Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Back-Up Documents
FY2019 Continuum of Care (CoC) Program GRANT AGREEMENT Between United States Department of Housing and Urban Development (USHUD) And Miami -Dade County Miami -Dade County Homeless Trust ATTACHMENT A "FY 2019 US HUD CoC Grant Agreement" U.S. Department of Housing and Urban Development Office of Community Planning and Development 909 SE First Avenue Miami, FL 33131 Grant Number: FL0211L4D001912 Tax ID Number: 59-6000573 DUNS Number: 004148292 CONTINUUM OF CARE PROGRAM (CDFA# 14.267) GRANT AGREEMENT This Grant Agreement ("this Agreement") is made by and between the United States Department of Housing and Urban Development ("HUD") and Miami -Dade County (the "Recipient"). This Agreement is governed by title IV of the McKinney-Vento Homeless Assistance Act 42 U.S.C. 11301 et seq. (the "Act"); the Continuum of Care Program rule (the "Rule"), as amended from time to time; and the Notice of Funds Availability for the fiscal year competition in which the funds were awarded, The terms "Grant" or "Grant Funds" mean the funds that are provided under this Agreement The term "Application" means the application submissions on the basis of which the Grant was approved by HUD, including the certifications, assurances, technical submission documents, and any information or documentation required to meet any grant award condition. All other terms shall have the meanings given in the Rule. The Application is incorporated herein as part of this Agreement, except that only the project (those projects) listed below are funded by this Agreement In the event of any conflict between any application provision and any provision contained in this Agreement, this Agreement shall control. HUD's total funding obligation for this grant is $695,520, allocated between the projects listed below and, within those projects, between budget line items, as shown below. www.hud.gov espanol.hud.gov Page 1 Project No. Grant Term Perforrnance Period Total Amount FL0211L4D001912 06-01-2020 - 05-31-2021 $695,520 a. Continuum of Care planning activities $0 b. Acquisition $0 c. Rehabilitation $0 d. New construction $0 e. Leasing . $0 f. Rental assistance $0 g. Supportive services $650,020 h. Operating costs $0 i. Homeless Management Information System $0 j. Administrative costs $45,500 k. Relocation Costs $0 1. HPC homelessness prevention activities: Housing relocation and stabilization services $0 Short-term and medium -term rental assistance $ 0 www.hud.gov espanol.hud.gov Page 2 If any new projects funded under this Agreement are for project -based rental assistance for a term of fifteen (15) years, the funding provided under this Agreement is for the performance period stated herein only. Additional funding is subject to the availability of annual appropriations. The performance period of renewal projects funded by this Agreement will begin immediately at the end of the performance period under the grant agreement being renewed. Eligible costs incurred between the end of Recipient's final operating year under the grant agreement being renewed and the date of this Agreement is executed by both parties may be reimbursed with funds from the first operating year of this Agreement. No funds for renewal projects may be drawn down by Recipient before the end date of the project's final operating year under the grant that has been renewed. For any transition project funded under this Agreement the performance period of the transition project(s) will begin immediately at the end of the Recipient's final operating year under the grant being transitioned. Eligible costs, as defined by the Act and the Rule incurred between the end of Recipient's final operating year under the grant being renewed and the execution of this Agreement may be paid with funds from the first operating year of this Agreement. HUD designations of Continuums of Care as High -performing Communities (HPCS) are published in the HUD Exchange in the appropriate Fiscal Years' CoC Program Competition Funding Availability page. Notwithstanding anything to the contrary in the Application or this Agreement, Recipient may only use grant funds for HPC Homelessness Prevention Activities if the Continuum that designated the Recipient to apply for the grant was designated an HPC for the applicable fiscal year. The Recipient must complete the attached "Indirect Cost Rate Schedule" and return it to HUD with this Agreement. The Recipient must provide HUD with a revised schedule when any change is made to the rate(s) included in the schedule. The schedule and any revisions HUD receives from the Recipient will be incorporated into and made part of this Agreement, provided that each rate included satisfies the applicable requirements under 2 CFR part 200 (including appendices). This Agreement shall remain in effect until the earlier of 1) written agreement by the parties; 2) by HUD alone, acting under the authority of 24 CFR 578.107; 3) upon expiration of the performance periods for all projects funded under this Agreement; or 4) upon the expiration of the period of availability of funds for all projects funded under this Agreement. HUD notifications to the Recipient shall be to the address of the Recipient as stated in the Application, unless the Recipient changes the address and key contacts in e-snaps. Recipient notifications to HUD shall be to the HUD Field Office executing the Agreement. No right, benefit, or advantage of the Recipient hereunder may be assigned without prior written approval of HUD. www.hud.gov espanol.hud.gov Page 3 The Agreement constitutes the entire agreement between the parties, and may be amended only in writing executed by HUD and the Recipient. By signing below, Recipients that are states and units of local government certify that they are following a current HUD approved CHAS (Consolidated Plan). This agreement is hereby executed on behalf of the parties as follows: UNITED STATES OF AMERICA, Secretary of Rousing and Urban Development Ann D. Chavis, Director (Typed Name and Title) November 3, 2020 (Date) RECIPIENT Miami -Dade County (Name of Organization) By: (Signature of Authorized Official) (Typed Name and Title of Authorized Official) I(C, (Date) OOOOP•PP Dago.ae ter OM 114/ Ppwww.1wd.gov espandhud.gov Page 4 MAURICE L. KEMP DEPUTY MAYOR MIAMI-DADE CTYP FL Indirect Cost Schedule Agency/Dept./Major Function Indirect Cost Rate Direct Cost Base This schedule must include each indirect cost rate that will be used to calculate the Recipient's indirect costs under the grant. The schedule must also specify the type of direct cost base to which each included rate applies (for example, Modified Total Direct Costs (MTDC)). Do not include indirect cost rate information for subrecipients. For government entities, enter each agency or department that will carry out activities under the grant, the indirect cost rate applicable to each department/agency (including if the de minimis rate is used per 2 CFR §200.414), and the type of direct cost base to which the rate will be applied. For nonprofit organizations that use the Simplified Allocation Method for indirect costs or elects to use the de rninimis rate of 10% of Modified Total Direct Costs in accordance with 2 CFR §200.414, enter the applicable indirect cost rate and type of direct cost base in the first row of the table. For nonprofit organizations that use the Multiple Base Allocation Method, enter each major function of the organization for which a rate was developed and will be used under the grant, the indirect cost rate applicable to that major function, and the type of direct cost base to which the rate will be applied. To learn more about the indirect cost requirements, see 24 CFR 578.63; 2 CFR part 200, subpart E; Appendix