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HomeMy WebLinkAboutBid ResponseIFB 1064383 Meals for the Adult Care Food Program REQUIREMENTS Bidders Randazzo Catering, Inc dba Creative Tastes Catering Red Chair Catering, LLC Completed Certification Statement Yes Yes Completed Certifications Form Yes Yes Current Business Tax Receipt / Occupational License Yes Yes Performed Services for at least 5 years Yes Yes Performed Services for at least 7 years N/A N/A State of Florida Professional License Yes Yes Last Inspection Yes Yes Sample Menu Yes Yes References Yes Yes Food Service Manager Certification Yes Yes Local Office Form Completed Yes N/A Local Office Confirmed Not a Local Office NIA Cure Items Primary Responsive and Responsible Secondary Responsive and Responsible Adult Care Food Program (ACFP) Approved Caterer List 2019-2020 Caterer Contact Information Serving Counties South Florida A Marshall Catering & Takeout II Gregory Marshall 613 E. Atlantic Boulevard Pompano Beach, FL 33060 Ph: (954) 889-4410 Email: amarshallcatering@gmail.com Broward AFF Catering, Inc. Abel Ferro 25355 SW 142nd Avenue Homestead, FL 33032 Ph: (786) 447-3259 Email: affcatering@gmail.com Miami Dade Annabella Cafe Ulises Fernandez 600 W 27th Street Hialeah, FL 33010 Ph: (786) 537-5383 Email: annabellacafe@outlook.com Broward, Miami Dade, Monroe Aroma Catering Arianna Gomez 530 Sharazad Boulevard Opa Locka, FL 33054 Ph: (305) 330-5432 aromacateringl2@gmail.com Broward, Miami Dade Chef Corp. John Carlino 935 Park Avenue Lake Park, FL 33403 Ph: (561) 281-2531 Email: chefcarlino@chefcorp.com Broward, Martin, Palm Beach Construction Catering Millie Bencomo 490 SE 10th Court Hialeah, FL 33010 Ph: (305) 633-5668 Email: constructioncateringinc1@gmail.com Broward, Miami Dade Creative Tastes Catering Frank Randazzo 12229 SW 131 Avenue Miami, FL 33186 Ph: (305) 256-8399 frank@creativetastes.com Broward, Miami Dade, Palm Beach D'Sabor Cafe Arianna Gomez 530 Sharazad Boulevard Opa Locka, FL 33054 Ph: (786) 231-1369 Email: dsaborcafe@gmail.com Broward, Miami Dade Adult Care Food Program (ACFP) Approved Caterer List 2019-2020 Elite Adult Care Food Program (ACFP) Approved Caterer List 2019-2020 Catering Services of Miami, LLC. Ph: (786)488'3638 Carlos Gomez Email: Miami Dade 77OONvV37thAvenue e|i^ecatohngnorvicoon0miami4ggmaiicum Miami, FL33147 GA Foods David Ka,pan Ph: (727)573-2211 Bmward.Miami Dade, Palm 122VV32ndCourt N Email: dkarpan@ygafondn.:nmn, Beach St. Petersburg, FL3371V gdovenport@gufnods.:nm Gauy'sCaf6.Inc. YudaisyHomondoz Ph: (3V5)51V'V575 Miami Dade 1361 SVV1o,Street Email: yudoisy@aoi"om Miami, pL331J5 Greater Miami Caterers JohnO|mo Ph: (3V5)G3J'4$16[x.1VV] Bnxwanj.Miami Dade, 4001 NYV31stAvenue Emai|:]o|mo@8mxawr.com Monmv, Pu|nn Beach Miami, FLxz1^2 Joshua Catering Robert Coleman Ph: (561)541'1546 %8n8N.Australian Avenue Pa|nnBeaxh Email: no�mun@tho|urdnp|amur0 West Palm Beach, rLzo4V7 Miami Nutrition Catering, Inc. Alejandro Santana Ph: (7uG)sa:'84o8 42OPalm Avenue 8�Miami Dade Emai|�a|osan1�mon��om Hialeah, FL 33010 Munchkin Caterers JoseBo,mU Ph: (JV5)2G2'12g2[x.10V004] Miami Dade 5301 NxV23ndAvenue Emai|:]boneU@i|shea|th.cum Miami, FL 3314e Red Chair Catering Jessica Rosales Ph: (754)V1u-4373 Brnwand,Miami Dade, Palm 15D1Oea8mpeWay Emai|:jessi,a@redchxi,catehng.neg Beach Hollywood, FL3JV19 Adult Care Food Program (ACFP) Approved Caterer List 2019-2020 Runoky.LLC. Ekatohna 1S504Biscayne Boulevard North Miami FLJ316O Ph: (7WG)28O'2SB8 Emai|:kavkazmiami@gmaiiconn Bmward.Miami Dade SerSin'sCamhng Ricardo Gonzalez 4r24NVV1x7Street Miami Gardens, FL3%O14 Ph: (7BG)48G'O2G4o,(3Oq4ou49OV Emai|:hxa,do@norSiocatehn8.com Bmwurd.Miami Dade, Palm Beach Star ofthe Sea Emily Dixon 1V2VUnited Street Key West, FL33U4V Ph: (781)820'8212 Enoai|:vmi|y@spomiosion.orB Monroe Sterling Kosher Johnathvn Rapp 5850S Pine Island Road Davie, FL 333e8 Ph: (S64)VV047DT Email: |miann@stedinSgmupfuods.00m B,nwand Miami Dade ' TuCodnimCatering OahiclyToUhia 27SOVYV8thStreet, Suito#1V5 Hialeah, FLJ301G Ph: (7O6)445'137V Emai|:oohidy12J^@yahuo.eo Central Florida Brmwurd.Miami Dade, Palm Beach ` Doing Dinner Rick Miller 21s5SVV19thAvenue Road, Suite #102 Ona|a, PLn4471 Ph: (J52)O75-7199 Emai|:hch@dpingdinnocconn Marion GAFoods ' Pinellas Co. OavdKorpan 122VO3xndCourt N St. Petersburg, FLJJ718 Ph: (72r)573'2211 Email: dka,panVggafoods.cunnor gdovenport@gafnods.:om Chadntte, Oenmw' Hurdeo, Hillsborough, Manatee, Pasco, Pinellas, Sarasota GAFoods ' Center Hill ovwdKarpan 27North Maryland Avenue P.V.Box 179 Center Hill, FLJ351G Ph: (727)573'2211 Email: dharpan@ygdbodo,:omor Sdavonport@8ahonds.com Alachua, Citrus, Columbia, Hamilton, Hernando, Lake, Marion, Sumter Adult Care Food Program (ACFP) Approved Caterer List 2019-2020 GAFovdo-Doytunu David Karpan 78oFentress Boulevard Daytona, FL3211^ Ph: <727>S73'2211 EnnvU: dkanpan@gofondo.nvmo, Sdovonport@gafoods.ovm C/ay, Ouvo|, F|ag|or, Orange, Putnam, Seminole, Vv|unia GAFoods 'Ft. Myers DavidKa,pan 5501 Division Drive BiUyCmrk!nduouia|Parx Pt. Myvra, FLo39o* Ph: <727>673'2211 Email: dkanpan@ah/odo�:vmnr g gdavenport@gafoodo.cvm Charlotte, �vUio��|ades ' Hendry,oeHigh/andm.L Manatee, Sarasota ' GAFoods 'Orlando David Karpan 5V12Carder Road, Unit C Orlando, FL3281O Ph: (727)5r3'2211 Email: dkaqmn@gafnodn.cnmn, Sdavenport@gafoodsznm Clay, Duval, F|ag|*r. Orange, Putnam, Seminole, Vo|usia Meals onWheels GhonyFinohor 2801 SFinancial Court Sanford, FL3%7rJ Ph: (4V7)333-O877 Emai|:nfinoh*n0mvu|*om.o»g Lake, Orange, Osceola, Semino(e.Vvlusia R&RCuban Cafe, Inc. Lonapdn Rojas 12995 S Cleveland Avenue, Suite #17V Fort Myers, FLVa8V7 Ph: (23g)730-37G4 Emai|:bn,mo|e@yahoo.:om Le, North Florida Elder Care Services Michael Henderson 2510 VVTennenov Street Tallahassee, rLocxO* Ph: (85O)%45'59^1 Email: hondemonm@yoosbigbendurg Leon G|o'sHomosy|eCooking Glory Mitchell 623Beechwond Street Jacksonville, FLJ2%o8 Ph: (VO4)7%V'3275 Email: g|orymitcheU1356@8maiicom Duval Quote: 2629368 (RFQ 1064383,1) Page 1 of 4 Sourcing - ‘;avigator -* Favorites Requisitions Negotiations Intelligence Negotiations > Advanced Search > Quote: 2629368 (RFQ 1064383,1) Attachments Time Left Quote Style Quote Currency Contact Suppliers' Quote Number Quote Status Note to Buyer N/A Name Title Update No results found. Home Logout Preferences Help Diagnostics Quote History (RFQ 1064383,1) > Title Invitation for Bid for Meals for the Adult Care Food Program 0 seconds Sealed USD Randazzo, Frank 00002 Active Requirements Show All Details I Hide All Details Details Section Hide General Requirements Actions Online Discussions Go Close Date Ranking Supplier Supplier Site Quote Valid Until Purchase Order Shortlist Status Delete 16-Jul-2019 1400:00 Price Only Randazzo Catering, Inc dba Creative Tastes Catering 31-Aug-2019 Included vm Maximum Score Score 0 0 Target Value Quote Value Legal Name of Firm: Randazzo Catering , Inc d/b/a Creative Tastes Catering Entity Type: Partnership, Sole Corporation Proprietorship, Corporation, etc. Year Established: 2,007 Federal Employer Identification 26-0770678 Number (FEIN) Office Location: City of Miami, 12229 SW 131 Ave Miami Florida 33186 Miami -Dade County, or Other Business Tax Receipt/ 6402739 Occupational License Number: ...„ Business Tax Receipt/ Miami Dade County Occupational License Issuing Agency Business Tax 30-Sep-2019 Receipt/ Occupational License Expiration Date: Please list and acknowledge all Addendum No 1 July 3, 2019 addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. 1, 7/1/07). If no addendum/addenda was/were issued, please insert N/A. If Bidder has a Local Office, as Yes defined under Chapter 18/Articlle Maximum Score Score http://imapl.riverside.cmgov.net:8003/0A_HTML/OAjsp?0AFu —PONRESENQ VIE... 8/21/2019 0uoic: 2629368 (BIrO 1064383,l) pn»e2of4 III, Section l8-Dof the City [ode has Bidder filled out, notarized, and included with its bid response the "City of Miami Local Office Certification" form? YES OR NO? (The City nfMiami Local Office Certification form is located inthe Oracle Sourcing system ("iSupp|ier")'under the Header/motesond Attachments ofsolicitation) _ Reference No. l: Name of American Red Cross ISouth Florida Region Company/Agency for which bidder iscurrently providing the services/goods asdescribed in this solicitation, orhas provided � such services/goods inthe past: Reference No. l: Address, City, 335 SVV27thAve. | Miami' FL]3135 State, and Zip for above referencecompany/agency listed: Reference No. l: Name of Monica Rusconi 305-728-2573 monica.msconi@redcross.org Contact Person, Telephone Number and Email for above reference no. l Reference No. I: Date of 2015 -Present Contract orSale for above reference no. l Reference No. 2: Name of Florida International University Company/Agency for which bidder iscurrently providing the services/goods asdescribed in this solicitation, orhas provided such i in.the past: ___-__-_______-_______-____-___---__-_-''_--_ Reference No. 2: Address, City, 10555 W. F|ag|erStreet, E[29]] Miami Florida 33174 State, and Zip for above referencecumpany/agency |ig�d� Refenence No. 2: Nameof Maria ].Madriz, P]U5.]f827Ol maha.madhz@fiu.edu Contact Person, Telephone Number and Email for above reference no. Z ���... �������������������������'���������` Reference No. Z: Date of 2010 Present Contract orSale for above reference no. 2 Reference No. ]: Name of Independent Purchasing Coop Company/Agency for which bidder iscurrently providing the services/goods asdescribed in this solicitation, orhas provided services/goods in the past: Reference No. 3: Address, City, 9200S. Dade|and Blvd. I Suite 800 1 Miami' FL3]156 State, and Zip for above refenencecompany/agency listed: Reference No. 3: Name of 3tephanieBerrios 786.270.1161 sbenios@ipcoopzom [ontactPerson,Te|ephooe Number and Email for above reference no. ] Reference No. ]: Date of 2007'Present Contract orSale for above 6nn://icoupl. riverside .cco�0v�nct��UO��}/\_T�T��L/()��jopo()/\FunC�PAI�I��SEY�(} VIE...8/7l/2O]g Quote: 2629368 (RFQ 1064383,1) reference no, 3 Total Contract Terms Variables Details Section No variables found. Deliverables Deliverable Name No deliverables found. Lines 'TIP All prices are in USD. Show All Details Clause Variable Description Pave 3 of 4 Value Due Date Status Alert Update Quote Total (USD) 122,220.00 Hide All Details Need - Start Target Quote Target Quote By Promised Line Active Details Line Ship -To Rank Price Price Price Unit Quantity Quantity Date Date Total Quotes EShow 1 Adult Care 261000 - 1 1.79 Each 12,000 12,000 31-Aug- 21,480.00 1 Food Procurement 2019 Program- 13:11:49 Individual Itemized Servings - Breakfast. (Inclusive of eating utensils, napkins and straws) Show 2 Adult Care 261000 - 1 2.98 Each 12,000 12,000 31-Aug- 35,760,00 1 Food Procurement 2019 Program- 13:12:03 Individual Itemized Servings - Lunch. ( Inclusive of eating utensils, napkins and straws) Show 3 Adult Care 261000 - 1 4.93 Each 7,200 7,200 -Aug- 35,496.001 Food Procurement 2019 Program- 13:12:09 Individual Itemized Servings - Supper. (Inclusive ,://irnap1 riversidc.cmgov.net:8003/0A_HT 0A.jsp?0Al'unc=PONI -SENQ 8/21/2019 Quote: Z62936O(KF0]OG4]837l) 9a�e4o[4 of eating utensils, napkins and straws) ,E a�_qw1Adult Care 26l0OO' Food Procurement Program - Individual Itemized Servings - AM Supplement (Inclusive of eating utensils, napkins and straws)____' �S,� c-!5AdultCare26I00 Food Procurement Program - Individual Itemized Servings - PM Supplement (Inclusive of eating utensils, napkins and straws) Return toQuote History (RFQl064]83'l) 0.91Each 20,400 20,400 ]l-Aug' 2Ol9 1]:12:15 0,920.00 31-Amg' 1E,564.001 2019 Actions |On|ineDiscu�s�n� �� ---` . �� / Requiaihons Negotiations Intelligence Hnme Logcmt Preferences Me|p DiagnouUcs Aboutthis Page PhvecyGtslement csr,/.�gm.c`-,"mso"woex�:����� ADULT CARE FOOD PROGRAM INVITATION TO BID (ITB) Purpose - This document contains an invitation to bid to furnish meals (unitized, if applicable) to be served to adults participating in the Adult Care Food Program (ACFP), a component of the Child and Adult Care Food Program established by the United States Department of Agriculture (7 CFR, Part 226), administered by the Florida Department of Elder Affairs and sets forth the terms and conditions applicable to the proposed procurement. Upon acceptance, this document and its required attachments shall constitute the contract between the bidder and the institution named herein. Increases and decreases in the number of meal orders may be made by the institution, as needed, within a prior notice period mutually agreed upon in the contract. Please Type or Print Clear! (in Ink) 1. Bid Issued BI", 2. RECORD OF BID OPENING Na ire of Institution/ACFP Provider Address: 444 SW 2nd AVP, 6th Finor Procurement Dept Date of public bid opening: July 5, 2019 Time: 8 23AM FL City/State: Miami, Zip 33130 Teleph Location: acceptance) one: (305 ) 416 - 1916 Fax: ( ) - OTHER CONTRACT OPTIONS 3. X Negotiated Initial Contract with State agency prior -approval (Vendor is on Approved Caterer List) by Institution and Vendor, with attachments: schedule and current cycle menus for each meal agency and current license to operate in current food service contract. 1ST year Bidded Contract Renewal Option exercised 2" year Bidded Contract Renewal Option exercised * * ACFP Provider will submit three copies of this page to State Agency, fully executed a. Debarment & Suspension Form recently completed by vendor, delivery b. Copy of Vendor's current Food Service Inspection Report from licensing c. Any other information needed, from either party, to update information RESPONSE TO LNVITATION TO BID Randazzo Catering, Inc 4. Name of Bidder d/b/a Creative Tastes Catering 5. By submission of this bid, the bidder certifies that, in the event he/she receives an award under this solicitation, he shall operate in accordance with all applicable, current ACFP regulations. Bidder's Signature: Nan ie of Approved Food Service Company Mailing Address 12229 SW 131 Ave Street Address (of kitchen providing meals) 12229 SW 131 Ave City/State: Miami, Flonda zip 33186 Telephone: ( 305 ) 256 _ 8399 _ Total Bid Amount $ 122, 20.00 6. ContractCommence Date: 08/31/2019 Expiration Date: 08/31/2022 Title: President f rice per meal:* Breakfast: $ 1.79 (Typed or Printed Clearly) Date: 7115119 Supplement: AM 5 '91 PM $ :91 Lunch: $ 2.98 * Note: price includes tax Sup # per $ 4.93 7. ACCEPTANCE BY INSTITUTION/ACFP PROVIDER 8. This contract must be approved by the Florida Department of Elder Affairs/ACFP Provider's Signature: Witness' Board President or Authorized Designee Title: Provider prior to commencement of food service. Signature: REPRESENTATIVE APPROVAL Narne: (Typed or Printed Clearly) Date: FLORIDA DEPARTMENT OF ELDER AFFAIRS/ACFP 9. Period of Provider Contract: - Approved Date: Denied Date: DOEA/ACFP REPRESENTATIVE 3 Randazzo Catering, Inc THIS CONTRACT is entered into between the h]ud service pn)vido u/maCremtive Tastes Catering hereinafter referred lnasthe "Vemoh,''.and the Adult Care Food Program provider , hereinafter referred tnusthe '7nstitution''and will comply with the Adult Care Food Program requiccnien\s administered byThe Florida Department of Elder AffairsA\du|rCare Food Pnngro/n` hereinafter referred to as THE PARTIES AGREE: L THE VENDOR AGREES: A. To provide services according to the conditions specified in Attachment(s) A & B, B.Federal Laws and Regulations l. This contract contains USDA federal funds, the vendor shall comply with the provisions of7CFK,226,and other applicable regulations as specified in Attachment(s) A & B . 2. Kthis contract contains federal funding in excess of $100,000, the vendorshall comply with all applicable standards, orders, or regulations iSSUed Linder Section 306 of the Clean Air Act, as amended (42 U.S.C. \857(h)c\neqJ.Section 5U8o[the Clean Water Act, usamended (3] U.S.C. l368eiseqj,Executive Order ||738,and Environmental Protection Agency regulations (40CFRPart 15). The provider sha|| report any violations o[the above Lothe department within ten (|0)days ofthe discovery ofany such violation. l The vendor shall comply with the provisions ofthe U.S. Department o[Lobor,Occupational Safety and Health Administration (OSH/\)code, 29CFR, Part 1910.1030. 4. Kthis contract contains federal funding inexcess of $|U8.O00.the vendor mLIS\`prior mcontract uCCmim\complete the Debarment, Suspension, bzo|iQjN|it,,'and Vo\untary Exclusion Certification Kxm, Attachment C. Civil Rights Certification l. The vendor gives this assurance in consideration of' and for the Purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guuronty), property, discounts, or other federal financial assistance to pmgronn or activities receiving or benefiting from federal financial assistance. 2. The vendor assures that hwill comply with: o. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which prohibits discrimination oil the basis of race, color, or national origin in programs and activities receiving or benefiting from federal financial assistance. h. The Americans with Disabilities Act of 1990, 42 USC 12101, et. seq., which prohibits discrimination against,und provides equal opportunities for individuals with disabilities, in employment, public services, and public accommodations e. All regulations, guidelines, and standards as are now or rmy be lawfully adopted Linder the above statutes. 4 D. Indemnification If the vendor isuState or local governmental cmit��, pursuant to subsccdon 76828(18) Florida Statutes, the provisions o{ this section do not apply. I. Vendor agrees that hwill indemnify, deferid,and hold harmless the institution and all ofthe institutions oDiucm. agents, and employees fromany claim, loss, damage, cost, charge, orexpense arising Out ofany acts, actions, neglect oromission bythe vendor, its agents, omp|oyncs.orsuhcontructorsduring the performance ofthe contract, whether direct or indircct, and whether to any person or property to which the department or said parties may be suGcct, except that neither vendor nor any ofits subcontractors will bcliable Linder this section for damages arising out o[injury or danmge tnpersons orproperty directly caused orresulting from the sole negligence o[the institution orany nfits officers, agents, or employees. 2. Vendor's obligation \oindemnify, defend, and pay for the defense ora/the institution's option, uoparticipate and us000|a1c with the /nzdt/dm/ in the defense and trial o[any c|uimand any related settlement negotiations, rhd| be triggered by the institution's notice ofclairn for indemnification to vendor. Vendor's inability toevaluate liability or its evaluation of liability shall not excuse vendor's dUty to del'end and indemnify the institution, Upon notice by the institution. Notice shall be given by registered or certified mail, or return receipt requested. Only an ad,�udic*ion or judgncntafter the highest appeal is exhausted specifically finding the institution solely negligent shall excuse performance ofthis provision hyvendors. Vendor shall pay all costs and fees related rothis obligation and its enforcement hythe institution. Institutions failure to notify vendor of a claim shall not release vendor orthe above duty iodefend. E. Retention ofRecords 1. Tonmintunbooks, records, and documcots(inc|mding electronic storage media) in accordance with generally accepted accounting procedures and practices, which Sufficiently and properly reflect all ncvenucsund expenditures of funds, provided by the institution Linder the conditions of this contract. 