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2018 Continuum of Care (CoC) Program pe/ g- aosn? Homeless Trust 111 N.W. 1st Street •27th Floor Suite 310 M I AM WADE Miami, Florida 33128-1930 .T 305-375-1490 F 305-375-2722 COUNTY miamidade.gov July 10,2019 Mr.Jimmy L.Morales,City Manager The City of Miami Beach 1700 Convention Center Drive Miami Beach,Florida 33139 RE: 2018 Continuum of Care(CoC)Program City of Miami Beach Outreach Program Grant Number: FL0177L4D001811 Dear Mr.Morales: Enclosed,please find for your file,one(1)fully executed original of the 2018 Continuum of Care(CoC)Agreement between Miami-Dade County,through the Miami-Dade County Homeless Trust and The City of Miami Beach for the abovementioned program. Please feel free to contact us at(305)375-1490 if you have any questions or require additional information. Thank you for your continued efforts with addressing the needs of the homeless of our community. S'i cerely, toria L.Mallette Executive Director - kr Miami-Dade County Homeless Trust Enclosures I have received the executed Agreement for above-referenced grants. Signature of Authorized Agency Representative Date Printed Name of Agency Representative MIAMI DADE COUNTY FY2018 United States Department of Housing and Urban Development (US HUD) Continuum of Care (CoC) Program Grantee: Miami-Dade County through its Homeless Trust And Subrecipient: The City of Miami Beach Program Name: The City of Miami Beach Outreach Program Grant #: FL0177L4D001811 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 i. Insurance;ii) Indemnification;iii) Certification and Representation;iv) Conflict of Interest; v)Affidavits---pages 14 through 17 h. Civil Rights---page 18 through 20 4. Suspension and Termination a. Suspension---page 21 b. Termination---page 21 through 23 5. Future Funding Applications---page 23 6. Reversion of Assets a Term of Commitment---page 24 b. Repayment of Grant---page 24 c. Prevention of Undue Benefit---page 24 d. Revocation of License or Permit---page 25 e. Declaration of Restrictive Covenant and Declaration of Restrictions---page 25 7. Uniform Administrative Requirements a Accounting Standards,Costs Principles and Regulations-.--page 26 b. Retention of Records---page 27 8.. Additional Requirements Items a through gg---pages 27 through 35 9. Religious Organizations---page 36 10. Health Insurance Portability and Accountability Act(HIPAA)---page 36,37 11. Proof of Licensure/Certification and Background Screening. a. Licensure/Certification---page 37 b. Background Screening---page 38 Signature---page 39 Index of Attachments A through L---page 40 CoC Grant#FL0177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page 2 i Subrecipient Agreement between Miami-Dade County and The City of Miami Beach . ii for the FY 2018 US HUD CoC Program Grant#FL0177L4D001811. The City of Miami Beach Outreach Program d c THIS AGREEMENT,entered this 3 r day of 76 �j ,201 / ,by and between Miami- Dade County, on behalf of its Homeless Trust(HT) (hereinafter called the"Grantee"),and The City of Miami Beach, (hereinafter referred to as the"Subrecipient") under this Agreement. I. WHEREAS, the. Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH Act) amended the McKinney-Vento Homeless Assistance Act, consolidating three (3) separate reauthorized McKinney-Vento Homeless Assistance Programs, Supportive Housing Program (SHP), Shelter Plus Care (S+C) Program, and Section 8 Moderate Rehabilitation Single Room Occupancy (SRO) Program into a single grant program known as the.Continuum of Care (CoC) Program. !j WHEREAS, the Grantee has applied for and received funds from the United States Department of Housing and Urban Development(US HUD)under the McKinney-Vento Homeless Assistance Act as amended by The HEARTH Act of 200.9 (42 U.S.C. 11301,et seq.). I! WHEREAS, the Grantee agrees to comply with all requirements of this Agreement and to accept responsibility for such compliance by the Subrecipient to which it makes grant funds available;and NOW,THEREFORE,it is agreed between the parties hereto that; ;! 1. Statement of Work a. Activities - The Subrecipient shall adhere to the "Continuum of Care Program Grant Agreement and Exhibit 1 Scope of Work for FY 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 with all applicable federal,state and local laws,regulations and ordinances,including but not limited to 24.CFR Part 578,as may be amended, the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11301 et seq.) (the "Act"),as may be amended,the Consolidated and Further Continuing Appropriations Acts of 2013 and 2014(The Consolidated Appropriations Act of 2014,Public Law 113-76,approved January 17,2014 in the"FY 2014 HUD Appropriations Act") as well as with any other terms and conditions as HUD mai have established in the applicable Notice of Funds.Availability (NOFA) and with any applicable guidance,.requirements and directives provided by US HUD and with any applicable guidance, requirements and directives provided by Miami-Dade County Homeless Trust. The Subrecipient shall carry out the activities specified in the"Scope of Service and US HUD eSnaps Documents"Attachment B. The Subrecipient shall also adhere to the Standards of Housing.and Services as set forth in the "Miami-Dade County Homeless Trust Standards of Care", as may be amended from time to time and incorporated herein by reference. The 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. II CoC Grant#FL0177L4D001811,The City of Miami Beach,The City,of Miami Beach Outreach Program Page 3 b. Time Schedule-The Grantee and the Subrecipient agree that this Agreement shall become effective on tune 1.2019. This Agreement shall expire on May 31.2020,one(1)year from the effective date. Any cost incurred by the Subrecipient beyond this date will not be paid by the Grantee;except as specifically provided herein. Notwithstanding any provision herein to the contrary,certain requirements imposed on the Subrecipient by this Agreement and federal regulations may continue for a term of at least•fifteen(15)years from the date of initial occupancy or service, as provided in this Agreement or as specified by law or regulation. The requirements of this Agreement shall remain in effect during any time period that the Subrecipient has control over any funds generated or provided in connection with this Agreement,including program income.. c. Budget-The Grantee agrees,subject to the availability of funds and payment of funds to the Grantee by the United States Department of Housing and Urban.Development and subject to the Subrecipient's compliance with all applicable laws and agreement terms as determined by the Grantee, to pay for contracted activities according to the .terms and conditions contained within this Agreement,Subrecipient's application for the CoC Homeless Assistance Program,and the Subrecipients NOFA application documents as Project Sponsor arid"Scope of Service and US HUD eSnaps documents"including the Budget incorporated herein as Attachment.B,in an amount not to exceed$0.00 for Rental Assistance,$0.00,for Leasing, $60.946.00 for Supportive Services, $0.00 for Operations, $0.00 for HMIS costs and $4266.00 for overall Project Administration Costs which added together equalsan amount of$65212.00 in TOTAL BUDGET. If the Grantee,Miami-.Dade County through its Public Housing and Community Development Department (PHCD) or such other department or party as may be selected by Miami-Dade County Homeless Trust, is the Rental Administrator; then the Grantee shall pay the "CoC Program HAP Contract"Attachment K payments directly to Landlord, owner(s). The total amount awarded pursuant to this Agreement,in amount up to $0.00 for Rental Assistance funds has been allocated for use as eligible rental assistance payments on behalf of the Subrecipient's program participants. Pursuant to 24 CFR 578.59, the Grantee shall retain 50% of the. Overall Project Administration Costs,except where limitations are imposed as maybe applicable pursuant to 42.USC§11383 (a)'. If applicable, the Subrecipient shall be reimbursed for capital funding on an incremental basis, based on the following completion benchmarks: 30%, 30%, 30% and 10% to be provided when a final Certificate of Occupancy is obtained from the developer,in accordance with any applicable laws and regulations: All other activities shall be paid on a reimbursement basis following the submission of a monthly invoice along with the appropriate supporting documentation. In accordance with federal requirements including 24 CFR Part 578.73, the Subrecipient agrees to provide match funds_in an amount that represents no less thantwenty-five percent(25%)cash or in-kind contributions on all eligible grant funds,except leasing. If in- kind services provided through a third party are used to fulfill part of the match, a fully- executed Memorandum of Understanding(MOU) between the Subrecipient and the third party that will provide the services must be submitted to the Grantee. CoC Grant#FLO177L4D0.01811,The City of Miami Beach,The City of Miami Beach Outreach Program 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 submittedin writing for the Grantee's consideration. The Grantee may,but is notrequired to,approve the proposed shift. Any approval must be in writing As such, if Attachment B is modified as described above, the figures within the"eSnaps Application"may not match the contracted figures delineated in the"US HUD Grant Agreement" In accordance.with 24 CFR 578 the Subrecipient is prohibited from moving more than.10% from one budget line item in a project's approved budget to another without written ups HUD grant amendment"and amendment to this Agreement. This is a Performance-based Agreement to deliver housing and or services to Subrecipient's Continuum of Care(CoC)program participants.The Subrecipient shall provide outreach and emergency placement services (Supportive Services Only(SSO) to three hundred and fifty (350) homeless individuals and families, including chronically homeless persons under the Continuum 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's sole discretion. If this Agreement is for permanent supportive housing or permanent housing for eligible homeless individuals and /or homeless families;the Subrecipient:agrees that, with some exceptions, no undocumented or illegal immigrants shall be eligible for servicesprovided under this Agreement. Additionally, the Subrecipient shall comply with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"),as may be amendedand applicable law,in verifyingcitizenship,residency and immigration status of potential participants: The Subrecipient shall comply with The Personal.Responsibility and Work Opportunity p Reconciliation Act.of 1996 .("PRWORA"), as may be amended and applicable law, in verifying citizenship, residency and immigration status of potential participants. The Subrecipient hereby acknowledges that PRWORA prohibits housing or services provided under this Agreement to undocumented or illegal immigrants. 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 a 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#FL0177L4D001811,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 Subrecipientis the rental administrator of payments of Housing Assistance Payment (HAP) Contracts for the Permanent Housing Tenant-Based, Sponsor-Based or Project Based Rental Assistance or Rapid:Re-Housing CoC Program. If this Agreement is for permanent supportive housing or permanent housing for homeless participants, under the Legacy SHP or CoC Rental Assistance Program and the .Subrecipient is the rental administrator of the"Housing Assistance Payments(HAP) Contracts"Attachment J,the following rules,regulations,and responsibilities apply: It is the Subrecipient's sole responsibility to identify eligible rental units for.eligible homeless program participants.in partnership with the established CoC's Coordinated Outreach and Assessment. It is the Subrecipient's sole responsibility to enter into a"Housing Assistance Payment:(HAP) Contract" Attachment J with the eligible owner of each rental unit ("Landlord"). The Subrecipient must use the HAP Contract template forms in Attachment J attached to this Agreement when the Subrecipient contracts with the Landlord. The Subrecipient is responsible for ensuring the HAP Contract complies with all program 'requirements, terms and conditions of this Agreement, and applicable law: .The Grantee, Miami-Dade County,shall not be a party to the HAP Contract. Should the Subrecipient desire or require any amendments to the HAP Contract template form;the Subrecipient shalladvise 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 on time. The Subrecipient shall develop forms for Landlords' use in collecting late fees arising from Subrecipient's failure to pay a Landlord rent on tithe: The Subrecipient shall be solely responsiblefor payment of any late fee arising from any late rent payment(s)to Landlord(s). The Subrecipient shall indemnify the Grantee, Miami-Dade County, and pay all costs of defense,' including attorneys' fees arising from .orrelated to the HAP Contract and this provision. .. • 2. Records and Reports a Financial Management-The Grantee and the Subrecipient shall adhere to the requirements for financial reporting as required pursuant to the Federal Office;of Management and Budget(OMB) Omni or Super Circular 2 CFR"Chapter I,and Chapter 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 aniended or updatedfrom 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 themonth.`._ in the following manner.All requests shall include supporting documentation for each line item;.including payroll reports,time sheets,invoices,_leasing agreements and shall be'signed by the Executive Director, Financial Officer or other dulyauthorized fiscal agent of the Subrecipient in the forms incorporated herein as combined"Consolidated Financial Record • .and Reports",Attachment B. 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 a-Snaps Documents"Attachment B. Any reimbursement may be withheld or reduced by the Grantee if missing receipt of documents verifying the in-kind or cash match expenditures or compliance requirements are not met Cash match or in-kind contributions must be used for the costs of activities that are eligible in the governing regulations. Any reimbursementmay 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 I am aware that any false,fictitious,or fraudulent information or the omission of any material fact,may subject me to criminal,civil or administrative penalties for fraud,'false statements,false claims or other offense." In no event shall the Grantee funds be advanced to any of the Subrecipient's subcontractors hereunder. The parties agree that the Subrecipient may request a revision,amendment, or modification of the schedule of payments or line item budget. However, such revisions, amendments or modifications shall be, in writing and subject to review and approval by the Grantee and,if applicable, by US HUD. If there is a request to shift greater than 10% of funds between funding activities, such requests shall be submitted to the Grantee no later than one hundred fifty(150) calendar days prior to the expiration of the grant. If the request is a shift of less than 10% of funds between funding activities, a modification or revision, shall be submitted to.the Grantee no later than ninety(90) calendar daysprior to the expiration. of the grant Failure to submit the appropriate supporting documentation in a timely manner may result in the inability of the Grantee to approve,revise,amend or modify the budget. A final request for reimbursement from. the Subrecipient will be accepted by the Grantee up to thirty (30) days after the expiration . of this Agreement:. If the Subrecipient fails to comply, all rights to payments will be forfeited if the Grantee so chooses. A final report of expenditures shall be submitted to the Grantee within thirty(30) calendar days..from the termination or expiration of this Agreement. If after the receipt of such final report,the Grantee determines that the Subrecipient has been paid funds not in compliance with the Agreement, andto which the Subrecipient is not entitled,the Subrecipient shall be required to return such funds However, if the Subrecipient submits documentation demonstrating that the. expenditure was in compliance with this Agreement to the satisfaction of the Grantee, the funds shall not have to be returned. The Grantee shall have. the sole and absolute discretionto determine if the Subrecipient is entitled to suchfunds and the decision of the Grantee in this matter shall be final 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 byy or at the direction of the Subrecipient or any subcontractor directly or indirectly related to the duties and obligations required by terms of this Agreement, including but not limited to financial books and records, ledgers, drawings, maps, pamphlets, designs, electronic tapes, computer drives,flash drives and diskettes or surveys. The Subrecipient shall maintain Agreement records that document all actions to comply with and that relate to this Agreement, including those on race, ethnicity, gender, disability and homeless status data;and those in accordance with generally accepted accounting principles, procedures, arid practices as required in OMB Omni or Super Circular Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards which shall sufficiently and properly reflect all revenues and expenditures of funds provided directly or indirectly by the Grantee pursuant to the terms of this Agreement which shall include but not limited to a cash receipt journal, cash disbursements journal, general ledger,and all such subsidiary ledgers as may be reasonably necessary. The Subrecipient shall provide to the Grantee; upon request by the Grantee, all Agreement records. The requested Agreement records shall become the property of the Grantee without restriction, reservation, or limitation of their use and shall be made available by the Subrecipient at any time upon request by the Grantee. The Grantee shall have unlimited rights to all books,articles,or other copyrightable materials developed in the performance of this Agreement. These unlimited rights include the rights of royalty-free, nonexclusive, and irrevocable license to reproduce,publish,or otherwise use,and to authorize others to use the work for public purposes. The Subrecipient shall ensure that the Agreement records shall at all times be subject to and available for full access and review, inspection, or audit by Grantee and Federal personnel and any other persons so authorized by the Grantee. The Subrecipient shall include in all the Grantee,approved subcontracts, language outlining eligible substantive programmatic services,recordkeeping and audit requirements as detailedin this Agreement. This includes all subcontractors eligible to . carry out substantive programmatic services as detailed in this Agreement. The Grantee shall, in its sole and absolute discretion, determine when services are eligible . substantive programmatic services and subject to the audit and recordkeeping requirements described in this Agreement. These records shall be maintained pursuant to this Agreement. If the Subrecipient received funds from or is_ under regulatory .control of other governmental agencies, and those agencies issue monitoring reports, regulatory examinations, or other similar reports,. then the Subrecipient shall provide to the Grantee a copy of each report and any follow-up communications and.: reports immediately upon such issuance unless : such disclosure is a violation of those agencies' rules. c. Public Records-Pursuant to Section 119.0701, Florida Statutes,the.Subrecipient shall: i. Keep and maintain public records that ordinarily and necessarily would be required by the Grantee in order to perform the service; CoC Grant#FL0177L4D001811,The City of Miami.Beach,The City of Miami Beach Outreach Program 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. Ensure that public records that are exempt or confidential and exempt from public records disclosurerequirements are not disclosed except as authorized by law for the duration of this Agreement's term and following completion of the services under this Agreement if the Subrecipient does not transferthe records to the Grantee;and iv. Meet all requirements for retaining public records and transfer to the Grantee, at no Grantee cost,all public records created,received,maintained and/or directly related to the performance of this Agreement that are in possession of the Subrecipient upon termination of this Agreement. Upon termination of this Agreement,the Subrecipient shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements.' All records stored electronically must be provided, to the Grantee in a format that is compatible with the information technology systems of the Grantee. For purposes of this Article, the term "public records" shall mean all documents, papers, letters, maps, books,tapes, photographs, films, sound recordings, data processing software, or other material,regardless of the physicalform, characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official business of the Grantee. In addition to penalties set for in Section 119.10, Florida Statutes, for the failure of the Subrecipient to comply with Section 119:0701, Florida Statutes,and this Article II,Section 2:1 (QQ) of this Agreement, the Grantee shall avail itself of the remedies set forth.in this Agreement. If the Subrecipient has questions regarding the application of Chapter 119, Florida Statutes, to the Subrecipient's duty to provide public records relating to this Agreement, contact Miami-Dade County's Custodian of Public Records at; Miami-Dade County Homeless Trust 111 NW 1St.,Street, 27th Floor, Suite 310 Miami,Florida 3.3128 : . Attention: Victoria L. Mallette, Executive Director Email:°vmallette(a miamidade.gov d. Encouraging Efficient Use of Information Technology and.Shared Services — in accordance with the May 2013 Executive Order on Making Open and Machine Readable the New Default for Government Information, OMB Omni or Super Circular.2 CFR Chapters I, CoC Grant#FLO177L4D001811,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 willbe used for.monitoring the progress, performance, and .. compliance with applicable Grantee and Federal requirements. i. Progress Reports - The Subrecipient shall submit a "Homeless Management Information System (HMIS) generated "Performance-Report",Attachment F, along with a summary, and the specified forms attached hereto as "Consolidated Financial Record and Reports",Attachment E. These reports may berevised.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 due by the fifteenth (15th) day following the close of the prior month. Subrecipients that are Domestic Violence Programs shall participate in a HMIS-equivalent system. Such Subrecipients shall provide proof to the Grantee of the:utilization of an alternative system to compile all required data for the Performance Report. ii. Annual Performance Report-The Subrecipient shall submit a HMIS generated"US HUD CoC Annual Performance Report(0625-HUD-CoC-APR)"Attachment F,in addition to a complete and accurate report using supplemental "eSnaps CoC:APR Financial and Performance Questions" provided by the Grantee Attachment F. The complete and accurate APR is due to the Grantee no later than thirty.(30) days after the end of each operating year. The above referenced report may be substituted for any other US HUD required Report if approved by US HUD and the Miami-Dade County Homeless Trust:. iii. A Program Rating 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 and survey results must be submitted to the Miami-Dade.County Homeless Trust no later than forty-five. (45) calendar days„ • from the date of issuance. iv. When the Grantee, Miami-Dade:County is the Rental Administrator: The Subrecipient shall submit a::.complete an accurate CoC Program "Participant.:Application for • Housing" Package, Attachment K, including all supporting documentation for each eligible program participant .acceptedthrough the. Cod's established- Coordinated Outreach arid Assessment"HMIS system to'Miami-Dade County Homeless Trust, 27th • Floor, Suite 310, 111 NW First. Street, Miami, Florida 33128.. Pursuant to 24 CFR • 578.7.7(c) the Subrecipient must examine program.participants'income initially,and at least annually thereafter, to determine the ainount of the,contribution toward rent . = • payable by the program participants. Adjustments to program participants'contribution -payment changes the: rental a ent must- be._made as chan es 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#FL01.77L4D001.811,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 HAP Contract. The Re-certification application shall include documented evidence of the program participants' continued lack of sufficient resources and support networks necessary to retain housing without assistance from the CoC Program. When the Subrecipient is the Rental Administrator:The Subrecipient shall complete and maintain an accurate CoC Program "Participant Application for Housing" Package, Attachment J, including all supporting documentation for each eligible program participant accepted through the CoC's established Coordinated Outreach and Assessment HMIS system. Pursuant to 24 CFR 578.77(c),the Subrecipient must examine program participants'income initially,and at least annually thereafter,to determine the amount of the .contribution toward rent payable by -the program participants. Adjustments to program participants' contribution toward the rental payment must be made as changes in income are identified. The Subrecipient is required for each program participant receivingassistance to retain records for the Grantee's review,changes in the participants' income or other circumstances that affect the program participants' eligibility or need for assistance. The Subrecipient shall retain records of "Re- certification of Participation Application for Housing" Package Attachment J, no later than one hundred-twenty (120) calendar days before the expiration of term of the Lease Agreement and HAP Contract. The Re-certification application shall include documented evidence of the program participants'continued lack of sufficient resources and support networks necessary to retain housing without assistance from the CoC Program. v. Program Income-the income received by the Subrecipient directly generated by a grant- supported activity. Program income earned during the grant term shall be retained and may either be 1) added to funds committed to the project by HUD and the recipient and used for eligible activities in accordance with the requirements pursuant to 24 CFR 578 or 2) used as match. Program Income is reported and submitted to the Homeless Trust monthly in the"Consolidated Financial:Record and Reports",Attachment E vi. A"CoC Homeless Assistance Program Guidelines"Attachment G shall be completed and retained by the Subrecipient. This report must be available upon request during any site visit or comprehensive monitoring or inspection as requested by the Grantee. This report is an informational guideline to assist in compliance to the CoC Homeless Assistance Program policies;procedures and requirements and regulations. vii. Audit Reports - Subrecipients shall submit an audit conducted in accordance with the provisions of Omni or Super Circular 2 CFR Chapter I,and Chapter II,Parts 200,215, 220, 225, and 230 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as applicable, and with 24 CFR 578.99(g) which provides that Subrecipients must comply with the audit requirements of OMB Circular A-133, "Audits of States, Local Governments, and Non-profit Organizations.". The Subrecipient shall provide such reports no later than one hundred-eighty(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#FLO177L4D001811,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. The following are identified as critical incidents as defined in CF-0P 215=6(Attachment H): • Child-on-Child Sexual Abuse . - I. 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 notificatio.n shall occur;within twenty-four(24)hours of the incident occurring. In addition, the Subrecipient shall report this incident to-the appropriate authorities as well as submit in writing a detailed account of the incident. This Incident Report should be addressed to Miami-Dade County Homeless Trust's.Disaster Coordinator,as.well as the Subrecipient's assigned Contract Officer. The Subrecipient shall comply with the privacy, security and electronic transfer standards in transmittalof 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) 375-1490and facsimile (305).375=2722. .ix The COOP Report - The Subrecipient shall submit a Continuity of Operations Plan - (COOP),also known as an Agency Wide and;Program Specific Disaster Plan in PDF format and emailed as an attachment .to. Miami-Dade County`Homeless. Trust's Disaster Coordinator and an -original paper copy submitted no later than April 1st.of each operating year. • x: Mandatory Disclosure The Subrecipientis required to disclose in.a timely mariner'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#FL0177L4D00'1811,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 Subrecipient shall follow the client referral process in the Scope of Service contained within the"Scope of Service and US HUD eSnaps Documents"Attachment B and through the Continuum of Care (CoC)'s Coordinated Outreach and Assessment system. The client referral process may be amended by the- Grantee to meet changing priorities of the Continuum of Care. All referrals shall be made to the Subrecipient and accepted by the Subrecipient through the established Coordinated Outreach and Assessment and HMIS system. c. The Subrecipient shall provide any documentation necessary, such as the "W-9 Form" Attachment C,to facilitate the reimbursement of services. d. The Subrecipient shall comply with all rules, guidelines and regulations governing the CoC Rental Assistance program under 24 CFR 578, and any other applicable law, rules and regulations. i. Rental assistance projects must serve eligible program participants,including but not limited to retaining records of disability and homeless verification as part of the recordkeeping requirements. ii. Rental assistance funds are to pay Landlord owner(s)in the community the difference between the contract rent amount of the unit and the homeless participants' or tenants' contribution toward rent. The program participants' or tenants' contribution toward rent is determined by the type of program. Under tenant-based rental assistance, sponsor-based rental assistance, and project based rental assistance, program participants are required to pay rent to the landlord as determined under 24 CFR 578.77. It is important to note in all the US HUD CoC Programs,the program participants enter into a Lease with the Landlord. iii. The Subrecipient must consistently follow policies and procedures used by the CoC's established Coordinated Outreach and Assessment (HMIS) system in accepting referrals of eligible program participants pursuant to 24 CFR 578.7(a)(8). iv. The Subrecipient shall establish referral protocols,policies and procedures subject to approval by Miami-Dade County Homeless Trust indocumenting rejection of program participants accepted from the CoC's established Coordinated Outreach and Assessment (HMIS) system,which must include at a minimum, assurances that such rejections are justifiedand that the program participants are able to access another suitable program within a reasonable amount of time. v. The Subrecipient shall establish protocols, policies and procedures subject to approval by Miami-Dade County Homeless Trust and consistent.with Miami-Dade County Homeless Trust's CoC "Standards of Care" pertaining to termination of assistance to program participants. The Subrecipient may terminate assistance to CoC Grant#FLO177L4D001811,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 review of the decision, in which the program participant is given the opportunity to present written or oral objections before a person other than the person(or a subordinate of that person)who made or approved the termination decision; and (4) Prompt written notice of the final decision to,the program participant. The Subrecipient providing permanent supportive housing for •hard-to-house populations of homeless persons must exercise judgment and examine • all extenuating circumstances indetermining when violations are serious enough to warrant termination so that program.participants'.assistance is terminated only in the most severe cases. e. The Subrecipient shall comply with the Violence against Women Reauthorization Act(VAWA) as well as with 24 CFR 5.200, as may be amended,and with all applicable provisions of 24 'CFR Parts 5,92,200,574, 576, 578, 880, 882,883,;884;886,891,'960;966,982,and 983•and with such administrative rules and policy guidance relating to VAWA as may exist, be adopted,or be amended from time,to time,as maybe 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 (CoC) Program Final Interim Rule, 24 CFR Part 578, as may be amended from time to time, the McKinney-Vento Homeless Assistance Act, as may be amended,from time to time (42 U.S.C. " 11301et seq.). (the '.