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Home My WebLink AboutComposite Exhibit GATTACHMENT "G" CITY OF MIAMI SENIOR MEAL ASSISTANCE PROGRAM Background: On March 11, 2020, the World Health Organization declared the novel coronavirus, also known as COVID- 19, a global pandemic. The declaration and spread of the virus have led the State of Florida and the City of Miami to declare a State of Emergency. Researchers have determined that seniors are particularly susceptible to the respiratory illness, which can cause pneumonia and symptoms such as fever, cough and shortness of breath. A recommendation from the Center for Disease and Control has the particle effect of seniors self -quarantining. This program is designed to minimize contact with the general public to avoid contracting COVID-19 for our most vulnerable population and mitigate the spread of the disease in general. Program Description: The Senior Meal Assistance Program is designed to provide nutritious and balanced meals to City of Miami (City) residents that are 60 years, or older. The intent of this Program is to provide meals to unserved seniors residents that are identified by Elected Officials who may be facing starvation and are not being served by other meal programs. Source of Funding and Amount: General fund in the amount of $1,000,000. Allocation of Funds: Allocated to Elected Official offices based on the current Anti -Poverty Initiative allocation as follows: District 1 District 2 District 3 District 4 District 5 TOTAL $180,000 $172,000 $194,000 $264,000 $190,000 $1,000,000 Costs to Resident(s): None. Eligible Resident(s) must meet the following requirements: • Be 60 years or older • Not be receiving meals from any other private, city, county, state or federal program • Must reside in the City of Miami Required Documentation (Obtained by City staff): • Meal Distribution Form (see attached) • Time stamped pictures of delivery confirmation with location enabled (GPS coordinates) when downloaded to a computer • Established drop-off centers or sites per districts and delivery time • Utilization of the three (3) approved vendors (see attached) City Staff: The City will commit two (2) staffers per elected office strictly for the implementation of the Senior Meal Assistance Program. Employees will follow all procedures related to COVID-19 activities as requested by the EOC. Page 1 of 2 ATTACHMENT "G" CITY OF MIAMI SENIOR MEAL ASSISTANCE PROGRAM Number of Meals to be Provided: The Elected Official, under the program's guidelines, will determine the number of meals per eligible resident not to exceed more than 2 deliveries per week Payment Processing: City will make payments to the approved service provider after receipt of supporting documentation and in accordance with their executed agreement. The City's goal is to seek reimbursement from eligible future federal programs or any other available funding source. Length of Program: Two months from implementation of this program or until funding allocation is depleted, whichever occurs sooner. NOTE: Guidelines, forms, and other documents attached to these Guidelines are subject to change from time to time to ensure proper utilization of public funding. Page 2 of 2 ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES TABLE OF CONTENTS Meal Coupon Assistance Program 2 Stakeholder Responsibilities 3 Sample Qualifying Recipient list 5 Sample Participating Restaurants Log 6 Payment Request Form 7 W-9 Form 8 ACH Authorization Form 9 Participating Restaurant Application 10 Application for Meal Coupon 11 Wage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES Program Purpose The Meal Coupon Assistance Program is an effort of the City of Miami (City) to invest in its community by providing nutritional meal supplements to eligible City residents while supporting the recovery of businesses negatively affected by actions taken by the government as officials tried to slow the spread of COVI D-19. Efforts to slow down the rate of transmission of the novel corona virus have had a negative economic impact to businesses. Local restaurants have been affected as well as City residents, many of whom have lost their employment. In an effort to reverse the economic effects of this necessary action, the