subrecipient.,is the rental administrator of payments of Housing Assistance Payment:(HAP) Contractsfor the Permanent Housing Tenant-Based, Sponsor-Based or Project Based Rental or Rapid Re-Housing CoC Program. If this Agreement is for permanent supportive housing or permanent housing for homelessparticipants, 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 theHAP. 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.Grantee of 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 onetime. 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 a•rising from any late rent payments)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 rovision 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 II,Parts 200,215, 220, 225, and 230 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as may be amended or:updated from time to time; 24 • CFR Part 578, as may be amended or updated from time to.time, and any:other applicable laws,regulations and standards. Requests for payment shall be submitted to the Grantee by the fifteenth(15th) of the month in the following manner.All requests shall include supporting'documentation for each line item,. ncluding'payroll reports,time sheets,invoices,' leasing agreements andshall be signed by the Executive Director, Financial Officer or other dulyauthorizedfiscal agent of the Subrecipient in the forms incorporated herein as combined:"Consolidated Financial Record and Reports";AttachmentE. CoC.Grant#FL0177L4D001811;The City of Miami:Beach;The City of Miami Beach Outreach Program Page 6 Reimbursement shall be provided only for eligible,costs associated with the activities outlined in the budget contained within the "Scope of Service and US HUD e-Snaps. Documents"Attachment B. Any reimbursement may be ;withheld or reduced by the Grantee if missing receipt of documents verifying the 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 ,I(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. l am aware that any false,fictitious,orfraudulent information or the omission ofany 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 r. of the;schedule_of payments orline item budget However, such revisions, amendments or modifications shall be; in Writing and subject to review and approval:by the.Grantee and,if applicable, by US HUD. If there is a request to shift greater than:10% of funds between funding activities, such requests ;shall be. submitted:to,the Grantee no.later than one hundred fifty:(150)'calendar:days . prior.to theexpiration of the grant If the request is-a • shiftof less than 10% of funds between funding activitiesf a modification or revision,shall be submitted to.the Grantee no laterthan ninety(90) calendar days prior to the expiration of the:grant.::Failure to submit the-appropriate, su ortin documentation in timelymanner supporting 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. &final report of expenditures shall be submitted to the Grantee within thirty(30) calendar daysfrom.the termination or expiration of this Agreement,. If aftertle 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 by 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 befinal and binding. CoC°Grant#FL0177L4D001811,The-City of Miami'Beach,The City of Miami Beach Outreach Program Page 7 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 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 thisAgreement, including but not limited to financial books and records, ledgers, drawings, maps, pamphlets, designs, electronic tapes, computer drives,flash drives and diskettes surveys: The Subrecipient shall maintain Agreement records that document allactions 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. :014B Omni ori Super Circular Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards whichfshall sufficientlyan d properly reflect all revenues arid expenditures of funds provided directly or indirectly by the Granteeursuant 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 hi this Agreement. This includes all subcontractors eligible to carry out, substantive programmaticservices-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 auditand-recordkeeping requirements described in this Agreement These records shall be maintained pursuant to this Agreement. if =the; Subrecipient received funds from: or is. under.'reulato g ry 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; CoG Grant#FLO177L4D00.181:1,The City of Miami Beach,The`Ci of Miami Beach Outreach Pro ram ". Page:8 ii. Upon request from the Grantee's custodian of public records identified herein, provide the Grantee with a copy of the requested records or allow the public with access to the public records on the same terms and conditions that the Grantee would provide the records and at a cost that does not exceed the cost provided in the Florida Public Records Act, Miami-Dade County Administrative Order No. 4-48, or as otherwise provided by law; iii. Ensurethat public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the durationof this Agreement's term andfollowing completionof 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 performanceof 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.' pursuant to law or ordinance or in connection with the transaction of official businessof 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 S ubreCipient's duty to provide public re cords 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: vmalletteRmiamidade gov - d: Encouraging Efficient Use of Information Technology arid 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, COC Grant#FL0177L4D001811;The City of Miami Beach;The City of Miami Beach Outreach Program Page 9 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. 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:FederaI 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(15th) day of the following month. The requests for reimbursement, are:also ;dueby the fifteenth (15th) day following the,close of the prior month. Subrecipients that are Domestic Violence Programs shall partrticipate 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 aHMIS generated"US HUD • " CoC Annual Performance Report(0625-HUD-Cot-APR)"Attachment F,in addition to a complete and accurate report using supplemental "eSnaps CoC APR Financial and Performance Questions" provided by the Grantee Attachment F. The complete and accurate APR is due to the Grantee no later than thirty(30) days after the end of each operating year. The above referenced report maybe substituted for any other US HUD required Report if approved by US HUD and the Miami-DadeCounty'Homeless Trust: iii. A ProgramRating and Satisfaction Survey Report shall be,°: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 aridsurvey,results:must be submitted to the Miami Dade:CountyHomeless 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 theamount 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 CoC Grant#FLO177L4D00181.1,The City of Miami Beach,The-City of Miami Beach Outreach Program Page.10 affect the program participants'eligibility or need for assistance. The Subrecipient shall submit "Re-certification of Participation Application for Housing" Package Attachment K, no later than one hundred-twenty (120) calendar days before the expiration of term of the Lease Agreement and d HAP Contract. The Re-certification application shall include documented evidence"of the programparticipants' continued lack of sufficient'resources and support networksnecessary to retain housing without assistance from the CoC Program. When the Subrecipient is the Rental Administrator:The Subrecipientshall 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' contributiontoward the rental payment must be made as changes in income are identified The Subrecipient is required for each program participant receivingassistance to retain records for the.Grantee's review,changes in the participants' income or other circumstancesthat affect the program participants' eligibility or. need .for, assistance. •-The 'Subrecipient. shall retain records of ."Re- certification of Participation Application,for- Housingr' Package Attachment J, no later than one hundred-twenty (120) calendar days before.the.expiration of term of the Lease Agreement and HAP Contract The Re=certification application shall include documented evidence of the program participants'"continued lack of sufficient resources and support networks necessary. to retain 'housing without assistance from the CoC Program v. Program Income-the income received by the Subrecipient directly generated by a grant- supported activity. Program income earned during the grant term shall be,retainedand 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 bythe Subrecipient. This report must be available upon request during any _ p; 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 submitanaudit conducted in accordance with the provisions of Omni or Super Circular 2 CFR Chapter-I 'and Chapter-II,Parts 200,2.15, 220,'225, and 230 Uniform Administrative Requirements,-Cost Principles, and Audit Requirements for Federal`Awards, as applicable, and with 24 CFR 578.99(g)_ which provides that Subrecipients must comply with the audit requirements of OMB Circular A-133, "Audits.of States, Local Governments, and Non=profit Organizations.". The Subrecipient shall provide such reports no later than one hundred-:eighty (180) calendar days following the end of the Subrecipient's.fiscal year, for each year during which this Agreement remains in force or.until all funds earned from this Agreement have been so audited,whichever is'later, provided that the Subrecipient has such an opinion CoC Grant#FL0177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program - Page 11 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 .programs,using form"Incident Report Attachment H. Thefollowing are identified as critical incidents as defined in CF-0P 215=6(Attachment H): • Child-on-Child Sexual Abuse . • Child Arrest • -.Child Death ;. : . • _Adult Death • Elopement refers to court ordered clients that run away and do not return • Employee Arrest. • Employee Misconduct Escape •.. Missing Child:. • Security Incident .Unintentional .•• Significant Injury to.Clients • . Significant Injury'to.,Staff • Suicide Attempt • Sexual Abuse/Sexual Battery • Other. Any Major event not previously identified as a reportable critical incident but has,or is likely to have,a significant impact on client(s),the Subrecipient,or Grantee; ; .; Such notification shall occur,within twenty-four(24)hoirs.of the incident'occurrin p p g• In addition, the Subrecipient shall re •ort'his incident to:the appropriate ro riate 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 Subrecipientshall submit a Continuity of Operations Plan (COOP),alsoknown 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 Subrecipientis 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. CoC Grant#FLO177L4D0g1811,The City of Miami.Beach,The City of Miami Beach Outreach Program Page:12 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 Subrecipientshall follow the client referral process in the_Scope of Service contained within the"Scope of Service:and US HUD.eSnaps 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' contribution toward rentis.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 7;7 It is important to:note iri 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 inaccepting 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 sof .program-participants accepted from the CoC's established CoordinatedOutreach and Assessment(HMIS) system,which must include at a minimum,:assurances.that such rejections are:justified.and that the program participants are.ableto access another:. suitable program within a:reasonable amount of time: V. The Subrecipient shall establishprotocols, policies and procedures, subject to approval by Miami-Dade-County Hoineless.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 CoC Grant#FL0177L4D001811,The City of Miami Beach,The'City of Miami Beach Outreach Program Page 13 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:reviewof the decision, in which the program participant is given the opportunity to present written.or oral objections before a person otherthan: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 personsmust exercise and examine all extenuating circumstances in determining when violations are serious enough to warrant termination so thatprogram participants' assistance is terminated only:'in the most severe cases.. e. The Subrecipientshallcomplywith the Violence;against Women Reauthorization Act(VAWA) as well as with_24 CFR „ ...S 200as.cnay be amended,-and with all applicable provisions of,24 CFR'Parts 5,92, 2:00; 574,576,578,880, 882,883,884,886,891, 960; 966,982;and 983 and with such administrative rules and .policy guidance,:relating to-VAWA as may:'.exist, be. adopted,or be;amended;from timeto time, as may be applicable: The Subrecipient may be subject to a,Performance Improvement Plan._(PIP) at the discretion of the Grantee g. General Conditions The Subrecipient shall comply with all applicable federal,state and local. laws,regulations and required policies, including but not limited to the Continuum of Care (Co.C)'Program'Final Interim Rule, 24;CFR Part 578, as may be:amended from time.to time, the McKinney-Vento-Homeless Assistance Act, as maybe from time frotime.to time(42 Appropriations 'Acts of 012, 2013, and 2014 the Homeless' Definition .Final Rule, U S:C 11301 et se the "Act" the Consolidated and Further Continuing 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 grant The responsi bility`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 servicesoffered 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). Subrecipientshall designate with its organization an'ADA Coordinator ' to ensure•that Fall 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 furnish the • Grantee,. uponrequest, written verification'of liability protection in accordance with CoC Grant#FL0177L4D001811,ThervCity of Miami:Beach,The Ci of Miami Beach Outreach Program Page'14. • ty Section 768.28,Florida Statutes. The written verification shall be submitted to Miami-Dade County Risk Management,Internal Services Division,located on the 23rd Floor.111 NW 1st Street,Miami,Florida 33128. Nothing herein shall be construed to extend any party's liability beyond that provided in Section 768.28, Florida Statutes. If the Subrecipient is a non-governmental entity said Subrecipient shall maintain required liability insurance coverage as noted below during this contract period. The Subrecipient shall maintain required liability insurance coverage as noted below at all times during this contract period. Public Liability Insurance on a comprehensive_basis in an amount not less than $300,000 combinedsingle 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 Insuranceshall 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'issuedby companies authorized to do business:underthe laws of thestate of.Florida,with the following qualifications: Thecompany 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 sectionor 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 indemnifyand hold harmless the Grantee and its past, present, and future employees and agents from and against any,and all claims, liabilities,:losses, arid 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 shalldefend 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 CoC Grant#FLO177L4D001811,The City of Miami Beach,The City-of Miami Beach Outreach Program Page 15 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 certificationstatement 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 conditionsof 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 far 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 the Subrecipient's discovery of such possible conflict. The.Grantee will then renderan opinionwhich 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 toMiami-Dade County Clerk of the Board and one (1) copy to the Subrecipient 1. Miami-Dade County Ownership Disclosure Affidavit(Section 2.-81 of Miami- DadeCounty Code"County Code"). 2. :.Miami-Dade County Employment Disclosure Affidavit(County Ordinance"90- 133,'Amending Section 2=81;Subsection(d) (2) of:the County Code). 3. Miami-Dade County Affirmative Action J Non-Discrimination of Employment, Promotion and Procurement Practices (County Ordinance 98-30 codified at 2,8.1.5 of the county 4. Miami-Dade County Criminal ,Record':Affidavit (Section 2-8.6of 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 11A29et 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 c) of e County 1( h 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 2-81.2:of the County Code). 12. Attestation regarding due and proper acknowledgement Miami-Dade County funding'support CoC Grant#FL0177L4D00181.1,The City of Miami Beach,The.City of Miami':Beach Outreach Program Page.16 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 submita 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 shove: i) the totalproject 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 bemade:bythe Subrecipient; - • and v) the amount of funds•devoted toward the`provision of the desired. services.or activities." 14 ;Miami=Dade Countycer'tificationnotto 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.....2711:1(S.) of the. County.-Code), `Lobbyist specifically"includes the principal,aswell:a's 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 m intothis•Agreeent •h.- Civil.Rights- The Subrecipie•nt agrees to abide by Chapter 11A Of Code of Miami-Dade. County("County Code"),.as maybe amended,.:in"the exercise of its.police,power for the public : : ,:safetyhealth and general welfare,tr.o:'eliminate and prevent discrimination in employment, family . leave, . .ublic accommodations, •`credit and' financiri racti'ces, and','housing,P . . . ,g P .. ,g accommodations because of race, color, religion, ancestry, national origin, sex; pregnancy, -age,•disability, marital status, :familial status, gender identity, gender expression, sexual ' : orientation,or actual or perceived status as a victim of domestic violence, dativig violence,or- , stalking Itis further hereby declared to be the policy of Miami Dade County. ;eminateand prevent discrimination in housing based on source of income. Initials here 40' - DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24CFR Parts 5, 91, 92,`570, 5:74; 576 and :9 03 Docket No FR=5173F= 04]`RIN 2501 AD33 Affirmatively`Furthering Fair. - •Housing-The FairHousing ( Act title VIII of the Civil Rights Act of 1968,42 U.S.C. 601=3619 ) declares that itis"the policy of the United States to provide;within constitutional;limitations; ' for'fair housing•throughout'.the United States See 42 U S.C;'3.601 Accordingly, the Fair Housing Act prohibits,among other things;discriminatio. he sale,rental,and financing of : • . - dwellings, and in other housing related transactions` .• of"race; color, religion, sex, : . , • ' familial status,national.origin,or handicap".)Initials'lie • `See•42 U.S.C. 3604-and 3605:'Section 808(d) of the Housing Act:requires all executive. .branch departments-and agencies adnin ring housingan d urban development pro rams and activities to,.--administer these pro 1/.1701.;:in a mannerthat=:affirmativey furthers,fair . PP housing See42 U.S.C. 3608 Initialshe �. - - The Subrecipient•agrees to abide and be governed by Title VI and VII;`of the-civil Rights Act - of 1964k42 U.S.C.2000 et.se"q)-and Title.VIII of the civil'Rights Act of 1968,as amended,`and . Cog Grant#FL0177L4D001811,The City of"Miami:Beach;The City:of Miami Beach Outreach Program Page.17 Executive Order 11063, as may be amended, as well aswith 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 performance of this Agreement, in regard to persons served,or in regard to employees or applicants fo employment or housing. It is expressly understood that upon receipt of evidence of suc i rimination,the Grantee shall have the right to terminate this Agreement. Initials here Executive Order 11063 prohibits discrimination: in the 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 andactivities, and.provides that the Secretary of HUD will be responsible for coordinatingthe effort. Executive.Order 12898 requires..nondiscriminationin federal programs that affect human health and the environment as well asprovides 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 po '_ :es andprograms to'determine if any can be revised or modified toimprove:.the avaiih.,�o!lts of:community-based living arrangements for persons with disabilities.' Initials her• �y Awareness of the Joint Letter of clarification dated August 5, 2017 from United States Department of Justice,.United States 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 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 for the protection of life or safety; (ii)-deliver'in kind services at the community level; and (iii) do not condition the provision ofassistance, the amount of assistance, or the`cost of assistance on the individual (participant's) -recipient's incoine or resources, that such programs are not subject to PRWORA's restrictions on immigrant access to • .lic.benefits and must be made available to eligible persons without regard to citizensh;.@onality, or immigration status,`8 U.S.C.Section 1611.(b)(1)(.D), 1621(b)(4).Initials he It is further understood that the Subrecipient mustsubmit affidavits;attesting that itis 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.0 3601 et.seq.), as May beamended,.as well as with any applicable regulations _If the Subrecipient or any owner,subsidiary, or other,firm;affiliated with or related to the Subrecipient is found by the responsible enforcementagency, the Courts or Grantee to be in violation`:;of these Acts, the Grantee shall:.conduct:no further.business with the Subrecipient Any;contract entered into based upon a false affidavit shall be voidable by - the Grantee. If the.Subrecipient violates anyof 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 L.... cipient was not in violation at the time the affidavits) were,submitted. Initials he � CoC Grant#FL0177L4D001811,The City of Miami Beach,The City.of Miami:Beach Outreach Program Page 18 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 may be amended,which requires an employer, who in the regular course of business and has fifty (50) or more employees working in Miami-Dade County for each working day during each of the twenty(20) or more calendar work weeks to provide domestic violence leave to its employees. Failure to comply with this local law May be grounds for voiding or terminating this Agreem: iter for commencement of debarmentproceedings against the Subrecipient.._Initials her ,t�! The Subrecipient agrees to abide and be governed by the.Age Discrimination Act of 1975,(42 6101 et seq.) and implementing:regulations at(24 CFR Part.146), as maybe amended, as well as with any applicable regulations,,which provides in part that there shall .• c 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.Rehabilitatio A ct of 1973, as amended, (29 U.S.C. 794, et seq.) as maybe amended,as well as with any:�. .; -b1e regulations,which prohibits discrimination on the basis of handicap. Initials her 71,09 Subrecipient agrees to abide and be governed by the requirements of the Americans with u +ilityAct (ADA), as maybe amended, as:well as with any applicable law. Initials here Pursuant to.24 CFR 578.23,Subrecipient hereby certifies andagrees that 1'.. Subrecipientwill 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 orlocation 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 applicablestate and local laws that prohibit disclosure of information relating to domestic violence centers;• . iii. Subrecipient willestablish 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.coinmunity includingearly childhood programs such as .Head Start;'Part`C of the individuals with Disabilities Act, and programs authorized.under Subtitle B of Title VII of the McKinney-Vento;Homeless:Assistance :Act'as amended; • v TheSubrecipient shall use the.centralized:or coordinated, assessment system .. established by the Continuum of Care as set forth pursuant to 24 CFR 578.7(a) (8); • vi Subrecipient;its officers,and employees.areriotdebarred or.'suspended from doing business with the federal government; and Subrecipient will provide:information,such as data'and reports,as required by US HUD. CoC Grant#FL0177L4D001811,The Cityof Miami;Beach,The City of Miami Beach Outreach Program Page 19' Additionally,Subrecipient agrees: i. . . .To establish Such fiscal controlsand,accounting procedures as maybe`necessary to assure theproper disbursal of, and accounting for grant funds in order to ensure thatall 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 1-loiiieless Trust's;Standards:'of Care=incorporated herein'by reference, ui , To comply with the provisions of 24 CFR 57823(c) (9} iv. To follow the written standards for providing-:Continuum. of Care assistance developed lythe Continuum of Care,including the minimum requirements set forth in'§ 578 7(a)(9);`and v To operate the projects)in accordance with the provisions of-the McKinney-Vento; Act and all requirements.under Z1.-:CFR part`578 ;and to;comply with such other terms:and-.conditions as:US a-IUD-may establish by.NOFA (Notice' of Funding: Ava Iability) 4 Suspension and:Termination a Suspension The Grantee may,for reasonable cause,temp orarily susp end the operation and • authority to obligatefunds of the Subrecipient,under this Agreement,or withhold payments. : • tothe Subrecipient pending necessary corrective action bythe Subrecipient or both Reasonable cause shall be determined by the Grantee:in its sole and absolute discretion and may include L Ineffective or.improper use:of any funds provided hereunder by the Subrecipient; ii Failure by the Subrecipient to `;.materially comply: m with:any ters,: conditions, r epresentations or.warrant^ies contained herein, iii Failure by the Subrecipient to submit any, documents required by this Agreement;-or iv Incorrect orincomplete document,submittal by the Subrecipient.; b Termination i Termination at Will.=This Ag reement,in whole or m part, nay be terminated:by the Grantee upon.;no less than fifteen (15) working days' notice when the Grantee determines that t'.would'.:=be in• the best interest of tle; 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 'Howe`ver,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,wholes or,part,when both parties.agree that,the Continuation of the CoC Grant#FL0177L4D001811 The City of Miami Beach,The.City of Miami Beach Outreach Program Page-i0 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 mayterminate 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 inwriting to the Subrecipient: Said notice shall be. . . . sent bycertified mail,return requested,or in person with proof of delivery; • TherGrantee 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 Grantee any or :Al-tests associated with termination of this'Agreement;including but not limited to transfer of the Subrecipient's•obligations under this Agreementand-or selection of a new:Pro.Project onsor. The Grantee.ma terminate this:Ag reement,in whole or in part, ] Sponger. Y. g, when the.Grantee determines in its sole and absolute discretion that the Subrecipient. is not mak_ ing sufficient progress in the performance of thisAgreement-as outlined in the,"Scope of Services." n.contained withithe"Scope.of Service and US HUD eSnaps Documents" Attachment B ;or is not:materiallyYI Pgany com l ,in with. term pr with.. . . 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 Th'e Subrecipient failed or`fails to furnish the Certificates of Insurance • requiredby thisAgreement or as determined by Miami-Dade County Internal Services ItiSk Management Division;; 3: The Subrecipient failed or-fails to furnish proof of;Licen sure. 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 Y, final expenditure,reports or submits incompletely or incorrectly, 5 Ther 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 recordsor 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 orfails to provide Domestic Violence Leave to its employees pursuant to local.law, 9. I,The Subrecipient falsifies or violates the provisions ofa:Drug;Free Workplace Affidavit; 10 The Subreci ient attem ted: er"attempts to meet,its;obligations under this P p P g Agreement through fraud,misrepresentation or material:misstatement; 1;1 The Subrecipient failed:,or .fails .:within a specified period, correct • deficiencies found during a monitoring, evaluation or review,'' COC Grant#FL0177L4D001811,The.G t i of Miami.Beach,The Citjof Miami Beach Outreach Program Page 21 12. The Subrecipient failed or fails to meet the terms and conditions of any obligation under this Agreement or otherwise of any repayment schedule to the Grantee or any of its agencies or instrumentalities; 13. The Subrecipient failed or fails to meet any of the terms and conditions of the Miami-Dade County Affidavits;and 14. The,Subrecipient failed or fails to fulfill in a timely and proper manner any and all of its obligations, covenants, agreements and.stipulations in this Agreement. The Subrecipient shall be given written notice of the claimed breach and ten (10) business days to cure same. If the.Subrecipient is.not-provided a written waiver of the breach by the Grantee,or if the Subrecipient remains in;breach-of this Agreement as determined by the Grantee;the Grantee shall initiate..written notice to terminate and said notice will be to terminate effective within no less than twenty-four.(24) hours. :Said notice shall be sent by certified mail, return receipt requested, or in personwith proof of delivery. Waiver.of Breach or any provision of this Agreement shall not be construed .tobe 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 entitywho attempts tomeeti its contractual obligations with the Grantee through fraud,'misrepresentation or material misstatement may be disbarred from County contracting for up to five:(5)years: •: 5. _Notice Regarding Future Funding Applications • Funding under this Agreement is provided byUSYHUD 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(NO FA) application process • The'Subrecipient .agreesto timely .notify the Grantee of the Subrecipient's intention not to be available to renew and'continue operatingor rovidin the program in its entirety as covered. P g under this Agreement Timely is defined as theearliest:of either 1) six (6) months_prior to this Agreement's.expiration; 'or 2), upon request to ;confirm allocations in thea 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 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 maintainedforpersons served by the Subrecipientunder 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 theattention of Miami-Dade County Homeless Trust:Executive Director:: CoC Grant#FLO17"7L4D00:1811,The City of Miami each,The City of Miami Beach Outreach Program Page 22 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" i:n accor.:dance 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 benefitof low-incomepersons pursuant-to a request for such use by the Grantee on behalf of the Subrecipient o:perating'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;bel alf 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 amt. ounof 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 this.provision shall survive the expiration:or termination of this Agreement 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 attributableto those funds, and any overpayment due to unearned funds or costs disallowed pursuant t0 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 anynecessary license, 'pertint,I. orapproval by a governmental authority may result in:immediate termination of this Agreement upon noless tha n twenty- four(24)-hours'notice Said notice shall.be certified by mail or hand delivery: e Declaration of .Restrictive Covenant and Declaration of Restrictions-Where grant funds are. used for acquisition, construction or rehabilitation under this;Agreement, the Subrecipient shall record a Declaration of Restrictive Covenants,as well as a Declaration of Restrictions,in accordance with this section. ' Cot Grant#FL0177L4D001811,.The City of Miami Beach,The:City of Miami Beach Outreach.Program Page.23 The Declaration of Restrictive Covena tsand the Declaration of Restrictions shall restrict the use of properties located at N , in Miami-Dade County, Florida such that the properties must be operated for the provision of homeless housing and services:for homelesspersons 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: g Tlie:SubreciP"�ient a reesthat the Declaration of Restrictive Covenants and the Declaration of Restrictions shall he 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•subleasingthe 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. TheSubrecipient shall be • responsible:for ensuring that:any'signatories required by U,S'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 RestrictiveCovenants`,executed by°the_ .Subre,cipient;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 ofthe approved Declaration of Restrictive.:Covenants before funds.for Rehabilitation or NeW Construction-may be;drawn down. Acquisition funds may be dr aWn dOWn before proof of recordation is received by US HUD;however,no other • grant funds will be available for draw down uritil US HUD is satisfied with the form and recordation of the DeclarationRestrictive 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 underthis 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 is The Subrecipient shall complywith 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 regulation of be deleted if modification is_impossible However;theobligations under this Agreement; as modified, shall continueand all .provisions of this Agreement shall remain in full force and effect • CoC _Grant#FL0177L4D001811,The City of Miami Beach;The City of Miami Beach Outreach Program • Page 24 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 arid Regulations(24 CFR Part 58 and 24 CFR Part 583.230). The"Subrecipient shall comply with all applicable laws and regulations governingthis Agreement: • b. The Subrecipient shall comply with the federal uniform administrative requirements and accounting,standards cost principles arid audit requirements according.to:OMB'Omni or Super Circular 2 CFR Chapter.I,and Chapter II,Parts 200,2.1:5,220,225 and 230,OMB:Circular A-122, and 24 'CFR=78 et se• q., as may be applicable and any other applicable laws and • regulations . t Performance Measurements - The` Subrecipient shall comply and d report all performance ;objectives outlined in the "Scope of Service US. HUD' eSnaps • ' •Documents" Attachment B and:as outlined in the NOFA application and in the Manner'specifiedcnd outlined in this Agreement ii: .Additionally, the Subrecipient shall'comply with the established United States - Department.:of Housingand Urban Develo � ' u.SHUDperformance measures Pments l ) PsrY related to the;Continuum of Care's (CoC)s stem p erformarice Specifically: 1.' Measure 1:The Length of Time Persons:Remain Homeless;: 2. 'Measure 2: 'TheExtent to :which Persons who.`Exit Homelessness to Permanent Housing Destinations Return to Homelessness:.: 3;..'•Measure 3: Number of Homeless Persons 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 Category3;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 ,muSe have 'a minimum.of 8.6% 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 Housin Invento Checklist, populated'in the g g rY regardless of whether the beds`are .fundedby HUD`,or the Homeless Trust, whether:or not funded by HUD or the Homeless`,Trust: iv. Internal Controls TheSubrecipientshall.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 CoC'Grant.