HomeMy WebLinkAboutExhibit 9EXHIBIT B — WORK PROGRAM
ELDERLY SERVICES
I. SUBRECIPIENT understands that the National Objective is assistance to low- to
moderate income persons.
2. SUBRECIPIENT will provide services to program participants that meet the
following criteria:
a) Must be a resident of the City of Miami
b) Must be a member of a low -to moderate income household
C) Must be at least 62 years of age
3. SUBRECIPIENT will submit the following information to the City of Miami
Department of Community Development to obtain certification that proposed
participant is eligible to receive program benefits and for SUBRECIPIENT to
invoice the CITY for services provided.
a) Program Application, in a form provided by the City of Miami
Department of Community Development, signed by prospective
participant and the SUBRECIPIENT.
4. SUBRECIPIENT must keep in file proof of the information listed below
demonstrating that each program participant is eligible to receive program
benefits:
a) Proof of living in the City of Miami
b) Proof of income
C) Proof of age
This information must match the information listed by the SUBRECIPIENT in
the participant Program Application form submitted to the CITY. A copy of this
form must also be kept in the participant's file.
5. SUBRECIPIENT may replace program participants who stop receiving program
benefits by providing the information required in items 2 and 3 for the new
participant. SUBRECIPIENT will not invoice the CITY until the proposed
participant is certified as eligible by the CITY.
6. SUBRECIPIENT will provide Elderly Services to a minimum of
participants, on a monthly basis, at the following location(s):
Address:
SUBRECIPIENT will provide program reports for the services provided to the
participants in a form provided by the CITY.
7. Program will commence on October 1, 2009 and will end on September 30, 2010.
SIGNED:
Name: Date
Executive Director
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this day of
200_, by
(Title),
(Name)
(Agency), a Florida
not-for-profit corporation, on behalf of the corporation. He/she is personally known to me
or has produced
as identification
Signature of Notary
State of Florida
Type, Print or stamp name of
Notary Public