Fiscal Year 2023-2024 Grant Agreement between CMB & Boys and Girls Clubs of Miami- Dade, Inc.DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
Reso No.: 2023- 32--) r� 6
/MIAAA IBEACH
CITY OF MIAMI BEACH
FISCAL YEAR 2023-2024 GRANT AGREEMENT
NUV 2 J 2023 GRANT PROJECT No.: 2024-CMB-02
This GRANT AGREEMENT (hereinafter the "Agreement') is made and entered into this
day of ,6Uabel , 20 Z3 by and between the City of Miami Beach, Florida
(hereinafter the "City"), and lorida not -for -profit
corporation (hereinafter the "Grantee"). This Agreement is effective October 1, 2023, the "Effective
Date."
ARTICLE I / GRANT DESCRIPTION
GRANTEE:
Boys and Girls Clubs of Miami -Dade, Inc.
GRANTEE CONTRACT ADMINISTRATOR:
Franchon Green
ADDRESS:
2805 SW 32 Avenue
CITY, STATE, ZIP:
Miami, FL 33133
PHONE, FAX, E-MAIL:
305-446-9910 ext 110
GRANT AMOUNT:
$17,000
PROJECT DESCRIPTION:
See Exhibit 1 hereto
GRANT PROJECT BUDGET:
See Exhibit 2 hereto
GRANT TERM:
October 1. 2023 — September 30, 2024
EXPENDITURE DEADLINE:
September 30, 2024
PROJECT COMPLETION DATE:
September 30, 2024
FINAL REPORT DEADLINE:
October 10. 2024
FINAL REIMBURSEMENT REQUEST DEADLINE: October 10, 2024
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IN WITNESS WHEREOF, the parties hereto have executed this Agreement.
FOR CITY:
ATTEST:
By:
Rafael E. Granado, City Clerk
Date
FOR GRANTEE:
ATTEST:
City of Miami Beach, Florida
'a
Alina T. Hudak, City Manager
NOV 2 J 2023
era► .. � � —"
Print Name and Title
APPROVED AS TO
FORM & LANGUAGE
& FOR EXECUTION
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City Attorney ter" Date
Boys and Girls Clubs of Miami -Dade, Inc.
Federal Id No. 59-0879227
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Authorized Signature ze
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Print Name and Title
Date WAIEL F~Da
NOUN Publk
State of FWWS
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ARTICLE II 1 GENERAL CONDITIONS
1. PARTIES: The parties to this Agreement are the Grantee listed in Article I, and the City, a
municipal corporation organized under the laws of the State of Florida. The City has delegated the
responsibility of administering this Grant to the City Manager or the City Manager's authorized designee
(the "Contract Administrator').
2. PROJECT DESCRIPTION: The Grantee may only use the Grant for the purposes that are
specifically described in the Project Description, attached hereto as Exhibit 1 (the "Project"). Any
modification to Exhibit 1 ("Project Description"), shall not be effective unless approved by a written
amendment to this Agreement signed by the City and Grantee. Grantee agrees that all funding provided
by the City pursuant to this Agreement will be used exclusively for goods or services to be provided
within the City of Miami Beach.
3. GRANT PROJECT BUDGET: Subject to the availability of City funds, the maximum amount
payable to Grantee for goods or services rendered under this Agreement shall not exceed the Grant
Amount as set forth in Article I of this Agreement. Grantee agrees that should available City funding be
reduced, the amount payable under this Agreement will be reduced at the sole option of the City of
Miami Beach. All of the Grantee's expenditures are subject to the terms of this Agreement, and as
specified in the Grant Project Budget, attached hereto as Exhibit 2. Any modification to Exhibit 2
("Project Budget"), shall not be effective unless approved, in writing, by the City and Grantee. Any
request by Grantee to modify the Project Budget shall be made in writing, using City approved forms,
detailing and justifying the need for such changes. Notwithstanding the foregoing, no modification to
the Project Budget shall exceed the Grant Amount set forth in Article I of this Agreement.
4. REPORTS: This Grant has been awarded with the understanding that the activities and services
contemplated under the Project Description will mutually contribute to the enhancement of services
available to City residents, businesses, and visitors. As a condition of disbursements of grant funds,
and to demonstrate that the Grant is fulfilling, or has fulfilled, its purpose, the Grantee must submit
quarterly reports to the Contract Administrator by the following dates: January 15", April 1511, July 15",
and the final report by October 1011.
New Grant awards will not be released to the Grantee until all Final Reports for previously awarded
grants are received. The City may withhold any future payments of the Grant, or the award of any
subsequent Grant, if it has not received all reports required to be submitted by Grantee, or if such
reports do not meet the City's reporting requirements_ Any reports may be disseminated by the City
without the prior written consent of the Grantee. All quarterly reports must be submitted on the Grant
Quarterly Status Report Form, attached hereto as Exhibit 3, detailing Grantee's compliance at the time
of a partial reimbursement request.
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5. REIMBURSEMENT REQUESTS: Reimbursement requests may be submitted to the City at any
time during the Grant Term. All reimbursement requests must be made after expenditures have
occurred. All reimbursement requests for funds must be submitted on the Grant Reimbursement
Request Form, attached hereto as Exhibit 4. All reimbursement requests must be submitted prior to
October 101", 2023. Grantee shall provide the City with copies of all receipts, invoices, cancelled checks
(with copies of both front of back) and proof of expenditures of Grant monies. Grantee shall provide the
City with and shall categorize all receipts, invoices, cancelled checks, and other documentation,
according to the categories set forth in the grant budget. Invoices and checks must be directly related
to expenses for Grant -funded activities taking place within the 2023-2024 Fiscal Year.
6. AMOUNT OF GRANT AND PAYMENT SCHEDULE: The total amount of the Grant is set forth
in Article 1, subject to the restrictions set forth herein. In awarding this Grant, the City assumes no
obligation to provide financial support of any type whatsoever in excess of the total Grant Amount. Cost
overruns are the sole principal responsibility of the Grantee. The Grant funds will only be remitted to
the Grantee once the Mayor and City Commission have approved the grant award, and once all parties
have executed this Agreement.
7. GRANT RESTRICTIONS: Grant funds awarded pursuant to this Agreement may not be used
for the following expenditures: remuneration of City employees for services rendered as part of a project
funded by this Grant; debt reduction; social and/or fundraising events; cash prizes; lobbying or
propaganda materials; charitable contributions; or events not open to the public.
8. NO GUARANTEE OF FUNDING: The Grantee acknowledges that the receipt of this Grant does
not imply a commitment on behalf of the City to continue or provide funding beyond the terms specified
in this Agreement.
9. PROGRAM MONITORING AND EVALUATION. The City Manager or the City Manager's
designee may monitor and conduct an evaluation of the Project under this Grant, which may include,
with or without limitation, visits by City representatives to Grantee's offices and/or the site of any project
funded by this Grant, to observe Grantee's programs, procedures, and operations, or to discuss the
Grantee's programs with Grantee's personnel; and/or requests for submittal of additional documentation
or written reports, prior to the Project completion date, evidencing Grantee's progress on the Project.
10, BANK ACCOUNTS AND BONDING: Grantee shall maintain all monies received pursuant to
this Agreement in an account with a bank or savings and loan association that is located in Miami -Dade
County. The Grantee shall provide the City with the name of the bank or savings and loan association,
as well as the name and title of all individuals authorized to withdraw or write checks on Grant funds.