IV to Part 200 (for nonprofit organizations); and Appendix ' II to Part 200 (for state and local governments). www.hud.gov espanol.hud.gov Page 5 FY 2019 Continuum of Care (CoC) Program Scope of Service eSnaps Budget and Performance Objectives ATTACHMENT B "FY 2019 Scope of Service and US HUD eSnaps Documents" Miami -Dade County Homeless Trust Scope of Service FL0211L4D0O1912 Miami Homeless Assistance Program (MHAP) CE Consolidation The Subrecipient shall provide street outreach to eligible homeless persons through the Supportive Services Only Program during the one (1) year grant term. The Subrecipient shall provide services as proposed in the application to United States Department of Housing and Urban Development (US HUD) pursuant to the 2019 NOFA (incorporated herein by reference), and pursuant to 24 CFR 578 including but not limited to: 1. Accept eligible homeless persons as defined by US HUD and through Miami -Dade County Homeless Trust CoC's established Coordinated Outreach and Assessment HMIS referral process; 2. Comprehensive assessment and case management; 3. Residential stability; 4. If applicable, locate and match eligible program participants with eligible Landlords with units in the community; 5. If Miami -Dade County is the Rental Administrator, provide, complete and submit to the assigned staff all documentation, records and reports, including but not limited to, Attachment K Participant's Housing Application; 6. If Miami -Dade County is not the Rental Administrator, provide, complete and maintain all documentation, records and reports, including but not limited to, Attachment J Participant's Housing Application. Provide, maintain and complete all documentation and supporting information for HQS Inspections, verify compliance with federal rules and regulations, verify Program Participants' Income Calculation and Rent Determination including any applicable utility allowances, review Lease Agreement, Lease Addendum if applicable, and Housing Assistance Payment (HAP) Contracts, issue move -in authorization, and issue payments to Landlords; 7. Provide policies and procedures which ensure compliance with Further Fair Housing Act, Client Rights and Grievance Procedures specifically regarding terminations of housing, termination from program, evictions, and Landlord Tenant issues and appeals; 8. Provide directly, or refer to all appropriate mainstream services (as applicable) including psychiatric or psychological evaluations, medical clearances, mental health treatment, substance abuse treatment, social rehabilitation, legal services, life skills training, family reunification, counseling services, benefits applications, veteran services, employment, vocation and job assistance services; 9. Provide at a minimum, an annual assessment of the services needs of the program participants and adjust services accordingly; and 10. Discharge planning to other types of mainstream positive housing. Conditions: The Subrecipient shall adhere to the "Continuum of Care Program Grant Agreement", which includes the "Exhibit 1 Scope of Service FY 2019 Competition" and which is governed by the Continuum of Care (CoC) program rules and regulations. The Subrecipient shall comply with all applicable federal, state and local laws, regulations and ordinances, including but not limited to 24 CFR Part 578, as may be amended, the McKinney- Vento Homeless Assistance Act (42 U.S.C. 11301 et seq.) (the "Act") as may be amended, the Consolidated and Further Continuing Appropriations Acts of 2013 and 2014 as well as with any other terms and conditions as HUD may have established in the applicable Notice of Funds Availability and with any applicable guidance, requirements and directives provided by Miami -Dade County Homeless Trust. Attachment B "Miami -Dade County Homeless Trust Scope of Service" Tag. Er tanti MIAMI-DADE OM ELESS T R US T July 21, 2020 Terrell T Ellis, Contract Monitoring and Management Supervisor Miami -Dade County Homeless Trust 111 NW 1st Street 27th Floor, Suite 310 Miami, FL 33128 RE: Miami Homeless Assistance Program CE Consolidation. Dear Ms. Ellis: Attached please find the budget narrative for the Project Name: Miami CE Consolidation for Fiscal Year 2020-2021 (from February 1, 2020 respectfully requesting your reviews and approval. Please feel free to contact me at (305) 960-4988 if you have any information. Sergio Homeless A Enclosure ST/ag ARTHUR NORIEGA, V City Manager Homeless Assistance Program to January 31, 2021), we are questions or need additional CITY OF MfAMI HOMELESS ASSISTANCE PROGRAM 450 SW 5th Street, Miami, FL 33130 / Phon4(305) 960-4980 Fax: (305) 400-5321 Miami Homeless Assistance Program CE Consolidation — FY-2020-21 BUDGET NARRATIVE SUPPORTIVE SERVICES: SALARIES & FICA: Information and Referral Specialist ($303,056.00), Funds for 12.00 FTE: This is specialized work responsible for providing direct outreach and referral services to homeless individuals, An employee in this classification must be able to identify and engage homeless individuals in public places, under bridges, in abandoned buildings, and other outdoor areas in an attempt to engage them in a non -threatening way, build relationships, and assist them in recognizing and defining their own service needs. Reports to a higher -level administrator. # IRS Funds would cover by CoC Program Funds would cover by MOA 12 80% 20% Information & Referral Aide ($179,442.00), Funds for 9.00 FTE: The essential functions for this position are: Maintains files of information gathered on the various governmental and social service agencies, Assists the Information and Referral Specialists or other staff members in distributing information to clients, translating documents and gathering routine background data on clients, either in the office or field, identifies supportive service resources, and makes referrals where appropriate, assists in developing systems for documenting and reporting all activities and services provided for clients. # IRA Funds would cover by CoC Program Funds would cover by MOA 8 80% 20% 1 100% 9 Housing Specialist ($25,255), 1.00 FTE: The CoC Consolidation funds would cover salary for 80% of one position time, the rest amount should be covered by MOA. The duties include, but are not limited to, the following: providing outreach and housing services to homeless clients; assessing the housing needs and eligibility of clients; assisting clients in identifying permanent or transitional housing, and following up periodically on clients referred through the criminal justice and public health systems. Reports to the Homeless Housing Supervisor or designee. Case Manager Assistant ($41,537.00), 1.00 FTE: The CoC Consolidation funds would cover salary for 100% of position time, This position is responsible for assisting Case Managers and Supervisory staff with varied case management activities including following up with clients pursuant to counseling sessions; assisting with the progress of clients in the fulfillment of their individual employment and training program service strategies. 2 Special Project Assistant ($58,152.00) 1.00 FTE: The CoC Consolidation funds would cover salary for 100% of one position time. This is a supervisory position overseeing the information and referral operation. Assist/coordinate special projects; assist with overall program operation. Serve as a liaison between program and outside businesses. Also, this position provides the outreach and referral services. Communication ($6,578.00): The requested is needed to cover part of the costs of office cell phones. These are used to communicate with outreach teams out in the field. Transportation ($36,000.00): This amount will be used to cover part of the services GSA for the rent of cars used for client transportation. The total expense for 21 cars assigned to the Homeless Program is $45,000.00 per year, however the real cost for 21 ears is $189,000 (21 cars *$750.00* 12 months). The CoC Program would cover $36,000.00 (17 cars), the other $9,000.00 would cover by Memorandum of Agreement (MOA). The difference between the total real cost for 17 cars ($153,000.00) vs total expenses under CoC Program ($36,000.00) represent the In -kind match ($117,000.00). 