Food and Shelter Program Certification DocuSign Envelope ID:4E209EEA-A357-4E58-80CC-34C92DDB0316
20 (tet - -30e3C‘
EMERGENCY FOOD AND SHELTER NATIONAL BOARD PROGRAM
PHASE 36 LOCAL RECIPIENT ORGANIZATION CERTIFICATION
By signing this Local Recipient Organization (LRO) Certification Form, our agenyy certifies we have read and
understand the Emergency Food and Shelter Program (EFSP)Phase 33 Responsibilities and Requirements Manual
and Phase 36 Addendum, including the Grant Agreement Articles, Financial Terms and Conditions, and Other
Terms and Conditions as well as the Eligible and ineligible Costs and Documentation sections and agree to comply
with all program requirements. Our agency understands that all parties will be held accountable for complying with
the provisions of the grant as well as full compliance with applicable requirements of all other Federal laws,
Executive Orders, regulations, and policies governing this program including those not specifically stated in the
Manual. All appropriate staff and volunteers have been informed of EFSP requirements. The Local Board has been
provided and we have retained a copy of this form for our records.
I certify that my public or private agency:
• Has the capability to provide emergency food and/or shelter services.
• Will use funds to supplement/extend existing resources and not to substitute or reimburse ongcing programs and services.
• Is nonprofit or an agency of government.
• Will not use EFSP funds as a cost-match for other Federal funds or programs.
• Has an accounting system,and will pay all vendors by an approved method of payment.
• Understands that cash payments(including oetty cash)are not etipible undecEFSP.
• Condugs an independent annual review if receiving S50.000-599.999/an independent annual au it if receiving 5100.000 or more in
. FSP funds.and follows OMIB's Uniformed Guidance if receiving 5750.000 or more in Federal nding.
• Has not received an adverse or no opinion audit.
• Is not debarred or suspended from receiving Federal funds.
• Has provided a Federal Employer Identification Number(FEIN)to EFSP.
• Has provided a Data Universal 1 urrer System (DUNS) number issued by Dun & Bradstreet (D&B) and required associated
information to EFSP.
• Practices non-discrimination (agencies with a religious affiliation, will not refuse service to an applicant based on religion, nor
engage in religious proselytizing or religious counseling in any program receiving Federal funds).
• Will not charge a fee to clients for EFSP funded services.
• Has a voluntary board if private,not-for-profit.
• Will provide all required reports to the Local Board in a timely manner;(i.e.,Second Payment/Interim Request and Final Reports).
• Will expend monies only on eligible costs and keep complete documentation(copies of canceled LRO checks - front and back,
other proof of payment,invoices,receipts,etc.) on all expenditures for a minimum of three years after end-of-program date,and
for compliance issues until resolved.
• Will spend all funds and close-out the program by my jurisdict'ion's selected end-of-program date and return any unused funds
(S5.00 or more)to the National Board.
• Will provide complete,accurate documentation of expenses to the Local Board,if requested,following my jurisdiction's selected
end-of-program date.
• Has no known EFSP compliance exceptions in this or any other jurisdiction.
• Will not use EFSP funding for any lobbying activities and if receiving S100,000 or more,will provide the"Certification Regarding
Lobbying"and,if applicable,will complete Standard Form LLL, "Disclosure Form to Report Lobbying",in accordance with its
instructions.
• Will not and will ensure its employees,volunteers or other individuals associated with the program will not engage in any trafficking
of persons during the period this award is in effect.
• Will nor and will ensure its employees,volunteers or other individuals associated with the program will not use EFSP funds to
support access to classified national security information.
PLEASEENSURE THIS LVFORlL4TION IS ACCURATE BEFORE SIGNING.
APPROVED AS TO
LRO ID#: 159400076 FORM & LANGUAGE
FEIN#: 59-6000372 & FOR EXECUTION
DUNS#: 020546289 �
LRO Legal Name: City of Mi ami Beach t _ ] n � {(- Zr(`
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Address: 1700 Convention Center Drive Miami Beach FLORIDA 33139 "'� '�' ��
Phone#: 305-604-2421 City Attorney , "� D Ire
Fax#: 786-394-4675
Email: judyhoanshelt@miamibeachfl.gov
LRO Contact: Judy Hoanshelt Authori -d Signa r:Jimmy L. Morales
S' ature: ► Date: Z/247