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HomeMy WebLinkAboutBackup5ann2 agi (.ef ✓ ran �1 Zic�a(ni, Jac. 1(ax a Eotint@-.` fto poan, &q. e'haixpetaan [Aloe Mesa 2'ice '(iurix Jet,. J(ada Jan 53u4ke .Ate/n&ex at Pave Daniel Silo -Cline .Attan!ien at L'axge .C'iooette 1'ary auoee, Eeq. .Me.mae at Lange Drc. 1'ynn 1'alkaueee .Atemavt at £axge .A aria ga&vde .Mc,,t1ic4 at Lave .Mz gaxet Rudolph .Atenntait at .earcge J3ta,:he ✓V'a,wa .A(emGex femme 2 ealaadfee .Mender. at. 53vwe&rf eaxte't [Remy. .Men,sxt J3axcarcaann lunge hiernta Xaxen..At, .MaAax .MU' nGert • Coporate Resolution Resolution 2007-2008 Be it so resolved that the Fanm Ayisyen Nan Miyami, Inc.'s Board of Directors on, August 30. 2007 authorized Marleine Bastien, Executive Director, and/or Marie Estime-Thompson, Chairperson to enter into a contract with The City of Miami on Funding in the amount of $28,263.00 for Public ServiceAfter School support services for FANM's clients on behalf of Fanm Ayisyen Nan Miyami, Inc. for the period of October 1, 2007 to September 30, 2008. The resolution was offered by motion ,k 2;3 Votes cast by Directors Diane Landsberg _Maria Roberts _Marie Estime Thompson Jerome Deslouches Manouchka Thermitus Tamara Labrousse Daniel Fils-Aime Karen Mahar _Beverly Remy Carter_ Gerri Lazarre Lissette Labrousse Margaret Rudolph The res9lution was duly passed on 7 Marie 1stjiane Thompson, Chairperson .t, A Y/s` Seat 799 l • 'NE 2"d Queruce, Suite 100, A ianu., ;Le 33138 and seconded by yeas ; no nas t ,. q1.cara.cam Jfarte: 305-756-8050 saa;: 3U5-756-815U City of Miami Master Report Enactment Number: R-07-0314 City Hall 3500 Pan American Drive Miami, FL 33133 www.miamigov.com File Number: 07-00673 Version: 1 File Type: Resolution Status: Passed Reference: Controlling Body: Office of the City Clerk File Name: Allocation 33rd Program Year CDBG Funds Introduced: 5/15/2007 Requester: Department of Community Cost: Final Action: 6/12/2007 Development Title: A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S), AUTHORIZING THE ALLOCATION OF 33RD PROGRAM YEAR COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS, IN THE AMOUNT OF $1,265,833, TO THE AGENCIES SPECIFIED IN "ATTACHMENT A," ATTACHED AND INCORPORATED, FOR PUBLIC SERVICES ACTIVITIES IN THE 33RD PROGRAM YEAR BEGINNING OCTOBER 1, 2007; AUTHORIZING THE CITY MANAGER TO EXECUTE AGREEMENT(S), IN SUBSTANTIALLY THE ATTACHED FORM(S), WITH SAID AGENCIES, FOR SAID PURPOSE. Sponsors: Notes: Indexes: Attachments: 07-00673 Legislation.pdf,07-00673 Exhibit 1.pdf,07-00673 Exhibit 2.pdf,07-00673 Summary Form.pdf,07-00673 Public Notice.pdf, History of Legislative File Version: Acting Body: Date: Action: Sent To: Due Date: Return Date: Result: Office of the City 5/23/2007 Reviewed and Attorney Approved 1 City Commission 6/12/2007 ADOPTED 1 Office of the Mayor 6/14/2007 Signed by the Mayor Office of the City Clerk 1 Office of the City Clerk 6/14/2007 Signed and Attested by City Clerk Pass C'irr'. A•iiumi Pak:. 