#.FL0177L4D001811,The City of Miami Beach,The_City of Miami Beach Outreach Program Page;25 information. These internal controls shall safeguard assets and provide reasonable assurance of compliance with federal statutes and regulations. v. Payment-The Subrecipient isrequired to report deviations from budget orproject scope or objectives and request prior approvals from federal awarding agencies through the Grantee on any and allchanges 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 acceptedas 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, 1. 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 federaLprograms;.,, 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 recordsand all records pertinent•to. a;federal awardfor a period of five (5) years from the date of submission'of the final expenditure report or,for Federal awards-that are renewedquarterly 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 therecords have been resolved and final action taken.,if the Grantee Or-the Subrecipient has received-pr beengiven notice of any kind indicating any threatened litigation, claim:or addif 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, claimor. audit is, in the sole and absolute discretion of.the.Grantee, fully, completely and finally resolved 2. Records for realpropertyand equipment acquired with federal funds must be retained far 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 ` ent's fu docum llterm;.: COC Grant#FL0.177L4D001811,Th"e'City of Miami Beach,The City of Miami Beach Outreach Program, Page'26 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 orany 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 duringthe 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 sand Regulations that:apply to-all program or client participants referred to the :; Subrecipient pursuant;to this:Agreement. This copy is due.withinth 30) calendar-da 's rt3'� ) Y foll`owing'the execution of this Agreement., b. Personnel Policies and:Administrative Procedure Manuals• The Subrecipient.shall submit detaileddocuments.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.. • • c. Monitoring The Subrecipient shall.permit the Grantee;and any other persons authorized by the Granteeto monitor,according to applicable regulations,all Agreement records,facilities, • • goods,services and activities of the Subrecipient which are in anyway'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 fiscaland programmatic compliance with all terms and conditions of this Agreement including'a'review of beneficiaries,supportive services,housing,;operating costs, rperformance•progress, site.habitability, participant eligiblhty progam anddocumentation • 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 suzve s,and Other techniues•deemed • .. . .,, P yq reasonably`necessary.to fulfill the monitoring function. .:ifthe Grantee monitors and there is a finding of deficiencies report; said report may delivered to the-Subrecipient, and if so delivered:the Subrecipient shall rectify all deficiencies cited within the` period oftime specified in the report. Pursuant to Board>of Miami-Dade County.Commissioners Resolution No..630-13,Miamz Dade CountyMayor'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: CoC Grant#FL0177L4D001811,The City Of Miami Beach,The City of Miami Beach Outreach Program ''Page 27 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 arid a related party transaction."A related party includes,but isnot limited to; a for-profit or nonprofit subsidiary oraffiliate organization,and organization with overlapping boards of directors or any'organization for which the Subrecipientt is responsible for appointing members. The Subrecipient shall report this informationto.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 arid Access to Records". . f. Required Meeting Attendance..- From..time to time, Grantee through Miami-Dade County Homeless Trust may schedule:meetings andor training sessionsto assist the Subrecipient in the performance of its contractual obligations orto"inform-the Subrecipient of new and or revised policies and -procedures. Attendance at some ofthese meetings may be Mandatory. The Subrecipient shall receive`notice no less than three (3) business days prior to any meeting or training session that may.require mandatory participation. A record .. of attendance shall be kept of meetings or training sessions where_noticewas given indicating the mandatory participation,of the Subrecipient and theSubreciplent shall be monitored for compliance on that record of attendance: Failure to attend meetings or training sessions for whicha mandatory.notice has`been provided can result in material non-compliance of the, Agreement, up to and including Breach or Default: Proof of mandatory notice:shall consist of fax record, certified mail, electronic confirmation and or verbal communication with the Agreement contact person .or persons. and other program administrative staff of the Subrecipient The.Subrecipient may selectone 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 overany determination to waive mandatory attendance, and n0 more than two'..(2). mandatory,attendance waivers shall be allowed. during the 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. • CoC Grant#FLo177L4D001811,The City of Miami Beach;The City of Miami Beach Outreach Program -Page 28 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 hereinor suppliers to supply the materials,.the Subrecipient shall provideMiami-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. Involvementof HUD-assisted individuals :and families per-24 CFR "57.8.23 (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,opportunitiesfor training and employment,for services or programs covered under this Agreement, should be:given to tower-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 OO 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 anyequipment or property purchased for greater than $5,000.09, shall, upon expiration 'or termination of this Agreement, be disposed in accordance with instructions from the..Grantee Real Property is`defined'asland, 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 greater $5;000.00 per unit 2):The Subrecipient shall list in:the'property records allequipment 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 Granteeor 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, andmap indicating where property is in parcels,lots or blocks and showing adjacent streets and roads. Notwithstanding documents required for reimbursement purposes, an additional coPyof the purchase receipt for any property described above which was purchased using Grantee or Miami-Dade County funds must'also beincluded in the reimbursement package along with the "Real Property and Equipment Asset Inventory"Attachment I in the month it was purchased. 3)All equipment with an acquisition cost of greater than.$5,000.00 per.unitand 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 to2 CFR 200:94;if the CoC Grant#FL0177L4D001811,:The City of Miami Beach,The City of Miami Beach Outreach Program. Page 29 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 complianceof 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,an d participants'surveys: Subcontracts and Assignments- The:Subrecipient shall not.assign this Agreement without the Grantee's written consent to the assignment, The Sub_ recipient shall ensure that all subcontractsssignm `and aents; 1correct a ) Identify the full,• arid legal name of the.party; 2) Describe the.activities to be performed;3.)Present a complete and'ac(urate;breakdown of all price components; arid.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 tosubcontracts and assignments in which parties are engaged.to carry out any eligible substantive programmatic service as set forth in . this.Agreement The Granteeshall in.its•se adiscretion:determine when . • services are eligible substantive.programmatic.services subject to the audit and record keeping requirements described�alove;: , •• . 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,allsuppliers;: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 and employees Of all such first tier subcontracts :This Agreement shall require the,Subrecipient to provide Miami-Dade County ther-ace,gender and ethnic information as soon as reasonably available and in;any event prior to final payment under the Contract:,The Subrecipient shall notchange 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 additionalprovision "The Subrecipient is not: responsible for any insurance or 'other'fringe.benef_ts'for;the consultant or its,.employees, (examples social security, income; tax withholdings,;.retirement or leave benefits)..: The. consultants assume full responsibilityfor'thepall.rovision.o insurance and` in.ge;befor „ f �' ne�is� themselves and..their employees r..etained by the consultants incarrying 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 enteringinto 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 frons the Grantee prior to either . assigning or-transferring any obligations.or responsibilities set forth in this Agreement or the right-to Teceive benefits or payments resulting,from this Agreement :Approval by the:Grantee. of:anysubcontract or assignmentshall not under any circumstances be$deemed to provide CoC:Grant#FL0177L4D001811,The-City of MiamBeach, i The:City of Miami Beach Outreach`Program ;. Page'3:0 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 topayment'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-, Systemselected 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 theyareresponsible for any ongoin• g costs to access-the HMIS s stem 'The Subrecipient Y P • agrees to `abide by terms of`any HMIS Agreements, which -are incorporated:herein by reference The Subrecipient shall indemnify`and hold harmless the Grantee arid.Miami-Dade • County,its agents and instrumentalities• from any and all liability; and damages arising out of or relating to this Agreement or the HMIS system D. 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, inspect and review operations,activities,performance and:procurement processes including but not limited to;project design;application andproject 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 net limited to chan es in the Project S onsor,changes in the project g g ) P : g P 7 :site location, additions,or deletions in types:of program.`or funding activities outlined in24 CFR 5.78 37- 578.63 and the Notice of Funding (NOTA) process approved in the ': Technical Submission for this program;or a shift of greater thanten`(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_ . 2 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 Anyapproval for changes is Contingent upon United States,.Department.of Cob Grant#FL0177L4D001811,The.City of•Miami•Beach,The Cityof Miami Beach Outreach Program Page 31 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 L The.Grantee may;_for good and sufficient cause,,determined by the Grantee in its,sole andabsolute discretion,'waive.provisi'ons 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 modificationor revision tothis Agreement • s• . Disputes- In the event that_an unresolved dispute exists between the Subrecipient and the Grantee, the Gr..antee shall refer the questions, including the views of all interested-parties and the.recommendation of the Miami=DadeCounty Homeless Trust, ;to;the Miami-Dade County Mayor or the Mayor's designeefor determination The Mayor or Mayor's designee • will issue a determination within:thi 30 calendar da s of receipt and so advise the rt3' � ) ; , Y P ', 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 thatthe determination of the Mayor'or the Mayor'sdesigneeshall be final-and-binding on all parties t Proceedings -This Agreement shall be construed in accordance with the laws of the State of F•lorida`and:any proceedings arising between the parties in any manner pertaining or:r:elated " to•this Agreement shall, to.:the-extent permitted by law,,be held in Miami Dade;County; Florida.,' u No Third'.pa : rty�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 7.waiver`of sovereign_.. immunity x Notice and Contact The Grantee's,representative for thisAgreement is•Victoria L 1Vlallette Executive;Director,Miamt Dade county Homeless Thai,-The Subrecipient's.representativ ;for greemen is t�((ft� oriCAe(•f" - The project site location is..Q.'i, n F.tit.CQtn l In tfie event that different:representativesare"designated by the Subrecipient after this.Agreement;is executed,`or the`Subrecipient`changes'the address of either the program site or principal;office,the Subrecipient must notify the Grantee prior to • such relocation:and obtain all necessary approvals. Notice of thename of the new representative or new'address will.be rendered in writing to.the:Gr,antee within five:(5) business days of the proposed change. CoC:Grant#F:L0177TL4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page 32 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 aProgram-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 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 andt address:of,the.payeelisted here Subrecipient's Nam . "(F L a r a.' % ,� £ ' / Cf Address v s[ m J CGI j . . on �1 � 3'i3G1 bb. All Terms and Conditions Included =thisAgreement`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 tYe contracting parties Theparties 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 relationShig of Principal and agent,:employer;and employee,master;and servant,partners or joint ventures r;Neither party shall have,expressly or.by implication,or represent itself as having,any authority to:make contracts or enter into any agreements inthe name.ofthe other " • party,,or to obligate orbind the other party in any mannerwhatsoever. 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 wouldthen 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,l erein,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 1 proceeding based upon or arising out of this Agreement, or thedealings or the relationship between or"amongthe parties to this Agreement ff Counties and Municipalities outside Miami-Dade County=The Sub"recipiientagrees.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 busmen's _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.Coun .tywho 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, , . ty t_ CoC Grant#FL017ZL4D00181-1,The'Ci of'Miaini Beach,The Ci_ of Miami Beach Outreach Program- Page 33 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 affectedby such contract,arrangement,or undertaking. gg. Compliance withall 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, com petitive 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 Agreementthe 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 withthe 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, b. It will not discriminate against any.person applying for homeless_housing or serviceson 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,'ena e,in no:religious proselytizing proselytizing and exert no other religiousinfluence in the provision;of homeless housing and services funded hereunder. d.:: Alternative.Provider-The Subrecipierit shall incorporate into their policies and procedures, a written approved policy to refer, or transfer any:programparticipant or prospective program participant of the Continuum of Care program wh•o objects to.the religious character. of the provider: The policy and procedures shall.be reviewed andsubject to approval by Miami Dade County Homeless Trust..At a minimum the policy and procedures:shall.include - actionto transfer or refer within a reasonably prompt time after objection and undertake the. reasonable:efforts to identify and refer the participant to an alternative provider to Which the •participant has.. no objection:: , xcept for.services provided by telephone,the Internet,or similar means, the referral must be:to ran`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 prospectiveprogram participants and any efforts to refer:. such participants:.-to ,alternative: providers in accordance with the requirements of 24 CFR 578.103(a)(13) - CoC Grant.#FL0177L4D001811;The-City of Miami'Beach,The City of Miami Beach Outreach Program z Page 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 3.9.908, 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 IIHLavailable to.Miami-Dade County for•corripliance audits and for other purposes as maybe permittedby law; and • h. .PHI shall maintain its protected status regardless of the form and method of transmission (including paper and or electronic transfer of data): The Subrecipient:must give its customers written notice of all privacy information practices including but not limited to description of the types of uses and disclosures that would bemade with protected health information: 11. Proof of Licensure/Certification and:Background Screening a. Licensure. If the Subrecipient is required by the Stage of Florida or.Miami-Dade County or any federal,state or local law or regulation tube 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.itssole:discretion, shall not disburse any funds until it is provided-with such licenses or certifications. Failure to provide the required licensesor certification within sixty(60) days of execution of this Agreement may result in termination of this Agreement at the Grantee's discretion. • b. Background Screening-The Subrecipient agrees to comply with all applicable federal,state and local laws, regulations, ordinances and resolutions regarding background:screening of employees, volunteers, subcontractors arid independent contractors.;Subrecipient's failure ' to comply with any applicable 'laws, regulations, ordinances and resolutionsregarding background screening of employees, .volunteers, subcontractors and independent CoC Grant#FL0177L4D001811;The Cityof Miami'Beach,The City of Miami Beach.Outreach'.Program Page 35 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 aniended 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 Subr•ecipie;nt wills 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 criminalhistory.records,as maybe,applicable.. ' The Subrecipient agrees to ensure that,_employees,volunteers,subcontracted personnel'and independent contractors who workwith vulnerable persons satisfactorily complete and pass Level 2 background screenings beforeworking or volunteering with.any:vulnerable persons. The:Subrecipient shall furnish.Miami-Dade .County with proof that employees, volunteers, • subcontracted personnel,and independent contractors who work with vulnerable persons, satisfactorily passed Level 2 background screenings pursuant to Chapter 435 Florida Statutes, as 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:priorto that employee,volunteer,subcontractoror. independent contractor working or volunteeringwith or in the vicinity of a vulnerable person or vulnerable. persons, Miami-Dade County shall not:disburse any further funds and this Agreementmay be:subject to termination at the•sole discretion:of Miami-Dade County. • • SIGNATURES CON.TIN:UE ON NEXT PAGE CoG.Grant#FL0177L4D00.1811,The City of Miami Beach The City of Miami Beach Outreach Program 1 I IN WITNESS WHEREOF,the parties have caused this(38) thirty-eight page Agreement to be executed by their respective and duly authorized officers the day and year first above written. WITNESSES: ENTITY: 1. City of Miami Beach ����-t/nJ�d _.„,..49241-t51-1Subreci '� i`Yft pl..IIt. (Signature of Ws (Print full nam ' "roller Ag-. cy) I &i S°1 04S6 -..kisiLAALVAIN I (Print Name of Witness) (Signature) 2. ' Jimmy L.Morales (S ature) l (Print Name of Authorized Agency Signatory) JL)0'4 t l b S 11 -1_7( City Manager (Print Name of Witness) (Print:Title of Authorized Agency Signatory) APPROVED AS TO FORM & LANGUAGE Affix & FOR EXECUTION Incor•c ',,� �" 1 - 21.- ATTES'Iy _ ; ,•e. cy,, City Attorney ✓ DatesF. ,' i IINCORP ORATED; c Rafael E.Granado,City Clerk •"r, '''••® ''-'-c3= ATTEST: Miami-Dade County,a political subdivision of The State of Florida HARVEY RUVIN,CLERK BY: Deputy Clerk Carlos A.Gimenez,Mayor Date See attached memorandum dated(March 12,2019)approved as to form and legal.sufficiency Resolution#R-1252-18 CoC Grant#FL0177L4D00.183.1,The City of Mianii.Beach,The'City.of Miami Beach Outreach Program. Page 37 INDEX OF ATTACHMENTS Attachment A - Continuum of Care Program Grant Agreement&Exhibit I. 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 t Attachment J- When Subrecipient is the RentalAdministrator"",,r. (Participant' I �gusix,g 11,c t or �HAP &LEASE " Attachment K- When Miami-Dade County is the.Rental Administrator (Participant's Housing Application)* HAP &LEASE Attachment L- Place-setter- Leave Blank * The"CoC Participant Housing Application"contained therein,maybe updated and amended from time to time and re-issued administratively CoC Grant#FL0177L4D001811,The City of Miami•Beach,The City of Miami Beach Outreach Program Page 38 FY 2018 Continuum of Care (CoC) Program GRANT AGREEMENT Between United States Department of Housing and Urban Development (USHUD) And Miami-Dade County Miami-Dade County Homeless Trust ATTACHMENT A"FY 2018 US HUD CoC Agreement" FY 2018 Continuum of Care (CoC) Program GRANT AGREEMENT Between United States Department of Housing and Urban Development (USHUD) And Miami-Dade County Miami-Dade County Homeless Trust { ATTACHMENT A"FY 2018 US HUD CoC Agreement" • Recipient Name: Miami-Dade County Grant Number: FL0177L4D001811 Tax ID Number: 59-6000573 DUNS Number: 004148292 SCOPE OF WORK for FY2018 COMPETITION (funding 1 project in CoCs with multiple recipients) 1. Theproject 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 fundingobligation for this grant is $_65212_for project number_FL0177L4D001811 . If the project isa 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. Acquisition $ 0 c. Rehabilitation $ 0 • d. New construction $ 0 e. Leasing _ $ 0 f. Rental assistance $ 0 g. Supportive services $ 60946 h. Operating costs $.0 i. Homeless Management Information System $ 0 j. Administrative costs $ 4266 k. Relocation Costs $ 0 www.hud.gov espanol.hud.gov Page 1 1. HPC homelessness prevention activities: Housing relocation and stabilization services $ 0 Short-term and medium-term rental assistance $ 0 4. Performance Period in number of months: 12 .The performance period for the project begins 06-01-2019 and ends 05-31-2020 . 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 and Subrecipients' federally recognized indirect cost rates on the attached Federally Recognized Indirect Cost Rates Schedule,which Schedule shall be incorporated herein and made a part of 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. If no federally recognized indirect cost rate is listed on the Schedule for a project funded under this Agreement,no indirect costs may be charged to the project by the subrecipient carrying out that project. 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. www.hud:gov espanol.hud.gov. Page 2 This agreement is hereby executed on behalf of the parties as follows: UNITED STATES OF AMERICA, Secretary of Housing and Urban Development By: D. Signature) Ann D. Chavis,Director (Typed Name and Title) February 21, 2019 (Date) RECIPIENT Miami-Dade County (Name of Organization) By: 1 l / (Signature of Au orized Of ficial) MAURICE L. KEMP (Ty ed Na e and Title of Authorized Official)E?U �Y ''�"p. �f(_)R ôJ111- 09 AM -DADS CT;° FL (Dae) . www.hud.gov espanol.hud.gov Page 3 Tax ID No.: 59-6000573 CoC Program Grant Number: FL0177L4D001811 Effective Date: 2/21/2019 DUNS No.: 004148292 FEDERALLY RECOGNIZED INDIRECT COST RATE SCHEDULE Grant No. Recipient Name Indirect cost rate Cost Base FL0177L4D001811 • www.hud.gov espanol.hud.gov Page 4 FY 2018 . • Continuum of Care (CoC) Program Scope of Service eSnaps Budget and Performance Objectives . k ATTACHMENT B"FY 2018 Scope of Service" Miami-Dade County Homeless Trust Scope of Service FL0177L4D001811 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 2018 NOFA(incorporated herein by reference), and pursuant to 24 CFR 578 including but not limited to: 1. Accept eligible homeless persons as defined by US HUD and through Miami-Dade County Homeless Trust CoC's established Coordinated Outreach and Assessment HMIS referral process; 2. Comprehensive assessment and case management; 3. Residential stability; 4. If applicable, locate and match eligible program participants with eligible Landlords with units in the community; 5. If Miami-Dade County is the Rental Administrator, provide, complete and submit to the assigned staff all documentation, records and reports, including but not limited to, Attachment K Participant's Housing Application; 6. If Miami-Dade County is not the Rental Administrator, provide, complete and maintain all documentation, records and reports,including but not limited to,Attachment J Participant's Housing Application. Provide, maintain and complete all documentation and supporting information for HQS Inspections, verify compliance with federal rules and regulations, verify Program Participants' Income Calculation and Rent Determination including any applicable utility allowances, review Lease Agreement, Lease Addendum if applicable, and Housing Assistance Payment (HAP) Contracts, issue move-in authorization, and issue payments to Landlords; 7. Provide policies and procedures which ensure compliance with Further Fair Housing Act, Client Rights 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 2018 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" IPa. 1�.. Irate Ii. Dy r,l,o- 1� Prw -. 1!y V. 11 p..., I„ _ -iii c� W _ =W 1 P _ _®® _ i'.;1411 _E: 1 _ -;Q - .146:1 =6 1,-.A 6 1 F f - i P UD Er United States Department of Housing and =6 r:til Urban Development (USHUD) 2018 Continuum of Care (CoC) Program ria riga Ik 1� g-g" Ci' ' Beach iE City . of Miami - 1'. r-i 11516 Outreach _Ilr 11'6Programnit _E--46 GrantNumber: -6 FL01.77L4D001.811 rith r:46 g=igib _546 E.-46 _E--itb Firth � 2= " 46'- I rit.. reit - - � - -n6 g-46 . - r;ith The City of Miami Beach ATTACHMENT B, BUDGET The City of Miami:Beach'Outreach Program Grant Number:. FL017.7L4D001811 Eligible Costs . ., . . • . Annual Annual Grant Term Grant Term Total Assistance : Annual • Assistance. Assistance (Renewal (HUD Requested for Assistance ...Requested: :• Requested Submission)• Award) . Grant Term Requested (HUD (Renewal (HUD Award) ; (renewal Award Total) la. Leased:Units ' 1 Year 1 Year $ 1b, Leased Structures 1Year 1 Year rG . ..Rental Assistance; 1 Year 1 Year $ • $ y :. 2 *3.Supportive:Services 1 1 Year $ . • 60,946.00 4.Operating ,94600 ' 1 Year• 1 Year '4$:: , $ 65,212.00 5 HMIS 1 Year 1 Year $ x r$, 6.Sub-total Costs Requested $ 60,946;00 't$r 60;946`00 7..'.Administration(Up:to-10%) $ 4,266.00 8 Total Assistance plus Admin Requested: ` • >65°212 00 $ 65,212.00 $ 9 Cash Match $ 16,303:00 10:In-kind Match 11.Total Match $ 16;30300 $ 16,303:00 r � 12:Total Budget 81,515:00 :Match.% 25% . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . , . . . . . . • , ... . • . • . . . . . . . . . , . . . . . . . . . ., . . . . . . . . .,. . . . .. . . . -•..:" • - . . . . • . . . , . . . . . . , . „ , . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . , . . . . . . . . . . .. . . . . .. . . . . . . . . . . . , . - . . . . . . . . . . . . , • . . . . . . , . . . . . . . . . . , . . . . . . . .. . . . .. ....... .. . . . . .. . , . . . . , . . . . . . . . . , . . . . . . . . . . . ... , . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . , . . . .. '..• ....„. ,. . . . . . . . . . , . . . . . . . . , . . . . . . .. . . . . . . . .. . . , . . . . . . . . . . . . . . , . . . . . . .- . . . . . . . .. . . . . . ,. . .,, . •. . , . . . . . . . , . , . . . , .. . . . . . . . . . . . . . , . , , . . . . . . . . . .. . , . . . . . . . . - ..„, . . . . . . , .".. . . . . . . . . . . . . . . . . . . . . . .. . , . . . . . ,. . . . .. . . . , . . . . . . . . ' • . . . . . . . . . . . . . . . . . . . . . , .. . . .. . , , .. . .. . . . . . . . . . . . . . ' . . .. .- . . .. . . . . . . . . . , . . . . . . . . .. . . . • . . . . , . . . . . . .. . . . . . . . . . • . . . . . . . . . . . .. _ . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... .. . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . .. . . . . . . . . . . . . •. , . . . . . . . . . . . . . . .. . . .... .. ... . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . .. . . .. . . . . .. . . . . . .. .. . . . ., . . . . . . ., . . . - . . . . . . . . . . , . . . . . . . , . . . , . . . . . . . . . . . . . ., . . . ,. . . . . . . . . , . . .. .. .. - . . . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . . . . . . . . . . . . .. .. . ., . , • . . . . . . . . . . . ' . . . . • • • . • • . . .• . . . . .. . . . . T . . . . . . .. . . . . . . . . . . • „ . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . • • . • . . . . , . . . . . .. .. . . , . a . . . . . . . . . . .. . . '. ...., r . . . . • . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . • a ... .. .. .. . . . . . . . . . . . . . . • . . . •• . . I . , . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . .. • . . . - . . . . . . .. . . . . . . . . . .•.. . . . . . . . . . ., , . . . . . . . ... . . . . , . . . . . . , . . . . . . . . . . . . . . ... . . , . • . . . . . . . .. . . . . - . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . • . . . . . . . . . . . . . . . . . . .. . . . . . . . . . .. . .. . . - . . . . . . . . . . . . . . . . . , . . • . . .. . . . . . . . . . , . . . . .. . . . . . . . . .. . . . . . .. ... . . . . • •. • . . . . . . ....., . . . . . . .. . • . . . . ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . .. . . . . , . . ...a . . . . . . . „ . . . . . . . . . . . . . . . . • . . . • . .. . . , . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . , . . . . . . . . . . . - . . . . , . , • . . . . . . - . .. . . . . . . . • . . . . . . . . . . . . . . . . , . . . . . . .• ...... , . . . . . . . . . . . . • . . . . , . . . . . . . . . . . . . . • . - . . . . . . . . . . . . . • . . . . . . . . . . . . . . . , . . . . . . . . :. . . . . . . . . . . . . . . . . . . . .. • ... . . .. . . . . . . . . . . - . . . . . . . . . . • . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . • . . . • . - . . . . . . . . . . . . . . . . . . _ . ... . . . . . .. . . . . . . . . . . . . . . • . . . . .. . , . . . . . . . . ' . - . . . . . . . . . . . ... . . . . . . . . • . . . . . . . . . . . .. .• . . . . . .. . , . . . . . . . . . . . . . . . . . . . , • . . . . . . . . . . . . . . . • , • . . . . . . . ., . . . . . . . . . , . . . . . . . , . . . . .a• , . . . . . , . . . , . . . - . . . , . . . . . . . . . . . . .. • • . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . .. . . . . . . • . • . . .. . . . . . . . . . . . . . . . . . . . . . . . , . . .. . . . . . . . . . . . . .. . .. ... . . . . . . . . . . . . . . . . . , , . . . . . , . . . . r . . . . . . . . . . . . . • . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . .. . .. - • .. . . . . . . . .. . . . . . .. . . . . . . . . , . . . . . . . . . . . . . . . . . . . ... . . . . . . . . • .. . . . . . . . . . . . . . . .• . . . . . . . . . . . . . . . . . . . . . . . . . . .. • • . . . . . . .. ... . . . . . . , . . . • . . • . • . . . .. • . — . . . . . . . . . . . . . . • .• • , .• . . . . . . . . . . . . . . .. . . , • • . . . . ... . , . . . .. . . . . . . . .. . . . . . , . . . . .. ..• . : .. . •. •. .,.... .. . . . . • , . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . - . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . 6E. SUPPORTIVE SERVICES BUDGET Annual Assistance Annual Assistance Eligible Costs Quantity AND.Description.(max 400 Requested characters)(Renewal Submission) (Renewal Requested (HUD. Submission) Award) 1.Assessment of Service Needs 2.Assistance with Moving;Costs 3. Case Management 4. Child Care 5.Education Services . 6.Employment Assistance 7.Food 8.Housing/Counseling,Services 9.Legal Services 10. Life Skills 11.Mental Health Services 12: Outpatient Health:Services 13. Outreach Services. 2 FTE Outreach'Case Workers-Salary and Fringe Benefits $ 60,946.00 .$ 60,946.00 14.Substance Abuse.Treatment Services 15.Transportation 16.:Utility Deposits 17. Operating Costs ; Total Assistance Requested ,$ s 60,946°00 i$ 60,946:00 Grant Term' a y. vm �, �• - , � � � , ,s�1�Y'ear� r �� 1°Rear Total Request=for{Grant Termj 6E. SUPPORTIVE SERVICES BUDGET Annual Assistance Eligible Costs Quantity,AND:Description:(max 400 Requested Annual Assistance characters)(Renewal Submission): . (Renewal Requested (H[JD Submission) Award) 1.Assessment of Service Needs 2.Assistance with Moving.Costs 3.Case Management 4.Child Care 5.Education Services . • 6.Employment Assistance 7.Food 8.Housing/Counseling Services 9.Legal Services 10.Life Skills 11.Mental Health Services 12: Outpatient Health,Services. 13. Outreach Services. 2 FTE Outreach Case Workers Salary and Fringe Benefits $ 60,946.00 $ 60,946.00 14. Substance Abuse.Treatment Services 15.Transportation 1.6.Utility Deposits 17. Operating Costs Total Annual Assistance Requested 4 � � r � r' 'A60,94.6�00� $' 60;946 00 Grant Term ... '1F,Y,ear . - - � x � � - Year Total,Request for!Grant Term 7 . . . . . . . . . . . . • . • , • . . .. . . , • . . . , • . .. . . . • , , . . , ,, . . , . . , . , . • . . . • • . . . . • , . ., . . • . . . . . . . . . . • . • . . • . . .. . . . . . . , . . . . • • ..• • - . . . . . . , • . . , .. . .. • - . . .. . . . ., . , . . . • . . .. ,.,. . ,,. .. . - . . .. • •. . , . . , . . • . . . • •. . . • . . . . , • .. .• . . . .,., ,:.-.. - ••'•- , -. . . ••, '•••„ ' ..• . : .• •. . , • , . . . . . . , . , , . . . ... ... . . .. . . • . . . - . . . . , ,., . - - :: .", ,-. . •.• - • . . . .. . • • • . . . • • . . . -• . . . ,. , . . . . ..,,, . . • . . . • . ., • . . , . , • . . • r ..., .. • . .. • . . . .., , • , . • .. • . .• -- •.• .,,• .. •. , .. • ''. , . .. . . . . . . . , . . . . . . . . .. , . • • • • , , . . .. . .. - ' . ... ... . . .._ ... •. . , - . -. • .. . , , • . . . . . • ... . . .. , .. :. • -•: . • , ,. ..:. , . . , . . • • ... . ., ,. ,,. . • ., .. . . . . , . . . • . . . . , . . , . . . . ..,.. , . . - . . .. ...• . . . . . , " •. • . , ...., , . .. . . . .. . , •.. . . • . ,. . . • .. . . .. .. . ... . . . . , . . . . .. .• , . . . . . . . -• . . , . - , • , . , . .. . • • . . . . . . . . . . . . ,• • . , . . _ , . . .. . . . , . . . . ., , . , - . . . . •,• . , ,..:, .•: , • . . . . . . . . _ . •-. . . .. , , • • , , . . • • .. , . . . „ . • . . . . . .. • . . . . . . .. •. ..: . ..• . . • .. .• .• . . .. .• . • • • •, • , • ' ., .- •••• - . . . • . . . . , . . .. ,• , • . . . . . . . .. . . . • . . . ,, , . . . • • , • - ••..• . . .- . ,. .. , . ,. .,.. • .• . , . , . . • . . ....- . . . ,.• . , . . ., , ,,•, ,, -. • - ' . . • . . . ...,,,,. . . . . . . . , . • . .., •,.. . ,. . , . • . . , • •,. • , .. . . . . . .. . . ... : .,•.• . , . , ,: , . ' . . . • • • . • • - -• ..'.. '.• ' • . . . • , . . . . . . .• ... . . . .. . .. . ' •,....- .-. . ,.,. . . • . . .• . . , .„ .. , , . . . . . . , , .. , . . . • . . . . . . , . . , . • ..: • . ... . .. . . . . . . . .• ,. . .-, , .. • . . . , . , .• .. ;.-, . .. ,. , . , . . " . . . , ._., . , . . . . . , • • . . . , , . . , , - - . ..•. •. ... • .. • • . . . . . - .,...,- •..' . •. ... .. . . , . , • . . ' . • " , . , ... . . . . . . . .., • . , . , . • • . . , ,,• ' .- . , . , . . . . , . • - . , . . . . . . . • - • . •• ., . , . . . • . ,. . .... ..,,,, , ,... . . . , . . . - . ' -- -. . .. . ....- - , ,.. . ., - • .. . . . ..... •• • . . , . • •- • . . , . ..,, ••,..,,,. . . . . . .. . . , , , . . ,. , .- •••• ... •. . . . . . . . , • . . • , • • - .. . • , :. , . •.. . ." . -, , . . •.: ', •-• : , . . . - .. , ,• . . . , . . , ,.