`Act") the Consolidated and Further Continuing Appropriations Acts of 2012, .2013, and 2014 the Homeless Definition Final Rule, published in the.Federal Register on December 5, 2011, as may be amended from time to • time; the '`Continuum of Care Program Grant Agreement" Attachment A and all other federal requirements of this grant. The responsibility for knowledge of and compliance with all Federaland 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 ,pro•aswith any guidance.provided by US HUD applicable to this"Agreement,'program and'the services:'offered hereunder: The Subrecipient shall abide and be governed by the requirements of the Americans with Disabilities Act(ADA). Subrecipient shall designate with its:organization an ADA Coordinator to ensure that all requirements of the ADA.and any,related applicable:;regulations. and requirements are met by the Subrecipient In addition,the Subrecipient agrees to comply with the following requirements.. Insurance i -If the Subrecipient is the-State of Florida or an agency or political subdivision of the State as defined by Section 768.28,Florida.Statutes,the Subrecipient shall furnish the Grantee,`upon request written`verification of. liability prot • ection in accordance with CoC Grant#FL0177L4D001811,The,City of Miami Beach,The City of Miami Beach Outreach Program Page 14 Section 768.28,Florida Statutes. The written verification shall be submitted to Miami-Dade County Risk Management,Internal Services Division,located on the 23rd Floor.111 NW 1st Street.Miami,Florida 33128. Nothing herein shall be construed to extend any party's liability beyond that provided in Section 768.28, Florida Statutes. If the Subrecipient is a non-governmental entity said Subrecipient shall maintain required liability insurance coverage as noted below during this contract period. The Subrecipient shall maintain required liability insurance coverage as noted below at all times during this contract period. Public Liability Insurance.on a comprehensive basis in an amount not less than $300,000 combined single limit for bodilyinjury 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 bodilyinjury and property.damage. Workers' Compensation Insurance for all employees of the Subrecipient as required by Florida Statutes 440. Flood Insurance shall be maintained as per the requirements in 24 CFR Part 583.330(a). The insurance coverage required shall include these classifications, listed in standard liability insurance manuals, which most nearly reflect the operations of the Subrecipient. All insurance policies required above shall be issued by companies authorized to do business under the laws of the state of Florida,with the following qualifications: The company must be rated no less than "B" as to management; and no less than"Class V" as to financial strength by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the approval of Miami- Dade County Risk Management Division. Or Compliance withthe foregoing requirements shall not relieve the Subrecipient of its liabilityand obligations under this section or under any other section of this Agreement. No modification or waiver of any of the aforementioned insurance requirements shall be made without thirty(30) days written advance notice to the Grantee,and is subject to the approval of Miami-Dade County Internal Services Risk Management Division. ii. Indemnification-The Subrecipient shall indemnify and hold harmless the Grantee and its past, present, and future employees and agents from and against any and all claims, liabilities, losses, and causes of action which may arise out of or relate to this Agreement, or which may arise out of actions or negligence,in whole or in part, of the Subrecipient,its officers, agents, employees, or assignees in: the direct or indirect fulfillment,of this Agreement. The Subrecipient shall pay all claims and losses of any nature in connection therewith,and shall defend all,suits,in the name of the Grantee when applicable, and shall pay all costs and judgments which may issue thereon. It is expressly understood and CoC Grant#FL0177L4D001811,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 certification statement for all annual financial reports and requests for payment that states the following: "By signing this report, I(duly authorized signature) certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false,fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal,civil or administrative penalties for fraud,false statements,false claims. or other offense." iv. Conflicts of Interest-The Subrecipient shall disclose to the Grantee in writing any possible or actual conflicts of interest or apparent improprieties relating to the Subrecipient under this Agreement. The Subrecipient shall make each disclosure in writing to the Grantee immediately upon.the Subrecipient's discovery of such possible conflict. The Grantee will then render an opinion which shall be binding on all parties. v. Affidavits - The Subrecipient shall complete, notarize and provide one (1) original set of "Miami Dade County Affidavits and Declarations 1 through 16","Attachment D". One (1) original set of Affidavits will remain on file with Miami-Dade County Homeless Trust, two (2) full set of copies will be created and one (1) copy provided to Miami-Dade County Clerk of the Board and one (1) copy to the Subrecipient. 1. Miami-Dade County Ownership Disclosure Affidavit (Section 2-8.1 of Miami- Dade County Code"County Code"). 2. Miami-Dade County Employment Disclosure Affidavit(County Ordinance 90- 133,Amending Section 2-8.1; Subsection (d) (2) of the County Code). 3. Miami-Dade County Affirmative Action/Non-Discrimination of Employment, Promotion and Procurement Practices (County Ordinance 98-30 codified at 2-8.1.5 of the County Code). 4. Miami-Dade County Criminal Record.Affidavit (Section 2-8.6 of the County Code). 5. Sworn Statement Pursuant to §287.133 Florida Statutes on Public Entity Crimes. 6. Miami-Dade Employment Family Leave Affidavit (County Ordinance 142-9 codified as Section 11A-29 et seq of the County Code). 7. Miami-Dade County Disability Nondiscrimination Affidavit (County Resolution R-385-95). 8. Miami-Dade County Regarding Delinquent and Currently Due Fees or Taxes (Section 2-8.1(c) of the County Code). 9. Miami-Dade County Current.on all County.Contracts, Loans and Other Obligations: (County Ordinance 9.9-162): 10. Miami-Dade County Domestic Violence Leave (11A-60 et seq of the County Code).; 11. Miami-Dade County Employment Drug Free Workplace Affidavit (County Ordinance:92-15 codified as Section 2-8.1.2 of the,County Code). 12. Attestation regarding due and proper acknowledgement Miami-Dade County funding support. CoC Grant#FLO1.77L4D001811;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 submit a detailed project budget, and sources and uses statement as contained within "Scope of Service and US HUD eSnaps Documents",incorporated into Attachment B, which shall be sufficiently detailed to show: i) the total project cost; ii) the amount of funds to be used for administrative and overhead costs; iii) whether the funds under this Agreement will be`gap'funds meaning that they wouldbe the last remaining funds needed to ensure funding for the total project costs;iv)any profit(program income)to be made by the Subrecipient; and v) the amount of funds devoted toward the provision of the desired services or activities.. 14. Miami-Dade County certification not to use"Pink Slime" in food programsor related housing programs providing food (County Resolution No. R-478-12) 15. Affidavit of Miami-Dade County Lobbyist Registration for Oral Presentation (County Ordinance Section 2-11.1(s) of the County Code), Lobbyist specifically includes the principal,as well as any agent,officer,or employee of a principal, regardless of whether such lobbying activities fall within the normal scope of employment of such agent, officer or employee. 16: Subcontract/Supplier Listing(Ordinance 97-104) The Subrecipient understands that the Grantee has relied on the Subrecipient's. aforementioned representations in entering into this Agreement. h. Civil Rights - The Subrecipient agrees to abide by Chapter 11A of the Code of Miami-Dade County("County Code"),as maybe amended,in the exercise of its police power for the public safety; health and general welfare, to eliminate and prevent discrimination in employment, family leave, public accommodations, credit and financing.practices, and housing accommodations because of race, color, religion, ancestry, national origin, sex, pregnancy, age, disability, marital status, familial status, gender identity, gender expression, sexual orientation, or actual or perceived status as a victim of domestic violence, dati rig violence or stalking. It is further hereby declared to be the policy of Miami-Dade County kiiiminate and prevent discrimination in housing based on source of income. Initials here 40 DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Parts 5, 91, 92, 570, 574, 576, and 903 [Docket No. FR-5173-F-04] RIN 2501-AD33 Affirmatively Furthering Fair Housing-The.Fair Housing Act(title VIII of the Civil Rights Act of 1968,42 U.S.C.3601-3619) declares that it is"the policy of the United States to provide,within constitutional limitations, for fair housing throughout the United States." .See 42 U.S.C. 3601. Accordingly, the Fair Housing Act prohibits,amongother things,discr.iminatio s " he sale,rental,and financing of dwellings, and in other housing-related transactions I e C.�i! of"race, color, religion, sex, familial status,national origin, or handicap."Initials he e ti See 42 U.S.C. 3604 and 3605: Section 808(d) of the Fair Housing Act requires all executive. branch departments and agencies admini ringhousing and urban development programs and activities to administer these pro!, . in a manner that affirmatively furthers fair housing.See 42 U.S.C. 3608:Initials he • t. The Subrecipient agrees to abide and be governed by Title VI'and VII, of the Civil Rights Act of 1964(42 U.S.C:2000 et seq.)and Title VIII of the Civil Rights Act of 1968,as amended;;and CoC Grant#FLO177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page.17 Executive Order 11063, as may be amended, as well as with any applicable regulations, which provide in part that there will be no discrimination of race,color,gender/sex,religious background, ancestry or national origin in performance of this Agreement, in regard to persons served,or in regard to employees orapplicants for employment or housing: It is expressly understood that upon receipt of evidence of suci.,6 rimination,the Grantee shall have the right to terminate this Agreement. Initials here �1 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 and activities,and provides that the rt y Ull responsible oting thffort. Executive.Order 12898 requiresSecr :nondisofHDcriminationwibe in federalfr programscoordina 'thate ea ffect human health and the environment as well as provides minority and low-income communities' access to public information and public participation. Executive Order 13166 requires federal agencies to examine the services they provide,identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services.so LEP persons can have meaningful access to them. Executive Order 13217 requires federal agencies to evaluate their po :es andprograms todetermine if any can be revised or modified to improve the availf. o ` of community-based living arrangements for persons with disabilities.: Initials her•�►��!'. 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 based on immigration status when the services are necessary to protect life or safety. In the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), Congress restricted immigrant access to certain public benefits,but also established a set of exceptions to these restrictions. It is understood that recipients of federal funding that administerprograms 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 of assistance, the amount of assistance, or the cost of assistance on the individual (participant's) recipient's income or resources, thatsuch programs are not subject to PRWORA's restrictions on immigrant access to I •lic benefits and must be made available to eligible persons without regard to citizensh',=,s o nality, or immigration status.8 U.S.C.Section 1611 b 1 D , 1621 b (4).Initials he a1 It is further understood that the Subrecipient must submit affidavits attestingthat it is not in violation of the American with Disabilities.Act, Section 504 of the Rehabilitation Act of 1973, as amended, (29 U.S.C. 794, et seq.),.the Federal Transit Act, (49 U.S.C..1612), and the Fair. Housing Act, (42 U.S.C. 3601 et.seq.), as may be amended, as well as with any applicable regulations. If the Subrecipient or any owner, subsidiary, or other,firm affiliated with or related to the Subrecipient is found bythe responsible enforcement agency,the Courts or Grantee to be in violation of these Acts, the Grantee shall.conductno further business with the Subrecipient Any contract entered intobasedupon a false affidavit shall be voidable by the Grantee. If the Subrecipient violates any y of the Acts during the term of any contract the Subrecipient has with Miami-Dade County, suchcontract shall be voidable by the Grantee, even:.if thecipient was not in violation at the time the affidavits) were submitted. Initials he � . CoC Grant#FL0177L4D0018,11,The City of Miami Beach,The City of Miami Beach OutreacIrProgram 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 maybe amended,which requires an employer, who in the regular course of business and has fifty (50) or more'employees working in Miami-Dade County for each working day during each of the twenty(20) or more calendar work weeks to provide domestic violence leave to its employees. Failure to comply with this local law may be grounds for voiding or terminating this Agreem: -•-I •r for" commencement of debarment proceedings against the Subrecipient. Initials her td► The Subrecipient agrees to abide and be governed by the Age Discrimination Act of 1975, (42 U.S.C. 6101 et seq.) and implementingregulations at(24 CFR Part 146), as may be amended, as well as with any applicable regulations, which provides in part that there shall‘IIIV°. . ;ih�� 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 Rehabilitati* aA ct of 1973,as amended, (29 U.S.C. 794, et.seq.) as maybe amended,as well as with any: � . ble regulations,which prohibits discrimination on the basis of handicap. Initials her Subrecipient agrees to abide and be governed by the requirements of the Americans with Act (ADA), as may be amended, as well as with any applicable law. Initials here Pursuant to 24 CFR 578.23,Subrecipient hereby certifies and agrees that: i. Subrecipient will maintain the confidentiality of records pertaining to any individual or family that was provided family violence prevention or treatment services through the project/program; ii. The address or location of any family violence project/program assisted under this part will not be made public, except with written authorization of the person responsible for the operation of such program and in accordance with any applicablestate and local laws that prohibit disclosure of information relating to domestic"violence centers; Subrecipient will establish policies and practices that are consistent with, and do not restrict the exercise of rights provided by Subtitle B of Title VII.of the McKinney Vento Homeless Assistance Act, as amended, and other laws relatingto 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 staffperson to be responsible for ensuring that children being served in the program are enrolled in school and connected to appropriate services in the community including early childhood programs such as Head Start, Part C of the individuals with Disabilities Education Act, and programs authorized under Subtitle B of Title VII of the McKinney-Vento Homeless.Assistance Act as amended; v, ;. The Subrecipient shall use the centralized or coordinated assessment system established by the Continuum of Care as set forth pursuant to 24 CFR 578.7(a) (8); vi. Subrecipient,itsofficers,and employees are not debarred or suspended from doing business with the federal government; and : vii. Subrecipient will provideinformation,such as data'and reports,as required by US HUD. CoC Grant#FL0177L4D001811,The City.of Miami Beach;The City of Miami Beach Outreach Program Page 19 Additionally, Subrecipient agrees: i. To establish such fiscal controls and accounting procedures as may be necessary to assure;the proper disbursal of, and accounting for grant funds in order to ensure that all financial transactions are conducted,and records maintained in accordance with generally accepted accounting principles; ii. To take the educational needs of children into account when families are placed in housing and will,to the maximum extent practicable,place families with children as , close as possibleto their school of origin so as not to disrupt such children's education. A Subrecipient that serves families with school-age childrenshall have at least one program staff member, knowledgeable of the McKinney-Vento Education for Children and Youth Act requirements and shall comply with all requirements related to facilitation of educational opportunities consistent with Miami-Dade County Homeless Trust's Standards of Care incorporated herein by reference; iii. To comply with the provisions of 24 CFR 578.23(c) (9). iv. To follow the written standards for providing Continuum of Care assistance developed by the Continuum of Care,including the minimum requirements set forth in§ 578.7(a)(9); and v. To operate the project(s) in accordance with the provisions of the McKinney-Vento Act and all requirements under 24 CFR part 578; and to comply with such other terms and conditions as US HUD may establish by NOFA (Notice of Funding Availability). 4. Suspension and Termination a. Suspension-The Grantee may,for reasonable cause,temporarily suspend the operation and.: authority to obligate funds of the Subrecipient,under this Agreement, or withhold payments to the Subrecipientpending necessary corrective action by the Subrecipient or both. Reasonable cause shall be determined by the Grantee in its sole and absolute discretion and may include: i. .Ineffective or improper use of any funds provided hereunder by the Subrecipient; ii. Failure by the Subrecipientto materially comply with any terms, conditions, , representations or warranties contained herein;. iii: Failure by the Subrecipient to submit any documents required by this Agreement; or iv. Incorrect or incomplete document submittal by the Subrecipient. b. Termination- i. Termination at.Will This Agreement,in whole or in part, may be terminated by the Grantee upon no less than fifteen (15) working days' notice when the Grantee determines that it wouldbe in the best'interest-of the Grantee and / or the Subrecipient materially fails to comply with the terms and conditions of the award. Said notice shall be delivered by certified mail, return receipt request, or in person. with proof of delivery. The Subrecipient shall have five:(5).days from the day the notice was delivered to state why it is not in the best interest of the Grantee to terminate the.Agreement. However,it is up to the discretion of the Grantee to make. the final determination as to what is in its best interest. ii. . Termination for Convenience - The Grantee or Subrecipient mayterminate this Agreement, in:whole or part,when both parties agree that the continuation of the CoC Grant#FL0177L4D.001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page 20. 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 arid 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 ormodified portionof the grant will not accomplish the purposes for whichthe grant was made it may terminate the grant in its entirety. iii. Termination Because of a Lack of Funds In the event funds to finance this Agreement become unavailable, the Grantee may terminate this Agreement upon no less than twenty-four (24) hours' notice in writing to the Subrecipient. Said notice shall be sent by certified mail, return receipt requested, or in person with proof of delivery. The Grantee shall be the final and sole authority in determining whether or not funds are available. iv. Termination for Breach— Upon terminating this Agreement under this section the Grantee,in its sole discretion,may require the Subrecipient to pay the Grantee any or all.costsassociated with termination of this Agreement, including but not limited to transfer of the Subrecipient's obligations under this Agreement and or selection of.a new Project Sponsor. The Grantee may terminate this Agreement,in whole or in part, when the.Grantee determines in its sole and absolute discretion that the Subrecipient is not making sufficient progress in the performance of this Agreement as outlined in the "Scope of Services" contained within the"Scope of Service and US HUD eSnaps Documents" Attachment B or is not materially complying with any term or provision provided herein including but not limited to the following: 1. The Subrecipient ineffectively or improperly used or uses the Grantee funds allocated under this Agreement; .2. The Subrecipient failed or fails to furnish the Certificates of Insurance required by this Agreement or as determined by Miami-Dade County Internal Services Risk Management Division; 3. The Subrecipient failed orfails to furnish proof of Licensure, proof of Certification or proof of Background Screening required by this Agreement; 4. The Subrecipient failed or fails to submit detailed reports of expenditures or final expenditure reports or submits incompletely or incorrectly; 5. The Subrecipient failed or fails to submit required reports or submits incompletely or incorrectly; 6. The Subrecipient refused orrefuses to allow the Grantee access to records or refused or refuses to allow the Grantee to monitor, evaluate and review the Subrecipient's program; 7. The Subrecipient discriminates under any of.the laws. outlined in this Agreement; 8, The Subrecipient failed or fails to provide.Domestic Violence Leave to its employees pursuant to local law; 9. The Subrecipient falsifies or violates the provisions of a Drug Free Workplace Affidavit; 10. The Subrecipient attempted or attemptsto meet its obligations under this - Agreement through fraud,misrepresentation ormaterial misstatement; 11. The Subrecipient failed or fails within a specified period, to correct deficiencies found duringa monitoring, evaluation or review;. CoC Grant#FL0177L4D00181.1,The City of Miami Beach,The City of Miami Beach Outreach Program : Page.21 12. The Subrecipient failed or fails to meet the terms andconditions 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 meetany of the terms and conditions of the Miami-Dade County Affidavits; and 14. The Subrecipient failed or fails to, fulfill in a timely andproper manner any and all of its obligations, covenants, agreements and stipulations in this Agreement. The Subrecipient shall be given written notice of the claimed breach and ten (10) business days to cure same: If the.Subrecipient is not provided a written waiver of the breach by the Grantee,or if the Subrecipient remains in breach of this Agreement as determined by the Grantee, the Grantee shall initiate written notice to terminate and said notice will be to terminate effective within no less than twenty-four (24) hours. Said notice shall be sent by certified mail, return receipt requested, or in person with proof of delivery. Waiver of Breach or any provision of this Agreement shallnot be construed to be a modification, or revisions of the terms of this Agreement. The provisions contained herein do not limit the rights to legal or equitable remedies or any other provision for termination by the Grantee under this Agreement The Subrecipient shall be responsible for all direct and indirect costs associated with such termination or cancellation, including attorney's fees. Any individual or entity who attempts to meet its contractual obligations with the Grantee through fraud, misrepresentation or material misstatement may be disbarred from Miami-Dade County contracting for up to five(5)years. 5. Notice Regarding Future Funding Applications Funding under this Agreementis provided by US HUD. The parties understand the Grantee, as the US HUD fundingrecipient, is responsible for review and approval of the funding application and response submitted to US HUD through the annual US HUD CoC Program Notice of Funding Availability(NOFA)'application process. The Subrecipient agrees to timely notify the Grantee of the Subrecipient's intention not to be. available to renew and continue operating or providing the program in its entirety as covered under this Agreement. Timely is defined as the earliest of either 1) six (6) months prior to this Agreement's expiration; or 2) upon request to .confirm allocations in the, Grant Inventory". Worksheet(GIW)registration processof the anticipatedannual application to US HUD CoC Program If the Subrecipient isnot available to apply for "renewal`funding" or for the continuation of the program outlined in this Agreement,and failed to timelyinform the Granteeas described herein,then the Grantee in its sole discretion may opt not to enter into future grant agreements with the Subrecipient. Further,in the event the Subrecipient will not be available to apply for renewal funding applicable to this Agreement,the Subrecipient agrees to ensure that housing is maintained for;persons served by the Subrecipient under this Agreement after theexpiration of this Agreement so:that those persons:. do not become homeless. Notice from:Subrecipient to Grantee pursuant to this section shall be delivered in writing by certified mail,;;return receipt request; or in person with proof of-delivery, to the attention of Miami-Dade County Homeless Trust Executive Director. CoC Grant#FL0177L4D00,1811,The City of Miami Beach;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" in accordance with this Agreement and applicable laws, and regulations for a term of at least twenty (20) years or if applicable fifteen (15) years from the date of initial occupancy or date of initial service provision. If the United States, Department of Housing and Urban Development (US HUD) determines a project is no longer needed for use as homeless assistance housing or services,then US HUD may provide authorization to the Grantee on behalf of the Subrecipient to convert the project to a project for the direct benefit of low-income persons pursuant to a,request for such use by the Grantee on behalf of the Subrecipient operating the project as'Project Sponsor. The partieshereby agree to this provisionshall survive the expiration or termination of this Agreement pursuant to 24 CFR 578.81 - The,request for authorization to US HUD from the Grantee on behalf of the Subrecipient must be made while the project is operating as homeless housing or supportive services for homeless individuals and families, must be in writing, and must include an explanation'of why the project is no longer needed to provide transitional or permanent housing or supportive services. The primary factor in US HUD's decision on the proposed conversion is the unmet need for transitional or permanent housing or supportive services in the Continuum of Care's geographic area. b. ' Repayment of Grant-If the Subrecipient does not provide supportive housing or supportive services for twenty(20)years or if applicable fifteen(15)years following the date of initial occupancy or date of initial service provision pursuant to this Agreement, then the Grantee shall require repayment of the entire amount of the grant or partial repayment of the grant used for acquisition,rehabilitation,or new construction,unless conversion of the project has been authorized by US HUD pursuant to the terms in the Term of Commitment. The parties hereby agree this provision shall survive the expiration or termination of this Agreement. c. Prevention of Undue Benefit- Upon the sale or other.:disposition of a project assisted with acquisition, rehabilitation or new construction funds occurring before the expiration of the twenty (20) years or if applicable fifteen (15) year period,the Subrecipient must comply with such terms and conditions as US HUD and the Grantee may prescribe to prevent the Subrecipient from unduly benefiting from such sale or disposition. The Subrecipient shall return to the Grantee, upon the expiration or termination of the Agreement any funds on hand,any accounts receivable attributable to those funds, and any overpayment due to unearned funds or costs disallowed pursuant to the terms of this Agreement that were disbursed to the.Subrecipient by the Grantee, d. Revocation of License or Permit Notwithstanding any provision of this Agreement to the contrary, revocation of any necessary license, permit, or approval by a governmental authority may result inimmediate termination of this Agreement upon no less than twenty- four(24) hours'notice. Said notice shall be certified by mail or hand delivery: e. Declaration of Restrictive Covenant and Declaration of Restrictions -Where grant funds are used for acquisition, construction or rehabilitation under this Agreement, the Subrecipient shall record a Declaration of Restrictive Covenants,as well as a Declaration of Restrictions,in accordance with this'section. CoC Grant#FL0177L4D00181:1,The City of Miami Beach,The City of Miami Beach Outreach Program Page 23 The Declaration of Restrictive Covenapts and the Declaration of Restrictions shall restrict the use of properties located at N/4 , in Miami-Dade County, Florida such that the properties must be operated for the provision of homeless housing and services for homeless persons in accordance with the provisions of(24 CFR Part 578, Code of Federal Regulations) and any other applicable laws or regulations for a term of at least twenty (20) years or if applicable fifteen (15) year period orfor such other purposes as may be approved by the Grantee and US HUD. The Subrecipient agrees that the Declaration of Restrictive Covenants and the Declaration of Restrictions shall be signed by the Subrecipient, as well as the titleowner of the subject property and any other relevant property interest holders, including but not limited to a lessee of the title holder subleasing the property to the.Subrecipient. If the Subrecipient is not the title owner of the subject property,the Subrecipient shall be responsible for obtaining execution of the Declaration of Restrictive Covenants and the Declaration of Restrictions by the title owner and by any other parties required by US HUD. The Subrecipient shall be responsible for ensuring that any signatories required by US HUD sign the Declaration of Restrictive Covenants and the Declaration of Restrictions whether.US HUD requires such signatories by regulation or by guidance provided directly regarding the project and / or property covered under this Agreement. The Declaration of Restrictive Covenants executed by the Subrecipient and any other required parties and recorded by the Subrecipient must be approved by US HUD. The Subrecipient must provide US HUD with proof of recordation of the approved Declaration of Restrictive Covenants before funds for Rehabilitation or New Construction may be drawn down: Acquisition funds may drawn down before proof of recordation is received by US HUD;:however,no other grant funds will be available for draw down until US HUD is satisfied with the form and recordation of the Declaration of Restrictive Covenants. The Subrecipient agrees to inform any lender or grantor which has loaned or granted funds for the purchase of such properties or structure on the subject property or properties covered under this Agreement and obtain their consent to the recordation of and subordination to the "Declaration of Restrictive Covenants" and the "Declaration of Restrictions". Such consent shall be in a form acceptable to the Grantee. The parties hereby agree this provision shall survive the expiration or termination of this Agreement.. 7. . Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards - a. Accounting Standards,Cost Principles and Regulations. i. The Subrecipientshall comply with applicableprovisions 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 theconflicting provision shall be modified to be consistentwith the law or regulation or be deleted if modification is impossible. However,theobligations under:this Agreement, as modified, shall continue and all provisions of this Agreement shall remain in full force and effect. CoC Grant#FLO177L4D00,1811,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), asamended: the Federal Water Pollution Control Act (33 U.S.C. 1251), as amended: Section 508.of the Clean Water Act (33 U.S.C. 1368); the environmental Protection Agency.regulations (40 CFR Part 15); Executive Order 11738; and the Environmental Review Procedures and Regulations (24 CFR Part 58 and 24 CFR Part 583.230). The Subrecipient shall comply with all applicable laws and regulations governing this Agreement. b. The Subrecipient shall comply with the federal uniform administrative requirements and accounting standards cost principles and audit requirements according to OMB Omni or Super Circular 2 CFR Chapter I,and Chapter II,Parts 200,215,220,225 and 230,OMB Circular A-122, and 24 CFR 78 et.seq., as may be applicable and any other applicable laws and regulations. i. Performance Measurements - The Subrecipient shall comply and report all performance objectives outlined in the "Scope of Service :and US HUD eSnaps Documents" Attachment B and as outlined in the NOFA application arid in the manner specified andoutlined in this Agreement. ii. Additionally, the Subrecipient shall comply with the established United States Department.of Housing and Urban Development's (USHUD) performance measures related to the Continuum of Care's (CoC) system performance. Specifically: 1. Measure.1:The Length of Time Persons Remain Homeless 2. Measure 2: The Extent to which Persons who 'Exit Homelessness to Permanent Housing Destinations Return to Homelessness. 