11. ACCOUNTING AND FINANCIAL REVIEW: Funded activities by this Grant must take place
during the City's fiscal year for which the Grant is approved (October 1 — September 30). The Grantee
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shall keep accurate and complete books and records of all receipts and expenditures of Grant funds, in
conformance with reasonable accounting standards. These books and records, as well as all
documents pertaining to payments received and made in conjunction with this Grant, including, without
limitation, vouchers, bills, invoices, receipts and canceled checks, shall be dated within the fiscal year
for which they are approved and retained in Miami -Dade County in a secure place and in an orderly
fashion by the Grantee for at least three (3) years after the Expenditure Deadline specified in in this
Agreement. These books, records, and documents may be examined by the City, and/or its authorized
representatives, at the Grantee's offices during regular business hours and upon reasonable notice.
Furthermore, the City may, at its expense, audit or have audited, all the financial records of the Grantee,
whether or not purported to be related to this Grant.
Grantee costs or earnings claimed under this Agreement may not also be claimed under
any other Agreement from the City of Miami Beach or from any other entity. Any claim for double
payment by Grantee shall be a material breach of this Agreement.
12_ INSPECTOR GENERAL AUDIT RIGHTS:
A. Pursuant to Section 2-256 of the Code of the City of Miami Beach, the City has established
the Office of the Inspector General which may, on a random basis, perform reviews, audits, inspections
and investigations on all City contracts, throughout the duration of said contracts. This random audit is
separate and distinct from any other audit performed by or on behalf of the City.
B. The Office of the Inspector General is authorized to investigate City affairs and empowered
to review past, present and proposed City programs, accounts, records, contracts and transactions. In
addition, the Inspector General has the power to subpoena witnesses, administer oaths, require the
production of witnesses and monitor City projects and programs. Monitoring of an existing City project
or program may include a report concerning whether the project is on time, within budget and in
conformance with the contract documents and applicable law. The Inspector General shall have the
power to audit, investigate, monitor, oversee, inspect and review operations, activities, performance
and procurement process including but not limited to project design, bid specifications, (bid/proposal)
submittals, activities of the Grantee , its officers, agents and employees, lobbyists, City staff and elected
officials to ensure compliance with the contract documents and to detect fraud and corruption. Pursuant
to Section 2-378 of the City Code, the City is allocating a percentage of its overall annual contract
expenditures to fund the activities and operations of the Office of Inspector General.
C. Upon ten (10) days written notice to the Grantee, the Grantee shall make all requested
records and documents available to the Inspector General for inspection and copying. The Inspector
General is empowered to retain the services of independent private sector auditors to audit, investigate,
monitor, oversee, Inspect and review operations activities, performance and procurement process
including but not limited to project design, bid specifications, (bid/proposal) submittals, activities of the
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Grantee, its officers, agents and employees, lobbyists, City staff and elected officials to ensure
compliance with the contract documents and to detect fraud and corruption.
D. The Inspector General shall have the right to inspect and copy all documents and records in
the Grantee's possession, custody or control which in the Inspector General's sole judgment, pertain to
performance of the contract, including, but not limited to original estimate files, change order estimate
files, worksheets, proposals and agreements from and with successful subcontractors and suppliers,
all project -related correspondence, memoranda, instructions, financial documents, construction
documents, (bid/proposal) and contract documents, back -change documents, all documents and
records which involve cash, trade or volume discounts, insurance proceeds, rebates, or dividends
received, payroll and personnel records and supporting documentation for the aforesaid documents
and records.
E. The Grantee shall make available at its office at all reasonable times the records, materials,
and other evidence regarding the acquisition (bid preparation) and performance of this contract, for
examination, audit, or reproduction, until three (3) years after final payment under this contract or for
any longer period required by statute or by other clauses of this contract. In addition:
i. If this contract is completely or partially terminated, the Grantee shall make available
records relating to the work terminated until three (3) years after any resulting final
termination settlement, and
ii. The Grantee shall make available records relating to appeals or to litigation or the
settlement of claims arising under or relating to this contract until such appeals, litigation,
or claims are finally resolved.
F. The provisions in this section shall apply to the Grantee, its officers, agents, employees,
subcontractors and suppliers. The Grantee shall incorporate the provisions in this section in all
subcontracts and all other agreements executed by the Grantee in connection with the performance of
this contract.
G. Nothing in this section shall impair any independent right to the City to conduct audits or
investigative activities. The provisions of this section are neither intended nor shall they be construed
to impose any liability on the City by the Grantee or third parties.
13. PUBLICITY AND CREDITS: The Grantee must include the City logo and the following credit
line in all publications related to this Grant: "This Project is funded in whole or in part by a grant
from the City of Miami Beach." Grantee's failure to comply with this paragraph may preclude future
grant funding from the City, in the same manner as if Grantee defaulted under this Agreement.
14. LIABILITY AND INDEMNIFICATION: Grantee shall indemnify, defend and hold harmless the
City and its officers, employees, agents, and contractors, from and against any and all actions (whether
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at law or in equity), claims, liabilities, losses, expenses, or damages, including, without limitation,
attorneys' fees and costs of defense, for personal, economic, or bodily injury, wrongful death, or loss of
or damage to property, which the City or its officers, employees, agents and contractors may incur as
a result of claims, demands, suits, causes of action or proceedings of any kind or nature arising out of,
relating to, or resulting from the performance of this Agreement by the Grantee or its officers,
employees, agents, servants, partners, principals or contractors. Grantee shall pay all claims and losses
in connection therewith and shall investigate and defend all claims, suits, or actions of any kind or nature
in the name of the City, where applicable, including appellate proceedings, and shall pay all costs,
judgments, and attorneys' fees which may issue thereon. Grantee expressly understands and agrees
that any insurance protection required by this Agreement, or otherwise provided, shall in no way limit
its obligation, as set forth herein, to indemnify, defend and hold harmless the City or its officers,
employees, agents, and contractors as herein provided.
If the Grantee is a government entity, this indemnification shall only be to the extent and within the
limitations of Section 768.28, Florida Statutes, subject to the provisions of that Statute, whereby the
Grantee entity shall not be held liable to pay a personal injury or property damage claim or judgment by
any one person which exceeds the sum of $200,000, or any claim or judgment or portions thereof,
which, when totaled with all other claims or judgments paid by the government entity arising out of the
same incident or occurrence, exceed the sum of $300,000 from any and all personal injury or property
damage claims, liabilities, losses or causes of action which may arise as a result of the negligence of
the Grantee entity.
15_ ASSIGNMENT: The Grantee shall not be permitted to assign this Grant, and any purported
assignment will be void, and shall be treated as an event of default pursuant to this Agreement.
16. COMPLIANCE WITH LAWS: The Grantee agrees to abide by and be governed by all applicable
Federal, State, County and City laws, including but not limited to Miami -Dade County's Conflict of
Interest and Code of Ethics Ordinance, as amended, which is incorporated herein by reference as if
fully set forth herein, and Chapter 2, Article VII of the City Code, as amended, which is incorporated
herein by reference as if fully set forth herein.
17. DEFAULT/TERMINATION PROVISIONS: In the event the Grantee shall fail to comply with any
of the provisions of this Agreement, the City Manager or the City Manager's designee may terminate
this Agreement and withhold or cancel all or any unpaid installments of the Grant upon giving five (5)
calendar days written notice to the Grantee, and the City shall have no further obligation to the Grantee
under this Agreement. Further, in the event of termination, the Grantee shall be required to immediately
repay to the City all portions of the Grant which have been received by the Grantee, as of the date that
the written demand is received.