1 I'rinie/ an NI :2u(L; EXHIBIT B — WORK PROGRAM FOR AFTER SCHOOL AND SUMMER/SCHOOL RECESS CARE 1. SUBRECIPIENT understands that the National Objective is Limited Clientele. SUBRECIPIENT will recruit program participants that meet the following criteria: a) Must be a resident of the City of Miami in the District funding the program b) Must be a member of a low -to moderate income household c) Must be between the ages of 6 and 15 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 of Miami for services provided. a) Program Application, in a form provided by the City of Miami Department of Community Development, signed by prospective participant or by legal guardian if prospective participant is incapable of doing so b) Proof of residency c) Proof of income d) Proof of age 4. SUBRECIPIENT may replace participants who stop receiving program benefits by providing the information required in 2 above. SUBRECIPIENT will not invoice the City of Miami until the proposed participant is certified as eligible by the City of Miami. 5. SUBRECIPIENT will provide: a) After school care to 14 participants from 2:30 pm to 7:00pm pm on the following days: _x_ Monday, _x_ Tuesday, x Wednesday, x Thursday, x Friday, at the following sites: Fanm Avisven Nan Mivami, Inc. 8325 N.E. 2"d Avenue, Suite 100 Miami, FL. 33138 After school care will be provided for up to a total of 140.62 program days. SUBRECIPIENT will present proof of having provided the after school care via signatures of parent or guardian on sheets which specify arrival and departure times for each day that services were provided and charged to the City of Miami Program. b) Summer day care or school recess care to 14 participants from 9:00 am to 5:00 pm on the following days: _x_ Monday, _x_ Tuesday, x_Wednesday, x Thursday, _x_ Friday, at the following sites: Fanm Avisven Nan Mivami, Inc. 8325 N.E. 2"d Avenue, Suite 100 Miami, FL. 33138 The summer program will be provided for up to a total of 52 program days. SUBRECIPIENT will present proof of having provided the summer day care via signatures of parent or guardian on sheets which specify arrival and departure times for each day that services were provided and charged to the City of Miami Program. 5. Program will commence on pc. c� re r 1 , 2007 and will end on rn 2008. SIGNED: 1\4\ew \evat., C1.5k1CY1 , b [Name of Executive Director] STATE OF FLORIDA COUNTY OF Frlievtvta Date -,-o The foregoing instrument was acknowledged before me this viA(.,t., )0_0 , t_(61 [Date] by n 10..j, a--.1. c )-14, , 11.''o•i-a._:.t (2 ; c [Title] of t-=- 40,.' i ,`-14,4 [Agency name], a Florida not -for -profit corporation, on behalf of the corporation. He/she is personally known to me or has produced r` ! , as identification. Print Notary Public's Name Signature (SEAL) NOTARY PUBLIC -STATE OF FLORIDA Antoinnette Gloria Penha Commission # DD446233 Expires: JUKE 29, 2009 Bonded Thru Atlantic Bonding Co., Inc. EXHIBIT C — COMPENSATION AND BUDGET SUMMARY AFTER SCHOOL AND SUMMER/RECESS PROGRAM A. .A11 payments shall be reimbursements for after -school programs and summer program care providers. Care providers will be paid according to the rates specified below : After School Care $7.7 Minimum of 2.5 hours Summer Prom -am $18.00 Minimum of 7 hours Rates may be negotiated for providers with active government agreements reflecting a higher rate for the identical service. The CITY shall pay the SUBRECIPIENT, as maximum compensation for the services required pursuant to this Agreement the sum of $ 2,, 2/ 3" '. B. SUBRECIPIENT'S Itemized Budget, Cost Allocation, Budget Narrative, Staff Salaries Schedule are attached hereto and made part of this contract. C. During the term hereof and for a period of four (4) 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 SUBRECIPIENT pertaining to any payments by the CITY. D. Requests for payment should be made at least on a monthly basis in a form provided by the Department. 