•• :." ••• ',.' . . • . „ . . .' , " . . . -. • . . . . . ,.... •.. , , . . . .. , , . . . .. • • . . . .., . .. . . . . , . . • . . . . . , , ...,. • .. '..-. : '. . . , • . . . --. :-., , .. ' .• .. . .. . . . . . . •... .. . . . . . _ . ' . . , . . . . . . . ..., . . • ,. -,. , - . , , . . . . . ,:, • , , . • • , . . . • , . . . . . . . . , , ,. • . . ..., . : • . . . • • . . . . . ,. . , . , . . • • . . , • . . . . . • . . . . . , . .. . . . , • - • , . • . . . . • . .. . • .. . . . . , . . . . ,. , , . • , . . . . .. . , . . . • , , , . . . . . . . . .. . • . . • . _ . . . . . . . . , , , - • . . . . . . , . . . . . . . • - . • . . . , . , . . . . . , • . , • •• . . . . . .. . . . , . . • . • • • . , ..,. . . .. . . • . • . - . . . . . • .. , . . . . . . . , . . , . . • • .. . • , . . . .. • • , , . . . . . . . . • . . . • • . . . . . . . . . . . . • . " , . • . . . . . . . .. . . . . . . . • . . , , . , . . . . , - • . ,. , . . . . . .. • . . • . . , . . . . . . . . .. . . . . . . •• . . . . . • • . . . . • • . . , . . • • . . • • . . . , • . ••• • • , . , - . . . . . . . . , . . , . . . ,• • , Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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)2018 Continuum of Care(CoC)Program Competition. For,more information see FY 2018 CoC Program Competition NOFA. -To ensure that applications are considered for funding, applicants should read all sections of the FY 2018 CoC Program NOFA and the FY 2017 General Section NOFA. -Detailed instructions can be found on the left menu within e-snaps. They contain more comprehensive instructionsand 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 may or may not be relevant. Data from the FY 2017 Project Application will be imported into the FY 2018 Project Application;however,applicants will be required to review all fields for accuracy and to update information that may have been adjusted through the 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 appearson 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 forms. -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 2018 CoC Program Competition NOFA. Renewal Project Application FY2018 Page 1 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: 09/07/2018 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 FY2018 Page 2 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 1B. SF-424 Legal Applicant 8. Applicant a. Legal Name: Miami-Dade County b. Employer/Taxpayer Identification Number 59-6000573 (EIN/TIN): c.Organizational DUNS: 004148292 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: Mr. First Name: Manuel Middle Name: Last Name: Sarria Suffix: Title: Asst. Executive Director Organizational Affiliation: Miami-Dade County Telephone Number: (305) 375-1490 Renewal Project Application FY2018 Page 3 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 Extension: Fax Number: (305) 375-2722 Email: Manuel.Sarria@miamidade.gov Renewal Project Application FY2018 Page 4 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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-6200-N-25 Title: Continuum of Care Homeless Assistance Competition 13. Competition Identification Number: Title: Renewal Project Application FY2018 Page 5 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: 06/01/2019 b. End Date: 05/31/2020 18. Estimated Funding ($) a. Federal: b. Applicant: c. State: d. Local: e. Other: f. Program Income: g. Total: Renewal Project Application FY2018 Page 6 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 FY2018 Page 7 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: 09/07/2018 Renewal Project Application FY2018 Page 8 05/20/2019 • Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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) Apphcant/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 FY2018 Page 9 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 CoC 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 PartIII 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$50,000 or 10 percent of the assistance (whichever is lower). Alphabetical list of all persons with.a Social Security No Type of 4 Financial Interest •Financial Interest '' Renewal Project Application FY2018 Page 10 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 reportable financial interest in the or Employee ID No., Participation in Project/Activity in Project/Activity project or activity ($) (%) (For individuals,;give the last name. fist) • See detailed attachment placed in 59-6000573 CA $29,811,202.00 100% "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: 09/06/2018 Renewal Project Application FY2018 Page 11 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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. Notifying the agency in writing,within ten calendar days after manufacture,distribution,dispensing,possession,or use of a receiving notice under subparagraph d.(2)from an employee or controlled substance is prohibited In the Applicant's 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 iempl1)The dangers ofdrug abuse In the workplace oyee who is so convicted— 2)The Applicant's policy of maintaining a 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 FY2018 Page 12 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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) 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: 09/07/2018 Renewal Project Application FY2018 Page 13 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 FY2018 . Page 14 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: 09/07/2018 Renewal Project Application FY2018 Page 15 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001811 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 FY2018 Page 16 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: 09/07/2018 Renewal Project Application FY2018 Page 17 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L40001811 Information About Submission without Changes After Part 1 is completed; including this screen, Recipient Performance screen, and Renewal Grant Consolidation screen, then Parts 2-6, are available for review as "Read-Only;" except for 3A, 7A and 7B which are mandatory for all projects to update. After project applicants finish reviewing all screens, they will be guided to a "Submissions without Changes" Screen. At this screen, if applicants decide no edits or updates are required to any screens other than the mandatory questions, they can submit without changes. However, if changes to the application are required, e-snaps allows applicants to open individual screens for editing, rather than the entire application. After project applicants select the screens they intend to edit via checkboxes, click "Save" and those screens will be available for edit. Importantly, once an applicant makes those selections and clicks "Save" the applicant cannot uncheck those boxes. If the project is a first-time renewal or selects "Fully Consolidated" on the Renewal Grants Consolidation screen, the "Submit Without Changes" function is not available, and applicants must input data into the application for all required fields relevant to the component type. Renewal Project Application FY2018 Page 18 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 Recipient Performance 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? Renewal Project Application FY2018 Page 19 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 Renewal Grant Consolidation Screen HUD encourages the consolidation of renewal grants. As part of the FY 2018 CoC Program project application process, project applicants can request their eligible renewal projects to be part of a Renewal Grant Consolidation. This process can consolidate up to 4 renewal grants into 1 consolidated grant. This means recipients no longer must wait for grant amendments to consolidate grants. All projects that are part ofa renewal grant consolidation must expire in Calendar Year(CY) 2019, as confirmed on the FY 2018 Final GIW, must be to the same recipient, and must be for the same component and project type (i.e., PH-PSH, PH-RRH, Joint TH/PH- RRH, TH, SSO, SSO-CE or HMIS). 1. Is this project application requesting to be No part of a renewal grant consolidation in the FY 2018 CoC Program Competition? If"No" click on "Next" or"Save & Next" below to move to the next screen. Renewal Project Application FY2018 Page 20 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L40001811 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 unt City of Miami C. City or Township Government C. City or Township Government $65,2 Beach 12 Renewal Project Application FY2018 Page 21 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001811 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 FY2018 Page 22 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 FY2018 Page 23 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 3A. Project Detail 1. Project Identification Number(PIN) of FL0177 expiring grant: (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? 7. Will this renewal project be part of a new No application for a Renewal Expansion Grant? Renewal Project Application FY2018 Page 24 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 1 pm-3:30 pm daily. Street outreach is conducted during walk-in center operating hours as well as early morning outreach (commencing at 4am) in conjunction with the Miami Beach Police Department. 2. Does your project 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 Renewal Project Application FY2018 Page 25 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001811 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 X Having a criminal record with exceptions for state-mandated restrictions X History of victimization (e.g.domestic violence,sexual assault,childhood abuse) X 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 FY2018 Page 26 05/20/2019 • Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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. At least annual follow-ups with Yes participants to ensure mainstream benefits are received and renewed? 3. Do project participants have access to Yes Renewal Project Application FY2018 Page 27 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 SSI/SSDI 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 FY2018 Page 28 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 5A. 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 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 i 335 Adults ages 18-24 3 45 _--- t 48 . Accompanied Children under age 18 32 0 _ 32 Unaccompanied Children under age 18 l 0 0 Total Persons 60 355 0 415 Click Save to automatically calculate totals Renewal Project Application FY2018 Page 29 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001811 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 Non : < Persons Chronic Cion c Ctio is Chronic Victims not fIly liy II Substan Persons` Severely of Physical Develop represen, Characteristics Homeles Homeles,Homeles •?ce with• _'Mentally Domesti Disabilit mental ted by ssNon ' s Abuse HIV/AID III c"" y Disabilit •listed Veterans VeteransVeterans S Violence 'y subpopu Adults over age 24 5 3 0 0 0 3 5 0 0 10 Adults ages 18-24 3 0 0 0 0 0 0 0 0 0 Children under.age 18 0 111111111111111 0 0 0 1 0 3 28 Totersons 8 3- 0 d' 0 3- . al P 6 0 0. . :: 3 36 Click Save to automatically calculate totals Persons in Households without Children .Non Persons Chronic C rorli Chronic Chronic Victim's . ,:not �. all ally ally Substan Persons Severely , Ph ofPhysical Develop represen Characteristics Ho a ees Homeles-Homeles ce with Mentally Domesti Disabilit mental ted by Non- `*- ss s Abuse HIV/AID Ill c ,y. Disabilit listed Veterans: eterans Veterans S Violence -.Y-,:'-'-. subpopu #" Adults over age 24 75 1 16 46 50 54 5 60 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 .c ve Non Persons; ^ Chronic Chronic Chronic Chronic • ` Victims ,not .. ally Ily al( Substan Persons ,Severely of" Physical Develop represen Characteristics Home�es Homeles<'Homeles Ce with " Mentally Domesti Disabilit •mental• - ted, by', s None .2r4 S,� Abuse HIV/AID=. Ill c y` Disabilit .listed Veterans Veterans Vete ns S Violence ;y subpopu, m* •,-.,'''' lations Accompanied Children under age 18111111111111111111 L Renewal Project Application FY2018 Page 30 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 FY2018 Page 31 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 fora 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 transitional housing eliminated in a previous CoC Program Competition. 100% Total of above percentages • Renewal Project Application FY2018 Page 32 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 6A. Funding Request 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 FY2018 Page 33 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: $16,303 Total Value of In-Kind Commitments: $0 Total Value of All Commitments: $16,303 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 08/10/2018 $15,770 Bea... Yes Cash Government Miami-Dade 09/10/2018 $533 County... Renewal Project Application FY2018 Page 34 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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: 08/10/2018 6. Value of Written Commitment: $15,770 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: 09/10/2018 6. Value of Written Commitment: $533 • Renewal Project Application FY2018 Page 35 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001811 6E. Summary Budget The following information summarizes the funding request for the total term of the project. Budget amounts from the Leased Units, Rental Assistance, and Match screens have been automatically imported and cannot be edited. However, applicants must confirm and correct, if necessary, the total budget amounts for Leased Structures, Supportive Services, Operating, HMIS, and Admin. Budget amounts must reflect the most accurate project information according to the most recent project grant agreement or project grant agreement amendment, the CoC's final HUD-approved FY 2017 GIW or the project budget as reduced due to CoC reallocation. Please note that, new for FY 2017, there are no detailed budget screens for Leased Structures, Supportive Services, Operating, or HMIS costs. HUD expects the original details of past approved budgets for these costs to be the basis for future expenses. However, any reasonable and eligible costs within each CoC cost category can be expended and will be verified during a HUD monitoring. Eligible Costs Total Assistance Requested for 1 year Grant Term (Applicant) 1a.Leased Units $0 1 b.Leased Structures $0 2.Rental Assistance $0 3.Supportive Services $60,946 4.Operating $0 5.HMIS $0 6 Sub=total,Costs Requested ` $60,946 7.Admin $4,266 (Up to 10%) 8.Total Assistance $65,212 plus Admin Requested 9.Cash Match - $16,303 10.In-Kind Match _ $0 11 total Match $16,303 12 Total Budget $81',515 Renewal Project Application FY2018 Page 36 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 7A. Attachment(s) Document Type Required? Document Description; Date Attached 1)Subrecipient Nonprofit No Documentation 2)Other Attachmenbt No 3) Other Attachment No Renewal Project Application FY2018 Page 37 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 Attachment Details Document Description: Attachment Details Document Description: FL0177 City of Miami Beach Match Documentation Attachment Details Document Description: 2017 HT CoC Match Documentation Renewal Project Application FY2018 Page 38 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 7B. Certification A. For all projects: Fair Housing and Equal Opportunity It will comply with Title VI of the Civil Rights Act of 1964(42 U.S.C. 2000(d))and regulations pursuant thereto (Title 24 CFR part I),which state that no person in the United States shall, on the ground of race, color or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the applicant receives Federal financial assistance, and will immediately take any measures necessary to effectuate this agreement.With reference to the real property and structure(s) thereon which are provided or improved with the aid of Federal financial assistance extended to the applicant,this assurance shall obligate the applicant, or in the case of any transfer, transferee, for the period during which the real property and structure(s)are used for a purpose for which the Federal financial assistance is extended or for another purpose involving the provision of similar services or benefits. It will comply with the Fair Housing Act(42 U.S.C. 3601-19), as amended, and with implementing regulations at 24 CFR part 100,which prohibit discrimination in housing on the basis of race, color, religion, sex, disability,familial status or national origin. It will comply with Executive Order 11063 on Equal Opportunity in Housing and with implementing regulations at 24 CFR Part 107 which prohibit discrimination because of race, color, creed, sex or national origin in housing and related facilities provided with Federal financial assistance. It will comply with Executive Order 11246 and all regulations pursuant thereto (41 CFR Chapter 60-1),which state that no person shall be discriminated against on the basis of race, color, religion, sex or national origin in all phases of employment during the performance of Federal contracts and shall take affirmative action to ensure equal employment opportunity. The applicant will incorporate, or cause to be incorporated, into any contract for construction work as defined in Section 130.5 of HUD regulations the equal opportunity clause required by Section 130.15(b)of the HUD regulations. It will comply with Section 3 of the Housing and Urban Development Act of 1968, as amended (12 U.S.C. 1701(u)), and regulations pursuant thereto (24 CFR Part 135),which require that to the greatest extent easible opportunities for training and employment be given to lower-income residents of the project and contracts for work in connection with the project be awarded in substantial part to persons residing in the area of the project. It will comply with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), as amended, and with implementing regulations at 24 CFR Part 8, which prohibit discrimination based on disability in Federally-assisted and conducted programs and activities. It will comply with the Age Discrimination Act of 1975 (42 U.S.C.6101-07), as amended, and implementing regulations at 24 CFR Part 146,which prohibit discrimination because of age in projects and activities receiving Federal financial assistance. Renewal Project Application FY2018 Page 39 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 It will comply with Executive Orders 11625, 12432, and 12138,which state that program participants shall take affirmative action to encourage participation by businesses owned and operated by members of minority groups and women. If persons of any particular race, color,religion, sex, age, national origin,familial status, or disability who may qualify for assistance are unlikely to be reached, it will establish additional procedures to ensure that interested persons can obtain information concerning the assistance. It will comply with the reasonable modification and accommodation requirements and, as appropriate,the accessibility requirements of the Fair Housing Act and section 504 of the Rehabilitation Act of 1973, as amended. Additional for Rental Assistance Projects: If applicant has established a preference for targeted populations of disabled persons pursuant to 24 CFR 578.33(d)or 24 CFR 582.330(a), it will comply with this section's nondiscrimination requirements within the designated population. B. For non-Rental Assistance Projects Only. 20-Year Operation Rule. Applicants receiving assistance for acquisition, rehabilitation or new construction:The project will be operated for no less than 20 years from the date of initial occupancy or the date of initial service provision for the purpose specified in the application. 15-Year Operation Rule—24 CFR part 578 only. Applicants receiving assistance for acquisition, rehabilitation or new construction:The project will be operated for no less than 15 years from the date of initial occupancy or the date of initial service provision for the purpose specified in the application. 1-Year Operation Rule. For applicants receiving assistance for supportive services, leasing, or operating costs but not receiving assistance for acquisition, rehabilitation, or new construction:The project will be operated for the purpose specified in the application for any year for which such assistance is provided. C. Explanation. Where the applicant is unable to certify to any of the statements in this certification, such applicant shall provide an explanation. Not applicable. Name of Authorized Certifying Official Carlos Gimenez Date: 09/07/2018 Title: County Mayor Renewal Project Application FY2018 Page 40 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 Applicant Organization: Miami-Dade County PHA Number (For PHA Applicants Only): I certify that I have been duly authorized by X the applicant to submit this Applicant Certification and to ensure compliance. I am aware that any false, ficticious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties . (U.S. Code, Title 218, Section 1001). Renewal Project Application FY2018 Page 41 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 Submission Without Changes 1. Are the requested renewal funds reduced No from the previous award as a result of reallocation? 2. Do you wish to submit this application Make changes without making changes? Please refer to the guidelines below to inform you of the requirements. 3. Specify which screens require changes by clicking the checkbox next to the name and then clicking the Save button. Part 2-Subrecipient Information 2A.Subrecipients X Part 3-Project Information 3A.Project Detail X 3B.Description X Part 4-Housing Services and HMIS 4A.Services Part 5-Participants and Outreach Information 5A.Households 5B.Subpopulations 5C.Outreach Part 6-Budget Information 6A.Funding Request X 6D.Match X 6E.Summary Budget X Part 7-Attachment(s)&Certification 7A.Attachment(s) X Renewal Project Application FY2018 Page 42 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 7B.Certification X The applicant has selected "Make Changes" to Question 2 above. Please provide a brief description of the changes that will be made to the project information screens (bullets are appropriate): Corrected Housing First questions and match The applicant has selected "Make Changes". Once this screen is saved, the applicant will be prohibited from "unchecking" any box that has been checked regardless of whether a change to data on the corresponding screen will be made. Renewal Project Application FY2018 Page 43 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 8B Submission Summary Page Last Updated 1A. SF-424 Application Type 09/06/2018 1B. SF-424 Legal Applicant No Input Required 1C. SF-424 Application Details No Input Required 1D. SF-424 Congressional District(s) 09/06/2018 1E. SF-424 Compliance 09/06/2018 Renewal Project Application FY2018 Page 44 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 1F. SF-424 Declaration 09/06/2018 1G. HUD-2880 09/06/2018 1H. HUD-50070 09/06/2018 11. Cert. Lobbying 09/06/2018 1J. SF-LLL 09/06/2018 Recipient Performance 09/06/2018 Renewal Grant Consolidation 09/06/2018 2A. Subrecipients 09/06/2018 3A. Project Detail 09/06/2018 3B. Description 09/06/2018 4A. Services 09/06/2018 5A. Households 09/06/2018 5B. Subpopulations 09/06/2018 5C. Outreach 09/06/2018 6A: Funding Request 09/06/2018 6D. Match 09/07/2018 6E. Summary Budget No Input Required 7A. Attachment(s) No Input Required 7B. Certification 09/06/2018 Submission Without Changes 09/06/2018 Renewal Project Application FY2018 Page 45 05/20/2019 FY :2018 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"W-9 Request for Taxpayer ID Number and Certification" Request• • • • for Taxpayer Form W-9 Give Form•to the (Rev.October 2018) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to_w_in0y irs gov/EormWafocinstructions-and-the-latest-information. • 1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank. • (i e/ w.. , 1A(ctr- B2.ccak' • 2 Business namisregarded entity name,if different from above , • 6 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the' 4 Exemptions(codes apply only to • g) fallowing seven boxes. . a. • certain entities,not individuals;see o ❑ Individual/sole proprietor or ❑ C Corporation ❑ S.Gor oration instructions on,page 3): p Partnership ❑'Trust/estate ai• c single-member LLC Exempt payee code(if any) •0 0 ❑ Limited liability company.Enter the tax classification'(C= =ParR C corporation,S=S corporation;Ptnership) ' Note:Check theappropriate box in the line above for the tax classification of the:single-member .owner. Do.not check' Exerription.from FATCA reporting • in LLC if the LLC is classified as a single member LLC that Is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from t :S he.owner for Ufederal tax purposes.Otherwise;a single-member LLC that.code;("any) 9- ° Is disregarded from the owner:should check the appropriate box for the tax classification of its owner. - - • .2: ❑..Other(see instnictions)'► _ .. •(App/rep to accounts maintained outside minus.) . • W•5•Address(number,street'and apt or suite no ea:instructions: 6..' . Requester's name.and address(optional) '00 wr1uQri+ On U2i1-i¢er . r, v. • . 6 City,state and ZIP code &A tQ rY)i � .Qui&. R- 33l�.. 7 List account number(s)here(optional) / . Mal .Taxpayer Identification.Number(TIN) Enter your TIN in the appropriate box:The TIN-provided must match-thename given on"line 1 to avoid • _I.Social security number ' backup,withholding.For individuals,this is generally your social security number(SSN)..However for a •• resident alien soleproprietor,or disregarded entity,seethe instructions for Part);later.For other entities,it is our em lo"er identification number EI If You do not have a number,see How.to get a Y Pv ( .M- y TIN,later; or Note:If the account isin more than one name,see the instructions for line 1.Also see What Name and • Employer identification number Number To Give'the Requester for guidelines on whose number to enter. DDU3 .Certification ,:• Under penalties• .of perjury;I certify that . • • - • 1.The number shown on'this form is my correct taxpayer identification;number(or I ernWaiting for a number to be issued•to me);.and ' 2:I am not subject to backup withholding because:(a)I am'exempt from backup withholding;or(b),I have not been notifiedby'the Internal Revenue Service.(IRS)that I am•subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS:has_notified me that I am no longer subject to backup withtolding;'and - - • 3-I am a U.S• .citizen or other U.S:.person(defined below);and .. •. 4 The FATCA codes)entered on this form(if any)indicating;that I am exempt from FATCA reporting is correct. Certiification instruction's.You must•creas out•item,2 above;if you have been notified by the•IRS that you are currently.subject to backup withholding`because you have failed toreport all interest,and•dividends on your tax return For real.estate.transactions;;Rem 2 does not apply:-For mortgage-interest.paid, ' acquisition or abandonment of secured propertyCance tion of debt,contributions to an individual.retirement arrangement(IRA) and generally,payments. other than interest-and•dividends you of r.q +redo ign•the certification but you must provide your correct TIN.See the instructions for Part Il,later. ' nature o. -1 Sign Sig Here U.S.person • !''� Data► !` /• l�] General Instructions Form 1099-DN dividends,includin those from stocks or mutual • funds)' Section referencesare•te the Internal Revenue Codeunlees otherwise •.Form 1099-M[SC(various es•of income rues awards,;or toss.- noted.. tYR ,P 9 prbeeeds} Future developments For the latest information about developments .•Form 1099 B(stock•ormutual fund sales and certain other • • related to Form W-9 and its instructions,such as legislation enacted transactions by brokers) after they were published,.go to www irs gov/Form W9. Form 1099-S(proceedsfrom real estate transactions)' Purpose of.Fornl' !.Forth 1'099-K(merchant card and third party network transactions) . An individual or.entity(Form W-9 requeste"r).who is required to'file.an Form 1098(home:mortgage interest),1098E(student loan interest), • information return With the IRS.must obtain your correct taxpayer: 1098-T(tuition). . .. ...•:-.. identification number(TIN)which•may be yoursocial security number •Form'1099,C(canceled debt) • (SSN),:individualtaxpayer identification number(If IN);adoption.: , -• ' • : . - - taxpayer identification'number(ATIN);or employer identification:numb r •Form 1099-A(acquisition or abandonment of:secured property) - (EIN);to report en an information return;the amount paid to you,'or other • Use Form W-9 only if you are a 0.s.person(including. a resident- • • amount;reportable'on an.information;return.Examples of information alien),to.provide•.your correct TIN • • returns include,but are not limited to,the following: , If you do not return.Form W;9 to the requester with a TIN you might • • . •Form 1099-INT(interesteamed or paid) .. be subject to backup withholding..See What is backup withholding, . • . • later. , Cat.No.10231x• Form W-9.(Rev.10-2018) • Form W-9(Rev.10-2018). : Page 2 By signing the filled-out form,you: ., ,: . • Example.•Article 20 of the_U.S: China income tax treaty allows an • 1.Certify that the TIN you are giving is correct(or you are waiting for a exemption from tax•for.scholarship income received by a Chinese number to heissued), • student temporarily,present in the :United States.Under.U.S.law;this .studeenit 111;bec�srn'e'a residentallerrfortaxpurposea if-his-brher'stay-in— 2.Certify that you are subject to backup withholding;or the United States exceeds 5 calendaryears.However paragraph 2 of 3.Claim exemption from backup withholding if you are a U.S.exempt the first Protocol to the U.S.-China treaty{dated_Apr11.30,1984)_allows • payee.If applicable,you are also certifying that as a U.S.-person,your the provisions'of Article.20 to continueti ,,to apply even after the Chinese allocable share of any partnership income from'a U.S.trade or business ' • student becomes a resident alien'of the United States A Chinese is notsubject to the withholding tax on foreign partners',_share of` student who:.qualifies for this exception(under paragraph.2 of the first effectively connected income,and . ' . protocol)and is relying on•this exception claim;an exemption-from•tax 4.Certify that-FATCA code(s)entered on this form(if any)indicating . . on his or her scholarship or fellowship income would attach-to Form. • that you are exempt from the FATCA reporting,is correct.See What Is W-9 a statement that includes-the information described above to •• FATCA reporting,:later,for further.information: support that exemption. . Note:.If,you are a U.S.personand a requester gives youa form,other :If you are a nonresident alien.or a foreign entity,'give tle'requester the • . • than'Form W-9:to.request your TIN,you:must use,the requester'sform if appropriate'completed Form W 8 or Form,8233 it is substantially similar to:this Formal 9 Back.- Withholding Definition of a U.S.person::For federal tax.purposes,;you are : - • - . considered a U.S.'person if you ares • What is backup withholding?P'ersons•making certain,payments to.you An individual who is a:U.S.:citizen-or U S resident alien; must under main condition`s withhold and pay to'the IRS 24%of such payments.This is called backup withholding Payments that maybe, •.A partnership,corporation,..company or association created or, • subject to.backup withholding.include interest tax-exempt interest organized-in,the United:States or underthe laws of the United States; dividends,'broker and,,barter exchangetransactions rents,royalties, • " •An.estate.(other than'a foreign estate);or - nonemployee pay;payments+made in settlement of.payment card and •A.domestic trust(as defined in Regulations section.301 7701-7). third party network transactions,and certain paym•ents frorrifishing boat operators-"Real estate transactions are not subject to backup Special rules for partnerships.Partnerships.that conduct a trade or,.' withholding.': business in the United States are,generaliyrequired;to pay a withholding. "You will not be subjectto backup withholding.onpayrzienfs you tax under section 1446on any foreign partners'share'of effectively . . :receive if you give the requester-your correct TIN;make the proper. conhected taxable income:from such business.Further;in certain cases certifications;and report ail yo r-your and dividends on. our -where a Form W-9-has not`;been received,the.rules under section 1446.` • y• require a partnership to presume that a partner is a foreign person and, tax,retum pay the Section:1446 withholding tax.Therefore if you area U S.,'person• Payments you receive will be subject to beckup withholding if. • that is.a-partner in a partnership conducting`a.trade:or business in the., 1.You donot#umish your TIN'to the requester,.., • ' United States provide Form W,9 to.the partnership to:establish.your • • • ' U.S.status'arid.gold section 1446.'withholding on your share of., 2.You do:not certify your TIN when required(see the instructions for partnership income •Part afar details) - In the;cases below,the following person must give Form W-9 to the 3.The IRS.tells•the requester that you furnished an incorrect TIN, , . partnership for purposes of establishing its U.S.atatus.and avoiding 4....The-IRS tells Y61.1thatyou are subjectto backup withholding ' withholding•Oni taallocable share of net income from the loartnerehip because you,did not report'al[your interest and dividendson.your tax. conducting a trade or business in the.United:States return(for reportable interest and dividends only}or • ....in the case of a disregarded entity,with a W.S.owner;the U.S.:owner 5.You do not certify the requesterthatyou:are not subjectto .: - ' `of.the disre ardedenti and not the.:enti • ` backup withholding•under 4 above(for reportable`interestand dividend, g ty . accounts,opened after;1983 only). ' • - •In the case of a grantor trust with a`U S grantor or.other U S owneY • .. - generally the U:S.`grantoror other U-S,.owner of the grantor trust and • Certain payees and payments;are exempt from backup withholding not the trust;and: See Exempt payee code later:and the separate Instructions for the: • f F • m rmat In the case of a U.S.trust.(other than a grantor trust);the U S trust Requester o:.•orm•W S for ore info ion ' ,(other than;a grantor.trust)and•not the beneficiaries of the trust,,. • Also see.Special rules for partnerships:earlier, Foreign,person.It you-area foreignsperson or:the U-S.branch of..k... What is FATCA Reporting? • foreign bank•that_has elected to be Treated as:a U S.person do,'.not use .• Form W-9 Instead;use the:appropriate Forrri:W 8 or Form 8233(see ` The Foreign Account Tax Compliance Act(FATCA);requires a Pub 515,Withholding of Taxon Nonresident Aliens.and-Foreign-: -• participating:foreign financial institution to repo'rt.;all United..States • Entities). • • account holders that:are specified United;States•p•ersons:.Certain, . • Nonresident'alien who becomes a resident ellen.'.Generally,only a payees are exempt from FATCA,reporting See Exemption from FATCA nonresident alien-individuarMay use:the terms.of atax treaty to,'reduce -. reporting code later,and the Instructions for the 13•equester of Form, .or eliminate U S.'tax on.cer •tain es of ineorri0 However mast tax W-9.for-more in•formation • - tYp ,: treaties Contain Aprovision•known as a saying•clause:!'Exceptions ` Updating YOW' Illfotillat1017 specified in the saving clause may permit an:exemption.from tax to • continuefor certain types of income,evern after the;payee has`otherwise Youmust'provide updated inforhationto. • any person to,whom you become a U.S.resident':alien for tax:purposes. f claimed to bean exempt payee if,you.are no'longer an:.exempt payee If you'ar6 a•U S :resident:•alien who,is relying on an.exception and anticipate receiving reportable payments inthe future from this . contained in the:saving•clause of a tax treaty to claim an exemption . - person For-example,you may:needto.provide.updated information.if from'U.S.