Any uncommitted Grant funds which remain in the possession or under the control of the
Grantee as of the date of the Expenditure Deadline specified in this Agreement must be returned to the
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City within fifteen (15) days after the Expenditure Deadline. If such funds have been committed but not
expended, the Grantee must request in writing from the City Manager an extension of the Expenditure
Deadline which, if approved, shall be for a period not to exceed one (1) year.
Grant funds which are to be repaid to the City pursuant to this Section are to be repaid upon
demand by delivering to the City Manager a certified check for the total amount due, payable to the City
of Miami Beach, Florida.
These provisions shall not waive or preclude the City from pursuing any other remedies that
may be available to it under the law or in equity.
Noblvithstanding the provisions of this Section, and without regard to whether City has exercised
the Default provisions thereof, the City reserves the right, at its sole and absolute discretion, to
discontinue funding of the Grant if it is not satisfied with the progress of the Project or the content of any
required written report. In the event of discontinuation of the Grant or at the close of the Project, any
unexpended Grant Funds shall be immediately returned to the City, except where the City Manager has
agreed in writing to alternative use of the unused unexpended Grant Funds.
18. INSURANCE REQUIREMENTS:
A. Verification of Coverage
Grantee shall provide the required insurance certificates, endorsements or applicable policy language
effecting coverage required by this Section, as follows. All certificates of insurance and endorsements
are to be received prior to any work commencing. However, failure to obtain the required coverage
prior to the work beginning shall not waive the Grantee's obligation to provide them. The City of Miami
Beach reserves the right to require complete, certified copies of all required insurance policies, including
endorsements required by these specifications, at any time.
i. Worker's Compensation Insurance as required by Florida Statute, Chapter 440, and
Employer's Liability Insurance with limits of no less than $1,000,000 per accident for
bodily injury or disease.
ii. Commercial General Liability on a comprehensive basis, including products and
completed operations, contractual liability, property damage, bodily injury and personal
& advertising injury combined single limit of $1,000,000 per occurrence for bodily injury
and property damage. City of Miami Beach must be shown as an additional insured with
respect to this coverage.
iii. Automobile Liability Insurance covering all owned, non -owned and hired vehicles used
in connection with the work, in an amount not less than $500,000 combined single limit
per occurrence for bodily injury and property damage.
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B. Additional Insured Status
The City of Miami Beach must be covered as an additional insured with respect to liability arising out of
work or operations performed by or on behalf of the Grantee.
C. Waiver of Subrogation
Grantee hereby grants to the City of Miami Beach a waiver of any right to subrogation which any insurer
of the Grantee may acquire against the City of Miami Beach by virtue of the payment of any loss under
such insurance. Grantee agrees to obtain any endorsement that may be necessary to affect this waiver
of subrogation, but this provision applies regardless of whether or not the City of Miami Beach has
received a waiver of subrogation endorsement from the insurer.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best's rating of no less than A:VII, unless
otherwise acceptable to the City of Miami Beach Risk Management Office.
E. Special Risks or Circumstances
The City of Miami Beach reserves the right to modify these requirements, including limits, based on the
nature of the risk, prior experience, insurer, coverage, or other special circumstances.
Certificate Holder
Certificate holder must read.
CITY OF MIAMI BEACH
c/o HR Department/Risk Management Division
1700 Convention Center Drive
Miami Beach, FL 33139
F. Compliance with the foregoing requirements shall not relieve the Grantee of its liability and
obligation under this section or under any other section of this Agreement.
19. FLORIDA PUBLIC RECORDS LAW:
A. Grantee shall comply with Florida Public Records law under Chapter 119, Florida Statutes,
as may be amended from time to time.
B. The term "public records" shall have the meaning set forth in Section 119.011(12), which
means all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data
processing software, or other material, regardless of the physical form, characteristics, or means of
transmission, made or received pursuant to law or ordinance or in connection with the transaction of
official business of the City.
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C. Pursuant to Section 119.0701 of the Florida Statutes, if the Grantee meets the definition of
"Contractor" as defined in Section 119.0701(1)(a), the Grantee shall:
i. Keep and maintain public records required by the City to perform the service;
ii. Upon request from the City's custodian of public records, provide the City with a copy
of the requested records or allow the records to be inspected or copied within a
reasonable time at a cost that does not exceed the cost provided in Chapter 119,
Florida Statutes or as otherwise provided by law;
iii. Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed, except as authorized by law, for the
duration of the contract term and following completion of the Agreement if the Grantee
does not transfer the records to the City;
iv. Upon completion of the Agreement, transfer, at no cost to the City, all public records in
possession of the Consultant or keep and maintain public records required by the City
to perform the service. If the Consultant transfers all public records to the City upon
completion of the Agreement, the Grantee shall destroy any duplicate public records
that are exempt or confidential and exempt from public records disclosure
requirements. If the Grantee keeps and maintains public records upon completion of
the Agreement, the Consultant shall meet all applicable requirements for retaining
public records. All records stored electronically must be provided to the City, upon
request from the City's custodian of public records, in a format that is compatible with
the information technology systems of the City.
D. REQUEST FOR RECORDS; NONCOMPLIANCE
A request to inspect or copy public records relating to the City's contract for services
must be made directly to the City. If the City does not possess the requested records,
the City shall immediately notify the Consultant of the request, and the Grantee must
provide the records to the City or allow the records to be inspected or copied within a
reasonable time.
ii. Grantee's failure to comply with the City's request for records shall constitute a breach
of this Agreement, and the City, at its sole discretion, may: (1) unilaterally terminate the
Agreement; (2) avail itself of the remedies set forth under the Agreement; and/or (3) avail
itself of any available remedies at law or in equity.
iii. A Grantee who fails to provide the public records to the City within a reasonable time
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may be subject to penalties under s. 119.10.
E. CIVIL ACTION
i. If a civil action is filed against a Grantee to compel production of public records relating
to the City's contract for services, the court shall assess and award against the Grantee
the reasonable costs of enforcement, including reasonable attorneys' fees, if
a. The court determines that the Grantee unlawfully refused to comply with the public
records request within a reasonable time; and
b. At least 8 business days before filing the action, the plaintiff provided written notice
of the public records request, including a statement that the Grantee has not
complied with the request, to the City and to the Grantee.
ii. A notice complies with subparagraph (i)(b) if it is sent to the City's custodian of public
records and to the Grantee at the Grantee's address listed on its contract with the City
or to the Grantee's registered agent. Such notices must be sent by common carrier
delivery service or by registered, Global Express Guaranteed, or certified mail, with
postage or shipping paid by the sender and with evidence of delivery, which may be in
an electronic format.
iii. A Grantee who complies with a public records request within 8 business days after the
notice is sent is not liable for the reasonable costs of enforcement.
F. IF THE GRANTEE HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
GRANTEE'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS
AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT:
CITY OF MIAMI BEACH
ATTENTION: RAFAEL E. GRANADO, CITY CLERK
1700 CONVENTION CENTER DRIVE
MIAMI BEACH, FLORIDA 33139
E-MAIL: RAFAELGRANADOAMIAMIBEACHFL.GOV
PHONE: 305-673-7411
20. E-VERIFY:
A. Grantee shall comply with Section 448.095, Florida Statutes, "Employment Eligibility" ("E-
Verify Statute"), as may be amended from time to time. Pursuant to the E-Verify Statute, commencing
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on January 1, 2021, Grantee shall register with and use the E-Verify system to verify the work
authorization status of all newly hired employees during the Term of the Agreement. Additionally,
Grantee shall expressly require that any approved sub -contractor performing work or providing services
pursuant to the Agreement to likewise utilize the U.S. Department of Homeland Security's E-Verify
system to verify the employment eligibility of all new employees hired by the subcontractor during the
contract Term. If Grantee enters into a contract with an approved subcontractor, the subcontractor
must provide the Grantee with an affidavit stating that the subcontractor does not employ, contract with,
or subcontract with an unauthorized alien. Grantee shall maintain a copy of such affidavit for the
duration of the subcontract or such other extended period as may be required under this Agreement.