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. E. The SUBRECIPIENT must submit the final request for payment to the CITY within 30 calendar days following the expiration date or termination date of this Agreement in a form provided by the Department. 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. E. Any payment due under this Agreement may be withheld pending the receipt and approval by the CITY of all reports due from the SUBRECIPIENT as a part of this Agreement and any modifications thereto. lV�r�r Ieine, _ - s— Name: Date Title: E--- Fanm Ayisyen Nan Miami City of Miami - PS0607-35 October 1,2007 to September 30, 2008 BUDGET Revenue 28,263.00 Expenditures Staff Salaries: Director of Human Services 7,829.00 Office Manager 5,000.00 Education Specialist 6,500.00 FICA/MICA 1,478.67 Workman's Comp. Ins. 193.29 Staff Unemployment 386.58 Group Health Insurance 2,300.00 Space Rental 3,607.33 Telephone 268.13 Program Supplies 700.00 Total Expenditures 28,263.00 Excess Rev. over Expenditure $ BUDGET FORM III COST ALLOCATION PLAN I of CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT (NON -HOUSING DEVELOPMENT ONLY) AGENCY: Fanm Ayisyen Nan Miyami, Inc. Oct - Sept 2008 1 ffe t. tiv ."im#4'. kw€°,. 24.56% T�,..., ,�. .. $,.b•?». Yh �`a..»."iio.z;`'iii"$: .. t3.,..:5.4:• KA�e;�''w 17.40% } ..., c,, ;? �y<; Amr1t� ??he r it es in'1,V$ 101 STAFF SALARIES - a.: .(.'» �M.x._;'�A;, WS.nTMY .*vk. t x;}3�''1:It 6885 9720 3645 48.84% 19329 39579 CLASSIFIED 0 200 STAFF MICA 201 STAFF FICA. 9.93% 185 69 79.34% 1478.67 7.03% 131 1863.67 202 STAFF WORKERS COMP. 36.96% 206 80 34.68% 193.29 14.00% 78 557.29 203 STAFF UNEMPLOYMENT 39.84% 2731 1294 5.64%, 386.58 35.65% 2444 6855.58 204 STAFF GRP HEALTH INS. 100.00%, 2300 2300 206 RETIREMENT STAFF 250 PROFIsSSIONAL SVCS. 252 AUDIT COST 260 SPECIAL 261 TEMPORARY STAFF 270 INDIRECT COST 300 DIR. PUI3. OFF. BOND 301 GEN. LIABILITY INS. 302 AUTO LIABILITY 303 BONDING 304 OTHER INSURANCE 350 TELEPHONE 44.22% 1965 819 6.03% 268.13 31.32% 1392 4444.13 360 ELECTRICAL SRVS. 370 GARBAGE 380 WATER & SEWER 400 EQUIPMENT REPAIR 410 EQUIPMENT MAINT. Total 155.50% $ 14,807.00 $ 5,907.00 274.53% $ 23,955.67 105.39% $ 10,930.00 0.00% $ 55,599.67 BUDGET FORM III COST ALLOCATION PLAN 2 of3 CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT (NON -HOUSING DEVELOPMENT ONLY) AGENCY: Fanm Ayisyen Nan Miyami, Inc. 1 ff`ccti e Lin le 411 BLDG. MAINTENANCE Oct - Sept 2008 0$ 415 CONF. & PROF. MTNG. 420 CONTRACTUAL MAIT. 421 MAINT. VEHICLE 422 OPERATIONAL MAINT. VEHICLE (GASOLINE) 450 EQUIPMENT RENTAL 460 SPACE RENTAL 38.93% 10560 4800 13.30% 3607.33 30.08% 8160 27127.33 501 POSTAGE 502 PRINTING OUTSIDE 503 PUBLICATIONS 504 ADVERTISING 507 MEMBERSHIP 510 LOCAL TRAVEL 511 OUT OF TOWN TRAVEL 513 PKNG. M.RAIL—STAFF 520 PRINTING REPRO. SUPPLIES 521 OFFICE SUP. STAFF 41.07% 2600 1035 11.06% 700 31.52% 1995 6330 522 TRAINING SUPPLIES 524 SPEC. SUP. (SFETC) Total 80.00% $ 13,160.00 $ 5,835.00 24.36% $ 4,307.33 61.60% $ 10,155.00 0.00% $ 33,457.33 BUDGET FORM III COST ALLOCATION PLAN 3 of 3 CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT (NON -HOUSING DEVELOPMENT ONLY) AGENCY: Fanm Ayisyen Nan Miyami, Inc. Oct - Sept 2008 525 EXPENDABLE TOOL SUPPLIES (SFETC) 526 COMPUTER SUPPLIES 527 SUPPORTIVE SERVICE 528 CHILD CARE/SUPP SERVICES 542 TUITION & BOOKS 600 O/T WAGES (PARTICIPANT) 900 CAPITAL OUTLAY E