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Douglas Gardens Comm Cent EMERGENCY SHELTER GRANTSAGREEMffiNT BETWEEN THE CITY OF MIAMI BEACH AND DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER This Agreement made and entered into this 1 day of October, 2000 by and between the CITY OF MIAMI BEACH, a municipal corporation, hereinafter referred to as "the City", and DOUGLAS GARDENS COMMUNITY MffiNTAL HEALTH CENTER, hereinafter referred to as "Provider"; WHEREAS, the City has received a grant from the u.s. Department of Housing and Urban Development as part of its Emergency Shelter Grants (ESG) Program for the period October 1, 2000 to September 30, 2001 (hereinafter "the contract period"); and WHEREAS, the ESG Program is designed to be the first step in a continuum of assistance to enable homeless individuals and families to move toward independent living as well as to prevent homelessness; and WHEREAS, the One-Year Action Plan was adopted by City of Miami Beach Resolution No. 2000-23997 on July 12,2000; and WHEREAS, the City has detennined, through its One-Year Action Plan for Federal Funds for FY 2000/2001, the necessity for engaging the Provider to render the following services in Miami Beach: Outreach and Emergency Placement Services (collectively, the Program). NOW, THEREFORE, in consideration of the mutual benefits contained herein, the City and Provider agree as follows: 1. Agreement Documents: Agreement documents shall consist of this Agreement and four (4) attachments, all of which are incorporated by reference into this Agreement Attachment I contains a description of the service and goals offered by the Provider. Attachment II is a line item budget. Attachment III outlines financial management procedures for use with Emergency Shelter Grants funds. Attachment IV contains all applicable federal regulations. 2. Statement of Work: The Provider agrees to implement the Activity in accordance with the Budget, as described in Attachment I and II. DOUGLAS GARDENS COMMUNITY MffiNTAL HEALTH CENTER - HOMffiLESS OUTREACH AND EMERGENCY PLACEMffiNT SERVICES (576.2I(a)(2)) To provide mobile outreach and case management services (including intake assessment and referral) to at least 130 Miami Beach homeless people and place at least 25 homeless persons into housing (as available.) This will include working with the Miami Beach Police Department, as well as other organizations participating in the Miami-Dade County Continuum of Care system. 3. Agreement Amount: The City agrees to make available $67,616 (Sixty-Seven Thousand Six Hundred and Sixteen Dollars) for use by the Provider for the contract period. 4. Alterations: Any proposed alterations in the work program or the budget shall first be submitted to and approved in writing by the City, said approval at the City's sole discretion. 5. Reporting Requirements: The Provider agrees to submit monthly program progress reports on the lOth day of each month to the City during the contract period herein. The Provider also agrees to submit on September 30, 2001 a comprehensive final report covering the agreed-upon objectives, activities, and expenditures for the entire contract period. Such shall include performance data on client feedback, with respect to the goals and objectives outlined in Attachment L 6. Monitoring: The City shall schedule no less than one (1) monitoring visit with the Provider to evaluate the progress and performance of the program and provide technical assistance. 7. Eligible Participants: The Provider agrees that the Program will serve only homeless individuals residing within the City limits of Miami Beach or individuals who are facing eviction or termination of utility services and are eligible to receive homeless prevention services in accordance with federal guidelines (the potential homeless.) 8. Subcontract: No part of this Agreement may be assigned or subcontracted without the prior written consent of the City, such consent to be at the City's sole discretion. 9. Term: This Agreement shall remain in effect through the contract period with the understanding that at the end of the fiscal year the City of Miami Beach City Commission has the authority to reappropriate any remaining funds. 10. Termination of Agreement for Cause: The City and the Provider agree that this Agreement may be terminated in whole or in part for convenience and without cause, by either party hereto by written notice to the other party of such intent to terminate at least thirty (30) days prior to the effective date of such termination. However, if, in the case of a partial termination, the City, in its sole discretion, determines that the remaining portion of the Agreement will not accomplish the purposes of such Agreement, the City may terminate same in its entirety, in the manner provided in this section. Notwithstanding the preceding paragraph, the City may also place the Provider in default of this Agreement, and may suspend or terminate this Agreement in whole, or in part, for cause. "Cause" shall include, but not be limited to, the following: a. Failure to comply and/or perform in a material way, as same shall be determined by the City in its sole discretion, in accordance with the terms of this Agreement, or any Federal, State, County or City of Miami Beach statute or regulation. b. Submitting reports to the City, which are late, incorrect or incomplete in any material respect c. Implementation of this Agreement, for any reason, is rendered impossible or infeasible. d. Failure to respond in writing to any concerns raised by the City, including substantiating documents when required/requested by the City. e. Any evidence of fraud, mismanagement, and/or waste, as determined by the City's monitoring of the sub-recipient, and applicable HOD rules and regulations. The City shall notify the Provider in writing when the Provider has been placed in default. Such notification shall include: (i) actions taken by or to be taken by the City, such as withholding of payments; (ii) actions to be taken by the Provider as a condition precedent to clearing the deficiency; and (iii) a reasonable date for compliance, which shall be no more than fifteen (15) days from notification date. In the event that Provider fails to correct such deficiency within the 2 forestated period, and following such notice from the City, this Agreement shall be terminated by the City, without further notice to Provider. In the event of curtailment of, or regulatory constraints placed on, the funds by HUD, this Agreement will terminate effective as of the time that it is determined such funds are no longer available. Costs of the Provider resulting from obligations incurred during a suspension or after termination, are not allowable unless the City expressly authorizes them in the notice of suspension or termination, or subsequent thereto. Other costs during suspension or after termination which are necessary and not reasonably avoidable are allowable if, in the sole discretion of the City: a. The costs resulting from obligations which were properly incurred before the effective date of suspension or termination, are not in anticipation of it, and, in the case of termination, are noncancelable; and b. The costs would be allowable if the award were not suspended or expired normally at the end of the funding period in which the termination takes effect. In the event of termination of the Agreement, at its sole discretion, the City may require Provider to transfer any CDBG assets to the City pursuant to Section III herein. 11. Equal Employment Opportunities: The Provider shall comply with equal employment opportunities as stated in Executive Order 11246, entitled "Equal Employment Opportunity" as amended Executive Order 11375, and as supplemented in Department of Labor regulations. 12. Matching Requirements: The Provider warrants herein that it will comply with the provisions of 24CFR 576.51 and 42 UOS.C. 11375(a)(3) and will provide the required dollar for dollar match from sources other than ESG, in accordance with Attachment II. The Provider will provide the City with evidence of such matching funds. 