3. Measure 3: Number of Homeless Persons 4. Measure 4: Employment and Income Growth for.Homeless Persons in CoC Program-funded Projects 5. Measure 5: Number of Persons who Become Homeless for the First Time 6. Measure 6: Homeless Prevention and Housing Placement of Persons Defined by Category 3 of HUD's Homeless Definition in CoC Program-funded Projects 7. Measure .7: Successful Placement from Street Outreach and Successful Placement in or Retention of Permanent Housing iii. HUD-funded agenciesmust have a minimum of 86% ofthe organization's total number of beds/units which arereported to HUD for the Miami-Dade County Continuum.of Care (CoC) through the Housing Inventory Checklist, populated in the HMIS, regardless.of whether the beds are funded by HUD or the Homeless Trust, whether or not funded by HUD or the Homeless Trust. iv: Internal Controls-.The Subrecipient shall comply with 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 is required to report deviations from budget orproject scope or objectives and request prior approvals from federal awarding agencies through the Grantee on any and all changes in scope or key persons and any other change to the program budget, in accordance with Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225 and 230 and any other applicable laws and regulations. vi. Cost Sharing or Matching-For all federal awards,any shared costs or matching funds and all contributions, including cash and third party in-kind contributions, must be accepted as part of the non-federal entity's cost sharing ormatching and such contributions shall meet all of the following criteria: 1. Are verifiable from the non-federal entity's records; 2. Are not included as contributions for any other federal award; 3. Are necessary and reasonable for accomplishment of project or program objectives; 4. Are allowable under Costs Principles of 2 CFR Part 200,et al. 5. Are not paid by the federal government under another federal award, except where the federal statute specifically provides that federal funds made available for such programa can be applied to match or cost sharing requirements of other federal programs; 6. Are provided for in the approved budget when required by, the federal awarding agency; and 7. Conform to 2 CFR Chapter II, Part 200.306,as applicable. c. Retention of Agreement Records i. The Subrecipient shall retain financial records, supporting documents, statistical recordsand all records pertinent to'a federal award for a period of five (5) years from the date of submission of the final expenditure report or,for Federal awards that are renewed quarterly or annually, from the date of the submission of the quarterly or annual financial report,respectively,as reported to the federal awarding agency. 1. If any litigation,claim or audit is started before the expiration of the five (5) year period,the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and:final action taken If the Grantee or the Subrecipient has received or been given notice of any kind n indicating any threatened litigation, claim or audit arising out of the services provided pursuant to the terms of this Agreement,the Retention Period shall be extendeduntil such time as the threatened or pendinglitigation, claim or audit is, in the sole and absolute discretion of the Grantee, fully, completely and finally resolved: 2. Records for real property andequipment acquired with federal funds must be retained for a minimum five(5)years after final disposition: 3 : Any leases or mortgages or similar documents or contracts with a term longer than five (5)years,must beretained for five (5)years beyond the end of the document's full term. CoC Grant#FL0177L4D001811,The 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 or any persons authorized by the Grantee full access to and the right to examine any of the records pertinent to the Federal Award and this Agreement 6. The Subrecipient shall notify the:Grantee in writing both during the pendency of this Agreement and after its expiration as part of the final close out procedure of,the location and address where all the Agreement records will be retained. 7. The Subrecipient shall obtain priorwritten approval by the Grantee for the disposal of any Agreement records before disposing of such records if it is within one (1)year after the expiration of the Retention Period.. 8. '.Additional Requirements The Subrecipient shall comply with the following additional requirements: . a. Client Rules and Regulations - The Subrecipient.shall submit to the Grantee a copy of the Client Rules and Regulations that apply to all program or client participants referred to the Subrecipient pursuant to this Agreement. This copy is due within thirty(30)calendar days following the execution of this Agreement. b. Personnel Policies and Administrative Procedure Manuals The Subrecipient shall submit detailed documents describing all the Subrecipient's policies and procedures for internal control, corporate, or organizational "structure, property management, .procurement, personnelmanagement, 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 Grantee to monitor,according to applicable regulations,all Agreement records, facilities, goods, services and activities of the Subrecipient which are in any connected to the activities undertaken pursuant to the terms of this Agreement including interview of any participant, employee; subcontractor, or assignees of the Subrecipient. The Grantee shall` monitor both fiscal and programmatic compliance with all terms and conditions of this Agreement including a reviewof beneficiaries,supportive services,housing,operatingcosts, program and performance progress, site habitability, participant eligibility, documentation for required match, record keeping, and compliance with circulars, administrative costs, technical assistancevisits, and environmental review . The Subrecipient shall permit.the Grantee to conduct site visits,participant assessment surveys,and other techniques deemed reasonably necessary to fulfill the monitoring function. If the Grantee monitors and there is a finding of deficiencies report; said report may be delivered to the Subrecipient, and if so delivered, the Subrecipient shallrectify all, deficiencies cited within the period of time specified in the report Pursuant to Board of Miami-Dade County Commissioners Resolution No.630-13,Miami-Dade County Mayor or Mayor's designee may make unannounced,on-site visits during normal working hours to the Subrecipient's headquarters and/or any locations orsite where the services contracted for are performed. CoC Grant#FL0177L4D0018'11,The City of MiamLBeach,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 inwriting and received by the.Grantee within thirty(30) calendar days of the Subrecipient's notification by the funding source. e. Related Parties - The Subrecipient shall report to the Grantee the name, purpose and any other relevant information in connection with any transaction conducted between the Subrecipient and a related party transaction. A related party includes,but is not limited to; a for-profit or nonprofit subsidiary or affiliate organization,and organization with overlapping boards of directors or any organization for which the Subrecipient is responsible for appointing members. The Subrecipient shall reportthis information to the Grantee upon forming the relationship or if already formed,shall report it,immediately. Any supplemental information shall be reported in the Grantee required Agency Narrative and Progress Report which are addressed in Section 2 b."Records and Access to Records". f. Required Meeting Attendance - From time to time,'Grantee through Miami-Dade County Homeless Trust may schedule meetings and or training sessions to assist the Subrecipient in the performance of its contractual obligations ortoinform the Subrecipient of new and or revised policies and procedures: Attendance at some of these meetings may be mandatory. The Subrecipient shall receive notice no less than three (3) business days prior to any meeting or training session that may require mandatory participation. A record of attendance shall be kept of meetings or training sessions where notice was given indicating :the mandatory participation of the Subrecipient and the Subrecipient shall be monitored for compliance on that record of attendance: Failure to attend meetings or training sessions for which a mandatory notice has been provided can.result in material non-compliance of the Agreement,up to and including Breach or Default Proof of mandatory notice shall consist of fax record, certified mail, electronic confirmation and or verbal communication with the Agreement contact person or persons and other program administrative staff of the Subrecipient. The Subrecipient may select one or more employees from their Agency,directly involved in the Agreement program, as their representative at the meeting or training session;i the participation of the Agreement contact person or persons pis 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 meetingdate and time, and justification : provided, including the reason the:Subrecipient:could not send any representative. The Grantee,shall have absolute and final approval over any determination to waive mandatory attendance; and no more than two (2).mandatory;attendance waivers.shall be allowed. during the:term of this Agreement The•Subrecipient is encouraged to attend all meetings of . Miami-Dade County Homeless Trust and or its Committees, as information relevant to their program or services may be discussed g: . Publicity.;and Advertisements The Subrecipient shall ensure .that all publicity and - advertisements prepared and released bythe Subreci lent, such as'pamphlets hlets and news P P 1?. releases already or indirectly related'to activities funded pursuant to this Agreement; and all events carried.out to publicize the accomplishments of any activity fundedpursuant to this Agreement,recognize the Grantee as"its:funding source: • CoC Grant#FL0177L4D001'811,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 maybe permitted by applicable law. If this Agreement involves the expenditure.of$100,000 or more by Miami-Dade County, and the Subrecipient intends to-use subcontractors to provide the services listed herein or suppliers to supply the materials,the Subrecipient shall provide Miami-Dade County with the names of the"Subcontractor/Supplier Listing",Attachment D. Subrecipient agrees that it will not change or substitute subcontractors or suppliers from those listed without prior written approval of Miami-Dade County. . • i. Involvement of HUD-assisted individuals and families — per 24 CFR 578.23 (c)(3), the Subrecipient agrees to ensure to the maximum extent practicable, that-individuals and families experiencing homelessness are involved, through employment, provision of volunteer services, or otherwise, in constructing, rehabilitating, maintaining and operating facilities for the project and in providing supportive services for the project. Further,per the Housing and Urban Development Act of 1968,as amended, (12 U.S.C. 17.01u) to the greatest extent feasible,opportunities for training and employment,for services or programs covered under this Agreement, should be given to lower-income residents of HUD-assisted projects and contracts for work in connectionwiththe project be awarded in substantial part to persons residing in the area of the project. j. Property - This section applies to equipment-with an acquisition cost of greater than $5,000.00 per unit and all real property. 1) Any real property under the control of the - Subrecipient that was acquired and or improved in whole or in part with funds from Grantee, or from Miami=Dade. County and any equipment or property purchased for greater than $5,000.00, shall, upon expiration or termination of this Agreement, be disposed in accordance with instructions from the Grantee. Real Property is defined as land, including land improvements, structures, and appurtenances thereto, including moveable machinery and.equipment.. Equipment means tangible, non-expendable, personal property having a useful life of more than one (1)year and acquisition costs of greater than$5,000.00'per unit 2) The Subrecipient shall list in the property records 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 Grantee or from.Miami-Dade County from this Agreement or from previous agreements. The property record shall include a legal description, size, date of acquisition, andvalue attime of purchase,owner's nameif different than the Subrecipient, information on the transfer or disposition of the property, and map indicating where property is in parcels,lots or blocks and showing adjacent streets and roads. Notwithstanding documents required for reimbursement purposes, an additional copy of the purchase receipt for any property described above which was purchased using Grantee or Miami-Dade County funds must also be included in the reimbursement package along with the "Real Property and Equipment Asset Inventory"Attachment I in the month it was purchased. 3)All equipment with an acquisition cost of greater than $5,000.00 per unit and all real property shall be inventoried annually by the Subrecipient and an Annual Inventory Report submitted to the Grantee. This report shall include the elements listed above:.Pursuant to 2 CFR 200:94,if the 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 compliance of the Subrecipient with generally accepted fiscal:and organizational standards and practices. The Performance Reviews will reflect the quality of service provided and value received of the funds using monitoring data such as progress reports,site visits, and participants'surveys. 1. Subcontracts and Assignments - The.Subrecipient shall not assign this Agreement without the Grantee's written consent to the assignment. The Subrecipient shall ensure that all subcontracts and assignments; 1) Identify the full, correct and legal name of the party; 2) Describe the activities to be performed; 3) Presenta complete and accurate breakdown of all price components; and 4) Incorporate provisions requiring compliance with all applicable regulatory and other requirements of this Agreement with any conditionsof approval that the Grantee deems necessary. This applies only to subcontracts.and assignments in which partiesare engaged to carry out any eligible substantive programmatic service as set forth in this Agreement. The Grantee:shall in its sole and absolute discretion determine when services are eligible substantive programmatic services subject to the audit and record keeping requirements described above.. The Subrecipient shall ensure.that all subcontracts and assignments which involve, the expenditure of one hundred thousand dollars ($100,000.00) or more,comply with (Miami- Dade County Ordinance 97-104, § 1, 7-8-97),which shall require the entity contracting with Miami-Dade County to list all first tier subcontractors who will perform any part of the contract and all suppliers who will supply materials for the contract work directly to such entity. The contract shall also require the entity contracting with Miami:=Dade County to report to Miami-Dade County the race,gender,and ethnic origin of the owners and employees of all such first tier subcontracts. This Agreement shall require the Subrecipient to provide Miami-Dade County the race,gender and ethnic information as soon as reasonably available and in any event prior to final payment under the contract. The Subrecipient shall not change or substitute subcontractors or suppliers from those listed except upon written approval of the County. The Subrecipient must provide the list of all first tier subcontractors and direct suppliers; see "Subcontractor / Supplier Listing" Attachment D. The Subrecipient shall incorporate into all consultant subcontracts this additional provision:"The Subrecipient is not responsible for any insurance or other fringe benefits for the consultant or its employees, (examples social security, income tax withholdings,: retirement or leave benefits). The consultants assume full responsibility for the provision of all insurance and fringe benefits for themselves and their employees retained by the consultants in carrying out the Scope of Service • provided in this subcontract';,' The Subrecipient shall be responsible for monitoring the contractual performance of all subcontracts.. The Subrecipient shall receive written documentation-prior to 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 ofany funds to the Subrecipient for the subcontract. The Subrecipient shall receive written approval from the Grantee prior to either assigning or transferring any obligationsor responsibilities set forth in this Agreement'or the right to receive benefits or payments resulting from this Agreement Approval by the Grantee of any subcontract or assignment shall not under any circumstances,be-deemed to provide ;CoC.Grant#.FL0177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page 30 for the incurring of any obligation by the Grantee in excess of the total dollar amount set forth in this Agreement. m. Consultant to the Grantee - The parties understand that in order to facilitate the implementation of this Agreement, the Grantee may from time to time designate a development consultant to work with the Subrecipient. The Grantee's Consultant shall be considered the Grantee's designee with respect to all portions of this Agreement with the exception of those provisions relating to payment_to.the Subrecipient for services rendered. The Grantee shall provide written notification to the Subrecipient of the name, address and employee representatives of the Grantee's.Consultant. n. Participation in the Homeless Management Information System (HMIS) - The Subrecipient . agrees to participate in a Homeless Management Information System selected and established by the Grantee. Participation will include, but not be limited to, input of client data upon intake, daily updates of bed availability information, as well as updates to current and prior client's records upon client contact, and maintaining current data for statistical purposes. Subrecipients of Domestic Violence Programs with heightened privacy and confidentiality concerns are required to participate in an HMIS equivalent system to include the necessary stricter privacy and confidentiality standards. The Subrecipient understands that they are responsible for any ongoing costs to access the HMIS system. The Subrecipient agrees to abide_ by terms of any HMIS Agreements, which are incorporated herein by reference. The Subrecipient shall indemnify and hold harmless the Grantee and Miami-Dade County,its agents and instrumentalities from any and all liability,losses and damages arising out of or relating to this Agreement or the HMIS system. o. Miami-Dade County Inspector General review - The Subrecipient understands that.Miami- Dade County, Office of the Inspector General may, on a random basis, perform audits on all Miami-Dade County contracts,throughout the duration of said contracts. p. Independent Private-Sector Inspector General review- The Subrecipient understands that Miami-Dade County Inspector General is also empowered to retain the services of lndependent Private-Sector Inspector Generals, to audit, investigate, monitor, oversee, inspect and review operations,activities,performance andprocurement processes including but not limited to project design,application and project specifications,proposals submittals, activities of the Subrecipient, its officers, agents and employees, lobbyists, Miami-Dade County staff, and elected officials toensure compliance with contract specifications and to detect fraud and corruption. q. Renegotiation or Modification-The Subrecipient agrees that modifications to provisions of this Agreement shall Only be valid, when in writing and signed by duly authorized representatives of all parties. In addition, the Subrecipient may not make any significant changes to an approved program without prior written approval by the Grantee. Significant changes include,but are not limited to,changes in the Project Sponsor,changesin the project site location, additions or deletions in types of program or funding activities outlined in 24. CFR 578.37- 578.63 and the Notice of Funding Availability(NOFA) process approved in the. Technical Submission for this program, ora shift of greater than ten (10) percentage points. between approved funding activities, or a change in the population served, the number of population served,or any other changesdeemed significant by the.Grantee. Depending upon thenature of the change,the Grantee may require a new certification of consistency with the Consolidated Plan Certification from the United States Department of Housing and Urban , Development Any approval for changes is contingent upon United States, Department of CoC Grant#FL0177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page 31 Housing d _Urban Dmi . continuation of the Subrecipientan's renewal ranking evelopin theent CoC Field NOFAOffacepplicationapprovalprocess.ofthe 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 havefinal authority in determining funding availability for this Agreement caused by changes listed above. Notwithstanding the foregoing, the Grantee retains all rights of suspension and termination set forth in other section(s) of this Agreement. r. Right to Waive-The Grantee may, for good and sufficient cause, determined by the Grantee in its sole and absolutediscretion, waive provisions in this Agreement in writing or seek to obtain such wavier from the appropriate authority. All waiver requests from the Subrecipient must be in.writing. Any waivershall not be construed as a modification or revision to this Agreement. s. Disputes - In the event that an unresolved dispute exists between the Subrecipient and the Grantee, the Grantee shall refer the questions, including the views of all interested parties and the recommendation of.the Miami-Dade County Homeless Trust; to the Miami-Dade County Mayor or the Mayor'sdesignee for determination. The Mayor or Mayor's designee will issue a determination within thirty (30) calendar days of receipt and so advise the Grantee and the Subrecipient; or in the event additional time is necessary, the Grantee will notify the Subrecipient within the thirty (30) day period that additional time is necessary. The Subrecipient agrees that the determination of the Mayor or the Mayor's designee shall be final and binding onall parties. t Proceedings-This Agreement shall be construed in accordance with the laws of the State of Florida and any proceedings arising between the parties in any manner pertaining or related to this Agreement shall, to the extent permitted by law, be held in Miami-Dade County, Florida. u. No Third Party Beneficiaries This Agreement has no intended or unintended third party beneficiaries. v. Construction of the Agreement- This Agreement shall not be construed against the drafter of this Agreement. w. Sovereign Immunity- Nothing in this Agreement shall be considered;a waiver of sovereign immunity. x. Notice and Contact-The Grantee's representative for this Agreement is Victoria L. Mallette, Executive Director,Miami=Dade Coun Homeless Trust The Subrecipient's representative for this greemen is Kd Qy1 SL►Q(f The project site location is i o:F /x'11. In:the event that different representatives are designated by the Subrecipient after this.Agreement is executed, or the Subrecipient changes the address of either the program site or principal office,the Subrecipient must notify the Grantee prior to such relocation and obtainall necessary approvals: Notice ofthe name of the new representative or new address will be rendered in writing to the Grantee within five.(5) business days of the proposed change CoC Grant#FLO177L4D0018.11,: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 a Program-Specific Table of Organization,which includes all current jobtitles in PDF format and which shall be emailed as an attachment to Miami-Dade County Homeless Trust's Contract Manager Terrell T.Ellis within five (5) business days of execution of this Agreement. aa. Name and Address of Payee-When payment is made to the Subrecipient,it shall be directed to the name and address of the payee listed here: Subrecipient's NamA: P IG, r •�A' i� � / / CP �+ c, Address: I U l/1 •a •, DYl �� Z� mi �CtG�y ►"'� 3313 bb. All Terms and Conditions Included this Agreement and its Attachments A through K as referenced in the Index of Attachment, contain all the terms and conditions agreed upon by the parties. cc. Autonomy - Both parties agree that this Agreement recognizes the autonomy of and stipulates or implies no affiliation between the contracting parties. The parties acknowledge that the relationship of Grantee and Subrecipient is that of independent contractors and that nothing contained in this Agreement shall be construedto place Grantee and Subrecipient in the relationship of principal and agent,employer and employee,master and servant,partners or joint ventures Neither party shall have,expressly or by implication, or represent itself as having,any authority to make contracts or enter into any agreements in the name of the other party,or to obligate or bind the other party in any manner whatsoever. dd. Severability of Provisions- If any provision of this Agreement is held invalid,the remainder of this.Agreement shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of all applicable law. ee. Waiver of Trial- Neither the Subrecipient, subcontractor nor any other person liable for the responsibilities,obligations,services and representations herein,nor any assignee,successor heir or personal representative of the Subrecipient,subcontractor or anyother such persons or entities shall seek a jury trial in any lawsuit, preceding, counterclaim or other litigation proceeding based upon or arising out of this Agreement, or the dealings or the relationship Betweenor among the parties to this Agreement.. ff. Counties and Municipalities outside Miami-Dade County-The Subrecipient agrees to provide • homeless housing within Miami-Dade County and further agrees to abide by, as well as to post this notice: Notice that all firms, corporations,organizations or individuals desiring to transact business or enter into a contract with Miami-Dade County for the provision of homeless housing and or homeless services swears, verifies, affirms and agrees that 1)they have not entered into any current contracts,arrangements of any kind,or understanding with any county, or municipality outside of Miami-Dade County to provide housing and services for homeless persons in Miami--Dade County who aretransported to Miami-Dade Countyby. or at thebehest 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, CoC Grant#FL0177L4D001811,The City of Miami Beach,The City 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 affected by such contract,arrangement, or undertaking. gg. Compliance with all applicable Laws, Regulations, Ordinances, Policies and Standards The Subrecipient agrees to comply with all applicable Federal, State;and local laws, regulations, ordinances, and standards including but not limited to any applicable requirements regarding payment and performance bonds and other requirements for public works, competitive bid and bid bond requirements, if applicable, as well as with requirements contained in the Grantee's"Continuum of Care Program Grant Agreement",.Attachment • A. The Subrecipient also agrees to sign and provide.the Grantee with any required affidavits. Additionally,.the Subrecipient,shall comply with any and all guidance that Grantee receives from US HUD regarding this Agreement, the program and / or services covered herein, and clarification of existing laws and regulations 9. Religious Organizations Pursuant to 24 CFR Part 578.87, a primarily religious organization is eligible to receive US HUD funding,if the organization agrees to provide homeless housing and services in a manner that is free from religious influences as described in section 24 CFR Part 578.87 and in accordance with the following principles; a. It will not discriminate against any employee or applicant for employment on the basis of religion and will not limit employment or give preference in employment to persons on the basis of religion; 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 basisof religion; and c. It will provide no religious instruction or counseling, conduct no religious worship or religious services,engage in no religious proselytizing and exert no,other religious influence in the provision of homeless housing and services funded hereunder. d. Alternative Provider-The Subrecipient shall;incorporate into their policies and procedures, a written approved policy to.refer, or transfer any program participant or prospective program participant of the Continuum of Care program who objects tothe religious character • of the provider:: .The policy and procedures shall be reviewed and subject to approval by Miami-Dade County Homeless Trust. At a minimum the policy and procedures hall include action to transfer or refer within a reasonably prompt time after the objection and undertake • reasonable efforts to identify and refer the participant toan alternative provider to which the participant has no.objection. Exceptfor servicesprovided'by telephone, the .Internet, or similar means,:.the referral must be to an'alternative provider in reasonable geographic proximity to the organization making the referral. In making the referral,the Subrecipient • shall comply with applicableprivacy laws and regulations. The Subrecipient shall document •any objections fromprogram participants and prospective program participants and any efforts to refer. such .participants.°to .alternative: providers in accordance -with the • requirements of 24 CFR 578.103(a)(13): CoC Grant#FL0177L4D00181`1,The City'of Miami Beach,The City of Miami Beach Outreach Program Page 34 • The Subrecipient shall comply with the provisions of this section and with 24 CFR Part 578.87, as well as with any other applicable laws or regulations governing a primarily religious organization. 10. Health Insurance Portability and Accountability Act(HIPAA) Any person or entity that performs or assists Miami-Dade County with a function or activity involving the use or disclosure of Individually Identifiable Health Information (IIHI) and or Protected Health Information(PHI) shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as may be amended, and any applicable federal, state, county and local laws and policies, including by not limited to 24 CFR 578.103, 42 CFR Part 2, and Section 39.908, Florida Statutes, as may be applicable. HIPAA mandates for privacy, security and electronic transfer standards that include but are not limited to the following: a. Use of information only for performing services required by the contract or as required by law; b. Use of appropriatesafeguards to prevent non-permitted disclosures; c. Reporting to Miami-Dade County of any non-permitted use or disclosure; d. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Subrecipient and provides reasonable assurances that IIHI and PHI will be held confidential; e. Making PHI available to the customer; f. Making PHI available to Miami-Dade County for an accounting of disclosures; g. Making internal practices,books and records related to PHI and IIHI available to Miami-Dade County for compliance audits and for other purposes as may be permitted by law; and h. PHI shall maintain its protected status regardless of the form and method of transmission (including paper and or electronic transfer of data). The Subrecipient must give its customers written notice of all privacy information practices including but not limited to description of the types of uses and disclosures that would be made with.. protected health information. 