City is taking steps to once again spur economic activity while assisting vulnerable residents that are in need of nutritional meal supplements. Timeline The Meal Coupon Assistance Program will be operational immediately once approved by the City Manager. Coupons will have an expiration date of two (2) months after the program is implemented regardless on when the coupons were issued. Program Value The City has made $1 million available for the aforementioned purpose. If used accordingly, the fund will allow restaurants to rehire employees and provide up to one hundred thousand meals city-wide to those in need. Allocation by district is as follows: District 1 District 2 District 3 District 4 District 5 Total $202,000 $139,000 $205,000 $177,000 $277,000 $1,000,000 Source: 50/50-API-CDBG How It Works The City will issue meal coupons to adult residents and their household members that can be redeemed for a meal at any participating restaurant of their choice (inclusive of tax and/or delivery). Each coupon is valued at or about ten dollars. Participating restaurants must accept the coupon as cash equivalent and provide a pre -determined meal to the coupon bearer. Restaurants and program participants must not exchange coupons for cash nor provide change to the coupon bearer if the amount purchased is less than $10.00. Coupons can only be utilized for the purchase of meals. Restaurants can only offer delivery or pick-up services. Restaurants must keep a record of all coupons and related receipts they redeemed attached to a request for reimbursement equaled to the sum all coupons. The reimbursement request consisting of coupons, and sale receipts must be delivered to the respective district office or a specified location accessible by the district office Mondays and/or Wednesdays. The district office will submit the reimbursement request to the City of Miami Administration for immediate payment to each participating restaurant. ACH payments occur weekly. Coupons will not be reissued if a recipient were to misplace or lose his/her coupon(s). In addition, coupons that are defaced or damaged beyond recognition also will not be replaced. Wage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES Why It Works The program discourages large gatherings that are indicative of traditional food distribution efforts by sending bearers directly to the participating restaurants to redeem a meal at any time they wish. Eliminating large gatherings by participants and volunteers follows the guidelines of social distancing requirements established by local governments. Each recipient must complete a "Meal Coupon — Resident Application Form" and submit it to the district office for approval to allow for proper documentation and record keeping of each dollar spent in order to encourage reimbursement by the state or federal government. Selection Methodology (selection may vary by district office) Example: • Application deadline and lottery based on district office preferences; • First come first serve; District Office Preferences (preferences may vary by district office) Preferences may vary by district office. The program has the following preferences: Example: • Elderly and/or disabled households; • Unemployed; NOTE: Guidelines, forms, and other documents attached to these Guidelines are subject to change from time to time to ensure proper utilization of public funding. District Office Responsibilities • Identify and determine recipients list (minimum requirements for auditing purposes). Complete the "Resident Application Form" for each recipient (see application form attached). • Ensure restaurants complete "Participating Restaurant Application Form" and provide all required forms and licenses. District office must select the participating restaurants and inform City Administration. • Approve design for coupon per district • Keep inventory of pre -numbered coupons in district office in a safe area for tracking purposes • Provide instructions to restaurant regarding the reimbursement process • Provide instruction to residents on participating restaurants and how to redeem coupons • Assign pre -numbered coupons to approved recipients. (see Sample Qualifying Recipient list and Related Coupon(s) • Record all redeemed coupons and