B. TERMINATION RIGHTS.
i. If the City has a good faith belief that Grantee has knowingly violated Section 448.09(1),
Florida Statutes, the City shall terminate this Agreement with Grantee for cause, and the
City shall thereafter have or owe no further obligation or liability to Grantee.
ii. If the City has a good faith belief that a subcontractor has knowingly violated the
foregoing Subsection 20(A), but the Grantee otherwise complied with such subsection,
the City will promptly notify the Grantee and order the Grantee to immediately terminate
the agreement with the subcontractor. Grantee's failure to terminate a subcontractor
shall be an event of default under this Agreement, entitling City to terminate this
Agreement for cause.
A contract terminated under the foregoing Subparagraphs (B)(i) or (B)(ii) is not in breach
of contract and may not be considered as such.
iii. The City or Grantee or a subcontractor may file an action with the Circuit or County Court
to challenge a termination under the foregoing Subparagraphs (B)(i) or (B)(ii) no later
than 20 calendar days after the date on which the contract was terminated.
iv. If the City terminates the Agreement with Grantee under the foregoing Subparagraph
(B)(i), Grantee may not be awarded a public contract for at least 1 year after the date of
termination of this Agreement-
v. Grantee is liable for any additional costs incurred by the City as a result of the termination
of this Agreement under this Section 20.
21. BOARD TRAINING: Pursuant to Resolution 2018-30552, Grantee is required to have 51%
or more of its board membership complete the City's training for board members, if all three of the
following apply: 1) the agency is a non-profit; 2) the agency has an annual operating budget of less than
$5 million; and, 3) the grant award is for $25,000 or more in City funds. The Board Training must be
completed within the last two years prior to the receipt of City funds.
22. WRITTEN NOTICES: Any notices required under this Agreement will be effective when
delivered to the City in writing and addressed to the City Grant Administrator, as identified in Section
23. Any notices required under this Agreement will be effective when delivered to the Grantee in writing
and addressed to the Grantee Contract Administrator.
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23. CITY CONTRACT ADMINISTRATOR: All contract related questions, reports and requests
for reimbursements to be submitted to Grants Management Department listed below:
Krystal M. Dobbins, Grants Management Division Director
KrystalDobbinsAmiamibeachfl.00v
Elizabeth Carrino, Grant Writer Researcher
ElizabethCarrinoOmiamibeachfl.00v
ARTICLE III / MISCELLANEOUS PROVISIONS
24. PUBLIC PURPOSE: The Grant awarded herein is the result of a finding by the City, based
on representatives, documents, materials and other information supplied by Grantee, that the Grantee
is performing a public purpose through the programs, projects, and/or services recommended for
support. As such, use of Grant funds for any program component not meeting this condition will be
considered a breach of the terms of this Agreement and will allow the City to seek remedies including,
but not limited to, those outlined in this Agreement.
25. NO DISCRIMINATION: The Grantee also accepts and agrees to comply with the following
Special Conditions:
A. Grantee hereby agrees that it will comply with Title VII of the Civil Rights Act of 1964
(Pub. L. 88-352) (Title VII), as amended, as it appears in volume 42 of the United States Code,
beginning at Section 2000e, prohibiting employment discrimination based on race, color, religion, sex
and national origin.
B. The Grantee hereby agrees that it will comply with City of Miami Beach Human Rights
Ordinance as codified in Chapter 62 of the City Code, as may be amended from time to time, prohibiting
discrimination in employment (including independent contractors), housing and public
accommodations, public services and in connection with its membership or policies on account of actual
or perceived race, color, national origin, religion, sex, intersexuality, gender identity, sexual orientation,
marital and familial status, age, disability, ancestry, height, weight, hair texture and/or hairstyle,
domestic partner status, labor organization membership, familial situation, or political affiliation.
C. The City endorses, and Grantee shall comply with, the clear mandate of the Americans
with Disabilities Act of 1990 (ADA) to remove barriers, which prevents qualified individuals with
disabilities from enjoying the same employment opportunities that are available to persons without
disabilities.
D. The City also endorses the mandate of the Rehabilitation Act of 1973 and Section 504
Page 13
DocuSign Envelope ID: 0120OF8F-3D2B-45B9-A9F7-C2C6FDF83C77
and prohibits discrimination on the basis of disability and requires that Grant recipients provide equal
access and equal opportunity and services without discrimination on the basis of any disability.
26. GOVERNING LAW AND EXCLUSIVE VENUE: This Agreement shall be governed by, and
construed in accordance with, the laws of the State of Florida, both substantive and remedial, without
regard to principles of conflict of laws. The exclusive venue for any litigation arising out of this
Agreement shall be Miami -Dade County, Florida, if in State court, and the U.S. District Court, Southern
District of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, GRANTOR AND
GRANTEE EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY
OF ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS AGREEMENT.
27. NO WAIVER: No waiver of any breach or failure to enforce any of the terms, covenants,
conditions or other provisions of this Agreement by either party at any time shall in any way affect, limit,
modify or waive either party's right thereafter to enforce or compel strict compliance with every term,
covenant, condition or other provision hereof.
28. CAPTIONS USED IN THIS AGREEMENT: Captions, as used in this Agreement, are for
convenience of reference only and should not be deemed or construed as in any way limiting or
extending the language or provisions to which such captions may refer.
29. CONTRACT REPRESENTS TOTAL AGREEMENT: This contract, including its special
conditions and exhibits, represents the whole and total agreement of the parties. No representations,
except those contained within this Agreement and its attachments, are to be considered in construing
its terms. No modifications or amendments may be made to this Agreement unless made in writing
signed by both parties. The City Manager, on behalf of the City, shall be authorized to execute
amendments to this Agreement; however, any changes to the Grant Amount shall require approval by
the Mayor and City Commission.
30. BACKGROUND SCREENING REQUIREMENT: (ONLY IF GRANTEE OR GRANTEE'S
EMPLOYEES WILL BE IN CONTACT WITH CHILDREN DO YOU NEED THIS BACKGROUND
SCREENING REQUIREMENT)ln accordance with Sections 943.0542, 984.01, 39.001 and 1012.465,
Florida Statutes and Chapters 430, 435, and 402, Florida Statutes, as applicable, employees,
volunteers, contractors, and subcontracted personnel who work in direct contact with children or who
come into direct contact with children must complete a satisfactory Level 2 background screening prior
to commencing work pursuant to this Agreement.
Level 2 Background screenings must be completed through the City of Miami Beach, Human
Resources Department. Contractor agrees to complete Level 2 Background screening prior to initiating
any work related to this Agreement, unless the City's Contract Administrator approves an alternative
process
Page 14
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
EXHIBIT 1
PROJECT DESCRIPTION
BACKGROUND/DESCRIPTION OF NEED
The Boys and Girls Clubs of Miami -Dade are requesting support to help cover the cost of both Project
Learn and Great Futures for Teens. Unfortunately, many of our participant's single parents have to work
long hours or even two jobs to pay for basic needs. To fill this essential need in our community our clubs
provide youth with a safe place and excellent educational programming during the most vulnerable
times of the day when school is out. According to the Office of Juvenile Justice and Delinquency
Prevention, "nearly one-third of all violent crime committed by juvenile offenders occurs between 3 p.m.
and 7 p.m." This is the time of day when our programs are operational and keeping youth away from
trouble. The Boys and Girls Clubs of Miami -Dade have established an outstanding reputation
throughout our many years of service to our community as an answer to this problem.
