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Home My WebLink AboutCD resoEXHIBIT A CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT ITEMIZED BUDGET -INCOME JESCA ELDERLY PROGRAM NUMBER OF NUMBER OF RATE TOTAL PARTICIPANTS PROGRAM DAYS CONGREGATE MEALS 37.16 PARTICIPANTS X 253 SERVING DAY @ $5.00 = $47, 000.00 CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT AGENCY: PERIOD FUNDING SOURCE ITEM Personnel Cost Social Security Unemployement Ins. Life Insurance Medical Insurance Worker's Comp. Gen. Liab. Ins Audit Fees Food Expense Office Supplies Recreational Expense BUDGET NARRATIVE BY LINE ITEM The James E. Scott Community Association, Inc. Ocotber 01, 2004 to September 30, 2005 City of Miami DESCRIPTION see attached spreadsheet of cost allocation salaries x 7.65% as per law see attached spreadsheet of cost allocation see attached spreadsheet of cost allocation see attached spreadsheet of cost allocation see attached spreadsheet of cost allocation 41.8% of program audit cost 1.20% of total food expense AMOUNT $18,056 $1,381 $397 $39 $3,200 $388 $1,774 $1,500 $7,000 $1,500 $11,765 $47,000 AGENCY: The James E. Scott Community Association, Inc_ PERIOD COVERING: Oct 1, 2004 to Sept. 30, 2005 Employee Name Althea Jackson Kimberly Smith Position Title Snr. Administrator Site Manager Social Security Ethnicity African American African American Type of Employee Pt/Ft FT FT Period 10/01/04- 9/30/05 10/01/04- 9/30/05 Budgeted Pay Periods 26 26 Annual Gross Salary $61,120.00 $15,000.00 Total Per P $2, $5 Salary .y Period Percent of Salary Charged to Cii Total Amount Charged to City 350.77 5.00% $3,056.00 76.92 100.00% $15,000.00 $18,056.00 Althea Jackson Kimberley Smith Total Salary LINE ITEM COST Description Social Security (7.65% of gross salary) Social Security (7.65% of gross salary) Unemployment Unemployment Bi-weekly Salary $2,350.77 $ 576.92 # of pay periods 26 26 Justification A. Jackson K. Smith A. Jackson Total I % allocated $ allocated Salary to this to this program program $ 61,120.02 $ 15,000.00 5.00% 100.00% $ 3,056.00 $ 15,000.00 S 76,120.02 $ 18,056.00 Total Cost $ 4,675.68 $ 1,147.50 $ 378.00 % allocated to this. program 5.00% 100.00% 5.00% $ allocated to this program $ 233.78 $ 1,147.50 $ 18.90 Administrative Cost /o $ 5.00% 0.00% 5.00% 5.00% $ 3,056.00 $ 233.78 $ 18.90 Direct Program Cost 0.00% 100.00% 100.00% $ 15,000.00 $ 1,147.50 K. Smith $ 378.00 100.00% $ 378.00 100.00% $ 378.00 Life Insurance Life Insurance Medical Insurance Medical Insurance Worker's Compensation Worker's Compensation General Liability Insurance Audit Fees Food Expense Office Supplies A. Jackson K. Smith A. Jackson K. Smith A. Jackson K. Smith $ 37.20 $ 37.00 $ 3,047.28 $ 3,047.00 $ 1,314.08 $ 322.50 $ 17,743.98 $ 50,000.00 $ 650,000.00 $ 6,000.00 5.00% 100.00% 5.00% 100.00% 5.00% 100.00% 10.00% 3.00% 1.08% 25.00% $ 1.86 $ 37.00 $ 152.36 $ 3,047.00 $ 65.70 $ 322.50 $ 1,774.40 $ 1,500.00 $ 7,000.00 $ 1,500.00 5.00% 5.00% 5.00% $ 1.86 $ 152.36 $ 65.70 100.00% 100.00% 100.00% 10.00% 3.00% 1.08% 25.00% Recreational Expenses $ 11,765.00 100.00% $ 11,765.00 100.00% $ 37.00 $ 3,047.00 $ 322.50 $ 1,774.40 $ 1,500.00 $ 7,000.00 $ 1,500.00 $ 11,765.00 IC24 n13.24 1 $ 47,000.40 1 $ 3,528.6611 ! 