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Home My WebLink AboutBack-Up DocumentsCity of Miami Anti -Poverty Initiative Program Funding Request Form CONTACT INFORMATION: Contact Person: ELAINE BLACK Title: PRESIDENT/CEO Phone number: (305) 329-4707 Email Address: eblack@miamigov.com Name of Person completing this form: Iris Hudson Legal Name of Organization: LIBERTY CITY COMMUNITY REVITALIZATION TRUST Address (Street, City, State, Zip Code): 4800 NW 12th AVENUE, MIAMI. F,L 3:U77 Executive Director of Organization: ELAINE BLACK Executive Director email: eblack@miamigov.com Executive Director Contact Phone Number: (305) 329-4707 or (786) 355-7654 The organization is a registered and active State of Florida Corporation (select one): For -profit organization Not -for profit organization {501(3)(c)} Local governmental unit C State governmental unit Educational and academic institution City of Miami department, agency and board Page 1 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program Funding Request Form ORGANIZATION AND PROGRAM/PROJECT INFORMATION Organization History and Background Information: THE LIBERTY CITY COMMUNITY REVITALIZATION TRUST WAS CREATED BY ORDINANCE 12859. THE LIBERTY CITY TRUST IS TASKED WITH PROVIDING OVERSIGHT AND FACILITATE THE CITY°S REVITALIZATION EFFORTS AND ACTIVITIES TO BE UNDERTAKEN IN THE LIBERTY CITY AREA, I.E. JOBS, HOUSING. THE LIBERTY CITY TRUST HAS IMPLEMENTED THE YOUTH EMPLOYMENT PROGRAM FOR THE LAST FOUR YEARS (4). Is your program/project providing direct services to residents of the City of Miami? YesENoEl Number of residents your entity will serve: _ 75 Frequency of Service: Summer Term Age Group Served: 14 to 18 Is your program/project impacting one of Miami's disadvantaged communities? Yes X[]�No[7 Geographic Area Served (specific to this project/program) District Served (1, 2, 3, 4, 5, Citywide) DISTRICT 5 Neighborhood/Community being served: Liberty City Program/Project Priority area (Select one): Educational Programs for children, youth and adults Crime Prevention Elderly meals, transportation, recreational and health/wellness related activities At -risk youth or youth summer job programs Transportation services and programs Job development, retention and training programs Homeless Services n XX Page 2 of 5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program - Funding Request Form Program/Project Title: THE LIBERTY CITY TRUST YOUTH: EMPLOYMENT PROGRAM Project/Program Description: PROVIDE YOUTH WITH AN OPPORTUNITY TO GAIN WORK EXPERIENCE THROUGHOUT THE CITY OF MIAMI AND BEGIN THEIR JOURNEY TO PROFESSIONALISM. Program Start Date: J E 2020 Program End Date: AUGUST 2020 Please describe how this program/project and funding will alleviate poverty within the City of Miami? THIS PROGRAM WILL ASSIST IN ALLEVIATING POVERTY BY PROVIDING YOUTH WITH THE OPPORTUNITY TO EARN INCOME AND EVEN BECOME THE MAIN PROVIDER FOR THEIR FAMILIES DURING THIS TIME - IMPACT AND PERFORMANCE: Describe overall expected outcomes and performance measures for this project/program: OUTCOME AND PERFORMANCE WILL FOCUS ON CHANGES THAT OCCUR AS A RESULT OF PARTICIPATION IN PROGRAM. THE:OUTCOME EVALUATION WILL ASK, SEE BELOW: 1. WHAT DIFFERENCE HAS THEPROGRAM MADE FOR INDIVIDUAL, FOR EXAMPLE: (Work Maurity) How has their appearance improved Ability to work with others Following Instructions Quality of Work/Motivation Dependability Personal Behavior Attitude Quantity of Work/Initiative (Please see the attached Evaluation Form) Please attach additional pages to the back of this packet, if the space above is not sufficient. Page 3of5 Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 TRUST rk=af Cartatim4, We—.6wI lwW 5,a PARTICIPANT: Liberty City Community Revitalization Trust Youth Employment Program Summer 2020 Evaluation Form Weekending: WORKSITE: RATING GUIDE 4-Excellent + 3-Above Average • 2-Satisfactory 1-Not Acceptable Meets the work maturity skill independency with no supervision Meets the work maturity skill independently with limited supervision Meets the work maturity skill under normal supervision Requires constant and close supervision to meet the work maturity skill Using the numbered Rating Guide above, please evaluate the participant in the following work maturity skill categories. The evaluation should be completed by the immediate supervisor. Please provide ONE response for each of the 10 work maturity skill measures. WORK MATURITY SKILLS Evaluation 1. Appearance Participant dresses appropriately for the job. Hair groomed neatly and appropriately. 