3 MHAP- CE-Consolidation-CoC Program -FY 2020-21 Supportive Services Expense Budget 12.0 FTE=>12(80%). Information & Referral Specialist Total Salary FICA 303,056 281,520 21,536 8.0 F'1'h =>8 80% Information and Referral Aide Total .._.._..._n,.... Salaryn. _......... _ _...m FICA 154,520 143, 539 10,981 1.0 FTE =>1 1001%2. Information and Referral Aide Total _._.., ...,.. Sam' . ._ .m,... ..., ..m.,m .... FICA 24,922 2y3 151 1,771 1.0 F I B =>(80% ). Housing S pecialist (Outreach stalk_ Total Salary._.__.._........_............_._._,................................................. _ .._......................... FICA 25,255 23,460 1,795 1.0 FTE =>(100%). Case Manager Assistant (Outreach staff) Total ..�.. Salary'_.. _...... ._�_�.M_. FICA 41,537 .._.._.�._.�_....._-38, 586 __ ... ..w._. 2, 951 1.0 FIE=>(100%). Special Project Assistance (Outreach staff) Total Salary_.............._........._..............................._......................._........................_................_........................................ FICA 58,1.52 54, 020 4,132 Total Salaries & Fica 607,442 Communication 6,578 Transportation k 9Y• Sty 'ola`ppo ervices r. 36,000 Administrative Cost 22,749 - Homeless Program Administration (50%) 22,749 Total Budget MHAP-C1 - Consolidation 672,769 4 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Project and Recipient Information 1. Awarded Grant Number: FLO211 L4D001912 2. Project Name: Miami Homeless Assistance Program CE Consolidation 3. CoC Number and Name: FL-600 - Miami -Dade County CoC 4. Recipient Legal Name: Miami -Dade County 5. EIN/TIN: 59-6000573 6a. DUNS Number: 004148292 6b. DUNS Extension: HUD Award Information Renewal Applicant Submission DO Review DD Review HUD Award 7. Component Type: SSO SSO SSO 8. Will the PH project provide PSH or RRH? 9. Grant Term: 1 Year 1 Year 1 Year 10. Reduced through Reallocation: No No No 11. Indirect Cost Rate: No No No Budget Summary Eligible Activities Annual Amount Requested (Renewal Applicant Submissio n) Annual Amount Requested (HUD Award) Grant Term (Renewal Applicant Submissio n) Grant Term (HUD Award) Total Requested for Grant Term (Renewal Applicant Submission) Total Requested for Grant Term (HUD Award) la. Leased Units ear. 0 lb. Leased Structures ear 0 2. Rental Assistance ear Year $0 3. Supportive Services 650,020 650,020 ear Year $650,020 650.020' 4. Operating 0 ear, 0 5. HMIS 1 Year $0I 6. Sub -total Costs s Requested 7. Admin (Up to 10%) 8. Total Assistance Plus Admin°Requested $650,020 $650,020 45,500 $45,500 $695,520 $695,520 HUD Conditional Award Summary Page 1 11/17/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 9. Cash Match 10. In -Kind Match °Ma Tot; $173,880. $173,880 $0 $0 $173,880 $173,880' $869,400 ; $869,400 HUD Conditional Award Summary Page 2 11/17/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Submission Summary Page Project & Recipient Info Last Updated No Input Required HUD Conditional Award Summary Page 3 11/17/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Recipient Acknowledgement For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. This text box presents comments and alerts, recorded by HUD, that do not qualify as issues or conditions. 10. Consolidation Project. This project application was conditionally awarded as a consolidated project. (Issue) HUD Award Recipient Acknowledgement Conditions Applicable to ALL Projects 1. Match amount update needed in e-snaps and/or match documentation required. (Condition) a. Additional match commitment amount is required to be added to the e-snaps Match Screen due to a budget increase. b. In -kind match commitment contributions provided by a third party must attach MOU documentation in e-snaps. c. Match commitment documentation for this new conditionally awarded project must be attached in e-snaps. 2. Code of Conduct not on file with HUD or does not comply with 2 CFR part 200. (Condition) 3. HUD SF 2880 - Incomplete Recipient Disclosure/Update Report. (Condition) 5. Performance or capacity concern(s). The applicant should provide a written management plan addressing the capacity concern(s) identified below. (Issue) a. Applicant has a history of consistently submitting late APRs. b. Applicant has a history of consistent drawdown issues or poor financial management. c. Applicant has a history of consistent unresolved HUD monitoring or audit findings. d. Other capacity concerns (details specified below in #22). 6. Homeless Eligibility - Clarification is needed in the project application to confirm homeless eligibility of proposed program participants. (Issue) a. Update(s) needed to Project Description on Screen 3B (details specified below in #22). Applicant Renewal Issues and Conditions Page 1 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 b. The project application identified 100% Dedicated to CH but Screen 5B tables did not identify a correct number of CH persons to equal the number of Dedicated CH Beds on Screen 4B. c. PH-PSH or SH project application is unclear if proposing to serve households having at least one person with a disability. Updates should be made to the disability category numbers in the tables on Screen 5B. 8. Unit/Bed Counts - Clarification is needed to unit and/or bed counts on Screen 4B and /or updates are needed to other numbers in the project application for a general correlation between Screens 4B, 5A, or 5B tables. (Issue) 10. Consolidation Project. This project application was conditionally awarded as a consolidated project. (Issue) The applicant and the local HUD field office should do a final review to confirm the combined information from the individual renewal project applications is accurately reflected in e-snaps for the FY 2019 conditionally awarded consolidated project application. Refer to Section V.B.3.a (6) of the FY 2019 CoC Program NOFA and to the "FY 2019 CoC Program Recipient's Post -Award Users Guide" for detailed e-snaps processing procedures. 11. Expansion Project. This project application was conditionally awarded as a Combined Renewal Expansion project. (Issue) 13. Housing Type - clarification is needed for the Housing Type selection(s) on Screen 4B for the component type identified below. (Issue) a. Joint TH/PH-RRH component project (details specified below in #22). b. PH-PSH or PH-RRH component projects. 20. Possible violation of program regulation on service participation (details specified below in #22). (Issue) 21. Renewal of YHDP youth projects under the CoC Program. a. Waiver Request Attachments (Condition) b. Youth Population Focus (details specified below in #22). (Issue) 22. Other policy and program related conditions: Other 1 Other 2 Other 3 Other 4 Other 5 Other 6 Applicant Renewal Issues and Conditions Page 2 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Attachments For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. Document Type Required? Document Description Date Attached 01) Match Documentation No 02) Attachment(s) No 03) Attachment(s) No 04) Attachment(s) No 05) Attachment(s) No 06) Attachment(s) No 07) Attachment(s) No 08) Attachment(s) No 09) Attachment(s) No 10) Attachment(s) No Applicant Renewal Issues and Conditions Page 3 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Attachment Details Document Description: Attachment Details Document Description: Attachment Details Document Description: Attachment Details Document Description: Attachment Details Document Description: Attachment Details Document Description: Attachment Details Document Description: Applicant Renewal Issues and Conditions Page 4 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Attachment Details Document Description: Attachment Details Document Description: Attachment Details Document Description: Applicant Renewal Issues and Conditions Page 5 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Adjustments For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. Has HUD required that you adjust information No submitted with your application to resolve Issues and Conditions made by HUD? Applicant Renewal Issues and Conditions Page 6 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 1A. Application Type For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. This information cannot be edited. If updates are needed to this information, exit this step and update the Project Applicant Profile. 