-tax on certain-types of income you must attach a statement' you area C'corporation,that elects•to be an S corporation;;or if you,no : •. to Form.W 9:that specifies_the following five items longer aretax exempt.In addition,you must furnish a newForm W9 if' • 1 Thettreaty country Generally,this must be the same treaty under the name.or,TIN changes for the account;for example if the grantor of:a • ' : which you claimed exemption from:tax as anonresident alien- ''. grantor trustdies • • 2.The treaty article addressing the.income:. Penalties • - 3 The article number(or location)in the tax treaty that contains the • saving:clause and its exceptions Failure to furnish TIN:if you fail to furnish your,correctTIN-to'a . 4.Thetype and amount of income that qualifies:for•the exemption requester,you are•subject to a:penalty.,of.$50 for each such failure. . from:tax : unless:your,failure.is due'to reasonable Cause and not to willful neglect. , . 5:Sufficient facts to justify the exemption from tax under the:terms of Civil'penalty false information withrespectto withhold• ing..If you . - - • •the.treaty article ,- '' - -. makes false statement with no reasonable basis'-that results.in'no. , . - ' backup withholding,you are subject to,a$500.penalty • Form W-9(Rev.10-2018) . Page 3 • • Criminal penalty for falsifying information.Willfully falsifying IF:the entity/person on line 1 is THEN check the box for.... certifications or affirmations may subject you to criminal penalties a(n)... entt including fines and/or imp 1sonm Misuse of TINs.If.the requester discloses or uses TINs in violation of • Corporation • Corporation federal law,the requester may be subject to civil and criminal penalties. •'Individual -Individual/sole proprietor or single- . • Soleproprietorship,or• member LLC . Specific. Instructions. • Single-member.limited liability company(LLC)owned by an • Line 1 individual and disregardedforU.S.. You must enter one of the following bn this.line;-do.not leave this line ' federal.tax purposes:.. . blank.The=name should match the:name on your tax return. • LLC treated as a;partnership for Limited liability-company and enter If this Form-W-0 is fora joint account(other than an account . U.S federal tax purposes, the appropriate tax.classification. maintained by a foreign financial institution(FFI)) list first,and then. • • LLC that has filed Form 8832 or (P=-Partnership;C=C corporation; circle,the name`of the person or entity whose number you entered in 2553 to::be taxed as a corporation, or 5=S corporation) Part I.of•Form1N 9.If you'are providing Form W 9 to'an,FFl to document or a joint:account,: each holder of the account that is a U.S.person must-. provide a Form.1N 9 LLC that is disregarded as an . entity separate from:its.:owner but a •Individual.Generally enter the name;shown on your tax return.If the owner is another LLC that is you•have changed your last name without,informing the Sociaf,Security not disregarded for U.S.'federal tax- ' Administration SSA of the name change,enter. our.first name,the.last - ..�, ) 9. Y purposes. name as shown;on your social security card;and your-new.lastname. Note:ITIN•applicant~Enter your:individual name as�itwas entered on ' Partnership Partnership. your Form W-7 application,iine`1 a.This`should also be the•same as he • Trust/estate Trust/estate' ' . name you entered on the Form 1040/1040A/1040EZ you filed-with.your application: Line 4, Exemptions .• b..Sole proprietor orsingle-member LLC Enter your individual`• If.you are.exempt from backup withholding and/or FATCA reportiing,': name as,shown on,your 1040/1040A/1.040EZ.oh line.1.You may enter enter in the appropriate space on line4 any Cadets)that may apply to. ou your business,tratle;Or°doing business as"(DBA);'hame online 2 y. • c. Partnership,LLC that isnot a single-member LLC,p,• Exempt,payee code:.; corporation,or S.corporation.Enter the entity's name as shownon the • Generally,individuals(including:sole.proprietors)are not exempt from• entity's tax return on line 1 arid any business,trade,.or;DEA name on backup withholding.' fine 2 • Except es provided below corporations are exempt from backup' • d. Other entities Enter your name as shown on required•U.S.federal • withholding for certain payments,including interest and dividends..., tax documents on line-l::This name should match the name shown on.the • Corporations are hot exempt from{backup withholding;for payments, charter'or other legal document creating theentity.You may enter any;.= made•in settlement of .a menticard'or third a • busines's trade,:or DBA name on line 2 . p Y Party networletransacfions: e Disregarded entity.For U S federal tax purposes,an entity that is, • Corporations are not exempt from backup withholding'wiith respectto aftorneys fees or gross proceeds paid to attorneys,and corporations • -disregarded as an entity separate from its owner is treated as a that provide medical or health-care services are'net exempt with respect "disregarded entity.",See.Regulations section 301'.7701 2(c)(2j(ui).Enter to payments'reportable'on Form.1099-MISC. the owners name on line'1 The-name of the-ent entered online 1. = - The followingcodes identi a eesthat are.exem p should never be a d•isregarded entity The name online lshould be the; fyP Y pt from backu name shown on the income tax return onwhich:the-income:should be withholding;Enter the appropriate"code.in the space in line 4. reported.For example,if a foreign LLC that is treated as a disregarded i—An organization:exempt from tax under section 501(a),:any IRA,or: entity U.S:federal tax purposes has a single owner that;is a U.S. a'custodial account under section'403(b)(7)if the account satisfies the person,the U.S.owner'sname is required to:be provided on line 1.If:. •. requirements of section 401(f)(2) the direct owner:of the.entity is also a disregarded entity enter the first;. � 2-The United States or any of its agencies or.instrumeritalities . owner that is not disregardedfor federal,tax,purposes.•enterthe .'3=A state-the District of Columbia a U S commonwealth or disregarded entity'S name on line 2 Business name/disregarded entity •• name..-"if the owner of.the'disregarded entityisa-foreign person the" , possession,or any of their political subdivisions`or instrumentalities owner must coiimplete'an appropriate Forrri:W-8 instead of a Form IN=9. , 4—A foreign government or any of its political subdivisions,agencies, Thiels the case even.if the foreign person has a U S.TIN m or instrumentalities.: . • Line 2 • 5—A corporation' _ . If you•have a,business name trade:name,DBA name,,or disregarded, 6:-A dealer in securities or.commodities required to register in the entityname,you;Mal/enter it-on line 2. United States the District of Colum•bia,or a U S..commonwealth•.or Line.3- possession'' .' 7-A futures commission merchant registered with the Commodity Check•the appropriate box on'line 3 for the.U.S.federal'tax Futures Trading Commission. , • .. • - . ` classification of the person whose name is entered on line 1.Check only 8-A realestate investment trust one box online 3: 9-An entity registered at all,times during the tax year underthe • - Ilnvestment:CompanyAct of•1940 . ' 10—A common trust,fund operated by a-bank under section 584(a) 11; A finanoial institution -. 12-A middleman known in the investment communityas anominee or ' custodian . 13—A trust exempt.from tax under section 664 or described in section • 4947 • • • Form W-s piev.10-2018) • Page 4 The following chart shows types of payments that may be exempt M-A tax exempt trust under a section 403(6)plan or section 457(g) from backup withholding:The chart applies to•the exempt payees listed• plan • • above,1 through 13. Note:You may wish to.consult withthe financial institution requesting:. IF the payment is for... THEN the payment is exempt this form to determine whether tie FATCA.code and/or exempt payee for....• code should be completed. . Interest and dividend'payments . All exempt payees xcept ; ' Line 5. • for 7• Enter your address(number,street;:and`apartment or suite number).' Broker transactions ' Exempt payees 1 through 4 and:6 This iewhere the requester of this Form W-9 will mait your information 'through 11 and all C corporations. returns.If this address differs from the one the requeater already has on P chance.fhe old address will'be used.. til to s provded,there is still a S corporations�must not enter an exempt payee.code because they e payor changes your ' are exempt:only•for sales of: '- - address in theirrecords. •. - • noncovered.securities acquired pnorto 2012. ' LI11e 6' Enter your city state,and•ZIP code Barter exchange transactions and Exempt payees 1 through 4 patronage:dividends• . Part I. Taxpayer:Identification Number(TIN)`: • Payments over$600 required to be Generally exempt payees '. Enter your TIN•in the appropriate box:If;you•area resident alien and reported and direct over . • :1 through 52,.. you dd-Tnot have and are not eligible,to get an:SSN;your.TIN is-your-IRS . $5;000' - individual taxpayer;identification num er(ITIN).Enter it ibthe social security • • number box•If you�do not have an ITIN see Now fa get a TIN �. Payments made in settlement of • -Exempt payees.:through 41..:'-' ' below payment card-or third party network If you;are a sole ptopnetorand,youhave arrEIN you.may ente':••••": either • . transactions • your.`SSN orEIN.. . 1 See Form 1999-MISC,:Miscellaneous Income and ita instructions If you are asingle-member-LLC:that is disregarded as an entity separate from itsbwner enter the owner's SSN(or EIN,if the owner has z Hovaever,the•:follewing payments made:to a corporation and one),Do"not enter the disregarded entity's EIN.If the LLC is classified as reportable on Form 1099 MISC are not exemptfrom backup a corporation orpartnership,enter•tfie entity's,EIN. withholding:medical and health;care.payments attorneys::feesgross • Note:See What Name and Number'To Give the Requester later,for pa meats fol ser is attorneb afederalexe u secaion dy.'.) and':. , further clarification of name:and TIN combinations payments'for seances'paid by a federal executive agency. - ` Exemption from FATCA reporting code.The following codes identify •How to'get a TIN.If you'do,not have:a TIN apply•for one immediately.;' payees that are exempt,from reporting under FATCA These codes•.••' To apply for an SSN,get Form SS-5,,Application for.a Social Security; • apply tb persons submitting this form`for accounts`,maintained outside; : Card,•from your local,SSA office or get thisform online at of the United''States by;certain.foreignfinancial institutions Therefore;,if www SSA.gov.You may also get this:form by calling 1-800 772-1213.. ou•are onl submittin 'this',form,for an account ou hold in.the United Use Form W 7 Application:for IRS Individual:Taxpayerr-Identification Y Y g. YNumber,to apply for an ITIN,or Form SS-4 VApplicationfor Employer : States,yqu may leavethis field;biank.Consult with the'person . requesting this form•ifyou are uncertain if the financial institution as ., Identification Number to•apforplyan'E1N You:can apply for an_EIN subject to these requirements..A=requem steray indicate that-a code is online by;accessing the IRS website at www irs gv/B ousinesses and. not required byproviding you•with a•Form..: 9 with, Not,Applicable'.'(or choking on Employer ldentifeation Number{EIN)under'Starting;a. - any similarindication)wntten,ofprnted ori;the linetfor a FATCA •'Business:Go to www irs goviForms to view;download;or print;Form • exemption code • W-7 and/or Form SS 4 Or:you can go to www irs govlOrderForms to A.;An or anization exem t.from tax under section 501 a.•or an place an order and`have Form W 7 and/or SS-4 mailed to you within:l0 9 P O. Y business:days individual retirement plan as defined in section 7701.(a)(37) If you are asked;to complete Form b -W 9 ut do not have a TIN,•apply: B=The United States or any ofits agencies,orinatrumentalities • '`for-a:TlN'end write.`"'Applied For in.the space for theTIN signand.dete C—A state,the District of Columbia a U.S commonwealth or the form;and give;it to the requester:For interest and dividend:; : possession r. oany of their political subdivisions or instrumentalities payments,,arid certain payments made with,respect to:readily tradable: , . • D..-A corporation the stock of which is regularly traded on.one:or. "instruments;generally you;will have;60 days,to get a TIN,and give it to • , . more established securities markets,as described Regulations the requester before you are subject;to backuPcwithliolding on_ section 1 1472-1(c)(1)(i)' • payments.The 60tday rule-does•notapply•to othertypes of payments.' • E-A corporation that is a member of the same expanded,affibated you pwill bde yo je t t i9 the requesterding • _ on all such payments;until. • group-ea:a.corporation:described in Regulations section 1 14.72 1(c)(1)O • • ' •F=A dealer.in securities commodities;or derivative financial - ' • "Note Entering Applied For",means that you have already applied fora. TIN or that you intend to apply for one soon instruments(including notional principel:contracts;futureS,forwards, - : and options)that is registered as such-under the laws of the United Caution:A disregarded U.S.entity that has a foreign owner must use States or any-state. • the appropriate Form W-8: " G=A real estate investment trust tlo • . ... .. � � Part; h Certiftca n H.-A,re•gulated inve •stment company as defined.in section:;851 or.an To•establish tothe withholding agent that you.are a U.S.person,•.or , entity registered at alltihtes during the tax year under theanvestment, resident alien,sign Form W-9.You may be.requested to sign"by the Company Acfof 194• - withholdiing.agent even if:item f',4,or 5 blow indicates otherwise. ' ' I A.co • mmon trust:fund as defined in section b84(a) < For a joint;account,,only the perso • n whose TIN is shown in Part I • 4-A bank as defined in section 581 ` ; .- should:sign(when:required)••In the:case of a disregarded entity,the. ' K:-A broker - . • person identified on line i must sign.Exempt payees;"see Exempt payee ..L—A trust exempt from tax under section 664 or described in section code earlier. 4947(a)(1) • ' •. •Signature requirements.Complete the certification as indicated'in • . items 1 through 5 below. • • • • • • • Form W-9(Rev.10-2018) Page 5 • 1..Interest,dividend;and barter exchange account.Topened For this type of.account: Give name and EIN of: before 19.84 and broker accounts considered active during 1983. 14.Account with the Oepartmentof The public entity You mils_f giy_�y_QutcolxeL T1N,bnLyou do noitiave.1asignuh - certification: ,gnculture in the name of a public " . ' entity(such as a state or local 2.Interest,dividend;broker,;and.barter exchange accounts government school district,or opened after 1983-and:broker accounts considered inactive•during prison)that receives agricultural. 1983.You must"sign,the certification or backup withholding will apply.If program payments • • • "you are"subject to backup withholding-and you are merely providing " your correct TIN to the;requester;you must cross opt item 2 in the - 15.Grantor trust filing.-under the Form :- The. trust- " - '. ' certification before signing the form. . 1041•Filing Method or the Optional " 3.Real estate transactions.You must sign the certification.You may Form 1099 Fling Method 2(see " cross out dem 2 of the certification. Regulations section 1.671-4(b)(2)(i)(B)) - 4 Other payments:You must give your correct TIN but" you do not 'List first and circle the'name of the person whose number you furnish. have to sign the;certification unless you have.been notified that you'' • If only one:person:on a joint account has an SSN;that:person's number have previously given an incorrect TIN 'Other payments,include`_ . must be furnished. • payments made in the course of the requester s trade or business for 2 Circle the minor's name•and furnish the minor's SSN. rents;royalties,goods(other'than bills for merchandise);.medical and - health%care services(including payments to corporations),paymentato • 3 You must show your individual name and you may also.enter your a nonemployee for services payments made in settlement of payment business'or DBAname on the`Business name/disregarded entity" card and third party network transactions,payments to certain fishing name line..You may use either your SSN or EIN(if you.have one);.but the . boat crew members and fishermen, gross androceeds paid to. _• IRS•encourages you to use your SSN. attorneys(including payments to corporations): • 4 List first and circle the name,.of the trust,estate,or pension trust(Do 5.Mortgage interest paid byyou,:acquisition or abandonment of not furnish the of the.personal representative or trustee unless the secured property,cancellation of debt,Of tuition program legal entity itself is not designated in the account title.)Also.see Special. payments(under section 529),ABLE accounts(under section 5.29A),; rules for partnerships,earlier:. • IRA;:Goverdetl ESA;Archer MSA or HSA contributions or *Note:The grantor also must provide a Form W-9 to trustee"of trust. distributions,and pension distributions.You must give your correct Note:If no name is circled When more than one name is.listed;the • TIN;_but you do not have to sign th"e,cerhfcation. number will;be considered to be that of the first name listed. ' What Name and Number TO.Give-the Requester. . Secure Your'Tax Records From Identity Theft • For this type of.account Give name:and SSN.of•-.: '' Identity theft occurs when sotneone uses your personal information " 1:Individual The individual '" such as your name;SSN,or.other identifying information,without your •. • 2.Two or more individuals foint The actual owner of the account or,if . permission,to commit fraud orother crimes.An identity,thief may use .account)other than an account combined funds,the first individual on your SSN-to get a job•or•may file a tax return using your SSN to receive . - ' : maintained by an'FF1 the"accounts a refund. . 3-Two or more U.S persons Each holder of the account To reduce your risk: Gointaccount:maintained by an FF) •'Protect your SSN, ' • 4.Custodial account of a minor: The minor2 - . •Ensure your employer is protecting your SSN;and (Uniform Gift to Minors Act) •" •Be careful when choosing a tax prepares. . 5.a.The usual revocable savings trust The grantor=trustee ' • If your tax records are affected'by identity theft and you receive a' (grantor is also trustee) " hoticefrom the IRS,respond,right away to thename and phone number: ..• b.;So called trust account that Is-not The actuaowner •. l , _ printed on the IRS'notice or.letter. • a legal or valid.trust under state.law ' . .If yourtax"records are not currently.affected by identity theft but you ' 6"Sole"proprietorship or disregarded The owner3 think you:are at risk due to a lost or stolen purse or wallet,questionable, entity owned by an individual - credit card activity or credit"report;contact the IRS.Identity Hotline.' " . - 7:Grantor:trust filing under;Optional' The grantor*' at 1-800=908 4490 or submit,Form:14039. - • Form 1 • 099'Fling Method 1(see'.. For more information;see Pub._5027,Identity Theft Information for Regulations section 1`.571=40(2)0. Taxpayers._ - (A)).. • • Victims of of theft who are.experiencing economic harm:or•a . For this type of account, " Give name and'EIN Of:, systemic problem,.or are seeking help in resolving tax problems that 81Disr•egarded.entity not owned.by,"an•• The owner- - have not been resolved through.normal channels may.be eligible for . individual.." Taxpayer Advocate.Service(TAS)assistance:You can reach TAS'by 4` -calling the TAS toll-free case intake line at 1-877-777=4778 orTTY/TDD ' 9 A=valid trust,.estate Cr pension trust Legal entity .1-800-829-4059. 10.Corporation or LLC electing The corporation. • Protect yourself from suspiciousjemails or phishing schemes. rm corporate status on Fo8832 or Phishing is the creation and use:of email and websites designed to 'Form 2553 ;, ' - - " mimic legitimate butinest,emailt and websites:The most common apt 11.Association,club,religious, The organization. m 'is sending.an email to a user falsely claiming to be an established . charitable educational,or other tax- legitimate enterprise'iin an attempt.to scam the user into surrendering. " exempt organization private information that will be:used identitytheft 12.Partnership or multi-member.LLC. The"partnership. • .. . 13 Abroker_or.registered nominee. The broker ornorriinee Form W-9(Rev.10-2018) Page 6 The IRS does not initiate contacts with taxpayers via emails.Also,the Privacy Act Notice, IRS does 'not request personal detailed information through email or ask . taxpayers for the PIN numbers,passwords;or•similar secret-access. Section 6109 of the Internal Revenue Code requires you to provide your mtormation for their credit card;Tank,or other-financial accounts. correct—TIN-to-persons(including-federalagencies)-who-are-required4o - - Ifyou receive an unsolicited email claiming to be from the;IRS, file information retues id to he IRS to-report interest,dividends,or forward this message to phishing©irs.gov.You may also report misuse acquintion or abar a paid to you; ure •d pr pert;th ythe of the IRS name,logo,or other IRS properly to the Treasury Inspector acquisition or abandonment of secured A,Ar ty,the cancellation of General for Tax Administration(TIGTA)at 1-800-3664484.You Can debt or contn4utionsfor made to an IRA;Archer MSA;or HSA.T• he' forward suspicious emails to the Federal Trade Commission at person collectingahis form uses the information on-theform to file. sparnauce.gov or report them at www.ftc.gov/complaint-.You•can;... information usesrof thiss informationthe.IRS, g giving it t the Depatme contact the FTC at www.ffc.gov/idtheff or 877-IDTHEFT(877-438-4338): Ro•utine of this itigti include to pitied, it to the s,the Ment of If you have been the victim of identitytheft,see'www IdentityTheft gov Justice for civil.and criminal:litigation and tosses;sfates the District of and Pub.5e 7. ` Columbia,and U.S.commonwealths,and possessions for use in . administering their laws The information also disclosed=to other Visit www irs.gov/IdentfiyTheft.to learnmore about• identity theft and countries;;under a;treaty,to f•ederal and state agencies td enforce'cNil how to reduce-your risk. -- • and criminal laws,or to federal law enforcement and intelligence " • agencies to combat terrorism You must provide your,TIN whether;or•` . not you,are requ¢ed to file a tax return Under section.3406 payers; must generally withhold a percentage of tax le interest,dividend and' . certain other payments to:a payee who does not give a TIMI to the payer. .. Certain penalties may also-apply for providing false,or fraudulent'- - information - • • • FY 2018 • Miami-Dade County Homeless Trust Continuum of:Care (CoC) Program • "Affidavits and Declarations" • • • • • ATTACHMENT D"Affidavits and Declarations" . . . . • . . .. . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . , . . _ ., . . . . • . . . . . . , , . . . . . . . . . . .. . . . . , . . , . • ' . . . . . . , . . . . , , , ' , . . . . . , . . . . . " , ' . ' • , . , . . . , . . . . . . . , . . . . . . . . . . . .. . . . . • . . . . . , :. . • • . . . ,. . . . . . . . . .. . . . . . . . . ' . . , . . . , . . . .. .. . . . . , , . , . . " . - • . . . . , . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . . . , , . . . . .. . . . . . , . . . . . . . . . . . ' ' • .- . . . . . . . . . , . . . . . . . :. . . . . . . . . . . . . . . , . ' . . . . . . . . . . . . . . - . . . . . . , . , . , . .. - . . . . .. .• . • , . . . . . . ., . . . . . . . . . . . , . . . , . . " . .. . • , . . , . . . . . . . . . . . . .,.. ,. . , . . . . , . . . . . • " .... . .- •. - . . . , . . . . , . . . , . .• . , . . . . . •,. , , . . . ' . . . . • . , • . . . . . . . . . . . . . . . , .- . . .. , „. ,, . ..,, . . . . ,., , .. . .. . . . , . . • . . ' . . . . . . .. . . . . . , . . .. , . . . . . . ... . . . . . • . . , . . . ., . .. . . . , , . . , . ., . . . .. . , . . . : . . • . .. . . , , .. " ... ..• . . , . . . . . . . . . • . . . . , , , . . . - . ' .. . . , . . . . .. . . . . . . . , . ,. • • . . . . . , ,. . . . ' ' • . . . . . .. • • _ . . . . . . . - , . - . . -. .... .., . . . . . . . . ' . . . „- . ..s. ' . .. . .. . , . . . . . . . , . , . . . . . . . . . .: . . .- . . . ., . . • . . , , .. . . . . . . , . . . . , , . . , . . . . . . . . . . . . . - . .. . . . . . . . . . . . , .. . . .. ' , . ., .. . .. .... . , , .., . . .. , . . . . . .. ... . . .. . . . . . .. .. . . . ' - .. • '., . . . • ,_,. . .... . . . . , . . . :. , . , . .. , . . . . . , .. . . .. . . . .• ..- . ,.. . . . .. . .. . ., . . , . , . . . . , . . . • -" ,' . . . . . . . .. . ' . . , • , , . . . . . . .. . . . . .. . , . . . . . . , . . . , . . . . . • ' . . , . • . . , ,. . , .. .. . . . . . _ . . . • . . , .. . , .. . . . . . .. ., . . . „ . " , . .. " ' , . . • •. . . .... , . . . . . , . . ... .. . . - . . . • " . . .. , • . . . . . , ... . . . . . . . . . . . , ' , . _ . . . . . . . . . . . . . . . . . . . . .. . . . , . , .. .. . . . . .• , . . . . . . . . . ' . ' . ,. . . . . . . . . . .. . . . . . . . . .. . . . . . , . . . ., , . .. . . . . . . . , . . • . . .•.. • ... . . • . . . . ,, . ., . . . . . .. . . . . . . , . . . , ' , . . .. . ,.. .,. . . . • ' . . . .. - .. ,. . • ,........ . . , , , . . . . . . . . .. .. . . . , , . . .. . . . . ... ..,, . . . , .. . . . . . . . , .„... . . . , . . . . , . . . . • . . . . . . . . . . . . . , • . . .. . . , . . . . . .. . , . .. . .. .. . . . . . . . , . . .. _ . . . . . . . .. .. . . .. . . . . , . • , . . . . , • . . . . , . . . . , .. . . . . . ... .. .. , . , ,.', . . ' . : , . . . , , . . . . .. . . ... . • . • .' . . . . . ' . , •, ,'.. . •', — -• . •.. , ''. . ,. .. . . . . . . , . . . . . . . . . . , .. ., ,. .. , , .. . . „ , . ., ,. . . . . . . . . . . . .. .. . . .. , . . . ' . . . . . . . . . . . . . . • . . . , . , . .. . ., .. . ..... , .. . . . .. . . . . .. . . . - .• •, . . . . . . . . . , . . . , • . . " ' • •" , .. : , , . , . .. . . . , . . . . . . .- . . . ., . . . . . . . . . ' . . . . . . , . . . . •, ... . .... , .. . . . .. .. : .. , : . , . . • . . . . . . . . .. . . .. .. . .., . . .. . ' , . „ . ' - • . . . . . . . . . . , . . . . . . . . . . . . . , . . . . .. . . . , .. • . ., . . ,. . . . . . . . . . . . . . . . , . . . . .. . , , „. . . ,,, .... . . . . . . . .. . . . . . . .. . . . . . . . • • . . , . , . . . . . . . . . . . . . . , , , . . , . . . . . . . . . . . . . . . . . . . . . . . , . . . . . -.,, . . . . . . . . . . . . . . . . . . . . • .,.. . • • . ,. , . . . . , . . . . . . . .,,.. . .' . . . . ' - - " • ' • - . . .. • . . .. . , „ . . . . .. . . . . . . , . . . , . , ,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . .. .. , . ... . . . .. . . . . . . ' ' • • • . . . . • . .. . . . . . , . . . . , . . ., . . . ,. . . . . ., . . . .. •.. ,. , , . " . . . .. ... . . . . . ' • . • ' .. . . . . • , • . .. -. . .,. ._ - . .. . . . . , .• ,.. . Miami=Dade County's Affidavits and Declarations MIAMI-DfADE COUNTY • Miami-Dade:County requires eachparty desiring to enter into a contract with Miami-Dade County to; (1) Sign an affidavit as tocertain matters and (2) make adeclaration as to certain other matters. This " form contains both Affidavit forms for matters requiring the entity,y 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 acid/or compliancewith'the County's policy related to the particular'affidavit For affidavitsections that you sdo not believe are applicable to your organization,please indicate this by placing"IRE"in the box next . toN/A. ALL SECTIONS MUST BE COMPLETED THE FOLLOWING MATTERS.REQUIRE THE ENTITY TO SIGN AN AFFIDAVIT UNDER OATH " STATE OF( I by- Com. COUNTY OF( -N.ianrn.( cwa'2 . COUNTRY OF( tin t - C. 5 `-es ) .. Before me the under e authority appeared -�-s (Print Name), ci \ / who, i ersonally known o.me or who has provided, as identification and who did swear to the following ; That he or she is the duly authorized representative of(Name.of Entity) Ci T� V0 Ki-t(,i iN,�E>. .kL eaC `l (Address of•Entity).:' 1'iOC) 61\V-e (-N' 1 C- e:r br i v-2 4 C tvt iter: Post Of ce addresses are:not:acce table: _ Sy4.6vo3a 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 fifte• en(1.6)Affidavits arid Declarations;: - ATTACHMENT D"Miami Dade CountyAffidavits and Declarations" ,Page:t of 11. Miami-Dade. County's Affidavits and Declarations - - 1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT(SECTION 2-81 OF THE COUNTY CODE) If the contract or business transaction is with a corporation,the full legal name and business addieSS'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 stick, . • •• If the contract or business transaction is with a partnership,the"foregoing information shall be provided for each partner If the contract or business transaction is with.a triiSt,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 contractswiththe United States or any department or-agenCythereof,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)- : Legal Name,Address,%Ownership) . (Full Legal Name,Address,%Ownership) Name,Address,%Ownership) The full legal nanles and business address Of any other individual(other thAn subcontractors,material person, suppliers,labdrerS,-OrilendersIwhdthaVe,•dr Wilthave, 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 theinformation required herein, or who knowingly discloses'false • •, information in this regard,shall be punished by i-fige of up to five hundred dollars ($50a00):orimrrisonnYont. . in jailfor up to sixty(00) days or both; . . . . . • , . - . • . . - ATTACHMENT D"Miami-Dade couptyAffiddv4sai.idPecUratiqn01?- 'Page-2 of 11 . Miami-Dade County's Affidavits and Declarations 2. . MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT(COUNTY Fertams L) ORDINANCE 90=133,AMENDING SECTION 2.p-1;SUBSECTION(d)(2) OF THE N/A ; . COUNTY CODE) ,Initial, " ' Except where precluded by Federal or State laws or'regulations,each contract or business transaction or renewal thereof which involves the expenditureof then thousand-dollars ($10,000) or more shall require the entity contracting or transaction business to disclose the followinginformation. The foregoing disclosure requirements°do not apply to contracts with the United States or any departmentor 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? ©Yes (:1146- Does your firm provide paid health care benefits for its employees? [ Ys C-,.) ' Provide a current breakdown (number of persons) of your firm's work force and ownership (below):- White - Males 304 Females .. ) : Black Males 3 Females Hispanic Males Females J g ., Males ;<:I f Females ' Asian.- 1`� American Native Males '-• 3 Females /.`y AIeut Eslmo Males Females O. ATTACHMENT D"Miami Dade County Affidavits arid Declarations Page-3 of 11 Miami-Dade County's Affidavits and Declarations 3. MIAMI DADE COUNTY AFFIRMATIVE ACTION NONDISCRIMINATION OF EMPLOYMENT,;PROMOTION AND Pertains O. PROCUREMENT PRACTICI:S'(CO.UNTY ORDINANCE 98=30 CODIFIED Initial(w'i; . AT-Z 15�(1F THE COUNMCODE) — Pursuant.to Miami,Dade County's Ordinance No.9830,,Section 2-8.1.5,entities with annual gross revenue in excess of$5,000;00.0 seeking to contract with the County shall,as a condition of receiving a County contract,..have: 1) a writtenaffirmative action.plan which sets forth the procedures:the entity-utilizes to assure it does not. discriminate in itsemployment and promotion practices arid`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.Suchaffirmative action plans and procurement Policies.shall provide for periodic reviewto•determinetleir effectiveness in assuring the entity does not discruninate in:its employment,promotion:and procurement practices.The foregoing,not withstanding,corporate entities whose board of directors are representative of the population make-up of.the nationshall 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 rebuttedThe;requirementsof this section maybe waived upon written recommendation of the County Manager that-it is in the best interest of the.County to.do so and approval of.the County Commission by.majority; . vote of the members present: Based on the above,:please complete the affidavit as,directed and return the completed affidavit along.with a cover letter onyour company's letterhead,listing:the company's address,phone and fax numbers;and`anyrequired documents,.to:Miami Dade County,Department;of Procurement• Management Affirmative Action Plan Unit 111 NW 1st Street,13th Floor Miami,FL 33128•: My company has an affirmative action plan and procurement policy and is Yes: Q :No. O , . available"for review. My company has annual gross revenues in excess of$5,000,000 .Yes D `.No D Therefore,our company's affirmative action plan and procurement policy 'is available for review. Yes D °No ❑: My company has annual:gross revenues less than$5,00.0,000. 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 Countymay 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 accordance with,Miami=Dade:County policy and/or applicable federal,state and local,laws 4 MIAMI DADE COUNTY CRIMINAL RECORD AFFIDAVIT Pei tains; •(SECTION 2-8 6 OF THE COUNTYCODE) ,. ... , The individual or entityenter:entering into a contract or receiving funding from Miami-Dade County:D has..:T'has not,. as:.of the:date of this affidavit,been,convicted of a'felony during the past ten(10)years Ail officer, director, or executive officer of the entity entering into a contract or receiving funding from Miami-Dade County O hashas':CSChas:not as of the date of this affidavit been convicted-of a felony during the,past ten(10)years.. ATTACHMENT D"Miami Dade County Affidavits and__Declarations" Page 4(4 11 . Miami-Dade County's Affidavits and Declarations 5. PUBLIC ENTITY CRIMES AFFIDAVIT(SECTIONPertains .. N/A 287,133(3)(a),FLORIDA STATUTES) hilt a1(11 611) The individualor entity entering into a contract or receiving funding from Miami-Dade Countyunderstands the following: That a"public entity crime"as defined in Paragraph.287.13.3 (1) (g) Florida Statutes,meansa violation of any state or federal law by a:per-son 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. but.net limited to,any bid or contract for goods or services to be providedto any public entity or an agency.or politicaI.subdivision of any other state of the United States of America and involving antitrust,fraud,theftbribery, collusion,racketeering,conspiracy;"or material misrepresentation: That"Convicted"or"conviction"as defined in Paragraph 287.138'[1) (b) Florida Statutes means a finding of guilt.. or a conviction of a public entity crime;with or without:an adjudication of guilt,in any federal state trial court of.. record relating to charges broughtby indictment or information:after July 1;1989,as a result of a juryverdict,non jury trial,or entry of plea of guilty or nolo contendere That an"affiliate"as defined inPar-agrapl 287.133 (1)(a)Florida Statutes:means•a) a predecessor or'successor of a person convicted of`a public_entity crime; or b) an entity under the control of;any natural person who:is active in the management of,the entity and who has been convicted of a public entity crime. The term"affiliate"includes. 