PROGRAM DESCRIPTION
1. Proiect Learn: This program's goal is to serve 150 children during after -school and 300
children/youth in summer camp at the Miami Beach site. Project Learn offers a safe structural
environment with evidence -based activities for children from kindergarten through sixth grade. The
activities include Science, Technology, Engineering, and Math (STEM) through our Boys and Girls
Clubs of America (BGCA) DIY -STEM program, literacy, academic support and homework
assistance, a cohort of art or music, physical fitness, family engagement, enrichment activities,
health education, mentoring, and arts/crafts. Over the last few years, we have enhanced the
program by bringing on State of Florida Board Certified Teachers to tutor struggling students.
Moreover, we also have Exceptional Student Education (ESE) Specialists to work specifically with
children who have a disability. Approximately 10% of the children in our programs have a disability.
This includes our Great Futures for Teens program.
2. Great Futures for Teens: This program caters to our pre -teen and teenage population. It offers
mentoring, academic support for increased educational achievement, college readiness and
preparation, social -emotional learning and skill building, sports, (STEM) Science, Technology,
Engineering, and Math, and financial education. Our teens visit local universities multiple times per
year to learn about the application and financial aid process. Our goal is to keep children and youth
in school and on track for graduation while providing them opportunities to learn and grow in different
directions for a better future.
LOCATION
Boys and Girls Clubs if Miami -Dade
South Beach Site
1200 Michigan Avenue
Miami Beach, FL 33139
Page 15
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
GRANT ACTIVITIES
Activity Name Activity Description Description of
No. Service
Service Recipients
Recipients
Literacy/Homework
Tutoring Children
150
Assistance
Spark/Sports
Sports, Play, and Active Recreation
Children
150
for kids
Social Emotional
Second Step/Date SMART
Children
150
Learning
Science, Technology, Engineering
Children
150
STEM
& Math through BGCA DIY
Curriculum
GOALSIOUTCOMES
Outcome Measure i Target Reporting Deadline
65% of children will make The PACER multi-� Based on time End of Year
meaningful improvement stage shuttle run. i improvement in four
I ,
on physical fitness laps from pre to post
performance. test
80% of children will ORF Oral Reading Improvement of one End of Year
improve reading fluency Fluency Assessment level unless testing at
(K-3rd Grades) i the mastery level.
75% of children improve Child Trends SEL
Social Emotional Learning Survey
STAFFING
Increase of .41 points End of Year
or maintaining a
score of 3.
�—vide-- 9 Y This is the only
South Beach Club � Provides direction for the P ro ram s da -to-day , y
I Director I operations, supervision, direction, and guidance for i position for which this
staff, assure implementation of evidence -based grant is in the budget.
curriculum or program protocols with fidelity
Page 16
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
EXHIBIT 2
PROJECT BUDGET
Bud et Line Item
Description
Project Budget
Staff Salary and Wages:
Club Director
$7,322
Fringe Benefits: Fica/Mica &
Health Insurance
_
Payroll Taxes
Health Insurance
$560
$946
Consulting Services
Medication Co -Payments
Professional Services
Marketin /Publicit /Advertisin
Outside Services
Trainin sMbrksho s
Materials/Su pplies
Printing & Copying
Postage & Delivery
Equipment Rental/Purchase
Utilities: Telephone, Internet,
Cable
Florida Power Lights, Miami -Dade
Water & Sewer
$6,500
_
Lease/Rent
Repairs/Maintenance
Insurance
Insurance (General Liability &
Commercial Umbrella
$1,672
Transportation & Admission
Waste/Garbage Collection
Child Care Subsidy
TOTAL
1 $17,000
Page 17
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
EXHIBIT 3
CITY OF MIAMI BEACH
GRANT QUARTERLY STATUS REPORT FORM
GRANT PROJECT No.:
GRANTEE NAME:
GRANTEE ADDRESS:
GRANTEE CONTRACT ADMINISTRATOR:
GRANTEE CONTRACT ADMINISTRATOR'S
E-MAIL ADDRESS:
I
REPORT PERIOD:
❑ Oct. 1 - Dec. 31 ❑ Jan. 1 — Mar. 31 ❑ Apr. 1 — Jun. 30 ❑ Jul. 1 - Sept.30
Due Jan. 15 Due Ap. 15 Due Jul. 15 Due Oct. 10
GOALS/OUTCOMES:
Outcome Measure Target Accomplishments
To -Date
PROBLEM ENCOUNTERED:
OTHER NOTABLE ITEMS:
Grantee
Report Prepared By:
Name
City of Miami Beach
Report Reviewed By:
Name
Page 18
Signature/Date
Signature/Date
DocuSign Envelope ID: 01200FSF-3D2B-45B9-A9F7-C2C6FDF83C77
EXHIBIT 4
CITY OF MIAMI BEACH
GRANT REIMBURSEMENT REQUEST FORM
GRANT PROJECT No.:
GRANTEE NAME:
GRANTEE ADDRESS:
'
GRANTEE CONTRACT ADMINISTRATOR:
j
GRANTEE CONTRACT ADMINISTRATOR'S
E-MAIL ADDRESS:
I
REQUEST No.
Amount of Assistance:
Less Previous Total Disbursements:
Balance Available:
Funds Requested This
Disbursement:
Certification of Payment: I certify that the above expenses were necessary and reasonable for
the completion of the Project and in accordance with this Agreement. I further warrant and
represent that these expenses have not been, and will not be, covered by any other third party
funding source, including under any other separate agreement between the City and Grantee.
Grantee
Report Prepared By:
Name
City of Miami Beach
Report Reviewed By:
Name
Page 19
Signature/Date
Signature/Date
ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
CITYWIDE ACCOUNTS
CITYWIDE,
FY 2021
FY 2022
FY 2023
FY 2024
2024 Prop to
Actuals
Actuals
Adopted
Proposed
2023 Adop
GRAMS & CONTRIBUTIONS
Garden Center (Botanical Garden)
152,000
38,000
152,000
152,000
0
North Beach Programming (fka Food Trucks/First Fridays)'
0
50,000
50,000
0
(50,000)
New Year's Eve/Fourth of July (Ocean Drive Association)'
2,999
40,250
50,000
0
(50,000)
Jewish Museum
23,722
0
50,000
50,000
0
UNIDAD Senior Center
14,000
0
0
0
0
Jewish Community Services of South Florida, Inc.
45,367
43,242
47,000
47,000
0
Miami Beach Chamber/Visitor Center
36,000
36,000
36,000
36,000
0
Veteran's Day
9,100
37,662
40,000
40,000
0
Miami Beach Gay & Lesbian Chamber of Commerce
25,000
25,000
25,000
25,000
0
Miami Design Preservation League
23,000
23,000
23,000
23,000
0
Douglas Gardens Community Mental Health Center, Inc.
21,868
22,000
22,000
22,000
0
Miami Beach Community Health Center
22,000
27,500
22,000
22,000
0
South Florida Greater Miami Hispanic Chamber
23,428
23,266
24,000
24,000
0
Boys and Girls Club
17,000
17,000
17,000
17,000
0
Orange Bowl
17,000
17,000
17,000
17,000
0
Ayudo, Inc.
