HomeMy WebLinkAboutExhibit 3EXHIBIT B — NN, ORK PROGR INI
ELDERLY SERVICES
SUBRECIPIENT understands that the National Objective is assistance to low- to
moderate income persons.
?. SliBRECIPIENT -,rill provide services to program participants that meet the
following criteria:
a) Must be a resident of the Cite- of Miami
b) 1\Tust be a member of a lo,v-to moderate income household
C) 'Vust be at least 62 vears of age
3. SUBR.ECIPIENT will submit the following il-ifonnation to the City of Miami
Department of Community Development to obtain certific ation that proposed
participant is eligible to receive program benefits and for SUBRECIPIEI.TT 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. A copy of this form must also be
kept in the participant's file.
4. SUBR.ECIPIENT 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 a6e
This Lnformation 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.
3. SUBR.ECIPIENT may replace program participants wTho 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. SUBR.ECIPIENT will provide Elderly Services (meals) as follows:
a) Congregate Meals: serve meals to a minimum of participants on
a daily basis at the following location.
Address:
Meals will be provided for up to a total of program days.
b) Homebound Meals: deliver meals to a minimum of paricipants
on a dai1v basis at the folio« iQ location.
Meals will be provided for up to a total of program days.
SUBRECIPIE--N-T 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
2009 by Executive Director of
a Florida not-for-profit
corporation, on behalf of the corporation. He/she is personally l not n to me or has
produced as identification.
Signature of Notary
State of Florida
Type, Print or stamp name of
Notary Public