HomeMy WebLinkAboutExhibit 5FORM B: PREVIOUS CLIENTS (2 pages)
For purposes of reference checks, demonstration of similar capacity -building work,
demonstration of experience with similar clients, etc.
1. Previous consultant engagements (contracts) with Miami NICE partners.
T Alliance for Human Services ❑ Miami -Dade County
n Center on Nonprofit Effectiveness (C-One) ❑ The Children's Trust
❑ City of Miami ❑ United Way of Miami NICE
E Family and Children Faith Coalition
Describe (if applicable):
2. Other clients:
Instructions: This form currently includes space for three clients. Adjust spacing in the grids
provided below as needed, and include additional clients if space allows. DO NOT EXCEED TWO
PAGES for Form B. If you would like to include additional client information beyond Form B, note
that up to three additional pages can be added as attachments to the overall submission (refer to page
12 for details about page limitations).
Client:
Contact name, phone, email:
Description of project; and specific services you provided (information should be specific to
the individual consultant, not the consultant's co-workers or firm):
Description of results, achievements, outcomes, etc.:
Other:
Client:
Contact name, phone, email:
Description of project; and specific services you, provided (information should be specific to
the individual consultant, not the consultant 's co-workers or firm):
Description of results, achievements, outcomes, etc.:
Other:
Client:
Contact name, phone, email:
Description of project; and specific services you provided (information should be specific to
the individual consultant, not the consultant's co-workers or firm):
Description of results, achievements, outcomes, etc.:
Other:
(Adjust spacing as needed. DO NOT EXCEED TWO PAGES for Form B. See page 12 for space
limitation and the opportunity to add additional, optional attachments.)
ATTACHMENT A
Miami NICE RFQ 2008-1
City of Miami Contracting Requirements
Note to respondents
Within this Attachment A, you will find information provided by the City of Miami with regard
to the City's specific contracting requirements. Four major informational components are
included:
(1)
Insurance Requirements -"Expert Consulting Agreement" (1 page)
Note: Applicable to individuals, sole practitioners, and similar.
(2) Insurance Requirements -"Professional Services Agreement" (2 pages)
Note: Applicable to organizations and similar.
(3) Corporate Resolution (1 page)
Note: Applicable to organizations and similar.
(4) Terms and Conditions (25 pages)
Note that some requirements in parts 1, 2, and 3 apply only to individuals and some
requirements apply to organizations.
Information is relevant to future contracts for all four consultant positions described in the
document titled Miami NICE RFQ 2008-1: Success Partner Consultants, Technical Consultants,
Training Consultants, and Evaluation Consultants.
For additional information, updates, revisions, or assistance, visit www.miaminice.org.
INSURANCE REQUIREMENTS
EXPERT CONSULTING AGREEMENT
Personal Automobile Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Limits of Liability -Split Limits $100,000/300,000/50,000, or
Combined $300,000
Endorsements Required
City of Miami included as an "Additional Insured"
II. Worker's Compensation
A. Limits of Liability
Statutory -State of Florida
OR Provide exemption certificate from the State of Florida, Division of Workers'
Compensation, and/or letter indicating number of employees, including corporate officers.
For information: State of Florida Division of Workers' Compensation
www.fldfs.com. See Division of Worker's Compensation, FAQs.
III. 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
IV. Professional Liability/Errors and Omissions Coverage (If Applicable)
A. Limits of Liability
Each Claim $ 1,000,000
General Aggregate Limit $ 1,000,000
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.
For more information about insurance, contact your insurance broker, or:
Brown & Brown, 1-800-877-2769, Teresa Schawb Extension 5756
INSURANCE REQUIREMENTS
PROFESSIONAL SERVICES AGREEMENT
I. Commercial General Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Each Occurrence $1,000,000
General Aggregate Limit $ 2,000,000
Personal and Adv. Injury $ 1,000,000
Products/Completed Operations $ 1,000,000
B. Endorsements Required
City of Miami included as an Additional Insured
Employees included as insured
Contractual Liability
II. Business Automobile Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Combined Single Limit
Owned/Scheduled Autos
Including Hired, Borrowed or Non -Owned Autos
Any One Accident $ 1,000,000
B. Endorsements Required
City of Miami included as an Additional Insurance
III. Worker's Compensation
A. Limits of Liability
Statutory -State of Florida
Waiver of Subrogation
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
V. Professional Liability/Errors and Omissions Coverage
Combined Single Limit
Each Claim $1,000,000
General Aggregate Limit $1,000,000
Deductible- not to exceed 10%
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 for certificates of insurance
are subject to review and verification by Risk Management prior to insurance approval.
For more information about insurance, contact your insurance broker, or:
Brown & Brown, I-800-877-2769, Teresa Schawb Extension 575
CORPORATE RESOLUTION
WHEREAS, , a Florida not for -profit
corporation whose principal address is
(hereinafter, the "Corporation"), desires to enter into a
Agreement with the City of Miami, a copy of which is attached hereto (hereinafter, the
"Agreement"); and
WHEREAS, the Board of Directors of the Corporation at a duly held corporate meeting
has considered the matter in accordance with the Articles and By -Laws of the Corporation,
copies of which Articles and By -Laws are attached hereto;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS of
the Corporation that as the President and
as the Corporate Secretary are hereby authorized and instructed
to enter into, to execute, and to deliver the Agreement and to undertake the duties,
responsibilities and obligations as stated in such Agreement in the name of and on behalf of this
Corporation with the City of Miami upon terms and conditions contained in the Agreement to
which this Resolution is attached.
DATED this
day of , 200_.
PRESIDENT (Signature)
ATTEST: Print Name:
CORPORATE SECRETARY (Signature)
Print Name: (CORPORATE SEAL)