'those-officers,directors,executives,partners,shareholders, emmployees,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 whennot 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 287133 (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 apublic.entity ;The,term"person'.'' . includes those officers,directors,executives partners,shareholders,employees,members and agents who are active inthe.management of;anentity Based on information:andbelief,the statement is as marked below, true in relation to the entity'submitting this sworn statement (Please indicate which. statement applies' by applying;the individual'initials":tear the box); • Z Neither the entity submitting this sworn statementnor 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 beencharged with and convicted of a public entity crime within.the past 36 months O 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 themanagement 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: • O.yes anadditional statement is applicable or O no an additional statement is not applicable: CI;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 'entitylas been charged with and convicted cif 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 ofAdministrative Hearings and.the Final .Order entered by the Hearing Officer determined that it was not inthe public interest to place the entity submitting . this sworn statem ;onentthe:"Convicted Vendor List". ., • The individual or entity entering into a contract or receiving funding from Miami Dade County understands that he or she is,required to,inform the public entity prior to entering intoa contract in excess of thethreshold amount .. provided in Section 28.7 017 Florida Statues for Category 2 of any change inthe contained in this form: ATTACHMENT D"Miami Dade CountyAffida its and Declarations" Page 5 of 11 • • Miami-Dade County's;-:Affidavits and-Declarations • 6:MIAMI DAD.E EMPLOYMENT FAMILY LEAVE AFFIDAVIT . Pertains O.. (GountyOrdrnance-No-1-47r93 codified=as-Section-11A -9=eta;: N�, seq,of the County Code) al � Initi That in compliance with Ordmance No 142 91 of the Code'of Miami Dade(ounty,Florida,an employer with fifty (50) or more employees workingin Dade County for each workingAday during each of twenty(20) or.'more- calendar workweeks,shall:provide the following information in compliance with all iitems in the aforementioned ordinance An employee who has worked for the above firm at least o•ne(1)year shall be entitled to ninety(90) days,of family, leave during any twenty four (24).month eriod,for medical,reasons,for':the birth or adtionopof a child,or for the care o£a child;.spouse or other closesrelative who has a serious health condition without risk'of termination of employment or employer retaliation The foregoingrequirements shall-not pertain to contracts with the United:States or any dep4iinent or agency thereof or the•State of Florida or any ppol tical subdivision or agency thereof It shall,however,pertain to :mumeipalities ofthisState 7: MIAMI DADE COUNTYDISABILITYNONDISCRIMINATION I'ertaus O : z, NSA mss, AFFIDAVIT[County Resolution R-385 95') t - Initial:..( . _s • That the above named firm,:corporation or organization is in]compliance with and agrees to continue to comply with,an'd assure that any subco itractor or third party contractor urider:this project complies.with all applicable requirements ofthe laws listed below including,but not hinted to,those:provsonspertaining to employrient, provision of programs and_'services,transportation,commun>cations,access to facilities,renovations,and new ; • Miami-Dade County's Affidavits and Declarations Pertains ❑,.. 9. CURRENT ON ALL COUNTY CONTRACTS,LOANS AND OTHER OBLIGATIONS N/A _ The individual entity seeking to transact business with the County is current in all its obligations to the County and is not otherwise in default of any contract,promissory note or other loan document with the County or any of its agencies or instrumentalities. 10 DOMESTIC VIOLENCE LEAVE(Resolution 185 00,99 5 Codified At 11A P am s ❑ 60 Et Se.of the Miami^Dade County Code] ni$a1 crop The firm:desiring todo business with the County is in compliance with DomesticLeave Ordinance, Ordinance 99 5, codified at 11A=60 et seq..of the Miami Dade County Code,which requirei an employerwhich 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 work weeks in the current or proceeding,calendar years,to provide Domestic Violence Leave to its'employees: : • 11 MIAMI DADE COUNTY EMPLOYMENT DRUG-FREE WORKPLACE Perta>tns;❑ :..' AFFIDAVIT(County Ordinance Na.92-15 codified as Section`2 81.2 of the County Code) . • Initial'I+b�,9® • That in compliance with Ordinance`No 92-15 of the Code of Miami Dade County,Florida,,the above named person- or entityis providing a drug-free workplace A written statement to each employee shall inform the employee about:- 1. danger of drug abuse in the workplace, . 2 the firm's policy of maintaining a drug-free environment at all workplaces;; 3; availability of drug counseling,rehabilitation and employee assistance programs, 4. '•• penalties that maybe 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 thatthe • employee Skill abide by the terms:and notify the employer of any criminal drug conviction occurring no later than five (5)adays 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 ` by-the person or entity make:it necessary for the-operation of the County or for the heal ;safety,welfare economic benefits and well-being of the public Contracts involving funding which is provided in,Whole or in part by the United States or the State of Florida shall be exempted from the provisions of this ordinance in those instances where those provisions are in conflict with the requirements of those governmental entities. • .ATTACHMENT D"Miami Dade County Affidavits and Declarations" Page.7 of 11 Miami-Dade County's Affidavits and Declarations 12. ATTESTATION REGARDING DUE AND PROPER ACKNOWLEDGEMENT OF Pertains Q , COUNTY FUNDING SUPPORT N/A Initial �N/., Bynitialing this subsection and accepting County funds,the above named firm,corporation,organization or individualagrees 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 activitiesat comparable dollar levels.. 13:MIAMI-DADE COUNTY RESOLUTION NO R-630.13 REQUIRING A DETAILED' PROJECT BUDGET,SOURCES AND USES STATEMENT,CERTIFICATIONS AS = Pertains O TO PAST DEFAULTS ON AGREEMENTS WITH NON-COUNTY FUNDING NIA, • SOURCES,AND DUE DILIGENCE CHECK Initi°a1' Pursuant to Miami Dade County Resolution No.R-630-13,requiring a detailed project budget,sources:and uses statement,certifications as to past defaults on agreements with non=countyfunding 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,Economibb.evelopment,-:CommunityDevelopment, and Affordable Housing Agencies and Providers.'. The.undersigned entity certifies,to the best of his-or her;knowledge and belief,that: 1 Within the.past five (5)years,neither theAgency nor its directors,partners,principals,members or board `" members::` (i) have:been suedbya funding source for breach of contract orfailure:to perform obligations tindera contract, (n)r have been citedby 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 requiredand explainnhow•the matters are being resolved(use separate sheet if necessary):, 14:MIAMI DADE COUNTY RESOLUTION No.:-.it-478-12 NOT TO USE PRODUCTS;' Pertains O • N/A OR FOODS CONTAINING."PINK:_SLIME" Initial Pursuant:to Miami Dade County Resolution No.R-47842,the undersigned..certifies,not:to use meat products containing"PinkSlime";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"M aim Dade CountyAffidavits and Declamations" Page 8 of 11 .' Miami-Dade County's Affidavits and Declarations 15.MIAMI-DADS COUNTY REQUIRED LOBBYIST REGISTRATION FOR Pertains.O ORAL PRESENTATION Section 2=11.1(i)(2) CONFLICT OF TNTEREST ' - AND CODE OF ETHICS ORDINANCE WO. All l-obbyist-s shall.regiSter wit the C1erkoffhe Board of-County Commissioners within five (5) business days of being retainedas a lobbyist or beforeengaging in any lobbying activities,whichever shall come first.Every person required to so register shall: 1.Register on forms preparedby the Clerk, 2.State under oath his or her name,business address`andthe nameand businessaddress of each person or entity which'has employed said registrant tolobby°If the lobbyist represents a corporation,the corporation shall`alsoae identified.Without liiniting the foregoing,the lobbyist'Shall also identify alp holding,.directly or indirectly; afive5 a ( )percent or more ownership interestin such corporation,partnership, or trust.Registration°:of ah 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 ofCounty .Commissioners,signed bythe principal orthe principal's representative;stating 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 isnot 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.lobbyiau st is authorizedto• represent.the principal. 4:Any public officer,-employee or appointee who only appears'in hisor her official capacity shall not'be required`to register as a lobbyist. --5 A yper-son-who-only appear-s-rn-his-or her-r idividual-capacity for-the purpose-of-self-represe itatiemwithout compensationor reimbursement,whether direct,indirect or contingent,to-express support of or opposition to any item,shall not berequired to register as a lobbyist • 6:Any personwho only appears asa representative of a notfor=profit corporation:or entity(such as a charitable organization, or a trade associationor 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 payany registration_fees. . The Clerk of the Board-of County Commissioners shall notifythe 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.P.ublic.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 shalt not be affected by thefailureof any. • person to comply with the provisions of this subsection(s). (Ord No. 00 19, § 1,2.8-.;00; Ord No:01A3;§ 1;5-22- 01; Ord.No 01-162;§1,10-.23.-01; Of&No:03-10.7 §1-5 6-03) • ATTACHMENT.D"Miami Dade County Affidavits and;Declarations" Page 9`of 11 Miami Dade: County's:Affidavits and Declarations .17 Pertauis D ; ' 16 Disclosure SUBCONTRACTOR./SUPPLIER LISTING(ORDINANCEE 97104) - farti • In iiah ; This form,or a comparable form meeting:the requirements.of Ordinance 97=104,must becomp)Leted:by all bidders.and proposers on Miami-Dade County contracts for purchase of"supplies, •materials. or services,, including:professional services whichinvolve expenditures of $100,000.00 or more, and all bidders and:proposers on County or Public Health Trust construction contracts which involve,expenditures of$100,909,00.or more This fornX or a comparable. form meeting .the i equ cements: of Ordinance 97-104, Must be, completed and subnutted 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 headmg,-:in.those instances where;no subcontractors or supphers wiIl;,be used on.the contract: 1.4 bidder 'or proposer who is awarded the contract shall notchange or, substitute first_tier.-subcontractors•or direct suppliers or the portions of the"contract worl� to he performed or materials`to be supplied from those identified.except upon written approval of the County Business Name and Address. Principal.O ner,.' Scope of Work to be Performed by [Principal Owner) of First Tier _ subcontractor/Subconsultant: Gender Race S,ubcontractor/J.Sub consultant lo"n `Business Name:and Address Principal:Owner; Supplies to be es/Materials/Servic (Principal Owner) of Direct>Supplier Provided by Supplier Gender Race • - I":certi that th se tions contained in this Subcontractor/*Supplier Listing'are to the best of myknowIedge f3' ' +1 true and ac = of Authorized epresentat ve Date: Y)'I YY1 PC M a ) • glint-14 e rint Ne (Duplicate if additional space;is needed) ATTACHMENT D°`Miann:Dade County Affidavits and Declarations" Page-1Q of1 Miami-Dade County's Affidavits and Declarations MIIAM I-DARE COUNT`L I have carefully read this.,entire 11'=page document entitled, "Miami-Dade County's Affidavits and Declarations"and agree to; (1) sign an affidavit as to certain matters and(2) make a declaration as to certain other matters. This form contains"both Affidavit forms for matters requiring the entity to sign under oath and Declaration forms for matters requiring only an affirmation or declaration for other matters. BY SIGNING AND NOTARIZING THIS PAGE YOU ARE ATTESTING TO A EIDAVITS AND DISCLOSURES 1-16 t MIAMI-DADE COUNTY AFFIDAVITS SIGNATURE PAGE L By.. C01 ;20 19 Signature_• W 11 e •r Secretary Seal Date et', ' ' 2-- ' Signature if Affiant • Federal Employer Identification Number 1 ►m rr►y .rc, p. rn% a Printed.Name of Affiant and Name of Agency d o o e®rl Vi2 n 41-071 QQii+er tdgi 3 .o Address of Agency - ' : SU.BSCRIBEA AND SWORN TO ((or affirmed)before me this 02� day pf�U:i-t2 ,20.1..9 . . He/She s personally known o me or has presented as identification.. Type .of identifieation • ' . . . i\.(1,-Lititc ' -e--• ---G-4'.' : - . ' - ..' - ..:' , - -. . . Signature.of Notary Serial Number Print or Stamp Name of Notary` . ExpirationDate NDE PN Notary Public State of 0�ri G(-C( • ��� c •' �o�� County ofa.iczivtt s . ..Noo 222116 �,.: �c• ,. ��Py .?ubirc UP t, ATTACHMENT D"Miami Dade County Affidavits and Declarations": . ' Page,11 of 11. • • • - F .:2018 . Miami-Dade County Homeless Trust Continuum of Care (CoC). i . Consolidated Financial Records : Performance:Reports ATTACHMENT E"Financial`.Records&Performance.Reports" .. . ' . Agency • Letterhead 11, Gc bate Attention:Assigned Contracts Officer Miami-Dade County Homeless Trust Suite 310,27th Floor 111 NW First:Street Miami,Florida 33128 Subject: FYZ018 US HUD CoC Prograiri': #FL0000L4D00.18 ,Program Name. Name ofAgency 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$0.06 for the>month of Month,:yyyy. The following documents are included in this checklist outlined below: - O •Cover Letter - O Performance Report-0625 HUD CoG Monthly UMIS generated Report O Homeless Trust Invoice O HUD form 27053=A SNAPS Request Voucher for rantPayment O Summary.and Compliance Report .. O Attachment E. Program Income-"Report O. Supporting documentsfor 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 amountof pr-ogram:income.(if applicable) is$0.00.1This is an adjustment#`[_:)for the month of Month,yyyy On behalf of our homeless community members who benefit from this progr-ani,.we thank you for your:time and assistance Please call(305) 000 000 extension.0 or email address7cysOxys.coin Withany concerns'or comments about this reimbursement package. :Sincerely;. Name Title Enclosures" AttachmentE"Consolidated Financial Record and Reports Cover Letter".. :: • • • Miami Dade County Homeless Trust ATTACHMENT E • LOCS/VRS U.S.Depaltmeilt of.Housing OMB ApprovalNo..2535 0102. SNAPS Special Needs Assistance Program and Urban Development .. • Request.VOUCher'fOr..Grant Payment Office.ofCommunity Planning Name of Agency-Name,ofprogram • and Development See Instructions and Public Reporting Burden Statement on back 1.Voucher Number.. ' 2 LOCCS PDM AREA `3.Period Covered by this-Request(date's) : ' " 4.Type of.Disbursement. .' SNAPS HPAC.. • r Partial Final. IHP Voice Response,No.(5 digits,hyphens 5 more)6.Grantee Organ¢ation's Name: 7.Grant No: 8.Grantee Organ¢ation's.TIN: • FLOOOOL4D0018 . 9..Line Item no. 10.Type of Funds Requested Amount.(round to nearest dollar) ',1010. -Acquisition, ; 1020 Rehabilitation ` . - 1021 'New Constriction . " . • 1022 . Substantial Rehabilitation . .. -. - 1023 Moderate Rehabilitation . •• • • ' . 1030 - Operating Cont, : . . . . $ . 1040 Rental Assistaince $ - 1050 Supportive Services 1051' HMIs Costs 1060 Administrative Cost; :. - 1062 CoC Planning Costs,, $ 1070' Chi•ld Ca•re• . .. 1080 Employment Assistance . 1090. Relocation _ 1100 Leasing 1110: Repair&Maintenance. • 1111 ,. Prevention(RH).- ' 1112 Capacity Building(RH) $ • _ Voucher Total, I hereby certify that all the information stated herein;as welt as any information provided in the accompaniriment herewith,is true and'accurate. •Warning[,• HUD wit prosecute false claims and.statements.Conviction nni mayresultin.cinal penalties U: (18 S C 1001.10101012;31 U.S.C.3729 3602) - '- • ' ; 11.Name&Phone Number(ncludmg area code)of the AuthorizedI12 Signature 113 Date of Request Person who called SNAPS System VRS. Ir Privacy Statement'Public Law 97,255 FinanciallntegntyPict,31 U:S.C:3512;authorizes the Department ofl-lousing.and.Urban Development(HUD).to collect all the information"(except the ' Social Security Number'(SNN))which will be used by HUD,to protect disbursement data from fraudulent actions.The Housing'and Community Development Act• of 1967,42 U S C:3543,authorizes HUD-to collect the SSN:The data are used to ensure'that individuals who no longer require_access to Line of Credit Control System(LOCOS)have their access"capability prompt deleted.Provision ' ' m of the SSN is andatory.HUD uses it as a unique identfier for safeguarding LOCCS from unauthorized access Failure to provide the information,requested may delay the processing of your approval for'access to LOCCS This information will not be•otherwlse disclosed or released.outside•of HUD except is permitted by law.:'.. form HUD-27053,A • • :Ya .. :1:, Miami,Dade County IW 2018 GoC Program;;. �.,�„� '; • PROVIDER NAME: • = PROGRAM NAME: MAfAMI,DAt DE• GRANT NUMBER:FL0000L4D0018_ For the month/year of( ) . Adjustment#.( ) REQUESTED AMOUNT THIS INVOICE: . _.._ • : •, Leasing Unit - Leasing Units. - LEASING.TOTALi f'$ TAL'ASSIS Rental Assistance Permanent,TenantBased RA„ • Rental Assistance-Permanent Sponsor Based BA �, Rental Assistance Permanent Rapid Re-housing I : . -. • RENTAL-ASSISTANCE.TOTAL $ :'SUPPORTIVE`SERVICE,S 1.4ssessment of Service:Needs " .'" : .;" • 2.Assistaiice With moving.costs 3.Case Management • _ r.4 Child:Care '. 5 Education services _ • 6 Employment Assistance : : • • 7 Food.i B'Housing/:Counseling Services: ` I 9.Legal services ::... I': . . 10:Life,Skills trainin 11:Mental Health Services: : ': • - • (2.Outpatient•Health Services . :: • 13 Outreach Services 14.Substance;Abuse Treatment 15.Transportation �,. 16.Utility Deposits f 17 Operating costs for SSDonly ' . ' SUPPORTIVESERVICESSUBTOTAL:;I.:$.. 1 Maintenance and Repair 2.PropertyTaxes.and Insurance'" I:, .:• '. • 3:ReplacementReserve .: ,' 4 Building Security I 5 Electricity,'.Gas and Water•. 6.Furniture - 7 Equipment(Lease/Buy) . .., .. . OPERATING COSTSSUBTOTAL'` $ HMIB gene'ratedActivities`. :IIMISSUBTOTAL. '$ r , ,PROJECTAADNIINIST 1.ATIION • Project'Athm stradon costs ADMINISTRA'TIONSUBTOTAL'.::.$ . TOTAL: . ' • INVOICE REQUEST AMOUNT • By signing this report,I certify to the best of mY knowledge and beliefthat the report istrue,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 anyfal'se,fictitious,•.or fraudulent infrmatio or the'omission of any material fact,may.subjectm'e to criminal;civil or adsninistrativepenalties for fraud false statements,false claims,or other offense. . Prepared this .(date) .. . .' • MAML=DADE•COUNTY FY 2018 US HUD COC-SUMMARY AND COMPLIANCt REPORT . Agency Name:. . •' • :. ..-- • • • • rogram Name: - . - __•. MCMFDIDE • • • Grant•#FLOOOOL4D0018 •• COUNTY Month/year•of Service( • /. •Duration;0,0/00/2019-00/00/2020 .• Is this an Adjustment?(#.. . ',. ) . .•, _. ., , " ACfUALMONTHLY TmocgAMINtObIE_;- MONTRIY -, TOTALYEARGRANT; 7 FY• 0:18 CoC Program RaYo cE ataTca $.tr'' R EROGRAD'l<EXEENSE ' E%Pg13'DBES AMOUNT _ .._._ -.1 ,f ' - AMOUNT LEASING , Leasing units' a _ ig'? , $ $'. _ .. LesingStuctures: : , . .. . • -. . ..._ Leasing Units•. • r, -., Subtotal• , . TOTAL LEASING • : . .. $ • $ • ' • -z''.$ ' ;$ RENTAL ASSISTANCE"... • RentalAssistance.. Units t._ ._. . : . ,,.7--- _. 7` ._._ _ $ -. $.. •. ' TEA. . . .. ... . ,.... .... .. SRA' - . 7. - . . SRO • : : Program Income to Landlords , .; r ••• ental.Administration Costs .. • .- R .:_Subtotal .- .$ $ .$ , :$ TOTAL RENTAL ASSISTANCE. '. `$ . $. $... . • _ _.. $ • 1•:':•::::•:•:•:• ,... c SUPPORTIVE SERVICES •. .: . ,...,,. <.: FTE: t -r : k, �Annual Assessment '' "? ' - i... �.:, t_..o:- «. l�.i .S.-s h:.s ..:L .-F'... .�sti.r.,,2 staff salary.. :---; % • ; Taxes&Fringe • .. •• .... • • 2 As•sis•tance Movnig Costs --• u,i. .;..,.,.o-,?._.:» :. .4:..' •,.mi.:...-�r .,...-?,.. -..;y-X.--.:r..a\ fir.': _.a.. Supplies totransition- • = . • moving.expenses.. . . :. ..s. ::,'..• Subtotal ' . .$ $:: .$;;;;...,-.: ........ .. .. 3:Case Management •FTE. R._ _�.., >_,.. _ ' ,. i :, ' •r< $, $ w� • staff salary,.: _. . • :`. Taxes&Finnge . . • Obtaining benefits. • .' .. '- ,. • • • Subtotal-. $ ,$:: •,$ '.....:::::!,:.:::%;:;;:::.;:...-:"•::::::: :...-;:.: .. 4-Chlld care'.. 1 � n , y ; ? J '. s di $ $_ .: Childcare vouchers • $ $...."....:".•:. _ :$ Meals and`Snacks in childcare s -, r; Subtotal_. - 5 Education Services - - ` o .� j^�" y � 3 z v ..- FTE � i _..__..:s�m _;:., . � _.. �.c � �� _z� ;. staff salarS' Taxes;&Fringe , ' ........ .. ....::::::::••'.; ."-.."':;;;.....":*.:-......:":!. education supplies • • • • _ . ....:. .• •Subtotal .... .•.' .' $ ;$•: • ••, . • :$ ... ................. 6 Ern�to ent.. Trainii •FTE ; • • FY 7:;":7:-•;-,-;-,77:',-.CProgram 'ACTUALMONTHLY 'PROGRAININCONIE; ENCHM TOTALYEARGRANT? i ` INVOICE MATCH BENCEA7ARR ; _ ,;, PRbGRAME$PENE a, , EXPENDITURES AMOUNT E z 74,!.. NT ' _.._..�,:-,--::-.j'-';'::',,s . - , ,, —8.Housiing-search .— Flk„__--;4',:,: J�4.. _ .- . : -S - _.$: - - staffsalarY i,-..'•'.•:," °/n" Taxes&Fringe . Landlord mediation . 'Rental application fee -.. .. Credit counseling _ - .. .... Subtotal : $ $;...' $ $.. - 9.I:egal services. FTE. . L,e ',K-� ,.�.'w --,_•,;11,i,,-..:,..,.,i... .::;_,...-4., . . .$ "• . - $ - . staff salary •• .. .. .. . % . - • • • .. Taxes&`Fringe ,. 10 Life Skulls Training. sFTE : . .;$.•'....": _ . . $ I.- $ staffalary % $ , $ •$ $ ,Taxes'&Fringe• - $ ,$:. .$.'_. $ .•. . Subtotal' . ..$ $: $ <$ -. .................,:7:•:-...:-...!:•:.......::,........‘........1;-...........'...'.7:•:•:•: 11.Mental health•services•. '., ,FTE Lf.,,..-:,'t,:,:..,.,,2::;:3:.;•!:.;,;:...'. .. -S,- .. ,- ]•tL..Yr! n5Y3+r.»...vr,..,dc�{;k $" - $ staffsalaly %o Taxes&Fringe_, ..... $ ,12.:0u}patientliealth' :-• FTE. '2 r " " `' $ - $ "Y- G. ..L..d a..fi vA a: ...+.,.+..... .-1....�..G _ ...tom-.+,...`-. . az...,.....:.C.i! • sraffsalary , " " a/o ... ............ ... .:Taxes:&:Fringe .. -. :.....,::::.;.:;.if:,....-.: ..... .:::.::.:.::'-:::.:i.._ . 13 Outreach Services: . FTE" • .._,.', _. .:;� n .1:.0 x,as. �_ i . h `',1_, f L $ •" - .$ . • staff.salary. %.2:.:E:::.:..':.';l'....7::......-.2:...'';.''..:: :r ....... .....,.. Taxes&Fringe r : ",Subtotal . $. ' , ::.$ ..:-...'....--:,$:-':. $ 14 Substanc'eAbuse .. .'FTE. .'.r; { 1:�L. ..a _.+:4-,6... .1: . z, h :_' -oma c.,i $....-,:j... - $ staff salary Taxes&,Fringe:; supplies _ • 15 Trainsportation , ''`. `'`" i. $ $ Van/gus/.maintenance.. Bus Tokens_ .... ... Subtotal 16 Utility deposits, - .r..a' -n.. u_::' R; . L;;t. , one-time fee Subtotal:. ,$ .....-,t,'...:. 7: • $. "$ • ... 17 Dlrect rovisions'of: �3-t. r:._ i ,.:,.. ?.`;_ ''� .:, 1 -t -1; - .+'a $ $ :Operational costs for SSO only. • .... ....... Subtotal: $,. $, $ • • :$ ........ ..... TOTAL SUPPORTIVE SERVICES.:.. ..., $" " . $..;•-•-,:' :$ : $,: • Paee 2 of3 ACTUAL MONTHLY FY 2018 CoC Program Qrypi x MATO.I PROGRAM WCOME BENCHMARK TOTALYEARGRANT •r PROGRAM ERPENSE- �ENDTTURBS"' • AMOUNT ti AMOUNT' — OPERATIONS. 1.Maintenance&Repair •FTE • _ f a F $ - • $ •_ staff salary % . - Taxes:&Fringe • - - • - • supplies .. .. :. .:........•......:..:....... .Subtotal. $ $.. 2.Propertytaxes insurance _ .. V,.R.•v.._u:.u+.Y.• - _ .tax.. - - - ............ .. ......... a...... insurance • - • - • :Subtotal $ $; 3 Reserve Replacement j __ .. __w, $ - $ - major:systems reserve' $": :$` , • $. , : •: $. 4:Building security ' FTE v ,. w _a �. �z• $:.. $ _ : . staff salary.. • % • -. Ta & xesFringe $ . $_ $, • $ subcontracted security . • '$ .$:. • $.. • • •:$ :Subtotal:, • $. • $ .: -: $ •• $ .:. •. i 5.:Electricity,gas and water • G aw. ' ' - _ k. utilities . 'Subtotal $ $`' - $. . $ :................. 6.Furniture: v n r :,$ _ $ _ furniture Subtotal •• . $. $r'r. $ . $ r- 3 r+ 7.Egwpment : $ operational equipment Subtotal' $. .. • . - $, • $ • . .: TOTAL:OPERATION $.. - •$ • -._: $ $ ; HMIS COS S. • HMLS _ HMiS`staff salary . • % $ • $::> .$ $ TOTAL HMIS COST$ $ :.• $ • r:$ • :.$ - • PROJEGTADMINISTRATION ;::. • - y r i L • Pro'ectAdminisLration FTE- ] � _ • $ $ staf•f salary; %. . $ • . Taxes&Enrage , $. • $. $ $ Tiavelto monitor, $. $''. -<• $., • 3rd PartyAdministration • ;$ • :$ $:. • . $ Audit-: :_' :$: $` $ $ Administrative.office space • .; .$: ''.• $.:;, $. CoC Training $ ::TOTALADMINISTRATION $: . C• :$ -.. • $ $ • ACTUAL MONTHLY • INVOICE gi g PROGRAM INCOME MONTH BENCHMARK TOTAL YEAR GRANT_ PROGRAM EX ENSE a • ENDITURES AMOUNT AMOUNTt e, ' ,• •• TOTAL $ •$. : • $ `$ $'.• By signing this reportI_certify to the best,ofmy knowledge and belief thatthe reportis true;;complete and accurate:and the'expenditures disbursements: • and cast receipts are.for the'purposes arid objectives set forth mthe terms and-conditions of the federal award I am aware.that any false,•fictitious;, fraudulent information or omission of:any material fact,may subject meta criminal,civil`or administrative penalties for fraud;false statements;false;= claims.or other offense: . • Prepared.this( • )mm/dd/yyyy • Certified b : y j )signature Print l`Tame'and Title[ - ) Page 3 of 3 FY 2018 CoC TRACKING CHART" for Agency Internal Use'Only' Agency Name: _ Program Name: i Grant#FL0000L4D0018_ Duration00/00/2019-,0Q/Op/2020' • - : r RENTAL `: - - ; 7: LEASING SUPPORT OPERATIONS HMIS '" ADMIN - TOTAL MATCII DATESUBMITTEDi TE PAYMENT . ,, .. ,; : '•ASSISTANCE � AxECEnii:n eSnaps Budget _ $0.00 :$0:00 " $0.00 $0:00 $0.00 .: ' $0 00 - `$0:00 $0,00 month 1 month 2 month 3 ,,, month 4 month • month7, month month 9 month 10' SUBTOTAL $0 $000 TOTAL"REMAINING0 $o:oo. . . • -$0.09 ... $000 $000 . :. $000 $o,00 $o:oo. .,.. >' •%.'USED #DIV/0� #DIV/0! • #)IV/0'; #13sIV/0!' #DIV/01 #DIV%0! #DIV/0! ' #DIV/01.` REMAINING • #DTV/0! ' #DIV%0l #DIV%0! #DIV/0! #AIV/0► #DIV/0! • • . . Prepared b'y 2%20/2019 - � • • income&Rent Option 1 • Project Sponsor .. . . Grant Number�y • rs1. • �[ * "j .g'-4v 75 f 'M..P�r lt, t ��T*Pf,:t ^�°7 r .,' �� 3 ���..,,eP�'�����, L+. �'�'74.7 c ft, ,�{�. 4 a.F�;t l'iJ°:v, 7 a: a'�"4 ` �.- �. �� �itl�y �.s�e .a..6�R¢,�'-"�a,:i �� b'��=.�� } dE'.R.r`.�"�'•t1Q'�`�,��� t :�i� �fk,"s�4' .+• . Last Name — _ First Name — HMIS# t X { ,-b 9 :-.-:1 y4 i ��X�74 �`k'j; 44'"+5111t4'ti' •;r rare.k.: a+f - 1 •- • .. a m.:a. �a ��'` __ �. �`�?��B`.��d,�. �` � fa{, nila'l Inc©me- r" .tx `7x�'V'{"�1� .�a'"� .r�,s �, ;�,tr� '0',...4,":;" .. :�, � Calculatin An � _ Annual amount not monthl ! � Y. $, __._ _ Supplemental Security Income-SSI :$7:•,. Social Security Disability Income SSRI r$_w,....',.:::,;....7..,-.....'''..,,„':•:5-,-,:;=:',--.:Social Security • •. $ General Public Assistance _ I:.$ __ Temp:oraryAid to Need Families TANF -$_ Salary from employment S. ` $ Child Support, '. , . ' • r-.$. -. f:.,.• . .. Veteran Benefits. . . •'" i$ .,.,,,,:'-2.2::!:,i,..:.:;:•2. . .' Employment Benefits. • $ Other Y . 1) Subtotal _ formula will add rows. • - ' :2) Income Exclusions Enter income exclusions , , . • .. •: 3) .: Annual income:i',_:$':..., • 722. . .= ,,atiMei 1 ". ,'(1lculat i Acl hated Income'-1%7 7' N e -,cine,§ a ,_, P Dependant Allowance: 4) • •• r,. 0'Number of dependants 5) : • ',1„-'7:::"•'...';':..1:•1.7.,:::::•,;,:`:•:-..',,, ,,`:::.',; 0:Multipies by$480 . Child Care Allowance . -'.6) _, �, ,,, i, Anticipated Unreimbursed Expenses ' :Disabled Assistance Allowance::': • • • . •: '7):' .;. , . . : ..•.;, is ., • •••..,„"' :. DisabledAssistance Expenses.: 8) ; f. r: • -,0 Multipies.Line a by 0:,03 9) 0.Subtract Line 8 from.Line 7. • ',• , Member earnings which were dependent,on . 10) assistance .." • . • 11) :. . ' ' . . : Lesser:of Line.9 or 10 - ..Medical Expenses.%Elderly Family Allowance : . . . :.12) • -- , ._ A List total for medical:expenses:: 13)J-i-:".. i •' if row 9>0 enter line 12 otherwise(71-12-8) ' .X14) if PSH add$40.0.00, . L.r _ .!$0,00.:Elderly/disabled Adult Allowance . Adjusted.Income '.. • • • .15) ..-s ••• •-•, , •••••••"'..-• •.., •. • $� s::'•add rows 3,5;6,11,13;&14.: . . 16) : .• .!.::.$1:-..1••!;"„'"....'‘,;_,-_,.,..;',"''' row15.-:3 . • Resident Rent Deterrniriation :17) 30PA.of Monthly Adjusted Income . $ 'divide.row 16 by 12.multiply'by 0:3 . • 18) 10.%'of Monthly Income : --:::::-"::-..1.,0'divide:row 3 by 12 Multiply by 01 . ' ' 19) Portion of Welfare e. nota licable7in'State•of Florida • • ,i,° 4 , PP if utilities are NOT included in the lease complete • 20) Resident Rent:* ., .t.•, _ . •, below . UtilityAllowance :. :•., Utility Allowance.chart• : $, • - . ... ,,,: ,,, ;., ._ •'PHCD list schedule ofutility allowances '. . ' •• water/sewer/trash•. =if riot included:m lease _ .21) TOTAL.UTILITY ALLOWANCE •;•$ Rent wtth.UtilityAllowance': .'22) Resident Rent : `$ s ':.,. ,,�" row 21 Trow 20 . . ' '. 'Client•Pays:no rent ••• . • :$.. : >:;if row 22<.0 •' 23) Utility ReimbursementI. ;F`$, "•', .•••::-..":,';',•:‘•;;,-.::', Payment made:to:Utility Company only - • , ot!'t',4"Y:...4..,.,',',$ ,..t d.' t. .r.5, •4444,INKT we. P—,-c,-H',�+, ,."h"i.: ''',..i!.,";111 J. w P •i ' t.," *F,),' i'F[;`,�a',;:'0..: ••..t.•`ADs'9' t'..• '.i. #W y 'i''�• `�1., R aintamnall ental 6alouailon dacumentsthi fiIef.review rentala oiins a le, a annual, and more often{if rent decrease/r=et financial 1`I,. r ;aa .. itTiemeil respon if*hoes or receipt and expenditure mfa a/.monifior far CtOMMNG�E attd QUA I,I Y,eeNTi Q ''':1. :0',..:?.-.� :�,3 " ;' ` l`f' •- F • .1. /Ayt3�3ti tsilal•__4Vj" : ,t..,1741: $NF1" ,l u .. ..'.�_..' ,. r ` .„�!i�+^ ht: A .^. ...,,:':',f4 • • Miami-Dad.e,County.Homeless-Trust , FIncome Determination/Rent Calculation:'ATTA:CI MENTIS Iii Participant/IiMIS Unit/Address 1) „ $ • Income 2) Income exclusion 3). $ Annual Gross Income �Calcu lating;1A`d1e1 edjInco a Dependent Allowances 4) Number of Dependents . Multiply lane 4 by$480(Child Care Allowance) . • �Cliild�Ca"reAllowance 6) $ Enter anticipated,unrei�nbursed Child Care,expenses - I➢ sabled4AssistanceiAllowance . , -Disabled Assistance Expenses 8) , $ Multiply Line 3 by0 03 .$•'. 5ubtr act Li e 8 from Lane 7 " Amountearned by.household members which was • 1p] $ • dependent upon•Disabled assistance expense • 11] $ Enter 4g.5.5'LesserAnmountof Lrne 9 or 10. _ .,, . ,_ d c MealtE'penes,/�Elderly{Househ-o1d Allownc ae• , . ' 12 $ Medical ex enses ` ) • 17 if lrne'9 is less than zero,-enter the airs:otin tfrom line 12 13), : , $ otherwise odd Innes 7 and 1Z and subtract lime 8 14) $ Elderly .or Disabled Fan ily Allowance enter$400 Adlustedsincome � • 15] $ Total Income Adjustments(add lines 5, 6, 1}1, 13:&14) Adjusted,Income (subtract line 15 from line 3) •Resident. 16] $ Rent Determination_ ccupancyAnountDetearminatibn', Programslncome 30% of MorlthlyAdjusted Income 17) $ (DWide.Line 16b 1Z&Multi l b .0 3 : Y pY .y ) ; ,. % of Monthly Grossincom:e 1p 18 =`_ (Divide Lrne 3"by 12 and l►%lultrply by 010).` • Wel ar e rend nota licable in State o Florida 20) Resident Rent:- largest of line 17 or 18 • " • Determining¢OccupancyiAmountfor`Units;wlieTeUthtesrenotincluded 21) `t` $ UtilityAllowance(published by PHCD) 22] `Resident Occupancy charge Program Income: • 23) '- $ • U,tilrties.Reimbusement**. , . **If the amount online'22 is less than , change:the minus to a plus This is the amount that may be paid on behalf of the resident as a utility reimbursment,paid to:the•Utility Company directly or rprovide documentation of paid utilities . Program Income REPORTING AGENCY:' ' PROGRAM NAME: -- • . GRANT NUMBER:'. . FL0000L4D0018_ •MIAMI. • TOTAL MONTHLY PROGRAM INCOME ,i,r.-.,..:, 905'~00 SERVICE MONTH :Month%2019 COUNTY 3,61.5.00- _ . -. •, - , . . , F . .. : - . • . N3C KAol'A . o t�nnt . M'' - - � TOTAL GTD PROGRAM INCOME • Total Annual Total Monthl ACTUAL AMOUNT j , .• Bld/unit iiiiiiiiiinglit m Y. .30%adjusted DIRECT Grant-to-Date(GTD). HNIIS#.: • Tenant Name , . • Ad usted or Gross Ad usted or ° . address 1 I or 10%gross TENANT•RETAINS LANDLORD �0 Coptribution Contribution . • Income- - Gross Income: / PROVIDER 1: 1A (in 3 months)last name,first .$ •4,200.00 $. '350.00 $. 105.00 •$ - 245:00 $ 105.00 30%.$ 315.00 ' ' 2 •1B (new in'progani),lastname,first $ : '.12,000.00 ".$ 1,000.00 $ " 300.00 -$ • 700.00' $ 300.00. 30% $ 300.00_ 3 : 2A • (in 6 months)lastnatne,.first $... 21,600.00 $; 1,800.00 ...$ '540.00 $ 1,300:00 -$ 500:00 -28% $ 3,000.00 • •; 4 2B . .. ' - last,nam'e,first.;$• _ $• .. .- $ $ . • - $ • #DIV/01 $ ' - 5 3A lastname; $first: - " $ • . - • .. 6 .• .. 3B - - , , $ $ - - • #DIV 0! - " last name .first ,$ .. -$ -$ - ,$: 4A . • $ - • #DIY/01 $ - 7 , Itme,first $ •• . . $ - • - - V/01 "$ . asna $ $ $ #DI - 8 #DIV/O! $ - 9 • 5A last name first .$ .. - • $ " 1. - ` $ - -$ - "$ #DIV/01 $ - 10 last naive first '$ _ • - 11. • •. • ; . •.., • lastname first $: • - $ - . - • DIV/01 $ • 12 _ �r ?• '/� �'% / % $ $ $ #DIV/0 13 • /%�l`,J� '���' ••r %ri, fir., lastnariie first $ $. • $•. $. _ $. - #DIV/0! $ ..i/ , i lastname first :$. - $ - • . •"$.: • - $ $: #DIV/01 $ - 14, , last name,first,$' $ $.. $ " $ - • #DIV/01 $ • 15 • • • • • - - last name first $ - $• - • $ • - $ $ #DIV/01 $ - • las . t naive,first '$ - $. $ • . $ $ #DIV/O! $ - •17 . - .lastname,first.$ . . - $ .$ , $ _. $ - #DIY/0! $ " - • • 18 last name,first $• $ $ $ - #DIV/O! $ 19 lastnaipe,:first $: $ $ $ $ #DIV/O! $ - • 20 last name first $ - $ - $ $ • _ $. _ #D IV/0! $ - ' 21 fast name first $ . - " _ $ $ $ $ _ • #DI V/01 $ 22 • ^'e= last name • _ #DI ..,a .. r,. z. ,1i••_ ?,af a .3' '.'P.; - .i •."i."_' - ,. - first "COMPLETE ONLY IF APPLICABLE Occupancy charges and rent collected froinprogr"am partic ants areprogram income and maybe.used-•s - o e �� SUBLEASE•or OCCUPANCY AGREEMENT•MUST B a pr vtd d under::24 CFR 578 97.-a:LEASE, EIN• LACE. . • • • MIAMlDAD,. . COUNTY , . • Re west for Aimendment; 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 (Si-C) . ' • Single:Room Occupancy for,die Homeless (SRO) '24:CFR 578.105 Grant.and.Project,Changes The recipient or subrecipients may not.;nake'any significant:changes to.a project . without prior US HUD approval evidenced by a grant amendment signed by:HUD andtlie Recipient. Significant changes includee-a •- change of recipient,a'change of project site;additions or deletions,in.theetypes•of eligible activities approvedfor a,project,a.sh ft of .more than :10% from" one approved eligible activity to 'another, a reduction in the number of units,::and a(change,in.the subpopulation served: i. . By signing this repot the duly.authorized.Project Sporrsor/Provider/Subrecfpient Official signature below certifies to the hese of their knowledge and belief that the reportIS true,complete and accurate.and is for the purposes and objectivessetforth in the terms and conditions:of the federal award;and are:.aware that anyfalse,fictitious,orfraudulent information or the omission of any material fact:may subject the duly authorized off cial ' to criminab civil;or administrative enalties or aud, alsestatements alse'claunsorotheroffense P . ... f �` f f ff. Print Name and Title of Auth•orized Project S onsor Provider Subreci lent D_fficial. P / / p . Signature&pate(mm/dd/yyyy): evieedbyMimDadeC. ountydfowadedo DoNoSn frMYi Da Cou ntygLYt . USHDfor queA ove(getehO% fi" c f 1 L C Ryk r F :e { i ::= iimds bew-eencaegnsorsantchang ) kr a� ii ti 5�.. CiJGE=IN'PRQJEG' SPONSrsOR Signature+&Date(rmfdd/ }, w.4 , ,.' a .A'.,..aua krf4 � s .xi e.§.' Sia ...i w kr a s iJ Fffi.f ,.e. 4 t i xL it a g 4 h..a a • { uJ✓ Ll J s 'S1C. fi '+dk Sf>`: {' 4` -• Z, ,;••" - .Cs Z._.4 . 4%07411:...—.0.'',--0.01.i17,7.-Z1):77.7! ?. J -'a'S-'s Repiewed and AAproved by Miami Dade County Do Not Sign- for Miami Dade county ONLY • � 2 � s 1 r�� p x Ssf. .aw �,..a � t;a d L., ! ,� : � ir3.. 7� t.i! kr�� �6j 54#!i t` ,�� .t .. .. rotor natidAfe*Ifi ed to US'HUDr(less ilitti,p°1o�shift g, , {ti �_ -� ,rg '8Lli ;x, , , u try ,',w , .' ,�. sti ff,,,.a. a S. r P Y / ' in fundsibetween`categories){ ; fes ',� .� , .