13. Religious Organization or Owned Property: ESG funds may be used by religious organizations or on property owned by religious organizations only with prior written approval from the City and only in accordance with requirements set in 24 CFR 576.23. 14. Reversion of Assets: Within 30 days of the expiration of this Agreement, the Provider shall transfer to the City any ESG funds on hand at the time of expiration and any account receivable attributable to the use of ESG funds. In accordance with Section 415(i) of the 1987 McKinney Act, each ESG recipient or sub-recipient herein certifies that it will maintain the facility as a homeless shelter for a period of ten (10) years in the case of major rehabilitation or conversion, or for three (3) years for other rehabilitation activities (other than major rehabilitation or conversion.) Any building for which ESG funds are used for other eligible activities must be maintained as a shelter for the homeless for the period during which such assistance is provided. Any real property under the Provider's control that was acquired or improved in whole or in part with ESG funds (including ESG funds provided to the Provider in the form of a loan) must either: (a) be used as a homeless facility for either ten (10) years or longer or three (3) years after the expiration of the Agreement or for such longer period of time as determined to be appropriate by the City; or (b) if not used in accordance with this paragraph (16), the Provider shall pay to the City an amount equal to the current market value of the property less any portion of the value attributable to expenditures of non-ESG funds for the acquisition of, or improvement to, the property. No payment is required after the period oftime specified in this section. 3 15. Conformity to HUn regulations: The Provider agrees to comply with all applicable federal regulations as they may apply to program administration and to carry out each activity in compliance with the laws and regulations as described in 24 CFR 576. The Provider shall comply with the requirements and standards of: 24 CFR part 85 (codified pursuant to OMB Circular No. A-I02), OMB Circular No. A-87, OMB Circular No. A-122, OMB Circular A-IIO (implemented as 24 CFR part 84), and/or the related ESG provision as they relate to the acceptance and use of Emergency Shelter Grants amounts, as applicable. The Provider agrees to comply with all the provisions of 24 CFR 576.57. In this regard, the Provider agrees that duly authorized representatives of the U.S. Department of Housing and Urban Development shall have access to any books, documents, papers and records of the Provider that are directly pertinent to this Agreement for the purpose of making audits, examinations, excerpts and transcriptions. 16. Homeless Assistance and Participation: Provider agrees that it will provide for the participation of homeless individuals on its policymaking entity, in accordance with 42 U.S.C. 11375(d). 17. Examination of Records: The Provider shall maintain sufficient records in accordance with 24 CFR part 5 to determine compliance with the requirements of this Agreement, the Emergency Shelter Grants Program, and all applicable laws and regulations. This documentation shall include, but not be limited to, the following: a. Books, records and documents in accordance with generally accepted accounting principles, procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided directly or indirectly by this Agreement, including matching funds and program income. These records shall be maintained to the extent of such detail as will properly reflect all net costs, direct and indirect labor, materials, equipment, supplies and services, and other costs and expenses of whatever nature for which reimbursement is claimed under the provisions of this Agreement. b. Time sheets for split-funded employees, which work on more than one activity, in order to record the ESG activity delivery cost by Program and the non-ESG related charges. c. How the objectives defined in 24 CFR 576.1 and the eligibility requirement(s) under which funding has been received, have been met. The Provider is responsible for maintaining and storing all records pertinent to this Agreement in an orderly fashion in a readily accessible, permanent and secured location for a period of four (4) years after expiration of this Agreement, with the following exception: if any litigation, claim or audit is started before the expiration date of the four year period, the records will be maintained until all litigation, claims or audit findings involving these records are resolved. The City shall be informed in writing after closeout of this Agreement, of the address where the records are to be kept. 18. Audits and Inspections: At any time during normal business hours, and as often as City and/or Federal Government representatives may deem necessary, the Provider shall make available all records, documentation, and any other data relating to all matters covered by the Agreement for review, inspection or audit. Audits shall be conducted annually and shall be submitted to the City 180 days after the end of the Provider's fiscal year. Sub-recipients shall comply with the requirements and standards of OMB A-133, "Audits ofInstitutions of High Education and Other Non-Profit Institutions" (as set forth in 24 CFR Part 45), or OMB Circular A-128, "Audits of State and Local Governments" (as set forth in 24 CFR Part 44), as applicable. If this Agreement is closed-out prior to the receipt of 4 an audit report, the City reserves the right to recover any disallowed costs identified in an audit after such closeout. 19. IndemnificationlInsurance Requirements: The Provider shall indemnify and hold hannless the City from any and all claims, liability, losses and causes of action which may arise out of an act, omission, negligence or misconduct on the part of the Provider or any of its agents, servants, employees, contractors, patrons, guests, clients, licensees or invitees. The Provider shall pay all claims and losses of any nature whatsoever in connection therewith and shall defend all suits in the name of the City, when applicable, and shall pay all costs and judgements which may issue thereon. The Provider shall not commence any work pursuant to this Agreement until all insurance required under this Section has been obtained and the City's Risk Manager has approved such insurance. In the event evidence of such insurance is not forwarded to the City's Risk Manager within thirty (30) days after the execution of this Agreement, this Agreement shall become null and void and the City shall have no obligation under the terms thereof unless a written extension of this thirty (30) day requirement is secured from the City Administration. The Provider shall maintain and carry in full force during the term of this Agreement and throughout the duration of this project the following insurance: a. Provider General Liability Policy with coverage for Bodily Injury and Property Damage, in the amount of $1,000,000 single limit. The policy must include coverage for contractual liability to cover the above indemnification. b, The City of Miami Beach shall be named as an additional insured under all such insurance contracts and City of Miami Beach Resolution No. 2000-23997 shall referenced in the certificate. c, Worker's Compensation and Employers Liability, as required pursuant to Florida Statute. d. Automobile and vehicle coverage shall be required when the use of automobiles and other vehicles are involved in any way in the performance of the Agreement. Limits for such coverage shall be in the amount of $500,000, e. Thirty- (30) day written notice of cancellation or substantial modification of the insurance coverage must be given to the City's Risk Manager by the Provider and hislher insurance company. f. The insurance must be furnished by insurance companies authorized to do business in the State of Florida, and approved by the City's Risk Manager. The