UIP. 901 OFFICE FURNITURE (BELOW $500.00) 902 SOFTWARE 902 SOFTWARE Total 0.00% $ 27,967.00 $ 11,742.00 $ 2.99 $ 28,263.00 $ 1.67 $ 21,085.00 $ - $ 89,057.00 STAFF SALARY FORECAST CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT (NON -HOUSING DEVELOPMENT ONLY) AGENCY: FANM Ayisyen Nan Miyami, Inc. PERIOD COVERING: Oct - Sept 2008 Employee Name FRANCOIS, ALINE B. Position Title Director of Human Services 3103 Ethnicity; Black FT 24 Oct 2007 - Sept 2008 Annua" Gross"' Salar $59,000.00 Total Salary Per Pay Period $4,750.00 Percent of Salary Charged to City 14% Total Amount Charged to City $7,829.00 Julien,Gislaine Office Manager 1831 Black FT 24 Oct 2001- Sept 2008 $35,000.00 $2,916.66 14% $5,000.00 GENNA, MAGALIE Education Specialist 0335 Black FT 24 Oct 2007- Sept 2008 $26,000.00 $2,166.66 25% $6, 500.00 34 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, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any 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 "All" 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 pre -requisite 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. no-) SUB-RECIPIENV 1VC(ri I\ 1 i arnt L-4 NVIr e_ t ne. 3 Gts en 11Gr� e;✓ - �= s� t r ri �, 1 6 oni pso m PRINT NAME OF CERTI SING OFFICIAL SIGN+A,irRE OF CERTIFYING OFFICIAL DATE * Note: In these instances, "All" 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 Sub -Recipient 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 judgement 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 1.b of this 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. rn SUB -RECIPIENT rl (r-Aum) ` 1-erg 1. rim PRINT,IaTA.ME OF CER - ING OFFICIAL 7 GNA;T '1' 0 ' TIFYING OFFICIAL 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. 1. This sworn statement is submitted to (print this individual's name and title) for i--cty rn CAA 1.l M) (print name of entity submitting statements) whose business address is g�2,� jv �, 2."‘ ." 1 &IF Sl.lk 100 and if applicable is Federal Employer Identification Number (FEIN) is (5 - v 33/4-ao ) 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 public 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, nonjury 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 arm's length agreement, shall be a prima 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 for the 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). ✓ 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 1 (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, FLORIDA STATUTES, FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM. re 6 Sworn to me and subscribed before me this 2-' day of k i (zt.L S , T9 x i Personally known Or produced identification ./ Notary Public —State of F= i . C' f&J. I 1D� (Type of Identification) NOTARY PUBLIC -STATE OF FLORIDA Antoinnette Gloria Penha Commission # DD446233 Expires: JUNE 29, 2009 Bonded Thru Atlantic Bonding Co., Inc. My commission expires 114r s f'1 (Printed, typed or stamped commissioned name of notary public) EXHIBIT G CD INSURANCE REQUIREMENTS - PUBLIC SERVICES CHILD CARE AND YOUTH SERVICES 1. Commercial General Liability A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence General Aggregate Limit Personal and Adv, Injury Products/Completed Operations B. Endorsements Required $300,000 $600,000 $300,000 $300.000 City of Miami included as an Additional Insured Contractual Liability II. Business Automobile Liability A. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit/Split Limits Owned/Scheduled Autos $50,000/100.000/50,000 Hired and Non Owned Autos $50,000/100,000 B. Endorsements Required City of Miami included as an Additional Insured • An agency may request in writing the waiver of this coverage in part or as a whole if: a) The agency does not own any vehicles b) The agency does not hire the services of a company to perform services for which the agency is being awarded the funding, and c) The agency does not allow employees to use their personal vehicle for business purposes. II1. Worker's Compensation Limits of Liability Statutory -State of Florida IV. Employer's Liability A. Limits of Liability $100,000 for bodily injury caused by an accident, each accident $100,000 for bodily injury caused by disease, each employee $500,000 for bodily injury caused by disease, policy limit • NOTE: All certificates of insurance must be provided for review and approval prior to the effective date of the agreement. The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer not less than (30) days prior to any such cancellation or material change. Companies authorized to do business in the State of Florida, with the following qualifications, shall issue all insurance policies required above: The company must be rated no less than "A" as to management, and no less than "Class V" as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of insurance are subject to review and verification by Risk Management prior to insurance approval. ACORD_ CERTIFICI OF LIABILITY INSURANC csR t�3 am satrDD.Y1 er FANNI-1 1341 PRODUCER MORTON D. 14E IN)^R/ADXAC CORAL GABLES 362 1GIN0RCA AVENUE CORAL GARL9S FL 33134 Phcne:305-444--2324 Fex:305-444-4980 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE FOLDER. THIS CERTIFICATE DOES MOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC INSURED HAs2TIAN WO= OF IdIAMI FARM AYISTER NAM 2 YAMI, INC. 8325 NE 2 AUE 1100 Miami FL 33138 INSURER k Burlington Insurance Ca. INSURER B; A$eomota3 Into-naisrnml Ins. INSURER C: Msoricun Berm Assurano. ce, INBURER 0: INSURER E: COVERAGES THE POLICIES OF INSLRANCE USTED BELOW NAVE SEEN ISSUED TO THE U4SURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT'WflHSTANDNG ANY RE OUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCL6AENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE D18tRANCE AFFORDED BY THE POLICIES DESCRIBED HEREN it SUBJECT TO ALL THE TERMS, EXCLUEtows AND CONOmONE Of SUCH POLICCIES. AGGREGATE LAMS SHOWN MAT NAVE BEEN REDUCED SY PAID CLAIMS TLTR M*RI TYPE OF INSURANCE POLICY NUMBER p TE It#WIPDDIYYIE OA ( M/DD 1m— UMTT5 GENERAL LLIBUTY EAfdl OGCURREACE 31 , 000,000 A X X COMAIERC!ALGEHEAALLIABILf1Y 3211001890 09/24/07 09/24/08 PREu1ISE9 EEa tArImItummo 5 100,000 CLAIMS MADE ® OCCUR men EKP (AM onE Perion, I 5,000 PERSONAL 6 ADV INJURY 51, 000, 000 ■ GENERALAGGREGATE S 2,000,000 son AGGREGATEppU��NrTAPPLIESPER PRODUCTS -COAL°APAGO $I2iCLIIDSO POLICY ! JECT FILM AUTOMOBILE LIABILITY ANY AUTO - COIrIB1FED SINGLE LIMIT (EA acci .A) S 1 , 000 , 000 A ALL OWNED AUTOS SCHEDULED AUTOS 321B001890 09/ 4 07 09/24/08 SLY B1,U RT tP Pww3I X Egi MIRED AUTOS MON-OWNED Auras - . BODILY MOUNT t ■ L'..