11. Proof of Licensure/Certification and.Background Screening a Licensure. - If the Subrecipient is required by the State of Florida or Miami-Dade County or any federal,state or local law or regulation to be licensed or certified to provide the services oroperate the facilities outlined in the Scope of Service contained within the "Electronic Review, Renewal Adjustment and HEARTH Renewal Application", Attachment B, the Subrecipient shall furnish to the Grantee a copy of all required current licenses or certificates. Examples of services or operations requiring such licensure or certification include but are . :not limited to childcare, day care,nursing homes, and boarding homes.' If the Subrecipient fails to furnish the Grantee with the licenses, certificates or certifications required under this Section, the Grantee in its sole discretion, shall not disburse any funds - until it is provided with such licenses or certifications. Failure to provide the required licensesor certification within sixty(60) daysof 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 locallaws, regulations, ordinances and resolutions regarding background screening of employees, volunteers,subcontractors and independent contractors. Subrecipient's failure to comply with, any applicable laws, regulations, ordinances and resolutions regarding. background screening of employees, volunteers, subcontractors and independent CoC Grant#FL0177L4D001811,The City of 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 amended from time to time), regulations, ordinances and resolutions regarding background screening of those who may work or volunteer directly with or in the vicinity of vulnerable persons as defined by Section 435.02 Florida Statutes,as may be amended from time to time. In the event criminal background screenings is required bylaw,the State of Florida and/or Miami-Dade County, the Subrecipient will permit only employees, volunteers, subcontractors and independent contractors with a satisfactory national criminal'. background check through an appropriate screening agency (i.e.,the Florida Department of Juvenile:Justice,Florida Department of Law Enforcement or Federal Bureau of Investigation) to work or volunteer in direct contact with or in the vicinity of vulnerable persons. The Subrecipient shall also comply with Section 943.059, Florida Statutes, regarding court- ordered sealing of criminal history records,and Section 943.0585,Florida Statutes,regarding court-ordered expunction of criminal history records,as may be applicable. The Subrecipient agrees to ensure that employees,volunteers,subcontracted personnel and independent contractors who work with vulnerable persons satisfactorily complete and pass Level 2 background screenings before working or volunteering with any vulnerable persons. The Subrecipient shall furnish Miami-Dade County with proof that employees, volunteers, subcontracted personnel, and independent contractors who work with vulnerable persons, 'satisfactorily passed Level 2 background screenings pursuant to Chapter 435 Florida Statutes,as may be amended from time to time. If the Subrecipient fails to furnish to Miami-Dade County proof that an employee,volunteer, subcontractor or independent contractor's Level 2 or other required background screening was satisfactorily passed and completed prior to that employee,volunteer,subcontractoror. independent contractor working or volunteering with or in the vicinity of a vulnerable person or vulnerable persons, Miami-Dade County shall not disburse any further funds and this Agreement may be subject to termination at the sole discretion of Miami-Dade County. SIGNATURES CONTINUE ON NEXT PAGE COC Grant#FLO177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page,36 IN WITNESS WHEREOF,the parties have caused this(38)thirty-eight page Agreement to be executed by their respective and duly authorized officers the day and year first abovewritten. WITNESSES: ENTITY: 1. a4/40't / /i Subrecipient: City of Miami Beach nature of Wi. ess (SiA 0,s6 (Print full nam °ro 'cer Ag-.,cy) iso, 1 (Print Name of Witness) (Signature) 2. / � Jimmy L. Morales (S :s ature) (Print Name of Authorized Agency Signatory) TO 0`- rtb S l"aC-( City Manager (Print Name of Witness) (Print Title of Authorized Agency Signatory) APPROVED AS TO FORM & LANGUAGE Affix & FOR EXECUTION Incor• :_'NI ^}y+a„\ )`� L 2 L J 1� ATTEST: _ ;:.• ,',•e. :....-sh' City Attorney Date INCORP ORATED! `)01Ne 2 712519 ''', .;,' Rafael E.Granado,City Clerk '',7...4. _ ATTEST: . Miami-Dade County,a political subdivision of The State of Florida . HARVEY RUVIN, , BY:. �� Deputy Clerk °° Cr®M4., ,`e Carlo A. timenez,Mayor 0 /3 . 1.9 �10:_e a• MAU ICE L. EIVI 3 (((////// COU�d"fY . n • Date v.�— DEPUTY MAYOR . °R`. MIAMII-DADS CTV. FL °•o ff•.* •oe' e See attached memorandum dated(March 12,2019)approved as to form and legal.sufficiency Resolution#.R-12'52-18 • CoC Grant#FL0177L4D001811,The City of Miami Beach,The City of Miami Beach Outreach Program Page 37 1 • INDEX OF ATTACHMENTS Attachment A- Continuum of Care Program Grant Agreement&Exhibit 1 Attachment B - Scope of Service and US HUD eSnaps documents Attachment C.- Form W-9 Request for Taxpayer Attachment D - Miami-Dade County Required Affidavits and Declarations Attachment E - Consolidated Financial Record and Reports - Excel Format Attachment F - Performance Reports (Monthly and Annual) Attachment G- • CoC Internal Wellness Checklist and Guidelines Attachment H - "Incident Report" form Attachment.I - "Real Property& Equipment Asset Inventory" form' Attachment j- When Subrecipient is the Rental Administrator (Participant's Housing Applicatioij)*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,may be 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 FY2018 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. The project listed on this Scope of Work is governed by the Act and Rule, as they may be amended from time to time. The project is also subject to the terms of the Notice of Funds Availability,for the fiscal year competition in which the funds were awarded and to the applicable annual appropriations act. 2. HUD designations of Continuums of Care as High-performing Communities (HPCS) are published in the HUD Exchange in the appropriate Fiscal Years' CoC Program Competition Funding Availability page. Notwithstanding anything to the contrary in the Application or this Grant Agreement,Recipient may only use grant funds for HPC Homelessness Prevention Activities if the Continuum that designated the Recipient to apply for this grant was designated an HPC for the applicable fiscal year. 3. Recipient is not a Unified Funding Agency and was not the only Applicant the Continuum of Care designated to apply for and receive grant funds and is not the only Recipient for the Continuum of Care thatdesignated it. HUD's total funding obligation for this grant is $_65212_for project number_FL0177L4D001811 . If the project is a renewal to which expansion funds have been added during this competition,the Renewal Expansion Data Report, including the Summary Budget therein, in e-snaps is incorporated herein by reference and made a part hereof. In accordance with 24 CFR 578.105(b),Recipient is prohibited from moving more than 10%from one budget line item in a project's approved budget to another without a written amendment to this Agreement. The obligation for this project shall be allocated as follows: • a. Continuum of Care planning activities $ 0 b. 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 A Signature) Ann D. Chavis,Director (Typed.Name and Title) February 21, 2019 (Date) RECIPIENT . Miami-Dade County (Name of Organization) By: i i I (Signature of Au orized 0 ficial) MAURiCELKEMP (Ty ed Na e and Title of Authorized Official!E P u-{y ;`6 r`°r' . O P-1- A9 WHAVvill--RADE CTY 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 ATTACHMENT S:"Fir 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 maybe 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" • • = a° - Ga .= Ge 0a _ ap - Ga _ Ba � as —/IIII 91 - 0e Be le eG = Gli al - as 276 • • • 1.,..„6, .. • . . . . .7„ . • E 78.. • z.7: .=,4L1.,.7I„.Ar 1: . r . . E. .-.. . .. . . . . .. .. z.5..,Basi,sa . rz c�� r . ... . . . . ... . . . . . r B. . 71 .6 0 GI a United..States Department of Housing andi! '`��a Urban :Develop.ment (USHUD) '' a J'• fl '‘..1.11' _ at 2018 Continuum of Care (CoC) Program , . Ga • ]B L2.71 .. .Fa 0° • • • . . . .-4"...;44, C 71 . CityofMiamiBeach � • ...- Ga _ EC GI �_� Outreach Pro ram = a 9 2 = 91 • , . . • ./...... . . . E GG • M °G Grant Number: - ae GY,_11 • - GG M . FL0177L4D0018111,.7. aa .. , . . • . , 35 a0 . . . . . .. . . , .. '. • ,.. . . ,',', '." . ./ . 4. .., • . . . . . , 91 mel al = as • • Ll::it • . - • „ "Hi / 'T /6716 ''7 "T /`'lT /`'l/ •%'°lT /`''7 �7 ` ''MT /'P`J °'�T ./`'l! M ,./'"7 ,%"7 ''s/ . ''� ..as = 11 0a Oa o= la aB as = ae 9a IB 01 GI II GG 61 Oe Da •' The City of Miami Beach . ATTACHMENT B, BUDGET The City of.Miami Beach Outreach Program., Grant Number:: FL0177L4D001811 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 Totall la. Leased Units : 1 Year. 1 Year -. lb. Leased Structures 1 Year 1Year , 2. Rental Assistance . .. 1 Year 1 Year - 3:Supportive Services 1 Year 1 Year $ 60,946 00 $ 60;946;00 4. Operating 1 Year 1.Year $ $ - $ 65,212.00 5 HMIS 1 Year 1 Year $ - $ - 6 Sub-total Costs Requested 60,946.00 $ • 60;946:00 7.`AdministrationUp.to Administration (Up 10%) $ 4,266.00 J:$ . 4,266.00 8:'Total Assistance plus.Admin Requested $ 65,212.00 65;212.00 9.Cash Match. . 16,303.00 $ :16,303:00 10 In-kind Match. ; . ' 11.Total Match 16,303.00 :.$ 16;303.00: . . 12.Total Budget $ ... 81,515.00 : $ 81,5.15-.00 M • tch.% X25% a , - • • 6E. SUPPORTIVE SERVICES BUDGET Annual Assistance Annual Assistance Eligible Costs- Quantity AND Description(max 400 Requested Requested (1IUD characters)(Renewal Submission) (Renewal Award) Submission) 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 2 FTE Outreach Case Worker _s Salary and 13 Outreach Services Fringe Benefits $ 60,946.00. $ 60,946.00 14.Substance Abuse.Treatment Services. 15.Transportation.. 16 Utility Deposits 17.Operating Costs Total Annual Assistance Requested •$ 60,946:00; $ 60;946:00. Grant Term - - 1,Near, - -1,Year Total Request for Grant Term '$ ,60:',946:00:: $- , 60;946:0.0. FY2018 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.October2oi8) • ,. • Identification Number and Certification• requester.Do not Department of the Treasurysend-to the IRS. .• • Internal R• evenue Service • 10-Go to www.irs;gov/Farm W9 for instructions and the latest information. • t Name(as shown on your income tax retum).Name is required on this line;do not leave,-this line blank. - ei off. teal •Bectek• • . 2 Business name! isregarded entity name,if different from above • • • 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'onlyto R following seven boxes. . ' • • certain entitles,not indiividuals;see o . instructions on.page 3): o ❑ Individual/sole proprietor or . ❑ C Corporation. '0 s Corporation [1 Partnership ❑Trust/estate . • is single-member LLC • a • Fxeinpt,payee code(if any) '4,1-1 El Limited liiabilityoompany.Enter the tax classification,(C=C corporation,S=S corporation;P=Partnership) - . . • • `oa Note:Check the appropriate box the line above for•the'tax classification of the:single-member;owner. Do,not check'-Exerription.from FATCA'reporting . c tt • . LLC ifthe LLC is classified as a single=member LLC that is disregarded from the owner unless the owner of the LLC is .'•code(if any) ' • • another LLC that is not disregarded from the•owner for.U.S,federal tax purposes.Otherwise,a single-member LLC that • a 9 • is disregarded from owner should check the appropriate box for the tax classification of its owner. • . -y • ❑ Other(see Instructions) • (Applies to accosna maintained outsidethe U.S.) • e .5 Address(number,street,and apt:or suite no. ee instructions: '. - Requester's name and address(optional) .' . 6"City,state,and ZIP code. • ' AAA-Ciirn 1•.'£ QJ C-&, .' 3-s t al 7 List account number(s)here(optional) • • . Taxpayer identifiication.Number(TIN)- .. •. Enter your TIN in:the appropriate box.The TIN provided must match the name given online 1 to avoid 1Social security number " • backup withholding.For individuals;this is-generally.your social security number(SSN).However,for a . ' . resident alien,sole proprietor,or disregarded entity,see the instructions for Part'I,later.For other - .- — . • entities,it is your employer identification number( IN)..If you do not have a number,see How to get a. TIN later. Note:If the account is in more-than-one name,see the instructions for lined.Also see What Name and .Employer identification number , . Number To Give the Requester for guidelines on whose number to enter. • l •Certification . • Under penalties of perjury,I:certify that:.. ' 1..The number shown on this form is my correct taxpayer identification number(ort am.waiting 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 notified by the Internal Revenue Service S)that I am subject to backup withholding as a result oft.a failure to reporall interest or dividends,or(c)the IRS.has notified me that I am (IR . . no longer subject to backup withholding;and ' • . 3.I am a U.S.citizen or other U.S:.person(defined below);and 4.The FATCA code(s)entered oh this form(f any)indicating that I am exempt from FATCA reporting is correct. • • Certification instructions.You must cross out item 2 above.if you have.;been notified by the IRS that you.are currently.subject to backup Withholding'because . ' youhave:failed tomport all interest and dividends,on your.tax return:For real'estate.transactions,•item 2 does'not apply'For mortgage interest paid . acquisition or abandonment of secured property canoe -ton of debt,contributions to art individual.retirement arrangement(IRA),and generally,payments . other than interest and dividends you - .ot r:q 'red o'ign'the certification,but you must provide.your correct TIN:See the.instructions for Part•II,later. . . Sign Signature o ' -LI-- .. • Here. . US, eson eV Flirt : Date . 0.® � General'Instructions: Form 1099-DIV(dividends,Includin those from stocks or mutual' - funds)' . Sectionreferences are to the Internal Revenue unless otherwise ..Form 1099-MISC(various types,of income;prizes,awards,Or gross:noted. proceeds) ' Future• 'deveopents For the latest,information about developments' . .'Form 1099-B(stock or mutual 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 wwiid.irs govfFormW9 ' Form 1099S(proceeds froin'real estate transactions). • ; Purpose•of-Forti •Form 1099-K(merchant card and third party network-transactions)'- . `An individual orentity(Form W-9 requester)who Is required to file.an . Form1098(home mortgage interest) 1098E(student loan interest),' information return with.the IRS.must obtain your correct taxpayer 1098-T(tuition): . . . identification'number(fIN)which may be your'social Security number •Form 1099-C(canceled debt) • - • -. • ' .(S$N);individual:taxpayeridentlfication•number(ITIN) adoption • •Form 1099-A(acquisition or abandonment'of: ty taxpayer identification number(ATIN),or-employeridentifcation'number. _ secured proper ) • •• (EIN),toreport on an information return the amount paid:to you,or other - Use Form W-9•only if you are a U.S,person.(including a.resident amount:reportable on an.information return:,Examples•of information:• : alien),to•provide`your correct TIN: . returnsinclude,but are not limited to,the following If you do not return Form.W 9 to fhe requester with a TIN you might Form 1099-INT(interest earned or paid) be subject tobackup withholding:.See What is backup withholding, titer, ' ' Cat No:10231X• Form'W-9 (Rev.10-2018) , ' • i • • Form W-9(Rev.10=2018):.." • Page 2" • ' 3y • signing`the filled-out"form,you: - ." • Example.'Article 20 of the U.S.-Chintax a income 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 be issued), .' student temporarily present in theUnited StatesUS...Under U .law;this . " • .student will become a resident alien for tax purposes'if his or.her stay in • 2.Certify that you are not subject to backup withholding,or "• the United States exceeds 5 calendar years.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'April 30,1984)allows •• payee.,If applicable,you are also certifying that asU. a S.person,your the provisions.of,Article:20 to continue 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 not subject 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 to claim an exemption from tax 4:Certify that FATCA codes)entered on this form(if any)indicating on his or her sch'olership•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 furtherinformation.. "supportthat exemption. • " . • Note:.If you are a.U.S.person and•a requester gives you a form.other If you are a nonresident alien ora foreign entity,give the requester the , than"Form W-9 to request your TIN,you must use•the requester's form if • appropriate'completed Form W-8 or Forrn,8233.: " it is substantially similar to this Form 1N 9 Backup,Withholding- `" . Definition'of'a IJ.S.person.For federal tax purposes,you are • ' considered a U:S,"person if you are• " -. What is backup withholding?Persons making certain payments to you, • •An individual wno is a•U.S,citizen or U.S.resident alien; • must under certain conditions withhold and pay toile IRS 24%of such • payments.This is called"backup withholding ,Payments that may be , •A partnership,corporation;.company,or association created or 'subject to backup withholding•include'interest tax-exempt interest;. organized in the United.States or under the laws of the United States; ' dividends broker and,barter;exchange transactions;rents,•royalties, •An estate"(other than a foreign estate);or . nonerriployee,pay ,payments made in settlement of payment•card and. • •A domestic trust(as defined'in.Regulations section 301 J701-�. third party network transactions;and certain payments frorn fishing boat " • • operators.Reel estate transactions are not subject to'backup S• pecial rules for partnerships.Partnerships that conduct a trade or withholding. • . . . . .. .. • • business in the United States are generally required to pay a withholding •You will not be subject to backup.withholding on payments you tax under section 1446 on any foreign partners''share of effectively •• receive:if you give the requester your correct TIN,make the proper ' connected taxable income from such business.Further,in certain cases certifications,and report •all your t• axable interest•and'dividends on your . ' . where a,Form_W-9 has'not been received,the rules under section 1446" tax return. • require a partnership to presume;that a partner is a foreign'person,arid -. • pay the section:1446 withholding tax.Therefore,if you area U.S..person •" Payments"you receive will"be subject to backup withholding if: • • • that is a partner in a partnership conducting a trade or•business in the • '1'.You do.not furnish your TIN to the requester, United States,provide Form W=9 to.the partnership to establish your : " '2,You,do not.certify your TIN"when required •(see the instructions'fo• r • - U:S.status and avoid section 1,446.withholding on your share of •Part II for details), partnership income.. • • - . • In the.cases_below,the following'person must give Form W-9 to the • 3.The IRS tells.the requesterthat:you furnished an incorrect TIN, • partnership for purposes of establishing its U.S.status and avoiding 4,The IRS tells you that you are subject to backup"withholding ' • withholding•on its allocable share of net income from the:partnership because you did not report all your interest and dividends on.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 entitywith a.U.S.owner,the-U.S.-owner • 5.You do not certify to the reqUesterlhat you are•not subject to " '" of the disregarded entity'and not the.entity • • backup•wiithholding under,4 above(for•reportable interest and dividend •In the case of a'grantor trust with a U.S.grantor or other U.S:owner, .accounts;opened.after19•-3 only) " • generally,the U.S.grantor or otherU. S.owner of the grant:if trust and " • Certain payees and payments are exempt from.backup withholding: not"the trust;andSee Exempt payee code,later;andhe separate Instructions for the . . 6 in the case of a U.S.trust(other than a grantor trust);'the U.S.trust . Requester of.Form W-9 for more information (other than a grantor trust)and•not the beneficiaries of the trust. Also see Special rules for.partnerships,earlier. • . • Foreign person.If you:are a,foreign person or the U.S:"'branch of a , • What's FATCA' RepOrtln&? • • .foreign bank that-has elected to:be treated as-a U.S.person„do.not use, Form.W-9.Instead,use the appropriate Form-W 8 or,Form 8233(see ' The Foreign:Account Tax Compliance Act(FATCA)requires a Pub.,$1.5,Withholding,of Tax on.N•onresident Aliens and Foreign participating foreign financial institution to report all United States • Entities),:• • - account holders that are specified United States persons.Certain Nonresident-alien who becomes a resident alien;Generally,only a payees are.exempt from"FATCA reporting.See Exemption from:FATCA "nonresident alien individuaY;may use the terms of a taxtreaty reduce rep•orting.code later,and the Instructions for the Requester of Form.. • •or eliminate US.tax on certain types of:income:However;most tax - information.- , • VJ 9formore"inform 'on. `` • treaties contain,a provision known'as a 'saving clause:"ITxceptions' Updating Your In�ormatOn specified in the saving clause may permit an exemption from tax to continue for certain types of friborne,eVen.efter the payee has otherwise" •You must provide information to any person to whom:you-.• • become a U.S.resident:alien for tax purposes. • • " , claimed to be an exempt payee if you are nd.Ionger an.exempt payee If you'are a U.S.resident alien who is relying on.an'exception, • •and anticipate receiving reportable•payrrients in the future from this . contained in the saving clause of a tax treaty claim an exemption • person For example,"you may.need to provide updated inf•ormation if, • from U.S:.tax on certain types•of"income;:you MuSt attach:a statement you,are a C corporation that elects:to"bean,S corporation,or if you no,: . to Form W-9 that.specifes the following five item•s._ • • : `longer are tax exempt.In addition;you must furnish a new Form.W-9•if ' 1:The treaty country.Generally;this mustbe the same treaty under the name or.TIN.changes for the account,forexampl'e,if the grantor of a .. •which'you claimed exemption from.tax•as a"nonresident alien: grantor trust dies., " 2 Thetreaty article addressing the income. Penalties 3 The.article number(orlocation)in the tax treaty that contains the " " ." saving clause and its exceptions " ' • Failure to furnish TIN.If you fail to furnish your correct•TIN to a 4 The type and amount income that qual•ifies'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 justifythe exemption from tax under the terms of , Civil penalty for false information with respect to withholding.;If you • the treaty article make;a.false statement with no"reasonable basis•that results'in•no • . . . ,backup withholding,you are"subject to a_$500.penalty. . "' - • • Form W 9(Rev.10-2D18) . 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) including fines and/or imprisonment. . • •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 criminalpenalties. Individual Individual/sole proprietor or single- • • - • Sole proprietorship,or ' ' ' member LLC. i . • Specific Instructions" • Single-member.limited liability .. . • company(LLC)owned by an •• • Line 1 individual and disregarded for'U.S. ' • 'You must enter one of the following on this.:line;do not leave this:line federal tax purposes: ' blank.The name should match the name onyour tax return. • LLC treated'as a partnership for Limited liability company and enter . If this Form W-9 is fora joint account(other thanan account " U.S.federal tax purposes, the appropriate tax.classification. maintained by a foreign financial institution(FF)),list, and firsthen. • 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 S=S corporation) • • •: Part I of Form W-9.:if you are providing Form W-9 to an FFI to document or . a joint account;each holder:of the account that.is a U.S.person must • • LLC that is disregarded as an providea'Form.1N 9:' • • 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 Social:Security not disregarded for U:S.federal tax Administration(SSA)of the name change,enter:your first name,the last purposes. • • •name as shown on your social security card;and your new last name.. " ' ' Note:ITIN applicant:Enter your individual name as•if was entered on ' Partnership Partnership your Form W-7 application,line la.This should also be the same as the • . • Trust/estate . . • , Trust/estate. • • name you entered on the Form 1040/1040A/1040EZ you filedwith,your . Llne'4,Ex• emptions • application. " b..Sole proprietor or.single-member LLC.Enter your individual . If you are exempt from backup withholding and/or FATCA reporting, name as shown on your 1040/1040AI1040EZ on line 1.You may enter enter in the appropriate space on line.4 any code(s)that may apply to - • your business,trade,or'doing business as",(DBA)narne on line 2: you. " ' . c. Partnership,LW that is not a single-member LLC,,C • �xampt payee code • corporation,or S corporation.Enter the entity's name as shown on the • Generally,individuals(including sole proprietors)are not exempt from entity's tax return on line 1 and any business,trade;or DBA name on backup withholding. line 2; • • Except as provided below ,corporations•are exempt from backup;• d. Other entities.Enteryour name as shown on required U_S.•federal • • withholding for certain payments,including.interest,and'dividends. • tax documents online 1.This name should match the name'shown on the . .Corporations are not exempt frombackup withholding for payments charter or other legal document creating the entity.You may enter'any:. • made:in settlement of payment card`or third party network transactions. • business,trade,or DBA name on line 2.' . . Corporations are not exempt from backup.withholding'with respect to • • e. Disregarded enti • ty.For entity. federal tax purposes,an entity that is: • attorneys'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 not exempt with respect, • • "disregarded entity." See theRegulations section.301.7701-2(c)(2)(iii):Enter • •to.payments reportable on Form 1099-108C. '. • owner's name on line'1.The name of the•entity entered on line 1 • 'should never be a disregarded entity.The name on line 1•should be the• .The following codes identify payees'that are exempt from backup . name shown`on the income tax return on which.the.income.should be withholding.Enter the appropriate code inthe space in line 4. ' 'reported.For example,'if a foreign LLC that is treated as a disregarded _ 1—An organization exempt from tax under section 501(a),,anyIBA,or. • entity for 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's name 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--fhe•:UnitedStates or•any of its agencies or instrumentalities.• owner•that is not disregarded for federal tax purposes.Enter the, , disregarded entity's name on line 2,:`Business name/disregarded entity 3=A state,the District'of Columbia,a U.S.commonwealth or .. name."If the owner of the disregarded entity is.a•foreign person;the possession,or'any of their political subdivisions or instrumentalities owner must complete an appropriate Form W-8 instead;of a Form W=9.. 4—A,foreign government or"any of.its political subdivisions,.agencies, This is the• .case•even if the foreign-person has a U.S.TIN: • or instrumentalities - Llne 2. , • '5=A corporation'" . • " • • l.Lyou have a.business name,trade name DBA name;Qr disregarded 6—A dealer in or.commodities required to register in the ` • - • - entityname,you fray enter it on line 2, . United States,the Dist• rict of Columbia;or a U"S.commonwealth or. possession - Line'3. 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 oh line 1:Check only.. 8'-A real estate investment trust " " " . one box on line 3.'. 9-An entity registered at all tunes.during•the tax year under the• , Investment:Compa• . of •• • 10_A • common trust fund operated•by a bank under section 584(a) •" • " 11.`A financial institution ' • .. — 12.".•A middleman.known in the investment community as a nominee or custodian ' 13-A trust exempt from tax under section 664 or described in section • = 4947 Form W-9,(Rev:.10-2018) Page 4 . The following chart shows types of payments that may be exempt .. • M.—A tax exempt trust underasection 403(b)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 with the"financial institution requesting- .' - IF the payment is fon... - • THEN.the payment is exempt this form to determine whether the FATCA code and/or exempt payee for....." • codeshould completed. . Interest and dividend payments" All exempt payees except LIIIe.5 • for 7. Enter your address(number,street,,andapartment'or suite number): Broker transactions • •Exempt-payees 1 through;4 and 6 This is where the requester of this Form W-9 will mail your information through 11 and all C corporations: returns.If this address differs from the one the requester already has on, . . S corporations must not enter an file,write NEW at the top.If anew address_is provided,there,is still a • exempt payee code because they chance the old address willbe used until the payor changes your are exempt only,for sales of address in their records.": • • noncovered securities acquired Line,6` , • prior to2012' . . . . , Enter your city,state,and ZIP code: • Barter exchange transactions,and Exempt payees 1 through 4 • ' patronage dividends , • ''Part I Taxpajier 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 sales over 1 through 52 you do not have,and are not eligible to.get an SSN;your,TIN is your IRS , $5,000' individual taxpayer identification number(ITIN)..Enter it,in the social; . security number hex.If you do'not have an•ITIN,see How to get a TIN • . . •. .Payments made In settlement of Exempt 1 through 4 • below. . payment card or third party network" • If"you.are.a sole proprietor-and-you have anEIN,you.may enter either ; . " transactions • your SSN or •EIN: • , 1 See Form 1099-MISC,Miscellaneous Income and its instructions.' If you are a single-member LLC that is disregarded as an entity ' •" •" ` • separate,from"its owner,enter the owner's SSN(or EIN if the owner has 2 Hgwever,the following payments made.to.a corpbration:and one)..Do not enter the disregarded.entity's EIN.If the LLGis classified as reportable on Form.1099_MISC are not exempt from backup a.corporation orpartnership,:enter the entity's EIN. • ' " " withholding:medical and healthcare payments,attorneys'fees,gross Note-See• What Name,and Number To Giye the R• equester,later,for • proceeds paid to an attorney reportable under section 604 • • 5(f),and. • • further clarification of•name dumber combinations:. • . payments for services 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 to persons submitting this form for accounts maintained,outside Card;from your local SSA office or get this form online at of the United`States.by certain foreign financial institutions Therefore;if www SSA:gov-You may also.get this form by calling 1 .800-772-1213. you are. submittin this forM.for.anaccountyou hold in the'United UseForniW-7 Application for'IRS Individual•Taxpayer'Identification, only g it Number;to apply for an ITIN,orForm.SS-4 Application for-Employer - Sta#es,.you mayleave this.feld"blank Consult with the:person ' " requesting this form if you.ere.uhcertelp if the financial.iinstitution s. . Identification Number;to apply for an EIN You can apply for an EIN online by accessing the IRS website at www•:irs.go•v/Businesses and subject subject to these requirements,A:requester may indicate that a code ie .. clicking;on'Em•ployer Identification Numb•er(EIN)under Starting a not required by Providing you with a Form.W-9 with"Not Applicable"(or any similar indication)written or printed on the line for a FATCA" Business.Go to www irs.goy/Forms fo View download,Or Print Form; exemption code: W-7 and/or Form'SS-4 Or,you can go to www.irs.gov/OrderForms to' place an order"and have Form W 7 and/or SS 4`mailed to you within 10 " A=An organization exempt from tax under section 501(a).or any. • business days._ individual-retirement plan as defined in section 7701(e)(37): . • If'you are,asked to complete:Form W-9 but do.not have e TIN,apply B-The United'States or any of its agencies or instrumentalities . , for a TIN and write"Applied.For'.in the space for the TIN,sign and date- . 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,"or any of their political"subdivisions or instrumentalities. payments;.and certain payments"made with respect to readily tradable. D=A corporation thestock of which is"regularly traded onone or instruments;generally you will•have 60•d•ays,to get a TIN and give it to . more established`securities markets,as described in•Regulations the'requester.before'you are subject to.backup-withholding On,, .section,1.1472-1(c)(1)(i) : payments.The 60.day rule-does not apply to other types of payments. . ' You will bkup e subject to bacwithholding on all such payments,until E—A corporation that is a member of the same expanded affiliated " • you provide.your TIN to the requester, r • '" .. group as a corporationdescribed.in Regulations section 1 1472-1(c)(1)(i) - Note.Entering 'Applied For",means that you have already applied for a • E, .A dealer in securities;commodities or derivative financial TIN•:or that intend AO apply for one soon. instruments Including notional principal.contracts futures forwards,• .. Caution A disre arded U.S.entity that has a foreign owner must use - and options)that.is registered'as such under the laws'of the United • g,.. • ". ' State's or.anystate _ the.appropriateForm.W 8. G—A real estate investment trust " ' ' Part 11.-Certifca#tion'- H A regulated_invesfinentoompany as defined.in,section.851 or an To establish"to.the withholding;agenf that you area U S,person,or. entit pany tered,atall times.during the tax yeerunder the Investment,'. resident alien,sign Form"W=9.You may be requested to sign bythe.. Company Actof.1940' . withholding'agent•even if:item:1,4,or•6'below indicates otherwise. - ' • I "A"corn.,•...ustfund as defined in.section•584• - For a joint account,;only the person;whose TIN is shown in:Part I. J"-A bank as defined in section 581 .• should sign.(when required):In the case of.a disregarded.entity;:the" .1<, ,A broker • person identified online 1 must sign.Exempt 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 ri items 1 through.5 below. • • • • • 'Form W-9,(Rev.10-2018) ', , _ P• age 5 • 1.Interest,dividend,and barter exchange accounts-opened • For this type of.account: Give• name and EIN•of • • before 1984 and broker accounts Considered active during 1983. •14.Account with the Depar ent.of The public entity• You.must give your correct TIN;but do.not have to sign the m certification. Agriculture 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 inactiive'during prison)that receives agricultural 1953.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 out item 2 in the .• 15.Grantortrust'filing-underthe 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 Filing Method 2(see - cross out item 2 of the certification. . Regulations section 1.671-4(b)(2)()(B)) 4:Other payments.You must give your correct TIN,:but you do not '.'i 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 accounthas an SSN,that person's number have previously given an,incorrectTIN.`•'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),payments to 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.DBA•name 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 9N(if youhave one),but the . boat crew members and fishermen;and gross proceeds paid to . IRS encourages you to use your SSN. • • attorneys(including payments to corporations). ..4 List first and circle the natne of thetrust,estate,orpension trust(Do . 