2. To assure these records shall be available at all reasonable times for inapec\inn, examination, rovcw, duplication or audit by the state personnel and other personnel duly authorized by the state ugm,cY as well as by federal personnel pursuant to226CFNduring the spedficdretention period. F. D&ooik/hug Vendor's food services are subject to inspection by the institution, state agenev or federal personnel. G. Assignments and Subcontracts Toneither assign the responsibility ofthis contract toanother party nor subcontract for any ofthework contemplated under this contract without priorwritten approval of the state agency. NoSuch approval by the state agency ofany assignment msubcontract shall hodoemedinany event orinany manner toobligate the institution beyond the total dollar umnun<agreed uponinthis contract. All such assignments orsubcontractsshu||bcsutjocL1o8hcuondkiunsnfihiscontoctund0»uoyuondidonnofoppmmddhu1thc department shall dcemnecessary. Subcontracting includes producing food fi-omany kitchen other than hnmthe location stated a\the street address found inSection Four (4)ofthe Invitation \oBid. 5 B. Invoice Vendor will provide an invoice for payment to the institution bvthe tenth ofthe month for services received during the previous month. Each invoice will reflect the following information which is supported by the data on the ,onubr's, signed, daily delivery slips: Invoice Number Number ofmeals delivered during calendar month (See sample of vendor's delivery slips in Attachment 13) Vendor� billing cycle will include (lie first day through the last day of the calendar month. 11.THE INSTITUTION AGREES: A.Conti-act Amount Topay for vendor services according \othe conditions ofAttachment /k inonamount not Loexceed the acoep/o6und approved contract price, subject to the availability of funds. The A-enc.V's performance and obligation to pay Under this contract bcontingent upon enannual appropriation bythe legislature. B. Contract Payment Invoice payment requirements do not start until n properly completed invoice for services received during tile calendar rrionth is provided to the institution by the vendor. Unless otherwise stated in the ConLract between the vendor and the institution, payments modz by the vendor to the subcontractor must be within seven (7) working days after receipt by the vendor o[fu|| or partial payments 0nmihu institution inaccordance with section 2&7.U5Q5.Florida Statutes. Failure <opay within seven (7)*orkingdaynwill osu|t in u penalty charged against the vendor and paid \othe subcontractor in the amount ofone-half (l/2) u[one (1%) percent nfthe umountdue, per day from the expiration o[the period allowed herein for payment. Such penalty shall hc'in addition toactual payments owed and shall not exceed fifteen (lS%)percent oftile Outstanding balance due. 111L7BE VENDOR AND INSTITUTION MUTUALLY AGREE: A. Termination 1. Termination urWill This contract may be terminated by either party upon no less than thirty (3O)calendar days notice, without cause, unless a lesser time is mutually agreed upon by both parties. Said notice shall be delivered by certified mail, otorn receipt requested, orinperson with proof ofdelivery. 2. Termination Because uyLack ofFunds In the event funds to finance this contract become unavailable, the institution may terminate the contract upon no |cos than twenty-four (24)hours notice inwriting iothe vendor. Said notice shall hedelivered hycertified mail, return receipt requested, orinperson with proo[u[delivery. The state agency sba||hcthe final authority osLuthe availability offundc 6 3. Termination for Breach w Unless the venohrN breach is waived by the institution in writing, or the vendor 6d|s to cure the breach within the time specified bythe institution, the institution may bywritten notice to the vendor, terminate this contract upon no less than i`ven\yfbur(24) hours notice. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof nfdelivery. Waiver of hrcuoh of any provisions of this contract ohu\| not he deemed to be a waiver of any other breach and shall not be construed to be u modification of the terms of this contract. The provisions herein do not limit the institutions right tnrcmedicsa\ law nr\odamages. w if the vendor accumulates ten (10) high priority findings in a 12'month period (July ]-June ]O\ has on Administrative Complaint, and/or c|nxu,c (temporary or permanent) issued by DBPK, the contract will be terminated immediately and automatically without further action from the Department. B. Notice and Contact l. The name, address and telephone number ofthe contact person for the institution for this contract is City v/Miami Institution contact Victoria Giraldo 444 SW 2nd Ave. 6th Floor, Miami, FL Institution address ( 305 416 1916 Ext |mhmovotelephone oonbv, Dp �3|30 2. The name, address and telephone number of the representative of the vendor responsible for udninimouion of the program Linder this contract is: Frank Randazzo- President Vendor's contact 12229 SW 131 Ave Miami Florida Zip_33186 Vendor's contact address 305 256 83Q� ( _) - C,t Vendor's telephone number 3. In the event that different representatives are designated by either party after execution of" this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to all originals of this contract, including the copy on file atoffice nfstate uXemcy. C. Renegotiation or Modification 1. Modifications of provisionsofthis contract shall only bovalid when they have been reduced tmwriting and duly signed. The parties agree to renegotiate this contract iffedcral and/or state revisions ofany applicable laws, or regulations make changes inthis contract necessary. 2. The rate ofpayment and the total dol|arsnount may hcadjusted retroactively to reflect pricelevel increases and changes inthe rate o[payment when these have been established through the appropriations process and subsequently identified in the department's operating budget unless otherwise specified in Attachment A, 7 D. Name, Mailing and Street Address of Payee 1. The name (vendor name as shown on page 1 of this contract) and mailing address of the official payee to whom the payment shall be made: Randazzo Catering, Inc d/b/a Creative Tastes Catering Payee. name 26-0770678 12229 SW 131 Ave Miami Florida 33186 Zi p Payee address 2. The name of the vendor contact person and street address where financial and administrative records are maintained: Frank Randazzo- President Nally of vendor's administrative contact 12229 SW 131 Ave Miami Florida zip 33186 Address where vendor's financial & administrative records are storedimintained CITY OF MIAMI LOCAL OFFICE CF,RTIFICATION Solicitation Type and Number: (City Code, Chapter 18, Article III, Section 18-73) IFB 1064383 (i.e. IFQ/IFB/RFP/RFQ/RFLI No. 123456) Solicitation Title: IFB 1064383 Meals for the Adult Care Food Program Randazzo Catering, Inc. (Bidder/Proposer) hereby certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Local office means a business within the city which meets all of the following criteria: (1) Has had a staffed and fixed office or distribution point, operating within a permanent structure with a verifiable street address that is located within the corporate limits of the city, for a minimum of twelve (12) months immediately preceding the datc bids or proposals were received for the purchase or contract at issue; for purposes of this section, "staffed" shall mean verifiable, full-time, on -site employment at the local office for a minimum of forty (40) hours per calendar week, whether as a duly authorized employee, officer, principal or owner of the local business; a post office box shall not be sufficient to constitute a local office within thc city; (2) If the business is located in the permanent structure pursuant to a lease, such lease must be in writing, for a term of no less than twelve (12) months, been in effect for no less than the twelve (12) months immediately preceding the date bids or proposals were received, and be available for review and approval by the chief procurement officer or its designee; for recently -executed leases that have been in effect for any period less than the twelve (12) months immediately preceding the date bids or proposals were received, a prior fully -executed lease within the corporate limits of the city that documents, in writing, continuous business residence within the corporate limits of the city for a tern of no less than the twelve (12) months immediately preceding the date bids or proposals were received shall be acceptable to satisfy the requirements of this section, and shall be available for review and approval by the chief procurement officer or its designee; further requiring that historical, cleared rent checks or other rent payment documentation in writing that documents local office tenancy shall be available for review and approval by the chief procurement officer or its designee; (3) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, a current business tax receipt issued by both the city and Miami - Dade County, if applicable; and (4) Has had, for a minimum of twelve (12) months immediately preceding the date bids or proposals were received for the purchase or contract at issue, any license or certificate of competency and certificate of use required by either the city or Miami -Dade County that authorizes the performance of said business operations; and (5) Has certified in writing its compliance with the foregoing at the time of submitting its bid or proposal to be eligible for consideration under this section; provided, however, that the burden of proof to provide all supporting documentation in support of this local office certification is borne by the business applicant submitting a bid or proposal. 1 FORM -City of Miami Local Office Certification 7/22/2013 PLEASE PROVIDE THE FOLLOWING INFORMATION: Bidder/Proposer Local Office Address: 12229 SW 131 Ave Miami FL 33186 Does Bidder/Proposer conduct verifiable, full- time, on -site employment at the local office for a minimum of forty (40) hours per calendar week? 1 YES NO If Bidder/Proposer's Local Office tenancy is pursuant to a lease, has Bidder/Proposer enclosed a copy of the lease? 1 YES NO [1] N/A Has Bidder/Proposer enclosed a copy of the Business Tax Receipt (BTR) issued by the City of Miami and Miami -Dade County? City of Miami: YES NO Exempt Cite Exemption: Miami -Dade County: i YES NO Exempt Citc Exemption: Has Bidder/Proposer enclosed a copy of the license, certificate of competency and certificate of use that authorizes the performance of Bidder/Proposer's business operations? 1 YES NO Bidder/Proposer's signature below certifies compliance with the Local Office requirements stated under Chapter 18/Article III, Section 18-73, of the Code of the City of Miami, Florida, as amended. Frank Randazzo Print Name (Bidder/Proposer Authorized Representative) Signature Date 2 FORM -City of Miami Local Office Certification 7/22/2013 STATE OF FLORIDA COUNTY OF TI) A 1,e Certified to and subscribed before me this ta-C-441„, (NOTARY SEAL) JCL:. day of A , 20 blic-State of Florida) (N of Notary Typed, Printed, or Stamped) Personally Known OR Produced Identification Type of Identification Produced LOLLA.,27r,NVIAIT1.0,2f.' .m12•11,-,U1FrEffals,411.,71,2,-.. YOLANDA LEZCANO MY CUMM EXPIRES: March 25, 2021 Bonded Thru Nclary Public UndarNrilers FORM -City of Miami Local Office Certification 7/22/2013 ATTACHMENT C All items listed under Attachment C will be created or completed by bidder and submitted with bid package Contents Cycle Menus (Four -week cycle for each type meal to be provided) Vendor to attach Picnic, boxed, holiday and special diet menus Vendor to attach Sa mple of vendor's "proposed" delivery slip Vendor to attach Copy of vendor's current Food Service Inspection Report from licensing agency Vendor to attach Copy of vendor's current license to operate a Food Service facility Vendor to attach Debarment a nd Suspension Form Completed by vendor Pages 35-36 37 Randazzo Catering, Inc. d/b/aCreative Taste,[atehng 122Z9SVVI3IAve Miami Florida 33l85 t305256.8399f305.2569868 Adult Meals Delivery Slip Day Menu Item & Portion Size Amount Delivered Date Signatures N1 n N D A Y 3ozChicken Large Pan Meals Ordered ]O I/2cRice Large Pan Meals Received .9OzWhole Grain Bread }OPnrtions Vendor Representative I cTossed Salad 30 [ XcGarbanzo 15[ 8 oz. 1 Y6 Milk 30 Containers � Site Representative T V E 5 D A Y 3ozChicken Large Pan Meals Ordered I/2cRice Large Pan Meals Received .9OzWhole Grain Bread 30Portions ' Vendor Representative IcTossed Salad 30[ . BcGarbanzo I5[ � 8 oz. I % Milk 30 Containers Site Representative VV E D N E S D A Y 3ozChicken Large Pan Meals Ordered l/2cRice Large Pan Meals Received .9OzWhole Grain Dread 30Portions Vendor Representative lcTossed Salad 30C BcGarbanzo` I5[ Onz. 1%Milk 30[ontaineo Site Representative T H U R S D A Y 3ozChicken Large Pan Meals Ordered 1/ZcRice Large Pan Meals Received .9OzWhole Grain Bread 30Portions Vendor Representative ^ lcTossed Salad 30[ B cG'amanzo IS C O oz. 1'% Milk � ` 30 Containers Site Representative F R | D A Y 3nzChicken Large Pan Meals Ordered 1/ZcRice Large Pan Meals Received .9OzWhole Grain Bread 30Pnrtions Vendor Representative IcTossed Salad 30[ Y,cGarbanzn 15[ Site Representative Comments: STATE OF FLORIDA DIVISION OF HO FELS AND RESTAURANTS L TMEN.101: BUSINESS AND PROFESSIONAL RL(UE Al JON ‘), \\.mvlioriclalicense.com Food Service Inspection Report This inspection report must be made public upon request per Florida law. Met Inspection Standards during this visit ANY VIOLATIONS noted herein must be corrected by the NEXT UNANNOUNCED inspection unless otherwise stated. Inspection Date: May 23, 2019 09:49 - May 23, 2019 1039 License Number: 2327049 Rank: CATR Owner Name: RANDAZZO CATERING INC Location Address: 12229 SW 131 AVE #82 MIAMI FL 33186-6401 Number of Units: 0 License Expiration: October 1, 2019 Inspection Reason: Routine - Food Business Name: CREATIVE TASTES CATERING License Type: Catering Telephone Number: 305.609.7129 Reinspection on or After: FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS 01A Food obtained from approved source IN 07 Unwrapped or PH/TCS food not re -served IN 018 Food safe and unadulterated; sound condition IN 08A Separating raw animal foods from: each other, RTE foods and unwashed produce IN 01C Shellstock tags: commingling N/A 08B Food protection during preparation, storage and display IN 010 Parasite destruction for raw/undercooked fish N/A 09 Bare hand contact with RTE food; Alternative Operating Procedure (AOP) IN 02A Consumer advisory on raw/undercooked oysters N/A 11 Employee health knowledge; ill/symploma lc employee present IN 02B Consumer advisory on raw/undercooked animal foods IN 12A Hands clean and washed properly; use of hand antiseptic if use of AOP IN 02C Date marking ready -to -eat (RTE) potentially hazardous / timel temperature control for safety foods IN 12B Employee eating, drinking, tasting food, smoking IN 03A Receiving and holding PH/TCS foods cold IN 22 Food -contact surfaces clean and sanitized OUT 03B Receiving and holding PH/TCS foods hot N/O 31A Handwash sink(s) installed, accessible, not used for other purposes IN 03C Cooking raw animal foods and plant foods; non -continuous cooking of raw animal foods IN 318 Handwashing supplies and handwash sign provided IN 03D Cooling PH/TCS foods; proper cooling methods N/O 41 Chemicals/toxic substances OUT 03E Reheating PH/TCS foods for hot holding N/O 53A Food manager certification; knowledge/active managerial control (except employee health) IN 03F Time as a Public Health Controi N/A 53B State approved food handler training; employee duty specific training/knowledge , . IN 03G Reduced oxygen packaging (ROP) and other Special Processes N/A GOOD RETAIL PRACTICES 02D Food items properly labeled; original container 35A No presence or breeding of nsects/rodents/pests; no live animals 04 Facilities to maintain PH/TCS foods at the proper temperature 35B Outer openings protected from n ects/pests, rodent proof 05 Food and food equipment thermometers provided and accurate 36 Floors, walls, ceilings and attached equipment properly constructed and clean; rooms and equipment properly vented OUT 06 PH/TCS foods properly thawed 38 Lighting provided as required; fixtures shielded or bulbs protected 10 In use food dispensing utensils properly stored 40 Employee personal belongings 13 Clean clothes; hair restraints; jewelry; painted/artificial fingernails 42 Cleaning and maintenance equipment 14 Food -contact and nonfood contact surfaces designed, constructed, maintained, installed, located OUT 43 Complete separation from living/sleeping area/private premise; kitchen restricted - no unauthorized personnel 16 Dishwashing facilities; chemical test kit(s); gauges 1. Wash 2. Rinse 3. Sanitize OUT 45 Fir'e extinguishing equipment (FOR REPORTING PURPOSES ONLY) May 23, 2019 at 10,3943 AM EDT Localion CREATIVE TASTES CATERING License #: CATR2327049 Inspector: James Seyba Food Service InspecEion Report DEPR Form HR 5022-015 - Rule 61C-1 002 Software Version 5.52 ORI DA DIVISION OF HO I LLS AND RES !Al RAN IS DEPARTMEN 101s BLSINESS AND l'ROFLSSIONAL WA. AI N \ .111 riOrida1 icense.com 21 Wiping cloths; clean and soiled linens; laundry facilities OUT 46 Exits not blocked or locked (FOR REPORTING PURPOSES ONLY) 23 Non-food contact surfaces clean 47 Electrical wiring/outlets in good repair (FOR REPORTING PURPOSES ONLY) 24 Storage/handling of clean equipment, utensils; air drying 48 Gas appliances; boiler certificate current/posted (FOR REPORTING PURPOSES ONLY) 25 Single -service and single -use items 49 Flammable/combustible materials (FOR REPORTING PURPOSES ONLY) 27 Water source safe, hot (100F) and cold under pressure 50 Current license, properly displayed 28 Sewage and waste water disposed properly 51 Other conditions sanitary and safe operation 29 Plumbing installed and maintained; mop sink; water filters, backflow prevention OUT 52 Misrepresentation: misbranding 32 Bathrooms 54 Florida Clean Indoor Air Act Compliance 33 Garbage and refuse; premises maintained 55 Automatic Gratuity Notice Items marked IN are in compliance. Items marked OUT are violations. Specific details of the violations are listed on subsequent pages. Items marked N/A are Not Applicable. Items marked as N/O are Not