HomeMy WebLinkAboutExhibit 6csureau of Child Nutrition Programs
Child Care Food Program
BOARD OF DIRECTORS CERTIFICATION
(Not -For -Profit Independent Child Care Centers, Affiliated Sponsoring Organizations of Child Care Centers,
Affiliated Afterschool Snack Programs, and Homeless Child Nutrition Program Contractors Only)
Authorization Number: A-2384 `1 certify that the following are the board members for : the City of Miami Parks & Recreation
Name of Organization
If attaching a is of board members, it must include addresses and phone numbers and you must still complete the last two columns bestow and sign the back of this forrrt.
Name of.board.Member
T:itle..bf •
Pbsitiori
1101dion.. •
irur,:
.:
tUtattfndress, liiclif$e
• • g
.40,01yeof R sfdenc`e
..., . . ....
f�la elf f lumhe .
miff$ '
tt7fer t
�tirr � try _:
¢{t?mptoyee of c r ,:
e :l
if ^�
1/
:Ref`tt'rf'r
cr t'er I c rr
i f
FIN o
Angel Gonzalez
Commissioner
(305) 250-5430.
N/A
NiA
Marc Sarno.ft!
Commissioner
(305) 250-5333
N/A
N/A
Joe M. Sanchez
Commissioner
(305) 250-5380-.
N/A
N/A
.
Commissi
r--
:::s::::::nes
Commissioner
:~
(305) 250-5390
N/A
N/A
Revised 6IO6
1 of 2
.11: 9-i13
BOARD OF DIRECTORS CERTIFICATION
I certify that, if an incorporated institution, this board is in compliance with all applicable state statutes and rules regarding governing boards
of. corporations. •
2. I certify that, as.an institution holding federal tax-exempt, not -for -profit status, the board Is in compliance the following:
• .A majority of the board resides in hegeographical area in which the institution is located, as defined below:
a. The urban area adjacent to or'surrounding the CCFP institution; or
b. The county/counties in which the;C:CFP institution is located and the bordering counties. -
• The board has described, in writing, the purpose(s) for which the institution is organized, and provisions for managing the business anct
regulating the affairs of the institution.
Less than 50%' of the board has a direct and/or indirect financial interest in the activities of the institution.
• Less than 50% of the board is related by blood or marriage to the institution's personnel or to each other.
▪ No board member has been convicted of or found guilty of, or entered a plea of nolo contet dere to a felony in any jurisdiction, regardless
of adjudication.
• Board members do not vote on decisions regarding their own compensation.
• . Minutes of board meetings are recorded and are available for review.
I understand that the submission of false information to the Department of Health is grounds for termination from, or denial of participation in,
the Child Care Food Program as described in 7 CFR Part 226.6(c)2.
City of Miami Parks and Recreation
Institution Name
Signature of Chairman of the Board, President,
or Delegated Authority
Mr. Ernest Burkeen Jr.
Printed Name of Chairman of the Board, .President,
or Delegated Authority
August 3, 2007
Date
See Att,.l hed Signature Sheet
2 of 2