5,Mortgage interest paidby you,acquisition orabandonment of not furnish the TIN of tha personal representative or trustee unless the . • secured property,cancellation of debt,qualified tuition program legal entity itself is not designated in the account title.)Also see Special payments.(under section 529),ABLE accounts(under section 529A); rules for partnerships, earlier. . • • IRA,Coverdell 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 riame,is listed,the •TIN;but you do not have to• .sign the certification. • • 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 someone uses your personal information 1:Individual - • ,The individual • ' - such as your name,SSN,or other identifying information,Without your •. • 2.Two or more individuals Quint .The actual owner of the account or,if permission,to commit-fraud or other crimes.An identity thief may use account).other than an account combined funds,the first individual on your SSN to gena job'or may file a tax return using your SSN to receive . • . maintained.byan,FF1 the account' a;refund. .. ' . . 3.Two.or more U.S.persons Each holder of the account• • To reduce.your risk: • ' - : • ' (Joint account.maintained.by an FFI) • •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 preparer. - 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) notice from the IRS,respond right away to the.nameand'phone number b.So-called trust account that is not The'actual owner ' printed on the(RS notice or letter. a• 'legal.or valid trust under state law • If your tax records are not currently affected by identity theft but you e.Sole:propretorship or disregarded The owner' think you are at risk due to.a lost or.stolen:purse orwallet,-.questionable • ' entity owned by an individual. credit card activity or credit report;contact the IRS Identity.Theft Hotline - 7.Grantor trust filing under Optional' : The grantor* at 1-800•;•908-21-490 or submit'Form.14039. Form1099 Filing Method'1(see: .. For more information,see Pub.5027,Identity Theft Information for Regulations section 1.8717'46)(2)0). ' Taxpayers. ; • Victims of identity theft who are experiencing economic harm or a - For this type of account: :. Give name and•EIN of: systemic problem,or are seeking,help inresolving tax problems that. • • s:Disregarded entity not owned byan•• 'The owner have not been:resolved throughrnormal channels,may be eligible for- individual., ' ' ' • . .. . • . Taxpayer Advocate.Seivide(TAS)assistance.You can reach TAS by • 9.A valid trust,estate,'or pensiontrust Legal ent tya' • calling the TAS toll-free case intake line at 1=877-777-4778 or TTY/TDD ' ' .1-600-829-4059. 10:Corporation or LLC electing The corporation • Protect.yourself.from•suspicious emails or phishing schemes. . • corporate status on Form 8832 or •- Phishing is the creation and.use of email websites designed to Form 2553 mimic legitimate;business emails and Websites:The most common act - 11.Association,:club,religious, The organization • 'is sending.anemail to a user falsely claiming to be an established •• • .. charitable-.educational,:or other tax,' : .;.: :. legitimate enterprise in anattempt;to scam the'user into surrendering' exempt organization • - private information that will'be used for identity theft. . 12.Partnership or multimember LLC: The'partnership ' .' • 13:A broker•or registered.nominee ' ;The broker ornoniinee' ' • Form W-9(Rev.10-2018) Page 6 The IRS does not initiate contacts with taxpayers via emails.Also,the Privacy.Act Notice does not request personal detailed information through email or ask • ' taxpayers for the PIN numbers,passwords;or similar secret access Section 6109 of thelnternal Revenue Code-requires'you to provide your information for their credit card;bank,or other financial.accounts. correct TIN to-persons(including federal agencies)who are required to. • If you receive an unsolicited email claiming to be from the IRS, file information returns with the IRS to.report interest,dividends,or forward this message to phishing©irs.gov.You may also report misuse Certain other income-paid to youmortgageuedpertrethe cancellationt paid;the of the IRS name,logo,or other roe to the TreasuryInspector acquisition or abandonment of secured property;the of" g p p rh! P debt or contributions you made town IRA,ArcherMSA,or HSA The General for Tax Administration(TIGTA)at 1-800-366-4484 You can person collecting this form uses the information on the form to file forward suspicious emails to the Federal Trade Commission at information returns'with the IRS,,reporting the aboveinformation. spamtiucegovv or report them at www.ftc.gov/complaint:You.can Routine uses of this information.include giving it to the Department of contact the FTC at www.ftc.gov/idtheft.or 677-IDTHEFT(877-438-4338).. Justice for civil and criminal.litigation and to cities;states;;the District of If you.have been the victim of identity theft,see www.IdentityTheft.gov Columbia,and U.S.commonwealths.and possessions for.use in arid Pull.5027: • administering their laws.The information also may be disclosed to other Visit www irs.gov/IdentityTheft.to learn.more about identity theft,and countries under a treaty,to federal and state agencies to enforce civil . how to reduce your risk. and criminal laws,or to federal law enforcement and intelligence agencies to combat,terrorism.You mu• st.provide,your TIN.whether or • • not you are required to'file a'tax return. Under.section 3406 payersr :: . must generally withhold a percentage of taxable interest,dividend,,and certain other payments.to:a payee who'does not.give'a TIN to the payer. Certain penalties may:also apply for providing false or fraudulent - information... • FY 2018 Miami-Dade County Homeless Trust Continuum of Care (Co C) Program "Affidavits and Declarations". ATTACHMENT D "Affidavits and Declarations" Miam =Dade Co-unty's Affidavits and:Declarations. • MIAMI-17 DE . . COUNTY \ . Miami-Dade County requires each party desiring to enter into a contract with Miami-Dade County to, • (1) Sign an affidavit as to certain matters and (2) make a declaration as to certain other matters This 'form contains both.Affidavit forms for matters requiring the entity to sign under oath and Declaration forms formatters requiring only an:affirmation or declaration forother matters. - Each section of this.forin must be read, and initialed in the top right hand box indicating acceptance and/or compliance with the County's policy related to the particular affidavit.For affidavit sections that you do not believe are applicable to your organization,please indicate this by placing"Q"in the box next to ALL SECTIONS MUST BE COMPLETED • THE FOLLOWING MATTERS REQUIRE THE ENTITY TO SIGN AN AFFIDAVIT UNDER OATH: STATE OF:( 1briec. ) COUNTY OF( 1\-)k.1 GLM.(`=bc-j ) :COUNTRY.OF Or 1. .. Before me the undersigned,authority appeared 7s. [Print Name), J C±~ 1., - . . who i ersonally:known o me .or who has:provided �. �. P as identification and who did swear to the following: —. c . , - That he or she is the duly authorized representative of(Name of.Entity) 6+1 6 3 y Clia.(\.ct. E C.Irl (Address of Entity).._, l iOC?• .Cbl1 v-e'cl s a(ke 1r brl V 1 -t cuvl_t k Post .Office addresses arenot acceptable . . 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 saysfor:the following'fifteen[16)Affidavits and Declarations:,. ATTACHMENTD"Mia i Dade CountyAffidavitsand,Declaratioins Page 1.of 11; : Miami-Dade County's.Affidavits and Declarations , 1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT(SECTION 2-8.1 Pertains OF THE COUNTY,(ODE) : If the contract or business transaction is with a corporation,the full legal name and business address shall`be. provided for.each officer and director and each stockholder who holds directly or indirectly five percent(5%) or more of the corporation's stock If the contract or business transaction is with a partnership,the foregoing information shall be provided for each partner.. If the contractor business transaction is with a trust,the full legal name and address shall be provided for each: trustee and each beneficiary. The foregoing requirements shall not pertain to contracts with publicly traded. corporations or to contracts with the United States or any departmentor agency thereof,the.State orany pohticalsubdivision or,agency thereof:or any municipality of this State. All such names and address'are outlined • below:Post Office'addresses are not acceptable, (Fail Legal Name,Address,%Ownership). (Full Legal Name,=Address,%Ownership) (Full Legal Name,Address,%Ownership) (Full Legal Naine,Address,%.Ownership) The full legal navies-and business address of any other individual(other than subcontractors,material person, suppliers,laborers, orlenders)who:have,or will have;any interest.(legal, equitable beeficial or otherwise)in the contract or business transaction with Miami Dade County are:. Post office addresses are not acceptable Any person who willfully fails to disclose the information required-herein, or who knowingly discloses false information in thus;regard,shall be punished by a fine of up to five hundred dollars ($500.00).or imprisonment in jail for up to sixty[60) days or both: • • • ATTACHMENT D 'Miami Dade Cax�nty Affidavits and:Declarations" Page:2 of 11. :.;,. • Miami-Dade County's`Affidavits ax d Declarations 2. MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT(COUNTY ,,;Pertains O ORDINANCE 90-1_33,AMENDING SECTION 2.$-1;.SUBSECTION(d)(2) OFT1-1 COUNTY.CODE) Initialfry ..� Except where precluded by Federal or State laws or regulations,each contract or business transaction or renewal thereof which involves theexpenditure of then thousand dollars.($10,000) or moreshall require the entity contracting or transaction business to disclose the following information. The foregoing disclosure requirements do not apply to contracts with the United States or any 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? Cl Yes Q No Does your firm provide paid healthcare benefits for its employees? (*Yes :D No Provide a current breakdown (number of persons) of your firm's work force and ownership (below): White _ Males .30 Females : Black: . .:Males 3203 Females.' j ( c' Hispanic Males Females ��C� (0 Females Asian:: Males American Native: Males 3 Females. Aleut(Eskimo):.. Males: Females • ATTACHMENT D.'MiamirDacde Coun.tyAffidavits and Declarations" Page 3 of 11 • Miami-Dade County's Affidavits and Declarations 3. MIAMI-DAD:E COUNTY AFFIRMATIVE ACTION`/ NONDISCRIMINATION OF EMPLOYMENT PROMOTION AND Pertains.: PROCUREMENT PRACTICES (COUNTY ORDINANCE 98-30 CODIFIED !N/A- ��®� Initial:(:�,a AT 2-8.1.S OF TIS COUNTY CODE) :. ..::: :. Pursuantto Miaini=Dade County's Ordinance No. 98-30,Section 2-8.1.5, entities with annual gross revenue in excess of$5,000,000 seeking to contract with the County shall,as a condition of receiving a County contract,have: 1) a written:affirmative action;plan which sets forth the procedures the entity utilizes to assure that it does not discriminate in its employment and promotion practices and 2) a written 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 review to determine their effectiveness in assuring the entity does.not : discriminate in its employment,promotion:and procurement practices.The foregoing;not withstanding,corporate entities whose board ofdirectors are representative of the population make-up of the nation shall be presumed to have non-discriminatory employment and procurement policies;and shall not be required to have a,written affirmative action plan and procurement policy in order,to receive a County contract.The foregoing.presumption . : May be rebutted.The requirementsof this section may be waived upon written recommendation of the County • Manager that it is in the best interest of the County to do so and approval of the County Commission by majority vote of the members present Based on the above,please complete the affidavitas directed and return the completed affidavit alongwith a cover letter on your company's letterhead,listingthe company's address,phone and fax numbers,and any required documents,to:Miami-Dade County;Department of Procurement Management Affirmative Action Plan Unit 111.NW 1st Street,13th Floor Miami,FL 33128. . Yes Q No My company has an affirmative action plan and procurement policyand is available for review. • Mycompany has annual gross revenues in excess of$5,000,000:• Yes O No E Therefore,our company's affirmative action plan and procurement policy. is available for review. Yes O .No D My company has annual gross revenues less than$5,000,0.00. ' If at anytime the Miami Dade County has reason to believe that any person or firm has willfully and knowingly provided incorrect information or made false statements,the County may refer the matter to the State Attorney's Office and/or other investigative agencies:The.County,may initiate debarment and/or pursue otherremedies in accordance with Miami-Dade County policy and/or applicable federal,state and local.laws.. . . . PertauisO 4. MIAMI-DADE COUNTY CRIMINAL RECORD AFFIDAVIT (SECTION 2-8.6 OF THE COUNTY CODE) o . .. .. .... ., . . .. ... ......... ... Initial- � t'. The individual or entity entering into a contractor receiving funding-from Miami=Dade County O has . J has not-, . as.of the date of this affidavit,been convicted of a felony during the past (10) ears: `.: • tenY An officer,director, or executive officer of the entity:entering into a contract or receiving fundi.ng.from Miami-Dade County 0 has tXhas not as of the date of this affidavit been convicted:of a felony during the past:ten (10)years.. ATTACHMENT..D"Mianu-Dade County Affidavits and:Declarations"; .. Page 4 of.11 • Miami-Dade.County's Affidavits and Declarations 5. PUBLIC ENTITY CRIMES AFFIDAVIT(SECTION. Pertains • 287.133(3)(a), FLORIDA STATUTES) 'N/A Initial�h`�' • The individualor entity entering intoa contract or receiving funding from Miami-Dade County understands 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 person with respect to and directly related to the transaction of business with any public:entity or with an agency or politicalsubdivision of any other state of the United States of America,including but not limited to,any bid or contract for goods or services to be providedto any public entity or an agency or political.sub'division of any other state of the United.States of America and involving antitrust,fraud;theft,bribery, collusion,racketeering,conspiracy, or material misrepresentation. • That"Convicted" or"conviction" as defined in Paragraph 287.133 (1) (b) Florida Statutes means a finding of guilt or a conviction of a public entity crime,with or without an adjudication of guilt,_in any federal state trial court of record relating to charges brought by indictment or information after July 1; 1989,as a result of a jury verdict,non jury trial,or entry of plea of guilty dr nolo contendere. That an"affiliate"as defined in Paragraph 287.133 (1) (a)Florida Statutes means a) a predecessor or successor of a person convicted of a public entity crime; 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,employees,members,and.agents who are active in the . management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or pooling of equipment:or income amongpersons when notfor.fair market value under anarir's•length agreement,shall be a prima facie case that one person controls another person. A personwho knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 monthsshall be considered an affiliate. • That a"person"as defined in Paragraph 287.133 (1) (e)Florida Statutes means any natural person or entity . organized:under the laws of any state or of the United States of America with the legal power to enter into a binding contract and which bids or applies to bid on contracts.for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity The•term"person" includes those officers,directors,exectitives,partners,shareholders, employees,members and agentswho are active in themanagement of an:entity. • Based,on information and belief,the statement as:marked below,is true in relation to the entity submitting this Swornstatement: (Please•indicate which statement applies by applying the individual initials;near the box). . Neither the entity submitting this sworn statement nor any of its officers,directors, executives,partners, • shareholders, employees,members or agents who are active in the,management of the entity,nor an affiliate:of the entity has been charged with and convicted of a public.entity crime within the past 36 months. • • 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 the:management of the entity,or an affiliate of the entity has been charged with and convicted of a public entity crime within the.past 36:.months,and • Oyes an additional statement is applicable or O:rio an additional statement is not applicable: • . . OThe entity submitting this sworn statement, or one or more of its officers,directors,executives;pai• tiers, . shareholders; employees,members,or agents who are active in the management of the entity has been charged • With:and convicted of a public erititycrime within the past 36:months. However,therehave been.subsequent proceedings before a Hearing Officer of the State of Florida,-Division of Administrative Hearings and the Final,: Order entered•by.the Hearing Officer determined thatit was not in the public interest to place the entity submitting this sworn statement.on the"Co• nvicted Vendor List". The individual or entityy entering into.a contract or receiving funding from Miami-Dade County understanOthat he or she is required to inform the public entity prior'to entering into a contract in excess of the threshold amount provided.in Section 28.7.017 Florida'Statues for Category 2 of any change in:the information contained in this form. • • ATTACHMENT D'Miami Dade.Comity.Affidavitsarid Declarations"` .'-Page• 5 of Miami-Dade County's Affidavits andDeclaration5 • 6.MIAMI7DARE EMPLOYMENT FAMILY LEAVE AFFIDAVIT . Pertains O . (County Ordinance No.142=91 codified as Section 11A-29 et. • seq of the County Code) Initial That in compliance with Ordinance No.142-91 of the Codeof Miami-Dade County,Florida,an employer with.fifty • (50) or more employees working inDade County for each working day during each,of twenty(20).or'more calendar work weeks,shall provide the following information in compliance with all items in the aforementioned ordinance: An employee who has worked for the above firm at least one (1)year shall be entitled to ninety(90) days of family leave during any twenty-four(24)month period,for medical reasons,for the birth.or adoption of a child,or for the care`of a child,spouse or other close relative who has a serious health condition without risk of termination of employment or employer retaliation: The foregoing requirements shall notpertain to contracts with the United States or any department or agency thereof, or the State of Florida or any political subdivision or agency thereof It shall,however,pertain to Mufti cipalities of this State. • • • 7. MIAMI-DADE COUNTY DISABILITY NONDISCRIMINATION Pertains O • AFFIDAVIT (County Resolution R-385=95) N,A.. ./40.• - Initial That the above named• firm,corporation or.organization is in compliance with and agrees,to continue.to comply with,and assure that any subcontractor,or third party contractor under this proj,ect.complies:with all applicable requirements of the laws listed below including,but not limited to,those:provisions:pertaining to employment, provision Of programs and services;.transportation,communications,access to facilities,renovations,and new construction:in the following laws;The Americans with Disabilities Act of 1990 (ADA),Pub.L. 101-336, 104 Stat. 327,.42 U.S.C. 12101-12.213 and 47 U.S. C.Sections 225 and 611 including Title I,Employment;.Title:II,Public. Services; Title III,Public Accommodation and Services Operated by Private Entities;Title IV,Telecorniniunications; and Title V,Miscellaneous Provisions:The Rehabilitation Act of 1973;29 U.S.C. Section 794:.The Federal Transit : . Act,as amended 49'U`:S.C.Section 1612:The Fair Housing Act as amended,42 U.S:C.Section.3601-3631.The' foregoing requirements shall not pertain to contracts with the:United States or any or agencythereof; or the State or,any political subdivision or agency thereof or.any municipality.of this State. . • 8;MIAMI-DARE COUNTY REGARDING DELINQUENT AND CURRENTLY DUE , Pertains O N/A FEES OR TAXES(Sec..2-8 1(c) of the County Code) Initial Except forsmall purclase orders and sole source contracts,that above named firm, corporation;organization or individual.desiring.to transact business or enter into a contract with the County verifies that all delinquent and : currently due fees or taxes--including but not limited to teal"and property taxes,utility taxes and occupational licenses--which are collected in thenormal course by the Dade County Tax Collector as Well as Dade County' issued parking tickets for vehicles registered in the name of the firm; corporation,org anization or individual have_ • been_paid. • ATTACHMENT.D"Miami-D:ade CountyAffidavits and Declarations' Page of of`11. • • Miami-Dade:County's Affidavits and Declarations - • • . - - - • .Pettaiii O- 9. CURRENT ON ALL COUNTY CONTRACTS,LOANS AND OTHER OBLIGATIONS N/A: Inrti074 ��sy The individual entity seeking to transactbusitess 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 withthe County or any of its agencies or•instrumentalites.. • • • 10. .DOMESTIC VIOLENCE LEAVE(Resolution 185 00; 99-5 Codified At 11,A- Pertains O; :-60 Et:Se of the.Miami-Dade�Coun y Code . .__. - _ _-- -. , • N/A p q� , t3' T • Lmtial brio The firm desiring to.. do with the County is in compliance with Domestic Leave Ordinance,Ordinance 99= 5, codified at 11A-60 et.-seq.of the Miami Dade County Code,which requires 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 workweeks in the current or proceeding calendar years,to.provide Domestic Violence:Leave to its employees: . 11. MIAMI-DADE:COUNTY EMPLOYMENT DRUG=FREE WORKPLACE Pertains O AFFIDAVIT(County Ordinance No '92-15 codified as Section"2 N/A • 8.1.2 of the County Code) . .• - - • Initial�i� - • That in compliance 'N with Ordinanceo.-92-15 of the Code of Miami-Dade County,Florida;,the above named person or entity isproviding a drug-free workplace..A written.statenient to eachemployee,shall informthe employee about: 1. - dangersof drug abuse:in the workplace; " 2: • the firm's policy of maintaining a drug-free environment at all workplaces;- " 1 availability of drugcounseling,rehabilitation and employee assistance programs, " - - 4. _- penalties that Maybe imposed upon employees for drug abuseviolations.. -Theperson or entity shallalso:require an;employee to sign a statement,as sa condition of employment that the • employee•will abide by the terms and notify the.employer of any.criminal drug conviction occurring no later than five(5) days after• .receiving not• ice of such-"conviction'and impose appropriate personnel action against the • em•ployee:up to and.incl• uding terriination. •• • . . Compliance with.Ordinance No. 92-15 maybe waived if the special:characteristics-of the product or service offered . by-the person or ent.�tyMake<itnecessaryfo'r the Operation of the County or for:the health,safety,welfare economic benefits and well-being of the public:Contracts involving funding which is,provided in whole•or;in partby the _. United States or the State of Florida shall`be.exempted from the.provisions•of.this ordinance ui those instances where those provisions are in conflict with the requirements of those governmental entities - . ATTACHMENT O:"Miami•Dade County Affidavits and Declarations" Page 7,'of 11 Miami Dade County's Affidavits acrd Declarations 12. ATTESTATION REGARDING DUE AND:PROPER ACKNOWLEDGEMENT OF Pertains O` N/Ar COUNTY FUNDING SUPPORT ' By initialing this subsection and accepting County funds,the above.named firm,corporation,organization or individual agrees to abide by the grant contract requirement to recognize:and acknowledge Miami-Dade County's grant support in a manner commensurate with all contributors and sponsors of its activities at comparable dollar levels. • • 13:MIAMI=DADS 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 N/A SOURCES,AND DUE DILIGENCE CHECK Initial Pursuant to Miami-Dade County Resolution No.R-630-13,requiring a detailed projectbudget,sources and uses statement, certificationsas'to past defaults on agreements with non-county funding sources and due diligence: • check prior to the County Mayor or County Mayor's designee recommending a commitment:of Miami-Dade County funds to Social Services,Economic Development,Community Development,and Affordable.Housing Agencies-and Providers. The undersigned entity certifies,to the best of his or her knowledge andbelief,that 1. Within the.past five'(5)years,neither the.Agency nor its directors,partners,principals,members.or board members: , (i) have been sued by a funding source for breach of contract orfailure to perforin obligations under a _ contract; have been cited by a funding source for non-compliance or defaultunder a contract' (iii) have been a defendant m a lawsuit based upon a contract with a-funding source.: Please list any which prohibit the Agency from making the certifications`required and explainhow the matters arebeing resolved(use separate sheet if necessary): Pertains; O' 14.:MIAMI DARE COUNTY RESOLUTION No R-478 12 NOT TO.USE PRODUCTS N%A OR FOODS CONTAINING:"PINK•SLIME", Initial 'e r� , Pursuant to Miami Dade•County Resolution No...R-478-12,the Undersigned certifies,not to use meat products containing"Pink Slime"info provided or served as part any food�prograin,urging allwho provide food services or operate a fOO dr program toimmediately discontinue using meat products containing slime"in.fo"od providedor;served:in these programs ATTACHMENT:D"Miami-Dade County Affidavits and Declarations" Page 8 of 11.;... • • • • • . Miami=Dade County's Affidavits and Declarations • 15.MIAMI-DADS COUNTY REQUIRED LOBBYIST REGISTRATION FOR Pertains O. .ORAL PRESENTATION Section 241.1(1)(2) CONFLIC T.OF INTEREST • N/A, : r; • AND CODE OF ETHICS ORDINANCE Innti.. jag All lobbyists shall register with the Clerk of.the Board of Comity Commissioners within five (5)business days of • • being retained as a lobbyist or before engaging in any lobbying activities,whichever shall:come:first.Every person • • required to so register shall: 1.Register.on forms prepared by the Clerk; .• 2.State under oath his or°her name,business address and.the name and business address of.each person or entity • which has employed said registrant to lobby.If the lobbyist represents a corporation,the corporation shall also be identified:Without limiting the foregoing,the lobbyist shall also identify allpersons holding,directly:or indirectly, • • a five•(5) percent or more ownership interest in such corporation,partnership, or trust:Registration of all • • ..•lobbyists shall be required prior to January 15 of each year and each person whowithdraws,as a lobbyist fora particular client shall file an appropriate notice of withdrawal. • • • . 3.Prior to conducting anylobbying,all principalsmust file a form with the Clerk of the.Board*of:County • Commissioners,signed by the principal or the principal's representative,stating that the lobbyist is authorized to . represent the principal:_Failure of.a principal to file the form required by the preceding sentence may be considered in the evaluation of a bid or proposal as evidence that a proposer or bidder is not a responsible • contractor:Each principal shall file a form with the Clerk of the.Board at the point in time at which a lobbyist is no longer authorized to represent the principal. • • )Ey initialing here,the principals or principal's representative have filed with the Clerk of the Board of County Commissioners stating thata lobbyist is authorized to represent the principal. 4.'Anypublic officer,employee or appointee who only appears in his or her official capacity shall not be required to register as a lobbyist. = —5 Anyper-son who-only app earsinhis' ir-her-ndivi..d-ual-capacityforthe-purpose-of seWrepresentation-without-= -- compensation.orreimbursement,whether direct,.indirect or contingent,to express support ofor opposition to any item,shall not be:required to register as a lobbyist. • •• . • 6:Any person who only appears as a representative of a not-for-profit corporation.;or entity(such as.a.charitable : organization,or a trade association or trade union),.without special compensation or reimbursement for the appearance,whether direct;indirect or contingent,.to express•support of or opposition•to any item,shall.register with the Clerk as required by the Ordinancesubsection,but,uponrequest,shall not be required to pay any 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 fineand 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 tofile the required disclosure.form.The Commission on Ethics and Public:Trust shall have the authorityto waive.thefine,in whole_or part,•based.on goodcause shown.•The Commission'op.Ethics and.Public.Trust shall have the authority to adopt rules of procedure regarding appeals from . the Clerk of the Board of County.Commissioners . • . - Except as otherwise provided iii subsection of the Ordinance,'the validity of any action or determination of the Board of County Commissioners or County pers•onnel,board or committee shall notbe affected by the failure of;any • person to comply with the provisions of this subsection(s). (Ord:No .00-19,§1,2:.-B.-,Q0; Ord.N :01 93,§ 1,5-22 01;s Ord No 01-162, §1;10:-.2.3.:01.; OrdNo.03 -107,§1,5-.6-0.3) • ATTACIIMENiami Dad T.D"Me County Affidavits.and Declarations' Page-9 of 11 Miami-Dade County's Affidavits and;Declarations " " Pertains :). 16. Disclosure SUBCONTRACTOR-/SUPPLIER LISTING(ORDINANCE 97-104) N/A : 1 ' • Ini-bal dtte., .. This form,or a comparable-form meeting the requirements.of Ordinance.97-104,must be completed by all biddersand 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 HealthTrust construction contracts'which involve expenditures of$100,000 00 or more: This form or a comparable form meeting the requirements of Ordinance 97-104; must.be completed and submitted even though,the bidder or proposer will not utilize subcontractors ot suppliers on the- contract; " Tlie bidderor'proposer should enter the word "NONE"under the appropriate"heading,in those instances where:no,subcontractors or.. suppliers will be used on the contract, A•bidder or proposer who is: awarded the'contract shall not change or substitute .first tier subcontractors.or direct suppliers or_the portions of the contract WorIc to be performed or materials to be supplied from those identifiedexcept upon written approval of the County: .Business Name and Address, Prin_cipal Owner, Scope of Work to be Performed by (Principal,Owner) of First.Tier Subcontractor/Subconsultant . Gender Race Subcontractor Subconsultant. - A(ne_. • Business Name and Address Principal:Owner: Supplies/Materials/Services to be (PrincipalOwner) • of Direct Supplier Provided by Supplier Gender Race. I certify that th- :se. tions contained in this Subcontractor/Supplier Listing are to the best of my knowledge true and acc Signa ''ofAutliorized 'epresentative Date - • ( 4 rri rr► ): ( e i [ i7r®rrPrint e Pri tTitle ) (Duplicate if additional space is needed). " ATTACHMENT>D 'Miapn Dade County Affidavits andDeclarations" , .Page.10 of 11 Miami-Dade County's Affidavits and Declarations MIAMI- COUNTY IAMaCOUNT°( I have carefully read this entire 11-pagedocument 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 AFFIDAVITS AND DISCLOSURES 1-16 MIAMI-DADE COUNTY AFFIDAVITS SIGNATURE PAGE By: .(i,1 !, ' ; . (0/4 , 20 `9 Signature-• W ,.e . it Secretary Seal Date tkrzr'` — (a cv0.3Z Signature if Affiant Federal Employer Identification Number 4-i r rroe. . rccL 0441 of Uearni re-aet Printed Name of Affiant and Name of Agency I D (or ,i4jO,1 Q91)-fer /414r tr ; ad' Address of Agency . SUBSCRIBED AND SWORN TO(or affirmed)before me thiso21ty of t , 20 19 He/She 's personally known o me or has presented - as identification. Type of identification )\1(1).- it14 -cFe7k Signature of Notary - Serial Number - • Print or Stamp Name of Notary _ _ Expiration Date 0011111111///J/ Notary Public-State of Pio(' �Q �� ap:� oPnr'Ko .•�gER41Oi County of 1\.1..Caw'('-� -e- =7o r r. • #GG 222716 i2% ..c e0nded k/`1,;K•� s 'PA+ sic UV. •� 41 /11111N1 ATTACHMENT b"Miami-Dade County Affidavits and Declarations" Page 11 of 11. FY 2018 Miami-Dade County Homeless Trust Continuum of Care (CoC) Consolidated Financial Records Performance Reports ATTACHMENT E"Financial Records&Performance Reports" Agency Letterhead mok Date Attention:Assigned Contracts Officer Miami-Dade County Homeless Trust Suite 310,27th Floor 111 NW First Street Miami,Florida 33128 Subject FY 2018 US HUD CoC Program #FL0000L4D0018 Program Name Name of Agency is respectfully submitting for your review and release of payment of the enclosed Consolidated Financial Record and Reports for the above subject program. We request reimbursement in amount requested is$0.00 for themonth of Month.yyyy. The following documents are included in this checklist outlined below: O Cover Letter O. Performance Report-0625 HUD CoC Monthly HMIS generated Report O Homeless Trust Invoice O HUD form 27053-A SNAPS Request Voucher for Grant Payment O Summary and Compliance Report O Attachment E-Program Income Report O Supporting documents for invoice requirements and match including invoices,cancelled checks,payroll,time and effort logs,and if applicable copy of Tenant paid utility bills consistent with utility allowance,documentation of match expenditure compliance consistent with OMB Omni or Super Circular and 24 CFR 578. The value of the match demonstrated is$0.00. The amount of program income(if applicable) is$0.00. This is an adjustment#()for the month of Month.yyyy . On behalfof our homeless community members who benefit from this program,we thank you for your time and assistance.. Please call(305) 000-000 extension 0 or email address xys(a xys.cozii with any concerns or commentsabout this reimbursement package. Sincerely, Name Title Enclosures Attachment E"Consolidated Financial Record and Reports Cover Letter • • Miami-Dade County Homeless Trust ATTACHMENT E • LOCSNRS U.S.Department of Housing OMB Approval No.253S-0102 SNAPS Special Needs Assistance Program and Urban Development • Request.Voucher for Grant Payment Office of Community Planning • Name of Agency Name of program and Development See Instructions and Public Reporting Burden Statement on back , 1.Voucher Number. 