2. Working with Others Shows proper respect for others. Gives help to co-workers, if requested. Is able to ask for needed assistance from co-workers. Show a positive attitude when working with others. 3. Following Instructions Exhibits a positive attitude toward supervisor. Listens to instructions. Asks questions if necessary. Carries out assignments as specified. 4. Quantity of Work/Initiative Completes work neatly, accurately, and thoroughly. Open to constructive criticism. Corrects errors. Makes efficient use of suggestions for improvement. Willing to try new things. 5. Quality of Work/Motivation Doesn't waste time. Completes assigned work on schedule. Does his/her share on group assignments. 6. Dependability Carries out assigned work effectively and efficiently without constant supervision. Shows initiative and good judgment when minimal instructions are given. 7. Personal Behavior Follows rules in regard to safety, use of equipment, care of property, and personal conduct. Accepts responsibility for his/her actions. 8. Attitude General demeanor on the job towards co-workers, supervisors, and (if applicable) public. For the following, please CIRCLE the appropriate rating: (P) Prelim 9. Excellent: 100% attendance Above average: infrequent excused absences 4 3 Attendance Satisfactory: complies with program policy, notifies of absences 2 Not acceptable: often absent with or without good reason 1 10. Excellent: 100% on time to work and from breaks, ready to work 4 Above average: notifies supervisor, late to work or from break infrequently but immediately ready to work 3 Punctuality Satisfactory: complies with program policy, notifies supervisor if going to be late 2 Not acceptable: lacking in punctuality, frequently late 1 If you have any comments to add please use the reverse of the form. COMMENTS: Youth Counselor: Park Manager (If available): Date: Date: City of Miami Anti -Poverty Initiative Program - Funding Request Form FUNDING REQUEST INFORMATION: Amount Requested: $ 200,000.00 Explain how the City of Miami Anti -Poverty funding will be utilized: FTINfTN(; WILL RF. TTPT?T) Tn 2AV T ] pR L Pe . TmAraw_ YOUTH, AND OTHER EXPENDITURES THAT ARE INCURRED IN IMPLEMENTING THEPROGRAM. Itemize API funding related to expenditures below: Personnel Salaries & Wages: $ 167,000.00 Personnel Benefits $ 13,000.00 Space Rental: $ Utilities (Electricity, Phone, Internet): $ Supplies: $ 2,000.00 Marketing/Printing $ 2,000.00 Transportation (Participants)/registratio$i 2, 000.00 2/225.00 Meals (Participants): $ Professional -Services -(List each): Other (please describe): T—Shirts (Uniforms) $4,500.00 Other (please describe): Background Check 4,875.00 Other (please describe): Payroll Fees 2,400.00 Return this form to: mtrevino@miamigov.com Page 4 of 5 Last revised: September 16, 2019 City of Miami Anti -Poverty Initiative Program Funding Request Form To be completed by the Entity/Recipient By signing below you agree to the guidelines and stipulate that the information provided on this form is accurate and complete. Completed by (Print & Sign): Date: l/( /,, CJ Additional Comments: 2E BLACK To be completed by District Commissioner/Mayor's Office Recommended for funding: YesnNo❑ Funding Recommendation: $200,000 Commission Meeting Date: 4/09/20 Additional Comments: Completed by (Print & Sign): Natal a Sangster Date: 3/18/2020 To be completed by the Department Received by (Print & Sign): Date: 3/19/20 M.T. Sutherland Additional Comments: Approved to proceed with placement on 4/09/20 Commission Agenda. Return this form to: mtrevino@miamigov.com Last revised: September 16, 2019 Page 5 of 5