track • Keep coupons in safe area until a request for reimbursement is prepared Wage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES ■ Prepare request for reimbursement for participating restaurants. (See sample Check request) Participating Restaurant Responsibilities ■ Receive coupons from coupon holder ■ Check for authenticity as instructed by the district office ■ Submit redeemed coupons to the district office ■ Provide a completed reimbursement package and attach receipts for each redeemed coupon ■ Write down name of person coupon was issued to on the back of the coupon. Administration Responsibilities ■ Have funds available for each elected official (Budget) as allowed by Manager under the COVID- 19 emergency Approve design for coupon (Budget) ■ Procure Check paper (special paper when copied depicts "do not copy" to prevent forgery (GSA) ■ Print coupons on demand — use prenumbered machine- Recommendation to start with 00000001 preceded by a two -letter initial of the district's choice. ex: HM-00000001 (GSA) ■ Initiate ratification of the Manager's Coupon Program by the Commission (Manager) ■ Receive redeemed coupons accompanied with a request for reimbursement from the district office (Finance- A/P) ■ Check supporting documentation and request for reimbursement per restaurant (Finance- A/P); ■ Issue check within a week of submittal (Finance- A/P) until the program expiration date ■ Assist in resolving challenges that may arise under the program ■ At the end of program provide reports of redeemed coupons per district (Finance) 41Page ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES Sample Qualifying Recipient list and Related Coupon(s) Coupon# Individual / Recipient Household Size Relationship Address Qualifier#1 INCOME <80%ofAMI Qualifier#2 Income TBD HM-00000001 John Doe 3 Self 444 NW 22 ST © ■ HM-00000002 Jane Doe - Wife 444 NW 22 ST © ■ HM-00000003 George Doe - Son 444 NW 22 ST © ■ HM-00000004 Mary White 2 Self 250SW 22 Avenue © ■ HM-00000005 Steven White - Husband 250SW 22 Avenue © ■ HM-00000006 Terry Smith 4 Self 720 SW 8th ST © ■ HM-00000007 Steven Smith - Husband 720 SW 8th ST © ■ HM-00000008 Terry Smith Jr - Daughter 720 SW 8th ST IN ■ HM-00000009 Jason Smith - Father 720SW 8thST © ■ HM-00000010 Juan Espinoza 1 Self 2201 SW nth ST © ■ HM-00000011 Nadir Salmon 2 Self 3223 NW 8th Avenue © ■ HM-00000012 Janice Salmon - Aunt 3223 NW 8thAvenue © ■ * ■ ■ * ■ ■ * ■ ■ * ■ ■ HM-00010000 Recipient 10,000 ■ ■ Custodian: District Office NOTE: The example above uses only one meal coupon per person. However, if you wish to provide multiple meal coupons per person, please indicate it in the chart as well. Wage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES Participating Restaurants Log City of Miami Meal Coupon Assistance Program District: 5 Restaurant Name Address Phone No Delivery Delivery Fee $ Pick -Up W-9 ACH Setup Chef Creole Seasoned Restaurant 200 NW 54th ST 305-411-5534 © -El El El Fiorito 5555 NE 2nd Avenue 305-445-8456 © $5.00 • Cafe Royal 5808 NE 4th CT 305-484-6656 © - ■ El El La Fourchette Restaurant 8267 N. Miami Avenue 786-225-5665 © $3.50 Sixty 6010 NE 2nd CT 305-556-7847 © $2.50 © © ■ Mandolin Aegean Bistro 4312 NE 2nd Avenue 305-466-6565 © $2.00 • © ■ 3 Queens Restaurant 7625 NE 2nd Avenue 305-878-6598 ■ - © © ■ Bon Gout BBQ 99 NW 54th ST 305-111-4565 © - © © ■ La Piazzetta Pizzeria 5143 NE 2nd Avenue 786-201-8876 © $5.00 • Casablanca Seafood Bar & Grill 400 NW N River Dr 786-556-0004 © - ■ El El Kiki on the River 450 NW N River Dr 305-775-5565 © $4.00 • Modern Garden 1422 NW N River Dr 305-556-8874 ■ -El El El Red Rooster 920 NW 2nd Avenue 786-203-5456 © -El El El Garcia's 398 NW N River Dr 305-225-8478 © $5.00 • © ■ Jackson Soul Food 950 NW 3rd Avenue 786-445-8799 © $2.00 © © ■ Burger King 797 NW 27th Avenue 305-998-8779 © $2.50 © © ■ McDonald's 8050 NW 27th Avenue 305-255-4566 ■ - © © ■ NOTE: This log can also be provided to program participants so they know where they can order food fro m Wage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES PAYMENT REQUEST FORM MEAL COUPON ASSISTANCE PROGRAM DISTRICT From (Name of Requestor): Subject: Check Request Please issue a check in the amount of: to the following participating restaurant: Participating Restaurant Name: as per the attached redeemed coupons (see attached "Summary Sheet"). 