1. Type of Submission: Application 2. Type of Application: Renewal Project Application If "Revision", select appropriate letter(s): If "Other", specify: 3. Date Received: 06/10/2020 4. Applicant Identifier: 5a. Federal Entity Identifier: 5b. Federal Award Identifier: FL0211 L4D001912 6. Date Received by State: 7. State Application Identifier: Applicant Renewal Issues and Conditions Page 7 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 16. Legal Applicant For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. This information cannot be edited. If updates are needed to this information, exit this step and update the Project Applicant Profile. 8. Applicant a. Legal Name: Miami -Dade County b. Employer/Taxpayer Identification Number 59-6000573 (EIN/TIN): c. Organizational DUNS: 004148292 PLUS 4 d. Address Street 1: 111 N.W. 1st Street Street 2: 27th floor, Suite 310 City: Miami County: Miami -Dade State: Florida Country: United States Zip / Postal Code: 33128 e. Organizational Unit (optional) Department Name: Homeless Trust Division Name: none f. Name and contact information of person to be contacted on matters involving this application Prefix: Mr. First Name: Manuel Middle Name: Last Name: Sarria Applicant Renewal Issues and Conditions Page 8 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Suffix: Title: Asst. Executive Director Organizational Affiliation: Miami -Dade County Telephone Number: (305) 375-1490 Extension: Fax Number: (305) 375-2722 Email: Manuel.Sarria@miamidade.gov Applicant Renewal Issues and Conditions Page 9 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 1 C. Application Details For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. This information cannot be edited. If updates are needed to this information, exit this step and update the Project Applicant Profile. 9. Type of Applicant: B. County Government If "Other" please specify: 10. Name of Federal Agency: Department of Housing and Urban Development 11. Catalog of Federal Domestic Assistance CoC Program Title: CFDA Number: 14.267 12. Funding Opportunity Number: FR-6300-N-25 Title: Continuum of Care Homeless Assistance Competition 13. Competition Identification Number: Title: Applicant Renewal Issues and Conditions Page 10 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 1 D. Congressional District(s) For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 14. Area(s) affected by the project (State(s) Florida only): (for multiple selections hold CTRL key) 15. Descriptive Title of Applicant's Project: Miami Homeless Assistance Program CE Consolidation 16. Congressional District(s): a. Applicant: FL-027, FL-026, FL-024, FL-025, FL-023 b. Project: FL-027, FL-026, FL-024, FL-025, FL-023 (for multiple selections hold CTRL key) 17. Proposed Project a. Start Date: 02/01/2020 b. End Date: 01/31/2021 18. Estimated Funding ($) a. Federal: b. Applicant: c. State: d. Local: e. Other: f. Program Income: g. Total: Applicant Renewal Issues and Conditions Page 11 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 1 E. Compliance For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. This information cannot be edited. If updates are needed to this information, exit this step and update the Project Applicant Profile. 19. Is the Application Subject to Review By b. Program is subject to E.O. 12372 but has not State Executive Order 12372 Process? been selected by the State for review. If "YES", enter the date this application was made available to the State for review: 20. Is the Applicant delinquent on any Federal No debt? If "YES," provide an explanation: Applicant Renewal Issues and Conditions Page 12 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 1 F. Declaration For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. This information cannot be edited. If updates are needed to this information, exit this step and update the Project Applicant Profile. By signing and submitting this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements herein are true, complete, and accurate to the best of my knowledge. I also provide the required assurances** and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) I AGREE: X 21. Authorized Representative Prefix: Mr. First Name: Carlos Middle Name: A. Last Name: Gimenez Suffix: Title: County Mayor Telephone Number: (305) 375-1490 (Format: 123-456-7890) Fax Number: (305) 375-2722 (Format: 123-456-7890) Email: cgimenez@miamidade.gov Signature of Authorized Representative: Considered signed upon submission in e-snaps. Date Signed: 06/10/2020 Applicant Renewal Issues and Conditions Page 13 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Recipient Performance For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Has the recipient successfully submitted Yes the APR on time for the most recently expired grant term related to this renewal project request? 2. Does the recipient have any unresolved No HUD Monitoring and/or OIG Audit findings concerning any previous grant term related to this renewal project request? 3. Has the recipient maintained consistent Yes Quarterly Drawdowns for the most recent grant terms related to this renewal project request? 4. Have any Funds been recaptured by HUD No for the most recently expired grant term related to this renewal project request? Applicant Renewal Issues and Conditions Page 14 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Renewal Expansion As part of the FY 2019 CoC Program project application process, project applicants can request their eligible renewal projects to be part of a Expansion. This process can combine up to 1 stand-alone renewal project application and 2 stand-alone new expansion project applications into 1 combined renewal expansion project application. This means recipients no longer need to combine expansion data in CoC Post -Award. Renewal projects that are part of an expansion must expire in Calendar Year (CY) 2020, as confirmed on the FY 2019 GIW or eLOCCS, must be to the same recipient, and must be for the same component and project type (i.e., PH- PSH, PH-RRH, Joint TH/PH-RRH, TH, SSO, SSO-CE or HMIS). 1. Is this project application requesting to be No part of a combined renewal expansion in the FY 2019 CoC Program Competition? "If "No" click on "Next" or "Save & Next" below to move to the next screen. Applicant Renewal Issues and Conditions Page 15 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Grant Consolidation HUD encourages the consolidation of renewal grants. As part of the FY 2019 CoC Program project application process, project applicants can request their eligible renewal projects to be part of a Renewal Grant Consolidation. This process can consolidate up to 4 renewal grants into 1 consolidated grant. This means recipients no longer must wait for grant amendments to consolidate grants. All projects that are part of a renewal grant consolidation must expire in Calendar Year (CY) 2020, as confirmed on the FY 2019 Final GIW, must be to the same recipient, and must be for the same component and project type (i.e., PH-PSH, PH-RRH, Joint TH/PH- RRH, TH, SSO, SSO-CE or HMIS). 