13,300
0
0
0
0
Sister Cities
0
20,000
25,000
25,000
0
COVID-19 Feeding Program
44,607
0
0
0
0
Hispanic and Black Affairs
0
0
3,000
0_
(3,000)
Subtotal $
490,390
$ 419,919 $
_ _
603,000
$ 500,000
_
$ (103,0001
CITY SERVICES
City Usage - Water/Sewer/Stormwater/Sanitation
2,727,905
3,472,764
3,348,000
4,181,000
833,000
Historic City Hall
209,000
275,000
149,000
12,000
(137,000)
77717thStreet
389,101
729,634
211,000
211,000
0
External Auditor'
159,000
155,185
180,000
0
(180,000)
Property Management of City -Owned Facilities
3,000
0
0
0
0
OIG Internal Service Chargeback
0
0
79,000
39,000
(40,000)
State Court Costs Article V'
0
10,996
0
0
0
Subtotal $
3,488,006 $
_
4,643,578 $
3,967,000 $
4,443,000 $
476,000
SPECIAL PROJECTS
Elections
56,631
611,939
654,000
620,000
1654,000)
Performance Improvement/Workshops/Community Survey
22,592
77,990
117,000
139,000
22,000
Cost Allocation Study'
0
9,500
25,000
0
(25,000)
Superlative Group (Coca Cola Sponsorship Commissions)
29,315
0
0
0
0
Contracted Repairs and Maint (Monuments)
30,000
37,960
30,000
30,000
0
OIG Funding
1,969,588
46,000
0
0
0
Other Studies
92,728
40,884
0
60,000
60,000
City Residency Pilot Program
0
0
150,000
150,000
0
Other
2,029,731
1,748,320
366,000
297,000
551,000
Subtotal $
4,230,584 $
2,572,593 $
1,342,000 $
1,296,000 $
(46,000)
GENERAL FUND CAPITAL PROJECTS
Pay-As-You,Go Capital Fund (Transfer)
4,252,000
34,141,0_00
3,974,000
6,746,000
Subtotal $
4,252,000 $
_ _
34,141,000 $
_
3,974,000 $
_10,720,000_
10,720,000 $
6,746,000
445
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
DIVISION OF CORPORATIONS
4 Utz/lii�Ut`r Dj
f �1i1 •OI'9 (E.' alLpJs'Tloi-
w1 u 11-Ml (fate vjf'loiida webslle
pgpartment of State / Division of Corporations / Search Records / Search by Entily,Name /
Detail by Entity Name
Florida Not For Profit Corporation
BOYS AND GIRLS CLUBS OF MIAMI-DADE, INC.
Filing Information
Document Number
725628
FEI/EIN Number
59-0879227
Date Filed
02/20/1973
Effective Date
07/25/1968
State
FL
Status
ACTIVE
Last Event
AMENDMENT
Event Date Filed
04/19/2013
Event Effective Date NONE
Principal Address
2805 SW 32 AVE
MIAMI, FL 33133
Changed: 02/02/2008
Mailing Address
PO BOX 330219
MIAMI, FL 33233-0219
Changed: 01 /18/2007
Registered gent Name & Address
BERNHARDT, JAMES T
2805 SW 32 AVE
MIAMI, FL 33133
Name Changed: 02/20/2014
Address Changed: 02/02/2008
Officer/Director Detail
Name $ Address
Title Chairman
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
STUART, ANDREW
2805 SW 32 AVE
MIAMI, FL 33133
Title Director, VC
RODOLFO, LLEONART
2805 SW 32 AVE
MIAMI, FL 33133
Title Secretary, Director
CUEVAS, ROBERT
2805 SW 32 AVE
MIAMI, FL 33133
Title Treasurer, Director
MARMOL,RAUL
2805 SW 32 AVE
MIAMI, FL 33133
Title President
RODRIGUEZ-ROIG, ALEX
PO BOX 330219
MIAMI, FL 33233-0219
Title Director
BERNHARDT, JAMES T
2805 SW 32 AVE
MIAMI. FL 33133
Annual Reports
Report Year
Filed Date
2021
03/01 /2021
2022
02/01 /2022
2023
02/24/2023
Document Imagg$
02/24/2023 --ANNUAL REPORT View image in PDF format
02/01/2022 -- ANNUAL REPORT
View image in PDF format
03/01/2021 --ANNUAL REPORT
View image in PDF format
02/19/2020 --ANNUAL REPORT
View image in PDF format
02/07/2019 —ANNUAL REPORT
View image in PDF format l
03/08/2018 — ANNUAL REPORT
05/04/2017 -- ANNUAL REPORT
view image in PDF format i I
View image in PDF format
02/08/2016 -- ANNUAL REPORT
View image in PDF format
DocuSign Envelope ID: 01200F8F-3D2B-4569-A9F7-C2C6FDF83C77
02/16/2015 -- ANNUAL REPORT
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02/20/2014 - ANNUAL REPORT
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02/06/2013 --ANNUAL REPORT
View image in PDF format
01/24/2012 -ANNUAL REPORT
View image in PDF format
01/19/2011 --ANNUAL REPORT
View image in PDF format
01/21/2010 --ANNUAL REPORT
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02/19/2009 --ANNUAL REPORT
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10/01/2008 -ANNUAL REPORT
View image in PDF format
02/02/2008 - ANNUAL REPORT
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09/21/2007 -Name Change
View image in PDF format
01/18/2007 -ANNUAL REPORT
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02/03/2006 --ANNUAL REPORT
View image in PDF format
01/05/2005 -ANNUAL REPORT
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02/17/2004 --ANNUAL REPORT
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01/30/2003 -- Amendment
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01/14/2003 --ANNUAL REPORT
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01/07/2002 --ANNUAL REPORT
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01/29/2001 --ANNUAL REPORT
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01/28/2000 --ANNUAL REPORT
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02/24/1999 --ANNUAL REPORT
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01/20/1998 --ANNUAL REPORT
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02/07/1997 --ANNUAL REPORT
View image in PDF format
03/08/1996 --ANNUAL REPORT
View image in PDF format
04/2011995 --ANNUAL REPORT
View image in PDF format
Fonda Department of Rate, D 5 or of Co,00a-,-s
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
Associated Industries Insurance Company, Inc.
A Stock Insurance Company
800 Superior Avenue East, 21st Floor
Cleveland, OH 44114
WORKERS COMPENSATION WC 00 00 01 A
AND EMPLOYERS LIABILITY
INSURANCE POLICY INFORMATION PAGE
1. Insured:
Policy Number:
AWC1190356
Boys & Girls Clubs of Miami -Dade, Inc.
Federal Tax ID:
590879227
P.O. Box 330219
Miami, FL 33233
Board File Number.
Other workplaces not shown above:
Renewal Of:
AWCI 176446
See Extension of Information Page
Entity:
Corporation
Producer:
Interim Adjustment:
Annual
USI Insurance Services, LLC
Ncci Code:
25372
2601 S. Bayshore Drive Suite 1600
SIC Code
0
Coconut Grove, FL 33133
2. The policy period is from I/l/2023 to l/l/2024 12:01 a.m. at the insured's mailing address.
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of
the states listed here: Florida
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.
The limits of our liability under Part Two are:
Bodily Injury by Accident $1,000,000 each accident
Bodily Injury by Disease $1,000,000 policy limit
Bodily Injury by Disease $1,000,000 each employee
C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here:
All states except ND, OH, WA, WY and State(s) Designated in Item 3A.
D. This policy includes these endorsements and schedules:
See attached endorsement schedule.
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. All information required below is subject to verification and change by audit.