companies must be rated no less than "B+" as to management, and not less than "Class VI" as to 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 the City's Risk Manager. g, Original Certificates ofInsurance for the above coverage must be submitted to the City's Risk Manager for approval prior to any work commencing. These certificates will be kept on file in the Office of the Risk Manager, Third Floor City Hall. h. All insurance required by this section of the Agreement shall be and remain in full force and effect for the entire contract period and each certificate or policy shall carry the provision that the insurance shall not terminate, lapse or otherwise expire, prior to thirty (30) days written notice to that effect, given by the insurance carrier to the City, and that the insurance carrier will not invoke the defense of performance of a governmental function by the Provider in performing this contract. Compliance with the foregoing requirements shall not relieve the Provider of the liabilities and obligations under this Section or under any other portion of this Agreement, and the City shall have the right to obtain from the Provider specimen copies of the insurance policies in the event that submitted Certificates of Insurance are inadequate to ascertain compliance with required 5 coverage. All of Provider's certificates, above, shall contain endorsements providing that written notice shall be given to the City at least thirty (30) days prior to termination, cancellation or reduction in coverage ofthe policy. 20. Conflict of Interest: The Provider covenants that no person under its employ who presently exercises any functions or responsibilities in connection with ESG-funded activities has any personal financial interests, direct or indirect, in this Agreement. The Provider covenants that in the performance ofthis Agreement, no person having such conflicting interest shall be employed. The Provider covenants that it will comply with all provisions of 24 CFR 576.57(d) "Conflict of Interest", and the Federal, State, County and City of Miami Beach statutes, regulations, ordinances or resolutions governing conflicts of interest. The Provider shall disclose, in writing, to the City any possible conflicting interest or apparent impropriety that is covered by the above provisions. This disclosure shall occur immediately upon knowledge of such possible conflict. The City will then render an opinion, which shall be binding on both parties. 21. Venue: This Agreement shall be enforceable in Miami-Dade County, Florida, and if legal action is necessary by either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for the enforcement of the same shall lie in Miami-Dade County, Florida. 22. Notices: All notices required under this Agreement shall be sent to the parties at the following address, with copies to the Office of the City Attorney: City: Joanna Revelo, Community Development Director CommunitylEconomic Development Department City of Miami Beach 1700 Convention Center Drive Miami Beach, FL 33139 Provider: Dr. Daniel Brady, Executive Director Douglas Gardens Community Mental Health Center 701 Lincoln Road Miami Beach, FL 33139 23. Limitation of Liability: The City desires to enter into this Agreement only if in so doing the City can place a limit on City's liability for any cause of action for money damages due to an alleged breach by the City of this agreement, so that its liability for any such breach never exceeds the sum of $10,000. Provider hereby expresses its willingness to enter into this Agreement with Provider's recovery from the City for any damage action for breach of contract to be limited to a maximum amount of $10,000, less the amount of all funds actually paid by the City to Provider pursuant to this Agreement. Accordingly, Provider hereby agrees that the City shall not be liable to Provider for damages in an amount in excess of $10,000, which amount shall be reduced by the amount of the funding actually paid by the City to Provider pursuant to this Agreement, for any action or claim for breach of contract arising out of the performance or nonperformance of any obligations imposed upon the City by this Agreement. Nothing contained in this subparagraph or elsewhere in this 6 Agreement is in any way intended to be a waiver of the limitation placed upon City's liability as set forth in Florida Statutes, Section 768.28. This Agreement shall be binding upon all parties hereto and their respective heirs, executors, administrators, succesSOrs and assigns. In witness thereof, the parties hereto have executed or caused to be executed by their duly authorized officials, this Agreement in three (3) copies, each of which shall be deemed an original on the date first above written. CITY OF MIAMI BEACH DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER ;JIA MI. Mayor Authorized Signatory 12{1.u} R-ucL___ City Clerk ~~ L?/tMI'1, 4),,, . Typed Name and Title F:\DDHP\$ALL\L YSSETTE\ACTPLAN\2000-01 \contract\Douglas Gardens.doc APPROVED AS 10 FORM & LANGUAGE & FOR EXECUTION ~ 7 ESG AGREEMENT October 1,2000 to September 30, 2001 ATTACHMENT 1 STATEMENT OF WORK AND GOALS DESCRIPTION OF PROGRAM To provide mobile outreach and case management services to the homeless in Miami Beach, resulting in at least 100 persons being placed in shelter care. Funding wiIl be used to partially fund a mobile outreach team, supportive services for the homeless, and emergencyltransitional beds. Homeless individuals and families currently living on the streets of Miami Beach wiIl be the targeted population to be serviced. The program wiIl offer a comprehensive level of services to ensure long-term success for homeless persons coming off the street. The mobile outreach team is a part of a multi-agency-coordinated network of teams working throughout Miami-Dade County. The purpose of the team is to engage homeless individuals and families living on the streets and assist them in accessing housing and services. Addressing the unique housing needs of each homeless person is essential for ensuring these persons stay in housing and are successful in meeting their goals. Douglas Gardens wiIl purchase emergency shelter beds at the Salvation Army for persons who are awaiting placement to transitional programs and for persons who are placed by the City of Miami Beach Police after hours. The Center wiIl also lease two hotel units on Miami Beach for persons who are not appropriate for placement at the emergency shelter. A wide array of transitional and permanent housing programs provided by Douglas Gardens on Miami Beach will be available for persons coming from the emergency placement or for persons who can skip the emergency shelter step. PROGRAM GOALS AND MEASURABLE OUTCOMES I. Contact at least 40 homeless individuals per week, or a minimum of 2,000 per year. 2. Complete an assessment of each homeless person's needs and placement goals by a case manager on staff with the outreach team. 3. Refer homeless persons to the appropriate housing and services. 4. Place at least 8 homeless individuals or families in housing on or off Miami Beach, for a minimum of 7 days, each month, totaling at least 100 per year. 5. Make at least 9 emergency shelter beds available throughout the year, in addition to existing transitional and permanent housing programs. 6. Provide outreach and case management in conjunction with the Miami Beach Police Department's Homeless Outreach Team. SCHEDULE FOR IMPLEMENTATION Goal 10/2000 11/2000 12/2000 1/2001 2/2001 3/2001 4/2001 5/2001 6/2001 712001 8/2001 9/2001 I X X X X X X X X X X X X 2 X X X X X X X X X X X X 3 X X X X X X X X X X X X 4 X X X X X X X X X X X X 5 X X X X X X X X X X X X 6 X X X X X X X X X X X X F:\DDHP\$ALL\L YSSEITEIACTPLAN\2000-OI\contract\Douglas Gardens All Ldoc Page 1 of1 ESG AGREEMENT October 1,2000 to September 30, 2001 ATTACHMENT II BUDGET SUMMARY SHEET Activity Name: Project Operator: Outreach and Placement Program Douglas Gardens Community Mental Health Center Funding Year: 200012001 Date Submitted: Seutember 25. 