1. Is this project application requesting to be Yes part of a renewal grant consolidation in the FY 2019 CoC Program Competition? If "No" click on "Next" or "Save & Next" below to move to the next screen. 2. Is this an individual project application or a Fully Consolidated fully consolidated project application? Renewal Grant Consolidation Table Project Identification Number PIN Total Requested Amount Surviving PIN or Terminating PIN Operating Start Date Expiration Date FL0189 $298,234 Terminating PIN 02/01/2019 01/31/2020 FLO190 $141,433 Terminating PIN 06/01/2019 01/31/2020 FLO211 $255,853 Surviving PIN 02/01/2019 01/31/2020 *The surviving PIN must have the earliest operating start date. Renewal Grant Consolidation Summary Total Number of Grants in Consolidation 3 Total Requested Amount in Consolidation $695,520 3. Has the consolidation been approved by Yes HUD HQ? Applicant Renewal Issues and Conditions Page 16 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 2A. Project Subrecipients This form lists the subrecipient organization(s) for the project. To add a subrecipient, select the icon. To view or update subrecipient information already listed, select the view option. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. Total Expected Sub -Awards: $695,520 Organization Type Sub - Award Amount The City of Miami C. City or Township Government $695,520 Applicant Renewal Issues and Conditions Page 17 06/10/2020 Applicant: Miami -Dade County 0041482920000 Project: Miami Homeless Assistance Program CE Consolidation FL0211 L4D001912 2A. Project Subrecipients For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. a. Organization Name The City of Miami b. Organization Type C. City or Township Government c. Employer or Tax Identification Number: 59-6000375 * d. Organizational DUNS: 118890230 PLUS 4 e. Physical Address Street 1 444 SW 2nd Avenue, 5th Floor Street 2 City Miami State Florida Zip Code 33136 f. Congressional District(s): FL-024 (for multiple selections hold CTRL key) g. Is the subrecipient a Faith -Based No Organization? h. Has the subrecipient ever received a Yes federal grant, either directly from a federal agency or through a State/local agency? i. Expected Sub -Award Amount: $695,520 j. Contact Person Prefix Mr. First Name Sergio Middle Name Applicant Renewal Issues and Conditions Page 18 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Last Name Torres Suffix Title Program Administrator E-mail Address storres@miamigov.com Confirm E-mail Address storres@miamigov.com Phone Number 305-960-4980 Extension Fax Number 305-960-4977 Applicant Renewal Issues and Conditions Page 19 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 3A. Project Detail For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. FY 2019 Grant Number: FL0211 L4D001912 (e.g., the "Federal Award Identifier" indicated on form 1A. Application Type) 2a. CoC Number and Name: FL-600 - Miami -Dade County CoC 2b. CoC Applicant Name: Miami -Dade County 3. Project Name: Miami Homeless Assistance Program CE Consolidation 4. Project Status: Standard Renewal Project Application HUD Award Adjustment 5. Component Type: SSO SSo SSo 6. Does this project use one or more No properties that have been conveyed through the Title V process? Applicant Renewal Issues and Conditions Page 20 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 3B. Project Description For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. la. Application description that addresses the entire scope of the proposed project. The City of Miami Homeless Assistance Program is the CoC's main CES access point, serving youth, unaccompanied adults and families. Our services extend to persons with and without disabilities. We staff the homeless helpline, provide discharge planning with institutions such as jails and hospitals that discharge into homelessness under an MOU, we canvas the full geography of Miami -Dade engaging persons experiencing homelessness, and we are the main referral source to shelter. We use mobile devises to perform assessments & referrals, & provide transportation, including handicap accessible City vehicles. MHAP employs and trains persons with lived homeless experience. Our goal is to identify, and engage homeless individuals & families and place them into appropriate housing at least 85% of the times. MHAP's policy is to place families w/children in hotel when shelter is not available. They work with law enforcement, DV and youth focused access points, and 2 behavioral health outreach teams to provide a greater level of engagement and comprehensive case planning. MHAP operates weekdays from 7 am to 10 pm, with staff on -call afterhours and weekends. MHAP assigns thirteen teams of two to canvas the streets. MHAP assists with building condemnations & encampments. Program Eligibility Requirements: The program specifically targets persons living on the streets. Funding is needed to provide comprehensive Coordinated Entry services including helpline, street outreach and transportation. Per the CoC's CES policy, SSO-SO and youth and DV access points are the sole source for referrals into the CoC's crisis response system. Last year MHAP served over 9,000 unduplicated persons. 1b. Provide changes, if required, to the description that addresses the entire scope of the proposed project. The City of Miami Homeless Assistance Program is the CoC's main CES access point, serving youth, unaccompanied adults and families. Our services extend to persons with and without disabilities. We staff the homeless helpline, provide discharge planning with institutions such as jails and hospitals that discharge into homelessness under an MOU, we canvas the full geography of Miami -Dade engaging persons experiencing homelessness, and we are the main referral source to shelter. We use mobile devises to perform assessments & referrals, & provide transportation, including handicap accessible City vehicles. MHAP employs and trains persons with lived homeless experience. Applicant Renewal Issues and Conditions Page 21 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Our goal is to identify, and engage homeless individuals & families and place them into appropriate housing at least 85% of the times. MHAP's policy is to place families w/children in hotel when shelter is not available. They work with law enforcement, DV and youth focused access points, and 2 behavioral health outreach teams to provide a greater level of engagement and comprehensive case planning. MHAP operates weekdays from 7 am to 10 pm, with staff on -call afterhours and weekends. MHAP assigns thirteen teams of two to canvas the streets. MHAP assists with building condemnations & encampments. Program Eligibility Requirements: The program specifically targets persons living on the streets. Funding is needed to provide comprehensive Coordinated Entry services including helpline, street outreach and transportation. Per the CoC's CES policy, SSO-SO and youth and DV access points are the sole source for referrals into the CoC's crisis response system. Last year MHAP served over 9,000 unduplicated persons. 2. Does your project have a specific No population focus? 