See Extension of Information Page
TOTAL ESTIMATED ANNUAL PREMIUM
17,406
STATE ASSESSMENT
0
TOTAL ESTIMATED COST
17,406
Minimum Premium
590
Deposit Premium
1,737
Issue Date: 11/29/2022 Countersigned by:
Authorized Representative
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77 BOYSGIR30
____411
A�O pQ® DATE (MMIDD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 9/18/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Commercial Lines - 305-443-4886 P ONE FAx
No. Exti, 7867851138 laic No): 6105372273
USI Insurance Services LLC E-AILADDRESS: dewin.molinaQusi.com
201 Alhambra Circle, Suite 1205 INSURERS) AFFORDING COVERAGE NAIC s
Coral Gables, FL 33134 INSURER A: Philadelphia Indemnity Insurance Company 18058
INSURED INSURERB: Philadelphia Insurance Company 23850
Boys & Girls Clubs of Miami -Dade Inc. INSURER CAssociated Industries Insurance Co, Inc. 23140
2805 S.W. 32 Ave INSURER 0: Scottsdale Indemnity Company 15580
Hank Kline Club INSURER E :
Miami, FL 33133 INSURER F :
COVERAGES CERTIFICATE NUMRFR- 15763/04 RFVISION NUMRFR- See below
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
I
R U
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MMID
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAINIS-MADE OCCUR
X
X
PHPK2524735
03/01/2023
03/01/2024
EACH OCCURRENCE
5 1,000.000
_
PTO RENTED
PREMISES Ea occurrence
_
$ 100,000
MED EXP (Any one person)
S 5,000
PERSONAL 8 ADV INJURY
S 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S 3,000,000
POLICY C JECT X LOC
PRODUCTS - COMP/OP AGG
S 3.000.000
ABUSE 8 MOLESTATION AG
S 3,000,000
X OTHER: ABUSE 8 MOLESTATION
AUTOMOBILE
LIABILITY
CEaOMBINED SINGLE LIMITS
accident
BODILY INJURY (Per person)
S
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
S
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
S
S
B X UMBRELLALUIB
X
OCCUR
PHUB853537
03/01/2023
03/01/2024
EACH OCCURRENCE
S 2,000,000
AGGREGATE
S 2,000,000
EXCESS LIAB
CLAIMS -MADE
DIED I x RETENTION $ 10,000
5
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
X
AWC 1176446
1/1/2023
1/1/2024
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
OFFICER/M EMBER EXCLUDED? I
(Mandatory in NH)
NIA
E.L. DISEASE - EA EMPLOYEE
5 1,000,000
If yes. describe under
DESCRIPTION OF OPERATIONS below
EL DISEASE - POLICY LIMIT
S 1,000,000
D
D80/EPL/Fiduciary
EK13472941
04/01M23
04/01/2024
$3,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
City of Miami Beach is named as additional insured as it relates to General Liability in accordance with the terms and conditions of the policy per their
written contract with the insured. Waiver of Subrogation is granted as it relates to Workers' Compensation in accordance with the terms and conditions of
the policy.
Umbrella follows form as it relates to additional insureds. The above coverage is primary and noncontributory where required by written contract.
t, r-r( I Ir'It�A I t NULUtK L;ANC.t LLA I IUN
City of Miami Beach SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
1700 Convention Center Dr THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
Miami Beach, FL 33139
AUTHORIZED REPRESENTATIVE
The ACORD name and logo are registered marks of ACORD 7 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103)
jl,„ c fi.. reputes ceroficatep 15694316issued - 311012023)
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
SID:15763104
Certificate of Insurance (Con't)
OTHER Coverage
INSR TYPE OF INSURANCE ADDL WVD POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE LIMIT
LTR INSR SUBR (MM/DD/YY) (MM/DD/YY)
Professional Liability PHPK2524735 03/01/2023 03/0112024 1.000,000 Ea Professional Incident
3.000,000 Agg Limit
Certificate Of Insurance-Con't
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
P 99REW1/E'
PALM BEACH INS
1901 SW 27 AVE
CONS
COMMERC/A[
MIAMI, FL 33145
Named insured
Policy number: 08264220
Underwritten by
Progressive Express !ns Company
July 14, 2D23
BOYS & GIRLS CLUB MIAMI DADE, INC
Policy Period: Jul 30, 2023 - Jul 30. 2024
PO BOX 330219
Page 1 of 5
MIAMI, FL 33233
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online Service
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Commercial Auto
1-305460-1052
Insurance Coverage Summary
PALM BEACH INS CONS
Contact your agent for personalized service.
This is your revised Renewal
1-800-444-4487
Declarations Page
le or to ice if your agent is
unavailable or to report a claim.
unavailable
Your policy information has changed
This Renewal Declarations Page is effective only if the minimum amount due to renew your policy is received or postmarked by luly 30,
2023.
Your coverage begins on July 30, 2023 at 12:01 a.m. This policy expires on July 30, 2024 at 12 01 a.m.
This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your
coverage. The policy limits shown for an auto may not be combined with the limits for the same coverage on another autc, unless the
policy contract allows the stacking of limis. The policy contract is form 6912 (02119). The contract is modified by forms 1652FL (02119),
1890 (02119), 1891 (02/19), 1303FL (04/08), 1198 (07/16), 4852FL (02/19), 4881 FL (02119) and Z228 (01/11),
The named insured organization type is a corporation.
Policy changes effective July 30, 2023
Premium change: $288.00
..................................................................................................................................._
Ctiariges: BERNARD SUMfNERALL has been added to the policy,
DERRICK BEAUCHAMP has been added to the policy
HAROLD JACOBS has been added to the policy.
>3 I
Can6nce
Form 6489 FL 0 10)
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
Policy number. 08264220
BOYS & GIRLS CLUB MIAMI DADE, INC
Page 2 of 5
Outline of coverage
Description
Limits
DllIUM111 Premium
..................................................................................................................................................................
Liability To Others
I ..........
$13,488
Bodily Injury and Property Damage Liability
............................................................................................................................................................................
$1,000,000 combined single limit
Hired Auto Liability To Others
120
Bodily. Injury. and Property Damage Liability
$1,000,000 combined single limit
...
Employer Non -Owned Auto Liability To Others
257
Bodily. Injuryand Property Damage Liability
$1,000,000 combined sin9,le limit
Uninsured Motorist
Rejected.
... .......
......I.. ...... ... ...
Basic Personal Injury Protection
.. ............................_
726
Without Work Comp -Named Insured & Relatives
... ........................................................................................................................................................................
$10,000 each person
so
M
MedicalPayments
Rejected.................................................
.
............................. --
..... ......
..... .... ...............................................
Comprehensive
723
See Auto Coverage Schedule
Limit of liability less deductible
, .
...,......
Collision
837
See Auto Coverage Schedule
Limit of liability less deductible
.. .... .... ............................................
Subtotal policy premium
........................... ........................................................
.... .
$16,151
.............
....................... ............. ..............................................................................
Additional Insured Fee
............................................
100
Total 12 month policy premium and fees
$16,251
Number of Employees: 01-20)
Cost of Renting, Hiring, or Borrowing: $5,000
or less (if any) t
Rated and Excluded drivers
Important information regarding excluded drivers
If any drivers are shown as excluded drivers, then you agree that there, may be no coverage under parts of this policy, for
accidents or loss arising out of the operation of any motor vehicles by the excluded drivers. Statutory required limits and
coverages may still be provided. If this policy is certified as proof of financial responsibility with the State of Florida, state
minimum limits may be provided. For heavy equipment vehicles, subject to FS 627.7415, statutory minimum limits may
be provided.