2000 Category Category Breakdown Number 1 Salaries and Benefits 2 Space Rental 3 Equipment Lease or Purchase 4 Other Operating Expenses S 6 7 8 9 10 Total CDBGIESG Funds Total Other Funds Grand Total CDBGIESG Other Fnnds Funds $13,100 $51,936 $11,510 $0 $2,790 $5,280 $40,216 $3,587 Other Funding Sources Total Funds U.S. HUDlTrust $65,036 $11,510 U.S. HUDlTrust $8,070 u.s. HUDlTrust $43,803 $67,616 $128,419 Page I of 5 ESG AGREEMENT BUDGET ITEMIZATION SHEET Activity Name: Outreach and Placement Program Funding Year 2000/2001 Date Submitted: 9/2512000 Project Operator: Douglas Gardens Community Mental Health Center Category Amount Category Category Breakdown CDBGIESG Other Funds Total Funds Number Funds 1 Coordinator, Homeless Programs (.25 FTE) $9,924 $0 $9,924 1 Outreach Case Manager (I FTE) $0 $26,208 $26,208 1 Peer Outreach Worker (I FTE) $0 $18,564 $18,564 1 Resident Support Staff $0 $0 $0 1 Fringe Benefits (at 32%) $3,176 $7,164 $10,340 Total Amount $13,100 $51,936 $65,036 Page 2 of5 ESG AGREEMENT BUDGET ITEMIZATION SHEET Activity Name: Outreach and Placement Program Funding Year 2000/2001 Date Submitted: 9/25/2000 Project Operator: Douglas Gardens Community Mental Health Center Category Amount Category Category Breakdown CDBGIESG Other Funds Total Number Funds Funds 2 Space Rental 1,000 sq. ft. @ $11.51 a sq. ft. $11,510 $0 $11,510 Total Amount $11,510 $0 $11,510 Page 3 ofS ESG AGREEMENT BUDGET ITEMIZATION SHEET Project Operator: Douglas Gardens Community Mental Health Center Funding Year 2000/2001 Date Submitted: 9/2512000 Activity Name: Homeless Outreach and Emergency Placement Category Amount Category Category Breakdown CDBGIES Other Funds Total Funds Number G Funds 3 Van Lease (at $460 a month x 5.6%) $0 $5,280 $5,280 Cellular Phone (lease and air time @ $55 a 3 month) for mobile outreach team referrals $660 $0 $660 3 Beeper (at $1.75 a month) $0 $0 $0 Parking Card for Outreach van, Case Manager 3 and Peer Outreach Worker (3 at $50 x I month $2,130 $0 $2,130 plus 3 at $60 x 11 months) Total Amount $2,790 $5,280 $8,070 Page 4 of5 ESG AGREEMENT BUDGET ITEMIZATION SHEET Activity Name: Homeless Outreach and Emergency Placement Project Operator: Douglas Gardens Community Mental Health Center Funding Year 200012001 Date Submitted: 9/2512000 Category Amount Category Category Breakdown CDBGIESG Other Funds Total Funds Number Funds Emergency shelter bed purchase from 4 Salvation Army (5 single or emergency beds at $18,250 $0 $18,250 $10 daily rate) Two emergency hotel units (four beds) at $520 4 monthly rate $12,480 $0 $12,480 4 Food for four persons ($100 a month each) $4,800 $0 $4,800 4 Miscellaneous clothing, household toiletries $371 $100 $471 4 Gas and oil for van (at $116 a month) $586 $804 $1,390 4 Bus tokens for clients ($100 a month x 12 $0 $1,200 $1,200 months) 4 Auto Insurance (at $176 a month) $2,112 $0 $2,112 4 Indirect Administrative Costs $1,617 $1,483 $3,100 Total Amount $40,216 $3,587 $43,803 Page 5 of 5 ESG AGREEMENT October I, 2000 to September 30, 2001 ATTACHMENT ill GUIDELINES FOR FINANCIAL MANAGEMENT OF ESG-FUNDED ACTIVITIES To comply with federal regulations, each program must have a financial management system that provides accurate, current and complete disclosure of the financial status ofthe activity. This means the financial system must be capable of generating regular financial status reports which indicate the dollar amount allocated for each activity (including any budget revisions), amount obligated (i.e., for which contract exists), and the amount expended for each activity. The system must permit the comparison of actual expenditures and revenues against budgeted amounts. The City must be able to isolate and to trace every ESG dollar received and prove where it went and for what it was used. Accounting records must be supported by source documentation. Invoices, bills of lading, purchase vouchers, payrolls and the like must be secured and retained for four years in order to show for what purpose funds were spent. Payments should not be made without invoices and vouchers physically in hand. All vouchers/invoices should be on vendor's letterhead. All employees paid in whole or in part from ESG funds should prepare a time sheet indicating the hours worked on ESG projects for each pay period. Based on these time sheets and the hourly payroll costs for each employee, a voucher statement indicating the distribution of payroll charges should be prepared and placed in the appropriate files. The City is responsible for reviewing and certifying the financial management of any operating agency, which is not a City department or bureau, in order to determine whether or not it meets all of the above requirements. If the agency's system does not meet these requirements and modifications are not possible, the City must administer the ESG funds for the operating agency. Financial records are to be retained for a period of four years, with access guaranteed to the City, to HUD or Treasury officials or their representative. One copy of the vendors' audited financial statement shall be submitted to the City immediately following the end of the vendors' fiscal year(s) during which ESG funds are received. Payments to sub-recipients will be on a reimbursement basis to be submitted to: Joanna Revelo, Director Community Development Division City of Miami Beach CommunitylEconomic Development Department 1700 Convention Center Drive Miami Beach, Florida 33139 Requests are to be submitted utilizing the enclosed financial status, client profile, and narrative report forms, in a format consistent with the approved budget as shown in Attachment 11, including an analysis of expenses to budget. A cash advance may be available upon special request. F:\DDHP\$ALL\L YSSETTElACTPLAN\2000-01IAttachment III ESG.doc Page 1 of1 ~ ICMB Budget Account 137.5190.000345 MonthlY ear CITY OF MIAMI BEACH EMERGENCY SHELTER GRANTS PROGRAM FINANCIAL STATUS REPORT Provider: Doul!las Gdns Communitv Mental Health Center Project Name: Outreach and Emerl!encv Placement Date Submitted: Title: Reporting Period: Person Submitting Report: Signature: ESG $67,616 FY 2000/2001 Budget Amount Month Description Monthly Expenses Year to Date Expenses October 2000 November 2000 December 2000 January 200 I February 2001 March 2001 April 2001 May 2001 June 2001 July 200 I August 2001 September 200 I Reimbursement Available Funds ~F.r~ "; ...;,.;::I:J, CITY OF MIAMI BEACH EMERGENCY SHELTER GRANTS PROGRAM MONTHLY NARRATIVE AND CLIENT PROFILE REPORT Provider: Doul!las Gardeus Comm Mental Health Ctr Reporting Period: Person Submitting Report: Project Name: Date Submitted: Signature: Homeless Outreach Please complete the following reports for activities undertaken during this month's reporting period. If reporting for more than one activity, provide a separate progress and client profile report for each distinct activity. I. Monthly Progress Report - Please document the progress achieved during this month towards the project goals and measurable outcomes that were outlined in the Schedule for Implementation ofthe Statement of Work and Goals (Attachment I of the Agreement.) Month Goal Met Not Met October November December January February March Month Goal Met Not Met April May June July August September In the space below, describe any problem, which may have affected your performance during the reporting period. Attach additional pages, if necessary and describe any special circumstance encountered, recognition or award received during the reporting period. II. Client Profile Report Month Clients Income Range Ethnicity Female Special HOH Needs3 New YTD 50% 80% White Not Black Not Hispanic American AsianlPacific (VLI)' (LM) 2 Hispanic Hispanic Indian Islandet/Other Oct Nov. Dec. Jan. Feb. March April May June July Aug. Sept Total Notes: (1) YTD indicates Year to Date. This number equals prior monthly figures + current monthly figures. (2) VLI indicates very-low income. LM indicates low/moderate-income. (3) Special Needs includes elderly/frail elderly persons, persons with AIDS, persons with disabilities, homeless