1 have verified that the information contained in this Payment Request Form and the attached Summary Sheet is accurate and correct and that the number of ORIGINAL meal coupons attached to this Payment Request Form mirror the information on the Summary Sheet. Signature of Authorized District Office Staff Print Name Date 7IPage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES W-9 FORM See full version on-line W-9 form and ACH enrollment forms are accessible via this link. Both forms can be completed through the City website: https://www.miamigov.com/Services/Doing-Business/Submit-a-W9- Form?BestBetMatch=w9 I d13b95b2-5146-4b00-9e3e-a80c73739a64 14f05f368-ecaa-4a93-b749- 7ad6c4867c1f1en-US Faun IN-9 Pee. Pee. October ?Gl6j Department of the Treasury ' Internal Re.+enue Ser,ce Request for Taxpayer Identification Nuinber and Certification ■ Go to wwwhs.gov/FormW9 for Instructions and the latest information. Give Form to the requostet. Donot send to to IRS. 1 Name lee Moen an your Income tax. r.t.rnl. Noma is required o1 this line; do not leer; this line blank. 2 Business narreedisregarded entty narmi if different frpm *wee I,g tS. g 3 Checf+u pcp+iate box fa tederai tax alasaflcation of the pe+son *frese•name is entered on Fne I. Check only zma of the following seven boxes ❑ lydfriduakrale pro0,6tur or ❑ C Carperetim ❑ s Corporation ❑ Partnership ❑ TrusL%estate sirila•nrertrber LLD 4 Exe. iptims ..ertam entities insvuoacne Exempt pay* ycodes agfly ony to not individuals see on page 3,1. cede Qf rim) ❑ limited liability company. Eater the tax etasdfkation [G=C corporation, S-.Scarperaticnn. P.Partnershipi ■ $ Not Check the appropriete bear in the Ina above for the tax classification of the eingle-rnernbw owner. Do net check LLC if the LLC ie aLssaleed as a smg e-membef LLC that Is dieregardad from the owtrar Coles the owner of the LLC is LLC that is nut dkregerowner U.S. ded from the owr for Ufederal tax purposes. Otherwise, a single member LLC that Exemption 07dk, if m1 from FATCA reposing Txanother 'a is disregarded trcm the owner should check the apprecriais box for the tax clasnafration of its owing. ❑ Other +seeknstructiens]■ :xNsa'.*ix aurrsms>Mnxaarsw:xu.:,, 4 m S Address number, street, and apt. cr suite no.) Sae instructions. fksquester's name and address icpt nary 6 sty. etatd. and ZIPccde 7 List aoowet ntlrllbertel bare {optic nala Part I Taxpayer Identification Number (TINY Enter your T1N in the appropriate box The TIN provided must match the name given on line 1 to avoid waist eewdty numb°, backup withholding. For individuals. this H generally your social security number4SSNj. However, fct a resident alai. sole proprietor, or disregarded entity see the instructions tar Par[ I. later. For other entities. it is your employer identificalion number (N). If you do not have a number. see How II, seta — — M. later. Of Hole: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer idertaiica lsrl nu,nher Ntnber To Give the Fteoocs:er for guidelines on wticea nu mbar to enter. Part 11 Certification Wage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES CITY OF MIAMI SUPPLIER DIRECT DEPOSIT (ACH) AUTHORIZATION Supplier Name (if known): Name of Supplier: Address: FEIN/TIN/SSN: Phone No.: Email Address: Fax No.: Direct Deposit/ACH Action Request (check one): Start ❑ Change ❑ Stop ❑ Checking Account Information: Name of Financial Institution: Address: Phone No.: Account No.: Routing No.: Voided Check Attached ❑ Authorization I hereby authorized and request the City of Miami to initiate credit entries, and if necessary, debit entries and adjustments for any credit entries in error to my account at the financial institution named. This authorization is to remain in effect until withdrawn by me in writing with sufficient notice to the City to allow adequate time to effect termination. Signature Date The signature above signifies agreement with the following terms and conditions: Instructions This authorization form for Direct Deposit/ACH Deposit must be completed and signed by an authorized representative of the Supplier requesting deposit. You must attach a copy or original (marked "VOID") of your bank check. To indicate the action