..............................Add¢ on Additional inrormari,.............................................................................
1. ALEXANDER RODRIGUEZ _
2 RAQUEL FERNANDEZ......................................................................................................................................
.................... .
3. RONNY F VERA
4. FRANCHON GREEN
5. DAVID ANTRA
6. GLENNIE THOAAPSON.......................................................................................................................................
........................................................................................................................................................................
7. LARECO LEWIS
.......................................................................................................................................................................
8. JOSE A TAVAREZ Exduded
.........................
............
......................................................
........................................................................._
9. OSMOLLO MILLER
10. RICHARD MEYNO »
11. LATRENIAANDERSON
12. YARDEN DIXON
13. BERNARD SUMMERALL
......... ... ............................ .............................................................................................................................
14. DERRICK BEAUCHAMP
.....................................................................................................................................................................
15.HAROLDJACOBS
Form 6489 FL (I IrA)
s
rM
DocuSign Envelope ID: 01200F8F-3D26-45B9-A9F7-C2C6FDF83C77 - — —
Policy number: 08264220
BOYS & GIRLS CLUB MIAMI DADE, INC
Page 3 of 5
Auto coverage schedule
1. 2004 CHEVROLET EXPRESS CUTAWAY Stated Amount:' $37,500 (including Permanently Attached Equip)
VIN: IGBHG31V241125466 Garaging Zip Code: 33133 Radius: 50 miles
Personal use: N
Body type: Passenger Van
tiWbby
Liability Preauutn
PIP
Premium ................................
Premium $4496
...... ......... ................................................ ............,..............................
$242
comp
Physical Damage Deductible
Camp Collision Collision
Pmauum Deductible Premium Auto Total
Premium $500
_..............................................................................................................................
$229 $500 $270 $5,237
2. 2006 FORD E350 SUPER DUTY Stated Amount: * $42,395 (including Permanently Attached Equip)
VIN: 1FDSE35L76DA34951 Garaging Zip Code: 33133 Radius: 50 miles
Personal use: N Body type: Passenger Van
uAdq PIP
Liability Premium Premium
Premium $4496 $242
CoUisiau Collision
Physical Damage Deducible Premium Deductible Premium Auto TaW
Premium $500 S249 $500 $186 $5,273
3. 2007 GMC SAVMA G3500 Stated Amount: * $41,300 (including Permanently Attached Equip)
VIN: IGDJG31UO71172077 Garaging Zip Code: 33133 Radius: 50 miles
Personal use: N Body type: Passenger Van
liability PIP
LiabilityPremiwn......... Pr F n. ... .... ... ............................................................................................
Premium $4496 $242
Comp Comp Collision Collision
Physical Damage Deductible Premium Deductible Premium AwDToW
Premium ....... _...._...........................................................................................
$500 $245 $500 $281 $5,264
*A vehid0s stated amount should indicate its current retail value, including any special or permanently attached equipment, In the
event of a total loss, the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value, less deductible. Be sure
to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy.
Premium discounts
Policy
............
. ..... ..,................ ........................................... ................ ......
08264220
Paid In Full and Multi -Product
vehicle
.............................................................................................................................................................................
2004 CHEVROLET EXPRESS CUTAWAY
Airbag, Anti -Lock Brakes and Anti -Theft Device Standard
2006 FORD E350 SUPER DUTY
Airbag, Anti -Lock Brakes and Anti -Theft Device Standard
2007 GMC SAVANA G3500
Airbag, Anti -Lock Brakes and Anti -Theft Device Standard
Loss Payee information
1. Loss Payee Auto 2
COCONUT GROVE BANK
2701 S BAYSHORE DR
MIAMI, FL 33131
2006 FORD E350 SUPER DUTY (1FDSE35L76DA34951)
................................. ....... .......................... ....... .............................
2. Loss Payee Auto 3
DCFS USA LLC
13650 HERITAGE PKWY
FORT WORTH, TX 76177
2007 GMC SAVANA G3500 (1 GDJG31 U071172077)
Form 6489 Fl. (11120)
I DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
Policy number. 08264220
BOYS & GIRLS CLUB MIAMI DADE, INC
Page 4 of 5
Additional Insured information
_......._..............._....._.................__...............................................
.. __.._........
1, Additional Insured WILLIAM LEAHMAN LEA
21400 NW 2 AVE
MIAMI, FL 33139
2. Additional Insured THE C'HILDRENS TRUST
3150 SW 3 AVE
MIAMI, FL 33129
..................................................................................
3. Additional Insured
................................................................................
FL DEPT OF JUV JUST
2737 CENTERVIEW
TALLAHASSEE, FL 32399
4. Additional Insured
Miami Dade County
111 NW First St
Miami, FL 33128
5. Additional Insured
City of Miami
444 SW 2nd Ave
Miami, FL 33130
6. Additional Insured
City of Miami Beach
1700 Convention Center Dr
Miami Beach, FL 33139
Reimbursement of Surcharge
In accordance with Florida Statute §626.9541, you are entitled to reimbursement of the surcharge imposed for the
accident(s) mentioned in the Driving History section if you demonstrate that the operator involved in the accident was:
• Lawfully parked;
• Reimbursed by, or on behalf of, a person responsible for the accident or has a judgment against such person;
• Driving a vehicle which was struck in the rear by another vehicle headed in the same direction and was not convicted of a
moving traffic violation in connection wah the accdent;
• Hit by a "hit -arid -run" driver, if the accident was reported to the props: authorities within 24 hours after discovering the
accident;
• Not convicted of a moving traffic violation in connection with the accident, but the operator of the other automobile
involved in such accident was convicted of a moving traffic violation;
• Finally adjudicated not to be liable by a court of competent jurisdiction;
• In receipt of a traffic citation which was dismissed or nolle prossed; or
• Not at fault as evidenced by a written statement from the insured establishing facts demonstrating lack of fault which are
not rebutted by information in the insurer's file from which the insurer in good faith determines that the insured was
substantially at fault.
Agent signature
C0406U d
Form 6489 FL 111120)
DocuSign Envelope ID: 0120OF8F-3D2B-45B9-A9F7-C2C6FDF83C77
Policy number: 08264220
BOYS & GIRLS CLUB MIAMI DADE. INC
Page5 of 5
Company officers
Secretary
Farm 6489 R 0 V20)
DocuSign Envelope ID: 01200F8F-3D2B-45B9-A9F7-C2C6FDF83C77
GRANTS MANAGEMENT
DIVISION
DATE:
November 14, 2023
TO:
Alina T. Hudak, City Manager
FROM:
Krystal M. Dobbins, Grants Director
SUBJECT:
Citywide Agreement FY 2023-2024
goys and Girls Clubs of Miami -Dade, Inc.
Ro uti n a (—DoeuSigned by
Krystal Dobbins
e (WS 11/14/2
Tameka Otto Stewart^
0 1/15/z
Jason Greene
a aw 11/16/
For:
x City Manager's Signature
Other Signature
Comments:
itywide Agreement - Fiscal Year 2023-2024
rant Agreement:
ays and Girls Clubs of Miami -Dade, Inc.
rant Amount:
)17,000
3udget Code Number:
)11-9980-000353-90-406-545-00-00-00
DocuSigned by:
— 49126110 C61844A...
Ayanna DaCosta-EarlL11/15/2023 i 10:33 AM EST
)23 i
1:08
PM
EST
)23 i
5:57
PM
EST
)23
8:01
M
EST
Return to:
Krystal ext. 26433