persons, and families participating in programs to achieve economic self-sufficiency. F:\DDHP\$ALL\L YSSETIE\ACTPLAN\2000-01 \contract\Douglas Gardens ESG Progress.doc ESG AGREEMENT October 1,2000 to September 30, 2001 ATTACHMENT IV APPLICABLE FEDERAL REGULATIONS Compliance with tbe Section 109 oftbe Housing and Community Development Act ofl974 The work to be performed under this Agreement is subject to the requirements of Section 109 of the Housing and Community Development Act of 1974, which states that: "No person in the United States shan, on the ground of race, color, national origin, sex or handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity funded in whole or in part with funds available under this title." Compliance witb Equal Opportunity Provisions of Executive Order No. 11246 In carrying out the Agreement, the Provider shan not discriminate against any employee or applicant for employment because of race, color, religion, sex, handicap or national origin. The Provider shan take affirmative action to insure that applicants for employment are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, handicap or national origin. Such action shan include, but not be limited to, the fonowing: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of payor other forms of compensation; and selection for training, including apprenticeship. The Provider shan post in conspicuous places, available to employees and applicants for employment, notices to be provided by the government setting forth the provisions of this nondiscrimination clause. The Provider shan state that an qualified applicants will receive consideration for employment without regard to race, color, religion, sex, handicap or national origin. For purposes of the Emergency Shelter Grants program, the term "dwelling units" in 24 CFR part 8 shall include sleeping accommodations. Use of emergency shelter grants amounts must also comply with the requirement that the Provider make known that use of the facilities or services is available to an on a nondiscriminatory basis. If the procedures that the Provider intends to use to make known the availability of the facilities and services are unlikely to reach persons of any particular race, color, religion, sex, age, national origin, familial status, or disability who may qualify for such facilities and services, the Provider must establish additional procedures that win ensure that such persons are made aware of the facilities and services. Providers must also adopt procedures which will make available to interested persons, information concerning the location of services and facilities that are accessible to persons with disabilities. Applicability of OMB Circulars The policies, guidelines, and requirements of 24 CFR part 85 (codified pursuant to OMB Circular No. A-I02), and OMB Circular No. A-87, as they relate to the acceptance and use of emergency shelter grant amounts by States and units oflocal government, and Nos. A-I 10 and A-122 as they relate to the acceptance and use of emergency shelter grant amounts by private nonprofit organizations. OMB Circulars referenced in this section are available at the Entitlement Cities Division, Room 7282, Department of Housing and Urban Development, 451 Seventh Street, SW, Washington, DC 20410. Page I 00 Compliance with Lead-Based Paint Regulations The requirements, as applicable, ofthe Lead-Based Paint Poisoning Prevention Act (42 USC 4821-4846) and implementing regulations at 24 CFR part 35. In addition, the Provider must also meet the following requirements relating to inspection and abatement of defective lead-based paint surfaces: A. Treatment of defective paint surfaces must be performed before final inspection and approval of the renovation, rehabilitation or conversion activity under this part; and B. Appropriate action must be taken to protect shelter occupants from the hazards associated with lead-based paint abatement procedures. Contlict of Interest In addition to the Conflict ofInterest requirements in OMB Circulars A-I02 and A-IIO, no person who is an employee, agent, consultant, officer or elected or appointed official of the City of Miami Beach or the Provider and who exercises or has exercised any functions or responsibilities with respect to the assisted activities, or who is in a position to participate in a decision making process or gain inside information with regard to such activities may obtain a personal or financial interest or benefit from the activity or have an interest in any contract, subcontract, or agreement with respect thereto, or the proceeds thereunder, either for him or herself or for those with whom he or she has family or business ties, during his or her tenure, or for one year thereafter. Audit The Provider is subject to the audit requirements ofOMB Circular A-l33, as set forth in 24 CFR part 45. Lobbying and Disclosure Requirements The disclosure requirements and prohibitions of 42 USC 3537a and 3345 Compliance with Section 3 of the Housing and Urban Development Act of 1968 A. The work to be performed under this Agreement is on a project assisted under a program providing direct federal financial assistance from the Department of Housing and Urban Development and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended, 12 U.S.CO 170 lu. Section 3 requires that, to the greatest extent feasible, opportunities for training and employment be given to lower income residents of the project area and contracts for work in connection with the project be awarded to business concerns which are located in, or owned in substantial part, by persons in the area ofthe project B. The parties to this Agreement will comply with the provisions of said Section 3 and the regulations issued pursuant thereto by the Secretary of Housing and Urban Development set forth in 24 CFR, and all applicable rules and orders of the Department issued thereunder prior to the execution of this Agreement The parties to this Agreement certify and agree that they are under no contractual or other disability, which would prevent them from complying with these requirements. Co The Provider shall send to each labor organization or representative of workers with which he has a collective bargaining agreement or other contract or understanding, if any, a notice advising the said labor organization or workers representative of his commitments under this Section 3 clause and shall post copies of the notice in conspicuous places available to employees and applicants for employment or training. Page 2 of3 D. The Provider will include this Section 3 clause in every sub-agreement for work in connection with the project and will, at the direction of the applicant for, or recipient of federal financial assistance, take appropriate action pursuant to the sub-agreement upon finding that the subcontractor is in violation of regulations issued by the Secretary of Housing and Urban Development, 24 CFR. The Provider will not subcontract with any subcontractor where it has notice or knowledge that the latter has been found in violation of regulations under 24 CFR and will not enter into any sub-agreement unless the subcontractor has first provided it with a preliminary statement of ability to comply with the requirements of these regulations. E. Compliance with the provisions of Section 3, the regulations set forth in 24 CFR, and all applicable rules and orders of the Department issued thereunder prior to the execution of the contract, shall be a condition of the federal financial assistance provided to the project, binding upon the applicant or recipient of such assistance, its successors and assigns. Failure to fulfill these requirements shall subject the applicant or recipient for such assistance, its successors and assigns to those sanctions specified by the grant or loan agreement or contract through which federal assistance is provided, and to such sanctions as are specified by 24 CFR Part 135. Compliance with Section 504 of the Rehabilitation Act of 1973, as amended The work to be performed under this contract is