^:; ` PROPERTY DAMAGE (Pal A zi0oot) GARAGE ULBILTTY AUTO ONLY • EA ACCIDENT I ■ ANY AUTO o-rmem THAN IA ACC i AUTO ONLY AG6 $ EXCESSruMaRF-LLA LJASIU1Y EACH OCCURRENCE $1 , 000 , 000 P 1OccUR E-2CLA'M6MAOE X09W1E80606 09/24/07 09/24/08 AGGREGATE $1,000,000 s ^— DEDUCTIHLE— RETENTION I WORKERS COMPENSATION AND NARY lArrs I .L EAR EMPLOYERS' LIA61111Y E.L EACH ACCIDENT S ANY PROPRIETORFPARTNERAD/ECUTNE OFFIERIMEMBER EJLCWOE09 E.L DISEASE • EA EMPLOYEE $ iszAL PRovumm B wow E.L DISEASE • POLICY LAC 6 C OTHER PROFESSIONAL LIF.PILITY SSA-50521E5 12/01/06 12/01/07 EACH ACT 1,000,000 AGGREGATE 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONE i VEHICLES / EXCLUSIONS. ADDED BY EMDORBENENT / SPECIAL PROVISION$ NON PROFIT ORM NIZATION i 10 DAYS NOTICE OF CANCELLATION FOR 40N PAYMENT OF PREKIUM C ETIFICATE HOLDER AS ADDITIONAL INSURED AS RESPECTS TO THE GEUTE&AL LIABILITY CERTIFICATE HOLDER CANCELLATION CTOrICL c:n' OF NUM: 444 SW 2 A;:4: IcAla FL 33130 ACORD 26 i200 /0E) SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED B°' RE THE £KPIRATON DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TC BAIL 30* GAYS WRTTTFN NOTICE TO THE CERTIFICATE HOLDER NA,UM TO THE: LEFT, BUT FAILURE TO DG SHALL ?IP=E NC. OELCATION Oo LLALSIL' Of AIN KIND UPOx THE IkSUREET, ITS AV2A TS OR REPRESENTATNES g ACORD CORPORATION 18ES ACORD,_ CERTIFICATE OF LIABILITY INSURANCE DATE (M WDD/YYYY) 9119/07 PRODUCER Ramsgate insurance 250 E Park Ave Lake Wales, FL 33853 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # ,p.'SURED Fanm Ayisyen Nan Miyami Inc 8325 NE 2nd Ave, #100 Miami, FL 33138 INsuRERA Aequicap Insurance INSURER B: INSURER C. INSURER D: INSURED. COVERAGES THE POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED TO 7HE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENI, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES -AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED EY PAID CLAIMS. NSF jj44DDD LTR)NSR - TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DAT=NMM'Defro POLICY EXPIRATION DATFIMM.'DD'YYI LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE S P PREMISES(Ea accarenca) $ CL AIMS MADE OCUR MEDEXP (Arty ono person) S G£N'L PERSONALS ADV INJURY S GENERAL AGGREGATE S AGGREGATE LIMIT APPLIES PER POLICY n PRO. fl LOC PRODUCTS- COMP.'OPAGG S AUTOMOBILE r-- LIABILITY ANY AUTO ALIOWNED AUTOS SCHEDULED AUTOS _ X�‹^'; f /,. - a`, CONBBJEDSINGLEUTAIT (Ea acciaem) E BODILY INJURY (Pry) S BODILY INJURY (Pere -stem) S PROPERTY DAMAGE (Fern-kwnt) S GARAGE LIAEBUTY ANY AUTO ' f l + V U I L. V; {(�� •� V AUTO ONLY -EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY: AG S .{`4 ^— EXCESS/UMBRELLA LIABILITY OCCUR I CLAIMS MADE DEDUCTIBLE RETENTION S Y 1 :'� /-1 � L� ` (li .. F� `1 .AGGREGATE EACH OCCURRENCE 5 S S S S x WORKERS COMPENSATION AND EMPLOYERS' UABILRY ANY PROPRIETORIPARTNEPJEXECUTNE OF FIMMIEMBEP. EXO.LUED? It e•sabe undIOer SPECIAL PROVLSNS ("NewELIMITL. WC07069579 06/03/2007 WC E1ATU. i 1 ORY LIMITS I I ER E.L. EACH S 100,000 06/03/2008 A$E• E£TJT E L. DISEA,.. • EA EMPLOYEE S 1OO r��o DISEASE •• POLICY L S 500 000 OTHER DESCRIPTI I CIF OPERATIONS/ LOCATIONS 1 VEHICLE51EXCWSIONS ADDEDBY ENDORSEMENT i SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION City of M;ami 444 SW 2nd Ave 2nd Floor Miami, FL 33130 SHOULD ART OF THE ABOVE DESCRIBED FOLICBE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TC MAIL 30 DATE WRITTEN NOTICE TC THE CER7IICATE HOLDER NAMED TO THE LEFT. EUT FAILURE 70 DC 5C SHALL INPOSE NO OBLIGATION LIAEIL'^' OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRES=_N'ATIVcS. A:'THOR1:E0 REPRESj,TWE v�. ACORD 25 (2001)08) ©ACORD C F iI PORATION 198B