43,471,411 AGENCY: The James E. Scott Community Association, Inc. Period Being Cost Allocated: October 01, 2004 to September 30, 2005 Effective Date City of Miami Other Funding 10/1/2004 Line -Item Description % % % % % Total 101 STAFF SALARIES 4.2% $ 18,056 95.8% $ 411,528 0.0% OA% 100.0% $ 429,584 200 STAFF MICA 4.2% $ 226 95.8% $ 5,144 0.0% 0.0% 100.0% $ 5,370 201 STAFF FICA 4.2% $ 1,156 95.8% $ 26,338 0.0% 0.0% 100.0% $ 27,493 202 STAFF WORKERS COMP. 0.7% $ 388 99.3% $ 55,128 0.0% 0.0% 100.0% $ 55,516 203 STAFF UNEMPLOYMENT 5.0% $ 397 95.0% $ 7,531 0.0% 0.0% 100.0% $ 7,928 204 STAFF GROUP HEALTH INS. 6.1% $ 3,200 93.9% $ 49,154 0.0% 0.0% 100.0% $ 52,354 206 RETIREMENT STAFF #DIV/01 #DIVIO! #DIV/0! #DIV/0! #DIV/0! $ - 250 PROFESSIONAL SERVICES #DIVIO! ` #DIV/0! #DIVIO! #DIV/01 #DIV/0! $ - 252 AUDIT COST 41.8% $ 1,500 58.2% $ 2,088 0.0% 0.0% 100.0% _ $ 3,588 260 SPECIAL #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! $ - 261 TEMPORARY STAFF #DIV/01 #DIV/0! #DIV/0! #DIV/0! #DIV/0! $ - 270 INDIRECT COST #DIV/01 #DIV/0! #DIVIO! #DIV/0! #DIV/0! $ - 300 DIR. PUB. OFF. BOND #DIV/0! 1 #DIV/0! #DIV/01 #DIV/0! #DIV/01 $ - 301 GEN. LIABILITY INS. 3.9% $ 1,774 96.1% $ 43,226 0.0% 0.0% 100.0% $ 45,000 302 AUTO LIABILITY 0.0% 100.0% $ 9,157 0.0% 0.0% 100.0% $ 9,157 303 BONDING #DIV/01 #DIV/0! #DIV/0! #DIV/0! #DIV/01 $ - 304 OTHER INSURANCE 5.0% $ 39 95.0% $ 741 0.0% 0.0% 100.0% $ 780 350 TELEPHONE 0.0% 100.0% $ 16,500 0.0% 0.0% 100.0% $ 16,500 360 ELECTRICAL SRVS. 0.0% 100.0% $ 29,000 0.0% 0.0% 100.0% $ 29,000 370 GARBAGE #DIV/01 #DIV10! #DIV/0! #DIV/01 #DIV/01 $ - 380 WATER & SEWER #DIVIO! #DIV/0! #DIVI01 #DIV/0! #DIVIO! $ - 400 EQUIPMENT REPAIR #DIV10! #DIV/01 #DIV/0! #DIVI01 #DIV/01 $ - 410 EQUIPMENT MAINT. #DIV/01 '#DIV/O! #DIV10! #DIV/01 #DIV/01 $ . - 411 BLDG. MAINTENANCE 0.0% 100.0% $ 13,700 0.0% 0.0% 100.0% $ 13,700 415 CONF. & PROF. MTNG. #DIV/0! #DIV/01 #DIV/0! #DIV/01 #DIV10! $ - 420 CONTRACTUAL MAINT. #DIV/01 #DIV/01 #DIV/0! #DIV/01 #DIV/01 $ - 421 MAINT. VEHICLE 0.0% 100.0% $ 17,710 0.0% 0.0% 100.0% $ 17,710 422 OPERATIONAL MAINT. #DIV/01 #DIV/0! #DIV/0! #DIV101 #DIV/01 $ - VEHICLE (GASOLINE) 0.0% 100.0%, $ 35,000 0.0% 0.0% 100.0% $ 35,000 AGENCY: The James E. Scott Community Association, Inc. Period Being Cost Allocated: October 01, 2004 to September 30, 2005 Effective Date Line -Item Description 450 EQUIPMENT RENTAL 460 SPACE RENTAL 501 POSTAGE 502 PRINTING OUTSIDE 503 PUBLICATIONS 504 ADVERTISING 507 MEMBERSHIP a/a #DIVID! #DIV10! 0.0% #DIVIO! #DIVID! #DIV/0! #DIV/0! #DIV/0! 100.0% #DIV/0! #DIV/0! #DIV/0! $ 300 % #DIV10! #DIV10! 0.0% #DIV/0! #DIV/0! #DIV/0! 510 LOCAL TRAVEL 511 OUT OF TOWN TRAVEL 513 PKNG. M.RAIL—STAFF 520 PRINTING REPRO. SUPPLIES 521 OFFICE SUP. STAFF 522 TRAINING SUPPLIES 524 SPEC. SUP. (SFETC) 525 EXPENDABLE TOOL SUPPLIES (SFETC) 526 COMPUTER SUPPLIES 527 SUPPORTIVE SERVICE 528 CHILD CAREISUPP SERVICES 542 TUITION & BOOKS 600 O/T WAGES (PARTICIPANT) 900 CAPITAL OUTLAY EQUIP. 901 OFFICE FURNITURE (BELOW $500.00) 902 SOFTWARE 902 SOFTWARE TOTAL #DIVMO! #DIV10! #DIV/0! #DIVIO! #DIVID! #DIV10! 50.0% 0.0% #DIV/O! #DIV10! #DIVID! #DIV/0! 3.2% #DIV/O! #DIVID! #DIV/0! #DIVID! #DIV10! #DIV/0! #DIV/0! #DIV/0! #DIVID! #DIV10! 3.5% $ 1,500 $ 18,765 $ 47,000 #DIV10! #DIV/0! #DIVID! #DIV10! #DIVID! #DIV/0! 