subject to the requirements of Section 504 of the Rehabilitation Act of 1973, as amended, which states that: "No otherwise qualified handicapped individual in the United States... shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance or under any program or activity conducted by any executive agency." F:\DDHP\$ALLIL YSSETTElACTPLAN\2000-01IAltachment IV ESG.doc Page 3 on CITY OF MIAMI BEACH GLOSSARY Affordable Housini>: Affordable housing is generally defined as housing where the occupants pay no more than 30 percent of gross income for gross housing costs, including utility costs. AIDS and Related Diseases: The disease of acquired immunodeficiency syndrome or any conditions arising from the etiologic agent for acquired immunodeficiency syndrome. Alcohol/Other Drug Addiction: A serious and persistent alcohol or other drug addiction that significantly limits a person's ability to live independently. Committed: Generally means there has been a legally binding commitment of funds to a specific project to undertake specific activities. Community Development Tari>et Area: Geographic area where at least 51 percent of the residents are low and moderate income persons. Consistent with the Plan: A determination made by the jurisdiction that a program application meets the following criterion: . The Annual Plan for that fiscal year's funding indicates the jurisdiction planned to apply for the program or was willing to support an application by another entity for the program; . The location of activities is consistent with the geographic areas specified in the plan; and . The activities benefit a category of residents for which the jurisdiction's five-year strategy shows a priority. Cost Burden> 30%: The extent to which gross housing costs, including utility costs, exceed 30 percent of gross income, based on data published by the U.S. Census Bureau. Cost Burden >50% (Severe Cost Burden): The extent to which gross housing costs, including utility costs, exceed 50 percent of gross income, based on data published by the U.S. Census Bureau. Disabled Household: A household composed of one or more persons at least one of whom is an adult (a person of at least 18 years of age) who has a disability. A person shall be considered to have a disability if the person is determined to have a physical, mental or emotional impairment that: (I) is expected to be oflong-continued and indefinite duration; (2) substantially impedes his or her ability to live independently; and (3) is of such a nature that the ability could be improved by more suitable housing conditions. A person shall also be considered to have a disability if he or she has a developmental disability as defined in the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.c. 6001-6006). The term also includes the surviving member or members of any household described in the first sentence of Page 1 of7 this paragraph who were living in an assisted unit with the disabled member ofthe household at the time of his or her death. Elderly Household: For HUD rental programs, a one or two person household in which the head of the household or spouse is at least 62 years of age. Elderly Person: A person who is at least 62 years of age. Existinlf Homeowner: An owner-occupant of residential property who holds legal title to the property and who uses the property as hisiher principal residence. Family: See definition in 24 CFR 812.2 (The National Affordable Housing Act definition required to be used in the CRAS rule differs from the Census definition). The Bureau of Census defines a family as a householder (head of household) and one or more other persons living in the same household who are related by birth, marriage or adoption. The term "household" is used in combination with the term "related" in the CRAS instructions, such as for Table 2, when compatibility with the Census definition of family (for reports and data available from the Census based upon that definition) is dictated. (See also "Homeless Family.") Family Self-Sufficiencv (FSS) Prolfram: A program enacted by Section 554 of the National Affordable Housing Act which directs Public Housing Agencies (PRAs) and Indian Housing Authorities (IRAs) to use Section 8 assistance under the rental certificate and rental voucher programs, together with public and private resources, to provide supportive services, that will enable participating families to achieve economic independence and self-sufficiency. Federal Preference for Admission: The preference given to otherwise eligible applicants under HUD's rental assistance programs who, at the time they seek housing assistance are involuntarily displaced, living in substandard housing, or paying more than 50 percent of family income for rent. (See 24 CFR 882.2]9.) First Time Home BlIyer: An individual or family who has not owned a home during the three year period preceding the HUD-assisted purchase of a home that must be used as the principal residence of the home buyer, except that any individual who is a displaced homemaker (as defined in 24 CFR 92) or a single parent (as defined in 24 CFR 921) may not be excluded from consideration as a first time home buyer on the basis that the individual, while a homemaker or married, owned a home with his or her spouse or resided in a home owned by the spouse. For Rent: Year round housing units which are vacant and offered/available for rent. (U.s. Census definition). For Sale: Year round housing units which are vacant and offered available for sale only. (U.s. Census definition). Frail Elderly: An elderly person who is unable to perform at least 3 activities of daily living (Le., eating, dressing, bathing, grooming, and household management activities). (See 24 CFR 689.]05.) Group Quarters: Facilities providing living quarters that are not classified as housing units. (U.S. Page 2 of? Census definition.) Examples include: prisons, nursing homes, dormitories, military barracks, and shelters. HOME: The HOME Investment Partnerships Program, authorized by Title 11 of the National Affordable Housing Act. Homeless Family: Family that includes at least one parent or guardian and one child under the age of 18, a homeless pregnant woman, or a homeless person in the process of securing legal custody of a person under the age of 18, living in situations described by terms "sheltered" or "unsheltered". Homeless Individual: An unaccompanied youth (17 years or younger) or an adult (18 years or older) without children, living in situations described by terms "sheltered" or "unsheltered". Homeless Youth: Unaccompanied person 17 years of age or younger who is living in situations described by terms "sheltered" or "unsheltered". Household: One or more persons occupying a housing unit (U.s. Census definition). See also "Family". Housing Problems: Households with housing problems include those that: (I) occupy units meeting the definition of Physical Defects; (2) meet the definition of overcrowded; and (3) meet the definition of cost burden greater than 30%. Table IC requests nonduplicative accounts of households that meet one or more of these criteria. Housing Unit: An occupied or vacant house, apartment, or a single room (SRO housing) that is intended as separate living quarters. (U.s. Census definition.) Institutions/Institutional: Group quarters for persons under care or custody. (U.S. Census definition.) Large Related: A household of 5 or more persons which includes at least one person related to the householder by blood, marriage or adoption. UHTC: (Federal) Low Income Housing Tax Credit. Low-Income: Households whose incomes do not exceed 50 percent ofthe median income for the area, as determined by HUD, with adjustments for smaller and larger families, except that HUD may establish income ceilings higher or lower than 50 percent of the median for the area on the basis ofHUD's findings that such variations are necessary because of prevailing levels of construction costs for fair market rents, or unusually high or low family incomes. NOTE: HUD income limits are updated annually and are available