2 LOCOS PGM AREA 3.Period Covered by this Request(dates) 4.Type of Disbursement HPAC Partial Final. II-IP 5.Voice Response No.(5 digits,hyphens,5 more)6:Grantee::::::: ' : • • 7.Grant No: 8.Grantee . FLOOOOL4D0018 • A 9.Line Item no. 10.Type of Funds Requested • Amount:(round to nearest dollar) 1010. Acquisition $ 1020 Rehabilitation $ 1021. New Construction $ 1022 Substantial Rehabilitation $ 1023 Moderate Rehabilitation $ 1030 Operating Cost $ - 1040 Rental Assistance $ - 1050 Supportive Services .$ _ 1051 HMIIS Costs 1060 Administratve Cost $ _ 1062 CoC Planning Costs $ 1070' .Child Care 1080. Employment Assistance $ 1090 Relocation. $ 1100 A.-easing $ 1110 Repair&Maintenance • $ • 1111 Prevention(RH). $ 1112 Capacity Building(R. $ . 1120 Other. • $ . Voucher Total:. $ 1 hereby certify that all the information stated herein,as well as any information provided in the accompaniment herewith,is true and accurate • . Warning: HUB will prosecute false claims and statements.Conviction may resultin criminal penalties:(18 US,C.1001.1010,1012;31 U.S.C.3729,3802) 11.Name&Phone Number(including area code)of.the Authorized - 12.Signature: ': - - 113.Date of Request. - - , Person who.called SNAPs System VRS: • •Privacy Statement Public Law 97-255,Financial Integrity Act,31 U.S.C.3512,authorizes the Department of Housing 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 1987,42 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 aroeRs capability prompt deleted.Provision of the SSN is mandatory:HUD uses it as a unique identifier for safeguarding LOCOS from unauthorized access.Failure to provide the information requested may delay the processing of your approval for access to LOCOS.This information will not be otherwise disclosed orreleased outside of HUD,except as permitted by law. • form HUD-270534V Miami-Dade County FY 2018 CoC Program PROVIDER NAME: PROGRAM NAME: MIAMI-DADE GRANT NUMBER:FL0000L4D0018 1.1111 For the month/year off 1 Adjustment#( ) REQUESTED AMOUNT THIS INVOICE LEASING Leasing Structure Leasing Units LEASING TOTAL: $ - RENTAL ASSISTANCE Rental Assistance -Permanent Tenant-Based RA I - Rental Assistance-Permanent Sponsor-Based RA I Rental Assistance Permanent Rapid Re-housing RENTAL ASSISTANCE TOTAL: $ - SUPPORTIVE SERVICES 1.Assessment of Service Needs - 2.Assistance with moving costs - 3.Case Management 4.Child Care 5.Education services 6.Employment Assistance - 7.Food B.Housing/Counseling Services 9.Legal services 10.Life Sidlis training 11.Mentai Health Services - 12.0utpatient Health Services 13:Outreach Servites 14.Substance Abuse Treatment 15:Transportation 16-Utility Deposits • 17.Operating costs for SSD only SUPPORTIVE SERVICES SUBTOTAL: $ - OPERATING COSTS 1.Maintenance and Repair 2.Property Taxes and Insurance I B-Replacement Reserve 4.Buiiding Security • S.Electricity,Gas and Water 6.Furniture 7.Equipment(Lease/Buy) I OPERATING COSTS SUBTOTAL: $ - - HMIS HMIS generated Activities HMIS SUBTOTAL: $ - PROJECT ADMINISTRATION Project Administration costs ADMINISTRATION SUBTOTAL: $ - INVOICE REQUEST AMOUNT • TOTAL By signing this report I certify to the best of my knowledge and belief that the report is true,complete and accurate and the expenditures,disbursements and cash receipt's,are for the purposes and objectives set forth in the terms and conditions of the federal award. I am aware that any faise,fictitious,or fraudulent infrmatio or the omission of any material fact may subject me to criminal,civil or administrative penalties for fraud,false statements,false claims or other offense. Prepared this (date) MIAMI-DARE COUNTY FY 2018 US HUD COC SUMMARY AND COMPLIANCE REPORT Agency Name: - - Program Name: MIAM Grant#FL0000L4D0018 COUNTY Month/year of Service( / Duration:00/00/2019-00/00/2020 • Is this an Adjustment?1# ) • MONTHLY ACTUAL MONTHLY PROGRAM INCOMETOTAL YEAR GRANT FY 2018 COC Program PROGRAM EXPENSE oICE MATCH BENC[DN6RK -TTURES AMOUNT AMOUNT LEASING Leasing. Units $ - $- - Leasing Structures - - - ........ ...................... Leasing Units . . Subtotal , $ $ - $: - $ TOTAL LEASING $ - $ • - .$ - $ RENTAL ASSISTANCE • Rental Assistance : . Units $ . $ - TRA SRA ............... _ .............. .. SRO ' Program Income to Landlords - - - - .. _ . . - . . Rental Administration costs - Subtotal - $ - $ , $ - $ •:•':•.•.-:•:-:•:•:::•:-:-:•:,:-::•:•:-:-:-:-..•:•-:.•:•:•:•:•:-:•-:•:-.: TOTAL RENTAL ASSISTANCE $ - $ - $ $ .. ... .. ... . . SUPPORTIVE SERVICES L Annual Assessment .FTE 1 $S. staff salary . % . - - _ Taxes&Fringe . - - - - Subtotal $. - $ $ - $ >:•::•:•:•:•:•:•:::•:•: 2:Assistance Moving Costs - $ - $ - Supplies to transition ' - - moving expenses •. - - Subtotal .$ - $ - .$ . - . . ........ .. • 3.Case Management .FTE : $ $ staff salary. % . - - - Taxes&Fringe • - Obtaningbenefits . - - ................ : :••••.*:::.::,:-.':::.::.:.::'•.: ::::.:*:: Subtotal'.. .. .: $ < $ . - $ 4:Child care • $ - $ Childcare vouchers $ - $ - $ - Meals and Snacks in childcare $ $ - $ .. . .. . • Subtotal $ - $ $ - : 5.Education Services '' • . FTE $ , - $ staffsalary % - - - Taxes&Fringe .. • ' • - - - education supplies • - - ...............:•:•:-:•:•:•:-•:::•:•:•:•:•:•.:•:•:•: . Subtotal $ - $ $ : .6..Employment/'Training . FTE $ • - $- - staff salary. . . . % - taxes&fringe. - .. :.• -. - - ...:....................... Computer training .• • . - - - ........ ..... .. .. ... Eligible job Stipends : : . Subtotal. • . • $ - $ - $ - . 7.Food • $ $ Providing meals Groceries . - Subtotal' .. ...$ - $ - $ - • MONTHLY ACTUAL MONTHLY PROGRAM INCOME TOTAL YEAR GRANT FY 2018 COC Program PROGRAM EXPENSE INVOICE MATCH EXPENDITURES BENCHMARK AMOUNT AMOUNT 8.Housing search FTE $ $ staff salary % 1 '•••:•:•:-:•:•:•:-1•:•:•:-.:-:•".,•:•:•:•:•:•:•:•:•:•:•:•:•:-:•:•:•:• - ........_........ . Taxes&Fringe ........ Landlord mediation - - - .....--.._ .••.. •.... "' Rental application fee Credit counseling Subtotal $ - $ - $ - $ 9 Legal services FTE $ ' $• staff salary • % - - Taxes&Fringe '. - - - Subtotal $ - $ - $ - $ • 10.Life Stuns Training FTE $ $ . - staff salary % $ - $ - $ - $ :->:•:-:-:::•::-:•:•:-:-:-:•>::•:•:•:•::f'_:::. Taxes&Fringe $ - $ - $ - $ ”:-:::::•:•:•:•:::•:.:•:•:•:•;•:•: Subtotal $ - $ - $ - $ 11.Mental health services FTE $ . - S. staff salary Taxes&Fringe - �............................................................. '.:.:.:.:.:.:.:.-:-: .:-:.:-::-:.:-::.:- :-:-:.:-:.:.:-::::::: Subtotal $ $ $ $ .•.•.•.•.•.•.•.•.-.•.•.•.-.•.•.•.••.-.•.•,-.•...•.•.•.•.•.•.•.•.•.•.• ......,............................. - ................................... 12.Outpatient health FTE $ ` $ ................................... ................. staff salary % .................................. Taxes.8z Fringe Subtotal $ - $ - $ - $ ...... ................... ...... 13.Outreach Services FTE $ $ " staff salary % .. ........ ..: ... .... ..... .. . ................................... Taxes&Fringe - - - Subtotal $ - $ - $ - $ - 14.Substance Abuse FTE $ -' $ staff salary %- - ......................... . Taxes&Fringe - c.::-:::-:•:,:•:-:.:-:•:-:-:•:-:-::.;-:•:.:•:,:-:::,..-.-:•:-: >:: supplies :.:,>:•:•:-:•:•:•:•:::.:::::::::-.: • ' Subtotal $ - $ - $ $ ••••••.•_ ........... • 15.Transportation $ ' $ ........... .... ................. . Van/gas/maintenance - - Bus Tokens ._..... Subtotal $ - $ - $ - $ 16.Utility deposits $ $ - one-time fee _ - - - • Subtotal $ $ $ $ 17.Direct provisions of $ - $ • Operational costs for SSO only - - - ..-...-.•• ..... .. . ......... Subtotal $ - 55 - - $ - $ - .......... ....... .............. . TOTAL SUPPORTIVE SERVICES $ - $ - $ - $ Pa aP 7 of MONTHLY ACTUAL MONTHLY PROGRAM INCOME TOTAL YEAR GRANT FY 2018 CoC Program pROGRAM EXPENSE INVOICE MATCH EXPENDITURES BENCHMARK AMOUNT AMOUNT OPERATIONS . 1.Maintenance&Repair .FTE $ - . $ - staff salary % - - : :: ....:::: Taxes&Fringe - - supplies - Subtotal $ - $ - I S $ 2.Property taxes,insurance $• - $ tax - - - ........... .. : insurance _ .•.. :: :: .......... • Subtotal $ - $ 3.Reserve Replacement - $ ........... ............ major systems reserve $ . - S - $ - $ FTE $............ :::::2-.:.-.:-.:-..:...:-.-::.::.:•..-..•.:•.:h::.: 4iBuIdingsecurity . . . staff salary % $ - $ - $ - $ Taxes&Fringe $ $ - $ - $• :::::. . subcontracted security $ $ - $ - $ Subtotal . $ - $ - $ - I $ - ....................... ........ 5.Rleclricity,gas and water $ - $ - utilities - - . Subtotal $ - $ $ - $ - ...::-:-::•:-:'.:::•... • •.•.•.•.:.:::::::....... 6.Furniture $ furniture - I I - ..................... .. • Subtotal ' $ - $ - $ - I $ - ........... .................... . 7.Equipment $ - $ - • operational equipment - Subtotal• $ - $ - $ - $ TOTAL OPERATION $ $ $ ..................•. HMIS COSTS HIVIIS $ . - $ - HMIS staffsalary % $ - $ - $ - $ .• TOTAL HMIS COSTS . $ - $ • - $ $ PROJECT ADMINISTRATION • . Project Administration FTE $ 7 $ - staff salary % $ - $ - $ - $ staff salary . : % .. •• $. - $' • - $ $ ` Taxes&Fringe - $ ' $ $ $ •Travel to monitor $ - $ - $ - $ - ..... •:•:•:•:•".•:•:-:•:•:•:-.:•.:•:•:•:•:• 3rd Party Administration $ • - $ - .$ - $ .......... ................. Audit $. -. $ - $ - $ ................ .. .. ... . 'Administrative office space $ - $ - $ - $ CoC Trainirig .. $ $ - $ .............. TO TALADMINISTRATION $ - - $ - $ - $ • ACTUAL MONTHLY INVOICE MATCHPROGRAM INCOME MONTH BENCHMARK TOTAL YEAR GRANT PROGRAM EXPENSE EXPENDITURES AMOUNT AMOUNT TOTAL $ _, . $.. . $ $ - $ - $ - Bysigiiing this report,I_certifyto thebest.of my linOwledge and beliefthatthe report is true,complete and accurate and the expenditures,disbursements and Cashreceipts are for the purposes and obj eatives set forth in the terms and conditions of the federal award.' I am aware that any false,fictitious,or . fraudulent information or omission Of any material fact,may subject me to criminal;civil or administrative penalties fdr fraud,false statements,false claims Or other offense: . • - - • •Prepared this( )thin/dd/yyyy :. Certified by:( •)Signature Print Name and Title( ) Page3of3 • FY 2018 CoC TRACKING CHART -for Agency Internal Use Only Agency Name: Program Name: Grant#FL0000L4D0018 Duration: 00/00/2019-00/00/2020 LEASING RENTAL DATE PAYMENT SUPPORT OPERATIONS HMIS ADMIN TOTAL MATCH DATE SUBMITTED ASSISTANCE RECEIVED 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 5 --- month 6 -- month 7 - month 8 --- month 9' --- month 10 - - - - - - - - month 11 - - - - - - - - month 12 - - - - - - - - SUBTOTAL $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL REMAINING $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 %USED #DIV/0! #DN/0! #DIV/0! #DIV/0! #DIV/0! #DN/0! #DIV/01 #DIV/0! %REMAINING #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! Prepared by 2/20/2019 Income&Rent Option 1 Project Sponsor Grant Number • Last Name .First Name HMIS# Annual I • ncome AL J Annual amount not monthly $ - Supplemental Security Income SSI _ $ - Social Security Disability Income SSDI _ $ - Social Security • $ - General Public Assistance - Temporary Aid to Need Families TANF • $ - Salary from employment $ - Child Support $ - Veteran Benefits $ - Employment Benefits $ - Other 1) Subtotal Income S - formula will add rows • 2) Income Exclusions Enter income exclusions 3) Annual Income $ - • C. _;Adjusted Income S Dependant Allowance . 4) 0 Number of dependants 5) 0 Multipies by$480 Child Care Allowance — 6) _Anticipated Unreimbursed Expenses Disabled Assistance Allowance 7) Disabled Assistance Expenses 8) 0 Multipies Line 3 by 0.03 : 0 Subtract Line 8 from Line 7 Member earnings which were dependent on 10) assistance 11) Lesser of Line•9 or 10 _ Medical Expenses/Eidetly Family Allowance 12) List total for medical expenses 13) if row 9>0 enter line 12 otherwise(7+12-8) 14)if PSH add$400.00 . $0.00 Elderly/disabled Adult Allowance Adjusted Income 15) $ - add rows 3,5,6.,11,13,&14 16) $ - row 15.-3 Resident Rent Determination 17) 30%of Monthly Adjusted Income $ - divide row 16 by 12 multiply by 0.3 18) 1.0%•of Monthly Iiicoine 0 divide.row 3 by 12 multiply by 0.1 • 19) Portion of Welfare not applicable in State of Florida if utilities are NOT included in the lease complete • 20) Resident Rent below UtilityAllawarice Utility Allowance chart . $ - PHCD list schedule of utility allowances water/se-wer/trash if not included in lease 21)TOTAL UTILITY ALLOWANCE $ - •• Rent with Utility Allowance 22)Resident Rent $ - row 21-row 20 Client Pays no rent $ - if row 22<0 23) Utility Reimbursement .` S - Payment made to.Utility Company only Maintain ad rental calcuation documents in file/review rental amounts at lease annually and more often if rent will decrease/meet financial management responsibilities for receipt and expenditure of rent/monitor for COMPLIANCE and QUALITY CONTROL Miami-Dade County Homeless Trust Income Determination/ Rent Calculation ATTACHMENT E Participant/ HMIS: Unit/Address: 1) $ - Income 2) $ - Income exclusion 3) _ $ - Annual Gross Income Calculating Adjusted Income Dependent Allowances 4) - Number of Dependents 5) $ - Multiply line 4 by$480 (Child Care Allowance) Child Care Allowance 6) $ - Enter anticipated unreimbursed Child Care expenses Disabled Assistance Allowance 7) $ - Disabled Assistance Expenses 8) $ Multiply Line 3 by 0.03 9) $ - Subtract Line 8 from Line 7 Amount earned by household members which was 10) $ - dependent upon Disabled assistance expense 11) $ - Enter the Lesser Amount of Line 9 or 10 Medical Expenses/Elderly Household Allowance 12) $ - Medical expenses if line 9 is less than zero, enter the amount from line 12, 13) $ - - otherwise add lines 7 and 12 and subtract line 8 14) $ - Elderly or Disabled Family Allowance enter$400 Adjusted Income 15) $ - Total Income Adjustments(add lines 5, 6, 11, 13&14) Adjusted Income (subtract line 15 from line 3) Resident 16) $ - Rent Determination Occupancy Amount Determination- Program Income 30% of Monthly Adjusted Income 17) $ - (Divide Line 16 by 12& Multiply by 0.3) 10% of Monthly Gross Income 18) $ - (Divide Line 3.by 12 and Multiply by 0.10) 19) N/A Welfare rent, not applicable in State of Florida 20) Resident Rent- largest of line 17 or 18 Determining Occupancy Amount for Units where Utilites are not included 21) $ - Utility Allowance (published by PHCD) 22) $ - Resident Occupancy Charge - Program Income 23) $ - Utilities Reimbusement** ** If the amount on line 22 is less than 0, 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 provide documentation of paid utilities. Program Income REPORTING;AGENCY: PROGRAM NAME: • GRANT NUMBER: FL0000L4D0018_ MIAMI.!.�_i: TOTAL MONTHLY PROGRAM INCOMEtlr-MgglPl9 SERVICE MONTH: Month/2019 COUNTY TOTAL GTD PROGRAM INCOME $ 3,615.00 ACTUAL AMOUNT Total Annual Total Monthly Bld/unit 30%adjusted . Grant-to-Date(GTD). HMIS# Tenant Name Adjusted or ted or Gross Adjusted %Contribution address . or 10%gross TENANT RETAINS LANDLORD/ 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 .113 (new in progam)last name,first $ 12,000.00 $ 1,000.00 $ 300.00 $ 700.00 $ 300.00 •30% $ 300.00 3 2A (in 6 months).last name,first $ 21,600.00 $ 1,800.00 $ 540.00 $ 1,300.00 $. 500:00 28% $ 3,000.00 4 2B last name,first $ $ - $ - $ - $ - #DIV/0I $ • 5 3A last name,first $ $ $ $ $ #DIV/0! $ 6- 3B • last name,first :$ - $ - $ - $ $ - #DIV/0! $ - _ 7 4A • last name,first $ - $ $ $ - $ - #DIV/0! $ B . 4B last naive,first $ $ - $ - $ - $ - #DIV/01 $ - 9 5A last name,first $ - $ - $ - $ - $ - #DIV/0! $ - 10 513 last naine,.first $ - :$ - $ $ - $ - #DIV/0I $ 11. t last name,first $ - $ - $ - $ . - $ - #DIV/01 $. - 12 �j'1f I ,V"��!rf]� iii. last name,first $ $ - $ - $ - $. - #DIV/0!. $ . 13 f50/17r- 0/17 -0 A �� irk r� „„, Iastfame,first .$ - $ - $. $ - $. - #DN/0! $ - 14 last name,first $ -. $ - $ - $ .- $ - #DIV/0! $ - 15, last name,first $ - $ - $ - $ - $ #DIV/01 $ - 16 last name,first $ - $. $ - $ . - $ - #DIV/01 $ - L7 last name,first $ - $ - $ - $ - $ - #DIV/01 $ _ - 18 last name,first.$ $ - $ - $ - $ - #DIV/0! $ - 19 last name,first $ $ - $ - $ - $ - #DIV/0! $ - 20 last name,first $ - $ - $ - $ - $ - #DIV/01 $ - 21 last name,first $ - $. - $ - $ $ - #DIV/0! $ 22 last name,first $ - $ - $ $ 4; - #DIV/0! ”. COMPLETE ONLY IF APPLICABLE-Occupancy charges and rent collected from program particpants are program income and maybe used as provided under 24 CFR 578.97 a LEASE, SUBLEASE or OCCUPANCY AGREEMENT MUST BE IN PLACE MIAMFDADE COUNTY Request for Amendment/ Modification / for US HUD Grant Funded Continuum of Care (CoC) Programs Includes Legacy Programs under the CoC Supportive Housing Programs (SHP) Shelter Plus Care Programs (S+C) Single Room Occupancy for the Homeless (SRO) 24 CFR 576.10.5 Grant and Project Changes -The recipient or subrecipients may not make any significant changes to a project without prior US HUD approval,evidenced by a grant amendment signed by HUD and the Recipient Significant changes include a change of recipient,a change of project site,additions or deletions inthe types of eligible activities approved for a project,a shift of more than 10% from one approved eligibleactivity to another, a reduction m the number of units, and a change in the subpopulation served. By signing this report the duly authorized Project Sponsor/Provider/Subrecipient Official signature below certifies to the best of their knowledge and belief that the report is true,complete and accurate and is for the purposes and objectives setforth in the terms and conditions of the federal award;and are aware that any false,fictitious,or fraudulent information or the omission of any material fact may subject the duly authorized official to criminal,civil or administrative penalties for fraud,false statements,false claims or other offense. Print Name and Title of Authorized Project Sponsor/Provider/Subrecipient Official: Signature&Date(mm/dd/yyyy): Reviewed by Miami-Dade County and forwarded to Do Not Sign-for Miami-Dade County ONLY US HUD for Request to Approve(greater than 10%shift in funds between categories or significant change) CHANGE IN PROJECT SPONSOR Signature&Date(mm/dd/yyyy): Reviewed and Approved by Miami-Dade County; Do Not Sign-for Miami-Dade County ONLY information forwarded to US HUD (less than 10%shift in funds between categories). Signature&Date(mm/dd/yyyy): Reviewed and NOT Approved by Miami-Dade County- Do Not Sign-for Miami-Dade County ONLY see attached letter for reasons for disapproval. Signature&Date(mm/dd/yyyy) 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 include a Summary chart; and all applicable detailed supportive services, operations, leasing, rental assistance and project administration charts. Reformat the far right-side column in the chart to reflect the budget modified or amendment requested. Please outline and clearly identify the changes to the budget. 2. Attach the eSnaps documents in Word format for summary of program. Reformat the far right-side column in the chart to reflect the budget request. 3. Type below or within the applicable Word-formatted eSnaps budget chart - a detailed budget narrative- the justification for the line-item change. Also if there is a change in match amount - a new letter of match commitment is required. 4. Assemble and attach page. one of this document. 5. Review, sign and submit the paper original to Miami-Dade County Homeless Trust, 111 NW 1st Street, 27th Floor, Suite 310, Miami, Florida 33128 Attention: Terrell Ellis, Contracts Manager. FY 2018 Continuum of Care (CoC) Miami-Dade County Miami-Dade County Homeless Trust Annual Progress Report (APR) ATTACHMENT F"2017 Annual Progress Report APR" MIAMEEDE COUNTY Annual Progress Report (APR) for US HUD Grant Funded Continuum of Care (CoC) Programs On April 1,2017,Continuum of Care(CoC)Program grant recipients report their CoC Program Annual Performance Reports (APRs)in Sage HMIS Reporting Repository(Sage). Recipients will be required to upload CSV data from their HMIS to fulfill the APR reporting requirement in Sage. All Subrecipients are required to continue to submit the hard copy of the HMIS report as well as the supplemental pages until further notice. By signing this report,the duly authorized Project Sponsor/Provider/Subrecipient Official signature below certifies to the best of their knowledge and belief that the report is true, complete and accurate and is for the purposes and objectives set forth in the terms and conditions of the federal award; and are aware that any false,fictitious, or fraudulent information or the omission of any material fact,may subject the duly authorized official to criminal,civil or administrative penalties for fraud,false statements,false claims or other offense Project Name Project Grant Number Print Name and Title of Authorized Project Sponsor/Provider/Subrecipient Official: Signature&Date (mm/dd/yyyy): Print Name&Title of Authorized Project Grant Do Not Sign-for Miami-Dade County ONLY Official (MDCHT Executive Director or Designee): Signature&Date(mm/dd/yyyy): Supervisory Review and Entry- Do Not Sign-for Miami-Dade County ONLY Print Name&Title Signature&Date(mm/dd/yyyy): Updated March 31,2017. Attachment F"Annual Progress Report(APR)Supplemental" Guidance was provided for e-snaps changes that were implemented to improve processing time;completing an"Applicant Profile";and on Q3,Q5,Q23,Q24,and Q 31-please submit the HMIS generated APR as well. US HUD -ANNUAL PERFORMANCE REPORT (APR) CONTINUUM OF CARE (CoC) Q1.Contact Information Project Name Recipient/Agency Name Grant Number Prefix(Mr.,Mrs.,Ms,Dr.,etc.) First Name Middle Name Last Name Suffix(LCSW,MSW,Etc.) Title Street Address 1 Street Address 2 City State Zip Code E-mail address Phone Number Extension Fax Number Q3.Project Information:Check the component for the program on which you are reporting Continuum of Care Program(CoC) Rental Assistance(RA) Section 8 Moderate Rehabilitation ❑Transitional Housing ❑Tenant-based RentalAssistance(TRA) 0 Single Room Occupancy ❑Permanent Housing for Homeless ❑Project-based Rental Assistance(PRA) 0(Sec.8 SRO) Persons with Disabilities ❑Safe Haven 0 Single Room Occupancy(SRO) ❑HMIS ❑Innovative Supportive Housing ❑Sponsor-based Rental Assistance(SRA) ❑Supportive Services Only Is this APR fulfilling the reporting obligation associated with a 20 or 15-year use.requirement? ([11) Number of Years in Operation: (1 1) Contract operating term or duration is from( / /20 ) to ( / /20 ) Q3.Project Information continued: Is this a Domestic-Violence Program(Yes or No) Was this project funded under a special initiative?If yes,what type? (Samaritan Bonus,Permanent Housing Bonus,Reallocation,Etc) Amount of Contract or Award • $ CoC Number and Name FL-600 Miami-Dade County Is this an APR for a grant that received a HUD- approved grant. ' extension?(Yes or No) Is this a final APR?(Yes or No) Attachment F"Annual Progress Report(APR) Supplemental" Financial Information for CoC Programs Q31a1 CoC Financial-Development Expenditure Type CoC Program funds Expenditures Acquisition Rehabilitation New Construction Development-Subtotal Q31a2 CoC Expenditures-Supportive Services Report on all CoC Program funds expended during the operating year on supportive services: If you have no expense for these items or these items were not included in your grant application enter"0"in each field on the question. Expenditures type CoC Program Funds Expenditures 1.Assessment of Service Needs. 2.Assistance with Moving Costs 3.Case Management 4.Child Care 5.Education Services 6.EmploymentAssistance. 7.Food. 8:Housing/Counseling Services 9.Legal Services 10.Life Skills 11.Mental Health Services. $ 12.Outpatient Health Services 13.Outreach Services $ 14.Substance Abuse.Treatment Services $ 15.Transportation $ • 16.Utility Deposits. Supportive Services -Subtotals Attachment F"Annual Progress Report(APR) Supplemental' Q31a4 CoC Financial-Leasing,Rental Assistance, Operating,and Administration Total Expenses COC Funds Development $ Supportive Services $ Real Property Leasing $ Short-/Medium Term Rental Assistance $ Long-term Rental Assistance $ Operating Costs $ HMIS $ SUBTOTAL $ • Administration-Provider $ Administration-Homeless Trust $ TOTAL Expenses plus Administration $ Cash Match $ In-Kind Match $ TOTAL Match $ Match% % TOTAL Expenditures and Match. $ Program Income $ Attachment F"Annual Progress Report(APR) Supplemental" Performance for CoC Programs Q36: Standard Performance Measures Performance Measure (Target)#of #of total. %expected to Actual Target# Actual #of total Actual%of (Measures are found Persons who were (Universal) accomplish of persons who (Universal) persons to to the eSnaps(Exhibit expected to persons who are this measure accomplished person to achieve achieve this accomplish this is expected to (eSnaps thismeasure this measure measure 2)of the HUD measure(eSnaps accomplish this Budget Reported bi Reported in HMIS Reported in application Budget Exhibit 2) measure (eSnaps Exhibit 2) HMIS HMIS Exhibit 6 A-C) Budget Exhibit 2) Persons exiting to permanent housing 11 16 69% 19 20 95% (subsidized or unsubsidized)duringI .n'( iu i p i e. the operating year. Housing Stability Measure Reported in HMIS. Q36 Total Income Measure Reported in HMIS R36 Earned Income Measure Reported in HMIS Q36 Other-specify Reported in HMIS Q37:Additional Performance Measures Performance Measure (Target)#of #of total. %expected to Actual Target Actual #of Actual%of (Measures are found in Persons who (Universal) accomplish this #ofpersons total persons to 2)of were expected persons who are measure who (Universal), achieve this the eSnaps(Exhibit the HUD application) to accomplish is expected to (eSnaps Budget- accomplished person to measure tins 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 or Vacancy Report Other. Q40: Significant Program Accomplishments. Describe in a brief narrative form(no more than 2,000 characters)all significant accomplishments achieved by your project during the reporting period: • • Q42,.Additional Comments Describe in a brief narrative form(no more than 2,000 characters)based on your experience during the last year any problems or explanations andor changesor needfor technical adviceor assistance. Attachment F"Annual Progress Report(APR) Supplemental 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018 CoC HMIS REPORTING REPOSITORY HUD Annual Performance Report 2018 - CoC Grant:Better Way Apartments-FL0170L4D001609 Type:PH Q01.Grant Information APR Information • Operating start date for APR. 11/1/2017 • Operating end 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 obligation associated with a use requirement? No Is this a final APR? Yes —off yes,have you completed your 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? No Target subpopulation(s):Does your project have a specific population focus? No Are 100%of the clients in HMIS or where 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 APS 54 July 55 October 56 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 Information Prefix Mrs • • First Name Pauline • Middle Name Last Name Trotman • Suffix • Organization . Better Way of Miami,Inc. • Department Permanent Housing Programs ' Title Director,Permanent Housing Programs Street Address 1 800 NW 28th Street • Street Address 2 City Miami State/Territory Florida ZIP Code "33127 E=mall'Address ptrotman@bwom.org " • Confirm E-mail Address" ptrotman@bwom.org Phone Number •(305)6343409 Extension 123 Fax 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-F1_01701_413001609 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(Pil) ' Data Element Client Doesn't Know/Refused Information Missing Data Issues %of Error Rate Name 0 0 0 0.00% Social Security Number 0 0 0 0.00% Date of Birth 0 0' 0 0.00% Race 0 0 0 0.00% . Ethnicity 0 0 0 0.00 Gender 0 0 . 0 0.00% Overall Score 0.00% ' Q06b:Data Quality:Universal Data Elements • Error Count %of - Error Rate . Veteran Status 0 0.00% Project Start Date :0 V 0.00%' ' .Relationship to Head of Household V 0 . 0.00% Client Location V 0 0.00% Disabiling Condition 2 3.1a% • • • . .. . . , , - ,.-.. -'---'--a'- ----^----s.r.__....,,_„�_. .�_ ' ..r, ....n_n. "wine_..a--•---..a_y._o nino 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 Approximate pp. /of Record: Count of Total Time Time Number of Times Number of Months Date Started Unable to Records in in DK/R/missing DKfRlmissing Institution Housing DK/R/missing 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% • Q06e: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 Days 5 .0 11+Days 3 7 Q06f:Data Quality:Inactive Records:Street Outreach&Emergency Shelter #of Records #of %of Inactive Records Inactive Records Contact(Adults and Heads of Household in Street Outreach or ES-NBN) 0 0 Bed Night(All Clients in ES-NBN) 0 0 — Q07a: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 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 Q07b:Point-in-Time'Count of Persons on the Last Wednesday Total• WithoutChildren. 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 Q08a::Households Served • -Total Without Children Wrth 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 009a: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 0 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) 0 0• 0 0 • .Trans Male(FTM or Female to Male) 0 0 0 . 0 Gender Non-Conforming(i.e.not exclusively male or female) 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 • Q10b:Gender of Children Total With Children and Adults With Only Children Unknown Household Type Male 0 0 0 0 • • Female 0 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 male or female) 0 0 0 0 - Client Doesn't Know/Client Refused 0 0 0 0 •Data Not Collected0 0 0 0 • Subtotal0 - 0 0 0 i,++..,•//,........c.,..eL,:..ic f..fr/t-e...., /.e.,..ho/fil+emonoc/nolorfir 0,,v),onnrtlrl=42R,-Iiont III=RRR7cs.1S7 d'3dr1-41F'2rlRim_A1R3f1RantnpYartirta-tn!PA___ 5/7R 2/20/2019 Sage:Reports:HUD 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 . 0 Gender Non-Conforming(i.e..not exclusively male or 0 0 0 0 o 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 Under 0 0 0 0 0 5-12 0 0 0 0 0 13-17 0 0 0 0. 0 18-24 1 1 0 0 0 25-34 0 0 0 0 0 35-44 6 6 0 0 0 45-54 27 27 0 0 0 55-61 15 15 0 0 0 62+ 15 15 0 0 0 Client t Know/Client Refused 0 0 . . 0 0 0 Data Not Collected 0 0 0 0 0 Total 64 64 • 0 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/Client Refused 0 0 0 0 0 Date 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-Hispanlc/Non-Latino 57 57 0 0 0 lispariic/Latino, • - 7 7 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 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 0 0 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 46 0 0 0 Q13a2:Number of Conditions at Start Total Persons Without Children With Children and Adults With Only Children Unknown Household Type None 2 2 0 0 0 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 Doesn't Know/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 Alcohol Abuse 0 0 0 0 0 Drug Abuse 0 0 0 0 0 Both Alcohol and Drug Abuse 8 8 0 0 0 Chronic Health Condition 3 3 0 0 0 HIV/AIDS 1 1 0 0 0 Developmental Disability• 0 0 0 0 0 Physical Disability B 8 0 0 0 Q13b2:Number of Conditions at Exit Total Persons Without Children With Children and Adults With Only Children Unknown Household Type None 0 0 0 0 0 1 Condition 0 0 0 0 0 2 Conditions 0 0 0 0 0 3+Conditions 8 8 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 • 8 8 0 0 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 54 0 0 0 Chronic Health Condition 21 21 0 0 0 HIV/AIDS 11 11 0 0 0 Developmental Disability 5 5 0 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 Children Unknown Household Type None 2 2 0 0 0 1 Condition 0 0 0 0 0 2 Conditions 2 2 0 0 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 No 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 0 0 Q14b:Persons Fleeing Domestic Violence Total Without Children With Children and Adults With Only Children Unknown Household Type Yes 0 0 0 0 0" No 20 20 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected - 12 12 0 0 0 Total • " 32 ' 32 0 0 0 212012019' Sage:Reports:HUD Annual Performance Report 2018-CoC' Q15:Living Situation Total Without With Children and With Only Unknown Householc Children Adults Children Type • Homeless Situations 0 0 0 0 0 Emergency shelter,including hotel or motel paid for with emergency 25 25 0 0 0 shelter voucher Transitional housing for homeless persons(Including homeless youth) 2 2 0 0 0 Place not meant for habitation 7 7 0 0 0 Safe Haven • • 0 0 0 0 0 Interim Housing 0 0 0 0 0 Subtotal 34 34 0 0 0 Institutional Settings 0 . 0 0 0 0 Psychiatric hospital or other psychiatric facility 0 0 0 0 0 Substance abuse treatment faciliity or detox center 28 28 0 0 0 Hospital or other residential non-psychiatric medical facility 0 0 0 0 0 Jail,prison or juvenile detention facility 1 1 0 0 0 Foster care home or foster care group home 0 0 0 0 0 Long-term care facility or nursing home 0 0 0 0 0 Residential project or halfway house with no homeless criteria 0 0 .0 0 0 Subtotal 29 29 0 0 0 Other Locations 0 0 0 0 D Permanent housing(other than RRH)for formerly 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 0 0 0 Rental by client,with other housing subsidy(including RRH) 0 0 0 0 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 D 0 Staying or living in a family member's room,apartment or house 0 0 0 0 0 Client Doesn't Know/Client Refused - 0 0 0 0 0 Data Not Collected 0 0 0 0 0 • Subtotal 1 1 0 0 0 Total 64 64 0 . 