Observed and were not being conducted at the time of inspection. FOOD TEMPERATURES Bar Area Buffet Line Cook Line Front Counter Front Line Kitchen Reach in 2:; beans (41°F - Cold Holding); garlic in oil (38°F - Cold Holding) Prep Area Reach In Cooler reach in 1:; ricotta (42°F - Cold Holding); sliced cheese (42°F - Cold Ho(ding); cut tomato (41°F - Cold Holding) Reach In Freezer Frozen solid: cheese roll, croissant, pastry dough, pastries, yucca Steam Table/Bain Marie Storage Area Wait Station Walk In Cooler potato salad (42°F - Cold Holding); chicken (104°F - Cooling); turkey (39°F - Cold Holding) Walk In Freezer Certified Food Manager and Date Certified: OTHER ITEMS Andrea Curto Randazzo 3/22/16 Manager Certified By: National Restaurant Association Educational Foundation - ServSafe Employees Trained By: Florida Restaurant and Lodging Association Sewage: Municipal/Utility Water Source: Municipal Boiler: No Boiler On Site Boiler Jurisdiction and Expiration: Sanitizer Details: Dishwasher (Chlorine 100ppm); Sanitizer Bucket (Chlorine 100ppm) May 23, 2019 at 1039:43 AM EDT Location: CREATIVE TASTES CATERING License #, CATR2327049 Inspector James Seyba Food Service Inspection Report DBPR Form HR 5022-015 - Rule 61C-1 002 FAG Software Verson 6 62 Page 2 or 3 STAI E OF FLORIDA. DIVISION OF H() FELS AND RES'IAtIAN I S DEPARTMEN BUSINLSS AND PROFESSIONAL REGU N Horidalicense.com Inspector Comments: Verified ownership with operator. Joint inspection with Supervisor Harvie. Calibrated Inspectors food probe thermometer (32°F) and operators food probe thermometer (32°F) during the inspection with the person in charge to ensure accuracy of the thermometer. Establishment open and preparing food at the time of inspection. During the time of inspection the establishment does not have any contracts with any food programs. Regular catering only. A link to the Florida Department of Agriculture's Food Recovery Resource Guide is located at: http://www.myfloridalicense.com/DBPR/hotels-restaurants/forms-publications This report has been provided electronically as requested by the person in charge at the time of inspection. VIOLATIONS 14-67-4 Observed: Reach -in cooler gasket torn/in disrepair. Reach in #2. Priority: Basic 14-69-4 Observed: Ice buildup in reach -in freezer. White chest freezer by office. Priority: Basic 16-46-4 Observed: Old labels stuck to food containers after cleaning. Priority: Basic 21-10-4 Observed: Soiled dry wiping cloth in use. Priority: Basic 21-38-4 Observed: Wiping cloth sanitizing solution stored on the floor. Chef moved into shelf. **Corrected On -Site** Priority: Basic 22-08-4 Observed: Interior of oven has heavy accumulation of black substance/grease/food debris. Next to mixer. Priority: Basic 29-49-5 Observed: Observed standing water in bottom of reach -in cooler. Reach in #2. Priority: Basic 36-18-4 Observed: Floor tiles cracked, broken or in disrepair. By double door oven. Priority: Basic 36-41-4 Observed: Fan cover in walk-in cooler/freezer has accumulation of dust or debris. Observed mold like substance on side of walk in cooler fan. Priority: Basic 36-73-4 Observed: Floor soiled/has accumulation of debris. On cook line. Priority: Basic 41-27-4 Observed: Wiping cloth sanitizer solution exceeds the maximum concentration allowed. Observed sanitizer bucket with chlorine level above 200, chef added more water to lower level to 100. **Corrected On -Site** Priority: High Priority Signature of Recipient Inspector Signature Andrea Curto Randazzo James Seyba Chef Senior Sanitation And Safety Inspector 12229 SW 131 Ave 8240 NW 52nd Terrace Suite 121 Miami, FL 33186 Doral, FL 33166 305-256-8399 850-487-1395 May 23, 2019 1039 May 23. 2019 1035 May 23, 2019 at 1039,43 AM EDT LocationCREATIVE TASTES CATERING License tr CATR2327049 Inspector James Seyba Food Service Inspection Report DBPR Form HFR 5022-015 - Rule 61C-1.302, FAO, Software Version 6.62 Page '3 of 3 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS 2601 GLAIR STONE ROAD TALLAHASSEE FL 32399-1011 RANDAZZO CATERINGCA[ERINc3 NC CREATIVE TASTES CATERING 12229 SW 131 AVE #B2 MIAMI FL 33186-6401 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Floridaeconomy strong Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloricialicense.com. There you can find more information about our divisions arid the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives, Our mission at the Department is License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers Thank you for doing business in Florida, and congratulations on your new license! RICK SCOTT, GOVERNOR Eicet4se CAT2327049 850-487-1395 STATE OF FLORIDA [DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CAT2327049 ISSUED: 10/02/2018 CATERER (2013) RANDAZZO CATERING INC CREATIVE TASTES CATERING IS LicENtscri tr,d, pro..1c., tif Cr, 60') FS xr,61,7, ddiv, 2, • L t DETACH HERE .10NATHAN ZACHEM, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS The CATERER (2013) Named below IS LICENSED Under the provisions of Chapter 509 FS. Expiration datei OCT 1 2019 RANDAZZO CATERING INC •-• • CREATIVE TASTES CATERING 12228 SW 131 Ave. #62 MIAMI FL 33186•6401 W Ur NON, ISSUED 10/02/2018 DISPLAY AS REOUIRED EY LAT,/ SL.UL,a 1 0020j605C6 ocal usmess Tax Receipt Miami -Dade Coi_lty, State of Florida 6139505 BUSINESS NAME,I..00ATIWN RECE,PT CREATIVE TASTES CATE1RINC 12229 SV1113157 AVE .64C2739 MIAMI FL 331.80 rypE 61,JSAESS RANDAllO CA:TER1VO 1 'SS EXPIRES SEPTEEVIBER 30, 2019 FAYVIEN,PC,C.F1,4VV IAX SI I 2.5ti 10/02/2018 EmployeeS I I 5 CI4ECK2 I —19-0001312 Thit, Loctil Birsiorrw. Tax Racelor only c02Ir,tu, ravoirlor nt the LOCkli BlIS1,11 Tax The fikr,,etirt WA h permit, or A certification ot the 114)141or Irn bwrriles3 HoliThr witivt c,Itliirly with oily govoniatental Or 110OgOlitfnillen101Iegulillory lions rind taliairerounts applyto the bus Tlic RECEIPT NO. shove must NI un ail efIlOillerGlili - Mirm-Cirruir: Corr, Sec Ork-271, Fur more Intarnintion, visit ww,niIsrniJeoourtoxeollNdul A RANDA770 I )!IIII ti r i1 e.--J PRATTction McIrTiTT-Tr Ceitificolion EATIntinuliTTIT kph (Dct--:,Tlitod ti Hn Niriti(;i1.:11 Simla -Ads Instiluie (Aft:AI-ConferenceL EcyTTTTI P(Tred'ion ((TIP) . DATE OF TTIws 5130 FIR EXAM FORM NUMBER 3/22/2021 DATE OF EXPIRATION ,ency for r,.,..TedifiC(III0I1 nr it CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS This certification is required by the regulation implementing Executive Order 12549. Drbunnoni and Suoponsion, signed February 18, 1986. The guidelines were published in the May 29, 1987, Federal Register (52 Fcd� Reg - pages 2036020369). (|) The prospective provider ccrtifixo, by si,,,pninQ this certification, that neither he nor his principals are presently debarred, ouxpcndod, proposed for doburnenl, declared ineligible, or voluntarily exc|uded hnnn participation in contracting with the Department of Elder Affairs by any federal department or agency. (2) Where the prospective provider is unable to certify to any of' the statements in this ccrtiflication, auoh prospective provider shall attach on explanation to this certification. Vendor's Signature Date July 13, 2019 Nmneand Title ofAuthorized Individual Frank Randazzo- President Name ofOrganization Randazzo Catering, Inc d/b/a Creative Tastes Catering 12228SVV131Ave 39 CERTIFICATION REGYA0DING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRACTS Each provider whose contract equals orexceeds $}O0.000 in federal monies must sign this debonncno cccti�ou�iou prinr10 contruot cxoouLion� |ndop�ndcnt auditurx v/ho uudit t�d�ru| pno�runno rcganj|exo of the dollar amount are required to sign a debarment certifitcution form. Neither the Department of Elder Affairs nor its contract providers can contract with providers iFthcy are debarred or suopcnded bythcfedera| government. 7. This certification is a ooutrcOl representation of fact upon which reliance is placed when this contract is entered into. If it is later determined that the signed knowingly rendered an erroneous certification, the Federal Government may pursue available remedies, including Suspension and/or debarment. ]. The provider uhuJ| provide immediate written notice to the contract manager at any ticno the provider |cnrnx that its certification was erroneous whun subnniik:d or has become erroneous by reason of changed circumstances. 4. The 1cnns "debarred," "Suspended," "ineligible," "person," "principal," and "voluntarily excluded," as used in this certification, have the meanings set out in the Definitions and Coverage sections ofru|cu inop\cnncn1ingExecutive Order 12549 and 45 CFR(Code ofFederal Regulations), Part7d. You may contact the contract manager for assistance in obtaining a copy of these regulations. 5. The provider further ugrcca by submitting this certification that, it nbaU not knowingly enter into ally subcontract with u person who is drhnrrod, suspended, declared ineligible, or vo|uniuh|ycxdudcd from participation in this contract unless -RUthorized bythe Federal Government. 6. The provider further agrees bysubmitting this certification that it will require each subcontractor o[ this contract whose payment will equal or exceed $100,000 in Rx]eru| monies, to Submit signed copy ofthis certification with each contract. 7. The Department of Elder Affairs and its contract providers may rely upon o certification of o provider that is not dchunrd, suspended, ineligible, or vo|unkni|y excluded from contracting/subcontracting unless i[knows that the certification is erroneous. Revised 7/2017 40 1BREAKFAST MENU FACILITY REQUIKEMLN IS: One Serving miff + One serving trust OK vegetable + two servings grainsfbreads URIVIeat, Alt tin place ot entire grains maximum i times per wee—M-1 . WEEK 1 Monday Tuesday Wednesday Thursday Friday Required serving Size Required 0orrponent Food Food Food Food ------1 Food 8 oz. Miik 13/4 Milk % Milk 1 % Milk 1 '4, Milk 1 % Milk 1/2 cup FrLt OR Veg Fres. on Banana Apple Wedges Fresh Fruit Cup 00% 0range Juice Exhibit A (oz.i • Grain/Bread I .9 oz Whole Grain Bread r Whole Grain Bread ,z Whole Grain Bread0.902 Whole Grain Bread 0.9 az Whole Grain Bread Exhibit A (oz.) ' rain/Bread 1 cup Cheerios 1 cup Kix Cereal 1 cup Cornflakes 1 cup Bran Flake 1 cp Rice Krispies Meat/AIL EK 2 Required -Servnig Size Required Component Food Food Food Food ,. ._..... Food . Mik 1% Milk 1 ,,; Milk 1 % Milk' % k 1 % Milk 1/2 cup Fruit OR Veg Fresh Melon 8anana Apple Wedges Fresh Fruit Cup % orange Juice it . Exhi A ;.' Graui/8readO.S.) oz Whole Grain Bread 0.9 oz Whole Grain n rea 0.9 oz Whole Grain 0.9 oz Whole Grain Brea 0 9 oz Whole Grain Bread - •hibit A oz.) ' Grain/Bread 1 cup Cornflakes 1 cup n Flakes 1 cup Rice Krispies 1 cup Kix Cereal 1 cuo Cheerios Me3t1'.Al. WEEK Required iServr Size Required thnipanent Food Food Food Food Food z. Milk 1 9,i, Milk 1 % Milk 1 % Milk 1 % Milk i k 2 cup Frut OR Vep, Fresh Melon Banana 100% orange Juice Fresh Fruit Cup Apple Wedges Exhibit A (oz.) - Grain/euead 0,9 oz Whole Grain 8read 0.9 oz Whole Grain Bread 0.9 az Whole Grain Bread 0,9oz WholeGrain Bread 0.9 oz Whole Grain Bread Exhibit A (.) • Grain/Bread 1 cup Cheerios 1 cup Kix Cerealcup Cornflakescup Bran Flakes 1 cup Rice Krispies Meat/AFt. WEEK 4 Required Servrng Size Required Cornponent Food Food Food Food ..,_, . Food z. MUk 1% Milk 1? ilk 1 % MUk 1 % Milk 1 % MUk 1/2 cup Fruit OR veldBanana % orange Juice Fresh Fruit Ciip Apple Wedges Fresh Melon Exhibit A (az.) Grain/Bread 0.9 oz Whole Grain Bread 0.9 or Whole Grain Bread 0,9 oz Whole Grain Bread 0.9oz Grain Bread , Whole Grain Bread Exhibit A (oz.)" rain/Bread 1 cup Cheerios 1 cup Bran Flakes 1 cup Rice Krispies 1 cup Kix Cereal 1 cup Cornflakes Meat/Alt. 't Exhibit A is from the 1pod Buying Guide (Section 3 Grains /Breads, p. 3-15). Follow Adult Meal Pattern, Food Buying Guide and Crediting Guide in the ACFP Policy Manual). Ana M. Alvarez, RD, L.D. eDE (ND #1819) Registered Licensed cietitianlartified Diabetes Educator (954) 328-4506 CATERER: Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 Tel: 305-256 8399 Effective Date: 3:1/‹..1C-IAW, //i 27 Expiration Date: To be valid, menus mu signed in red with an embossment seat and an address that matches:fie place LUNCH MENU FACILITY: REQUIREf •T :one rvu mservingitk + one sernnserving v get abies f one serving fruit OR vee etabtei two srvings grain reads + one serving me0t or alternative WEEK 1 Monday Tuesday Wednesdy Thursday Friday Required Sprvr- , -- e • Required nt Food Food T Food Food Food Fallow handout , AI . - Z Chicken 3 oz FishFilet - z Pork in Fricassee 3 oz Ground Bee Picadi o oz Meatalls in Sauce for ounces " Grain r /2 cup White Rice 1/2 cup hi e Rice 1/2 cupWhite R• 2 cup yeilow Rice 1/2 cup White Rice FocEi Pattern " G in/Bread 0.9 oz Whole Grain readB a - oz Whole Grain Bread O..: oz Whoe Grain Bread 0.9 oz Who!e Grain Bread 0.9 oz Whole Grain Bread /2 cup Vegetable 1 cup Tossed' d Green Beans Stewed Vegetables Mixed Vegetables 1 cup Tossed Salad 1/2 cup Fruit OR Veg. Garbanzos Black BeansLentils Split Peas in Soup Boiled Pumpkin z. Milk 1 % , ilk 1% Milk 1 % Milk 1% Milk 1 % Mik Optiona I 1 ood WEEK 2 Required PrwjnP - . Required erajsnnt Food Food Food Food Food Fcflow handout Meat/At. 3 07 Ham Steak 3 oz Chicken in Fricassee3 oz Baked Fish 3oz Shredded Beet/Ropa Viejo3 oz Roast Pork tor 00nces " Graln ead 1/2 cup YellowRice ._ cup White Rice 1,2 cup thi e Rice1/2 cup White Rice . cup Congri (1/2 cup Rice) Food Pattern "' Grain read 090z Whole Grane 0.9 oz Whole Grain Bread 0.9 oz WholeGrain Bread 0.9 oz whole Grain Bread 0.9 oz Whole Grain Bread 1/2 (up vegetable 1 cup Tossed Salad Carrots 1 cup Tossed Salad Mixed Vegetabies 1 cup Tossed Salad 1/2 cup Frut OR veg. Split Peas in Soup lack Beans Lentils Red Beans assava wjth Mojo -a ce S o' Milk 1 % In 1 % i k 1 % Milk 1 % MUk 1 %Mi!k )p ti ona 1 Food WEEK 3 Requred • Requred Food Food Food Food _ Food Followhandout e 'A oz Stripped Steak 3 oz Pork in Pork Casserole 3 oz Fish in Stew 3 oz •cken 3 o SteaknaP for ounces • 4 - in/Bread 1/2 cup White Rice 1/2 cup White Rice 1/2 cup White Rice 1/2 cup Yellow Rice 3/4 cup Congri (1/2 cup Rie) Food Pattern "" Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0,9 07 ‘, hole Grain Bread 0.9 oz Whole Grain 8read 0.9 oz Whole Grain Bread I- 112 cup vegetable Carrots 1 cup Tossed Salad 1 cup Tossed Saad Green Beans 1 cup Tossed Salad 1/2 cup Fruit OR Veg Red Beans BtackBeans NawBeansSweet Plantains Cassava with Mojo Sauce 8 o . Milk 1 % MUk 1 % Mitk 1 % MUk 1 % Milk 1 % Milk OptionalFood WEEK 4 flequired ' a • Requlred cmnnt Food Food Food Food Food Follow handout Meat/Aft, 3 oz MeatbaHsin Sauce 3 oz Pork Chunks 3 ozChicken with 3 oz Fish Filet oz Baked chicken with Mojo for ouuces " Grain/Bread 1/2 cup Penne Pasta 1/2 cup White Rice1/2 cup Yetlow Rice 1/2 cup White Rice 1/2 cup White Rice d Pattern"i" Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz whole Grain Bread 0.9 oz Whole Grain 8read 0.9 oz Whole Grain Bread • . cup Vegetable 1 cup Tossed Satad Carrots 1 cup Tossed Salad Mixed Vegetablescup Tossed Salad 1J2 cup Fruit OR veg White 8eansBlack BeansSweet P antains Split Peas in Soup Black Beans oz MiIk 1 % Miik • k % Mk 1 % MUk 1% Mflk Optional Food , . t Food Buying Guide Grains/ Breads handout to list theoUnCe'S per se. ving, You MUSTuse ttie Adult Meal Pattern for meat requirements. a, Ana M. Alvarez, RD, LD, COE (ND tit1819) Registered Licensed Dietitian/Certified Diabetes Educator 954) 328-4506 T ER: Creative Tastes Catering & Event Producno 12229 SW 131 Avenue, Miami, FL 33186 Tel: 305-256-8399 Effective Da te A Expiration Date: —3;2' Are.":79ev / 1, To be valid, menu4sust be signed in red with an embossment seal and an address thai matches the place afbusirsass 1 SNACK MENU FACILITY: REM iR EMENTS: TWO of five must be served :One serving milk , one ervug frult , one serving vegetable, one serving grains/breads, one serving meat or alternative EEK 1 Monday Tuesday Wednesday Thursday Friday ' Required Serving Sze Requfred Coniponetit Food Food Food Food Food 8 az Milk 1/2 cup Fruit 100% Blended Juice Fruit Cocktail 100% Blended uice Pineapple Applesauce 1/2 c p Vegetable Exhibit A ., '' Grain/Bred .7 oz SItine Crackers 0.9 oz Anirna Crackers 0.7 oz Ritz Crackers 0.9 oz Graham Crackers .7 oz AssortedCrackers . t A . K 2 Required ServingSernng Sire Required Conponent Food Food Food Food Food 8 oz. Milk 1/2 cup Frult 100% Blended Juice Peaches 00% Blended ice Pears Mandarin Oranges 1/2 cup Vegetable Exhibit A (oz.) Grain/Bread 0.7 oz Ritz Crackers 0.9 oz Graham Crackers 0.7 oz Saltine Crackers 0.9 oz Animal Crackers 0.7 oz Assorted Crackers Meat/Alt, EEK 3 Required .Servng Size Required Component Food Food Food Food Food z, Miik 1/2 cuo Fruit Applesauce Pears Pineapple Mandarin Oranges 100% Blended Juice 1/2 rup Vegetable Exhibit A (oz.) Grain/8read 0,7 oz Sa!tine Crackers 0.9 oz Animai Crackers 0.7 oz Assorted Crackers0.902 GrahamCrackers 0.7 oz Ritz Crackers Meat/Alt_ EEK 4 Reauired Serving Size Required Component Food Food Food Food Food 8az. Milk 1/2 cup Fruit Peaches Applesauce 100% Blended uice fruitCocktail0% Biendediuice 2 cup Vegetable . Exhibit A (oz.) '' Grain ad 0.7 oz i ed Crackers.9 oz Graham Crackers.7 oz Ritz Crackers0,9 oz Animalacker 0.7 oz Saltine Crackers Meat/Alt. '' Exhibit A is from the Food Buying Guide (Section 3 Grains /Breads, p. 3-15). Follow Aduit Meal Pattern, Food Byng Guide, and Crediting Guide (in the ACFP Policy a Iltia .. .,, fi j 4 -,1',- I 4),4,,y: /1-1 14 fIE CATERER: Creatire Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 Tel:305-256-8399 ---.T C Date:---)4E(...r/40/ 1// Z.t.