from local HUD offices. (This term corresponds to low and moderate-income households in the CDBG Program.) Moderate-Income: Households whose incomes are between 51 percent and 80 percent of the median income for the area, as determined by HUD, with adjustments for smaller or larger families, except that HUD may establish income ceilings higher or lower than 80 percent of the median for the area on the basis ofHUD's findings that such variations are necessary because of prevailing levels of construction costs or fair market rents, or unusually high or low family incomes. (This definition is different than that for the CDBG Program.) Page 3 of7 Middle-Income: Households whose incomes are between 81 percent and 95 percent of the median income for the area, as determined by HUD, with adjustments for smaller or larger families, except that HUD may establish income ceilings higher or lower than 95 percent, of the median for the area on the basis of HUD's findings that such variations are necessary because of prevailing levels of construction costs or fair market rents, or unusually high or low family incomes. (This definition is different than that for the CDBG Program.) Non-Elderly Household: A household which does not meet the definition of "Elderly Household," as defined above. Non-Homeless Person with Special Needs: Includes elderlylfrail elderly persons, persons with AIDS, disabled families, and families participating in organized programs to achieve economic self-sufficiency. Non-Institutional: Group quarters for persons not under care or custody. (U.S. Census definition.) Occupied Housin~ Unit A housing unit that is the usual place of residence of the occupant(s). Other Household: A household of one or more persons that does not meet the definition of a Small Related household, Large Related household, or Elderly Household. Other Income: Households whose incomes exceed 80 percent of the median income for the area, as determined by the Secretary, with adjustments for smaller and larger families. Other Low-income: Households whose incomes are between 51 percent and 80 percent of the median income for the area, as determined by HUD, with adjustments for smaller and larger families, except that HUD may establish income ceilings higher or lower than 80 percent of the median for the area on the basis of HUD's findings that such variations are necessary because of prevailing levels of construction costs or fair market rents, or unusually high or low family incomes. (This term corresponds to moderate-income in the CDBG Program.) Other Vacant Vacant year round housing units that are not For Rent or For Sale. This category would include Awaiting Occupancy or Held. Overcrowded: A housing unit containing more than one person per room. (U.s. Census definition.) ~: A household that owns the housing unit it occupies. (U.S. Census definition.) Physical Defects: A housing unit lacking complete kitchen or bathroom. (U.S. Census definition.) Jurisdictions may expand upon the Census definition. Primary HOlJsin~ Activity: A means of providing or producing affordable housing.. such as rental assistance, production, rehabilitation or acquisition -- that will be allocated significant resources andlor pursued intensively for addressing a particular housing need. (See also, "Secondary Housing Activity".) Proiect-Based (Rental) Assistance: Rental Assistance provided for a project, not for a specific tenant. Tenants receiving project-based rental assistance give up the right to that assistance upon moving from the project Page 4 of7 Public Housing ClAP: Public Housing Comprehensive Improvement Assistance Program. Public Housin~ MROP: Public Housing Major Reconstruction of Obsolete Projects. Rent Burden> 30% (Cost Burden): The extent to which gross rents, including utility costs, exceed 30 percent of gross income, based on data published by the U.S. Census Bureau. Rent Burden> 50% (Severe Cost Burden): The extent to which gross rents, including utility costs, exceed 50 percent of gross income, based on data published by the U.S. Census Bureau. Rental Assistance: Rental assistance payments provided as either project-based rental assistance or tenant-based rental assistance. Renter: A household that rents the housing unit it occupies, including both units rented for cash and units occupied without cash payment of rent. (U.S. Census definition.) Renter Occupied Unit: Any occupied housing unit that is not owner occupied, including units rented for cash and those occupied without payment of cash rent Secondary Housing Activity: A means of providing or producing affordable housing such as rental assistance, production, rehabilitation or acquisition -- that will receive fewer resources and less emphasis than primary housing activities for addressing a particular housing need. (See also, "Primary Housing Activity". ) Section 215: Section 215 of Title II of the National Affordable Housing Act Section 215 defines "affordable" housing projects under the HOME program. Service Needs: The particular services identified for special needs populations, which typically may include transportation, personal care, housekeeping, counseling, meals, case management, personal emergency response, and other services to prevent premature institutionalization and assist individuals to continue living independently. Severe Cost Burden: See Cost Burden> 50%. Severe Mental Illness: A serious and persistent mental or emotional impairment that significantly limits a person's ability to live independently. Sheltered: Families and persons whose primary nighttime residence is a supervised publicly or privately operated shelter, including emergency shelters, transitional housing for the homeless, domestic violence shelters, residential shelters for runaway and homeless youth, and any hotel/motel/apartment voucher arrangement paid because the person is homeless. This term does not include persons living doubled up or in overcrowded or substandard conventional housing. Any facility offering permanent housing is not a shelter, nor are its residents homeless. Small Related: A household of2 to 4 persons which includes at least one person related to the householder by birth, marriage, or adoption. Page 5 of7 Substandard Condition: Housing not meeting the City of Miami Beach's Housing Code, containing deficiencies such as holes in roof, faulty or non-existent plumbing, etc. Substandard Condition and not Suitahle for Rehab: By local definition, dwelling units that are in such poor condition as to be neither structurally nor financially feasible for rehabilitation. (See also "Substandard Condition.") Suhstandard Condition-but Suitable for Rehab: By local definition, dwelling units that do not meet standard conditions but are both financially and structurally feasible for rehabilitation. This does not include units that require only cosmetic work, correction or minor livability problems or maintenance work. (See also "Substandard Condition.") Substantial Amendment: A major change in an approved housing strategy. It involves a change to the five-year strategy, which may be occasioned by a decision to undertake activities or programs inconsistent with that strategy. Substantial Rehabilitation: Rehabilitation of residential property at an average cost for the project in excess of $25,000 per dwelling unit Supportive Housing: Housing, including Housing Units and Group Quarters, that have a supportive environment and includes a planned service component Supportive Service Need in FSS Plan: The plan that PHAs administering a Family Self-Sufficiency program are required to develop to identify the services they will provide to participating families and the source of funding for those services. The supportive services may include child care; transportation; remedial education; education for completion of secondary or post secondary schooling; job training; preparation and counseling; substance abuse treatment and counseling; training in homemaking and parenting skills; money management and household management; counseling in home