3. Housing First a. Does the project quickly move participants Yes into permanent housing b. Does the project ensure that participants are not screened out based on the following items? Having too little or little income X Active or history of substance abuse X Having a criminal record with exceptions for state -mandated restrictions X History of domestic violence (e.g. domestic violence, sexual assault, childhood abuse) X None of the above c. Does the project ensure that participants are not terminated from the program for the following reasons? Select all that apply. (All Projects) Failure to participate in supportive services X Failure to make progress on a service plan X Loss of income or failure to improve income X Any other activity not covered in a lease agreement typically found in the projects geographic area X None of the above Applicant Renewal Issues and Conditions Page 22 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 d. Does the project follow a "Housing First" Yes approach? 4. Please select the type of SSO project: Street Outreach Applicant Renewal Issues and Conditions Page 23 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 4A. Supportive Services for Participants For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. For all supportive services available to participants, indicate who will provide them and how often they will be provided. Click 'Save' to update. Supportive Services Provider Frequency Assessment of Service Needs Assistance with Moving Costs Case Management Child Care Education Services Employment Assistance and Job Training Food Housing Search and Counseling Services Legal Services Life Skills Training Mental Health Services Outpatient Health Services Outreach Services Substance Abuse Treatment Services Transportation Utility Deposits 2. Please identify whether the project includes the following activities: 2a. Transportation assistance to clients to Yes attend mainstream benefit appointments, employment training, or jobs? 2b. At least annual follow-ups with No participants to ensure mainstream benefits are received and renewed? 3. Do project participants have access to No SSI/SSDI technical assistance provided by the applicant, a subrecipient, or partner Applicant Daily Applicant Daily Applicant Monthly Applicant Daily Applicant Daily Applicant Renewal Issues and Conditions Page 24 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 agency? Applicant Renewal Issues and Conditions Page 25 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 5A. Project Participants - Households For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. Households Total Number of Households Characteristics Adults over age 24 Persons ages 18-24 Accompanied Children under age 18 Unaccompanied Children under age 18 Total Person's Households with at Least One Adult and One Child 765 Persons in Households with at Least One Adult and One Child 650 115 1,912 2,677 Adult Households without Children 3,865 Adult Persons in Households without Children 3,700 165 3,865 Households with Only Children Persons in Households with Only Children Click Save to automatically calculate totals Total 4,630 Total 4,350 280 1,912 0 6,542 Applicant Renewal Issues and Conditions Page 26 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 5B. Project Participants - Subpopulations For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. Adults over age 24 Persons ages 18-24 Children under age 18 Total persons Adults over age 24 Persons in Households with at Least One Adult and One Child 230 5 0 235 aa1 IInoP. 121 101 150 15 0 165 with HIV/AIDS 35 5 0 40 Severely; Mentally 111 350 80 0 430 Victims,of Domestic Violence: 200 5 0 205 Click Save to automatically calculate totals Persons in Households without Children mill elATI ik}a Y�kX 14 4 1,160 120 100 1,000 Persons with HIV/AIDS 25 Severely Mentally 2,000 Victims of Domestic Violence 80 Physical Disability 45 2 0 47 Physical Disability - 7 Developm ental" Disability" 4 1 0 5 Developm ental , Disability 5 Persons not represent ed by listed subpopul. ations 1,912 1,912 Persons not represent ed"by listed .= subpopul ations Persons ages 18-24 1 1 50 5 100 10 2 2 Total ;Persons: 1,160 121 101 1,050 30 2,100 90 9 7 0 Click Save to automatically calculate totals Persons in Households with Only Children Characteristics` ivy=1ka T Iffir1(-Ti4iPPIISTO`t Accompanied Children under age 18 Unaccompanied Children under age 18 Chronic Substan ce Abuse Persons with HIV/AID S Severely Mentally III Victims of. Domesti o; Violence Physical Disabilit Y Develop Mental - Persons not represen ted by listed subpopu Cations Applicant Renewal Issues and Conditions Page 27 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Total Persoi 0 0 0 0 0 0 0 0 Describe the unlisted subpopulations referred to above: Children of head's of households Applicant Renewal Issues and Conditions Page 28 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 6A. Funding Request For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Do any of the properties in this project No have an active restrictive covenant? 2. Was the original project awarded as either No a Samaritan Bonus or Permanent Housing Bonus project? 3. Does this project propose to allocate funds No according to an indirect cost rate? 4. Select a grant term: 1 Year 6. Select the costs for which funding is being requested: Renewal Application HUD Award Adjustment Leased Units Leased Structures Rental Assistance Supportive Services X X X Operations HMIS Applicant Renewal Issues and Conditions Page 29 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Applicant Renewal Issues and Conditions Page 30 06/10/2020 Applicant: Miami -Dade County 0041482920000 Project: Miami Homeless Assistance Program CE Consolidation FL0211 L4D001912 6H. Sources of Match The following list summarizes the funds that will be used as Match for the project. To add a Matching source to the list, select the icon. To view or update a Matching source already listed, select the icon. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. Summary for Match Total Value of Cash Commitments: $173,880 Total Value of In -Kind Commitments: $0 Total Value of All Commitments: $173,880 1. Does this project generate program income No as described in 24 CFR 578.97 that will be used as Match for this grant? Match/ Levera ge Type Source Contributor Date of Commitment Value of Commitments Yes Cash Government Miami Dade County... 08/15/2019 $173,880 Applicant Renewal Issues and Conditions Page 31 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Sources of Match Detail For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. 1. Will this commitment be used towards Yes Match? 2. Type of Commitment: Cash 3. Type of Source: Government 4. Name the Source of the Commitment: Miami Dade County Homeless Trust - Admin. (Be as specific as possible and include the office or grant program as applicable) 5. Date of Written Commitment: 08/15/2019 6. Value of Written Commitment: $173,880 Applicant Renewal Issues and Conditions Page 32 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 61. Summary Budget For help in completing Post Award steps, please take a look at the FY2019 Recipients Post -Award Instructional Guide available on the Hud Exchange. To edit this screen, click "Adjustments" on the left menu, select "Yes" from the dropdown menu and briefly explain the adjustments that you would like to request in the text box provided. The following information summarizes the funding request for the total term of the project. However, the appropriate amount of administrative costs must be entered in the available fields below. Eligible Costs Annual Assistance Requested (Renewal Submission) Annual Assistance Requested (HUD Award) Annual Assistance Requested (Adjustment) Grant Term (Rene wal Submi ssion) Grant Term (HUD Award) Grant Term (Adjust ment) Total Assistance Requested for Grant Term (Renewal Submission) Total Assistance Requested for Grant Term (HUD Award) Total Assistance Requested for Grant Term (Adjustment) Budget Chang e (Adjust ment) la. Leased