HomeMy WebLinkAboutExhibit 3EXHIBIT B — WORK PROGRAR'I
ELDERLY SERVICES
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 60 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. A copy of this form must also be kept in the participant's file.
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 transportation services to the elderly and handicap 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 January 14; 2010 and gill 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 known to me or has produced
identification.
Signature of Notary
State of Florida
Type, Print or stamp name of
Notary Public
M
IOW. _ 40404
COMPENSATION.4-ND BUDGET
A. The maximum compensation under this Agreement shall be S _61000.00
B. SUBRECIPIENT's Itemized Budget, Cost Allocation, Budget Narrative, Staff Salaries
Schedule are attached hereto and made part of this Agreement.
C. Requests for payment should be made at least on a monthly basis. Reimbursement requests
should be submitted to the CITY within thirty (30) calendar days after the indebtedness has
been incurred in a form provided by the Department. Failure to comply with these time
frames for requesting reimbursement/payment may result in the rejection of those invoices
within the reimbursement package which do not meet these requirements.
D. Each written request for payment shall contain a statement declaring and affirming that
services were provided to certified program participants and in accordance with the
approved Work Program and Program Budget. All documentation in support of each
request shall be subject to review and approval by the CITY at the time the request is made.
E. All expenditures must be verified with a copy of the original invoice and a copy of a check
or other form of payment which was used to pay that specific invoice. Within 60 days of
submitting each reimbursement request, copies of the cancelled checks or other CITY
approved documents evidencing the payments by the SUBRECIPIENT, for which
reimbursement was requested, shall be submitted. In the event that an invoice is paid by
various fielding sources, the copy of the invoice must indicate the exact amount (allocation)
paid by various funding sources equaling the total of the invoice. No miscellaneous
categories shall be accepted as a line -item budget.
F. The SUBR.BCIPIENT must submit the final request for payment to the CITY within thirty
(30) calendar days following the termination date of this Agreement. If the
SUBRECIPIENT fails to comply with this requirement, the SUBRECIPIENT shall forfeit
all rights to payment and the CITY shall not honor any request submitted thereafter.
G. Any payment due under this Agreement may be withheld pending the receipt and approval
by the CITY of all reports due from the SUBR.ECIPIENT as a part of this Agreement and
any modifications thereto.
H. During the term hereof and for a period of five (5) years following the date of the last
payment made hereunder, the CITY shall have the right to review and audit the time records
and related records of the SUBR.ECIPIENTpertaining to any payments by the CITY.
Name:
Title:
Date