� Af t a,Icl' i F nN ._ + }w v s �x �t yt* ' Signature&Date(mm/dd/,yyyy) z. 4 � :!:,.,:c,-',,'-,/.1,-,-1-,,::'.:.,0;, avis tred,'and NC+T�'Approved`'t?yoamftrAil County DolNdi Sign for„NliamipDade county ONLY ' seeattached�Iefer for reasonsfor disapproval' j �� I L F . =,a6 -`, ' F , 4.i4 .a � Signature&Date(rnnln/,cld/yyyy} P Program Name ( _ • • Grant Number 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 incl'ude`a Summary chart; and all applicable detail• ed 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 tp 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; a original Miami Dade county Homeless Trust,.11:1 NW 1St Street, 27th Floor, Suite 310. 'Miaxi , Florida 33128 Attention Terrell:Ellis, Contracts Manager. FY 2018 Continuum of Care (CoC) Miami-Dade County Miami Dade County Homeless Trust .: Annual Progress Report (APR) ..... . ....: ATTACHMENT F"2.017 Annual Progress Report APR" • • MIAMHDADE : . Annual Progress Report (APR) for US HUD Grant Funded Continuum. of Care CoC Pro . nias, . On April 1 2017,Continuum off Care:(CoC)Program grant recipients report their CoC Program Annual Performance • Report• s(APRs),in,Sage HMIS Reporting Repository(Sage):'Recipients hill 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/Provider:/Subrecrpient Official signature below certifies to' '. the best of their knowledge and belief.that the report is"true, complete and accurate:end';is for the purposes.and . , • objectives set'forth" i'n the ;terms'and conditions of the federal award,:and are:aware::that,.any,false, ctitious, or . fraudulent information or the omission of any material fact,may subject theduly authorized official to•criminal,civil or", 'administrative penalties for..fraud;false statenten ts,false claims orother offense Project'Name. Project Grant`Number Print Name'and Title ofAuthorized , Project S :onsor/ /ProvidreSubreiPentclOfficial P • S• i ature&Date (mm dd .. / /yYYY) } Print;Na�ne&„Title of Authorized Protect Grant Do Not Sign for Miami°bade,County ONLY , t t L i} :ti..-x r K:.. l:. .. . .� f4 r' c "L Y r r. 'i t 4 -M Official . •, 'i L 4- Z . L ( � C (MDCHTrtExecutive`Director or Designees" 3 .. ": * - _ •�,y � n . ^' •� , 4=' • tu'e&D t an d YYYY • • Signa r a e(m /d / ) z .. . .a.: ''r vat. rdu: ! .i.. SupervisoryRevlew'and'hntry- gn f imi a CountyONLY . � n � s x Do Not Si 4or Mia f Dads � � 4 Print Name&Tule UA x y+S 'r r x x t ^ 1 ,.i e a y • di tq A d, ytii AS 4tiL. s. Signature&Date(mm/dd/yyyy) ., ,.. .j J .. ,( .r .. .I..:. :.' .,.-✓..r v.; ,;1:..: �. .�-.q.�1., ly.fs ..aF.� .s7_"s,i4iC..`:-X .a..4. 4 31 Updated March ,201,7, • • Attachment F"Annual Progress Report(APR) Supplemental Guidance was provided for a-snaps changes that.were implemented to improve processing time;completing An"Applicant Profile";and on Q3,Q5,Q23,Q24,and Q.31—please submit the HMIS generated APR as well. US THUD ANNUAL PERFORMANCE'REPORT(APR) ' CONTINUUM OF CARE(CoC) - -- Q1.Contact Information. ProjectNaiY e : Recipient/Agency Name Grant Number prefix(Mr:,Mrs.,Ms,;Dr,.etc.) • .FirstName MiddleNarie.` LastName • Suffix(LCSW,MSW,Etc;) Title S treetAddress 1 StreetAddress:2 City State Zip Code E mailaddress Phone.;Nuriiber Extension • FaxNumber :., Q3.Project InformationCheck the component for the program on which you arereporting Continuum of Care Program(COC) RentalAssistance(RA) Section 8-Moderate • Rehabilitation ❑.Transitional Housing- ❑Tenant-based.Rental.Assistance(TRA) ❑.Single Room O-ccupaiicy. Pro ect based Rental Assistance. PRA Sec 8 SRO ❑Permanent Housing for Homeless; 0 J. (.; ) � ❑:( ) Persons with Disabilities ; Safe:Haven ❑Single Room Occupancg(SRO) 0 HMIS • ❑:Innovative Supportive.:Housing ❑Sponsor-based.Rental Assistance(SRA)` -. - ❑Supportive Services Qnly Is this APR fulfilling the reporting obligation associated with;a 20 or 15 year'use requirement' (n),.. ; Number of.Years iri Operation (n) Coniract operating term or dui ation;is from:[ •X20.. ) to ( / 120', ) - Q3 Project Information continued:' Is:this a Domestic Violence Program'(Yes or No) . Was this.project funddeunder:a al speciinitiative?If yes,what type? (Samaritan onus Permanent;Housing Bonus,Reallocation;'Etc) . Amount of Contractor Award_:.. $ , ;.CoCNumberandName: FL-600 Miami-Dade.County Is:this an APR for a grant that received a HUD approved:grant. ' extensions(Yes;or No) Is this a final APR?(Yes:.or.No) ; • AttachmentF"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 gear 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 typeE i • CoC"Program Funds Expefiditures_ - v 1.Assessment Service Needs. 2 Assistance with Moving Costs 3:Case Management 4.Child.Care • .5.EducationServices • 6:EmploymentAssistance. • 8.°Housing/CouriselingServices.: 9,l.,egal Services . 10.Life S:lalls'. 11.Mental Health Services- •` • . 12.Outpatient Health Services 13.Outreach Services . . . 14.Substance Abuse:TreatmentServices 15.Transportation ; 16:Utility Deposits Supportive Services_Subtotal$ • 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 $> QPetating Costs • HMIS $: SUBTOTAL $ • Administration:=:Provider $ Administration=Homeless Trust TOTAL Expenses plus Administration ,$ • - Cash Match In-Kind Match $ TOTAL Match TOTAL Expenditures Match. $ • Program:Income .$: • • • • • • • • Attachment F"Annual:Progress Report(APR) Supplemental" - Performance for CoC Programs , Q36: Standard Performance Measures Performance Measure (Target)#of #of total. %expected to Actual Target# .: Actual #of total Actual%of Persons who were (Universal) accomplish .of persons who , (Universal) " personsto(Measures are found in the eSna s hibit 2).ofthe HUD. expected.to. personswhio are this measure. accomplished' person to achieve achieve this 1? accomplish thi lis is expected to (eSnaps this measure : this measure• 'measure measure(eSnaps , accomplish this Budget . Reported in "Reported in HMIS Reported in application Budget Exhibit 2): measure (eSnaps Exhibit 2) HMIS . HMIS Exhibit 6 A-C) . Budget Exhrbit 2} Persons exiting to • permanent housing 11 16 : 69% 19 • 20 95 (subsidized or Irl ju 1i� '� unsubsidized)during Ee. . -�- the operating year. . Housing Stability Measure Reported in HMIS. Q36 Total Income Measure R eportedin HMIS . Q36. Earned Income Measure.. Reported in:HMIS-. Q36 Other=specify Reportedin HMIS •. ' Q37:Additional Performance Measures" • Performance Measure (Target)#of #of total: : %expected to. Actual Target Actual=#of Actual%of Persons who (Univers accomplish'this #ofpersons total persons to (Measures are found in were a ectedersons who are measure. the eSnaps(Exhibit 2)of p ; who (Universal) achieve this • the HUD a Mbcait 2) to accomplish'. is expected'to' (eSnaps Budget. - accomplished._ , person to . . measure ppOn this measure accomplish this -- Exhibit 2)- this measure .achieve this Reported in Exhibit 6 A-C) :(eSnaps Budget measure(eSnaps Reported in • measure HMIS - Exhibit 2) Budget Exhibit 2) HMIS ' Reported in - HMIs *Utilization Rate'of Vacancy'Report. Other. :Q40: Significant Program Accomplishments Describe in a brief narrative form'(no morethan2,000 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" 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018=CoC :$1, HMIS REPORTING - i ` REPOSITORY . 7 :''''1°-'''4''',11/F.;34.41'..': `s a ,r{:x iN 'q ,, 14 x 1 E . 4, 1 7:717,...-t4,... .,;.',,s,.;.,77,77 vg^- 77,1 y .1 �. " Y �'b.4'•.3+-2� fR`�' 'L' • i '.-- �4 f�'.� 3' .} X i.. (P ryr �h 4i fi ':1 r ,w .xS::.3,s . u �t� i4 ,4 S"`�re A'ii` +P+y��• k`7 .;nv� ` < 4 _P 4° �"1 '.t -'P.".'"'',4 *'qr HUD Annual P6rrfOrmance.Report2018 COCA �' . x`' 1-P' " `,; y{1, \ i £ " 4' 4 k7 1" 1F,T,It 2 "S:a "w .4140�c^`"fiit. t '44 h t4R.4dfift .1 �s,,; 4 .°,tw` t.#.7Y-.4::" t • a a ,<.(°t 7yk4..0-4;,ns; f baa 40.,N.,,,-Alia.... J; :t..'+Gn,rx 1'x. ,s y ,,, ty ci .. i rk s �4 �7x a � `, -wf" ,,di';:11,-:,,� Grant Better Way Apartments .FL0170L4D001609-kType P,H 4- -1 : ,� ` '. , " k '�y,,p a t. Q01:Grant Information ' • `APR,Information " Operating start datefor APR. . 11/1/2017 Operating ehd date for APR. 10/31/2018 • Are the'dates shown.above.the dates.your CSV-APR was • generated;for? Yes " Is this.an APR for a grant that received a HUD-approved;grant extension? No. • What operating year'are you reporting on? 21.+ • Is this APR fulfilling,the reporting obligationassociated:with a use requirement'? No • • • Is this a final •-, ' Yes • •If yes;have'you completedyour,final draw in LOCCS? Yes —.If yes,have you renewed this project? Yes ' Identify the specific project type of this grant: • PSH Grant Focus Information Was this project funded under a special,initiative? N•o . . • . Target subpopulation(s):Does your project have a specific population`focus? ' No • •Are 100%of the clients in HMIS'orwhere applicable in a comparable data base? Yes: ::: • 2/20/2019 . Sage:Reports:HUD Annual Performance Report 2018-CoC Q02.Bed and Unit Inventory and Utilization Proposed Bed and Unit Inventory • • Total Number of Year Round Beds/Units from Application • • - - Total Units 55 • Total Beds 55 Total Dedicated CH Beds . ' 22 •Total Non-Dedicated CH Beds 33 ' PIT Actual Bed and Unit Utilization on the Last Wednesday of the.Month , . Actual Inventory-Total Units . January 55 - • April • 54 July -55 October 56 Actual,Inventory-Total Beds January 55 April 54 • -July 55 • • . ' October56 • Utilization Rate=Unit • January •".100.00% April. . 98.18% July 100:00% • October. ' 101:82% , Utilization Rate-Bed January 100''-00% April; 98.18% July `100.00% ' . . . October 101.82°! If the number of units and beds proposed is different from the number' available on the-last Wednesday of each month please explain why Q03.Contact Inform• ation Prefix Mrs ' First Name Pauline. - Middle Name Last Name Trotrnan • . Suffix Organization' - Better Way of Miami;Inc. • • • . Department Permanent Housing Programs - 1 itle Director,Permanent Housing Programs -. _ • Street Address I •;800NW28thStreet . - Street Address 2 City Mianti State/`Territory Florida - ZIP Code 33127 E=mail•Address ptrotman@bwom.org • • •. Confirm E-mail Address' ptrotman@bwom:org ' • Phone•Number, -(305)634-3409.' _ • • • Extension 123' - - • Pax Number . (305)779-0681_`' 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC• • Q04a:Project Identifiers in HMIS Organization Name Better Way of Miami,Inc. • . • Organization ID • 12 Project Name Better Way of Miami,Inc.Apts.SRA PSH-FL0170L4D001609 Project ID 144 HMIS Project Type 3 Method of Tracking ES • . • • Is the Services Only(HMIS Project Type 6)affiliated with a residential project? • ' Identify,the Project ID's of the Housing Projects this Project is Affiliated with • CSV Exception? No Uploaded via emailed hyperlink?. No • - . Q05a:Report Validations Table Total Number of Persons Served 64 • Number of Adults(Age 18 or Over);, 64 Number of Children(Under Age 18) 0. Number of Persons with Unknown Age 0 ' Number of Leavers 8. Number of Adult Leavers 8 Number of Adult and Head of Household Leavers • 8 Number of Stayers 56 ' Number of Adult Stayers 56 Number of Veterans •• 4 ' Number of Chronically Homeless Persons • 21 - Number of Youth Under Age 25 • 1 • - ' • Number of Parenting Youth Under Age 25 with Children • 0 .. Number of Adult Heads of Household 64 ; Number of Child and Unknown-Age Heads of Household: ;0 Heads of Households and Adult Stayers in the Project 365 Days or More -47 • Q06a:•Data Quality:Personally Identifying Information(PII) • Data Element ClientDoesn't Knouv/Refused •Inforrnatipn Missing Data Issues Error Rate Name. 0 0 0 0.00°/a Social Security Number 0. .0 • 0 0.00% ' Date of Birth 0.' 0 0.00%. Race 0 . 0 0 0.00%. . Ethnicity: . • 0 0. 0, •Gender 0 Overall Score 0.00%•. Q06b Data Quality Universal Data Elements Error Count %of • • Error Rate Veteran Status 0 0:00% •. . Project Stan Date , • .Relationship to Heed.of Household - .,0: 0.00% • • Client Location. 0 0.00 Disabiling Condition 2 3:T3'"/° 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC Q06c:Data Quality:Income and Housing Data Quality Error Count %.of Error Rate Destination : 0 0.00% Income and Sources at Start . 5 7.81% Income and Sources at Annual Assessment 3 6.38% Income and Sources at Exit 0. 0.00% Q06d:Data Quality:Chronic Homelessness Missing Missing' %of Records Count of Total Time Time Approximate Number of Times Number of Months Unable to Date Started Records in in DK1Rlmissing DK/R/missing Institution Housing DK/Rlmissing Calculate ES,SH,Street: 0, 0 0 0 D 0 Outreach TH 0 0 0 0 0 0 PH(All) 19 0 0 0 0 0. 0:00 Total 19 0. 0 0 0 0 0.00%° QD6e:Data Quality Timeliness. Number of Project. Number of Project Start Records Exit Records. 0 days 0 0 1-3 Days 1 • 0 4-6 Days 0 1 7-10 Days5 0 Q06f:Data Quality:Inactive Records:Street Outreach&Emergency Shelter . #of Records #rof /of. • Inactive Records Inactive Records Contact(Adults and Heads of.Household in Street Outreach or ES-NBN) 0 0 Bed Night(All Clients inES--NBN) 0 0 — Q0 • 7a:Number of Persons Served, .Total Without Children With Children and Adults. With Only Children Unknown Household Type Adults 64 . 64 0,. : 0 0 Children 0 0 Client Doesn't Know/Client Refused. 0 0 0 0 0 Data Not Collected '. ' 0 0 0 0 0 • Total 64 64: 0 0 0' Q07b:Point in-Time Count of Persons on the Last Wednesday • Tota! Without Children. With Children and Adults -.With Only Children' Unknown Household Type January 55 55 0 0 .. 0 Q08a:Households Served 'Total Without Children With Children and Adults With Only Children Unknown Household Type Total Households :'64 64 0 0 0 • 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC Q08b:Point-in-Time Count of Households on the Last Wednesday . ,Total . Without Children With Children and Adults. With Only Children Unknown'Household Type , January 55 55 0 0 0 • • • April 54 • 54 0 0 . 0 • ' July 55 55 0 0 0 - • • October .56 56 0 0 0 " Q09a:Number.of Persons Contacted All Persons First contact—NOT staying on the First contact—:WAS staying on Streets, First.contact—Worker unable to Contacted -Streets,ES,or SH ES,or SH • determine Once 0 0 0 0 2-5.Times 0 0 0 0 6-9-Times 0 0 0 0 . 10+Times • 0 0 0 t) Total Persons. 0 0 0 0 Contacted • Q09b:Number of Persons Engaged, • All Persons First'contact—NOT staying on the First contact—WAS staying on Streets, First contact-Worker unable to Contacted Streets,ES,.or SH ES,or SH determine : Once.. 0 0 . , 0 0 .. . 2-5'Contacts 0 0 0 0 6-9 Contacts 0 ' • ' •0 0 0 ' 10+Contacts. 0 0 0 0 '••Total:Persons- 0 0 0 0. Engaged Rate of 0.00 0.00 0.00 0.00 Engagement Q10a:'Gender of Adults Total: Without Children With Children and Adults Unknown,Household Type • • Male,- 32 32 0 0 Female 32 .32 0, 0 -. Trans Female(MTF or Male to Female) Trans Male(FTM or Female to Male) .. Gender'Non-Conforming(i e'not exclusively:male or fem•ale) 0 0 0 '. '0 Client Doesn t Know/Client Refused 0 0 0 0 . • Data::Not•Collected ,, 0 , 0 0 0 Subtotal 64 64 0 - 0 co Ob:Gender of Children , - • Total With Children and Adults, .,With Only_Children Unknown Household Type Male. p" 0 0 0' ; Trans Male(FTM or Female to Male) '0 0 0 0 .Trans Female(MTF or Male to Female) , _ 0 0 0 - 0 - Gender Non-Conforming`(i.e.not exclusively maleor female) 0 0 0 0 ' • Client Doesn't Know/ClientRefused• • • 0 0 0 0 . Data Not Collected. ''- . 0 0 0 0 Subtotal 0 • 0 0 0 2/20/2019 Sage:Reports:1-IUD Annual Performance Report 2018-CoC Q10c:'Gender of Persons Missing Age Information • Total Without .With Children and With Only Unknown Household • Children Adults Children Type Male • 0 0 .0 0 0 • Female 0 0 0 0 0 Trans Male(FTM or Female to Male) . 0 0 0• 0 .0 • Trans Female(MTF or Male.to Female) 0 0 0 0. Gender Non-Conforming(i.e.not exclusively male or 0 0 0' 0 0 female) • Client Doesn't Know/Client Refused • 0 0 0 0 0 Data Not Collected 0 .0 0 .0 0 Subtotal 0 0 0 '0. 0 • • • Q11;Age • Total Without Children With Children and Adults With Only Children Unknown Household Type • Under5 0 0 D 0 .0 • 5-12 0' 0 '. .0 0 • 0 13-17 0 0 0 0 0 • 18-24 25-34 0. 0 0 0 •0. .. 3544 6. 6 0. 0 0 45--54. 27 27 0 0 55-61 15 , 15 0 0 0. 62+ 15 15 0 .. . 0 0 Client Doesn't Know/Client.Refused 0 ' 0 " 0 ' 0 0 Data Not Collected ' •0 • 0 0. 0 0 Total 64 : 64 0 0 • Q12a:Race Total Without Children With Children and Adults With Only Children Unknown Household Type . White 15 15 0 0 0 . Black or African.American 47 47 0 0.. 0. Asian 0 0 0 • 0 0 . American Indian or Alaska Native 0 0 0 0 0 Native Hawaiian or Other Pacific Islander 0 0 0 0 0. Multiple Races.: • 2 2 0 0. 0 Client Doesn't Know/Cliefit Refused • 0 0 0 0 • 0 Data Not Collected. 0 0 0 0 0 Total 64 . 64 0 0 0 •Q12b:Ethnicity Total • Without Children With Children and Adults With Only Children •.Unknown Household Type • •• " Non,Hispanic/Non-Latlno ,; 57: : 57 - 0 0 0 lispanic/Latino. 0 .• Client Doesn't Know/Client Refused 0 ' 0 •0 0 0. Data Not Collected . :Total fi4; 64 .. 0 0 0. • 2/20/2019 ..Sage:Reports:HUD Annual Performance Report 2018-CoC Q13a1:Physical and Mental Health Conditions at Start Total Persons• Without Children With Children and Adults With Only.Children Unknown Household Type , Mental Health Problem 53 53 00 • 0 . Alcohol Abuse 0 0 0 0 0 • Drug Abuse 0 0 0 0 0 Both Alcohol and Drug Abuse 62 62 0 0 0 . .Chronic Health Condition 24 24 0 0 0 HIV/AIDS 12 12. 0 0 0 Developmental Disability 5 5 0 0 0 Physical Disability . 46 4-6 : 0 0 0 . . : Q13a2:Number of Conditions at Start • • Total Persons Without Children With Children and Adults With Only Children Unknown Household Type 1 Condition 0 0 0 0 0 2 Conditions 2: • • 2 0 0 0 3+Conditions 60 60 0' 0 0 Condition Unknown 0 0 . 0 0 0 Client DoesntKnow/Client Refused .0.. 0 0 0 0 . • Data Not Collected • 0. 0 0 0 0 Total: • 64 '. 64. , 0 0 0 Q13b1:Physical and Mental.Health Conditions at Exit "Total Persons Without Children.. With Children and Adults With Only Children Unknown Household Type Mental Health'.Problem' . 4 4 0 0 0 . ' AlcoholAbuse - 0. 0 0 0 0. Drug Abuse 0. • 0 0 0 0' .:Both Alcohol and Drug.Abuse 8• - 8 0 Chronic Health Condition ' 3 3: 0 •. '0 - 0. HIV/AIDS .' . 1 1 0 0 0 - Developmental Disability- 0 0 Physical Disability, -8,. ; . .8 0 0' 0 '' Q13b2:Number of Conditions at Exit : Total'Persons. Wir.thout Children With Children and Adults With Only Children.'•Unknown Household Type 2 Conditions 0 0 0' • 3+Conditions' 8 8 0. 0 0, - Co'ndition.Unknown 0 0 .0 0 0 Client Doesn't Know/Client•Refused 0 0:'. 0' • - 0 0 ' TotaC' 8 8 0. p _0 • 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC Q13c1:Physical and Mental Health Conditions for Stayers • • Total Persons Without Children With'Children and Adults With Only Children Unknown Household Type Mental Health Problem 49 49 0 - 0 .0 Alcohol Abuse 0 0 0 0 0 Drug Abuse 0 0 0 0 . 0 Both.Alcohol and Drug Abuse 54 Chronic Health Condition 21 21 0 0 - 0 HIV/AIDS. 11 11 0 • 0 0 Developmental Disability 5 ' 5. 0 . . 0 Physical.Disability 38 38_ . ' 0 0 . 0 Q13c2:Number of Conditions for Stayers . Total Persons Without Children With Children and Adults With Only Childrerr Unknown Household Type None • 0' . 1 Condition .0 2 Conditions 2 : 2 0 • 3+Conditions 52 52` 0 ' 0 • 0 . Condition'Unknown 0' • 0. .0 • . 0 0 • Client Doesn't Know/Client Refused 0 0 0 0' 0 Data Not Collected . 0 0 0 0 0 Total • 56 . 56 0 0 0 ' Q14a:Domestic Violence History' Total Without Children With Children and Adults With Only Children Unknown Household• Type ' Yes 32 `- 32 - 0 ' . 0 0 Client Doesn't.Know/Client Refused 0 0 0 0 . '0 , Data Not Collected 0 0 0 0 • 0 ' Total, 64. 64 . -0• • Q14b:Persons Fleeing Domestic Violence ' Total Without Children With Children'and Adults. With Only Children Unknown-Household Type Yes ,0 0 No 20 20 . 0 0 0 • • Client Doesn't Know/Client Refused •0 00.' 0 0 'Data Not Collected 12.. • 12 0 0. 0 Total ` ' • 32' 32 0 0 0 2/20/2019. Sage:Reports:HUD Annual Performance:Report 2018-Coo . • Q15:Living Situation Total Without ' With Children and With Only Unknown Householc • Children • Adults Children Type Homeless Situations . • • 0 ' 0 0 0' b Emergency shelter,including hotel or motel,paid for with emergency 25 25 0 0 50 shelter voucher' Transitional• housing,for homeless persons(including homeless youth) 2 2 - 0 0 0' Place'not meant.for habitation : 5 5 7 •7 0 0 0 Safe Haven S 0 0 0 0• . Interim Housing 0 Subtotal • 34 34 • 0 0 0 Institutional Settings 0 0 0 0 0 Psychiatric hos•pital or other psychiatric facility • 0 0 0 0 0 Substance abuse:treatment facility or detox center 28' .28 - : i); 10 0- - Hospital or other residential non-psychiatric medical facility ;0.• 0 0 Jail,prison or juvenile detention facility 1 1. Foster care home or foster care group home 0 0 0• 0 0. Long temi care facility:or nursing home 0 0 0 0' 0 Residential project or halfway house with'nohomeless.criteria 0 0 Subtotal 29 29 0 0• 0 • : Other Locations' • ,0. 0 0.. • 0 0 ' Permanent,housing(other than RRH)for homeless persons.'.: 1 1` 0 '0 " 0 ', Owned.by'Client,no'ongoing housing subsidy 0 ' 0 0 0 0 : Owned by client,with ongoing housing,subsidy 0 •. 0 0 0 0 Rental by client,no ongoing housing subsidy' 0 0 0 • • .0 • 0• Rental by client,with VASH subsidy '. : 0' 0. 0 0 0, Rental by client:with GPD TIP subsidy • 0 0 D 0 0. Rental by client,with other housing si.ibsidy(including RRH) 0 ' 0 0 - '0 0 Hetet or motel paid for without emergency shelter voucher' 0 -0 0 ' 0 0': .• Staying or living in:a friend's room,apartment or house' - 0 .0 • : ' 0 . . 0 0`' !Staying or living.Ilya familymernber's room;apartment or.house. 0 ' 0' .. 0 - 0 0 Client'Doesn't Know/Client Refused 0 :0 0 • 0 - .0: Data,NotCollected. '; '0..' 0 • 0 Subtotal" 1.. .. ,'�.•:t.,' ...,: 0 0 i Total, " '..Q16:Cash Income'-Ranges.' '_ Income at Latest Annual: Income at Start'• Income atF�titfor Leavers • ,. Assessment forSi:ayers,' . No income $151.$250 $1,001 $1,500. 6 13 1 $1;501 $2,0002 - , 5 3 $2,0011 10 9 1 :Client:Doesn't Know/Client Refused . .- • 0. 0: 0;- - - .Data Not Collected` . • 0 0. 0 Number of Adult,Stayers Not Yet:Required to Have anAnnual Assessment 0 9.. 0 . Number of Adult Stayers Wthout Required Annual Assessment' 0 • •0 0'.- - : Total�Adults • . . '. :` ' : : 64- ' : •-56; 8 • 2/20/2019 - - Sage:Reports:HUD Annual Performance Report 2018-CoC - ' Q17:Cash Income-Sources . • Income at Start Income at Latest Annual Income at Exit for Leavers Assessment for Stayers • • • Earned Income 19 10 3 • • Unemployment Insurance'. SSI 28 •28 • 5 SSDI • 3 2 . 0 • VA Service-Connected Disability Compensation - 0 0 . ' • - 0 .. • VA Non-Service Connected Disability Pension • 0 0 0 • Private Disability Insurance • 0 0 0 - -Worker's Compensation . 0 0 0 • TANF or Equivalent 1 0 0 •• . General Assistance • 5• . 3. 1 • Retirement(Social Security)` 1 • 0 0 - - Pension'from'Former Job ' 1 0 0 .Child Support 0 • 0 - 0 Alimony(Spousal Support}' • 0 0 0 • Other Source .- 13 9 3 • - Adults:with Income Information at Start'and Annual Assessment/Exit 0 ' 34 7 . Q78:Client Cash Income Category-Earned/Other Income Category-by Start and Annual Assesament/Exit Status -' • Number of Adults.:. Number of.Adults at. • Number of'Adults' at Start Annual Assessment(Stayers) at Exit(Leavers) : •Adults with Only'Earned Income(i.e„Employment Income) 12 6 2 - Adults with Only Other Income • 29 31 . 5 • Adults with Both Earned.and Other Income • • 7 • Adults with No Income - • Adults with Client Doesn't Know/Client Refused Income Information 0 0 0. • Adults with Missing Income.Information ,. :- 0 0 - 0'- " - .Number,ofAdult Stayers Not Yet Required to Have ani Annual Assessment 0 9 ' 0 • Number ofAdult.StayersWithout RequiredAnnual.Assessment, .. :.0 0 0' Total Adults, 64 56. B I or More Source ofIncome - ' ' • 51 44.. • 8 . Adults with Income Information at Start and Annual'Assessment/Exit:, 0 , 34 • 7 • 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC , , • Q19a1:Client Cash Income Change—Income Source-by Start and Latest Status Did Not have perfomance Had Income Retained Retained Retained the Income Did.Not • Total • Measure: Adults Performance Category.at . 'Income Income Income Category,at have the Start and • Category But• Category 'Category Start and Income Adults Who Gained or measure: Did Not Had Less;$ and Same$ and ' Gained the• Category at (Including Increased Percent of h Tose Income from persons whc Have it at at Annual at Annual Increased$ Income Start or at with No Start to Annual • accomplishe Annual Assessment. Assessment at Annual ' Category.at Annual Income) Assessment- this measun Assessment Than at Start as at Start Assessment Annual Assessment ,Average Gain • 'Assessment Number of. Adults with Earned • 4 3 1 3 1 32 47 5 10.64 Income(i.e., Employment Income) . . Average - Change in -323.25 -905:00 0.00 828.67. 971.00 0.00 0.00 709.40 0.00% • Earned Income • Number of • Adults with 0 1 2 • 23 9 10 47 32 68:09 Other • . Income • , . Average • Change in — 36.00 0.00 557.00 927.11 0.00 0.00: 661.09 ' 0.00.% Other Income . Number of Adults with Any Income -0 3 1 30 5 '' 3 47 37 78:72% i '(i.e.,Total .. - .. Income) • Average • Change in ,650.33. , 0.00 592.43: 79920 0.00 430.00 611.05' 0.00 Overall . Income 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC • Q19a2:Client Cash Income Change-Income Source-by Start and Exit • Had Retained Retained Retained Did Not have the Did Not Total Performance Performance Income Income .Income Income Income Category -have the Adults Measure:Adults measure: Category Category Category Category .at Start and Income (Including Who Gained or Percent of at Start but Had and Same and Gained the Category Those Increased Income and Did Less$-at 9 ry persons who Not Have it 'Exit than at $at Exit as Increased Income Category at Start or with No. from Start to Exit; accomplished at Exit Start at Start $at Exit at Exit at Exit .Income) Average Gain this measure Number of • Adults with Earned1 0 1 1 1 4 8 2 25.00% . Income(i.e., Employment • Income) • Average Change in • -841.00 — 0.00 1100.00 1501.00 0.00 0.00 1300.50" 0.00% Earned - Income • Number of Adults with • 0 • 0 0 5 1 2 8 6 75.00% Other Income Average Change in — _ _ 46320 750.00 0.00 0.00 511:00 0:00 Other. Income • Number of Adults with Any Income 0 1 0 6 1 0 8 7 87.50 (.a. Total Income). , Average • Change in — 91.00 — 569.33 1501.00 — 603.00 . 702.43 0.00:/ Overall . Income - 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC . Q19a3:Client Cash Income Change-Income Source-by Start and Latest Status/Exit • Did Not Have the Performer Retained Income Retained Income Income'.;'• ' Total. Measure:,. Had Income Retained Income Did Not have the Category But Category and Category at Start Adults Who Gain( Category at Start Category and Income Had Less$at Same$at and Gained the • (Including .Increased and Did Not Annual • Annual Increased$at Incorne` Category at Starts .Those Income frc have it at Annual • Annual or Annual . AssessmentlExit Assessment/Exit Category at with No Start to Ar. . ' Assessment/Exit Assessment/Exit Ass'essment/Exit Than at Start as at Start Annual Income) Assessme • Assessment/Exit ' • Average G Number of • • Adults with • Earned . 5 3 2 .4 2 36 55 • 7 Income(i.e:, . Employment . • Income) " Average Change in 426.80` -905 .00 0.00 896:50 1236.00 • 0.00 . 0.00 878.29 Earned • Income . • Number of Adults with 0 1 • 2 28 10 . 12 • 55 38 Other Income ' Average ' Change in — -36.00 0.00 540.25 909.40. 0.00 0.00 • 637.39 Other , Income Number of Adults.with Any'Income 0 4 1 36 , 6 (i.e.,total income) • • ' Average. Change in — -510:50 0.00. 588.58 916:17 0.00' . 455.00 625:59. Overall . Income Q20a:Type of Non-Cash Benefit Sources- • • BenefitssamtentfoLatestrStayersAn AsseAnnual Benefit at Start Benefit at Exit for Leavers • • Supplemental Nutritional Assistance:Program. 58 42 8 • WIC. :; 0 0 . TANF Child Care Services 0 ' 0, ; 0 TANF Transportation Services. • 0 0 0 . Other TANF Funded Services. 0 0 0 Other Source,. 51. . 40... 8 Q20b:Number of Non-Cash Benefit Sources ' Benefit at Latest Annual Benefit at'Start Benefit at Exit for Leavers. Assessmentfor Stayers, No sources 5 4 0 1+Source(s) 59 43 . 8 _ . Client Doesn't Know/Client Refused 0 - '.. • 0 0 _ • ' Data Not Collected. • 0, • 9 0 . Total 64 56 8 2/20/2019 • Sage:Reports:HUD Annual Performance Report.2018-CDC Q21:Health Insurance At Start At Annual Assessment At Exit.for'Leavers for Stayers' Medicaid. 33 28 5 • Medicare 3 1 1 State Children's Health Insurance Program 0 0 0 VA Medical Services 1 1 0 Employer Provided Health Insurance 0 0 0 Health Insurance Through COBRA 0 0 0 Private Pay Health Insurance 0 0 0 State Health.Insurance for Adults 28 . 20 4 Indian Health Services Program 0 0 0 Other 0. . 0. 0 No Health Insurance Client Doesn't Know/Client Refused 0 0 0 Data Not Collected 0 0 0 , Number of Stayers Not Yet Required to Have an Annual Assessment 0 9 0 1 Source of Health Insurance 51 38 6 More than 1 Source of Health Insurance 7 6 2 Q22al:Length of Participation.--CoC Projects • Total Leavers Stayers 30 Days or Less 1 0. 1 • 31 to 60;Days 1 ' 0 1 61 to 90 Days 1 0 1 • 91'to 180:Days` 3 0 3 181 to 365:Days 3 ' 0 '.. 3 ... 366 to 730 Days(1-2 yrs) • 11 1 10 731 to 1,095 Days(2-3 yrs). 3 . 0. 3 1096 to 1,460 Days(3-4 yrs) 5. 1 4 1461..to 1,825 Days(4-5 yrs) 3 0 3 • More than 1,825 Days(>5 yrs) 33 6 27 Data Not.Collected . 0 •0 0 Total 64`: 8'' 56 • .. Q22b:Average and Median Length of Participation.in Days Leavers Stayers •:Better Way of Miami,Inc.Apts.SRA PSH=FL0170L4D001609 a.Average length in days 2386.0000 •2002.0000 Better Way of Miami,IncrApts.SRA PSH-FL0170L4D001609 . b Median length in days : 2115.0000 1779.0000" • • • • • 2/20/2019 Sage:Reports:HUD Annual.Performance Report 2018-CoC Q22c:Length of Time between Project Start Date and Housing Move-in Date(post 10/1/2018) Total . Without Children With Children and Adults With Only Children Unknown Household Type 7 days or less 2 2 0 0 0 8to14days 0 0 0 0 0 15to21 days 0 0 0 0 .. 0 22 to 30 days 0 0 0 0 0 31 to 60 days 0 0 0 0 0' 61 to 180.days 0 0 0 0 0 181 to 365 days 0 0 0 0 0 366 to 730 days(1-2 Yrs) 0 0 0 0 0 Total(persons moved into housing) 2 2 0 0 0 Average length of time to housing 0.00 0.00 — — — Persons who wereexited without.move-in 1 1 0 0 0 Total persons. 3 3 0 • 0 0 Q22c:RRH Length of Time between Project Start Date and Housing Move-in Date(pre 10/1/2018) Total Without Children With Children and Adults With Only Children Unknown`Household Type • -no data 2/20/2019 • Sage:Reports:HUD Annual Performance Report 2018-CoC . Q23a:Exit Destination—More Than 90 Days • • Total Without With Children ; With Only Unknown Children and Adults Children Household Type Permanent Destinations 0 0 0 0 0 Moved from one HOPWA funded project to HOPWA PH 0 0 0 0 0 Owned by client,no ongoing housing subsidy 0 0 0 0 0 Owned by client,with ongoing housing.subsidy • 0 0 0 0 ' 0 Rental by client,no ongoing housing subsidy 3 .3 0 . 0 0 Rental by client,with VASH housing subsidy 0 0 0 0 0 . Rental by client,with GPD TIP housing subsidy 0 . 0 - 0 0 0• Rental by client,with other ongoing housing subsidy .' 3 3 0 Permanent housing(other than RRH)for formerlyhomeless persons Staying or living with family,permanent tenure. 0 0 0 .0 0 ' Staying or living with friends,permanent tenure• ' 0 0 0 Rental by client,with RRH or equivalent.subsidy. 0 0 0 0 0 Subtotal 6 6 0 0 0 .Temporary,Destinations ' 0 0 0 0. 0 Emergency shelter,including hotel or motel paid for with emergency shelter voucher 0 0 0 0 0 Moved from one HOPWA funded project to HOPWATH 0 0 0 0 0 Transitional housing far homeless persons(including;homeless youth) 0 0- 0 0 0 Staying or living with family,temporary tenure(e_g room,apartment or house) ' Staying or lving with friends;temporary tenure(e.g:room;apartment or house) 0 0 0 0 0 Place not meant for habitation(e.g.,a'vehicle,an abandoned building,bus/train/subway 0" 0 0 0 0 • station/airport or anywhere outside) Safe Haven0 .0 0 0 0 ' Hotel or motel.paid for without emergency shelter voucher •. 0 0 0 0 0 Subtotal 0 . . 0 Institutional Settings 0 0 0• 0 0 Foster home or group foster care home 0 0 0 0 ' 0 • Psychiatric hospitalor.other psychiatric facility 0 0 0 0 0 ' Substance abuse treatment facility or detox center 0 0 Hospital or other residential non-psychiatric medical facility 0 0 Jail,.prison,or juvenile detention facility- - . 0. 0 0 0 ' 0 Long-term care facility or nursing home . 0 - 0. 0 . 0 - 0 Subtotal' .. Other Destinations: 0. 0. 0 0 0 . Residential project or halfway house with no,homeless criteria Deceased 2 2 0. 0- 0 Other . 0 0 D Client Doesn't Know/Client Refused . 0 0 0 0 0 Data Not Collected.;(no exit interview completed) 0 0 Subtotal 2 2 0 0.. 0 Totat 8 8- 0 0 0 Total persons exiting to positive housing destinations 6 6 0 0. 0 . . Total persons whose destinations eXcludedthem from the calculation , 2 2 - '"'0 0 • 0 100,00 . Percentage 100.00% — — 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CDC ' Q23b:Exit Destination—90 Days or Less Total Without With Children With Only Unknown Children and Adults Children Household Type Permanent.Destinations • 0 0 0 0. 0 Moved from one HOPWA funded project to HOPWA PH • 0 0. 0 0 0 Owned by client,no'ongoing housing subsidy 0 0 0 0 0 Owned by client,with ongoing housing subsidy . 0 0 0 0 0 Rental,by client,no-ongoing housing subsidy 0 0 0 0 0 Rental by client,with VASH housing subsidy 0 0 0 0 . 0 Rental,by client,with GPD TIP housing subsidy. 0 0 0 . 0 0 Rental by client,with other ongoing housing subsidy. 0 0 0 '0 : 0 ' Permanent housing(other than RRH)for formerly homeless persons 0 0 0 0 0 Staying or living with family,permanent tenure - " 0 0 0 0 0 Staying or living with friends,permanent tenure•• 0 '0 Rental by client with RRH or equivalent subsidy ' ' 0 0 0 0: 0 Subtotal-. 0 0 0 0 0. . Temporary Destinations 0 0 0 0 0 Emergency shelter,including hotel'ormotel paid for with emergency shelter voucher 0 0 0 0: 0 Moved from one HOPWA funded project to HOPWA TH 0' 0 0 0 - 0 Transitional housing for homeless persons.(including homeless.youth) 0 0 ' 0, 0 0 Staying or living with family,temporary:tenure(e:g.room,apartmentor house) 0 ,0 0 0 0. Stayingor living with friends,temporary tenure(e:g.room;:apartment or house) : 0 0 0 :0: 0, ' Pla• ce not meant for habitation.(e.g.,a vehicle,an`abandoned building;bus/trainlsubway 0 0 0 0` D • station/airport or anywhere outside) Safe Haven. 0 0 0 ,0` ` 0 ' Hotel or motel paid for without emergency shelter.voucher • ' Subtotal 0 0 . 0 0 0 Institutional Settings Foster care homeor group foster care home . Psychiatric hospital or other psychiatric facility . : 0 0 0 Substance abuse treatment facility or:detox center, 0 0 0, 0 0: ' Hospital or other residential non-psychiatric medical facility 0 0 0 0 0 ' Jails:prison;.or juvenile detention facility 0 Long-term"care facility or nursing'home Subtotal 0 0 0. 0 0. `Other Destinations 0 0.' 0 0 0 Residential project or halfway house with no homeless criteria ' .0 0 0 , . 0 Deceased-: : 0.: 0 : 0 0 0 Other 0 0. 0 0• 0 • Client.Doesn'tKnow/Client ,Refused 0 0 . 0 Data Not Collected(no exit intenriew.completed) 0 0 0 0 0 Subtotal 0 0 0 0 0 Total persons exiting to positive housing destinations • Total persons whose destinations,excluded-th• em:from the calculation 0 0 Percentage _ 2/20/2019 • Sage:Reports`.HUD Annual Performance Report 2018-CoC Q25a:Number of Veterans ' Total Without Children. With Children and Adults Unknown Household Type • Chronically Homeless Veteran 0 0 ' 0 0 • Non-ChronicallyHomeless Veteran 4 4 0 • 0 Not a Veteran 60 60 0 0 Client Doesn't Know/Client Refu'sdd 0 0.'. 0 0 Data Not Collected . 0 0. 0 0 • • Total 64 64 0 0 • Q25b:Number of Veteran Households Total Without Children With Children and.Adults Unknown Household Type Chronically Homeless Veteran 0 0 0 0 • Non-Chronically Homeless Veteran 4 4 . 0.. 0' Nota Veteran 60. 60 0 0 Client.Doesn't Know/Client Refused ' 0. 0 0 0 Data.Not Collected 0 0 Total • Q25c:Gender-Veterans Total Without Children With Children and Adults Unknown Household Type Male • Female . . 0 0 . .. 