Units $0 l $0 1 Year 1 Year 1 Year $0 $0 $0 1b. Leased Structures $0 $0 $0 1 Year 1 Year 1 Year $0 : $0 $0 2. Rental Assistance $0 $0 $0 1 Year 1 Year 1 Year $0 $0 $0 3. Supportive Services $650,020 $650,020 $650,020 1 Year 1 Year 1 Year, $650,020 $650,020 $650,020 4. Operating $0 $0 $0 1 Year 1 Year 1 Year $0 $0 $0 5. HMIS $0 $0 $0 1 Year 1 Year 1 Year $0 $0 $0 6 Sub total Costs Requested $650,020 $650,020 $650,020 7. Admin (Up to 10%) $45,500 $45,500 $45,500 8 p $695,520 $695,520 $695,520 9. Cash Match $173,880 -' $173,880 $173,880 10. In -Kind Match $0 $0 $0 11. Total Match ; ` $173,880 $173,880 $173,880 12. Total Budget $869,400 $869,400 $869,400 Applicant Renewal Issues and Conditions Page 33 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FLO211L4D001912 Submission Summary Page, Acknowledgement Attachments Adjustments 1A. Application Type 1 B. Legal Applicant 1C. Application Details 1 D. Congressional District(s) 1E. Compliance 1 F. Declaration Last Updated 06/10/2020 No Input Required 06/10/2020 No Input Required No Input Required No Input Required 06/10/2020 No Input Required No Input Required Applicant Renewal Issues and Conditions Page 34 06/10/2020 Applicant: Miami -Dade County Project: Miami Homeless Assistance Program CE Consolidation 0041482920000 FL0211L4D001912 Recipient Performance 06/10/2020 Renewal Expansion 06/10/2020 Grant Consolidation 06/10/2020 2A. Subrecipients 06/10/2020 3A. Project Detail 06/10/2020 3B. Description 06/10/2020 4A. Services 06/10/2020 5A. Households 06/10/2020 5B. Subpopulations 06/10/2020 6A. Funding Request 06/10/2020 6H. Match 06/10/2020 61. Summary Budget No Input Required Applicant Renewal Issues and Conditions Page 35 06/10/2020 FY2019 Continuum of Care (CoC) Program Form W-9 Department of the Treasury Internal Revenue Service (IRS) Request for Taxpayer Identification Number and Certification ATTACHMENT C "W-9 Request for Taxpayer ID and Certification" Form (Rev. October2018) Department of the Treasury Internal Revenue Service Request for Taxpayer Identification Number and Certification I. Go to www.irs.gov/FormW9 for instructions and the latest information. Give Form to the requester. Do not send to the IRS. Print or type. See Specific Instructions on page 3. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. Individual/sole proprietor or MI C Corporation • S Corporation Partnership El Trust/estate single -member LLC 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax Otherwise, a single -member LLC that Exemption from FATCA reporting code (if any) purposes. is disregarded from the owner should check the appropriate box for the tax classification of its owner. I♦ Other (see instructions) ► (Applies to accounts maintained outside the U.S.) 5 Address (number, street, and apt. or suite no.) See instructions. Requester's name and address (optional) 6 City, state, and ZIP code 7 List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number. see How to aet a Social security number - - TIN, later. Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter. or Employer identification number Part II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax,return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later. Sign Here Signature of U.S. person ► Date ► General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) Form W-9 (Rev. 10-2018) Page 2 By signing the filled -out form, you: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting, later, for further information. Note: If you are a U.S. person and a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: • An individual who is a U.S. citizen or U.S. resident alien; • A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States; • An estate (other than a foreign estate); or • A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax under section 1446 on any foreign partners' share of effectively connected taxable income from such business. Further, in certain cases where a Form W-9 has not been received, the rules under section 1446 require a partnership to presume that a partner is a foreign person, and pay the section 1446 withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid section 1446 withholding on your share of partnership income. In the cases below, the following person must give Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States. • In the case of a disregarded entity with a U.S. owner, the U.S. owner of the disregarded entity and not the entity; • In the case of a grantor trust with a U.S. grantor or other U.S. owner, generally, the U.S. grantor or other U.S. owner of the grantor trust and not the trust; and • In the case of a U.S. trust (other than a grantor trust), the U.S. trust (other than a grantor trust) and not the beneficiaries of the trust. Foreign person. If you are a foreign person or the U.S. branch of a foreign bank that has elected to be treated as a U.S. person, do not use Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see Pub. 515, Withholding of Tax on Nonresident Aliens and Foreign Entities). Nonresident alien who becomes a resident alien. Generally, only a nonresident alien individual may use the terms of a tax treaty to reduce or eliminate U.S. tax on certain types of income. However, most tax treaties contain a provision known as a "saving clause." Exceptions specified in the saving clause may permit an exemption from tax to continue for certain types of income even after the payee has otherwise become a U.S. resident alien for tax purposes. If you are a U.S. resident alien who is relying on an exception contained in the saving clause of a tax treaty to claim an exemption from U.S. tax on certain types of income, you must attach a statement to Form W-9 that specifies the following five items. 1. The treaty country. Generally, this must be the same treaty under which you claimed exemption from tax as a nonresident alien. 2. The treaty article addressing the income. 3. The article number (or location) in the tax treaty that contains the saving clause and its exceptions. 4. The type and amount of income that qualifies for the exemption from tax. 5. Sufficient facts to justify the exemption from tax under the terms of the treaty article. Example. Article 20 of the U.S.-China income tax treaty allows an exemption from tax for scholarship income received by a Chinese student temporarily present in the United States. Under U.S. law, this student will become a resident alien for tax purposes if his or her stay in the United States exceeds 5 calendar years. However, paragraph 2 of the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows the provisions of Article 20 to continue to apply even after the Chinese student becomes a resident alien of the United States. A Chinese student who qualifies for this exception (under paragraph 2 of the first protocol) and is relying on this exception to claim an exemption from tax on his or her scholarship or fellowship income would attach to Form W-9 a statement that includes the information described above to support that exemption. If you are a nonresident alien or a foreign entity, give the requester the appropriate completed Form W-8 or Form 8233. Backup Withholding What is backup withholding? Persons making certain payments to you must under certain conditions withhold and pay to the IRS 24% of such payments. This is called "backup withholding." Payments that may be subject to backup withholding include interest, tax-exempt interest, dividends, broker and barter exchange transactions, rents, royalties, nonemployee pay, payments made in settlement of payment card and third party network transactions, and certain payments from fishing boat operators. Real estate transactions are not subject to backup withholding. You will not be subject to backup withholding on payments you