0 0 Q16:Cash Income-Ranges Income at Start Income at Latest Annual Income at Exit for Leavers Assessment for Stayers No income 16 6 0 $1-$150 3 4 0 $151-$250 3 1 0 $251=$500 2 1 0 $501-$1000 22 8 3 $1,001-$1,500 6 13 • 1 $1,501-$2,000 2 5 3 $2,001+ 10 9 1 Client Doesn't Know/Client Refused 0 0 0 • Data Not Cbllected . 0 0 0 Number of Adult Stayers Not Yet Required to Have an Annual Assessment 0 9 0 • Number of Adult Stayers Without Required Annual Assessment 0 0 0 . • Total Adults 64 56 8 2/20/2019 • Sage:Reports:HUD Annual Performance Report 201 B-CoC • Q17:Cash Income-Sources Income at Latest Annual Income at Start Income at Exit for Leavers Assessment for Stayers • Earned Income 19 10 3 Unemployment Insurance 1 1 0 SSI 23 .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 General Assistance 5 3 1 Retirement(Social Security) 1 0 0 Penslon'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 Q18:Client Cash Income Category-Earned/Other income Category-by Start and Annual Assessment/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 4 1 Adults with No Income 16 6 0 Adults with Client Doesn't Know/Client Refused Income Information 0 0 0 Adults with Missing Income.Information • 0 0 0 Number of Adult Stayers Not Yet Required to Have an Annual Assessment 0 9 0 Number of Adult Stayers Without Required Annual Assessment :0 0 0 Total Adults 64 . 56 8 1.or More Source of Income :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 Have it at at Annual at Annual Increased$ Income Start or at Those Income from persons ish( Annual Assessment Assessment at Annual Category at Annual with No Start to Annual this accomplish his Than at Start as at Start Assessment Annual Assessment Income) Assessment; this measun • Assessment Average Gain 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 78172% (i.e.,Total Income) Average Change in -650.33 0.00 592.43 ' 799.20 0.00 430.00 611.05 0.00% Overall Income . • 2/20/2019 Sager Reports:HUDAnnual 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 at Start but Had Category Category at Start and Income (Including Who Gained or Percent of and Did Less$.at and Same and Gained the Category Those Increased Income 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 $at Exit at Exit at Exit Income) Average Gain this measure Number of Adults with Earned 1 0 1 1 1 4 8 2 25.00% Income(i.e., Employment Income) Average Change in _ • 841.00 — 0.00 1100.00 1501.00 0.00 0.00 1300.50 0"00% Earned Income Number of Adults with 0 0 0 5 1 2 8 6 75.00% Other. . income Average. Change in 463.20 750.00 0.00 . 0.00 511:00 0.00% Other. Income Number of Adults with Any Income 0 1 • 0 6 1 0 8 7 87.50% (i.e.,Total Income) Average Change in _91.00 — 569.33 1501.00 603.00 702.43 0.00% Overall Income 2/20/2019 • Sage:Reports:HUD Annual Performance Report 2018-COC Q19a3:Client Cash Income Change-Income Source-by Start and Latest Status/Exit Did Not Have the Performer Retained Income Retained Income Income • Total Measure: Had Income Retained Income Did Not have the Category But Category and Category at StartIncome Adults Who Gain( Category at Start Category and Had Less$at Same$at and Gained the (Including Increased • and Did Not Increased$at Category at Start Annual Annual Income Those Income fn have it at Annual Annual or Annual Assessment/Exit Assessment/Exit Category at with No Start to Ar. . ' Assessment/Exit Than at Start as at Start Assessment/Exit Annual Assessment/Exit 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 3 55 44 (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 Benefit at Start Benefit at Latest Annual Benefit at Exit for Leavers Assessment for Stayers Supplemental Nutritional Assistance.Program 58 42 8 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 51 40 8 Q20b:Number of Non-Cash Benefit Sources Benefit at Start Benefit at Latest Annual Benefit at Exit for Leavers Assessment for 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 CoC Q21:Health Insurance • At Start At Annual Assessment At Exitfor 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 6 3 0 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 Q22a1:Length of Participation.—CoC Projects Total Leavers Stayers 30 Days or Less 1 0 1 31to60Days 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-FL0170L40001609 a.Average length in days 2386.0000 2002.0000 Better Way of Miami,Inc:Apts.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 10/1.12018) Total . Without Children With Children and Adults With Only Children Unknown Household Type 7 days or less 2 2 0 0 0 8 to 14 days b 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 were exited 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 1011/2018) Total Without Children With Children and Adults With Only Children Unknown Household Type -nodata- • 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018.—.CDC Q23a:Exit Destination—More Than 90 Days . Without thout 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 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 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 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 0 0 0 0 0 station/airport or anywhere outside) Safe Haven 0 .0 0 0 0 Hotel or motel paid for without emergency shelter voucher 0 0 0 0 0 Subtotal 0 . 0 0 0 0 Institutional Settings 0 0 0 0 0 Foster care home or group foster care home 0 • 0 •0 0 •0 Psychiatric hospital orother psychiatric facility 0 0- '0 0 0 Substance abuse treatment facility or detox center 0 0 .Cl 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 D 0 Subtotal 0 0 0 0 0 Other Destinations 0. - G. 0 0 0 Residential'project or halfway house with no homeless criteria 0 0 ' 0 0 0 Deceased ' 2 2 0 0 0 Other 0 .0 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected:(no exit interview completed) 0 0 0 0 0 Subtotal 2 2 0 0 0 Total . 8 8 0 0 0 . . Total persons exiting to-positive.housing destinations 6 6 0 0 0 • Total persons whose destinations excluded them from the calculation . 2 2 0 0 0 1.00.00 Percentage % 100.00% — -- — -2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC 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 D 0 D 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 0 0 0 Rental by client,with RRH or equivalent subsidy ' 0 0 0 0 p 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 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,apartrnent 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 D 0 0 station/airport or anywhere outside) Safe Haven 0 0 0 0 0 Hotel or motel paid for without emergency shelter voucher 0 0 0 0 0 Subtotal 0 0 0 0 0 Institutional Settings 0 0 0 0 0 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 D 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 D 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 0 0 Other 0 0 0 0 0 • Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected(no exit interview completed) 0 0 0 0 0 • Subtotal • 0 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 -- -- -- — -- 2/20/2019 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 Won-Chronically Homeless Veteran 4. 4 0 0 Not a Veteran 60 60 0 0 Client Doesn't Know/Client Refused 0 0. 0 0 Data Not Collected 0 0" 0 0 Total 64 84 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' Not a Veteran 60 60 0 0 Client Doesn't:Know/Client Refused 0 0 0 0 Data Not Collected 0 0 0 0 Total . 64 64 0 0 Q25c:Gender-Veterans Total Without Children With Children and Adults Unknown Household Type Male 4 4 0 0 Female 0 . 0 0 0 Trans Male(FTM or Female to Male) D 0 0 0 Trans Female(MTF or Male to Female) 0 0 0 0 Gender•Non-Conform ing(Le.not exclusively male or female). 0 0 0 0 Client Doesn't.Know/Client Refused" 0- 0 0 0 Data Not Collected 0 0 . 0 0 Total 4 4 0 0 Q25d:Age-Veterans Total Without Children With Children and Adult Unknown Household Type 18-24. A -0 0. 0 26-34 0 0 0 It 35-4q 0 0 0 0 45-54• 2 2 Cl 0 55-61 0 0 . 0 0 62+ 2 2. 0 0 Client Doesn't Know/Client Refused 0 0 • U 0 Data Not Collected • 0 0 0 0 Total 4 4 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 Problem 3. 3' 0. Alcohol Abuse D 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 Q25f: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 Earned 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 Veterans Not yet Required to Have an Annual 0 0 0 Assessment Number of Veterans Without Required Annual Assessment 0 0 0 Total Veterans 4 4 0 Q25g:Type of Cash Income Sources-Veterans Income at Start Income at Latest Annual Income at Exit for Leavers Assessment for Stayers Earned Income 1 1 0 Unemployment Insurance 0 0 0 SS1 3 3 0 SSDI 0 Q 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 0 0 0 General Assistance 1 1 0 Retirement(Social Security) 0 0 0 • Pension from Former Job 0 0 0 Child Support 0 0 0 Alimony(Spousal Support) 0 0 0 Other.Source 2 2 0 ' Veterans with Income Information at Start and Annual Assessment/Exit 0 4 0 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-C0C 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 2/20/201) , .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,noongoing housing•subsidy 0 0 0 0 0 Rental by client,with VASH housing subsidy. 0 0 0 0 0 Rental by client,with GPO 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)fel-formerly homeless persons 0 0 0 0 0 • Staying or living with family,permanent tenure0 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 0 0 0 0 Subtotal 0 0 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 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 0 0 0 0 0 station/airport or anywhere outside) • Safe Haven0 0 0 0 0 Hotel or motel paidfor without emergency shelter voucher 0 0 0 0 0 Subtotal 0 0 0 0 0 Institutional Settings 0 0 0 0 0 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 facility0 0 0 0 0 Long-tram care facility or nursing home • 0 0 0 0 0 .Subtotal - 0 0 0 0 0 Other Destinations 0 0 U. 0 0 • "Residential project or halfway house with no homeless criteria 0 0 0 0 0 Deceased . 0 0 0 0 0 • •. Other. 0 0 0 0 0 Client Doesn't Know/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 ' . . • — -- -- -- • 2220/2019 Sage: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 0 0 Data Not Collected 0 0 0 0 0 Total 64 64 0 0 . 0 Q26c:Gender of Chronically Homeless Persons hout With Children and With Only Unknown Household Total Wit Children . Adults Children Type Male 7 7 0 0 0 Female . . 14 14 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 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 Total 21 21 0 0 0 Q26dr Age of Chronically Homeless Persons Total Without Children With Children and Adults With Only Children Unknown Household Type 0-17 0 0 0 0 0 18-24 1 - 1 0 0 0 25-84 0. . . 0 0 0 0 • 35-44 1 1 0 0 0 45'-54' 9 9 0 0 0 55-61 7 7 0 0 0 62+ . 3 . 3 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 D,afallot Collected 0 0 0 0 0 Total 21 21 0 0 0 2/20/2019 Sage:Reports:HU{]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 4 4 1 Income(i.e.,Employment Income) Chronically Homeless Persons with Only Other 5 8 0 Income Chronically Homeless Persons with Both Earned 3 2 0 and Other Income 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 0 3 0 Required to Have an Annual Assessment • Number of Chronically Homeless Persons Without 0 0 0 Required Annual Assessment • Total Chronically Homeless Persons 21 . 20 1 Q26g:Type-of Cash Income Sources-Chronically Homeless Persons Income at Start Income at Latest Annual Income at Exit for Leavers Assessment for Stayers Earned Income 7 6 1 Unemployment Insurance 1 1 0 • SSI 7 8 0 SSD] • 1 1 . • 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 1 .0 0 Retirement(Social Security) 0 • 0 0 Pension from Former Job. • 0 • '0 '. 0 • Child Support • 0 0 0 • Alimony(Spousal Support) 0 0 0 Other Source 4 4 0 ChronicallyHomeless Persons with.Income Information at Start and Annual Assessment/Exit 0 . 10 0 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 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 0 18-24 1 1 . . . 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 0 0 Q276:Parenting Youth tal Total Parenting Youth ToparentvngChildren Youthof Total Persons Total Households 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 • Male . . ' 0 0 0 0 0 Female - 1 1 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 0 Gender Non-Corifonning(i.e.not exclusively male or 0 0 0 0 female) • Client Doesn't know/Client,Refused • 0 0 0 0 0 Data Not Collected- 0 0 0 0 0 Total 1 1 0 0 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 Emergency shelter,including hotel or motel paid for with emergency 1 1 0 0 0 • shelter voucher Transitional,housing for homeless persons(including homeless youth) 0 0 0 0 0 Place hot 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 0 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 Foster care home or foster care group home 0 0 0 0 0 Long-term care facility or nursing home 0 0 0 0 0 Residential project or halfway house with no homeless criteria 0 0 0 0 0 Subtotal 0 0 0 0 0 Other Locations 0 0 0 0 0 Permanent housing(other than RRH)for formerly homeless persons 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 byclient,no ongoing housing subsidy 0 0 0 0 0 Rental-by client,with VASH subsidy 0 0 0 0 0 Rental by client with GPO TIP subsidy 0 0 0 0 0 Rental by client,with other housing subsidy(including RRH) 0 0 0 0 0 ' Hotel or motel paid for without emergency shelter voucher 0 0 0 0 D Staying or living in a friend's room,apartment or house• 0 0 0 0 0 Staying or living in a farnily member's room,apartment or house 0 0 0 0 0 Client.Doesn't KnowdClient Refused . 0 0 0 0 0 DataNot Collected 0 0 0 0 0 Subtotal • 0 0 0 0 0 Total 1 1 0 0 0 Q27e:Length of Participation-Youth . Total Leavers Stayers 30 Days or Less 0 0 0 31 to 60 Days 0 0 0 • . 61to90Delta. . . 0 . 0 0 91 to 180Days.- 0 0 0 181 0365 Days ' . _ 0 0 0 366 to 730 Days(1-2 yrs) '' 1 0' 1 731 to 1095 Days:,(2-3 yrs) . • 0 0 0 1,096 to 1,460 Days(3-4 yrs) 0 0 0 1,461 to.1,825.Days(4-5 yrs) . 0 0 0 More than 1,825 Days'(>5 yrs) ' 0 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, 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 0 .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 or motel 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,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 0 0 0 . Hotel or motel paid for without emergency shelter voucher 0 0 0 0 0 Subtotal - 0 0 0 0. 0 Institutional Settings 0 0 0 0 0 • 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,orjuvenile 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 0 0 0 0 0 Residential projector halfway house with no homeless criteria 0 0 0 0 0 Deceased 0 0 0 0 0 • ' Other' 0 0. . 0 0 0 Client Doesn't Know/Client Refused 0 0 0 0 0 Data Not Collected(no exit interview completed) 0 0 0 0 0 Subtotal 0 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 — -- — — — 2/20/2019 Sage:Reports:HUD Annual Performance Report 2018-CoC Q28.Financial Information Development Acquisition 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 0 Food 0 Housing/Counseling Services 0 Legal Services 0 Life Skills. 0 Mental Health Services 0 Outpatient Health Services 0 Outreach Services 0 Substance Abuse Treatment Services 0 Transportation 0 Utility Deposits 0 Operating 0 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 Require Match) 0 • Short/Medium-Term Rental Assistance 0 Long-Term Rental Assistance 432,109.58 Operating Costs 0 Leasing,Rental Assistance,&Operating Subtotal 432,109.58 Administration • Administration 29,753.00 Administration Subtotal 29,753.00 Total Expenditures 461,862.58 • Match Cash Match 0 In-Kind Match 124,671.00 Total Match 124,671.00 Total Expenditures Requiring a Match 461,862.58 Percentage Match 25.99%p; Total Budget (Expenditures Plus Match) 586,533.58 • 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 unIIs of permanent accomplishments achieved by your program during the operating housing and supportive services.The program assisted the participants with achievinglong term recovery goals,increasing skills and 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 additional comments on other areas of the APR that need - The Miami-Dade County Homeless Trust will continue to work with the local Miami HUD explanations,such as a differencein anticipated and actual program outputs or Field Office to address any issues related to the submittal of the Annual Progress Repor bed utilization: (APRs). - FY2018 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 assisthomeless 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 24CFR578.23(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) Intake/screening 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 CNK 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(AIR 2424,24 CFR 225 _Policy identifying the involvement of homeless/formerly homeless individuals 24 CFR 578.23(c)(3) Domestic Violence Policy 24 CFR 578.23(c)(4)(i)(ii),24 CFR 578.103(a)(17) Housing First Policy,if applicable HUD CPD Notice 14-02 _10.Documentation of participation of homeless/formerly homeless individuals in policymaking 24 CFR 578.75(g)(1) 11.Documentation of compliance with environmental review requirements 24 CFR 578.99,24 CFR 578.31 12.Documentation of compliance with fair housing requirements 24 CFR 578.87(b),24 CFR 578.103(a)(14)and(17),24 CFit 578.93(c)(1) 13.Documentation of other federal requirements(i.e. lead based paint, Section 3, Section 504), if applicable 24 C.FR 578.99,24 Cleit 35,24 CFR 578.99(b) Financial Files 1. Written Financial Policies 2 CFR 200302,24 CFR 578.23(c)(5),24 CFR 578.103(a) 2.Written Procurement Procedures 2 CFR 200.318 and 2 CFR 200.319 3.Written Conflicts of Interest Policy 2 CFR 200.317 and 2 CFR 200.318,24 CFR 578.95(a) 4.Documentation of match(25%of total Grant Amount less leasing) 24 CFR 578.73(a) _5.Documentation of Grant Expenditures(during grant term and for approved items in application) 24 CFR 578.37,24 CFR 578.103 6.Documentation of Indirect Cost Rate Proposal, if applicable 24 CFR 578.63(b),24 CFR 578.103(a)(17) Internal Wellness Checklist Page 3 Grant#: 7.Documentation showing compliance with the SingleAudit 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 HMIS or a comparable database 24 CFR 578.103(a)(3) 2.Documentation participant was screened via centralized or coordinated assessment systems 24 CFR 578.23(c)(9) 3.Documentation of Homelessness at intake 24 CFR 578.103(a)(3) 4.Permanent Supportive Housing-Documentation of disability 24 CFR 578.37(a)(i) 5.Transitional Housing- No more than 24 months of services provided except under documented extenuating circumstances 24 CFR 578.79 6.Documentation of ongoing assessment of services 24 CFR 578.75(e) 7.Documentation of examination of income(initial and recertification) 24 CFR 578.103(a)(7)(i) 8.Documentation of initial and follow-up Housing Quality Standards inspections 24 CFR 578.75(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 578.49(b)(5) 11.Leasing-is there an occupancy agreement, lease or sublease in the file(for individual.units)? 24 CFR 578.103(a)(17) "- 12. 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 HUD-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 578.49(a)(3) Internal Wellness Checklist Page 4 Grant#: 15.Leasing-Documentation of occupancy charges with annual income calculations 24 CFR 578.77,24 CFR 578.99(b)(6) 16. Rental-Documentation the participant has a an executed lease agreement with the landlord 24 CFR 578.77,24 CFR.578.51(d)(e) 17.Rental-Documentation of rent reasonableness for the period of approval for an assisted unit 24 CFR 578.51(g) NOTE: For additional guidance,please refer to the following resource materials: (1)Homeless Emergency Assistance and Rapid Transition to Housing: Continuum of Care Program CoC regulations at 24 CFR Part 578, and (2)Monitoring handbook 6509.2 REV-6 CHG-2 that can be accessed at: http://portal.hud.gov/hudportal/HUD?src=/program offices/ad ministration/hudclips/handbooks/cpd/6509.2. s Completed by: Signature: Date: Typed/Printed Name: Title: This document isto be maintained in the applicable CoC project file. MIAMI E COUNTY Attachment G"CoC Program Guidelines" Page 1 of 14 Miami-Dade County Homeless Trust CoC Program Guidelines MIAMI•DADE COUNTY Miami-Dade County Homeless Trust Monitoring Team Information Staff: Date of Visit: CoC Program Subrecipient:Agency and Program Information Subrecipient: Program Name: Subrecipient staff consulted; Grant Amount: Grant Number: Program Type: O PSH O RRH O TH O SH O SSO O Legacy SPC O RRH Number to be served: Number of-chronic beds/units: Program serves: O Individuals O Families O Both CoC Program grant funds.are used for: O Leasing(no match required) O Rental Assistance O Operations O Supportive Services 0 HMIS O Administration Is the Subrecipient a faith based organization? i Yes O No CoC Matching funds (25%)required are: O Cash/Cash Equivalent 'O In Kind O N/A Is there an active restrictive covenant on one or more of the project's properties?O Yes'O No Attachment G."CoC Program Guidelines" Page 2 of 14 PART 1:PROGRAM MONITORING: SUBRECIPIENT OPERATIONS: POLICIES.AND PROCEDURES: Conflict of Interest 1.There are written standards of conduct governing O Yes the performance of covered persons engaged in the O No award and administration of contracts.24 CFR§ 578.95(a);24 CFR§578.1.03(a)(11) 2.The Subrecipient has a general conflict-of-interest O Yes policy for staff and Board members 24 CFR§ 0 No 578.95(c);24 CFR§578.103(a)(11) 3.If the Subrecipient is an approved exception to the 0 Yes. conflict of interest policy,the agency has documented 0 No the exception 24 CFR§578.103(a)(11) Involvement of homeless persons 1.There is at least one homeless/formerly homeless O Yes person is on the Board of Directors or equivalent O No policymaking entity.24 CFR§578.75(g)(1) 2.The Subrecipient involves homeless individuals O Yes and families through employment;volunteer O No services;or otherwise;in constructing,rehabilitation, maintaining,and operating the project,.and in providing supportiveservices for the project 24 CFR §578.75(g)(2) Confidentiality 1.The Subrecipient has written policies to ensure: - O Yes • Records containing protected identifying 0 No information of any individual/family receiving assistance will be kept confidential; • The location of any family violence protect will not be made public,except with the written permission of the person responsible for operating the project;and • The location of any housing_of any program participant will not be made public,except as provided in a preexisting privacy and as provided by law. 24 CFR§578.103(b) (These policies are in addition to IMIS related confidentiality/security requirements) • •• . Fair Housing and E i ual Opportunity 1.The Subrecipient has written nondiscrimination: 0 Yes and equal opportunity policies that apply to housing 0 No and employment 24 CFR§578.93. • 2.The Subrecipient has policies and procedures for Q Yes providing reasonable accommodations and 0 No reasonable modifications for persons with disabilities.24 CFR§.100.204(a),2$CFR§ 35.130(b)(7) Attachment G"CoC Program Guidelines": Page 3 of 14 3;The Subrecipient maintains copies of marketing, O Yes outreach,and other materials used to inform eligible Q 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 O Yes place to provide meaningful access for Spanish- O No speaking and other Limited English Proficiency persons to access the Subrecipient's programs and services.72 federal regulation 2732 5.The Subrecipient provides program participants O Yes with information on rights and remedies available 0 No under applicable federal,State and local fair housing and civil rights laws.24 CFR§578.93(c)(3) Drug-Free Workplace 1.The Subrecipient has a drug-free workplace policy O Yes statement which includes the requirement of O No notification to HUD if an employee is convicted for a criminal drug offense.24 CFR§84.13 POLICIES AND PROCEDURES FOR COC GRANT-FUNDED PROGRAM Number.Served 1.The Subrecipient serves at least as many program O Yes participants as show in its application for assistance.. . O No 24 CFR§:578.51(h)(3) Termination Process 1.The Subrecipient has a written policy for O Yes termination of participation for violation of program Q 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 Q No policies or occupancy agreements.24 CFR§ 578.91(b) Residential Supervision 1.The Subrecipient provides adequate residential O Yes supervision.24 CFR§578.75(f) O No Program Fees 1.The Subrecipient does not charge participant s O Yes program fees.24 CFR§578.87(d)Program fees are Q No not the same as rent or occupancy-rent;program participants maybe charged rent for housing).- Attachment 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 CoC PROGRAM.PARTICIPANT FILES Eligibility:Homelessness 1.Each participant file contains verification of O Yes homelessness status at the time of program entry.24 D No CFR§578.103(a)(3) 24 CFR§576.500(b) 2.The Subrecipient has written policies and D Yes procedures for documenting homelessness. Intake O No staff document eligibility at intake;documentation is required for all persons seeking assistance;written policies state the evidence that may be relied upon to establish and verify homeless status. The Subrecipient makesefforts 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 D Yes contains verification of participant's disability,24 D No CFR§578.37(a)(I)ji) 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 fl Yes are chronically homeless,participant files contain D No verification of chronic homelessness. Service Assessment 1.The fire contains participant assessments and .D Yes ' service plans,updated at least annually.24 CFR§ D No 57853(a) Services Provided and Costs 1.The file contains documentation of services D Yes provided and the agency tracks the amounts spent on. No those services,24 CFR§..578.10.3(a)(9); Duration of Services 1.The file reflects that supportive services are made O Yes available throughout resident's entire time in the Np project.24 CFR§578.53(b) . . 2.'Rapid rehousing:The file reflects that program D Yes participant meets with case manager not less than O No once per month.24 CFR§578.53{b)(4) Attachment G "CoC Program Guidelines" Page 5 of 14 Participants Terminated from Program 1.If a participant has been terminated from the O Yes program,file includes documentation that the O No Subrecipient followed its written procedure for termination of assistance.24 CFR§ 578.103(a)(7)(ii);24 CFR§578.91 RENTAL ASSISTANCE OR LEASING(complete this section if the Subrecipient pays rental assistance or leasing costs for a unit that the program participant lives in) Rental Agreement/Lease 1.The program participant has an occupancy O Yes agreement or lease with the Recipient/Subrecipient O No or Landlord.24 CFR§578.77(a)For tenant and project based assistance;the program participant must be the tenant on the lease. For sponsor based assistance,lease between the Subrecipient and the Landlord,sub-Lease between participant and Subrecipient 2.For project-based,sponsor-based,or tenant-based O Yes permanent housing.(PH)rental assistance;initial O No lease must be least one year,terminable for cause. The leases must be automatically renewable upon expiration for terms that are a minimum of one month long,except on prior notice by either party,up to a maximum term of 24 months.24 CFR§ 578.51(1)(1) 3.For transitional housing;initial lease term must be O Yes at least one month. The lease must be automatically O No renewable upon expiration,except on prior notice by either party;up to'a maximum term of 24 months.24 CFR§578.51(1)(2) Habitability 1.File includes documentation that units passed O Yes housing quality standards inspection prior to initial O No client move-in.24 CFR§578.75(b);and . 24 CFR§57.8.103(a)(8) 2.File includes.documentation that unit has passed O Yes • annual housing quality standards inspections, O No including an inspection within the last 12 months.24 CFR§578.75(b) 3.Dwelling unit is correct size:The dwelling unit 'O Yes must have at least one bedroom or living/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 supportive housing for persons with • O Yes disabilities;the Subrecipient must make available O No meal preparation facilities for residents or provide meals 24 CFR§578.75(d) Attachment G"CoC Program Guidelines" Page 6 of 14 Unit Rents 1.Documentation that rents are reasonable in 0 Yes. relation to rents charged in the same geographic area 0 No for comparable space 24 CFR§578.49(b) 2.Rents do not exceed the HUD-determined Fair 0 Yes Market Rents(FMRs). This documentation must 0 No include chart show current year's FMRs. 24 CFR§578.49{b)(4) 3.Security deposit does not exceed two months'rent; 0 Yes in addition to the security deposit,the Subrecipient 0 No may also pay the final months'rent in advance 24 CFR§578.49[b).(4) Annual Income 1.The file contains an income evaluation form O Yes completed by program participant and source 0 No 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 demonstrating.that 0 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:BEST PRACTICE:The file 0 No contains a printout of the HUD rent calculation 24 CFR§5.78.103 . . 2.Is the participant charged rent(unless$0 income) 0 Yes and is the rent treated as program income? • 0 No (required) 3:Is rent calculated initially,annually,and when O Yes there is any change in income? 0 No 4:Is there documentation of compliance of an eligible 0 Yes "utility allowance"The Subrecipient has received a 0 No copy of the Tenants paid utility bill for compliance. Vacancies 1.The Subrecipient does not pay rent for more than 0 Yes. 30 days for any unit that has been vacated. Rent may 0 No not be paid on the vacated unit again until there is a new occupant (NOTE:Brief periods of stays in. institutions, not to exceed 90 days for each occurrence, are not considered vacancies). 24 CFR§578.51.(9) . Attachment G"CoC Program Guidelines" Page 7 of 14 • LEASING_(complete this section if the Subrecipient leases buildings for the purpose of providing program services or if there isa 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(b) 2.Rents do not exceed rents charged for comparable 0 Yes units rented by the Sitbrecip.ient: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 O No may also pay the final months'rent in advance. . 24 CFR§578.49(b)(4) 4.The Subrecipient must have an occupancy O Yes agreement,and if applicable a sublease. 0 No • S.Is rent calculated initially and when the tenant 0 Yes requests? 0 No 6.Is the participant charged.rent?(not required) 0 Yes O No 7.Has an occupancy charge been imposed?(not 0 Yes required)If so,the charge cannot exceed the highest O No of 1) 30%of the households monthly adjusted income;2) 10%of the households'monthly income, or;3)The portion of the households'welfare assistance,if any that is designated for housing costs. (not applicable in the State of Florida) 8.Leasing funds are not used to lease units or . O Yes structures owned by the Recipient,Subrecipient, O No their parent organi7ation(s)or organizations that are members of a partnership where the partnership owns the structure. (Doesn't apply to rental assistance). REQUIRED POLICIES AND PROCEDURESFOR SPECIFIC PROGRAMS/ CIRCUMSTANCES' Participant Household Policies(complete this section for any program that serves families with. children) 1:The age and gender of a:child under age 18 must 0 Yes not be used as a basis for denying any participant 0 No . 0 _ • . household's admission to a project that receives funds under this part. Faith-based Activities(complete this section if the Subrecipient is a faith-based organization) 1.The Subrecipient serves all potential participants O Yes. without regard to religious_belief,refusal to hold a O No religious belief,or refusal to attend or participate in religious services.24 CFR§578.87(b)(1) 2.If the Subrecipient provides explicitly religious 0 Yes activities(including worship,religious instruction,or O,No proselytizing),these activities are separate from HUD-funded activities and beneficiaries of HUD- funded activities are not required to participate. Attachment G "CoC Program Guidelines" Page 8 of 14 24 CFR§578.87(b)(2) Projects involving acquisition,new construction,and rehabilitation 1.Records for acquisition,newconstruction,and • : O Yes rehabilitation must be retained for 15 years O No following the date the project is first occupied,or . used,by program participants.24 CFR§ 578.103(C)(2) 2.If the project resulted in dislocation of any O-Yes persons,the Subrecipient compliedwith 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 O No Section 3 reports have been completed and submitted timely? 24 CFR§578:99(1) Transitional Housing 1.Participants do not regularly 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 O No extended participation.24 CFR§578.79 3.If participants stay longer than 24 months,is the D Yes number of participants with longer stays less than O No 50%of the total number served by the project? 24 CFR§578.79 Transfer Due to Domestic 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 documentation of the domestic violence and imminent threat PART 2: FISCAL MONITORING: INTERNAL.REVIEW Audit 1.Is the Subrecipient subject to the OMB A-133 O Yes single audit requirement?(Required if$5000,000 or Q No more,in aggregate Federal funds expended) 2.If subject to A-133 audit,has the Subrecipient O Yes provided its most recent audit and management O No letter? 3..If not bound by A-133 has the agency . Q Yes provided financial statements audited by a CPA? O No Board of.Directors 1.Has the Subrecipient provided Miami-Dade County O Yes a list of the members of its Board of Directors? O No Authorized Check Signers 1.Has the Subrecipient provided Miami-Dade County D Yes with a list of authorized check signers? O No. Attachment G"CoC Program Guidelines" Page 9 of 14 Invoicing 1.The Subrecipient submits invoices on a monthly 0 Yes basis(on time or within time)? O No Procurement 1.The Subrecipient has a written procurement policy . 