---")/47 Expiration Date: A44/09 Ae i t/ Ana M. Alvarez, RD, t1D, CDE (ND #1819) Registered Licensed Dietitian/Certified Diabetes Educator Effective (954) 328-4506 To be valid, menus m,st be signed in red with an embossment seal and an addreslthat matchesh place of Adult Meals -Special Menus* Picnic or "Boxed" Lunch Options Housemade Egg, Tuna or Chicken Salad Dressed with Greens & Tomato on Sliced Whole Wheat Bread Each "Boxed" Lunch Includes Individual Pasta Salad, (2) Mini Cookies, Bottle of Water & Baked Potato Chips & Utensil Kit Holiday Menu Options Roasted Turkey Breast, Herb Stuffing, Gravy, Brussels Sprouts, Pumpkin Pie Baked Ziti, Homemade Meatballs, Tre Colore Salad, Pecan Chocolate Pie, Focaccia Roast Beef (Carving Required), Au Jus, Roast Potatoes, Roasted Mushrooms, Apple Pie Special Diet Options Please Contact Us Regarding Special Restrictions Such as Vegetarian, Gluten Free & Other Requests * Certification Pending by Licensed Nutritionist Randazzo Catering, Inc. d/b/a Creative Tastes Catering 12229 SW 131 Ave Miami Florida 33186 t 305.256,8399 f 305.256.9868 AC# STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE DATE LICENSE NO. -° "CONTROL NO. 0311512019 ND 1819 39711 The DIETITIAN/NOTRtT1ONIST named below has met all requirements of the laws and rules of the state of Florida. Expiration Date: MAY 31, 2021 ANA ALVAREZ, RDN 15739 NW 11 STREET PEMUIBROKE PINES, FL 3302 Ron DeSantis GOVERNOR DISPLAY IF RE( UIREt E.Y LAVV LUNLI1 IVILNU FACILITY: REQUIR- ENTS: one serving milk + one serving v g a + one , i i OR ve able + tvvo servin .rains/breads + one serving meat or alternative WEEK — on y es y nes ay Thursday Friday -Required Servine Site • Required Comnonent Food Food Food Food Food Follow handout Meat/Alt. 3 oz Chicken 3 oz Fish Filet 3 oz Pork in F cassee 3 oz Ground Beef (Picadillo) 3 oz Meatalls in Sauce for ounces •• Grain/Bread 1/2 cup White Rice 1/2 cup White Rice 1/2 cup White Rice 1/2 cup Yellow Rice 1/2 cup White Rice Food Pattern ' • • Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 1/2 cup Vegetable 1 cup Tossed Salad Green Beans Stewed Vegetables Mixed Vegetables 1 cup Tossed Salad 1/2 cup Fruit OR Veg Garbanzos Black Beans Lentils Split Peas in Soup Boiled Pumpkin 8 oz. Milk 1 % Milk 1% Milk 1% Milk 1% Milk 1% Milk Optional Food WEEK 2 Required Servine Sire • Required Comnonent Food Food Food Food Food Follow handout Meat/Alt. 3 oz Ham Steak 3 oz Chicken in Fricassee 3 oz Baked Fish 3oz Shredded Beef/Ropa Vieja 3 oz Roast Pork for ounces " Grain/Bread 1/2 cup Yellow Rice 1/2 cup White Rice 1/2 cup White Rice 1/2 cup White Rice 3/4 cup Congri (1/2 cup Rice) Food Pattern ••• Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 1/2 cup Vegetable 1 cup Tossed Salad Carrots 1 cup Tossed Salad Mixed Vegetables 1 cup Tossed Salad 1/2 cup Fruit OR Veg. Split Peas in Soup Black Beans Lentils Red Beans Cassava with Mojo Sauce 8 oz. Milk 1 % Milk 1% Milk 1% Milk 1 % Milk 1% Milk Optional Food WEEK 3 'Required servinr, Sire • Required Comonnent Food Food Food Food Food Follow handout Meat/Alt. 3 oz Stripped Steak 3 oz Pork in Pork Casserole 3 oz Fish in Stew 3 oz Chicken 3 oz Steak in a Pot for ounces ** Grain/Bread 1/2 cup White Rice 1/2 cup White Rice 1/2 cup White Rice 1/2 cup Yellow Rice 3/4 cup Congri (1/2 cup Rice) Food Pattern" Grain/Bread 0,9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 1/2 cup Vegetable Carrots 1 cup Tossed Salad 1 cup Tossed Salad Green Beans 1 cup Tossed Salad 1/2 cup Fruit OR Veg. Red Beans Black Beans Navy Beans Sweet Plantains Cassava with Mojo Sauce 8 oz. Milk 1 % Milk 1% Milk 1% Milk 1% Milk 1% Milk Optional Food WEEK 4 Required Servine Sire ' Required Somonnent Food Food Food Food Food follow handout Meat/Alt. 3 oz Meatballs in Sauce 3 oz Pork Chunks 3 oz Chicken with 3 oz Fish Filet 3oz Baked Chicken with Mojo for ounces '• Grain/Bread 1/2 cup Penne Pasta 1/2 cup White Rice 1/2 cup Yellow Rice 1/2 cup White Rice 1/2 cup White Rice Food Pattern *** Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 1/2 cup Vegetable 1 cup Tossed Salad Carrots 1 cup Tossed Salad Mixed Vegetables 1 cup Tossed Salad 1/2 cup Fruit OR Veg. White Beans Black Beans Sweet Plantains Split Peas in Soup Black Beans 8 oz. Milk 1 % Milk 1% Milk 1 % Milk 1 % Milk 1% Milk Optional Food 4' Rv Slihmittinv thic inrm_ vnu are verifyinv vrnir servinv Si7PS match or exceed the featured servine sire for Milk. Fruit and Veeetahles. These are the minimum recuncements. You can serve more d vou wish. " You MUST use the Food Buying Guide Grains/ Breads handout to list the ounces per serving ***You MUST use t he Adult Meal Pattern for meat requirements. Fisic " CATERER: f ,t _ 111V. tfr - Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 Tel: 305-256-8399 Ana M. Alvarez, RD, LD, CDE (ND t$1819) Registered Licensed Dietitian/Certified Diabetes Educator Effective Date', ,Iztliff,f6247WV ?An Expiration Date: // ?6.)2,7 (954) 328-4506 To be valid, menuvinust be signed in red with an embossment seal and an address thal matches the pofb1sines SNACK MENU FACILITY: REQUIREMENTS: TWO of five must be served : One serving milk , one serving ' , one serving vegetable, one serving grains/breads, one serving meat or alternative WEEK 1 Monday Tuesday Wednesday Thursday Friday Required 'Serving Size Required Component Food 4 Food Food Food Food 8 oz. Milk 1/2 cup Fruit 100% Blended Juice Fruit Cocktail 100% Blended Juice Pineapple Applesauce . 1/2 cup Vegetable Exhibit A z. * Grain/Bread 0.7 oz Saltine Crackers 0.9 oz Animal Crackers 0.7 oz Ritz Crackers 0.9 oz Graham Crackers 0.7 oz Assorted Crackers Meat/A.lt, WEEK 2 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk 1/2 cup Fruit 100% Blended Juice Peaches 100% Blended Juice Pears Mandarin Oranges 1/2 cup Vegetable Exhibit A (oz.) * Grain/Bread 0.7 oz Ritz Crackers 0.9 oz Graham Crackers 0.7 oz Saltine Crackers 0.9 oz Animal Crackers 0.7 oz Assorted Crackers Meat/Alt. WEEK 3 Required !Serving Size Required Component Food Food Food Food Food S oz. Milk 1/2 cup Fruit Applesauce Pears Pineapple Mandarin Oranges 100% Blended Juice 1/2 cup Vegetable ' Exhibit A (oz.) Grain/Bread 0.7 oz Saltine Crackers 0.9 oz Animal Crackers 0.7 oz Assorted Crackers 0.9 oz Graham Crackers 0.7 oz Ritz Crackers Meat/Alt. - WEEK 4 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk 1/2 cup Fruit Peaches Applesauce 100% Blended Juice Fruit Cocktail 100% Blended Juice 1/2 cup Vegetable Exhibit A (oz,) * Grain/Bread 0.7 oz Assorted Crackers 0.9 oz Graham Crackers 0.7 oz Ritz Crackers 0.9 oz Animal Crackers 0.7 oz Saltine Crackers Meat/Alt, * Exhibit A is from the Food Buying Guide (Section 3 Grains /Breads, p. 3-15). Follow Adult Meal Pattern, Food Buying Guide, and Crediting Guide (in the ACFP Policy Manual). si ,it I :f1,-..p9 :7-1„c' CATERER: Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 Tel 305-256-8399 —1--- --r---' , fl 67 Effective Date:— , Expiration Date: ...._.-1,4A/01 '1/22-e. ' /4 Ana M. A varez, RD,LD, CDE (ND (41819) Registered Licensed Dietitian/Certified Diabetes Educator :(954) 328-4506 To be valid, menus mclst be signed in red with an embossment seal and an addres.s that matches the place of BREAKFAST MENU FACILITY: HECIU1REMLNIS: One serving milk + one serving truit OR vegetable + two servings grains/breads UR Meat/ Alt (ln place ot entire grains maximum 3 times per week) WEEK 1 Monday Tuesday Wednesday Thursday Friday Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk Leche 1% Leche 1% Leche 1% Leche 1% Leche 1% 1/2 cup Fruit OP veg. Melon Fresco Banana ... Manzana en Lascas Frutas Frescas 100% Jugo de Naranja Exhibit A (oz.) • Grain/Bread 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo Exhibit A (oz.) • Grain/Bread 1 taza Cheerios 1 taza Cereal Kix 1 taza Cornflakes 1 taza Cereal de Bran Flakes, 1 taza Rice Krispies Meat/Alt, WEEK 2 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk Leche 1 % Leche 1% Leche 1% Leche 1% Leche 1% 1/2 cup Fruit OR Veg Melon Fresco Banana Manzana en Lascas Frutas Frescas 100% Jugo de Naranja Exhibit A (oz.)• Grain/Bread 0.9 or Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo Exhibit A (oz.) * Grain/Bread 1 taza Cornflakes 1 taza Cereal de Bran Flakes 1 taza Rice Krispies 1 taza Cereal Kix 1 taza Cheerios Meat/Alt. WEEK 3 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk Leche 1% Leche 1% Leche 1% Leche 1% Leche 1% 1/2 cup Fruit OR Veg. Melon Fresco Banana 100% Jugo de Naranja Frutas Frescas Manzana en Lascas Exhibit A (oz.) • Grain/Rread 0.9 oz Pan de Trigo 0.9 or Pan de Trigo 0.9 or Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo Exhibit A (oz.) • Grain/Bread 1 taza Cheerios 1 taza Cereal Kix 1 taza Cornflakes 1 taza Cereal de Bran Flakes 1 taza Rice Krispies Mea 1/Alt. WEEK 4 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk Leche 1 % Leche 1% Leche 1% Leche 1% Leche 1% 1/2 cupFruit OR veg, Banana 100% Jugo de Naranja Frutas Frescas Manzana en Lascas Melon Fresco Exhibit A (oz.) • Grain/Bread 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo Exhibit A (oz.) ' Grain/Bread 1 taza Cheerios 1 taza Cereal de Bran Flakes 1 taza Rice Krispies 1 taza Cereal Kix 1 taza Cornflakes Meat/Alt. • Exhibit A he Food Buying Guide (Section 3 Grain ds, p. 3-15). FollowAdult Mea Pattern, Food Buying Guide, and Crediting Guide (in the ACFP Polio 4 ia Ana M. Alvarez, RD, LD, COE (ND 81819) Registered Licensed Dietitian/Certified Diabetes Educator (954) 328-4506 Effective Date: ---1/2-41?-997-77 CATERER: Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 Tel: 305-256-8399 Expiration Date: ' To be valid, menus must be signed in red with an embossment seal and an address that matches the place of business LUNCH MENU FACILITY: REQUIREMENTS: one serving milk + one serving vegeta;a#es + one serving fruit OR vegetatate +two servings grains/breads + one serving meat or alternative WEEK 1 Monday Tuesday V. nes ay urs ay Friday Required ServinP Sire' Required Component Food Food Food Food Food Follow handout Meat/Alt. 3 oz Polio 3 az Filete de Pescado 3 oz Fricase de Puerco 3 az Picadillo 3 oz Albondigas en Salsa for ounces '• Grain/Bread 1/2 taza Arroz Blanco I/2 taza Arroz Blanco 1/2 taza Arroz Blanco 1/2 taza Arroz Amarillo 1/2 taza Arroz Blanco Food Pattern • Grain/Bread 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 1/2 cup Vegetable 1 taza Ensalada Mixta Habichuelas Vegetates Estofados Vegetales Mixtos 1 taza Ensalada Mixta 1/2 cup Fruit OR Veg, Garbanzos Frijoles Negros Lentejas Chicharos Calabaza Hervida 8 oz. Milk Leche 1 % Leche 1 % Leche 1 °a Leche 1 % Leche 1 % Optional Food WEEK 2 itequired SenrineSi;re'flt- Required Meat/Ak. Food Food Food Food Food Fot#ow handout 3 oz Bistec de Jamon 3 oz Fricase de Polio 3oz Pescado Asado 3oz Ropa Vieja 3 oz Puerco Asado for ounces ** Grain/Bread 1/2 taza Arroz Amarillo 1/2 taza Arroz Blanco 1/2 taza Arroz Blanco 1/2 taza Arroz Blanco 3/4 taza Congri (1/2 t Arroz} ,Foot# Pattern ** Grain/Bread 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 1/2 cup Vegetahle 1 taza Ensalada Mixta Zanahorias 1 taza Ensalada Mixta Vegetates Mixtos 1 taza Ensalada Mixta 1/2 cup Fruit OR Veg. Chicharos Frijoles Negros Lentejas Frijoles Colorados Yuca con Mojo 8 oz, Milk Leche 1 % Leche 1 % Leche 1 % Leche 1 °la Leche 1 ° O tional Food 49JEEK Required Servine Size * RegJired Cornnntent Food Food Food Food Food Follow handout MeatjAit. 3 oz Filetillo de Carn.e 3 oz Caserola de Puerco 3 oz Pescado en Salsa 3 oz Polio 3 oz Bistec en Cazueta for ounces •' Grain/Bread 1/2 taza Arroz Blanco 1/2 taza Arroz Blanco 1/2 taza Arroz Blanco 1/2 taza Arroz Amarillo 3/4 taza Congri (1/2 t Arroz} Food Pattern'* Grain/Bread 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0,9 oz Pan de Trigo 12`2cup Vegetable Zanahorias 1 taza Ensalada xta 1 taza Ensalada Mixta Habichuelas 1 taza Ensalada Mixta 1/2 cup Fruit OR Veg. Frilotes Colorados Frijoles Negros Frijoles Btancos Maduros Yuca con Mojo 8 oz. Milk Leche 1 °ro Leche 1 °rig Leche 1 % Leche 1 °r'e Leche 1 % OptionaI Food WEEK 4 Requ€red Cerv:ne Size * lRequrred tsrmtTffnent Food Food Food Food Food Follow handout Meat/A#t. 3 oz Albondigas en Salsa 3 oz Masas de Puerco 3 oz Polio con 3oz Filete de Pescado 3oz Polio Asado con Mojo ferounces *' Grain/Bread 1/2 taza Macarrones 1/2 taza Arroz Blanco 1/2 taza Arroz Amarillo 1/2 taza Arroz Blanco 1/2 taza Arroz Bianco Food Pattern ** Grain/Bread 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo 0.9 oz Pan de Trigo /2 cup Vegetable 1 taza Ensalada Mixta Zanahorias 1 taza Ensalada Mixta Vegetales Mixtos 1 taza Ensalada Mixta 112 cup Fruit OR Veg. Frijoles ncos Frijoles Negros Maduros Chicharos Frijoles Negros 8 oz. Milk Leche 1 % Leche 1 % Leche 1 % Leche 1 % Leche Optional Food •n...,.L�I..;,... a{.i. %..._ ......�....�..—.:T..:. . .. ..............r .... . n ... PA:iI. t...:t.....i tt..rtat tilA. Tom.-nc.n r.. .,,-,.. .=-77.47-flV .RAt Ci' usetheFo Buying GuideGrains / Breads handout to list the ounces per servink,. •'• You MUST use the Adult Meal Pattern for meat requirements. Ana M. Alvarez, RD, LD,tDE (ND 81819) Registered Licensed Dietitian/Certified Diabetes Educator (954) 328-4506 Effective Date: _—% CATERER: Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 �1�Tel:305-/25/6-8399 {f 9 Expiration Date: iLl� l7(� / ! To he valid menus musitban embossment seat and an address that matched the place of business SNACK MENU FACILITY: REQUIREMENTS: TWO of five must be served : One serving milk , one serving fruit , one serving vegetable, one seniing ins eads, one serving met or alternative WEEK 1 Monday Tuesday Wednesday Thursday Friday , Required Serving 542e Required Component Food Food Food Food Food 8 e . Milk 1/2 cup Fruit 100% Jugo Surtido Coctel de Fruta 100% Jugo Surtido Pina Pure de Manzarta 1/2 cup Vegetable , Exhibit A (oz.) • Grain/Bread 0.7 oz Gailetas Saltines 0,9 oz Gailetas deAnimales0.7 oz Gailetas Ritz 0.9 oz Galietitas Graham 0.7 oz GalletasSurtidas Mea t/Alt. WEEK Required 'serving Sire Required Component Food Food Food Food Food 8oz- i k '1.1/2 cup rujt 100% Jugo Surtido Melototores 100% Jugo Surtido Peras Mandarinas 1/2 cup Veltble Exhibit A .) ' Frain d 0.7 oz Galletas Ritz 0.9 oz Gailetitas Graham 0.7 oz Gailetas Saltines 0.9 oz Galletas de Animales 0.7 oz Galletas Surtidas Meat/Alt. WEEK 3 Required Serving Size Required Conponent Food Food Food Food Food 8 oz. Milk 1/2 cup Fruit 00`1-F, Jugo Surtido Peras Pina andarinas 0% Jugo Surtido 1/2 cup VeetabIe Exhibit A (oz,) ' Grain/Bread 0.7 oz Gailetas Saltines 0.9 oz Galletas de Animales 0.7 oz GailetasSurtidas 0.9 oz Gailetitas Graham 0.7 oz Galletas Ritz Meat/Alt WEEK 4 Required Serving Sire Required Component Food Food Food Food Food 8oz. Milk 1/2 cup Fruit Me)ocotones Pure de Manzana 10011 Jugo Surtido Coctel de Fruta 100% Jugo Surtido 1/2 cup Vegetable Exhibit .4 (oz.) * Grain/Bread 0.7 oz GalletasSurtidas 0.9 oz Gailetitas Graham 0, oz Gailetas Ritz 0.901 Galletasc e Animales 0.7 oz Gailetas Saltines Meat/Alt ' Exhibit A is trom theFood Buying Guide Sec ion 3 Grains /Rreads, p. 3-1 . Follow AdultPattern, Food Buying Guide, and crediting Guide (In the ACFP Policy Manual). -F----L-Vtk--1,-- ' T'''-' ±1 CATERER: Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 33186 Tel: 305-256-8399 /1 7/7„iic-: r "— Date: .-_-1/5//t/(,---?Wcici / / f (--L'i I Expiration Date: ,-,_)/-347 2Y14. V / / Ana M. Alvarez, RD, LD, CDE (ND 41819) Registered Licensed Dietitian/Certified Diabetes Educator Effective _ 4) 328-4506 To be valid, menus mustikie signed in red with an embossment seal and an address that rnAches the place of business BREAKFAST MENU FACILITY: HEQUIHEMENIS: Une serving milk 4- one serving trurt UFt vegetable + two servings grams/breads UR Meat/ Alt On place or entire grains maximum 3 times per week) WEEK 1 Monday Tuesday Wednesday Thursday Friday Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk 1 % Milk 1 % Milk 1 % Milk 1 9i, Milk 1 % Milk 1/2 cup Fruit OR Veg Fresh Melon banana Apple Wedges Fresh Fruit Cup 100% Orange Juice Exhibt A (oz.) • Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread Exhibit A (oz.) •' Grain/Bread 1 cup Cheerios 1 cup Kix Cereal 1 cup Cornflakes 1 cup Bran Flakes 1 cup Rice Krispies Meat/Alt. WEEK 2 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk 1 % Milk 1 % Milk 1 % Milk 1 % Milk 1 °% Milk 1/2 cup Fruit 0R Veg Fresh Melon Banana Apple Wedges Fresh Fruit Cup 100% Orange Juice Exhibit A (oz,) ' Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread Exhibit A (oz.) > Grain/Bread 1 cup Cornflakes 1 cup Bran Flakes 1 cup Rice Krispies 1 cup Kix Cereal 1 cup Cheerios Meat/Alt. WEEK 3 Required Serving Size Required Component Food Food Food Food Food 8 oz. Milk 1 % Milk 1 % Milk 1 % Milk 1 % Milk 1 % Milk 1/2 cup Fruit OR leg Fresh Melon Banana 100% Orange Juice Fresh Fruit Cup Apple Wedges Exhibit A (oz.) • Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread Exhibit A (oz.) • Grain/Bread 1 cup Cheerios 1 cup Kix Cereal 1 cup Cornflakes 1 cup Bran Flakes 1 cup Rice Krispies Meat/Alt. WEEK 4 Required Servir Size Required Component Food Food Food Food Food 8 oz. Milk 1 % Milk 1 % Milk 1 % Milk 1 % Milk 1 % Milk 1/2 cup Fruit OR Veg Banana 100% Orange Juice Fresh Fruit Cup Apple Wedges Fresh Melon Fx!,ihit A loz.) • Grain/Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9 oz Whole Grain Bread 0.9oz Whole Grain Bread 0.9 oz Whole Grain Bread Exhibit A ioz) • Grain/Bread 1 cup Cheerios 1 cup Bran Flakes 1 cup Rice Krispies 1 cup Kix Cereal 1 cup Cornflakes Meat/Alt. Exhibit A is from the Food Buying Guide (Section 3 Grains /Breads, p. 3-15). Follow Adult Meal Pattern, Food Buying Guide, and Crediting Guide in the ACFP Policy Manual). Ana M. Alvarez, RD, LD, 6F3E (ND t$1819) Registered Licensed Dietitian/CertiFied Diabetes Educator (954) 328-4506 CATERER: Creative Tastes Catering & Event Production 12229 SW 131 Avenue, Miami, FL 3318637```—Tel: 305-256-8399 Effective Date: ✓/Y �( //1 �G Expiration Date: 7/9/C% ., /// To be valid. menus mus?`be signed in red with an embossment seal and an address that matches the place of business �/���,_- - ' `~'" ' : STATE 0FFLORIDA ` DEPARTMENT 8FHEALTH DIVISION OFMEDICAL QUALITY ASSURANCE DATE LICENSE NO. CONTROL NO, 02/11/2017 ND1B1S 33194 The D|ET|TkAN8NUTR|Tk]N|3T ' named bo|mwhas met all requirements of the }awn and rules of Une state of Florida, Expinahon Da�e: MAY 31' 2018 ANAALVAREZ, RD 15739NVV11 STREET PEManOKE r/wsa, FL 33028 �okScoM GOVERNOR Co|eyVaM. hUip.0.O,W�P�H. _ Sur eonGeoenalandSocetary ' Office: 754-610-4373 Fax:954-756-7747 Mobile: 954-347-1124 Project Manager: Jessica Rosales (Owner) jessica@redchaircatering.net www.redcha ircaterin2.net 3944B Pembroke Rd Hollywood, FL 33021 CATERING I FOOD SERVICES I EVENTS DADE BROVVARD PALM BEACH Certification Statement Please quote on this form, if applicable, net prices for the item(s) listed. Return signed original and retain a copy for your files. Prices should include all costs, including transportation to destination, The City reserves the right to accept or reject all or any part of this submission. Prices should be firm for a minimum of 180 days following the time set for closing of the submissions, In the event of errors in extension of totals, the unit prices shall govern, in determining the quoted prices. We (1) certify that we have read your solicitation, completed the necessary documents, and propose to furnish and deliver, F.O.B. DESTINATION, the items or services specified herein. The undersigned hereby certifies that neither the contractual party nor any of its principal owners or personnel have been convicted of any of the violations, or debarred or suspended as set in section 18-107 or Ordinance No. 12271. All exceptions to this submission have been documented in the section below (refer to paragraph and section). EXCEPTIONS: We (I) certify that any and all information contained in this submission is true, and we (I) further certify that this submission is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a submission for the same materials, supplies, equipment, or service, and is in all respects fair and without collusion or fraud. We (I) agree to abide by all terms and conditions of this solicitation and certify that I am authorized to sign this submission for the submitter. Please print the following and sign your name: PROPOSER NAME. Per, C ADDRESS: tl 8 26441) pHoNE:7CV 616 ‘.