50.0% 100.0% #DIV/0! #DIV/0! #DIV/0! #DIV/0! 96.8% #DIV/O! #DIV/0! #DIVID! #DIV/0! #DIV/0! #DIVID! #DIV/0! #DIV/0! #DIVID! #DIVID! 96.5% $ 1,500 $ 700 $ 567,829 $ 1,292,273 #DIV/0! #DIV10! #DIv/01 #DIV/0! #DiV/0! #DIV/0! 0.0% 0.0% #DIV10! #DIV/0I #DIV10! #DIV/0! 0.0% #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIVID! #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0.0% 0 #DIV10! #DIV/01 0.0% #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0.I #DIV/0! #DIV/0! #DIV/O! #DIV/0! 0.0% 0.0% #DIV/0! #DIV/0! #DIV/01 #DIV/0! 0.0% #DIV/0! #DIV/01 #DIV/0! #DJVIO! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! 0.0% 0 a/a #DIV/0! #DIV10! 100.0% #DIV/0! #DIV10! #DIV10! #DIV/01 #DIV/0I #DIV/0! #DIV/O! #DIV/0! #DIV/0! Total $ 300 $ 100.0% 100.0% #DIV10! #DIV/0! #DIV/0! #DIV10! $ $ $ 3,000 $ 700 100.0% #DIV/01 #DIV/0! #DIV/0! #DIV/0! #DIV10! #DIV/0! #DIV/0! #DIVIO! #DIV/O! #DIV/0! $ $ 586,594 $ $ $ .$ 100.0% $ 1,339,273 CERTIFICATION REGARDING LOBBYING Certification for Contracts, Grants, Loans, and Cooperative Agreements The undersigned certifies to the best of his or her knowledge and belief, that: (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 an agency a Member of Congress, am officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of aiiy 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 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 an 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) This undersigned shall require that the language of this certification be included in the award documents for "Alt" sub -awards at all tiers (including subcontracts, sub -grants, and contracts under grants, loans, and cooperative agreements) and that all sub -recipients shall certify and disclose accordingly. This certification Is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $ 100,000 for each such failure. James F_ Srntt (rnmi1rli ty Assnr PROPOSER SIGNATURE OF YING OFFICIAL * Note: in these instances, "AA" in the Final Rule is expected to be clarified to show that it applies to covered contract/grant transactions over $ 100,000 (per QMB). CERTIFICATION REGARDING DEBARMENT, SUSPENSION AND OTHER RESPONSIBILITY MATTERS PRIMARY COVERED TRANSACTIONS 1. The Proposer certifies to the best of Its knowledge and belief, that it and its principals: a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency. b. Have not within a three-year period preceding this Proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or"State antitrust statutes or falsification or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph Lb of tbis certification; and d, Have not within a three-year period preceding this application/Proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall submit an explanation to the City of Miami. James_E. Scott Community Assoc. PROPOSER/AGENCY Dorrin D. Rolle PRINT , ME OF C RTIFYING OFFICIAL �r 1 SI t' ATURE 0 pFYING OFFICIAL e`® DATE SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(A). FLORIDA STATUTES ON PUBLIC ENTITY CRIME THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS. I . This sworn statement is submitted to City Of Miami By Dorrin D. Rolle, President & CEO (print this individual's name and title) for