ownership; job development and placement; follow-up assistance after job placement; and other appropriate services. Supportive Services: Services provided to residents of supportive housing for the purpose of facilitating the independence of residents. Some examples are case management, medical or psychological counseling and supervision, child care, transportation, and job training. Tenant-Based (Rental) Assistance: A form of rental assistance in which the assisted tenant may move from a dwelling unit with a right to continued assistance. The assistance is provided for the tenant, not for the project Total Vacant Housin~ Units: Unoccupied year round housing units. (U.S. Census definition.) Ilnsheltered: Families and individuals whose primary nighttime residence is a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings (e.g., streets, parks, alleys). Vacant Awaitin~ Occupancy or Held: Vacant year-round housing units that have been rented or sold and are currently awaiting occupancy, and vacant year round housing units that are held by owners or renters for occasional use. (U.S. Census definition.) Page 6 of7 Vacant housing Unit: Unoccupied year-round housing unit that are available or intended for occupancy at any time during the year. VerY Low-Income: Households whose incomes do not exceed 50 percent of the median area income for the area, as determined by HUO, with adjustments for smaller and larger families and for areas with unusually high or low incomes or where needed because of prevailing levels of construction costs or fair market rents. (This term corresponds to low income households in the COBO Program.) (For the purpose offurther distinguishing within this category, two subgroups (0 to 30% and 31 to 50% ofMFI) have been established in the CHAS tables and narratives.) Worst-Case Needs: Unassisted, very low-income renter households who pay more than half of their income for rent, live in seriously substandard housing (which includes homeless people) or have been involuntarily displaced. Year Round Housing Units: Occupied and vacant housing units intended for year round use. (U.S. Census definition.) Housing units for seasonal or migratory use are excluded. Page 7 of7 CERTIFICATION OF RELIGIOUS ORGANIZATION REOUIREMENTS In accordance with First Amendment of the U.S. Constitution - "church/state principles", ESG assistance may not, as a general rule, be provided to primarily religious entities for any secular or religious activities. Therefore, the folIowing restrictions and limitations apply to any provider which represents that it is, or may be deemed to be, a religious or denominational institution or an organization operated for religious purposes which is supervised or controlIed by or operates in connection with a religious or denominational institution or organization. A religious entity that applies for and is awarded ESG funds for public service activities must agree to the folIowing: I. 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; 2. It will not discriminate against any person applying for such public services on the basis of religion and will not limit such services or give preference to persons on the basis of religion; 3. It will provide no religious instruction or counseling, conduct no religious worship or services, engage in no religious proselytizing, and exert no other religious influence in the provision of such public services; 4. The portion of a facility used to provide public services assisted in whole or in part under this Agreement shalI contain no sectarian or religious symbols or decorations; and The funds received under this Agreement shalI not be used to construct, rehabilitate, or restore any facility which is owned by the Provider and in which the public services are to be provided. However, minor repairs may be made if such repairs are directly related to the public services; are located in a structure used exclusively for non-religious purposes; and constitute, in do lIar terms, only a minor portion of the ESG expenditure for the public services. I hereby acknowledge that I have read the specific requirements contained in this Certification, and that eligibility of my organization's project depends upon compliance with the requirements contained in this document. DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER M~ Signature ~~a~ A~JatOry " I ' /J-ryt Date ' . )(~~ ~cs. 7"/U6 Print Title of Authorized Signatory Page 1 of1 CERTIFICATION REGARDING LOBBYING Name of Recipient: CITY OF MIAMI BEACH Name of Sub-recipient: DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER Grant Program Name: EMERGENCY SHELTER GRANTS Grant Number: S-OO-MC-12-0007 If It; /z,qo I f The undersigned certifies, to the best of his or her knowledge and belief, that: Date: 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 any agency, a Member of Congress, an officer or employee of Congress, or any 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 any 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 Form to Report Lobbying", in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award documents for all sub-awards at all tiers (including sub-contracts, sub-grants, and contracts under grants, loans, and cooperative agreements) and that all individuals receiving sub-awards shall certify and disclose accordingly. DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER ~71~ II /Q/2U4 f Signature Date D{rt.J1 "- ~'1 Print Name of Authorized Signatory 6I..f'c.o~ Ve' v,~ Print Title of Authorized Signatory Page 1 of 1 CERTIFICATION REGARDING DRUG-FREE WORKPLACE REOUIREMENTS Name of Recipient: CITY OF MIAMI BEACH Name of Sub-recipient: DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER Grant Program Name: EMERGENCY SHELTER GRANTS Grant Number: S-OO-MC- 12-0007 Date: II Jq /z.o 0 ( ( The Provider shall insert in the space provided below the site(s) expected to be used for the performance of work under the grant covered by the certification: Place of Performance (include street address, city, county, state, zip code for each site): 70 I t...J N VtCl'J IltH H'~ ~ ,{.if' 33.38 DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER J.JJ ~ ~ttIWJ II /q fzno Date I ( IC!IE... Print Name of Authorized Signato ~a.1)n .,; /JIlt. Print Title of Authorized Signatory Page I of I ACKNOWLEDGEMENT OF DISABILITY NONDISCRIMINATION AFFIDAVIT CONTRACT REFERENCE ESG Fiscal Year 2000/2001 NAME OF FIRM, CORPORATION, OR ORGANIZATION DOUGLAS GARDENS COMMUNITY MENTAL HEALTH CENTER '"\ AUTHORIZEDAGENTCOMPLETI GAFFIDAVIT jJ/bJ(~ 6~ POS~N ~~~ PHONENUMBER~ S),.ncl/ I, .!) ftN ( ec:.. I I'U'+r "j , being duly first sworn state: That the above named form, 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 project complies with all applicable requirements ofthe 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. The Americans with Disabilities Act of 1990 (ADA): Pub. L. 101-336, 104 Stat 327, 42 U.S.CO 12101-12213 and 547 U.S.CO Sections 225 and 611 including Title I, Employment; Tittle II, Public Services; Title III, Public Accommodations and Services Operated by Private Entities; Title IV, Telecommunications; and Title V, Miscellaneous Provisions. The Rehabilitation Act of 1973: 29 U.S.CO Section 794. The Federal Transit Act, as amended: 49 U.S.CO Section 1612. The Fair Housing Act as amended: 42 U.S.C. Section 3601-3631. A~ Signature ~ Date "JQ J~ , , SUBSCRIBED AND SWORN TO (or affirmed) before me on II/t /z-4 , by ~"i,.j (Affiant) 5ruf (Date) @he is personallv known to me or has presented as identification. (Type of identification) #~ (J-i- (Sjg1lature of Notary) Ct'i")")/5"1 (Serial Number) (Print or Stamp Name of 0 ANA C. SANTOS .. f CC855159 EXPIR 5. 2003 IOMl>fD "'""""" /IJJ'l/AHTAOI HOf~ 7-,/lSb-J (Expiration Date) Notary Public ~,,-A (State) Notary Seal The City of Miami Beach will not award a contract to any firm, corporation or organization that fails to complete and submit this Affidavit with the firm, corporation or organization's bid or proposal or fails to have this Affidavit on file with the City of Miami Beach. Page 1 ofl