requested, and account type, please a check mark or an "X" inside the provided check box next to the appropriate choice. After the form is completed, signed and the required documents attached, it should be returned to the Finance Department of the City of Miami, 444 SW 2"dAvenue, 6`h Floor, Miami, FL 33130 or Faxed to 305-416-1987 or emailed to parables@miamigov.com 9IPage ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES SAMPLE CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM PARTICIPATING RESTAURANT APPLICATION FORM This Program is aimed at assisting local restaurants that are economically impacted by COVID-19. The program will provide a $10.00 voucher to adult residents and their household members for a meal at a local participating restaurant. The voucher will be paid directly to the restaurant by the City of Miami on a reimbursement basis. RESTAURANT INFORMATION Legal Name of Business: Tax ID No.: Business Address: Miami, FL Zip Code: Owner/Authorized Signer's Name: Email Address: Phone No.: SERVICE INFORMATION District(s) Served: 1 ❑ 2 ❑ 3 ❑ 4 ❑ 5 ❑ RESTAURANT OWNER QUALIFICATION CRITERIA I am able to provide balanced and nutritional meals for $10.00 (tax included) I am able to accept Meal coupon vouchers that must be presented to the City for reimbursement I have a pickup window or a place in front of my restaurant to set up a rapid pick up location I am able to offer different menus to coupon holders I have delivery capabilities and can deliver meals to my clients at no extra cost I have delivery capabilities, but the additional cost per delivery is: $ Have you applied for an SBA Loan such as Payment Protection Program (PPP), Economic Injury Disaster Loan Emergency Advance (EIDL), SBA Express Bridge Loans, or SBA Debt Relief If you answer was "YES" on the question above, have you received the SBA benefit already? YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO ❑ ADDITIONAL SUPPORTING DOCUMENTATION — Please attach the following to this Application Form. • Form W-9 • Business Licenses • Copy of Last Health Inspection Report • Direct Deposit Form • Business Tax Receipts • Sample Menu • Dept. of Health License ACKNOWLEDGMENT as the owner/authorized signer of Business nary acknowledge that the services provided are in the City of Miami, and that I am responsible for providing the documentation requested in order to participate in this program, and further certify that the information provided above is true and correct. Print Owner/Authorized Signer Signature Date 101 Page Name (Nombre): Address (Direcci6n): City (Ciudad): MIAMI ATTACHMENT "G" CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM GUIDELINES SAMPLE CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM APPLICATION FOR MEAL COUPON Solicitud pars cupones de comida Email Address (Correa Electronico): Phone # (Telefono #): SSN No.: Apt No.: State (Estado): FL Zip Code (C6digo Postal): Are you currently employed (tiene trabajo actualmente?) YES 0 NO 0 You and your family are eligible IF (1) you are low income as noted in the chart below and (2) you meet the documentation requirements of being a City of Miami resident. Usted y su familia son elegible SI usted: (1) es de bajos ingresos e indicado en la grafica debajo; (2) cumple con los requisites de ser un residente de la Ciudad de Miami Current Income Limits for the Program (Limites de Ingresos vigente del programa) Household Size (No. de Integrantes en su Familia) 1 2 3 4 5 Maximum Income (Ingreso Maximo) $51,200 $58,500 $65,800 $73,100 $78,950 € $84,800 (80% of Area Median Income) (80% del promedio del area) _ Annual Combined Household Income for ALL household members: (Ingresos Anuales Combinados de TODOS los miembros del hogar) In the following chart, please write down the household composition (Including yourself). (En la siguiente tabla, escriba la composition familiar de su hogar (incluyendose a Ud.) No. Name (Nombre) Relationship (Relaci6n) Last 6-digits SSN (ultimos 6-digitos del SSN) Age (Edad) Race (Rana) Hispanic Y / N FOR CITY USE ONLY (Solo para el use de la Ciudad) Coupon # 1 SELF (Solicitante) 2 3 4 5 6 7 APPLICANT CERTIFICATION • I am currently NOT receiving any meal/food assistance from any other local, state, or federal housing assistance program. (YO