0 Yes that meets the requirements of Miami-Dade County 0 No competitive procurement standards. 2.The Subrecipient retains copies of all procurement 0 Yes contracts and documentation of compliance with 0 No federal procurement requirements 24 CFR§578.103(a)(16)(iii)- Match 1.The Subrecipient has documentation of the source 0 Yes 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 contribution is counted. The records must show how the value placed on 3rd party in kind contributions was derived. Costs incurred by a partnering organization to provide"in kind" services to the program participants must be documented by a MOU. Cash or any in kind contribution used as match for another grant is not an eligible in kind contribution used as match for another grant is not an eligible match. 24 CFR§ 578.73,24 CFR§578.103(a)(10),24 CFR§84.23 and 24 CFR§578.23(c)(6) 2.Match must be spent oneligible project costs(in O Yes the budget) D.No 3.Where match is documented by MOU,the MOU 0 Yes must;establish the unconditional commitment O No identify the service to be provided;identify the profession of the persons providing the service;and identify the cost of the service to be provided. Internal Controls 1,The Subrecipient has written job descriptions for 0 Yes all HUD-funded positions -. 0 No 2.The Subrecipient has written fiscalpolicies and 0 Yes procedures specifying approval authority for all _ 0 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 0 Yes and Occupancy charges are considered program 0 No income as is any utility allowances in rental programs 2.Is program income part of your match? Program 0 Yes, income is riot an eligible source of match. 0 No Attachment G"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 C)Yes as applicable O No DOCUMENTATION REVIEW Salary Documentation 1.Original timesheets-signed;grant duties O.Yes identified,if split time(copy in reimbursement []No package) 2.Payroll sheets O Yes O No 3.Cancelled checks to the employee O Yes O No 4.If time is divided between the CoC Programs and O Yes another funding source,review time distribution 0 No records supporting the allocation of charges among the sources. Staff time breakdown allocation chart Space/Utilities Documentation/Leases 1.Rental or lease agreement-signed by participant; O Yes valid lease period;correct rental amount O No 2.Otiginal invoices. O Yes 0 N 3.Cancelled checks t6 the landlord/mortgagee; 0 Yes utility company,etc,: O No 4.Unit inspection report(s);no longer than 1 year old O Yes O No: 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 O No 2.Requisitions.. O Yes ONo 3:Cancelled checks O Yes O No 4.Determine where supplies are being kept O Yes O No 5.Determine what cost objective is being used O:Yes Review Inventory list any equipment shall be. . O Yes labeled as property of Miami-Dade County through Q No its Homeless Trust • Attachment G"CoC Program Guidelines". Page 11 of 14 INTERNAL CONTROLS 1.Internal control questionnaire O Yes 0 N 2.Review organizational chart .O Yes 0 N 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 is a separation of duties O Yes (authorizing,recording and custody should be O No • separate) 6:Review control over assets O Yes 0 N EVALUATION OF.SELECTED TRANSACTIONS Is the expenditure allowable a.Is the expenditure necessary,reasonable and O Yes directly related to the grant? O No b.Is the-expenditure authorized by the grant? O Yes 0 N Source documentation evaluation a.Were the expenditures incurred during the term of O Yes the grant? O No b.Was the money actually paid out? O Yes 0 N c.Were the expenditures approved by the O Yes responsible Subrecipient officials . O No d.Is there adequate documentation to support the O Yes expenditures? O No Does the Subrecipient maintain the appropriate records? Does the Subrecipient maintain the following? a.Chart of accounts . O Yes O No b.Cashreceipts journal O Yes • El No c.Cash disbursements journal. O Yes O'No d.Payroll journal O Yes O No e.General ledger O Yes O No 1.Does the Subrecipient maintain documentation . O Yes concerning its 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 0 Yes Agreement to use the HMIS license O.No 2.Are the Subrecipient's HMIS Administers O Yes registered and approved to enter the data into the 0 No HMIS system . 3.The Subrecipient has designated an HMIS site Q Yes Administrator(s),who is the Point of Contact for O.No Miami-Dade County through its Homeless Trust as HMIS Lead Agency. 4.the.Subrecipient has ensured that each HMIS user 0 Yes within its Organization has signed a user agreement 0 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 0 No location 2.The Subrecipient has a written Privacy Policy or 0 Yes uses the CoC's written Privacy Policy 0 No 3.If the Subrecipient has a web site,the Privacy 0 Yes Policy is posted to the web site. . 0 No 4.The Subrecipient has a signed authorization for 0 Yes release of information form thatit uses for any client 0 No for which the Subrecipient uses HMIS for data sharing` . 5:The Subrecipient ensures that all signed forms are: O.Yes locked in a designated location with limited access to 0 No -staff 6:The Subrecipient has executed the Agency Sharing. 0 Yes • Data Agreement,if applicable(MOM) 0.No 7.The Subrecipient has a written client complaint O.Yes policy O No 8.The Subrecipient has established a process of : 0 Yes 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 0 Yes users 0 No 2.The Subrecipient regularly contacts the HMIS Lead 0 Yes when an employee leaves the Organization,in order: 0 No to make sure that.the.person's HMIS account is disabled. 3.Are the Subrecipient's HMIS workstations located O.Yes in secure-locations or,if not are the:workstations 0 No Manned at all trines? . 4.Has Subrecipient identified a person who willO 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? 0 No 6.Does the Subrecipient have in place policies and 0 Yes procedures to protect hard copies(paper)with O No personal identifying information? Data Quality At a minimum the Subrecipient collects the Universal 0 Yes Data Elements for every client entered and minimum O No data quality standards are met. The Subrecipient enters Client Basic Demographic 0 Yes Data into the HMIS system at a minimum within one 0 No week of intake The Subrecipient staff review monthly reports 0 Yes received from HMIS Program Administrator.and 0 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" MIAM COD NTY; 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 El Primary Care D CcC Program 0Emergency ❑ Challenge 0 Other Specific location/address-where incident occurred: TYPE OF INCIDENT 0 ALTERCAT101V D CL FNT.DEATH D CLIENT'AVERY OR ILLNESS D THEFT ❑SEXUAL BATTR.RY. 0 SUICIDE ATTEMPT D PROPERTY DAMAGE 0 OTHER LNICIDENT Specr i PARTICIPANT(S)/WITNESS(ES) (Pleasemark W or P for either Witness or Participant) LAST NAME,FIRST IDENTIFIER# CLIENT EMPLOYEE OTHER W/P 0 0 . 0 0 0 DESCRIPTION OF INCIDENT Give detailed account who,what,where,when,why,how—add pages if necessary ATTACHMENT H"MDC-HT Incident Report Form" Page 1 of 2 MIAM3 Ecdl e Crey CORRECTIVE ACTION AND FOLLOW UP Immediate corrective action taken Is follow up action needed? 0 Yes 0 No If yes,specify INDIVIDUALS NO'ILVIED *Abuse Registry 1-800-962-2873 *Applicable Law Enforcement Department Indicate person contacted,if report was accepted,the date and the time,and if by telephone or if copy of report available. Incident Reports—The Subrecipient must report to Miami-Dade County Homeless Trust information related to any critical incidents occurring during the administration term of its programs. In addition to reporting this incident to the appropriate authorities the Subrecipient must within twenty-four(24)hours of any incident,submit in writing a detailed account of the incident. This incident report should be addressed to the Contract Officer or Administrative Officer assigned. This incident report should be addressed to Miami Dade County Homeless Trust, 111 NW First Street,271 Floor,Suite 310,Miami;Florida 33128;telephone(305)375-1490-and facsmilie(305)375-2722. Definitions of Reportable Incidents a. Altercation. A physical confrontation occurring between a client and employee or two or more clients at the time services are being rendered,or when a client is in the physical custody of tbe department,which results in one or more clients or employees receiving medical treatment bya licensed health care professional. :b. Client Death. A person whose life terminates due to or allegedly due to an accident,,act of abuse,neglect or other incident occurring while in the presence of an employee,in Homeless Trust contracted program facility. c. Client Injury or Illness. A medical condition of a client requiring medical treatment by a 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 a Homeless Trust contracted program. d. Other Incident An unusual occurrence or circumstance initiated by something other than natural causes or out of the ordinary such as a tornado,kidnapping,riot,or hostage situation,which jeopardizes the health,safety and welfare of clients. e. Sexual Battery. An allegation of sexual battery by a client on a client, employee on a client, or client on an employee as evidencedbymedical evidence or law enforcement involvement. f. Suicide Attempt An act which clearly reflects the physical attempt by a client to cause his or her own death while in the physical custody of the deportment or a departmental contracted or certified provider,which results in bodily injury requiring medical treatment by a licensed health care professional: g. Property damage—an incident involving damage to any property procured with Miami-Dade County Homeless Trust funding. Print Name of Person Submitting Report Signature . ATTACHMENT H"MDC-HT Incident Report Form' Page 2 of 2 A/TANII-DADE COUNTY ITOMELESS TRUST POLICY&PROCEDURES SUBJECT ' INCIDENT REPORTING PROCEDURES EFFECTIVE DATE: 9/9/2.015 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 Carer PROCEDURES: 1. Homeless 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 the attention of our Incident Report Coordinator: Miguel Pimentel.These incidents are defined and outlined in CF-013215-6. • Child-on-Child Sexual Abuse • Child Arrest.. . • Child Death • Adult Death • Elopement refers to court ordered clientsthat 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 2. For each critical incident,an incident report must be submitted to Miami-Dade County Homeless Trust within one business day. The incident report needs to include•. • Facility/Home • Clients.Name • CIients 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 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 Treatment/First Aid • Signature of Staff Completing Fm in,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 Reporting Process.0515 - s NIIANII-DADE COWFY HOMELESS TRUST POLICY&PROCEDURES SUBJECT: INCIDENT REPORTING PROCEDURES EI I1 CTIVE DATE: 9/9/2015 < REVISED DATE: PURPOSE: The purpose of this policy is to define theprocess for receiving and processing incident reports. SCOPE Miami-Dade County Homeless Continuum of Care PROCEDURES: 1. Homeless 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 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 • Adult Death • Elopement refers to court ordered clients that runaway and do not return • Employee Arrest • Employee Misconduct • Escape • Missing Child • Security Incident -Unintentional • Significant Injury to Clients • Significant Injuryto Staff • Suicide Attempt • Sexual Abuse/Sexual Battery • 2. For each critical incident,an incident report must be submitted to Miami-Dade County Homeless Trust within one business day. The incident report needs to include: • Facility/Home • Clients Name. • Clients Age • Date&Time of Accident/Incident • Place of Accident/Incident • Description of Accident/Incident • . Description ornature of injury • Witness(es)to Accident/Incident MIAMI-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 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 Reporting Process.0 515 CFOP 215-6 STATE OF FLORIDA DEPARTMENT OF CF OPERATING PROCEDURE CHILDREN AND FAMILIES NO.215-6 TALLAHASSEE,April 1,2013 Safety INCIDENT REPORTING AND ANALYSIS SYSTEM(IRAS) 1. Purpose. This operating procedure establishes the guidelines for reporting and analyzing critical 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 licensed and contracted service providers. 2. Scope. a. This operating procedure applies to ail critical incidents occurring within the following Department of Children and Families program areas: (1) ACCESS; (2) Administration; (3) Adult Protective.Services; (4) Family Safety; • (5) Mental Health; and, (6) Substance Abuse. b. Incidents to be reported are those that occur:. s 7 (1) Involving a client, Department employee, or a licensed or contracted provider serving clients of the Department, or involving an employee of a licensed or contracted provider serving clients of the Department in the identified program areas;or, (2) Involving any licensed public or private substance abuse provider agency licensed in accordance with Chapter.397, Florida Statutes(RS.),and Chapter 65D-30,Florida Administrative Code (F,A.C.),and their employees. Compliance with this procedure is a condition of substance abuse licensureregardless of whether or not the provider serves any clients funded by the Department. c. The Incident Reporting and Analysis System (IRAS)allows for the timelynotification of 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 specific case management information,such as the progression of events and actions following the occurrence of a orifice!incident This operating procedure supersedes CFOP 215-8 dated December 1,2012. OP R: Assistant Secretary for Operations DISTRIBUTION: A April 1, 2013 CFOP 215-6 e. State mental health treatment facilities, public and private,are required to adhere to CFOP 155-25, Critical Event Reporting in State Mental Health Treatment Facilities, and are 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 law. 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 175-85, Prevention, Reporting and Services to Missing Children. (4) The reporting requirements provided for in CFOP 180-4, Mandatory Reporting Requirements to the Office of the Inspector General. 3. Definitions. a. Abuse. Any willful or threatened act or omission that causes or is likely to cause significant impairment to a child or 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. e. .Neolect. The failure or omission on the part of the caregiver to provide the care, supervision and services necessary to maintain the physical and mental health of a child or vulnerable adult; or the failure of a caregiver to make reasonable efforts to protect a child or vulnerable adult from abuse, neglect,or exploitation by others. f. Restraint. Any manual method or physical or mechanical device, materials,or equipment attached or adjacent to the individual's body so that he 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 person in any fashion, or involuntary isolation of a person in a room or area from which the person is prevented from leaving. The prevention may be 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. Policy. 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 by a Department employee to comply with this operating procedure may lead to disciplinary action. Failure by a Department licensed or contracted provider to comply with this operating procedure constitutes a lack of compliance with licensure status or contract provisions. 2 April 1,2013 CFOP 215-6 5. Critical incidents To Be Reported. a. Adult Death. An individual 18 years old or older whose life terminates while receiving services, during an investigation,or when it is known that an adult died within thirty(30) days of discharge from a treatment facility. 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. (1) The final classification of an adult's death is determined by the medical examiner, However,in the interim,the manner of death will be reported as one of the following: (a). Accident. A death due to the unintended actions of one's self or another. (b) Homicide. A death due to the deliberate actions of another. (c) Suicide. The intentional and voluntary taking of one's own life. (d) Undetermined. The manner of death has not yet been determined. (e) Unknown. The manner of death was not identified or made known. (2) If an adult'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 IRAS. b. Child Arrest. The arrest of a child in the custody of the Department. c. Child Death. An individual less than 18 years of age whose life terminates while receiving services,during an investigation,or when it is known that a child died within thirty(30) days of discharge from a residential program or treatment facility or when a death review is required pursuant to CFOP 175.17, Child.Fatality Review Procedures. The manner of death is the classification of categories used to define whether a death is fromintentional 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 interim,the manner of death will be reported as one of the following: (a).Accident A death due to the unintended actions of one's self or another. (b) Homicide. A death due to the deliberate actions of another. (o) Natural Expected. A death that occurs as a result of,or from complications of, a diagnosed illness for which the prognosis is terminal. (d) Natural Unexpected. A sudden deaththat was not anticipated and is attributed to an underlying disease either known or unknown prior to the death. (e) Suicide. The intentional and voluntary taking of one's own life. (f) Undetermined. The manner of death has not yet been determined. (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 IRAS. 3 April 1, 2013 CFOP 215-6 d. Child-on-Child Sexual Abuse. Any sexual behavior between children which occurs without consent,without equality, or as a 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 adult during involuntary civil placement within a Department-operated, Department-contracted or licensed service provider. (2) The unauthorized absence of a forensic client on conditional release in the community. (3)The unauthorized absence of any individual in a Department contracted or licensed residential substance abuse and/or mental health program. f. Employee Arrest. The arrest of 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 contracted or licensed service providers that results in potential liability for the Department; death or harm 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 court to a state mental health treatment facility pursuant to Chapter 916 or Chapter 394, Part V, Florida Statutes. i. Missing Child. When the whereabouts of a child in the custody of the Department are unknown and attempts to locate the child have been unsuccessful. j. Security Incident—Unintentional. An unintentional action or event that results in compromised data confidentiality,a danger to the physical safety of 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. k. 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 to a client, or a client to an employee regardless of the consent of the client. This may include sexual battery as defined in Chapter 794 of the Florida Statutes as`oral, anal, or vaginal penetration by, or union with, the sexual organ of another or the anal or vaginal penetration of another by any other object; however, sexual battery does not include an act done for a bona fide medical purpose." This includes any unsolicited or non-consensual sexual battery by one client to another client, a DCF 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 bodily trauma 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 permanent damage 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 thatrequires immediate medical or surgical evaluation or treatment in a hospital emergency department to prevent permanent damage or loss of life. 4 April l,2013 CFOP 215-6 n: Suicide Attempt. A potentially lethal act which reflects an attempt by an individual to cause. his or her own death as determined by a licensed mental health professional or other licensed healthcare professional. o. 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 Department,or itsprovider(s): These events may include but are not limited to: • (1) Human acts that jeopardize the health,safety, or welfare of clients such as kidnapping,riot, or hostage situation; (2) Bomb or biological/chemical threat of harm to personnel or propertyinvolving an explosive device or biological/chemical agent received in person,by telephone,in writing,via mail, electronically, or otherwise; (3) Theft,vandalism,damage, fire,sabotage,or destruction of state or private property of significant value or importance; (4) Death of an employee or visitor while on the grounds of the Department or one of its contracted or licensed providers; (5)Significant injury of a visitor(who is not a client)while on the grounds of the Departmentor one of its contracted,designated, or licensed providers;or, (6) Events regarding Department clients orclients of contracted or licensed service providers that have led to or may lead to media reports. 6. Guidelines for Reporting Incidents. a Notification/Reporting and Actions Taken-Staff Discovery of an Incident. (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 outlined in this operating procedure. (2) The employee's first obligation-is toensure the health,safety,and welfare of all individual(s)involved: (3) The employeemust immediately ensure contacts are made for assistance as dictated by the needs of the individuals involved: These types of contacts may include,but are not limited to: emergencymedical services(911), law enforcement,or the fire department. When the. incident involves suspected abuse,neglect,or exploitation,the employee must call the Florida Abuse Hotline to report the incident. The employee must ensure that the client's guardian, representative or relative is notified,as applicable: (4) Once the situation is stabilized and the staff has addressed any immediate physical or psychological service needs of the person(s)involved inthe incident,-the employee must report the incident to the Incident Coordinator. Eachservice provider/agency will use their internal reporting process and timeframes for notifying provider/agency leadership of incidents. All critical incidents must be entered into IROS within one business day of theincident occurring. (5) In the case of subcontractors, Managing Entities;or Lead Agencies,the responsibility for reporting critical incidents to the Department rests with the Department's contracted provider. 5 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 provider/agency. This person will manage the provider's/agency's incident notification process. Additional staff may be designated to enter incident information into the IRAS at the discretion of the service provider/agency. (2) When a supervisor is informed of a critical 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 shall develop internal procedures regarding reporting incidents to their Incident Coordinator or designee. (3) If the incident qualifies as a critical 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 report to the Department's designated Incident Coordinator or designee. The provider's/agency's Incident Coordinator will provide the information regarding the incident to the Department's Incident Coordinator or designee via the IRAS. (4) The service provider/agency will ensure timely notification of critical incidents is made to appropriate individuals or agencies such as emergency medical services (911), law enforcement, the Florida Abuse Hotline, the Agency for Health Care Administration (AHCA), or Center for Mental Health Services(for licensed mental health facilities), as required. The IRAS reporting process does not replace the reporting of incidents to other entities as required by statute, rules or operating procedure. c. Notification/Reporting and Actions Taken by Department's Incident Coordinator(s) 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 and make revisions as necessary. (2) The Department's Incident Coordinator or designee will make a determination regarding any required notifications that should be sent to Department leadership. The Department's Incident Coordinator or designee is 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 Information 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 not substitute for a direct phone call to the Department's leadership staff when the incident type or severity of the incident warrants such contact. This determination is to be made by the Department's Incident Coordinator or designee in consultation with other Department leadership staff, as needed. (4) The Department's incident Coordinator or designee should submit incidents in IRAS even in cases where there is missing information not readily available. When the information is obtained,the Incident Coordinator or designee should submit an update in IRAS as soon as possible. (5) The Department's Incident Coordinator or designee shall ensure all necessary information is entered into the IRAS in order to have a complete notification. The incident report is considered to be"complete"when the initial notifications have been made and sufficient information regarding the incident has been submitted. Additional information, such as from an autopsy or medical 6 April 1,2013 CFOP 215-6 examiner report regarding an incident can be submitted into the IRAS after the incident has been determined to be"complete" (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 what actions 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 wasrevised 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. 7 FY 2018 Miami-Dade County Homeless Trust Continuum of Care (CoC) Program "Real Property and Equipment Asset Inventory Report" ( ATTACHMENT I"2018 Real Property and Equipment Asset Report' mumita Eal ze 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: Cost Vendor Name: %of Purchase Cost from Grant. Location of Property Use and Condition of Property Who.Holds Title? Equipment 3: 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? *(please create additional pages as required) ATTACHMENT I"Miami-Dade County Real Property and Equipment Asset Inventory" • FY 2018 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'"2018 Rental Assistance Forms { FY 2018 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" • 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 instructions and so should be used in tandem with onscreen text and the hide/show instructions found on each individual screen. - Before starting the project application, all project applicants must complete or update (as applicable)the Project Applicant Profile in e-snaps. -Carefully review each question in the Project Application. Questions from previous competitions may have been changed or removed, or new questions may have been added, and information previously submitted 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 appears on the CoC's HUD-approved GIW. If the ARA is reduced through the CoC's reallocation process, the final project funding request must reflect the reduced amount listed on the CoC's reallocation 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 1 B. 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 FLO177L4D001811 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 1 F. 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 FLO177L4D001811 1G. HUD 2880 Applicant/Recipient Disclosure/Update Report - Form 2880 U.S. Department of Housing and Urban Development OMB Approval No. 2510-0011 (exp.11/30/2018) Applicant/Recipient Information 1. Applicant/Recipient Name, Address, and Phone Agency Legal Name: Miami-Dade County Prefix: Mr. First Name: Carlos Middle Name: A. Last Name: Gimenez Suffix: Title: County Mayor Organizational Affiliation: Miami-Dade County Telephone Number: (305) 375-1490 Extension: Email: cgimenez@miamidade.gov City: Miami County: Miami-Dade State: Florida Country: United States Zip/Postal Code: 33128 2. Employer ID Number (EIN): 59-6000573 3. HUD Program: Continuum of Care Program 4. Amount of HUD Assistance $65,212.00 Requested/Received: (Requested amounts will be automatically entered within applications) Renewal Project Application 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 Part III Interested Parties You must disclose: 1.All developers, contractors, or consultants involved in the application for the assistance or in the planning, development, or implementation of the project or activity and 2. any other person who has a financial interest in the project or activity for which the assistance is sought that exceeds$50,000 or 10 percent of the assistance (whichever is lower). Alphabetical list of all persons with a Social Security No. Type of Financial Interest Financial Interest Renewal Project Application FY2018 Page 10 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FLO177L4D001811 reportable financial interest in the or Employee ID No. Participation in Project/Activity in Project/Activity project or activity ($) (%) (For individuals,give the last name first) See detailed attachment placed in 59-6000573 CA $29,811,202.00 100°a' "Other Attachment" {1 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 (1)The dangers of drug abuse in the workplace employee 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 FLO177L4D001811 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 FL0177L4D001811 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 of a 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 FL0177L4D001811 2A. Project Subrecipients This form lists the subrecipient organization(s) for the project. To add a subrecipient, select the icon. To view or update subrecipient information already listed, select the view option. Total Expected Sub-Awards: $65,212 Organization Type Type Sub- Awar d Amo 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 FL0177L4D001811 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 FLO177L4D001811 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 FLO177L4D001811 3A. Project Detail 1. Project Identification Number (PIN) of FLO177 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 FLO177L4D001811 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 FLO177L4D001811 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 25 310 335 Adults ages 18-24 3 45 48 Accompanied Children under age 18 32 0 32 Unaccompanied Children under age 18 0 0 Total Persons 60 355 0 415 Click Save to automatically calculate totals Renewal Project Application FY2018 Page 29 05/20/2019 Applicant: Miami-Dade County 0041482920000 Project: City of Miami Beach Outreach FL0177L4D001811 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 Chronic Chronic Chronic Victims not ally ally ally Substan Persons Severely of Physical Develop represen 'Characteristics Homeles Homeles Homeles ce with Mentally Domesti Disabilit mental ted by s Non- s s Abuse HIV/AID III c y Disabilit listed Veterans Veterans�Veterans S Violence y subpopu 1 lations 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 0 0 0 1 0 3 28 Total Persons 8 3 0 0 0 3 6 0 3 38 Click Save to automatically calculate totals Persons in Households without Children Non- 1 1 Persons Chronic Chronic Chronic Chronic Victims not . ally ally ally Substan Persons Severely of Physical Develop represen Characteristics Homeles Homeles Homeles ce with Mentally Domesti Disabilit mental ted by s Non- s s Abuse HIV/AID III c y Disabilit listed Veterans Veterans Veterans S Violence y subpopu lations 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 Non- Persons Chronic Chronic Chronic Chronic Victims not ally ally ally Substan Persons Severely of Physical Develop represen Characteristics Homeles Homeles Homeles ce with Mentally Domesti Disabilit mental ted by s Non- s s Abuse HIV/AID III c y Disabilit listed Veterans Veterans Veterans S Violence y subpopu lations Accompanied Children under age 18 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 FLO177L40001811 5C. Outreach for Participants This screen is currently read only and only includes data from the previous grant. To make changes to this information, navigate to the Submission without Changes screen, select "Make Changes" in response to Question 2, and then check the box next each screen that requires a change to match the current grant agreement, as amended, or to account for a reallocation of funds. 1. Enter the percentage of project participants that will be coming from each of the following locations. 100% Directly from the street or other locations not meant for human habitation. Directly from emergency shelters. Persons at imminent risk of losing their night time residence within 14 days,have no subsequent housing identified, and lack the resources to obtain other housing(TH and SSO Pojects Only) Directly from safe havens. Persons fleeing domestic violence. Directly from transitional housing. Directly from 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 FLO177L4D001811 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 FL0177L4D001811 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) la.Leased Units $0 lb.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 FLO177L4D001811 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 feasible 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 FLO177L4D001811 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). 1 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 FLO177L4D001811 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 FLO177L4D001811 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 FLO177L4D001811 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