HomeMy WebLinkAboutRouting Form.474: .... Ili )
allvv • 1. mop a • ••••1 ••.•r.....
CONTRA
CO ROUTING FORM
ORIGINATING DEPARTMENT: Miami Homeless Assistance Program
DEPT. CONTACT PERSON: Sergio Torres EXT.305 576 9900 Ext. 233
NAME OF OTHER CONTRACTUAL PARTYJENTITY:_Miami- Dade County
IS THIS AGREEMENT AS A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? El YES
TOTAL CONTRACT AMOUNT: $ sae 7' G, • 4C)
TYPE OF AGREEMENT:
❑ MANAGEMENT AGREEMENT
❑ PROFESSIONAL SERVICES AGREEMENT
® GRANT AGREEMENT
❑ EXPERT CONSULTANT AGREEMENT
❑ LICENSE AGREEMENT
❑ PUBLIC WORKS AGREEMENT
❑ MAINTENANCE AGREEMENT
❑ INTER -LOCAL AGREEMENT
❑ LEASE AGREEMENT
❑ PURCHASE OR SALE AGREEMENT
NO
OTHER: (PLEASE SPECIFY)
COMMISSION APPROVAL DATE: / / RESOLUTION NO.
IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN:
'ING .INFORMATION
Date
Initials
DEPARTURE FROM ORIGINATING DEPARTMENT
Jl
•
SUBMITTED TO RISK MANAGEMENT
SUBMITTED TO CITY ATTORNEY
RECEIVED BY CITY MANAGER
`9 2c7r,(0
SIGNED BY CITY MANAGER
SUBMITTED TO AND ATTESTED BY CITY CLERK
/ oh DID
ONE ORIGINAL TO CITY CLERK
REMAINING ORIGINAL(S) TO DEPARTMENT
f
COPY TO CITY ATORNEY'S OFFICE
DEPARTMENT OF RISK MANAGEMENT
INSURANCE/SAFETY APPROVAL FORM
Name
David Rosemond
Department
NET
Review
Status
Commercial General Liability
Owned, Hired and Non Owned Autos
Workers Comp:
Liquor Liability:
Builder Risk:
Professional Liability:
Garage Keepers Liability:
,
Excess Liability:
ne Coverage
Pollution:
Description Grant between Dade County and City for the Homeless
Assistance Outreach to Homeless Detainees Program
Tracking #
Date:
9/26/2006
Financial
Ratings Strength REQUIREMENTS:
Insurance NOT Required
City of Miami is Named Additional Insured
The City is providing insurance
City of Miami is Loss Payee
Bayfront Park Named Additional Insured
APPROVAL STATUS
xx APPROVED
Frank Gomez
P&C Coordinator
Patrice Rey
Safety Manager
Not Approved
Coverage is insufficient
Not A Rated Company
A Type of Coverage is Missing
Other
The City NOT Named Additional Insured
Insurance/Safety Comments:
Grant to City in the amount of $85,796 towards the Miami Homeless Assistance Program.
Indemnification language in accordance and subject to the limitations as set forth in Section 768.28, Florida
Statutes.
Risk 002 9/26/2006 9:32 AM