•?73 EMAIL: J.. vS.Si CA IA (10 i /Oki PeELL(Optional). SIGNED BY• TITLE: (20, eel,Alcyre ()ark/ f 33024 FAX ?,59, 7 370 ,7 7 17,7 DATE' FAILURE FAILURE TO COMPLETE, SIGN, AND RETURN THIS FORM SHALL DISOUALIFY THIS RESPONSE, Page 2 of 41 Certifications Legal Name of Fir Entity Type: Partnersktip, Sole Proprietorship, Corporation, etc. ec, i (1-19(ctb'oni Year Established: 2-01y Federal Employer Identification Number (FEIN) 23, Office Location: City of Miami, Miami -Dade County, or Other Perkbro Pct., ( Business Tax Receipt/ Occupational License Number: Nos11Q23 Business Tax Receipt/ Occupational License Issuing Agency: sh4-7e o1 Flof;dct (DWA-P-D y Business Tax Receipt/ Occupational License Expiration Date: 39/ 0/2-0/ 9 Please list and acknowledge all addendum/addenda received. List the addendum/addenda number and date of receipt (i.e. Addendum No. I , 7/1/07). If no addendum/addenda was/were issued, please insert N/A. ic-8().Q4ury, 714/? If Bidder has a Local Office, as defined under Chapter 18/Articlle III, Section 18-73 of the City Code, has Bidder filled out, notarized, and included with its bid response the "City of Miami Local Office Certification" form? YES OR NO? (The City of Miami Local Office Certification form is located in the Oracle Sourcing system ("iSupplier"), under the Header/Notes and Attachments Section of this solicitation) a/ Reference No. I: Name of Company/Agency for which bidder is currently providing the services/goods as described in this solicitation, or has provided such services/goods in the past: Clr\'‘lar-to Seivices Coui\Cil df Yrou*-r Gni/4*y Reference No. 1: Address, City, State, and Zip for above reference company/agency listed: (0000 Wes-t- Corc\fA-ertiA-i vd 1,ckoaerhiil I FL, 3-331q Page 3 of 41 Reference No, 1: Name of Contact Person, Telephone Number and Email for above reference no, 1 A dcoma Doc;11Q_ 95q. 377, 1k2 u c;)142.. s cs c6 Reference No. 1: Date of Contract or Sale for above reference no. 1 DA130IN 012-0/2,01 5ff1/7b0/ feAtixA-1 Reference No. 2: Name of Company/Agency for which bidder is currently providing the services/goods as described in this solicitation, or has provided such services/goods in the past: ekvicLv 14-0spt4-Pri Reference No. 2: Address. City, State, and Zip for above reference company/agency listed: 12c AI, f7 A-qe. 4)1kt wow) FL. 3302.1 Reference No. 2: Name of Contact Person, Telephone Number and Email for above reference no. 2 Alf oc\S,F) I4les 7 sc./ ,777, 5-boi co-x,cor‘,.ve si Reference No. 2: Date of Contract or Sale for above reference no. 2 av&oIA, 09/7W20 17 - I 17_0 q tc-e itl) Reference No. 3: 'Name of Company/Agency for which bidder is currently providing the services/goods as described in this solicitation, or has provided such services/goods in the past: /2._ It wrt Reference No, 3: Address, City, State, and Zip for above reference company/agency listed: -5D NE 33( d s+ Dak ir.fr\J ett,,k /rt, 57 .55'./ Reference No. 3: Name of Contact Person,Telephone Number and Email for above reference no. 3 5S- Reference No. 3: Date of Contract or Sale for above reference no. 3 vsipi171(. Line: 1 Description: Adult Care Food Program- IndividualIndividuaI ltemizcd Servings- Breakfast.(1nclusive of eating utensils, napkins and straws) The estimated number of units is based on the estimated total number of breakfast per day (50) times the estimated number of serving days per year (240). Category: 95218-00 Unit of Measure: Each Unit Price: $ S-0 Line: 2 Number of Units: 12,000 Total: S SY/ 00.0 Description: Adult Care Food Program- Individual Itemized Servings- Lunch.( Inclusive of eating utensils, napkins and straws) The estimated number of units is based on the estimated total number of Lunch Meals per day (50) times the estimated number of serving days per year (240). Category: 95218-00 Unit of Measure: Each Unit Price: $ Line: 3 Number of Units: 12,000 Total: $ 721 Description: Adult Care Food Program- Individual Itemized Servings-Supper.(Inclusive of eating utensils, napkins and straws) The estimated number of units is based on the estimated total number of Supper per day (30) times the estimated number of serving days per year (240). Category: 95218-00 Unit of Measure: Each Unit Price: $ 'CO Line: 4 Number of Units: 7,200 Total: Description: Adult Care Food Program- Individual Itemized Servings- AM Supplement (Inclusive of eating utensils, napkins and straws) The estimated number of units is based on the estimated total number of AM Supplement per day (50) times the estimated number of serving days per year (240). Category: 95218-00 Unit of Measure: Each Page 5 of 41. Unit Price: $12" ' ° ° Line: 5 Number of Units; 12,000 Total: $ 2--9( OPC) Description: Adult Care Food Program- Individual Itemized Servings- PM Supplement (Inclusive of eating utensils, napkins and straws) The estimated number of units is based on the estimated total number of PM Supplement per day (85) times the estimated number of serving days per year (240). Category: 95218-00 Unit of Measure: Each Unit Price: $ 0(7 Number of Units: 20,400 Yoi goo Total: S Page 6of41 ADULT CARE FOOD PROGRAM INVITATION TO BID (ITB) Purpose - This document contains an invitation to bid to furnish meals (unitized, if applicable) to be served to adults participating in the Adult Care Food Program (ACFP), a component of the Child and Adult Care Food Program established by the United States Department of Agriculture (7 CFR, Part 226), administered by the Florida Department of Elder Affairs and sets forth the terms and conditions applicable to the proposed procurement. tpon acceptance, this document and its required a ttachments shall constitute the contract between the bidder and the institution named herein. Increases and decreases in the number of meal orders may be made by the institution, as needed, within a prior notice period mutually agreed upon in the contract. Please Tv .)e or Print Clearly (in 1114 . &el Is if caL. nt of InstitiitionACFP Provider Address: -111.SIN 2n0 Ave. 6.0 Floorrrocarement Dept. Cit/State: 416 one: 305 ) 1916 ) Fax: Miami. FL Zip_ 3313( Tele ph Date of public bid opening: Location: acceptance) OTHER CONTRACT ormoNs Time: X Negotiated Initial Contract with State agency prior -approval (Vendor is on Approved Caterer List) lsr vearBidded Contract Renewal Option exercised* 2" year Bidded Contract Renewal Option exercised * ACFP Provider will submit three copies of this page to State Agency, fully executed by Institution and Vendor, with attachments: a. Debarment & Suspension Form recently completed by vendor, delivery schedule and current cycle menus for each meal b. Copy of Vendor's current Food Service Inspection Report from licensing agency and current license to operate c. Any other information needed, from either party, to update information in current food sers ice contract. RESPONSE TO INVITATION TO BID ,Vgine of filthier Ze E> rkcm r Naive of A tproved Food Service (or AlailingAddress 1.5151 seA.tiOtPe t.J71/ JlIyu Street Address (of kitchen Lirosid),ng meals) Cit,Otate: yerts.ltPr7C-1* et'/ Telephone: (lyti ) - 7%77 3 Fa (9Stk ) —7797 6. Contract Commence Date: Expiration Date: Brealfast: S LISD Supplement: AM S 2.150 PM S 2— °C) Lunch: Or- 51/4RPkr s if). no Note: price includes tax Sup per U tsS i 5. Bs se hniss- of this hid, the hidder certifies that, in the event he/she receiv award under this solicitation, he shall operate in accordan si h ail a iplica hie, current ACFP regulations. Bidder's Signature Total Bid Amount S ACCEPTANCE BY INSTITUTION/ACFP PROVIDER # ped or Printed Clearly 8. This contract must be approved by the Florida Department of Elder Affairs/ACFP Provider prior to commencement of food service. Pros ider's Signature: lAitness' Signature: Board President or ,Anthortzed Designee Title: Name: yped or Printed Clearly) Date: FLORIDA DEPARTMENT OF ELDER AFFAIRS/ACFP REPRESENTATIVE APPROVAL 9. Period of Provider Contract: DOE/ACFP REPRESENTATIVE Approved Date: Denied Date: 7/7 THIS CONTRACT is entered into between the food service provider t C, i \ A V Lc( (Al hereinafter referred to as the "Vendor", and the Adult Care Food Program provider 1 ' AA/ i , hereinafter referred to as the "Institution" and will comply with the Adult Care Food Program requirements administered by The Florida Department of Elder Affairs/Adult Care Food Program, hereinafter referred to as the "state agency". THE PARTIES AGREE: I. THE VENDOR AGREES: A. To provide services according to the conditions specified in Attachrnent(s) A & B. B. Federal Laws and Regulations I. This contract contains USDA federal funds, the vendor shah comply with the provisions of 7 CFR, 226, and other applicable regulations as specified in Attachment(s) A & B . 2. If this contract contains federal funding in excess of $100,000, the vendor shall comply with all applicable standards, orders, or regulations issued under Section 306 of the Clean Air Act, as amended (42 U.S.C. 1857(h) et seq.), Section 508 of the Clean Water Act, as amended (33 U.S.C. 1368 et seq.), Executive Order 11738, and Environmental Protection Agency regulations (40 CFR Part 15). The provider shall report any violations of the above to the department within ten (10) days of the discovery of any such violation. 3. The vendor shall comply with the provisions of the U.S. Department of Labor, Occupational Safety and Health Administration (OSHA) code, 29 CFR, Part 1910.1030. 4. If this contract contains federal funding in excess of $100,000, the vendor must, prior to contract execution, complete the Debarment, Suspension, Ineligibility and Voluntary Exclusion Certification form, Attachment _C., C. Civil Rights Certification 1. The vendor gives this assurance in consideration of and for the purpose of obtaining federal grants, loans, contracts (except contracts of insurance or guaranty), property, discounts, or other federal financial assistance to programs or activities receiving or benefiting from federal financial assistance. 2. The vendor assures that it will comply with: a. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et seq., which prohibits discrimination on the basis of race, color, or national origin in programs and activities receiving or benefiting from federal financial assistance. h. The Americans with Disabilities Act of 1990, 42 USC 12101, et. seq., which prohibits discrimination against, and provides equal opportunities for individuals with disabilities, in employment, public services, and public accommodations c. All regulations, guidelines, and standards as are now or may be lawfully adopted under the above statutes. 4 D. Indemnification If the vendor is a state or local governmental entity, pursuant to subsection 768.28 (18) Florida Statutes, the provisions of this section do not apply. 1. Vendor agrees that it will indemnify, defend, and hold harmless the institution and all of the institution's officers, agents, and employees from any claim, loss, damage, cost, charge, or expense arising out of any acts, actions, neglect or omission by the vendor, its agents, employees, or subcontractors during the performance of the contract, whether direct or indirect, and whether to any person or property to which the department or said parties may be subject, except that neither vendor nor any of its subcontractors will be liable under this section for damages arising out of injury or damage to persons or property directly caused or resulting from the sole negligence of the institution or any of its officers, agents, or employees. 2. Vendor's obligation to indemnify, defend, and pay for the defense or at the institution 's option, to participate and associate with the institution in the defense and trial of any claim and any related settlement negotiations, shall be triggered by the institution's notice of claim for indemnification to vendor. Vendor's inability to evaluate liability or its evaluation of liability shall not excuse vendor's duty to defend and indemnify the institution, upon notice by the institution. Notice shall be given by registered or certified mail, or return receipt requested. Only an adjudication or judgment after the highest appeal is exhausted specifically finding the institution solely negligent shall excuse performance of this provision by vendors. Vendor shall pay all costs and fees related to this obligation and its enforcement by the institution. Institution's failure to notify vendor of a claim shall not release vendor of the above duty to defend. E. Retention of Records I. To maintain books, records, and documents (including electronic storage media) in accordance with generally accepted accounting procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds, provided by the institution under the conditions of this contract. 2. To assure these records shall be available at all reasonable times for inspection, examination, review, duplication or audit by the state personnel and other personnel duly authorized by the state agency as well as by federal personnel pursuant to 226 CFR during the specified retention period. F. Monitoring Vendor's food services are subject to inspection by the institution, state agency or federal personnel. G. Assignments and Subcontracts To neither assign the responsibility of this contract to another party nor subcontract for any of the work contemplated under this contract without prior written approval of the state agency. No such approval by the state agency of any assignment or subcontract shall be deemed in any event or in any manner to obligate the institution beyond the total dollar amount agreed upon in this contract. All such assigrunents or subcontracts shall be subject to the conditions of this contract and to any conditions of approval that the department shall deem necessary. Subcontracting includes producing food from any kitchen other than from the location stated at the street address found in Section Fotu-(4) ofthe Invitation to Bid. 5 H. Invoice Vendor will provide an invoice for payment to the institution by the tenth of the month for services received during the previous month. Each invoice will reflect the .following information which is supported by the data on the vendor's, signed, daily delivery slips: Invoice Number Number of meals delivered during calendar month (See sample of vendor's delivery slips in Attachment 13) Vendor's billing cycle will include the first day through the last day of the calendar month. 11. THE INSTITUTION AGREES: A. Contract Amount To pay for vendor services according to the conditions of Attachment _A_ in an amount not to exceed the accepted and approved contract price, subject to the availability of funds. The Agency's performance and obligation to pay under this contract is contingent upon an annual appropriation by the legislature. B. Contract Payment Invoice payment requirements do not start until a properly completed invoice for services received during the calendar month is provided to the institution by the vendor. Unless otherwise stated in the contract between the vendor and the institution, payments made by the vendor to the subcontractor must be within seven (7) working days after receipt by the vendor of full or partial payments from the institution in accordance with section 287.0585, Florida Statutes. Failure to pay within seven (7) working days will result in a penalty charged against the vendor and paid to the subcontractor in the amount of one-half (1/2) of one (I%) percent of the amount due, per day from the expiration of the period allowed herein for payment. Such penalty shall be in addition to actual payments owed and shall not exceed fifteen (15%) percent of the outstanding balance due. III. THE VENDOR AND INSTITUTION MUTUALLY AGREE: A. Termination 1. Termination at Will This contract may be terminated by either party upon no less than thirty (30) calendar days notice, without cause, unless a lesser time is mutually agreed upon by both parties. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. 2. Termination Because of Lack of Funds In the event funds to finance this contract become unavailable, the institution may terminate the contract upon no less than twenty-four (24) hours notice in writing to the vendor. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. The state agency shall be the final authority as to the availability of funds. 6 3. Termination for Breach Unless the vendor's breach is waived by the institution in writing. or the vendor thils to cure the breach within the time specified by the institution, the institution may by written notice to the vendor, terminate this contract upon no less than twentyfour (24) hours notice. Said notice shall be delivered by certified mail, return receipt requested. or in person vvith proof of delivery. Waiver of breach of any provisions of this contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this contract. The provisions .herein do not limit the institutions right to remedies at law or to damages. • If the vendor accumulates ten (10) high priority findings in a 12-month period (July 1-June .3D), has an Administrative Complaint. ancLor closure (temporary or permanent) issued by DBPR, the contract will be terminated immediately and automatically without. further action from the Department. B. Notice and Contact 1. The natne, address and telephone number of the contact person for the institution for this contract is: otMiarm Institution contact 'Victoria Giraldo 444 SW 2nd Ave. 6th Floor, Miami, FL 416 ( 3(.5 ) nstitution address 1916 Est Institution telephone number Zi p 33130 2. The name, address and telephone number of the representative of the vendor responsible for administration of the program under this contract is: Vendor's telephone number 3. in the event that different representatives are designated by either party afler execution of this contract, notice of the name and address of the new representative will be rendered in writing to the other party and said notification attached to all originals of this contract, including the copy on file at office of state agency. C. Renegotiation or Modification 1. Modifications of provisions of this contract shall only be valid when they have been reduced to writing and dui_ signed. The parties agree to renegotiate this contract if federal and/or state revisions of any applicable laws, or regulations make changes in this contract necessary. 2. The rate of payment and the total dollar amount may he at Listed retroactively to reflect price level increases and changes in the rate of payment when these have been established through the appropriations process and subsequently identified in the department's operating budget unless otherwise specified in Attachment 41, 7 D. Name, Mailing and Street Address of Payee I. The name (vendor name as shown on page 1 of this comra.ct) and mailing address of the official payee to whom the payment shall be made: LI 7 /2. ct 17.E.11.1). 