0 0_ • Trans Male(FTM or Female to Male) 0 0: 0 0 Trans Female(MTF or Male to Female) • Gender Non-Conforming(i.e.not exclusively male-or female) 0 0 • 0 0.. Client Doesn't.Know/Client Refused 0 p' 0 0 • 'Data Not Collected 0: •,, 0 0 0 0 • Q25d:Age..Veterans. • Total Without Children With Children:and Adult Unknown HouseholdType 18-24. 25-34 35:-44 0 0 0 D 2 0 . 0. 55-61 0 0 0 Client Doesn't Know/Client Refused 0 0 • 0 0 Data Not Collected • :. 0 0 0 0 • 2/20/2019 Sage:Reports:-HUD Annual Performance Report 2018-CoC Q25e:Physical and Mental Health Conditions-Veterans ' Conditions At Start. .Conditions at Latest Assessment for Stayers Conditions at Exit for Leavers • Mental.Health Problam 3. - 3• • 0 • Alcohol Abuse 0 • 0 0 Drug Abuse . 0 0 0 Both Alcohol Abuse and Drug Abuse 4 4 0• Chronic Health Condition 2 2 . 0 HIV/AIDS . 0 0 0 • Developmental Disability 1 1 0 Physical Disability 3 3 0 • Q251:Cash Income.`Category.-Income Category-by Start and Annual/Exit Status-.Veterans Number of Veterans at Number of Veterans at Annual Assessment Number of Veterans at Exit Start • (Stayers)- •" (Leavers) :• - • Veterans with Only Eamed Income(i.e.,Employment 0 0 0. • Income): ' Veterans with Only Other Income • 3 3 0 Veterans with Both Earned and Other Income. 1 1 0 Veterans with No Income 0 0 . 0 Veterans with Client Doesn't Know/Client`Refused income 0 0 0 Information Veterans with Missing Income Information 0 0 0 Number of VeteransNot yet Required to Have an Annual 0 0 0 Assessment' Number of Veterans Without Required Annual Assessment 0 0 0 Total Veterans 4 Q25g Type of Cash Income,Sources.-Veterans• . Income.at Latest Annual ' Income at Start Income at Exit for Leavers • Assessment for Stayers • • • Earned Income. Unemployment Insurance. 0 0 0 • SSI g,. 3 0 VA Service-Connected.Disability Compensation 0 0 0 VA Non-Service Connected Disability Pension 0 0 b • Private Disability Insurance Worker's Compensation 0 0 0 • TANF or Equivalent. • 0 0 0` General Assistance 1 1' 0 Retirement(Social Security) Pensionfrom Former Job. 0 0 0 Child Support. _ • Alimony.(Spousal Support) 0 0 0' Other.Source.'. Veterans with.ncome-Infor Income at Start and:Annual'Assessment/Exit 0 4' 0 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC ' Q25h:Type of Non-Cash Benefit Sources-Veterans Benefit at Start Benefit at Latest Annual Benefit at Exit for Leavers_ Assessment for Stayers Supplemental Nutritional Assistance Program 4 4 0. WIC 0 0 0 TANF Child Care Services 0 0 0 . TANF Transportation Services 0 0 0 Other TANF-Funded Services 0 0 0 • Other Source 4 4 0 • • • • • • • • • • • • • • • • • • k4+.../A.,..A.. ..,.,F.'..:i..i..F../n....��..,/.......'.t:.lt.1a......:._,:../,-..I..,.a:,...:=.,n____ o_i:__i 1n—nnn,r0 Ar, A nnn_nn nnno..-i_nan-.n a_..a__..__...__.._._a _ nn.nn 2/20/2019 .Sage:Reports:HUD Annual-Performance Report 2018-.CoC . Q251:Exit Destination-Veterans Total Without. With Children : With Only Unknown Children and Adults Children Household Type Permanent Destinations . . " 0 0 0 - • 0 0 - Moved from one HOPWA funded project to HOPWA PH 0 0 0 0 -0 Owned by client,no ongoing housing subsidy 0 0 0 0 0 . Owned•by client,with ongoing housing subsidy 0 . 0 0 0 0 Rental by client,no"ongoing housing•subsidy 0 0 .0 0 O. Rental by client,with VASH housing subsidy. 0 . 0 .. 0 0 b Rental by client,with GPD TIP housing subsidy 0 0 0 0 0 ' Rental by Client,with other•ongoing housing subsidy. 0 0 0 0 0 Permanent housing(other RRH)for formerly homeless persons 0 0 0 • '0 0 Staying or living with family,permanent tenure 0 0 0 0 0 Staying or living with friends;permanent tenure• 0 0 0 0 0 Rental by client,with RRH or equivalent subsidy 0 00 0 0 Subtotal 0 0 0 0 0 Temporary Destinations - 0 0 0 0 0 Emergency shelter,including hotel or motel;paid•TOT-With emergency shelter voucher 0 0 0 0 0 . ` Moved from one HOPWA funded:project to HOPWA TH - 0 0 0 0. 0, Transitional housing-for homeless.persons(including"homeless youth) 0 0 0 0 0 Staying:or living with•.family;temporary.tenure(e.g.room;apartment or house) 0 0 0 0. 0. • Staying or living with'friends,temporary.tenure(e.g:room,apartment or house) 0 0 0 0 0 Place not meant for habitation(e:g.,a vehicle,:an abandoned building,bus/train/subway station/airport or'anywhere outside) 0 0 0 0 0 Safe Haven 0' 0 0 0 0 ' Hotel ormotel paid"for without emergency shelter voucher" 0 0 0 0 0 Subtotal..: 0 0 0 0` 0. ' Institutional Settings" ' " foster care home or group foster care home. 0 0 0 0 0 Psychiatric hospital or other psychiatric facility • 0 0 0 0 0 Substance abuse treatment facility or detox center.. 0. 0 0 0 0. Hospital or other residential non-psychiatric:medical facility 0 0 0 0 ' 0 Jail;prison,.or juvenile.detention.facility 0 0- • 0 0 0 Long-term care facility or nursing home : 0 0 . ' 0 0 0` Subtotal 0: 0 0 0 0 Other,Destinations: "Residential projector halfway with no homeless criteria 0: 0 0 . 0 0 Deceased Other0 0. 0. 0 0, Client-Doesn'tKnow/Client Refused . 0 "' 0 0 0 0 Data Not Collected(no:exit interview completed) 0 0 • 0 0 0 Subtotal ' Q 0 0 0 0 Total 0 0 0: 0 0 Total persons exiting to positive housing destinations•" 0 0 - 0 0 • 0 , Total persons whose destinations excluded them from the calculation 0. 0 .• 0 0 0 Percentage, - - —• - . 2/20/2019Sage:Reports:HUD Annual'Performance Report 2018-CoC " Q26a:Number of Households w/at least one or more Chronically Homeless person . Total Without Children With Children and Adults With Only Children Unknown Household Type Chronically Homeless ' • 21 21 ' 0 0 0 ' • Not Chronically.Homeless ' 43 43 • 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected 0. 0 0" 0 0 • . Total' . • 64 64 0 0 •' 0 . ' ' Q26b:Number of.Chronically.Homeless Persons by Household - • Total . Without Children With Children and Adults With Only Children ' "Unknown Household Type Chronically Homeless 21 . 21. . - 0: '' 0 ' 0 • ' . • - • Not Chronically Homeless '43 .43 • 0 0 0 Client Doesn't know/Client Refused. 0• - : 0 . 0 A 0 . • Data Not Collected ` .. 0 0 0 0 0 Total . • • 64 64 . 0 0 p. ' Q26c:Gender of Chronically Homeless Person's ' Total ' Without With Children and _With Only Unknown Household • Children . • Adults Children -Type. " Male • 7 7.. • 0 Female 14 , 14 0 , Trans Male(FTM or Female to-Male) 0 ' 0 • Trans Female(MTF or Male to Female) 0 0 0 0 0. Gender Non-Conforming.(i:e.not,exclusively male or female) 0 0, 0 0 0 . Client Doesn't Know/Client Refused 0. 0 Data Not Collected 0 tl ' 0 Total , 21 21 • •Q26d:'Age of Chronically Homeless Persons .. .. - , : : T• o , .Without.Children With Children and Adults With Only Children Unknown Household Type 35 44 1 1 0 0 0 455-_.54 9 9 0 0 . 0 55 :61 7 7 0. 0 0 62i r. 3 3 0 0 0. • Client Doesn't Know/Client Refused 0. 0 0 0 - 0 , Data.Not Collected 0 0 • '0 0 0 total 21 . • • • 212O/2019 Sage:Reports:FILO Annual Performance Report 2018-CDC • Q26e:Physical and Mental Health Conditions-Chronically Homeless Persons , Conditions at Start Conditions at Latest • Conditions at Exit.(Leavers) Assessment(Stayers) ' Mental Health Problem 19 19. 0 Alcohol Abuse 0 0 0 • Drug Abuse 0 0 0 •. Both DrUg.and Alcohol Abuse 21 .20 1 ' Chronic Health Condition 10 9 1 HIV/AIDS 2 2 0 Developmental Disability 3 - 3 0 Physical Disability 13 12 1' Q26f:Client Cash.income-Chronically Homeless Persons . Number of Chronically ' ' Number of Chronically Homeless Persons Number of Chronically Homeles •Homeless Persons at Start` at Annual Assessment(Stayers) Persons at Exit(Leavers). • Chronically'Homeless Persons with Only Earned . Income(i:e.,Employment Income) .. 4 1 Chronically Homeless Persons with Only Other Income 8 0' - Chronically Homeless Persons with Both,Earned3 - and Other Income• 0 Chronically Homeless,Persons with No Income 9. 3 0 • Chronically Homeless Persons with Client,Doesn't " 0 0 0 Know/Client.Refused Income Information Chronically Homeless Persons with Missing.Income 0 0 0 Information, . Number of.Chronically Homeless Persons Not yet Required to Have an Annual Assessment 0 3' 0, Number of Chronically Homeless Persons Without • 0 0 0 Required,Annual Assessment Total Chronically Homeless Persons. • 21 20. . , 1 Q26gi Type:of Cash Income Sources-Chronically Homeless Persons • •- Income at Latest''Annual nc Income atExit for L a a ver: I `ome at Start . Assessment for Stayers Earned Income 7 6..: 1 . • Unemployment Insurance 1 1 0 B 0 SSDI 1 1 • 0 •,VA Service-Connected Disability Compensation - :,0 0.. 0 VA'Non=Seivice-Connected•Disabiliity Pension 0 0 0 Private Disability Insurance 0 0 0 Worker's Compensation 0 0 0 • TANF or_Equivalent . General:Assistance:. 1 0 Retirement(Social Security)' 0. 0 0 Pension from Former Job. - • • 0 -0 - • .0 Child Support ' Alimony(Spousal Support) Other Source Chronically Homeless Persons with-Income Information at Start and Annual Assessment/Exit 0 • 10 10 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC • Q26h:Type of Non-Cash Benefit Sources-Chronically Homeless Persons Benefit at Start Benefit at Latest Annual Benefit at Exit for Leavers • Assessment for Stayers Supplemental Nutritional Assistance Program 18 . 15 • 1 • •• WIC 0 0 • TANF Child Care Services 0 , 0 0 • TANF Transportation Services 0 0 • 0 • Other TANF-Funded Services • 0•. 0 0 Other Source 15 13 1 . • • Q27a:Age of Youth • Total Without Children With Children and Adults. With Only Children Unknown Household Type . 12'-17. . 0• 0 0 . 0 Client Doesn't Know/Client Refused•• 0• 0 0 • 0 0 • • Date Not Collected • ' 0 0• 0 0 0 Total 1 1 • 0 p 0 • Q27b:Parenting Youth Total Children Youth Total Persons Total Householdof. .Total Parenting' s.' • Parenting Youth • • Parent Youth<18 0 0 0 0 Parent.Youth 18 to 24 . 0 0 0 0 Q27c:Gender Youth ' • Total' Without. With'Children and With.Only. •Unknown Household • Children •Adults Children: •.Type • Female Trans Male.(FTM or Female-fo Male). 0 0 0 0 0:- Trans Female(MTF or Male to Female) GenderNon-Conforming(i.e.not exclusively male or female) •. 0 0 0 0 0 . Client Doesn't know/Client.Refused 0 0 0 .•. 0 0 Data'Not Collected. .;' ._ : 0, 0 • 0' • 0 0 Total'. 1 1 0 2/20/2019 • Sage:Reports:HUD Annual Performance Report 2018-CoC Q27d:Living Situation-Youth • Total Without With Childrem and With Only Unknown Householc Children Adults Children Type Homeless Situations 0 0 • '0 0 0 Emergencyshelte,including hotel or motel paid for with emergency 1 1 0 0 shelter voucher. . Transitional,housing for homeless persons(including homeless youth) 0 0 0 0 0 • Place not meant for habitation • 0 0 0 0 0 Safe Haven 0 0- 0 - 0 0 Interim Housing 0 0 0 0 0 • Subtotal • 1 1 0 o 0 Institutional Settings 0 0 0 0 0- , Psychiatric hospital or other psychiatric facility 0 0 0 0 . 0. . Substance abuse treatment facility or detox center 0' 0 0 0 0 Hospital or other residential non-psychiatric medical facility 0 0. ' 0 . • 0 0 • Jail,'prison or juvenile detention facility • 0 0 0 " 0' 0: Fostercare home or foster care group home 0 D 0 0 0 Long-term care facility or nursing home 0 Residential project or halfway house with no homeless criteria 0 0 0 , 0 • 0 Subtotal 0 0 p. 0: 0 Other Locations - 0 a: - `'0 - • 0 , 0 Permanent housing(other than R41)for formerly homeless persons 0 0 Owned by client,no ongoing:housing subsidy •0 0 0' 0 0 Owned by client,with ongoing housing subsidy 0 0 0 0 0 -Rental by.cliiient,no ongoing housing subsidy 1 0 0 D; 0" 0 - ' Rental by.client,with VASH subsidy ' 0 0 0 0 0 Rental by client with GPD TIP subsidy 0. 0. 0 0 0 Rental by client with other housing subsidy(including RRH). 0 ' Hotel or motel paid for without emergency shelter voucher 0 0. 0 0 0 Staying'or living in,a friend's room;:apartment or house. 0 0 ' 0 0 : 0 • ' Staying or living in a family member's room;apartmentor house 0 0 0 0 0 . Client,Doesn'tKnow/Client Refused . • . 0 0 Data Not Collected: . r subtotal 0: 0,:: 0 0 0. • Total 1 1 0. 0 . . o Q27et.Length of.Participation Youth . - Total `` Leavers Stayers - . •30 Days"or Less : ... 0 :o . . 0, 31 to 6D Days 0 0 - 0' , . 6.1to90;Days. . :D 0 •0 . 91.to:1B0 Days..' .. 0 .. _.;0 0:,. • 181:to.365 Days 0 i 0 0 366,to 730 Days(1-2'yrs) 1 0 1' ... 731 to 1095;Days2 3'Yrs) 0 0 p' • ..(, 1,096 to 1,460'Days(3-4 yrs) 0 0 0 1,461 to:1,825 Days(4-5 yrs)- . '.0 ... .0' 0 ' Moreaan'1,825.Days(>5Yrs) 0:. : 0 - Data Not Collected •0 0 0" • Total 1 0.: 1 _ . 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC . Q27f:.Exit Destination-Youth - Total Without . With Children With Only Unknown . Children and Adults Children Household Type Permanent Destinations . . 0 .0 0 0 0 Moved from one HOPWA funded project to HOPWA PH 0 0 0 . 0 0 Owned by client,no ongoing housing subsidy 0 0 0 0 0 Owned by client,with ongoing housing subsidy . - 0 0 0 0 D Rentel'by client,no ongoing housing subsidy • • . 0 • 0 0 .0 0 Rental by client,with VASH housing subsidy. " 0 0 0 0 • •'0 Rental by client,with GPD TIP housing subsidy 0 . 0 '. . 0. 0 0 • • Rental by client with other ongoing housing subsidy 0 Cl 0 0 0 Permanent housing(other than.RRH)forforinerly ho"meless.persons • 0 0• 0 0 0 Staying or living with family,permanent tenure' Staying or living with friends,'permanent tenure .. - 0 0 0 • 0 0 Rentalby client with RRH or equivalent subsidy - . 0 0 0. 0. 0. Subtotal 0 0 . 0 . 0. ' 0 Temporary Destinations0 0 • 0 .. 0: 0 ' Emergency shelter including hotel'or motel paid for with emergency'shelter voucher 0 • 0 ' 0 0 • D Moved from one HOPWA funded project to HOPWA TH 0 . 0 0 0 0 Transitional housing.for homeless persons(including homeless;youth) 0 0 . 0 0 0. • Stayingor living with family,temporary tenure(e.g.room,apartment or,house) 0 0 '0 • 0' 0 Staying or living with friends,temporary tenure(e.g,room,apartment or house). 0 • 0 0 0 0 . Place-not meant for.habitation(e.g.,a vehicle,an abandoned building,bus/train/subway 0 0 0 0 . 0 station/airport"or.anywhere outside) Safe Haven • 0, 0 • 00.. 0 . • Hotel or motel paid for without emergency shelter voucher 0' • .0. 0 0 0 Subtotal D ' 0. 0 0: 0 Institutional Settings Foster care home or group foster care home• 0 0 0 0 0 Psychiatric hospital or other psychiatric facility 0 0 0 0. 0 Substance abuse treatment facility or detox center 0 0 0 O . 0 •Hospitalor other residential non-psychiatric medical facility 0 . 0: 0 0.: - 0 Jail,prison,orjuvenile detention facility 0 0- 0. • 0 0.. . ' • Long-term care facility or nursing home 0,`' 0:.: 0' Subtotal. 0 0 0 .. 0.0 . 'Other Destinations 0 0 0 0 0 Residential.project or halfway house With no homeless criteria' 0 '0 ' 0 0 0 Deceased 0. 0 0 D D . Other 0 0 0 ' 0, 0 Client Doesn't.Know/Client Refused 0. 0. 0 0 0 Data Not Collected(no exit interview completed) Subtotal,• Total • • • • Total persons'exiting to positive housing destinations ' 0 0 0 0 • 0- . • . Total persons whose destinations excludedthem from the calculation' .0 0 0 0 0 Percentage . . - - — _ • 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC Q28.Financial Information • • Development . Acquisition 0 0 • Rehabilitation • - 0 New Construction • 0 • . - Development Subtotal 0.00 Supportive Services Assessment of Service Needs 0 - • • Assistance with Moving Costs 0 Case Management 0 • Child Care. 0 Education Services 0 • • Employment Assistance Food: 0. Housing/Counseling Services 0 Legal Services: Life Skills. • Mental Health Services • 0''. Outpatient Health Services 0' Outreach.Services 0 Substance:Abuse Treatment Services , 0.. Transportation o Utility'Deposits 0 Operating. 5 Supportive Services.Subtotal 0.00" HMIS Equipment(Server,Computers,Printers) 0 'Software(Software Fees,User Licenses;Software Support) 0 ' Services(Training,•Hosting„Programming) 0, ' Personnel(Costs Associated.with Staff) . 0 Space and Operations 0 HMIS'Subtotal, 0.00 • Leasing,:Rental Assistance,and Operating Real Property Leasing(Does Not.Requi•re Match) . ; 0 • Shot/Medium-Term Rental Assistance :0 Long-Tenn Rental Assistance 432109.68 , • Operating,Costs, 0 • Leasing Rental Assistance;8'Operating Subtotal 432 109.58 ' Administration Administration 29 753':00. Administration SubtotaC: 29,753.00: Total Expenditures' '461 862:58 Match Cash Match 0 In-kind Match 124,671.00 Total.Match. 124,671100 ”. • Total Expenditures Requiring a Match 461 862.58 Percentage Match : • 26-.99%".' •Total.:Budget`(Expenditures Plus.Match) 586,533.68 2/20/2019 Sage:Reports:HUD Annual Performance•Report 2018-CoC • Q29.Performance-Accomplishments • Please describe any significant The Better Way West Apartments provided housing to 64 single homeless persons with disabilities by.providing 55 units of permanent accomplishments achieved by housing and supportive services.The program assisted the participants with achievinglongterm recoverygoals,increasingskills andyour program during the operating • income,and providing greater self-determination.The program achieved 100%occupancy at the end of this operating year. year. • Q30.Additional Comments • • • Please;provide any additionalcomments on other areas of the APR that need The Miami-Dade County F-lorneless Trust will continue to work with the local Miami HUD explanations,such as a differencein anticipated and actualprogram outputs or Field Office to address any issues related to the submittal of the Annual Progress Repor bed utilization: •(APRs). FY 2018 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.Department of Housing and Urban Development. Recipient Name: Project Name:. Grant Term:.1 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 Recordkeeping 1. 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 debarred • 24 CFR 578.23(.c)(4)(v) 5. Documentation of annual monitoring;of Subrecipients 24 CFR 578.23(c)(8) 6. :Executed Memorandum of Understanding with Service Providers . 24 CFR 578.73(c)(3). .. • 7. Project Application should be 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)... ... Intakelscreening:procedures 24 CFR 578.103(a)(3)and(4) Internal Wellness Checklist Page 2 Grant#: 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 LFR.2424,24 CFI(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 $UD CPD Notice 14-02 _10.Documentation ofparticipation of homeless/formerly homeless-individuals in policymaking: 24 CFR 578,75(g)(1) 11.Documentation of compliancewith 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 CY R.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 tJ J(578.103(a) 2 Written Procurement Procedures, 2 CFR 200.318 and 2 CFR 200319 - ` 3.Written Conflicts of Interest Policy 2 CFR 200:317 and-2;C1+'R.20.0.318,:24 CFR.578.95(a) 4:Documentation of match(25%o of total Grant Amount less leasing) 24 CFR 518.73(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#: 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(b) Participant Program Files. 1.Documentation participants are entered into HM[S 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(e)(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- Nomore than 24 months of services provided except under documented extenuating'circumstan ces 24 CFR 578.791, 6.Documentation of ongoing assessment of services 24 CFR 578,75(e) 7.Documentation of exammation;of income(initial�and recertification) - 24 CFR 578.103(a)(7)(i) 8.Documentation ofinitial'and follow-up.Housing Quality Standards inspections 24 CFR 578.75(b)(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 57849(b)(5)' 11.Leasing-Is there an occupancy agreement,lease or sublease in the file(for individual.units)? 24 CFR 578.103(4)(17) 12.Leasing-Documentation of rent reasonableness for the period of approval for an assisted unit 24 CFR 578.49(b)(1) 13.Rents charged(including utilities) do not exceed HOD-Fair Market Rents . 24 CFR 578:49(b)(2) 14.'Documentation.supporting the correct/current utility allowance schedule is used 24 CFR 578:103(a)(17),24 CFR 57849(a)(3) • • • Internal Wellness.Checklist Page 4 Giant#: 15.Leasing-Documentation of occupancy charges with annual:income calculations - :. 24 CFR 578.77,24°CFR 57899(b)(6), 16:Rental-Doc-Mentation the participant.has a an executed lease agreement with the landlord • 24 CFR 5.78.77,24.CFR:.578:51(d)(e) • 17.Rental-Documentation of rent reasonableness for.the;period of approval for an assisted-ahit 24.CFR 578,51(g) • • NOTE: For:additional guidance,please refer to the following • resource materials: 1 Homeless EmergencyAssistance,and Rapid Transition to • • Housing: Continuum of Care Program.CoC regulations at 2•4 CFR Part 578,and (2)Monitoring handbook'6509.2 REV 6"CHG-2.that can be accessed at http://portal hud. ov/hudportal/HUD?src=/program offices/ad • . ministration/h udcl ips/handbooks/cpd/6509.2. Completed by: Signature: Date.. .. ... Typed/PrintedName.; Title This.docummenf is.to be maintained m t}ie.appllcable CoC project MIAMI. COUNTY Attachment G"CoC Program Guidelines" r Page 1 of 14 Miami Dade County Homeless Trust _ CoC:Program Guidelines • MIAMI DADS COUNTY Miami=Dade County Homeless Trust Monitoring Teain Information Staff: . . Date of Visit . CoC Program Subrecipient.Agency and ProgramInformation Siibreciplent. • .Pro.gram.Name: Subrecipient staff consulted: • Grant Amount: r Grant:Number: • t • . Program Type: O PSH O RRH O TH O SH 0.SSO O Legacy.SPC O RRH; Number to be served Number ofchronicb"eds/units: Program serves: O Individuals 0 Families' O Both CoC Program grant funds:are used:for • 0 Leasmg;[no match required) O Rental Assistance , 0 Operations .. °0 Supportive Services O HMIS 0.:Admimstration Ts;the Subrecipient a faith-based organization?= ;• O Yes O No • 'CoC Matching funds"(25%) required are:: 0-Cash/Cash Equivalent O In,Kind:0 N/A Is therean active restrictive covenant on one or more of the project's properties? 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 theperforinance of covered persons engaged in the: O No award and administration of contracts.24 CFR§ 578.95(a);24 CFR§578.103(a)(11) • 2.The Subrecipienthas a:general conflict-of:interest-: OYes' - policyfor staff and Board:members 24 CFR§ O No 578.95(c);24.CFR.§578.103(a)(11) 3.If the Subrecipientis an approved exception to the O Yes. :conflict of interestpolicy,the agency has documented :O No the exception:24.CFR§578.103(a)(11)' .Involvm eent of homeless"persons ` 1.There is.at least one homeless/form.erlyhoiiieless O;Yes . ' • 'person is on the Board.of Directors or:equivalent Q No • policymaking:entity.24 CFR§578 75(g).(1) 2.The Subrecipientinvolves homeless individuals O yes and families through employment;volunteer services,orbtherwise;in constructing,rehabilitation; maintaining,and operating the:proj ect;;and in providing supportive services for the project.24 CFR §:578.75(g)(2) .` :. ... . Confidentiality.: - 1'The Subrecipi_enthas written policies to ensure • I Yes:.. • • Records containing protected identifying O No information of any individual/family ., • receiving;assistance willbe kept• - - '. confidential, • • The location of any family violenceproj.ect m1ll not be:made public'except with the':, written-permission of the person - responsible for'operating the project;and • Tiie location of;any housing,of any program . participant tniill not be made public,except as.provided in a:.preexisting privacy and as provided by law.;;.. 24.CFR§.578.103(b) (These policies are in addition ": to'HMIS related-confidentiality./security requirements} F '.. air Housing.and Equal Opportunity`. . .. 1:The Subrecipient has written nondiscriminationO Yes and equal opportunity policiesthat apply to housing. and`employment,,24 CFR:§:578.93.. - 2 The Subrecipient has:policies'and procedures;for (:)-Yes providing reas:onable accornmodations,'and : .O No•>; reasonable modifications for persons with . disabilities:24 CFR§100.204(a) 2$CFR§. ; . . 35.130(li)(7) • - Attachment G"COC Program Guidelines Page 3`of 14 • • 3:The Subrecipient maintains copies of marketing, 0 Yes outreach,and other materials used to inform eligible O No persons of the program and these materialsshow that the agency markets their housing and supportive:services to those least likely to apply in the absence of special outreach.24 CFR §578.93(c)(1) 4.The Subrecipient has policies and procedures in 0 Yes place to provide meaningful access for Spanish- , 0 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 rightsand remedies;available No„; ` under applicable federal,State and local fair:housing - and civil rights laws.24 CFR§578.93(c).(3) Drag-Free-Workplace' 1:The Subrecipient has a drug-free workplace policy 0 Yes ; statement which includes the requirement.of •n1,0- • notification to'HU.D if an employee is convicted for • criminal drug offense:24.CFR§`84.13 , • _ POLICIE• S AND.PROCEDURES FOR COC•,GRANT FUNDED,--PROGRAM • Number Served .: 1:The Subrecipientserves at least as many program •;O Yes • participants as show in its application for assistance D No 24:-CFR§:578.51(h)(3) ; Termination Process.. .. . • 1:The Subrecipient has•awritten policy for Dyes ;: . • termination of participation for violation of program O No •• - policies-or OCcupancy agreements:24 CFR§ 578.91(b). Services Related to Housing Stability 1:The Subrecipient has"a written policy for O Yes . termination of participation for violation of program O No policies or occupancy agreements.24 CFR 578.9:1(b) Residential Supervision 1 The.Subrecipient provides.adequate residential` 0 Yes. supervision..24 CFR: .578 75 Program.Fees; 1.:The Subrecipient'does not charge participants: 0 Yes . : program fees.:24 CFR§.578,87(d)Program:fees are 0 No ' not thesame as rent or;occupancy rent;program. Partici'ants may be chared rent for_housin • • • Attachm'ent.G"CoC Program.Guidelines" • Page 4 of;14 Recordkeeping 1.The Subrecipient has systems in place to ensure O Yes that records related to CoC-funded programs are O No maintained for a 5-.year period.24 CFR§578.103 REVIEW OF Cot PROGRAM PARTICIPANT FILES Eligibility:Homelessness 1.Each participant file contains verification of 0 Yes homelessness status atthe time of program entry.24 Q No. • CFR§578.103(a)(3)24°CFR§576.500(b), 2.The Subrecipient has writtenpolicies and O Yes • procedures for documenting homelessness. Intake Q No staff document eligibility at intake;documentationis required for all persons seeking assistance;written policiesstate the evidence that may be relied upon to establish,and verifyhomeless 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 .0 Yes contains verification of participant's disability;.24 0 No CFR§578.37(a)(1)D) 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 SSDI check] Eligibility ,Chronic:homelessness 1.If the program has units dedicated to persons who O'Yes • are chronically participant files contain O.No: - . • verification of chronic homelessness. Service Assessment: 1:The file contains participant assessments and , .O Yes • service,plans,updated at least annually.24 CFR:§ O No • S ervices`Providednnd Costs '1.The file contains documentation of services O Yes provided and the agency tracks the amounts spent on -0 No; those services:24 CFR§,578.103(a)(9). Duration.of Se vices 1 The file reflects that supportiveservices are made O Yes - ' available throughout resident's entire time:in the Q:No project:24 CFR:§.578:53(b)', , 2 Rapid rehousing The file reflects that program 0'Yes participant meets with:case manager not less.than- Once han 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 O Yes program,file includes documentation that the O No Subrecipient followed its written procedure for termination of assistance.24 CFR§ 5.78:103(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 participantlives.in) RentalAgreement/Lease: 1.The program participant has an occupancy. : Q Yes . agreement or lease with the Recipient/Subrecipient Q No OrLandlord.24 CFR§578.77(a)For tenant and. project based assistance;the program participant must be the tenant on the lease. For sponsor based assistance,:lease between the Subrecipient and the e Landlord,sub-Lease between participant and • Subrecipient 2.For project-based,sponsor-based,:or tenant-based • O Yes • permanent housing(PH).rental assistance;initial 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 24CFR§ • 3 For transitional housing ini_tial•lease.term must be O'Yes at least one month.'The lease must be automatically Q No, renewable upon expiration,except on prior'notice by • either party,up to maximum:term of 24 months.24 Habitability 1.File includes.documentation that units passed O'Yes housing:quality standards inspection prior to initial • O No client 11101r .-111-24 CFR§578.75(b);and 24 CFR:§578.103(a)(8) • 2. File includes,documentation that unit has passed I Y• es: • ' -annual housing quality standards inspections;,: O::No including an inspection within the last;12 months.24 CFR§:578:7.5(b) 3.Dwelling unit is correct size:The dwellinguriit O Yeq,_. must haveat,least one:bedroom.or hying/sleeping . O No 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 supportivehousing for persons with Yes -. , disabilities;the Subrecipientmust-iiiake available O=No: 'meal preparation facilities for residents or provide•. .meals .2.4 CFR§578:75(d) . Attachment G."CoC Program'Guidelines" Page`6 of 14 • Unit Rents 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 the HUD-determined Fair O Yes . " Market Rents(FMRs). This documentation must O.No include chart show current year's FMRs: • 24 CFR§578.45(13)(4) 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(b)(4) , ..Annual Income . • 1.The file contains an income evaluation formO Yes completed byprogram participant and source; ONO documents verifying income and assets(or,if source documentation nOt available,3rd party verification; or if 3rd party verification not available,written certification by program participant ,24:CFR§578.103(a)(6) . 2:The file contains documents demonstratingthat O Yes income is re-examined annually. O No. 24 CFR§.578.77(c)(2) . _. . Rent Calculation 1.The file contains the annual rent calculation,and O Yes the"calculation is,accurate:BSTPRACTICE The file • contains a printout:of'the HUD rent calculation • . 24 CFR§'578 103 2.Is the:participant charged rent(unless$0 income) O Yes and is the rent treated as program income7 ., 0 No (required) 3::Is rent calculated initially,annually,and when O Yes` there is•any.change in income?: ._ O No" - 4i`Is.there documentation of compliance ofan.ehgible O:hes `.`.utility allowance The Subrecipient has received a Q No . copy of.the Tenants paid utility bill for compliance:.. Vacancies. 1.'The Subrecipient does,not pay rent for more than.` O Yes 30 days for:any unit that has been vacated. Rent may O'No not be paid on the'vacated unit again until there is•a . : ` new:occupant.(NOTE:Brief perioc4 ofstays iri, institutions,not to exceed 90 d_aysforeach:occurrence, ' . are not considered vacancies).. � - 24`CFR§ . . Attachment G"Co C 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 Q'No for comparable space.24 CFR§578.49(3) 2.Rents do not exceed rents,charged for comparable O Yes units rented by the:Subrecipient 24 CFR§578:49.(b) O.No 3.Security deposit does not exceed:two months'rent; 0 Yes • in addition to the security deposit,.the.Subrecipient LI No may also pay thefinal mon_ths'.rent:in advance.. 24 CFR§x.578.49(b)(4)' 4.The Subrecipientmust hay..e an occupancy : O Yes agreement,and'if applicable a sublease. O No • 5 Is rent calculated initially and when the tenant Q Yes requests? .: 6:Is the participant charged.rent?(not.required) O Yes O No • 7::Has an occupancy charge been imposed7[not - O.Yes required)If so,the charge cannot exceed the highest O Nb of 1)30%of the 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). ; • 3..Leasing funds are not used to lease units or O Yes : structures owned by the Recipient;Subrecipient, 0 N0 -their parent organi7ation(s);•or organizations;.that are members of apartnership where the,partnership, owns the structure. (Doesn'tapplyto rental assistance): - .. . • `REQUIRED'POLICIES-AND PROCEDURES FOR SPECIFIC:PROGRAMS/ CIRCUMSTANCES': • Participant Household Policies(complete this section for°any program that serves families with.. children)_ I.::The age and gender of a:child under age 18 must O:Yes. oot be.used as a.basis for denying any participant 0 No household's admission to a project that receives . funds'under:this part .' .: Faith-based Activities(complete this section[f the Subrecipient:is a faith based o'rganization) . .: 1:.The Sub recipient serves all'potential participants 0-:Yes without.regard to religions=belief•,refusal:to hold a LI No. religious,belief,.or refusal • to ttend or participate in 'religious services.24 CFR 58.87(b)(1).... • • 2.If the-Subreciipient provides.explicitly religious O Yes activities(includingworship,religious instruction,or O.No proselytizing),theseactivities are separatefrom : • HUD funded,activities and beneficiaries of HUD funded activities:are not required to participate. : •Attachment:G`:`CoCProgram'Guidelines" Page:8 of 14: • 24 CFR§578.87(b)(2) Projects involving acquisition;new construction,arid rehabilitation 1.Records for acquisition,new construction,and- O Yes rehabilitation must be retained for 15 years • O No following the date the project is first occupied,or used,byprogram participants.24 CFR§ 578.108(c)(2) 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 3;For projects including new construction or., ':O Yes rehabilitation,do the Recipient's records show that. ` 0 N • Section 3 reports have been completed:aid , submitted timely? 24 CFR§578:99(i). , Transitional Housing . 1.Participants do.notregularly exceed 24 months in O Yes 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 _ 0 No extended participation.24 CFR§578:79 • • 3.Ifartici antsstaY g lon er.than 24 months,is the O Yes P P.. . . . . number of participants with longer:stays less than O No 50%of the total number served by the project? 24 CFR§`578.79 TransferDile_to Domestic`Violence: ` 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, - docuinentation of the domestic violence and imminent threat PART 2 FISCAL MONI.TORING. INTERNAL:REVIEW Audit, 1.'Is the Subrecipient subject to.the 0MB A=133 O yes" ' single audit requirement?(Required if$5000,000".or more.inaggregate Federal funds expended) • - 2.If subject°to A 133 audit;has the Subrecipient Oyes" • provided.its most recent audit and management - letter? 3..If not bound byA-13:3:requirement,has the agency :.OYes' : • provided financial statements audited by a CPA? OiNo : .. •• Board of.Directors 1:Has the Subrecipient provided-Miami Dade:Comity ` O Yes a list of the members of its B oard'of Directors? :Authorized Check Signers. • 1:Has-the Subrecipient provided Miami-Dade County dyes • - With a.listofauthorized'checksigners? O No • • ` Attachment"G"CoC Program Guidelines" Page 9 o114 • 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 0 No competitive procurement standards: 2.The Subrecipient retains copies;of all procurement O Yes contracts and documentation of compliance:with No federal procurement requirements 24 CFR§578::103(a)(16)(iii).. 1.The.Subrecipient has documentation of the source and use of contributions made to satisfy the 25% O No match requirements.(match maybe cash or in kind). • •• Records must indicate the grant and fiscal'_year for' which each matching contributions'counted The records must.show how the value placed on 3rd party in kind contributions was derived. Costs incurred by : apartnering organization to:provide"in land" services to the program participants must be documented:by a NFOU Cash or any-inland, contribution used:as match for another grant is not , an eligible in kind contribution used as matchfor another grant is not an eligible match 24 CFR§ 578 73,24 CFR§578.103(a)(10),24 CFR§84.23 and OO 24'GFR§578.23,_c 6 .. •. ..., 2 Match must be spent on,eligible project.costs(in O Yes the bud et,'. 3.Where match is documented by.MOU,the MOU O Yes must;establish the unconditional commitment O No identify the service to beprovided,identify the profession of the persons providing the service;and identify.,the cost of the.service to:be provided; <, Internal Controls. 