actualmente NO recibo ninguna asistencia de comida de ningen otro programa de asistencia de vivienda local, estatal o federal); I certify that the information provided to determine my eligibility for assistance on this application is true and correct to the best of my knowledge. I, the applicant, further understand that any false information provided in connection with this application may be grounds for termination from the program. (YO certifico que la informaci6n proporcionada para determinar mi elegibilidad pars recibir asistencia a traves de esta solicitud es verdadera y correcta, bajo la que yo conozco y entiendo. Yo, el solicitante, entiendo ademas que cualquier informaci6n falsa proporcionada en relaci6n con esta solicitud puede ser motivo de terminaci6n del programa. • I understand that this assistance is contingent upon the availability of funds; (ro entiendo que esta asistencia depende de la disponibilidad de fondos); Signature of Applicant/Head of Household Print Name Date Firma del Solicitante/Cabeza de Familia Nombre completo con tetra de molde Fecha 111 Page Name (Nombre): Address (Direccion): City (Ciudad): MIAMI CITY OF MIAMI MEAL COUPON ASSISTANCE PROGRAM APPLICATION FOR MEAL COUPON Solicitud para cupones de comida Email Address (Correo Electronico): Phone # (Telefono #): SSN No.: Apt No.: State (Estado): FL Zip Code (Codigo Postal): Are you currently employed (tiene trabajo actualmente?) YES 0 NO 0 You and your family are eligible IF (1) you are low income as noted in the chart below and (2) you meet the documentation requirements of being a City of Miami resident. Usted y su familia son elegible SI usted: (1) es de bajos ingresos e indicado en la grafica debajo; (2) cumple con los requisitos de ser un residente de la Ciudad de Miami Current Income Limits for the Program (Limites de Ingresos vigente del programa) Household Size (No. de Integrantes en su Familia) 1 2 3 4 5 6 7 8 Maximum Income (Ingreso Maximo) (80% of Area Median Income) (80% del promedio del area) $51,200 $58,500 $65,800 $73,100 $78,950 $84,800 ........................................................................................................................................................................................................................:........................................:.....................................:.......................................:.....................................:.......................................:................................. Annual Combined Household Income for ALL household members: (Ingresos Anuales Combinados de TODOS los miembros del hogar) $90,650 $96,500 In the following chart, please write down the household composition (Including yourself). (En la siguiente tabla, escriba la composicion familiar de su hogar (incluyendose a Ud.) No. Name (Nombre) Relationship (Relacion) Last 6-digits SSN (Ultimos 6-digitos del SSN) Age (Edad) Race (Roza) Hispanic Y / N FOR CITY USE ONLY (Solo para el use de la Ciudad) Coupon # 1 SELF (Solicitante) 2 3 4 5 6 7 APPLICANT CERTIFICATION • I am currently NOT receiving any meal/food assistance from any other local, state, or federal housing assistance program. ( o actualmente NO recibo ninguna asistencia de comida de ning6n otro programa de asistencia de vivienda local, estatal o federal); • I certify that the information provided to determine my eligibility for assistance on this application is true and correct to the best of my knowledge. I, the applicant, further understand that any false information provided in connection with this application may be grounds for termination from the program. (YO certifico que la informacian proporcionada para determinar mi elegibilidad para recibir asistencia a troves de esta solicitud es verdadera y correcta, bajo to que yo conozco y entiendo. Yo, el solicitante, entiendo ademas que cualquier informacian falsa proporcionada en relacion con esta solicitud puede ser motivo de terminacion del programa. • I understand that this assistance is contingent upon the availability of funds; (YO entiendo que esta asistencia depende de la disponibilidad de fondos); Signature of Applicant/Head of Household Print Name Date Firma del Solicitante/Cabeza de Familia Nombre completo con letra de molde Fecha