4 3(44)e k.k.)i--i Payee address 2. The name of the vendor contact person and street address wilele flnancial and administrative records are maintained: Name n (0S vendor's administrative contact vinA)i'th€' P.e zip gkai Address where vendor's financial & administrative records are stored/maintained 8 CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION CONTRACTS/SUBCONTRAC'TS This certification is required by the regulation implementing Executive Order 12549, Debarment and Suspension, signed February 18, 1986. The guidelines were published in the May 29, 1987, Federal Register (52 Fed. Reg., pages 2036020369). (1) The prospective provider certifies, by signing this certification, that neither he nor his principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in contracting with the Department of Elder Affairs by any federal department or agency. (2) Where the prospective provider is unable to certify to any of the statements in this certification, such prospective provider shall attach an explanation to this certification. Date 's Signature Namand Title of Authorized Individual Name ofOrganization C (})nq I I( vra 39 [lose (tddress is g clX;( C A (OW 0/ 17' voc Scrvice 1)Iclor is Agreement is made and entered into by and between 2 A) P liose address is ixicmorandom ot Aoreenletfl to F Furnish 1' ooU Se ce . 331.0Vame of Institution and the -tititrioo 's Acidres's IN *15 ftpxbaikt. D. e T 330z1 Fowl Service l'enOhr ' s A aOress to Food Service Vendor agrees to furnish meals from the above location daily, except for attached list of holidays or other days of in- )eration. elms will meet or exceed the Adult Care Food Program pattern, as outline in the ACFP Policy Manual, AC FP Food Crediting Guide and SDA Buying Guide, Menus will be created by:11 Adult Care Center or XTood Service Vendor. day menu cycle(s) for: breakfast am. snackX1unch (p.m. snack supper is are attached. [tacked menu cycle is the proposed tnenu cycle. Menu cycle must he approved by ACFP Conn act Manager prior to use. Adult Care Center Corporation:Institution must approve menucycle substitutions prior to meal service. Adult Care Center or Corporation./InstitUt I011 Will not 1Y for unapproved, inappropriate menu substitutions. )od Service Vendor will provide meals in tilk or LI. individual containers. Each container must be labeled with meal type, food item, date 'prQduction. and serving size. If meals are provided in bulk, appropriate rnetsured serving utensils will be provided by: Adult Care Center Food Service Vendor. calill be: picked up by Adult Care Center or delivered by Food Service Vendor. eak will be: 7 available for pick up at (+7- 1.0 minutes) or -livered by Food Service Vendor at ..):12(2,11/1"i 10 minutes). Adult Care Center or Corporation/Institution may not pay for meals provided outside approve( tittle Frame. iod safe, transportation containers capable of maintaining potentia1ly. hazardous hot .food at 140 deurees F or above, and potentially tzardous cold .foods at 41 deuces F. or below, will be provided in an adequate quantity by: t. Adult Care Center or )<Food Service Vendor. (ilt Care Center will ensure potentiallyhazardous foods are received at appropriate temperatures and will ensure appropriate temperatures e vita intained prior to serving. Adult Care Center will not accept nor pay for potentially hazardous foods delivered or picked up at the correct temperature. or Weekly delivery slips, in accordance with ACFP policy 5,14 or 6.15 will be created by:11. Adult Care Center or Food Service Vendor. and will be used. Adult Care Center will ensure delivery slips are in accordance with ACFP policy. -.)ocl Service Vendor will submit billing invoice for payment within 30 days, Invoice will be mailed to: ).KA.dult Care Center address or as Care Corporation 'Institution address or I other: • and Service Vendor agrees to furnish meals. complete with required Japer products, k-z: o n di m c nt s and.>..tifiilk pursuant to the following: :Name of Institution and Address of the facility Projected 4 of Daily Meals linit Price ..- Delive -‘,' tr Pick up Time Site I €) Ckt' t6i_. re VIA. 4-er IN A bcOic-,0 , ,f Breakfast: AM Snack: - Lunch: PM Snack: - Supper: Breakfast: LI, So AM Snack:. 1.- ,-60 Breakfast: AM Snack: Lunch: PM Snack: Supper: WOO A,Ai aLe>04.44 Lunch: a 6 .00 PM Snack:0z . DO Supper: (0. 90 Site-, 2 and Service Vendor will maintain receipts, cost determination records and product on records for a period of three (6) years after the end of [e aercement period to which they pertain. These records will be made available to Adult Care Center, Day Care Corporation'Institution. que AL,enQ, USDA and / or the Comptroller' s Office tor audit purposes. his Agreement covers the period of 9444/ . 20.1 throuo).8 ?_[ 2021). Period will not exceed 36a days. anv reason, this agreement is no longer desired, either party may terminate these services by giving two weeks written notice. 'the Food Service Vendor has an accumulation of 1.0 high priority violations (July 1-ittne 30), an Administrative Complaint. and/or closure sued by DBPR, .this agreement will be terminated immediately and automatically without further action from the Department, /Fr-NESS WHEREOF; The parties hereto have caused this agreement to be executed bytheir duly authorized officers: Bv: Witness: ane Dav Care Corporation / institution Witness to Day Care COrporai ion 77usiiint ion ,4u )ri.:eci Representative ' ..s• signature Witncss: ndor ness to Foo7 7 Service rend -or A utT7T.'iri:e"c7 epremnitat ire ' signature Itached: -Excluded holidays or inoperative days -Current Food Service Inspection Report -28 day menu Cycle SDDC Adult Day Care August 5, 2019- August 11, 2019 BREAKFAST Week 1 MON BKFST: French toast 2 slices whole wheat, watermelon 1/2 cup, 1% milk 8oz., syrup TUES BKFST: Hard boiled eggs 2 each, orange slices 1/2 cup, 1% milk 8oz. WEDS BKFST: Cereal 1 cup, banana whole, 1% milk 8oz. THURS BKFST: Sausage (1oz.), eggs (2) and cheese croissant (2.8oz), hash browns 1/2 cup, 1% milk 8oz. FRI BKFST: Bagel 2.8oz., cream cheese 1oz., fruit salad 1/2 cup, 1°/0 milk 8oz. SAT BKFST: Whole grain oatmeal 1 cup, berries 1/2 cup, milk 1% 8oz. SUN BKFST: Biscuit 2oz., scrambled eggs (2), roasted potatoes 1/2 cup, 1% milk 8oz., jelly packet SDDC Adult Day Care August 5, 2019 August 11, 2019 AM SNACK Week 1 MON SNACK: Yogurt 4oz., blueberry muffin TUES SNACK: Hummus I/4 cup, celery sticks % cup WEDS SNACK: Hardboiled eggs 2 each, 1 whole banana THURS SNACK: Cottage cheese IA cup, pineapple % cup FRI SNACK: Cornbread, watermelon IA cup SAT SNACK: Fruit parfait (4oz. Yogurt, with IA cup mixed berries) SUN SNACK: Diced cantaloupe IA cup, banana nut bread 1 slice SDDC Adult Day Care August 5, 2019- August 11, 2019 LUNCH Week 1 MON LUNCH: Beef hot dogs (2ea), green beans 'A cup, baked beans 'A cup, watermelon 1/2 cup, 2 whole wheat buns, 1% milk 8oz., ketchup, mustard TUES LUNCH: Shredded chicken tacos (2ea), corn 1/2 cup, yellow rice 1/2' cup, apple sauce 1/2 cup, 2 whole wheat tortilla, 1% milk 8oz. Topping: lettuce, tomato, cheese, salsa, sour cream WEDS LUNCH: Hamburger 2.4oz 100% ground beef, macaroni & cheese 1/2 cup, potato salad 1/2 cup, mixed veggies 1/2 cup, 1% milk 8oz., whole enriched bun Topping: lettuce, tomato, onion, cheese, ketchup, mustard THURS Lunch: Meatballs garlic parm 3oz, sweet potatoes % cup, steamed broccoli 1/2 cup, dinner rolls 2 each, 1% milk 8oz. FRI LUNCH: Grilled chicken strips 3oz, brown rice 1/2 cup, peas 1/2 cup, pear slices 1/2 cup, dinner rolls 0.9oz, 1% milk 8oz. SAT LUNCH: Penne pasta 1/2 cup, ground beef with marinara 3oz., garlic toast 1 slice 1.75oz, steamed carrots 1/2 cup, sliced mandarins % cup, 1% milk 8oz. SUN LUNCH: Turkey sub 3oz with cheese slice, potato salad 1/2 cup, apple sauce 1/2 cup, 6in. sub bun, 1% milk 8oz. Toppings: Lettuce, tomato, onion, mustard, mayo SDDC Adult Day Care August 5, 2019 - August 11, 2019 PM SNACK Week 1 MON SNACK: Yogurt 4oz., 1 whole banana TUES SNACK: Applesauce IA cup, cornbread 2oz. WEDS SNACK: Pineapple chunks % cup, cottage cheese % cup THURS SNACK: Blueberry muffin, berries % cup FRI SNACK: 2 mini bagels 2oz., cream cheese 1oz. SAT SNACK: Strawberries % cup, yogurt 4oz. SUN SNACK: Peanut butter 2 tbsp, biscuit 2oz. SDDC Adult Day Care August 5, 2019- August 11, 2019 SUPPER Week 1 MON SUPPER: Chicken parmesan 3oz., mashed potatoes 1/2 cup, steamed carrots 1/2 cup, dinner rolls 2 each, 1`)/0 milk 8oz. TUES SUPPER: Apple teriyaki salmon 3oz., stir fry veggies 1/2 cup, orange slices 1/2 cup, rice 1/2 cup, dinner roll 1oz., 1% milk 8oz. WEDS SUPPER: Mojo pork 3oz., rice % cup, black beans 1/4 cup, mixed veggies % cup, caesar salad 1 cup, dinner roll 1oz., 1`)/0 milk 8oz. THURS SUPPER: Fajita chicken breast strips 3oz., roasted onion and bell peppers 1/2 cup, steamed broccoli 1/2 cup, yellow rice 7/2 cup, dinner roll 1oz., 1% milk 8oz, FRI SUPPER: Ground beef hamburger 4oz, corn 1/2 cup, potato salad 1/2 cup, baked beans 1/4 cup, whole wheat hamburger bun 2.2oz, 1°/0 milk 8oz. Topping: lettuce, tomato slices, cheese, ketchup, mayo, mustard SAT SUPPER: Baked chicken legs 2 each., au gratin potatoes 1/2 cup, green peas 1/2 cup, cornbread 2.2oz., milk 1% 8oz., bbq sauce SUN SUPPER: Grilled steak 3oz., 1baked potato, broccoli and cheddar cheese sauce 1/2 cup, garlic toast 1.8oz., 1°/0 milk 8oz., steak sauce SDDC Adult Day Care August 12, 2019- August 18, 2019 BREAKFAST Week 2 MON BKFST: Waffles 2 each, roasted sweet potatoes % cup, 1% milk 8oz., syrup TUES BKFST: Cereal 1 cup, strawberries % cup, 1% milk 8oz. WEDS BKFST: Bagel 2.8oz., cream cheese 1oz., cheesy hash brown casserole % cup, 1% milk 8oz. THURS BKFST: Hard boiled eggs (2), cantaloupe % cup, 1% milk 8oz. FRI BKFST: Scrambled eggs (2), biscuit 2.8oz, roasted potatoes 1/12 cup, 1% milk 8oz. SAT BKFST: Grits % cup, toast whole wheat 1 slice, fruit cocktail % cup, milk 1% 8oz., jelly packet SUN BKFST: Cereal 1 cup, banana whole, 1% milk 8oz. SDDC Adult Day Care August 12, 2019 - August 18, 2019 AM SNACK Week 2 MON SNACK: Peanut butter 2tbs., celery sticks % cup TUES SNACK: Yogurt 4oz., 1 whole banana WEDS SNACK: Watermelon 1/2 cup, carrot bread 1 slice THURS SNACK: Apple cinn, Muffin, sliced mandarins % cup FRI SNACK: 6in. pita sliced, hummus IA cup SAT SNACK: Bagel 1 whole 2.8oz., cream cheese 1 oz. SUN SNACK: Fruit salad, yogurt 4oz. SDDC Adult Day Care August 12, 2019 - August 18, 2019 LUNCH Week 2 MON Lunch: Baked spiral ham 3oz., au gratin potatoes % cup, green beans 1/2 cup, biscuit 2.5oz., 1% milk 8oz. TUES LUNCH: Ground beef tacos 3oz, corn % cup, yellow rice % cup, fruit cocktail % cup, whole wheat tortilla 6in. 2 each, 1% milk 8oz. Topping: lettuce, tomato, cheese, sour cream, salsa WEDS LUNCH: Mojo grilled chicken strips 3oz., brown rice % cup, black beans 1/2 cup, mixed veggies 1/2 cup, apple sauce % cup, cuban bread 0.9oz., 1% milk 8oz. THURS DINNER: Meatballs bbq sauce 3oz., mashed potato % cup, steamed carrots % cup, cornbread 2.2oz, 1% milk 8oz. FRI LUNCH: Grilled chicken 3oz alfredo sauce, fettuccine % cup, steamed broccoli % cup, apple sauce % cup, 1 garlic toast 1.75oz., 1c)/0 milk 8oz. SDDC Adult Day Care August 12, 2019 - August 18, 2019 PM SNACK Week 2 MON SNACK: Cheese cubes 2oz., grapes 1/2 cup TUES SNACK: Yogurt 4oz., blueberry muffin WEDS SNACK: Diced pears 1/2 cup, croissant 2oz, THURS SNACK: Peanut butter 2tbsp, muffin 2oz. FRI SNACK: Cornbread 2oz., watermelon IA cup SAT SNACK: Yogurt 4oz., 1 whole banana SUN SNACK: Peach slices IA cup, cottage cheese 1/2 cup SDDC Adult Day Care August 12, 2019- August 18, 2019 SUPPER Week 2 MON SUPPER: Ground beef lasagna 5oz. (2oz. Ground beef, 3oz. pasta), steamed carrots 1/2 cup, caesar salad 1 cup, garlic toast 1.75oz., 1% milk 8oz. TUES SUPPER: Chicken marsala 3oz., sliced mushrooms % cup, mashed potatoes 1/2 cup, 2 dinner rolls 2oz., 1% milk 8oz, WEDS SUPPER: Crispy cod 3oz. Au gratin potatoes % cup, green beans 1/2 cup, biscuit 2.8oz., 1`)/0 milk 8oz., tartar sauce THURS SUPPER: Grilled pork chop 3oz., brown rice 1/2 cup, steamed broccoli % cup, dinner roll 1oz., 1% milk 8oz. FRI SUPPER: Ground beef hamburger 4oz. corn 1/2 cup, potato salad 1/2 cup, baked beans 1/4 cup, whole wheat hamburger bun 2.2oz, 1(3/0 milk 8oz. Topping: lettuce, tomato slices, cheese, ketchup, mayo, mustard SAT SUPPER: Lemon pepper baked chicken breast 3oz., 1 baked potato, peas and carrots 1/2 cup, 2 dinner rolls 2oz., milk 1% 8oz., sour cream, butter SUN SUPPER: Boneless skinless chicken thigh 3oz. with teriyaki sauce, rice IA cup, stir fry veggies % cup, diced pineapple 1/2 cup, dinner roll 1oz., 1% milk 8oz. SDDC Adult Day Care August 19, 2019- August 25, 2019 BREAKFAST Week 3 MON BKFST: Ham (1oz.) egg (2) and cheese croissant (2.2oz.), hash browns IA cup, 1% milk 8oz. TUES BKFST: Scrambled eggs (2) with bacon bits, toast 1 slice whole wheat, watermelon 'A cup, 1% milk 8oz., jelly packet WEDS BKFST: Oatmeal 1 cup, berries 'A cup, 1% milk 8oz. THURS BKFST: Cereal 1 cup, whole banana, 1% milk 8oz. FRI BKFST: Bagel 2.8oz, cream cheese loz. roasted potatoes IA cup, 1% milk 8oz. SAT BKFST: Scrambled eggs 2, bacon strips 2, biscuit 2oz., cheesy hash brown casserole IA cup, milk 1% 8oz. SUN BKFST: Frech toast 2 whole wheat, fruit salad IA cup 1% milk 8oz., syrup SDDC Adult Day Care August 19, 2019 - August 25, 2019 AM SNACK Week 3 MON SNACK: Blueberry muffin, cottage cheese % cup TUES SNACK: Berries % cup, yogurt 4oz. WEDS SNACK: Croissant 2.5oz., cream cheese 1oz. THURS SNACK: : Fruit cup 1/2 cup, banana nut bread 1 slice FRI SNACK: Fruit parfait ( 1/2 cup fruit, 1/2 cup yogurt) SAT SNACK: fruit cocktail % cup, cornbread slice 2oz. SUN SNACK: Apple sauce % cup, carrot bread 1 slice SDDC Adult Day Care August 19, 2019 - August 25, 2019 LUNCH Week 3 MON LUNCH: Tuna salad 3oz. Sandwich, potato salad 1/2 cup, fruit cocktail 1/2 cup, whole wheat buns 2.1oz, 1`)/0 milk 8oz. TUES LUNCH: Shredded chicken tacos 3oz., yellow rice 1/2 cup, watermelon 1/2 cup, corn '/2 cup, 6in. Tortillas 2 each, 1% milk 8oz. Topping: lettuce, tomato, cheese, salsa, sour cream WEDS LUNCH: BBQ chicken 3oz., macaroni salad 'A cup, green beans 1/2 cup, apple sauce 1/2 cup, dinner roll 0.9oz, 1% milk 8oz. THURS LUNCH: Ground beef hamburger 2.4oz., mashed potatoes 1/2 cup, mixed veggies 1/2 cup, buns 2.2oz., 1% milk 8oz. Topping: lettuce, onion, tomato, cheese, ketchup, mustard FRI LUNCH: Chicken teriyaki 3oz., lo mein noodles % cup, steamed broccoli, cantaloupe 1/2 cup, dinner roll 0.9oz., 1% milk 8oz. SAT LUNCH: Crispy chicken sandwich 3oz., au gratin potatoes % cup, steamed carrots 1/2 cup, buns 2.2oz., 1% milk 8oz. Topping: lettuce, tomato, cheese, bbq sauce, ketchup SUN LUNCH: Meatballs 3oz. Garlic parm, mashed potato 1/2 cup, peas 1/2 cup, dinner rolls 2 each, 1% milk 8oz. SDDC Adult Day Care August 19, 2019 - August 25, 2019 PM SNACK Week 3 MON SNACK: 1% milk 8oz., whole grain cereal 1 cup TUES SNACK: Fruit Parfait ( % cup berries, 4oz. yogurt) WEDS SNACK: Cornbread 2oz., sliced oranges 1/2 cup THURS SNACK: Muffin, 1 whole banana FRI SNACK: Yogurt 4oz., strawberries % cup SAT SNACK: Biscuit loz., sliced pears % cup SUN SNACK: Apple sauce % cup., peanuts 2oz. SDDC Adult Day Care August 19, 2019- August 25, 2019 SUPPER Week 3 MON SUPPER: Ground beef 2oz. with marinara sauce, penne pasta IA cup, steamed carrots IA cup, apple sauce I/2 cup, garlic toast 1.75oz., 1% milk 8oz. TUES SUPPER: Ground beef 3oz., macaroni I/2 cup, green peas IA cup, caesar salad 1 cup, dinner roll 1oz., 1% milk 8oz. WEDS SUPPER: Beef tips 3oz. with brown gravy, mashed potatoes I/2 cup, green beans IA cup, biscuit 2.8oz., 1`)/0 milk 8oz. THURS SUPPER: Grilled chicken breast strips 3oz., rice pilaf I/2 cup, steamed broccoli 1/2 cup, corn 1/2 cup, dinner roll 1oz., 1% milk 8oz. FRI SUPPER: Shredded beef brisket 3oz. with bbq sauce., sweet potatoes I/2 cup, peas and carrots I/2 cup, cornbread 2.2oz., 1% milk 8oz. SAT SUPPER: Mango salsa tilapia 3oz., brown rice % cup, boiled yucca % cup, plantains % cup, dinner roll 1oz., milk 1% 8oz. SUN SUPPER: Monterey chicken breast 30z. (Grilled chicken breast with bbq sauce and shredded melted cheese), steamed broccoli 1/2 cup, fruit cocktail % cup, garlic toast 1.8oz., 1% milk 8oz. SDDC Adult Day Care August 26, 2019- September 1, 2019 BREAKFAST Week 4 MON BKFST: Cereal 1 cup, strawberries IA cup, 1% milk 8oz. TUES BKFST: Bkfst burrito (2 eggs, 1 oz. bacon, cheese, and 8in. whole wheat tortilla), roasted sweet potatoes I/2 cup, 1% milk 8oz. WEDS BKFST: Bagel 2.8oz., cream cheese 1oz., watermelon 1/2 cup 1% milk 8oz. THURS BKFST: Pancakes 2 whole wheat, sausage links (2), hash browns I/2 cup, 1°./0 milk 8oz., syrup FRI BKFST: Scrambled eggs (2), Biscuit 2.8oz., fruit salad IA cup, 1% milk 8oz. SAT BKFST: Hard boiled eggs 2, toast whole wheat 2 slices., orange slices I/2 cup, milk 1% 8oz., jelly packet SUN BKFST: Grits IA cup, scrambled eggs 2, roasted potatoes 1/2 cup, 1% milk 8oz. SDDC Adult Day Care August 26, 2019 - September 1, 2019 AM SNACK Week 4 MON SNACK: Watermelon 1/2 cup, hard boiled eggs 2 each TUES SNACK: Yogurt 4oz., banana whole 1 WEDS SNACK: Cheese cubes 1.5oz, grapes 1/2 cup THURS SNACK: : Pasta salad 1/2 cup, diced ham 1oz. FRI SNACK: Cucumber slices 1/2 cup, hummus 1/4 cup SAT SNACK: Peanut butter 2tbsp, celery sticks 1/2 cup SUN SNACK: Bagel sliced 2.8oz., cream cheese 1oz. SDDC Adult Day Care August 26, 2019 - September 1, 2019 LUNCH Week 4 MON LUNCH: Grilled pork chops 3oz., mashed potatoes 1/2 cup, apple sauce IA cup, cornbread 2.2oz, 1`)/0 milk 8oz., bbq sauce TUES LUNCH: Shredded beef brisket 3oz. Tacos, yellow rice 1/2 cup, corn IA cup, pears slice IA cup, tortilla 6in. 2 each, 1% milk 8oz. Topping: lettuce, tomato, cheese, sour cream, salsa WEDS LUNCH: Shredded bbq chicken breast 3oz., peas and carrots I/2 cup, potato salad 1/2 cup, buns 2.2 oz, 1% milk 8oz. Topping: lettuce, onions, cheese THURS LUNCH: Salisbury steak 4oz., mash potatoes 1/2 cup, green beans 1/2 cup, biscuit 2.5 oz, 1% milk 8oz. FRI LUNCH: Meatballs 3oz. Marinara, spaghetti IA cup, steamed carrots I/2 cup, caesar salad 1 cup, garlic toast 1.75oz., 1`)/0 milk 8oz. SAT DINNER: Ground beef lasagna 5oz,, baked potato 1 each, steamed broccoli 1/2 cup, dinner roll 0.9oz, 1% milk 8oz. SUN LUNCH: Turkey burger 3oz., corn 1/2 cup, orange slices 1/2 cup, baked beans 1/2 cup, whole wheat buns 2.2oz., 1% milk 8oz. Topping: lettuce, onion, tomato, ketchup, mustard SDDC Adult Day Care August 26, 2019 - September 1, 2019 PM SNACK Week 4 MON SNACK: Cinnamon apple muffin, apple sauce % cup TUES SNACK: Fruit cocktail, cornbread 2oz. WEDS SNACK: Yogurt 4oz., carrot bread slice THURS SNACK: : Whole wheat graham cracker 4 pcs 1oz., peach slices % cup FRI SNACK: Cottage cheese % cup, pineapple chunks % cup SAT SNACK: Blueberry muffin, 1 whole banana SUN SNACK: Strawberries % cup, muffin 1oz