1 The Subrecipient has written job descriptions for 0 Yes all HUD-funded positions '.0 No. 2 The:Subrecipient.has written fiscalpolicies and O Yes" procedures specifying approval authority for all O No financial transactions and guidelines for controlling expenditures: 3 The Subrecipient has writtenprocedures for O Yes.: - recording financial transactions,and:an accounting •O.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 1No income asis any utility allowances in rental: ,: : . . • . programs . 2.`Is•program income part of your match? Program 0 Yes: incomeis riot an eligible source of match. O No. • Attachment "CoC Program Guidelines" ;.: Page 10 of 14 Indirect Costs 1.Does the organization use grant funds for indirect O Yes . costs? O No 2.Are the costs consistent with OMB Super Circulars O Yes as applicable O No D 0 CUMENTATION REVIEW: . Salary Documentation 1.Original timesheets-signed;grant duties O.Yes identified;if split time(copy in;reimbursement package) 2.Payroll sheets O Yes ONo :.. 3.Cancelled checks to the employee O Yes ONo'. 4.If time is divided between the•Co.C.Prograins'and O Yes another funding source,review time distribution : : Q No records supporting the allocation of charges:among the sources: Staff time breakdown allocation chart.` • Space%Utilities Documentation)Leases 1.Rental or lease agreement-signed by participant; O Yes • valid lease period,correct rental amount • ;LI No 2:Original invoices O.Yes O.No.. 3:Cancelled checks to the landlord/mortgagee,• O Yes utility:company,etc:. O N.o 4.Unit inspection report(s);no longerthan.1 year:old O Yes ONo: 5.Verification.of what;payment:was used for(e.g. O Yes first month's rent,security deposit;etc:) O.No:. Supplies 1;Purchase orders. .`• O Yes ONo - 2 Requisitions . ._ . O Yes O.No .. 3.Cancelled checks O Yes: O.No 4.Determine where supplies are beingkept O Yes. Q No 5.Determine what cost objective is being used 0:Yes Review Inventory list any equipment shall be. . O Yes labeled as property of Miami-Dade County through::` []No•.' its Homeless Trust Attachment G::"CoC Program Guidelines": Page 11 oi.14,-.; • • • INTERNAL CONTROLS. 1.Internal control questionnaire O Yes. 0 N :2.Review organizational:chart O Yes ::O No . 3.Review job descriptions/definitions of employees' O Yes duties . ,O No 4.Review Subrecipient's system of authorization and , O Yes supervision. O No• . 5.Ensure that there a separation of duties O Yes, (authorizing,recording and custody should be O No separate) 6`Review control'.aver assets' • • O Yes ONo:. EVALUATION OF.SELECTED,TRANSACTIONS ;.. :..: Is.the expenditure allowable ...:; a.Is the expenditure necessary,reasonable and O Yes • directly related to the grant?: O:No xp y gr . the.e eriditure.authorized b ' li'e ant? O Yes ` � r' O No So V urce documentation evaluation a.Were tb:e:expenditures incurred during the term'of O Yes the grants O No. li.Was.the money actually paid out? O Yes • ' ONO • 6..Were'the expenditures approved bythe O Yes responsible Subrecipient officials O:No d..Is there adequate documentation to support the O Yes• '` ' • expenditures? •. O.:No . • Does the Sulirecipient maintain the appropriate records? Does the Subrecipient maintain:the following? • a..Chartof accounts. O Yes ONo b,Cashreceipts journal O Yes. ONo' c:Cash'disbursements:journal- - .O.Yes O No _ • d:Payroll journal ' O Yes ONo :.e.Gen..eralledger O'Yes. O,No 1:Doesthe Subrecipientmamtain documentation ElYes concerningIts sources.of funding : O 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 O Yes Agreement to use the HMIS license []'No • - • 2,Are the Subrecipient's HMIS-Administers.• . ; : O Yes • registeredand approved to enter the data into the O No HMIS.system • 3.The Subrecipient has designated an HMIS site O Yes Admnnstrator(sJ,who is the Point of Contact for Miami-Dade County through its Homeless Trust as .` ' HMIS Lead Agency. 4.the.Subrecipienthas ensured that each HMIS:user 0:Yes • • within its,Organization has signed a user agreement • Q No stating full Understanding of user rules,protocols' and confidentiality.. - Privacy 1.The Subrecipient has a Data Collection./Privacy. •O Yes Notice posted in English and Spanish at each intake O No location .. 2.The Subrecipierit has a:written Privacy'Policy or. O Yes uses the CoC's written Privacy`.Policy • O No :. 3.If the:Sub recipient has a web site,the Privacy O Yes • Policy is.posted to the web site:- • O No 4:The Subrecipient a signed authorization for O Yes release of information form that it uses for,any clientO No • for which'the Subrecipierit.uses•HMIS for:data, ' . • 5.:The Subrecipient ensures that all signed forrnsare: O Yes locked in a designated-location with limited access to.. O:No staff • 6:'The Subrecipient has=executed the Agency Sharing. O Yes . • • Data Agreement if applicable(MOT:?) O No 7.The Subrecipient has a written clientcoinplaint •.,O,Yes ' policy O'No • 8 The Subrecipient has established a process of •: OYes _ tracking all filed complaints and can provide copies , . O:No" of complaints and resolutions to the HMIS Lead Agency if.requested. Security 1...The Subrecipient maintains:a list of active:HMIS D Yes users 2.The Subrecipientregularly contacts the HMIS Lead D Yes when an.employee leaves the Organization,in order: O No • to•make sure that the person's HMIS account is 3.Are the Subrecipient s HMIS workstations located O Yes insecure locations or,if'not,are tli'eworkstations O No mannedat all trines? 4:Has the Subrecipient:identified a person who will O Yes serve as.the Organization's HMIS security officer? Attachment G"CoC Program Guidelines" Page 13 of 14 O No 5..'Has.the HMIS security officer completed an HMIS O Yes security self-certification within the last-12,months? O No 6.Does the Subrecipient have in place policies and O Yes procedures to protect hard copies(paper)with O No personal 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 quality standards are met. The Subrecipient enters Client Basic Demographic. O Yes Data into the HMIS system at a minimum within one Q No week of intake _ The:Subrecipient staff review monthly reports O Yes received from HMIS Program Administrator and O No addresses any issues noted. • • • Attachment-;G'"CoC.Program Guidelines" Page 14 of 14 FY 2018 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program "Incident Report" ATTACHMENT H"2018 Incident Report". f MODE • _ 2. .4,5EQd41.,. NT.ay' INCIDENT REPORT .. IDENTIFYING INFORMATION Reporting Party Phone# Date of Incident / / Time of Incident am/pm Reporting Party Name Contract Provider Name Program Name Provider Location Specific Program:(check all that apply) ' ❑:Miami-Dade County•D.Primary Care 0 CoCPrograin 0'Emergency 0 Challenge 0 Other Specific location/address:where incident occurred:.. : TYPE SOF INCIDENT . ❑.ALTERCATION ' 0 CL;IENTDEATH • - d C IENT NARY OR ILLNESS 0 THEFT s QSE'XUALBAIJBPP. . 0 S TJICIDEAZ1E111PT ' 0 PROPERTYDAM4GE . 0 OTHER INCIDENT .PARTICIPANT(8)/WTTNESS'(ES) :'. (Please..mark W Or P:for.either Witness or Participant) : • LAST NAME,FIRST: . IDENT1J R## CLIENT E•MPLOYEE, , OTHER W/P o 0 : • DESCRIPTION OF INCIDENT - . Give detailed account—who what, where,when,why,hpw—addpages ifnecessary:. ' • 'r' .. .:• :: ATTACHMENT H"MDC-HT Incident Report Form Page'1 of ti 1 1 • • • • MIAM COUNTY CORRECTIVE ACTION AND FOLLOW UP • • Immediate corrective action taken • • • Is follow up action needed? 0 Yes 0`No:- . • . If yes,specify " • IIVV IDUALSNO'i'I i NDD *Abuse Registry 1-800-962-2873 ' *Applicable Law Enforcement Department ' : ' • Indicate person contacted,ifrepoit:was accepted,the date and the tune,and.if by telephone'or if copy of report available...: ' Incident:Reports-The Subrecipient:must report to:Miamr Dade County Homeless Trustinformation related to an Critical'incidents occurring,durmg.the administration term of its programs. In:addition to reporting this incident to the.appropriate authorities the: Subreciplent'must within twenty-four(24)hours of any incident,submit in;writing a detailed account of the incident. This incident leport should b'e addressed to the Contract Officei:or Administrative • Officer assigned This incident report should be addressed to MianuDade County Homeless Trust, 111 NW First• . • Street,270.Floor,Suite 310,Miami Florida 33128,telephone(3.05)375-1490.and facsmilie(305)375:-272Z: Defnutions of Reportable Incidents • • . . a. Altercation- Aphysical.confrontation oceurnngbetween a client and employee or two or more clients at the time services'are being rendered,or when,a client is,in thephysicalcustody of the department,which results in one or ' • ' :more clients or employees receivin•g medical treatment by a lcen•sedhealth care professi•onal ' - M • ' 'b. Client Death. A person whose life terminates due to or allegedly due to an.accident,act of abuse neglect or other • incident occurnng while m the presence of an employee'inHomeless Trust confractedprogram facility. ' c. Client Injury or Illness A;medical condition:of a client`requiring medical treatment bya licensed;health care ' professional sustained or allegedly:sustained due to an accident;act of abuse neglect or other incident occurring • while in_the:presence of an employee;in aHoineless Trust contracted program . d..' Other Incident An unusual occurrence or circumstance initiated by something other than natural causes or quit of the;ordinary,such as a tornado;lddnapping;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 clienti.employee on a client;or client on an • •emPlOyed,as evidenced by medical evidence or layv enforcement involvement ' Suicide Attempt:An actwhich.clearly reflects the physical attempt by a client to cause his:or her own death while • • • in the.physical custody of the department or a departmental contracted'or certified provider,which results in • bodily injury requiring medical treatment by a licensed health Care professional • g '•.Property dainane=an incident'involving damage to;any property procured With Mianii Dade County Homeless ` • Trust funding. Print Name`of Person Submitting Report - Signature ; . • ATTACHMENT-H"MD.0-HT Incident ReportForm" • •Page 2 of 2 • • MIAMI—DADE COUNTY IIOMELESS TRUST POLICY&PROCEDURES i SUBJECT:. INCIDENT REPORTING PROCEDURES EFFECTIVE DATE: 9/9/2015 REVISED‘DATE: 1 PURPOSE The purpose of this policy is to define. the process for receiving and processing incident reports. ' SCOPE: Miami-Dade.County Homeless Continuum of Care 1 PROCEDURES: i 1. .Honieless CoC providers contracted with Miami-Dade County Homeless Trust must report the following types of critical incidents,via fax(305)375-2722 or email,to. f. the attention of our Incident Report Coordinator:Miguel Pimentel.These incidents . . are defined and outlined in CF-OP'215-6. •_ Child-On-Child Sexual Abuse • . Child Arrest Child Death g • :Adult Death • Elopement refers to court ordered=clientsthat run away and do not return •. Employee Arrest. Employee Misconduct . : t • Escape Missing Child • • Security Incident-Unintentional • ' Significant Injury to Clients • : Significant Injury to Staff .i • Suicide Attempt .. • Sexual Abuse/Sexual Battery• 1 . • 2. For each critical.in_incident,an incident report must be submitted to Miami-Dade County Homeless Trust within one busmess;day. The incident report.needs to include: { Facility/Home j . ..Clients•Name Clients Age • `Date&Time ofAcciderit/Incident - • 1 • Place of Accident/Incident: 1 Description of Accident/ Incident Descriptionor nature of injury Witness(es)to Accident/Incident 1 • MIA I-DADE COUNTY.HOMELESS TRUST POLICY&PROCEDURES SUBJECT: INCIDENT REPORTING PROCEDURES EFFECTIVE DATE: 9/9/2015 REVISED DATE: • What action(s)were taken? Parent/Guardian information,and if they were contacted?Time?How? • Other Persons Contacted • Describe Medical:Treatrnent/First Aid Signature of Staff Completing Form,Date and Time Signature of Director/Person in Charge,Date and Time 3 When a critical incident occurs,subcontracted provider staff should; • Taloaction to ensure the health,safety;and welfare of all individuals involved in the incident,and • Contact law enforcement, emergency responders,or the Abuse Hotiine. TOOLS: Miami-Dade County:Homeless Trust Incident ReportForzi M:\Policies_Miami-Dade County Homeless Trust\Incident Repotting Process.0515 . i MIAMI-DADE COUNTY HOMELESS TRUST POLICY&PROCEDURES . l SUBJECT: INCIDENT REPORTING PROCEDURES EFIe.ECTTVE DAIS: 9/9/2015 REVISED DATE: PURPOSE: . The, purpose of this policy is ;to define the process for receiving and processing incident reports. SCOPE: Miami-Dade County Homeless Continuum of Care P ROCEDURES • 1. Homeless CoC providers contracted with Miami-Dade County Homeless Trust must report the'followingtypes of critical incidents,via fax(305)375-2722 or email,to the attention of our Incident Report Coordinator:Miguel Pimentel.These incidents are defined and outlined in CF-QP 215-6, • Child-on-Child`Sexual Abuse. • . Child Arrest • Child'-Death: • Adult Death • Elopement refers to court ordered clients that runaway and do not return • Employee Arrest i. • Employee Misconduct • Escape • • Missing Child • • Secirity.Incident Unintentional .. • Significant Injury to Clients • Significant Injury to Staff. ; • Suicide Attempt • Sexual•Abuse/Sexual Battery 2. For each critical incident,an.incident report mustbe submitted to Miami-Dade County Homeless Trust within one business day;The:incident report needs to include . Facility/Ho• me • Clients Name .,. Clients Age : • Date&Time of Accident/Incident . • Place.of Accident/Incident , . . • •: :Description of Accident/Incident : • Description or nature of injury • Witness(es):to Accident/Incident • • MIAMI--DADE COUNTY HOMELESS TRUST P.OLIGY&PROCEDURES. . SUBJECT: INCIDENT REPORTING PROC%DURES - 'EFFECTIVE DATE: 9/9/2015 REVISED DATE: • What.,action(s)were.taken? • 'Parent/Guardian information,and if they were contacted?Time?How? •. Other Persons Contacted • Describe Medical Treatment/First Aid • Signature of Staff Completing Form,Date and Time • Signature of Director/Person.in Charge,Date and Time: 3. When a critical incident occurs,subcontracted provider staff should • • Take action to ensure the health, safety,and welfare of all individuals involved in the incident and ,:•. Contact law enforcement, emergency.'responders,.or the Abuse Hotline. TOOLS:` Miami-Dade County Homeless Trust-Incident Report Form M:\Policies-Miami-Dade County Homeless Trust\Incident Repoilang Process.0515 i i 3 i a CFOP 215-6 i 1 I STATE OF FLORIDA I DEPARTMENT OF _ i CF OPERATING PROCEDURE CHILDREN AND FAMILIES NO.215-6 . TALLAHASSEE,,April 1,2013 F Safety 1 . I INCIDENT'REPORTIN.G AND ANALYSIS SYSTEM (IRAS) , • 1, Purpose.. This operating procedure establishes the guidelinesfor reporting and analyzing critical e incidents as defined below: The analysis of incidents should be considered part of the.Overall risk management program and quality improvement process of the Department, its employees, and its 1 licensed and contracted:service,providers. I 2. Scope.: 1 I a. This operating procedure applies toall critical incidents occurring within the following I Department of Children and Families program areas: I i 5. (1) ACCESS; . - (2) Administration;' t -(3) Adult Protective Services (4) Family Safety; r I (5) Mental Health;and, I (6) Substance Abuse., b. Incidents to be reported are those that occur . 1 (1) involving a client, Department employee,or a licensed or contracted provider serving clients of the Department or involving en employee,of a licensed or contracted provider serving I clients.,of the Department in:the identified program areas, or, t (2) Involving any licensed public or private substance abuse provider agency licensed in. # accordance`with Chapter 397_,`Florida.Statutes(F S.), and.Chapter:65D-30,Florida Administrative Code. I (FAC:),and.their employees;.Compliance.with this.procedure is a condition of substance abuse :. licensureregardless of whether ornot the provider serves any clients funded by the Department • 1 I c. The Incident Reportinand Analysis System (ERAS)allows for the timely.notification of I g critical incidents, provision of details.of the incident and immediate actions taken,.and,the,ability;to track and analyze incident-related'data. : • d. The IRAS is not a case;management'system,and cannot be utilized to..capture:ongoing and. f specific case Management information,such as the progression of events and actions following the I occurrence of a critical • `This operating procedure supersedes CFOP 215-6 dated December 1;.2012, `: OPR: Assistant.Secretary for.Operations DISTRIBUTION:`.A .,. I April• 1,2013 CFOP 215-6 e. State mentalhealthtreatment facilities, public and private,are required to adhere to CFOP 155-25, Critical Event Reporting in State Mental Health.Treatment Facilities, andare specifically excluded from.compliance with this operating procedure . f: The incident reporting procedures do not replace; (1) The mandatory reporting requirements to the Florida Abuse Hotline for abuse, • neglect and exploitation reporting protocols, as required by iaw. Allegations of abuse, neglect,or exploitation must always be reported immediately to the Florida Abuse Hotline. (2) The investigation and review requirements provided for in-CFOP 175-17,.Child Fatality Review Procedures:. (3) The reporting requirements provided for in CFOP:175418,:Prevention, Reporting and Services to Missing Children. (4) The reporting requirements provided for in CFOP 1804, Mandatory Reporting Requirements to the Office of.the Inspector General. 3. Definitions: a: Abuse: Any willful or threatened act or omission that causes oris'likely to cause:significant impairment to a child gr vulnerable adult's physical; mental or emotional health: b. Department: The Department of Children and'Families. . c: Hospital. A facility licensed under Chapter 395, F.S.. This.includes facilities licensed as specialty hospitals under Chapter 395', F:S. d... Incident Coordinator: The designated Department or provider/agency:staff whose role is to.. add and:update incidents, create and send initial and,updated notifications and change the status of an • incident Department.Incident Coordinators are.designated,by.their respective Circuit/Region/Headquarters leadership.. _ .6Neglect, The failure or omission on the part of the caregiver to providethe care; supervision 'and services necessaryto.mainfain the physical and Mental'health-Of child or vulnerableadult, or the failure'of a caregiver•to snake reasonable efforts to protect a;child or vulnerableadult from abuse, neglect,or exploitation.by others. • f Restraint..Any manual method-or physical or mechanical device,matenals,:orequipment attached or adjacentrto the individual's body so thathe or she cannot easily remove the restraint and-which restricts.freedom of movement or normal-access to one's body., g- Seclusion: The physical segregation'of a ppraohz in any fashion,or involuntary isolation of a person in a room or area from which theperson is:'prevented from leaving The prevention maybe:by physical barrier'or by a staff member Who is acting in a Manner, or who is physically'situated, so as to prevent the person from leaving the room or area- 4 ,Policv .It is the responsibility of all Departmental personnel;and Department licensed or contracted providers,to promptly report within one business day all critical incidents'in:accordance with the requirements of this Operating procedure. Failure bye Department employee tocomply with this , operating procedure may lead to disciplinary action: Failure by a Department licensed or contracted. provider to.complywith this operating procedure constitutes a lack of:compliance with licensure status. or contract provisions: •• 2 1 5 .1 i April 1,2013 S CFOP 215-6 i 1 5. Critical Incidents To Be Reported. a. Adult Death. An individual 18 years old or older whose life terminates livhil .receiving 1 I services, during an investigation,or when it is known that an adult died within thirty(30) day's of t .1 discharge from a treatment fadility. For the Adult Protective Services program, deaths that are a result •; of the vulnerable adult's documented condition are not subject to critical incident reporting requirements. The manner of death is the classification of categories used to define whether a death is from intentional causes,unintentional causes, natural causes, or undetermined causes. t (1) The final classification of an adult's death is determined by the medical eXamiper, i However, in the interim,the mannerof death will be reported as one of the following: . • . g.° (a) Accident A death due to the unintended actions of one's self or another. (b) Homicide. A death dile to the deliberate actions of another. 1 t . . . i - - (c) Suicide, The intentional and voluntary taking of one's own life . 5 . _ I (d) Undetermined. The manner of death has not yet been determined. p. (e) 'Unknown. The manner of death wast identified or Made known. ' - I • . . . . : (2) If an adult's death involves a suspected overdose from alcohol and/of drugs, or • 1 seclusion and/or restraint, additional information about the death will need to be reportedinRAS. , - 1 b. Child Arrest The arrest of a child in the custody of the Department 1 . . c; Child Death: An individual less than 18 years Of age whose fife terminates while receiving services,during an investigation,or when it is known that a child died within thirty(30)days of 1 discharge from a residential program or treatment facility or when a death.review is required pursuant ; to CFOP 1M-17, Child Fatality Review Progedures. The manner of death is the classification of categbriesused to define whether a death is from intentional causes, unintentional causes, natural causes or-undetermined causeS. . , (1) The final classification of a child's death is determined by the medical examiner.- However, in the interirn,the manner of death will be reported as one of the following: i (a) Accident.'A death due to the unintended actions of ones self or anether. ; ., • . . , . . I .: . (b) Homicide. A death due to the deliberate actions of anOther. .... _ . _ •, - - (c) Natural Expected A death that occurs as a result of, or from complications' 1 • of, a diagnosed illness for Which the prognosis is terminal. •' ' • . '' .. ' . : i I ' : •-, (d) Natural Unexpected A sudden death that was not anticipated and is ' attributed to an underlying disease either knownorunknown prior to the death• • . : - (e) Suibide. The intentional and Voluntary taking of one's own life. • . i , I (f) Undetermined. The manner of death has not yet been deterrnined, (g) Unknown. The manner of death Was not identified or made knoWn.• ' • • -, . - . . '• (2) If a child's death involves a suspected overdose from alcohol and/or drugs, or seclusion and/Or restraint, additional information about the death will need to be reported in IRAS5 , 3 . • . i . : . : • • April 1,2013 CFOP 215-6 • d. Child-on-Child Sexual Abuse. Any sexual behavior between children which occurs without consent,without equality, or asa result of coercion.This applies only to children receiving services from:. the Department or by a licensed, contracted:provider, e.g. children in foster care placements or in residential treatment. e. Elopement. . • (1) The unauthorized absence beyond four hours of an.aduit during involuntary civil placement within a Department-operated, Department-contracted or licensed service provider.: (2) The unauthorized absence of a forensic on conditional release in the community: (3)The unauthorized absence ofany individual in a Department contracted or licensed. residential substance abuse and/or mental:health program,• f. Employee Arrest. Thearrestof an employee of the Department or its contracted,or licensed service providers for a civil or.criminal offense. • g Employee Misconduct. Work-related conduct or activity of an.employee Of the Department or its contractedor.licensed service providers that-results in,potential liability for'the Department; death. • • or herrn to:a client abuse, neglect.or exploitation of_a client;or results in a violation of statute, rule; regulation, or policy This includes,..but:is,not limited to; misuse of position or state property; falsification.of records failure to report suspected abuse or neglect, contract mismanagement; or. improper commitment or expenditure of state funds • • h'. Escape. The unauthorized'absence of a client:who is committed.;by the cOurf to a state mental health treatment facility pursuant to.Chapter 916 or Chapter 394, Part:V, Florida Statutes: Missing Child..When the whereabouts.:of a child in the custody.of the Department,ere unknown and:attempts to;locate the:child have been unsuccessful Security Incident—.Unintentional. An unintentional action or event that results in .. compromised data confidentiality,a danger to the.physical safety Pf.personnel, property, or.technology resources;misuse of state property-or technology resources;and/or denial of.use of.property or technology.resources This:excludes instances::of compromised:client information. Ic Sexual Abuse/Sexual Battery _.Any unsolicited or non-consensual sexual activity`.by one client to another client;.a DCF or service provider employee or other individual'toa client,or a client to an employee regardless ofthe consent of•the client This may:include.sexual battery as defined in Chapter 794 of the Florida:Statutes as.°oral, anal,orvaginal:penetration by, or"union,with,:the sexual organ of another-or the anal or vaginal.penetration of:another by anyother object; however,sexual battery:does not-include an act done fora bona•fide medical purpose.''.Thisincludes any..unsolicited or non-consensual sexual battery by one client to,another client,aDCF or service.provider employee or • other individual to a.client;or a client to-an-employee regardless of consent of the client, I Significant Injury to Clients: Any severe bodilytrauma received by a client in a treatment/service.program_that requires:immediate medical:or surgical evaluation or treatment in a hospital emergency.department to address and'prevent permanentdamage or loss of life. m. Significant Injury to Staff,. Any serious bodily trauma received by a staff member as a result of work related activity that requires immediate medical or surgical evaluation_:or treatment in a hospital emergencydepartment to prevent'permanent damage or loss of life 4 • • • • i 1 f i i April 1,2013 CFOP 215-6 • 1 n. Suicide Attempt A potentially lethal act which reflects an attempt by an individual to cause. I • his or her own death as determined by a licensed mental health professional or.other licensed 1 • healthcare professional. o. Other. Any major event not previously identified as a reportable critical incident but has, or is i likely to have;a significant impact'on client(s), the Department, or its provider(s): These events may 3 includebut are not limited:to: I (1) Human acts that jeopardize the health,safety, or welfare of clients such as y kidnapping,riot, pr hostage situation; - , (2) Bomb or biological/chernicaltEreat of harm to personnel or property involving an explosive:device'or biological/chemical agent-re• ceived in.person, by t•elephone, in.w•riting,via mail, l ' electronically, or otherwise ; 1 • (3) Theft, vandalism,damage,fire,sabotage,or destruction of state or private:property. 3 of significant value or importance; - f i (4)• Death of an'employee or visitor on the rounds:of the Department or one of its l 9.-. . p contractedor licensed providers; J (5)Significant injury of a visitor(who is not a client)while on the grounds of the - - _- Department or one of its contracted,designated, or licensed providers;or,: i ' (6) Events regarding Department clients or.clients of contracted:or licensed service ; providers that have led to or may lead to media reports: 6. Guidelines:'-for Reportind'Incidents - a: Notification/Reporting:and Actions Taken—Staff Discovery of an incident. I ' (1) Any employee of the Department; or one of its-contracted or licensed.providers,who discovers that a reportable critical incident;as described herein,'has occurred,Will-report the incident as 1 outlined in this operating procedure..- i (2) The employee's first obligation-is to ensure the:health,safety and welfare of all ° - I - individual(s)involved, - 1 • • - :(3) The employee must immediately ensure:contacts-are made for`assistance as I. dictated by the°needs of the individuals involved °These types of contacts;may include,`but'ar�e`not limited to emergency,medical services(911),law enforcement;or the fire department: .When the • i • inciident involves suspected a_buse,-:neglect,;or exploitation,the::employee must call:the Florida Abuse I Hotline-to report.the-incident The employee must ensure that the client's-guardian, representative or - relative is'notified,as:applicable;,. • . (4) Orce the situation is stabilized and the staff has ad •dressed any immediate physical - or.psychologicalservice'needs of the person(s)`involved in'the`incident,'tie'employee'must report the incidentto.the Incident-Coordinator. Each service provider/agency will use their internal reporting process°and timeframes for,notifying provider/agency-leadership of incidents All critical incidents;must • be entered into iRAS within.one business day of the.incident occurrinc. . .-: (5)-In the case of subcontractors,-Managing Entitles,or Lead Agencies;the ' responsibility for;reporfing critical incidents to the Department rests with•the Department's contracted - ' provider; . .. • April 1_, 2013 CFOP 215-6 . • b...Notification/Reporting and Actions Taken by the Provider's/Agency's Incident Coordinator or the Coordinator's Designee. (1) Each Department licensed or contracted service provider will designate one staff person to be the Incident Coordinator for.the providerlagency. This person will manage the' • provider s/agency's.incident notification process. Additional staff May be designated to enter:incident information iiinto.the IRAS at the discretion of the service provider/agency. ' (2)';When:a supervisor is informed of a.crtical incident,that person shall verify what has occurred, confirm the known facts with the discovering employee, and:ensure that appropriate:and • timely notifications'and actions occurred: The service provider/agency shaildevelop internal . procedures regarding reporting incidents to their Incident Coordinator or designee. (3):'If the incident qualifies`as acritical incident according to the definitions contained in • this operating procedure;.the provider's/agency's Incident Coordinator will review the incident information and clarify,or obtain any necessary information before forwarding the•incident reportto the, ' - Departmentrs designated Incident•Coordinator or designee. The provider`s/agency's Incident Coordinator will provide the information regarding the incident torthe-Department's Incident Coordinator or designee via:the:IRAS.. . (4) The sece provider/agency:will ensure timely notification`of critical iincidents is made to appropriate Individuals or-agencies such as emergency medical services (91:1), law ' • enforcement;the-Florida Abuse Hotline;.the Agency for.Health..Care Administration(ARCA);.or Center for Mental Health Services(forlicensed mental health facilities);,as'requi.red.The ERAS reporting . _ process does not replace.the reporting of:Incidents to other entities.as'required by statute; rules.01- operating procedure.. . c Notification/Reporting and Actions Taken by Department's Incident.Coordinatoris)or the. • Coordinator's Designee.' (1) The•Department's Incident Coordinator or designee At the Circuit/Region level Will . review•the incident information and clarify or obtain any necessary•additional information from the. ,applicable service_provider:a• nd;make revisionsas'necessary,. .. (2) The Department's incident Coordinator or designee.will make'a determination regarding any required notifications that should be.sent fo;Department.leadership:. The.Department's . .. Incident Coordinator or designeeis responsible for ensuring:appropriate notification.is provided and serves.as the contact person:regarding the,IRAS: ,In addition to Department's leadership staff,the- Department's Incident Coordinator,-or designee-will notify the Circuit/Region;Public'Inforrnation.Officer within two (2);hours of any incident•that may have:Department impact,.or media:coverage-. (3) The entry of the incident.into IRAS does pot substitute•for edirect phone call to the Department's_leadership staff when the incident type or severity.of fie incident.warrants such contact: This determination is:to be made by the Departments Incident'Coordinatoror:.designee in-consultation' • with other.Department leadership staff, as needed. ` . (4) The Department's incident Coordinator.or designee.should submit incidents €n IRAS even in cases-where there is:.missing information not readily available When the information,is •• obtained the Incident:Coordiinator or designee should:submit an;update.in IRAS es soon as-'possible.- . (5) The Departmentsr Incident Coordinator or designee shall ensure all necessary information isentered into:the IRAS_in order:to have a complete notification:„ Theincident report is considered-to be `complete"wheri,the initial notifications have',been made and sufficient information, regarding the incident:has been.submitted, Additional information, such as frorri an autopsy or medical . ' 3 April 1,2.013 CFOP 215-6 examiner report regarding an incident can be submitted into the IRAS after the incident has been . determined to be"complete.' j (6) Each Circuit/Region shall develop an internal process for reviewing and analyzing trends regarding critical incidents within their Circuit/Region across all Department program areas. Each service provider/agency including.Managing Entities will establish a system forreviewing critical incidents to determine whatactions need to be taken, if any,to prevent future occurrences and a follow- up process to assure such needed actions are implemented. BY DIRECTION OF THE SECRETARY: (Signed original copy on file) PETER DIGRE Assistant Secretary for Operations SUMMARY OF REVISED,ADDED,OR DELETED MATERIAL { This operating procedure was revised to specify the Department of Children and Families programs which are subject to the requirements of this operating procedure,and to separate the requirements for reporting adult deaths and child deaths. i •• • 7 FY 2018 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program "Real.Property and Equipment Asset Inventory Report" 1 .'ATTACHMENT I"2018 Real Property and Equipment Asset Report" MWM ' BEE F-7Dq Real Property and Equipment Asset Inventory Equipment with an acquisition cost of greater than$5,000.00 per unit and all real property must be inventoried. Real property includes land;land improvements,structures and appurtenances, moveable machinery and equipment Property and Property Improvement Record: Legal description: Size: Date of Acquisition: Value at time of purchase: Owner's name(if different than the Subrecipient): Map: (attach map)indicate where property is in parcels,lots or blocks and show adjacent streets and roads Equipment 1: Description of Property: . Serial/ID Number: Acquisition Date: Cost:. ' Vendor Name:' %of Purchase Cost from Grant Location of Property; Use and Condition of Property.: Who Holds Title? 'Equipment 2 Description of Property: . Serial/ID Number: Acquisition Date: Cosa Vendor.Name:' %of PurchaseCost from Grant. Location of Property:. Use and Condition of Property: • • Who.Holds Title? Equipment Description of Property:•• Serial j ID Numberi 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 CountyReal. roperty and Equipment Asset Inventory" FY2018 Miami-Dade County Homeless Trust Continuum of Care (CoC) When the Subrecipient is the Housing Administrator (Leasing or Rental.Assistance) (Previously Provided to the Provider) ATTACHMENT r"2018 Rental Assistance Forms FY2018 - Miami-Dade County Homeless Trust Continuum of Care (CoC) When Miami-Dade County is the Rental Administrator (Previously Provided to the Provider) ATTACHMENT K"2018 Rental Assistance Forms"