James E. Scott Community Association (print name of entity submitting statements) whose business address is 2389 NW 54 Street 1iaoni, Fi 33142 and whose Federal Employer Identification Number (FEIN) is 5 9 - 0 71 1 1 7 8 If the entity has no FEIN, include the Social Security Number of the individual signing this sworn Statement: 2. I understand that a "public entity crime" as defined in paragraph 287.133(1)(a), Florida Statutes mean a violation of any state or federal law by a person with respect to and directly related to the transactions of business with any public entity or with an agency or political subdivision of any other state or with the United States including, but not limited to any bid or contract for goods or services to be provided to any public entity or any agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 3, I understand that "convicted" or "convection" as defined in Paragraph 287.133(1)(b), Florida Statutes means a finding of guilt or a conviction of a publib entity crime, with or without adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a Jury verdict, non -jury trial, or entry of a plea of guilty or nolo contendere, 4, I understand that an "affiliate" as defined in paragraph 287.133(1)(a), Florida Statutes, means: I. A predecessor or successor of a person convicted of public entity crime; or 2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arrn's '.length agreement, shall be a p. it'.a facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. I understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts fo, .,te provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity, The term "person" includes those officers, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Based on information and belief, the statement which I have marked below is true in a relation to the entity submitting this sworn statement. (Please indicate which statement applies). k Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or any affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. AND_(Please indicate which additional statement applies). The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. However, there has been a subsequent proceeding before a Hearing Officers of the State of Florida, Division of Administrative Hearings and the Final Order by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (Attached is a copy of the final order), I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH I (ONE) ABOVE IS FOR THE PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED AND FOR THE PERIOD OF THE CONTRACT ENTERED INTO, WHICHEVER PERIOD IS LONGER. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017, FIRMA STA ES F' . CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS (Signa City of M i r141 I STATE OF FLORIDA Sworn and subscribed before me this ./`). day of /I 1) 0- i t _ 2004 by bc.,'Li2_t i .L 1€ who is Personally known to me Or who produced identification - �/r,/ .'' rr ( (Type of Identification) 1,. 'd t 4i l•� rL�,< (/ �,\ti f 1 t_ 1) r' it ' (:1J (Signature) Notary P'yblic-State of Florida (Printed, typed ar ,,tamped commissioned name of notary public) My commission expires: • 1 t. l+r , / (SEAL) c Jackson MY Commission costars ex$., .i y to. sari