SDDC Adult Day Care August 26, 2019- September 1, 2019 SUPPER Week 4 MON SUPPER: Grilled chicken breast strips 3oz. with alfredo sauce, Fettuccine pasta 1/2cup, steamed broccoli 'A cup, caesar salad 1 cup, garlic toast 1.75oz, 1% milk 8oz. TUES SUPPER: Pesto baked chicken breast 3oz., baked potato 1, mixed veggies % cup, dinner rolls 2, 1% milk 8oz., sour cream and butter WEDS SUPPER: Baked spiral ham 3oz., au gratin potatoes 'A cup, macaroni and cheese I/2 cup, peas and carrots % cup, dinner roll 1oz., 1% milk 8oz. THURS SUPPER: Baked chicken leg 2 each, corn % cup, sweet potato % cup, cornbread 2.2oz, 1% milk 8oz., bbq sauce FRI SUPPER: Pork lechon 3oz., rice IA cup, black beans 1/4 cup, mixed veggies IA cup, fruit cocktail 1/2 cup, dinner roll 1oz., 1% milk 8oz. SAT SUPPER: Crispy cod fish 3oz., macaroni and cheese % cup, green beans % cup, mashed potatoes % cup, dinner roll loz. milk 1% 8oz., tartar sauce SUN SUPPER: Country fried steak 4oz., mashed potatoes IA cup, peas and carrots % cup, biscuit 2.8oz., 1`)/0 milk 8oz., country white gravy SDDC SPECIAL IIET SAMPLE Diabetic LUNCH: Grilled chicken breast 3oz, steamed broccoli % cup, cucumber slices 1/2 cup, rice % cup, dinner roll whole wheat 1 oz., 1% milk 8oz. SNACK: Baby carrots % cup, hummus % cup Low Sodium LUNCH: Grilled chicken breast Mrs. Dash no salt seasoning 3oz., steamed broccoli no salt % cup, cucumber slices no salt % cup, rice no salt % cup, dinner roll whole wheat low sodium 1oz, 1% milk 8oz. SNACK: Fruit cocktail % cup, hard boiled eggs 2 each Boxed Lunch LUNCH: Turkey sliced 3oz., 2 slices whole wheat bread, potato salad % cup, fruit salad % cup, 1% milk 8oz., tomato slice, lettuce, mustard, and mayo on side with box. SNACK: Blueberry muffin, peach slices % cup Picnic LUNCH: Turkey sliced 3oz., 2 slices whole wheat bread, apple sauce % cup, pears diced % cup, 1`)/0 milk 8oz., tomato slice, lettuce, mustard, and mayo on side SNACK: Peanut butter 2 tbsp, celery sticks % cup Holiday Menu LUNCH: Roasted Turkey breast 2oz., mashed potatoes % cup, green beans % cup, mac and cheese % cup, 1 dinner roll whole wheat 1oz, 1% milk 8oz., gravy on side % cup each SNACK: Blueberry muffin, fruit salad % cup Vegan LUNCH: Grilled tofu 3oz., steamed broccoli % cup, corn % cup, rice % cup, dinner roll whole wheat 'I oz., almond milk 8oz. SNACK: hummus 1/4 cup, celery sticks % cup Office: 754-610-4373 DAILY DELIVERY SLIP Delivery site: SDDC Today's Date: August 12th, 2019 Delivery time: 10:58am Number of meals lunch delivered: 50 Number of meals snack delivered: 80 Lunch Menu Serving Size Delivery Temperature Count Baked Spiral Ham 3oz 155 1 full deep pan Au Gratin Potatoes % cup 155 2 half deep pans Green Beans % cup 155 2 half deep pans Biscuit 2.5 oz 155 1 full deep pan 1% milk 8oz 40 50 each Snack Menu Serving Size Delivery Temperature Count Peanut Butter 2 tablespoons n/a 80 count Celery Sticks 1/2 cup 40 80 count Meals Received by: SDDC Meals Delivered by: Red Chair Catering LLC Office: 754-610-4373 WEEKLY DAILY DELIVERY SLIP Menu Cycle: Week 1 Delivery Site: SDDC Day Lunch Menu & Delivery Temp Serving/Portion Size Amount Delivered Date Signatures Monday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Tuesday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Wednesday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Thursday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Friday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Saturday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC >-• ra 73 c = ir) # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Day Snack Menu & Delivery Temp Serving/Portion Size Amount Delivered Date Signatures >-. co TO C o 2 # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Tuesday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Wednesday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Thursday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC ›- co 7 E u_ # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Saturday # Meals: Time: Name/SDDC Name/Red Chair Catering LLC # Meals: Time: Name/SDDC Name/Red Chair Catering LLC Comments: RON DESANTIS, GOVERNOR LICENSE' u HALSEY BESHEARS, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS NOS1623916 NBR . OF SEATS: 0 The NON -SEATING FOOD SERVICE (2010) Named below IS LICENSED Under the provisions of Chapter 509 FS. Expiration date: DEC 1, 2019 RED CHAIR CATERING LLC RED CHAIR CATERING 3944B PEMBROKE RD PEMBROKE PARK FL 33023 ISSUED: 01/15/2019 DISPLAY AS REQUIRED BY LAW NON- TRANSFERABLE. SFQ # 1_1901150000673 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft, Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1,2018 THROUGH SEPTEMBER 30, 2019 DBA: Business Name: RED CHAIR CATERING Owner Name: RED CHAIR CATERING LLC Business Location: 3944 PEMBROKE RD PEMBROKE PARK Business Phone: 7546104373 Rooms Seats Employees Receipt #:,.AZE0 1; -71— 27UPV TAKE OUT Business Type: Business Opened:03/01/2016 State/County/CertJReg:NOS1623916 Exemption Code: Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 45.00 0.00 0.00 0.00 0.00 0.00 45 . 00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: JOE GRENAT 2631 LEE ST HOLLYWOOD, FL 33020 This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2018 - 2019 Receipt #WWW-17-00164006 Paid 08/15/2018 45.00 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2018 THROUGH SEPTEMBER 30, 2019 DBA: RED CHAIR CATERING Business Name: Owner Name: RED CHAIR CATERING LLC Business Location: 3944 PEMBROKE RD PEMBROKE PARK Business Phone: 7546104373 Rooms Seats Employees Receipt #: 173-275353 Business Type: TAKE OUT FOODS Business Opened:03/01/2016 State/County/Cert/Reg: NOS 1623916 Exemption Code: Machines Professionals Signature For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 45 . 00 0.00 0.00 0.00 0.00 0.00 45 . 00 Receipt #WWW-17-00164006 Paid 08/15/2018 45.00 CERTIFICATE OF USE 2018 - 2019 TOWN OF PEMBROKE PARK 3150 S.W. 52r7Nd Avenue Pembroke Park Florida 33023 Local Location: 39443 REMB RD Name Of Business/Mailing Address: RED CHAIR CATERING RED CHAIR CATERING LLC 2631 LEE STREET HOLLYWOOD FL 330200000 Type of Business/Limitations RESTAURANT -TAKE OUT FOOD Account No 113315 Fee S 52.50 Del. Penalty $ Date Paid Name of Business RED CHAIR CATERING Is Hereby Engaged In The Business Profession or Occupation Of RESTAURANT -TAKE OUT FOOD I Location: 39443 PEMB RD Name Of Business/Mailing Address: RED CHAIR CATERING RED CHAIR CATERING LLC 2631 LEE STREET HOLLYWOOD FL 330200000 Business Tax Receipt Oct. 1, 2018 To Sept. 30, 2019 TOWN OF PEMBROKE PARK 3150 S.W. 52nd Avenue Pembroke Park Florida 33023 Receipt No. 19-113315 Account No, 113315 Fee $ 52 50 Del. Penalty $ 1/2 year Date Paid e (.c) NOTICE: In the event the business for which this receipt was issued changes hands, said receipt may he transferred within 30 days of such change or will become null and void. All personal tax due on said business must be paid before such transferwill be granted. This Receipt Must Be Posted In A Conspicuous Place JOSH SCHULDINER arlirca lane i n IXnira(ion Uaic AIR© CERTIFICATE OF LIABILITY INSURANCE DATE(MNI/DD/YYYY) 07/12/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the poiicy(Ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Automatic Data Processing Insurance Agency, Inc, 1 Adp Boulevard Roseland NJ 07068 CONTACT NAME: PHONE 1 FAX (A/C No Ext): 1 (NC, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC k INSURER A : Hartford Casualty Insurance Company 29424 INSURED RED CHAIR CATERING LLC 3944E PEMBROKE RD Hollywood FL 33020 INSURER B : INSURER C: INSURER D: INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 1210969 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. --- -ADM IN§R LTR TYPE OF INSURANCE INSR .SUER WVD POLICY NUMBER ' POLICY EFF (MM/DD/YYYY) POLICY EXP IMM/DO/YYYY) LIMITS L_ ! COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR 6AMTGETG71-ENTE6 PREMISES Ea occurrence) I— 1' MED EXP (Any one person) $ GEN'L AGGREGATE LIMIT APPLIES PER PERSONAL & ADV INJURY 1 GENERAL AGGREGATE $ $ POLICY OTHER JE __.. i LOC PRODUCTS - COMP/OP AGG $ AUTOMOBILE .,,,,, LIABILITY ANY AUTO OWNED SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident)_ BODILY INJURY (Per person) $ _.. $ BODILY INJURY (Per accident)S PROPERTY DAMAGE ,_ _(per accident) $ UMBRELLA LIAR EXCESS LIAR O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED I RETENTON$ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNEREEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) 11 yes. describe under DESCRIPTION OF OPERATIONS belev+ Y/ N Y N/A N 76WEGZR9988 CTH- STATUTE ER 01/01/2019 01/01/2020 E L EACH ACCIDENT S 100,000 ----.:--------------------------- E.L. DISEASE - EA EMPLOYE ------------- $ 100,000 __...,... E DISEASE - POLICY LIMIT _-.....---.-__...__.- ._.._. $ 500,000 j I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) CERTIFICATE HOLDER CANCELLATION INSURED COPY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACO/ZL' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 07/12/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER. THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE. A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Veracity Insurance Solutions, LLC. 260 South 2500 West, Suite 303 Pleasant Grove UT 84062 NSURED Red Chair Catering, OBA Red Chair Catering 3944E & 3948A Pembroke Rd Hollywood FL 33021 CONTACT FLIP Program Support NAME. PHONE 844 520 6992 nooss: nfo(c fliprogram.com INSURER B INSURER C INSURER E INSURER F : FAX INSURERISI AFFORDING COVERAGE. Great American Alliance Insurance Co. NAIC fr COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ....... O ...._ _.... ._... _. .... __. Y IlTD TYPE OF INSURANCE gROTAT" POLICY NUMBER (MM/OOIYYYVI (MMDDIYYYY) LIMITS GENERAL LIABILITY X COMMERCIAL. GENERAL LIABILITY X CLAIMS.MADE X OCCUR I A PL2260060-F070037 06/01/2019 86/0112020 GEN'L AGORLG.Art.LIMITAPPLIG. I PER X .oLICY PRCA LOC JECT EACH OCCURRENCE & PM SESOFaENTED RF,MED EXP (Any one person) S _ PERSONAL & ADV INJURY s GENERAL. AGGREGATE 5 PRODUCTS - CCM0 tOP AGO S ANIMAL BAILEE a 1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000 AUTOMOBILE LIABILITY I'-- �_ __.' . ANY AUTO ALL OWNED SCHEDULED '. ' AUTOS AUTOS _ _ _.... NON OWNED FARED AUTCS _, AUTOS ICOMBINED SINGLE LIMI' (E dnt) S .... I BODILY INJURY (Per person) S BODILY INJURY (Per accidr':nl). S PROPERLY DAMAGE .._.. 5 .. ;_(F'.r aradeat).. _.... . ....... UMBRELLA LIAR OCCUR EXCESS LIAR CLAIMS MADE DED RETENTIQNS EACH OCCURRENCE S AGGREGATE 5 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFrtCE/MEMBER EXCLUDCD? J N L A (Mandatory In NH) IPTIONe under It DEes SCRIPTION GE,SCWPTI(}ry Or OPEn.AtlDNf, pal4vx WC STATU- .OTH-.. E L EACH ACCIDENT 5 _ ..._._ ...... E L DISEASE - EA EMPLOYEE 5 E.L. QI5EASE -POLICY LIMIT S _........ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD t51„ AdditionaI Remarks Schedule, if more space is requerd) Certificate holder had been added as additional insured regarding the above mentioned policy per attached Additional Insured - Designated Person or Organization (CG 20 26 Ed. 04 13) CERTIFICATE HOLDER CANCELLATION City of Miami 444 SW 2nd Ave Miami, FL 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) INS025 1201 00 1958-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FLORIDA AUTOMOBILE INSURANCE IDENTIFICATION CARD COMPANY:Cove's:rm.:0 Employees Insurance Company POLICY #: 91002607270C 09245 EFFECTIVE DATE: 07-13-2019 PERSONAL INJURY PROTECTION X BENEFITS 1 PROPERTY DAMAGE LIABILITY NAMED INSURED: RED CHAIR, LLC YEAR: 2008 MAKE: FORD BODILY INJURY X I LIABILITY L VIN 0:1FMNE11W68DA99181 FLEET COVERAGE: (If more than 25 vehicles insured) NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE FLORIDA AUTOMOBILE INSURANCE IDENTIFICATION CARD COMPANY: VOID POLICY it: VOID EFFECTIVE DATE: VOID r PERSONAL INJURY PROTECTION L BENEFITS 1 PROPERTY DAMAGE LIABILITY NAMED INSURED: VOID YEAR: VOID MAKE: VOID BODILY INJURY LIABILITY VIN #: VOID FLEET COVERAGE: (If more than 25 vehicles insured) NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE FLORIDA AUTOMOBILE INSURANCE IDENTIFICATION -1 CARD COMPANY: Government Employees Insurance Company POLICY #: 91002E1072700 09245 EFFECTIVE DATE: , 07-13-2019 PERSONAL. INJURY PROTECTION ; BODILY INJURY X BENEFITS / PROPERTY DAMAGE LIABILITY X LIABILITY NAMED INSURED: RED CHAIR, LLC YEAR: 2005 MAKE: FORD VIN #:1FMNE11 \AE8DA001131 FLEET COVERAGE: I (If more than 25 vehicles insured) NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE FLORIDA AUTOMOBILE INSURANCE IDENTIFICATION CARD COMPANY: VOID POLICY #: VOID EFFECTIVE DATE: VOID PERSONAL INJURY PROTECTION BODILY INJURY BENEFITS / PROPERTY DAMAGE LIABILITY 1 LIABILITY NAMED INSURED: VOID YEAR: VOID MAKE: VOID VIN VOID { FLEETCOVERAGE: more than 25 vehicles Insured) NOT VALID FOR MORE THAN ONE YEAR FROM EFFECTIVE DATE THIS CARD MUST DEKEPT |wTHE INSURED VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACCIDENT: Report all accidents Vnyour Agent/Company as soon as possible. Obtain the � following information: 1 Name and eddoaoy of each drive/, passenger i and witness. 2. Name ofInsurance Company and policy number for each vehicle involved. r—� Rental car coverage aprovided. xrema/car coverage mprovided, | �—J refer mthe outline mcoverage a,mthe details u,extent mcoverage. | MISREPRESENTATION opINSURANCE m^FIRST DEGREE w/vo,ms^wom �ACORD 5nFL'2017112) m`994zm,ACnRDCORPORATION. All rights reserved. , THIS CARD MUST BEKEPT |NTHE INSURED VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACC|DENT: Report all accidents Uoyour Agent/Company an soon as possible. Obtain the following information: 1 Name and address of each dhvmr, pouaanQor and witness, 2. Name ofInsurance Company and policy number for each vehicle involved. �i Rental car coverage isprovided. xrental car coverage aprovided, refer wthe outline ofcoverage ""* the details or extent mcoverage. MISREPRESENTATION opINSURANCE /n^FIRST DEGREE M/vocmcAxnn ACORomrL/zmmq w/994-20,rACuRD CORPORATION. All rights reserved. THIS CARD MUST BEKEPT |NTHE INSURED VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. Obtain the following information: 1 Name and address of each driver, passenger and witness. 2. Name ofInsurance Company and policy number for each vehicle involved. Rental car coverage is provided. nrental car coverage uprovided, �—' refer '" the outline mcoverage "omthe details mextent mcoverage MISREPRESENTATION o'INSURANCE /s^FIRST DEGREE M/ousm^^wox ACoRDmo(2wV12) m,994-20nACvRDCORPORATION. All rights reserved, � ' THIS CARD MUST BEKEPT |NTHE INSURED � VEHICLE AND PRESENTED UPON DEMAND IN CASE OF ACCIDENT: Report all accidents to your AgenbCompany as soon as possible. Obtain the following information: 1. Nome and address of each driver, passenger and witness. 2. Name ofInsurance Company and policy number for each vehicle involved. |—| Rental car coverage aprovided. nrental car coverage wprovided, '— refer mthe ""u/"°mcoverage °,wthe details ., extent "rcoverage. MISREPRESENTATION o,INSURANCE /,^ FIRST DEGREE MISDEMEANOR ^ConomFL(20,7/,2) w,yo^20,,Ac"poCORPORATION, All right. .,","^� M0Q2-17 _ MEMORANDUM OFINSURANCE' COMPANY: Government Employees Insurance Company OneGBCOBoulevard Fredericksburg, VA22412 INSURED: RED CHAIR, LLC 15O1SEAGRAPEWAY MOLLYWOOD.FL3301Q 1'866-509-9444 COVERAGES This memorandum is furnished to you as a matter of _fn'_fo' -r-m--a"-ti-o-n-"f"'o-r'--y"-o--u-,r-,c--o-,n-v,-enience. It is not intended to reflect all the terms and conditions or exclusions of such policies. This memorandum is not an insurance policy and does not amend, alter, or extend the coverage afforded by the listed policies. The insurance afforded by the listed policy is subject to all the terms, exclusions and conditions of such r----' TYPE OFINSURANCE POLICY EFF. DATE EXP'DATE NUMBER COMMERCIAL AUTOMOBILE LIABILITY ElANY AUTO LJALL OWNED AUTOS LJM|R[DAUTOS _XSCHEDULED AUTOS NON'OVVNEDxUTOS rl OTHER COVERAGES !ANY AUTO LJALLOWN EDAUTOS LJHIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS L� 9100200727 9100260727 | 07/13/2019 LIMITS SHOWN ARE A5REQUESTED 07/13/2020 COMBINED SINGLE LIMIT (Ea. Accident) BODILY INJURY (Per Person/ Per Accident) . $10K/20K PROPERTY DAMAGE S10,000 (Per accident) COMBINED SINGLE LIMIT (Ea. Accident) UNINSURED MOTORISTS (UMCSq UNDER|N8URBD MOTORISTS (UIMCSL) UNINSURED MOTORISTS (Per Person/ Per AcciUenV UNDER|NSURED MOTORISTS (Per Person/ Per Accident) UNINSURED MOTORISTS PD (Per accident) PERSONAL INJURY PROTECTION(PIP) MEDEXP Q1OK/20K S1OK/2OK |NCL �:DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS 'PHYSICAL DAMAGE COVERAGE - - ------ ACTIVE VEHI61(�)­_ VIN 2008 FORD ECDNOUNE �[-iCOMPREHENSIVE DEDUCTIBLE COLLISION DEDUCTIBLE N/A COMPREHENSIVE DEDUCTIBLE LJCOLLISION DEDUCTIBLE ACTIVE DRIVERS: Joseph Grenat, Jessica Rosales K8O|02-17 STATE OF FLORIDA Lmisi()N()i 1i()11_LS AND RLLU R\\1 DLI).11<.1 N1LN ,1:\D 1)1WELSSIONAL, I<L• ON \\ \\,.111\ floricktlicclic.com Food Service Inspection Report This inspection report must be made public upon request per Florida law. Met Inspection Standards during this visit ANY VIOLATIONS noted herein must be corrected by the NEXT UNANNOUNCED inspection unless otherwise stated. Inspection Date: License Number; Owner Name: Location Address; Jun 12, 2019 11:20 -Jun 12, 2019 11:47 1623916 Rank: NOST RED CHAIR CATERING LLC 3944B PEMBROKE RD PEMBROKE PARK FL 33023 Number of Units: 0 License Expiration: Inspection Reason: Business Name: License Type: Telephone Number: Reinspection on or After: December 1, 2019 Routine - Food RED CHAIR CATERING Permanent Food Service 954.336.9849 FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS 01A Food obtained from approved source IN 07 Unwrapped or PH/TCS food not re -served IN 01 B Food safe and unadulterated; sound condition IN 08A Separating raw animal foods from: each other, RTE foods and unwashed produce IN CIC Shellstock tags; commingling N/A 08B Food protection during preparation, storage and display IN 01 D Parasite destruction for raw/undercooked fish N/A 09 Bare hand contact with RTE food; Alternative Operating Procedure (AOP) IN 02A Consumer advisory on raw/undercooked oysters N/A 11 Employee health knowledge; ill/symptomatic employee present IN 02B Consumer advisory on raw/undercooked animal foods N/A 12A Hands clean and washed properly; use of hand antiseptic if use of AOP IN 02C Date marking ready -to -eat (RTE) potentially hazardous / time/ temperature control for safety foods IN 12B Employee eating. drinking, tasting food, smoking N/0 03A Receiving and holding PHrTCS foods cold IN 22 Food -contact surfaces clean and sanitized IN 03B Receiving and holding PH/TCS foods hot IN 31A Handwash sink(s) installed, accessible, not used for other purposes IN 03C Cooking raw animal foods and plant foods; non -continuous cooking of raw animal foods N/0 31 B Handwashing supplies and handwash sign provided IN 03D Cooling PH[TCS foods; proper cooling methods N/0 41 Chemicals/toxic substances IN 03E Reheating PH[TCS foods for hot holding N/0 53A Food manager certification; knowledge/active maragerial control (except employee health) IN 03F Time as a Public Health Control N/A 53B State approved food handler train ; employee duty specific training/knowledge IN 03G Reduced oxygen packaging (ROP) and other Special Processes N/A GOOD RETAIL PRACTICES 02D Food items properly labeled; o 'gine' container 35A No presence or breeding of insects/rodents/pests; no live animals 04 Facilities to maintain PHITCS foods at the proper temperature 35B Outer openings protected from insects/pests, rodent proof 05 Food and food equipment thermometers provided and accurate 36 Floors, walls, ceilings and attached equipment properly constructed and clean; rooms and equipment properly vented 06 PH/TCS foods properly thawed 38 Lighting provided as required; fixtures shielded or bulbs protected 10 In use food dispensing utensils properly stored 40 Employee personal belongings 13 Clean clothes; hair restraints; jewelry; painted/artificial fingernails 42 Cleaning and maintenance equipment 14 Food -contact and nonfood contact surfaces designed, constructed, maintained, installed, located 43 Complete separation from living/sleeping area/private premise; kitchen restricted - no unauthorized personnel 16 Dishwashing facilities; chemical test kit(s); gauges 1. Wash 2. Rinse 3. Sanitize 45 Fire extinguishing equipment (FOR REPORTING PURPOSES ONLY) June 12, 2019 at 11 47 21 AM EDT Location RED CHAIR CATERING license # NOST1623910 Food Service Inspection Report DBPR Form HR 5022-015 - Rule 61C-1.002, FAC " " STATE OF FLORIDA DIVISION OF HOTIIS AND RES'IALRANTS DEPARTMENT OF BLSINESS AND PROFESSIONAL REGULATION \\r, \\.rnyfloridalicense.com 21 Wiping cloths; clean and soiled linens; laundry facilities 46 Exits not blocked or locked (FOR REPORTING PURPOSES ONLY) 23 Non-food contact surfaces clean 47 Electrical wiring/outlets in good repair (FOR REPORTING PURPOSES ONLY) 24 Storage/handling of clean equipment, utensils; air drying OUT 48 Gas appliances; boiler certificate current/posted (FOR REPORTING PURPOSES ONLY) 25 Single -service and single -use items 49 Flammable/combustible materials (FOR REPORTING PURPOSES ONLY) 27 Water source safe, hot (100F) and cold under pressure 50 Current license, properly displayed 28 Sewage and waste water disposed properly 51 Other conditions sanitary and safe operation 29 Plumbing installed and maintained; mop sink; water filters; backflow prevention 52 Misrepresentation; misbranding 32 Bathrooms 54 Florida Clean Indoor Air Act Compliance 33 Garbage and refuse; premises maintained 55 Automatic Gratuity Notice Items marked IN are in compliance. Items marked OUT are violations. Specific details of the violations are listed on subsequent pages. Items marked N/A are Not Applicable. Items marked as N/O are Not Observed and were not being conducted at the time of inspection, FOOD TEMPERATURES Bar Area Buffet Line Cook Line Front Counter Front Line Larger Hot Point -dressings only* freezer, frozen solid Kitchen Hot hold chicken nuggets 150° Prep Area Hot Pount refrigerator, boiled egg 41°, yogurt 41°,Freezer-frozen solid Reach In Cooler Hobart, brisket 40°, Reach In Freezer Steam Table/Bain Marie Storage Area 2 chest freezers, frozen solid Wait Station Walk In Cooler Walk In Freezer OTHER ITEMS Certified Food Manager and Date Certified: Josh Schuldiner 3-14-17 Manager Certified By: National Registry of Food Safety Professionals Employees Trained By: Florida Restaurant and Lodging Association Sewage: Municipal/Utility Water Source: Municipal Boiler: No Boiler On Site Boiler Jurisdiction and Expiration: Sanitizer Details: Quaternary triple sink & sanitizer bucket 300ppm. June 12, 2019 at 1147,21 AM EDT Location: RED CHAIR CATERING License 6 N0ST1623916 Inspector Marie Chapdelaine Food Service Inspection Report DBPR Form HR 5022-015 - Rule 6.1C-1,062, FAC Software Version 6,62 Page 2 of 3 STATE OF FLORIDA DIVISIHN E [1()I'LLS \\L) NIS , L)1:1).\R'INILN 1 ()IT BLSI:\ ELSS ,1.\ PROELSS1()X,lL RiAt,' _1[1( )N \\,.111\ norkkdiccnsc,com Inspector Comments: REVIEW: Foodbourne illness - management must be aware of employee health & have an active health policy. Employees must report vomiting, diarrhea, jaundice or sore throat. Be aware of the Foodbourne illnesses: Hepatitis -A, E-coli, Salmonella, Shigella & Norovirus. Gloves and utensils used with Ready To Eat Foods. Cold holding 41 °F or below, hot holding 135°F or above, Cooling from 135°F to 70°F within 2 hrs and from 135°F to 41°F within a total of 6 hrs. Reheating to 165°F within 2 hrs. Proper storage and cooking ternps: top shelf RTE foods(including washed produce) next shelf raw pork, fish, lamb, goat 145'f; next shelf raw ground beef ,injected steaks 155°F; next shelf raw poultry 165°F. Date marking on all RTE TCS food held longei than 24 hrs. Thermometer calibration in ice water to 32°F. Last inspection report available on premises upon request. Employees must receive food safety training within 60 days of been hired. Verified ownership. A link to the Florida Department of Agriculture's Food Recovery Resource Guide is located at: http://www.myfloridalicense.com/DBPR/hotels-restaurantstforms-publications This report has been provided electronically as requested by the person in charge at the time of inspection. VIOLATIONS 24-05-4 Observed: Clean glasses, cups, bowls, plates, pots and pans not stored inverted or in a protected manner, Pots and plastic containers, manager inverted, **Corrected On -Site** **Repeat Violation** Reference: 4-903.11(B) FC: (B) Clean equipment and utensils shall be stored as specified under Paragraph (A) of this section and shall be stored: (1 ) In self -draining position that allows air drying; and (2) Covered or inverted. Priority: Basic Signature uf Reclprent Joe Grenat Manager 754-610-4373 Jun12, 2019 11 47 June 12 2019 af 11 4721 AM EDT Lonalldn RED CHAIR CATERING License #. N0ST1623916 Inspector. Mane Chapdelame Food Gerkfce Inspection Report OBPR Form HR 5022-015 - Rule 61C-1 002 FAC Software Version 6 52 Inspernor Signature Mane Chap,delatne Samar Safety And Sarkfalion Spenfallet 5C110 Coconut Creek Parkway Sate A Margate FL 33063 954-632-6650 Jun 12 201S %I 20 Page 3 c LEASE AGREEMENT This Lease Agreement ("Lease'') is made as of. this day of October ,_20I8 between PEIVIBROKE ROAD CENTER, LLC, a Florida limited liability company, having an office at 12895 SW 1 — Ste-203 Miami, FL 33186, ("Landlord"), and RED CHAIR CATERING, LLC a Florida Corporation, D/B/A having a business address oF3944B & 3948A Pembroke Rd, Hollywood, FL 33021. Lease Sunman. Lease Commencement Date: November 1, 2018 Lease Expiration Date: October 31, 2023 Lease Term: 5 Years Security Deposit: $9,398.04 (First Month Rent in the amount of $3,015.38 including sales tax, Last month Rent in the amount of $3,38166 including sales tax and one month security in the amount of $3,000. Free Rent Period: N/A Rent Commencement Date: November e, 2018 Base Monthly Rent: $1,611.20 Estimated Monthly CAM: $1,238.88 Monthly Gross Rent Year 1: $2,850,08 Monthly Gross Rent Year 1 plus Taxes: $3,015,38 Year One (1) Annual Base Rent: $19,334.40 ($12,16_ PSF) Year Two (2) Annual Base Rent: $20,304.30_ ($12,77 PSF) Year Three (3) Annual Base Rent: $21,321.90_ ($13.41 PSF) Year Four (4) Annual Base Rent: S22,387.20_ ($14,08 PSF) Year Five (5) Annual Base Rent: $23,500.20_ ($14.78 PSF) Tenant Contact Info Primary Contact Person: JOE GRENAT Phone Number: CELL 954-336-9849 Alternate Phone NUM ber: 813-643-4996 E-Mail Address: jessicaeredchaircateringmet Landlord Rep. Contact Info Name: Pembroke Road Center, LLC in c/o Southern Management &. Development, LP Primary Contact Person: Lilly Vasallo Phone Number: (561)-948-7115 E-Mail Address: lillyv@smdproperty,corn RECITALS A. Landlord is the owner in fee simple of the Premises. The Premises is a unit, Exhibit A- 1 of the collective successive units which, along with the surrounding grounds, including the parking lot areas located in front of and in back thereof, which shall collectively be referred to as the "Plaza". B. Landlord desires to lease the Premises to Tenant, and Tenant desires to lease the Premises from Landlord, in accordance with the terms and conditions of this Lease. TERMS The parties agree as follows: 1. RECITALS, DEFINITIONS. 1.01 Recitals. The foregoing recitals are true and are made a part of this Lease. 1.02 Definitions. Unless the context requires otherwise, the following capitalized terms used in this Lease shall have the respective meanings set forth below. 1.03 "Additional Rent": Such surns, charges, and expenses as are due under this ease from Tenant to Landlord in addition to the Base Rent. 1.04 "Base Rent": The basic monthly rent which is due under this Lease from Tenant to Landlord. 1.05 "Commencement Date": November lst, 2018 1.06 "Event of Default by Tenant": Any event constituting an ''Event of Default by Tenant" under Section 15. 1.07 "Expiration Date": October 3 I' , 2023 1.08 "Fee Mortgage": Any mortgage, deed of trust, or similar instrument which at any time encumbers Landlord's interest in this Lease and/or in the Premises. 1.09 "Hazardous Materials": Any flammable explosives, radioactive materials, hazardous materials, hazardous wastes, hazardous or toxic substances, or related materials as defined under any Legal Requirements, including, without limitation, the following statutes and the regulations promulgated under their authority: (a) the Comprehensive Environmental Response, Compensation, and Liability Act of 1980, as amended (42 U.S.C. §§ 9601 et seq.); (b) the Hazardous Materials Transportation Act, as amended (49 2 IN WITNESS WI-IEREOF. the parties have executed this Lease A2reement/ i the date set flail: in the first paragraph. WITNESSES: LANDLORD: 77 PEMBROKE ROAD CENTER. a Florida Limited Liability Company Print l`stanie: .410 r • e. Its: 7 :2 !..)i Print Name: Print r' Print N TENANT: [ADDITIONAL SIGNATURES ON NEXT PAGE] 31 (e) (0 This Guaranty shall he one olpayment and performance and not of collection. Guarantors shall, without limiting the aencratiry of the foregoing, be jointly and severally bound by this Guaranty in the same manner as thouan Guarantors ‘vere the tenant named in the Lease. (e) With respect to all amounts paid by any GlIarantors pursuant to this Guaranty, such Guarantors expressly waives and disclaims ally right to, and agrees !lotto seek or claim, contribution, inderrinitication or reimbursement from Tenant, right of subrogation to the rights of Landlord, or right of recourse to any security for the debts and obligations of Tenant to Landlord. No payment hereunder by any Guarantors shall givc rise to any claim by any Guarantors against Landlord or Tenant. Upon the occurrence of a default, violation or event of default under the Lease, any and all debts and obligationsof, and other payments from Tenant to an Guarantors shall he deemed postponed in favor of and subordinated to the full payment and performance of all debts and obligations of Tenant to Landlord. At any such time or times after the occurrence of a default, violation or event of default under the Lease, and until the same shall have been cured or satisfied, any such subordinated interests or payments received by any Guarantor shall be received and held in trust for Landlord and promptly delivered to Landlord. (19 All of the terms, agreements and conditions of this Guaranty shall extend to and be jointly and severally binding, upon (5uarantors, their heirs, successors and assigns.. and shall inure to the benefit of and be enforced by, Landlord, its successors and assigns, and the holder of any mortgage to which the I.ease may he subject and subordinate from time to time. {i) (ivarantorts) shall he jointly and severally liable for all court costs; all auornev's fees, and all collection costs and fees for the enforcement of this Guaranty and prejudgment interest in addition to any other obligations under this Guaranty. (ph'the undersiaicd have executed this Guaranty as o (iUARANTOR(S): By: - -7 State D/L 4 S.S,# 47 ,i/ 1-, , I ( ) day of LEASE AGREEMENT This Lease Agreement ("Lease") is made as of, this 2day of September 2015 between PEMBROK.E ROAD CENTER, LLC, a Florida limited liability company, having an office at 1.2895 SW 132ND STREET, SUITE 202 MIAMI, 'FLORIDA 33186 ("Landlord"), and RED CHAIR CATERING, LLC, a Limited Liability Company, having a business address of 394413 Pembroke Road, Pembroke Park FL 33023 Lease Summary Lease Commencement Date: September 8, 2015 Lease Expiration Date: November 30, 2020 Lease Term: Five (5) Years and three months Security Deposit: $4,880.73 (First Month Rent in the amount of $1,590.00 inclusive of sales tax, Last month Rent in the amount of $1,790.73 inclusive of sales tax and one month security in the amount of $1,500.00) Free Rent Period: Remainder of September 201.5, October 2015, and November 2015. Rent Commencement Date: December 1, 201.5 Base Monthly Rent: $880,57 Estimated Monthly. CAM: $619.43 Monthly Gross Rent Year 1.: $1,500.00 Monthly Gross Rent Year I plus Taxes: $1,590.00 Year One (1) Annual Base Rent: $10,566.84 ($13.29 PSF) Year Two (2) .Annual Base Rent: $11.,095.18 ($13.95 PSF) Year Three (3) Annual Base Rent: $11,649,94 ($14.65 PSF) Year Four (4) Animal Base Rent: $12,232.44 ($1.5.38 PSF) Year Five (5) Annual Base Rent: $12,839.25 ($16.15 PST) Tenant Contact Info Primary Contact Person: JOE GRENAT Phone Number: CELL 954-336-9849 E-Mail Address: jessicarcdchaircatering.net Landlord Rep. Contact Info Name: Primary Contact Person: Pembroke Road Center, LLC in c/o Southern Managetnent &. Development, LP STATE OF FLORIDA SS: COUNTY OF c..41,21 The foregoing instrument was acknowledged beforc inc thisjr.:5_ day of C-..‘„ , 2015, by Cir., fA. e ter as of PEMBR6KE ROAD CENTER, LLC, a Florida limited liability company, on behalf of the company. My Commission Expires: /.y,OpOie STATE OF FLORIDA) ) SS: COUNTY OF 'N-w^o) MIRIAM CASUSO NMary Public - State of Florida My Comm. Expires Dec 20, 2018 Commission * FF 153912 The foregoing instrument was acknowledged before me this g day of S. E 15;`" ,2015, by r‘i AT as of RED CHAIR CATERING, LLC, a Florida Limited Liability Company, on behalf of the company. Notary P iblic State of Florida at Large 30 DIEGO YERMOLI Y COMMISSION V1,080769 EXPIRES: January 05, 2018 belief that such work is necessary or required by any Environmental Law, and (ii) any claims of third parties for loss, injury, expense, or darnage arising out of the Handling of any Waste on, under, in. above, to or from the Premises, or any Notice or Non -Compliance. 7. SurvivaltDefault. Notwithstanding anything in this Lease to the contrary, the covenants, representations, warranties, indemnities and undertakings of Tenant set forth in this Addendum shall survive the expiration or termination of this Lease regardless of the method of expiration or termination of the Lease. The breach of any covenant, representation or warranty hereunder shall be deemed an event of default under the Lease. 8. Surrender/Environmental Risk. This Lease is intended to be, and shall be construed as, an absolutely net to Landlord of any environmental liability arising out of or in connection with Tenant's use of the Premises. As a material inducement to Landlord to enter into this Lease, Tenant agrees to assume all responsibility and cost of any kind associated with or arising out of any Notice. Non-Complia.nce or environmental liability on or about the Premises arising out of or in connection with Tenant's operations on the Premises, to Indemnify the Indemnified Parties as provided herein, and to fully comply with the terms and conditions of this Addendum. At the expiration or termination of this Lease, the Premises shall be returned to Landlord in as good condition as at the commencement of this Lease notwithstanding any remediation levels for Waste or spill cleanup imposed by environmental Laws which may be in excess of the levels of such Wastes at the Premises prior to the Lease's commencement. WITNESS: h./4g Print Name: Print Name: "LANDLORD" PEMBROKE ROAD CENTER, LLC a Florida Iimite4ii1ity company By: Its: Print Name: TENANT: RED CHAIR CATERING LLC a Florida Limited Liability Company By: Its: Print NI e: c 42 Coe AcIaCL- (g) With respect to all amounts paid by any Guarantors pursuant to this Guaranty, such Guarantors expressly waives and disclaim.s any right to, and agrees not to seek or claim, contribution, indemnification or reimbursement from Tenant, right of subrogation to the rights of Landlord, or right of recourse to any security for the debts and obligations of Tenant to Landlord, No payment hereunder by any Guarantors shall give rise to any claim by any Guarantors against Landlord or Tenant. Upon the occurrence of a default, violation or event of default under the Lease, any and all debts and obligations of, and other payments from Tenant to any Guarantors shall he deemed postponed in favor of and subordinated to the full payment and performance of all debts and obligations of Tenant to Landlord. At any such time or times after the occurrence of a default, violation or event of default under the Lease, and until the satn.e shall have been cured or satisfied, any such subordinated. interests or payments received by any Guarantor shall be received and held in trust for Landlord and promptly delivered to Landlord. (h) All of the terms, agreements and conditions of this Guaranty shall. extend to and be jointly and severally binding upon Guarantors, their heirs, successors and assigns, and shall inure to the benefit of and be enforced by Landlord, its successors and assigns, and the holder of any mortgage to which the Lease may be subject and subordinate from time to time, (i) Guarantor(s) shall be jointly and severally liable for all court costs, all attorney's fes, and all collection costs and fees .for the enforcement of this Guaranty and prejudgment interest in addition to any other obligations under this Guaranty. (i) This guarantee shall be limited to the TERMINATION AGREEMENT attached to this lease and any items listed in. this personal guarantee. IN WITNESS WHEREOF, the undersigned have executed this Guaranty as of September 8, 2015. WITNESSES: Signature. of Witness Print Name: )46-(ic,ne/ct Signature of Witne Print Name: .wirrNESS.ES: Signature Prsnt 1\i' Prin a e: GUARANTOR: By: Address: V4pAk.. GUARANTOR: 45 te,e_ s-4 6-L 3-3620 Signed, sealed and delivered LESSOR: in the presence of: //N/ I A w6 � Print -u'� / Name: /w4y��~- rkvv///\ Signed, sealed and delivered in the presence of: Pembroke Road Center, LL[aFlorida Limited Liability Company By: PembmkeRoad Center, LLC aFloridn Limited Liability Cnmpany,asManager By: LESSEE: Authorized Representative RED CHAIR CATERING, iLCaFlorida Limited Liability Company Its: 47