receive if you give the requester your correct TIN, make the proper certifications, and report all your taxable interest and dividends on your tax return. Payments you receive will be subject to backup withholding if: 1. You do not furnish your TIN to the requester, 2. You do not certify your TIN when required (see the instructions for Part II for details), 3. The IRS tells the requester that you furnished an incorrect TIN, 4. The IRS tells you that you are subject to backup withholding because you did not report all your interest and dividends on your tax return (for reportable interest and dividends only), or 5. You do not certify to the requester that you are not subject to backup withholding under 4 above (for reportable interest and dividend accounts opened after 1983 only). Certain payees and payments are exempt from backup withholding. See Exempt payee code, later, and the separate Instructions for the Requester of Form W-9 for more information. Also see Special rules for partnerships, earlier. What is FATCA Reporting? The Foreign Account Tax Compliance Act (FATCA) requires a participating foreign financial institution to report all United States account holders that are specified United States persons. Certain payees are exempt from FATCA reporting. See Exemption from FATCA reporting code, later, and the Instructions for the Requester of Form W-9 for more information. Updating Your Information You must provide updated information to any person to whom you claimed to be an exempt payee if you are no longer an exempt payee and anticipate receiving reportable payments in the future from this person. For example, you may need to provide updated information if you are a C corporation that elects to be an S corporation, or if you no longer are tax exempt. In addition, you must furnish a new Form W-9 if the name or TIN changes for the account; for example, if the grantor of a grantor trust dies. Penalties Failure to furnish TIN. If you'fail to furnish your correct TIN to a requester, you are subject to a penalty of $50 for each such failure unless your failure is due to reasonable cause and not to willful neglect. Civil penalty for false information with respect to withholding. If you make a false statement with no reasonable basis that results in no backup withholding, you are subject to a $500 penalty. Form W-9 (Rev. 10-2018) Page 3 Criminal penalty for falsifying information. Willfully falsifying certifications or affirmations may subject you to criminal penalties including fines and/or imprisonment. Misuse of TINs. If the requester discloses or uses TINs in violation of federal law, the requester may be subject to civil and criminal penalties. Specific Instructions Line 1 You must enter one of the following on this line; do not leave this line blank. The name should match the name on your tax return. If this Form W-9 is for a joint account (other than an account maintained by a foreign financial institution (FFI)), list first, and then circle, the name of the person or entity whose number you entered in Part I of Form W-9. If you are providing Form W-9 to an FFI to document a joint account, each holder of the account that is a U.S. person must provide a Form W-9. a. Individual. Generally, enter the name shown on your tax return. If you have changed your last name without informing the Social Security Administration (SSA) of the name change, enter your first name, the last name as shown on your social security card, and your new last name. Note: ITIN applicant: Enter your individual name as it was entered on your Form W-7 application, line 1 a. This should also be the same as the name you entered on the Form 1040/1040A/1040EZ you filed with your application. b. Sole proprietor or single -member LLC. Enter your individual name as shown on your 1040/1040A/1040EZ on line 1. You may enter your business, trade, or "doing business as" (DBA) name on line 2. c. Partnership, LLC that is not a single -member LLC, C corporation, or S corporation. Enter the entity's name as shown on the entity's tax return on line 1 and any business, trade, or DBA name on line 2. d. Other entities. Enter your name as shown on required U.S. federal tax documents on line 1. This name should match the name shown on the charter or other legal document creating the entity. You may enter any business, trade, or DBA name on line 2. e. Disregarded entity. For U.S. federal tax purposes, an entity that is disregarded as an entity separate from its owner is treated as a "disregarded entity." See Regulations section 301.7701-2(c)(2)(iii). Enter the owner's name on line 1. The name of the entity entered on line 1 should never be a disregarded entity. The name on line 1 should be the name shown on the income tax return on which the income should be reported. For example, if a foreign LLC that is treated as a disregarded entity for U.S. federal tax purposes has a single owner that is a U.S. person, the U.S. owner's name is required to be provided on line 1. If the direct owner of the entity is also a disregarded entity, enter the first owner that is not disregarded for federal tax purposes. Enter the disregarded entity's name on line 2, "Business name/disregarded entity name." If the owner of the disregarded entity is a foreign person, the owner must complete an appropriate Form W-8 instead of a Form W-9. This is the case even if the foreign person has a U.S. TIN. Line 2 If you have a business name, trade name, DBA name, or disregarded entity name, you may enter it on line 2. Line 3 Check the appropriate box on line 3 for the U.S. federal tax classification of the person whose name is entered on line 1. Check only one box on line 3. IF the entity/person on line 1 is a(n) ... THEN check the box for ... • Corporation Corporation • Individual • Sole proprietorship, or • Single -member limited liability company (LLC) owned by an individual and disregarded for U.S. federal tax purposes. Individual/sole proprietor or single- member LLC • LLC treated as a partnership for U.S. federal tax purposes, • LLC that has filed Form 8832 or 2553 to be taxed as a corporation, or • LLC that is disregarded as an entity separate from its owner but the owner is another LLC that is not disregarded for U.S. federal tax purposes. Limited liability company and enter the appropriate tax classification. (P= Partnership; C. C corporation; or S= S corporation) • Partnership Partnership • Trust/estate Trust/estate Line 4, Exemptions If you are exempt from backup withholding and/or FATCA reporting, enter in the appropriate space on line 4 any code(s) that may apply to you. Exempt payee code. • Generally, individuals (including sole proprietors) are not exempt from backup withholding. • Except as provided below, corporations are exempt from backup withholding for certain payments, including interest and dividends. • Corporations are not exempt from backup withholding for payments made in settlement of payment card or third party network transactions. • Corporations are not exempt from backup withholding with respect to attorneys' fees or gross proceeds paid to attorneys, and corporations that provide medical or health care services are not exempt with respect to payments reportable on Form 1099-MISC. The following codes identify payees that are exempt from backup withholding. Enter the appropriate code in the space in line 4. 1—An organization exempt from tax under section 501(a), any IRA, or a custodial account under section 403(b)(7) if the account satisfies the requirements of section 401(f)(2) 2—The United States or any of its agencies or instrumentalities 3—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities 4—A foreign government or any of its political subdivisions, agencies, or instrumentalities 5—A corporation 6—A dealer in securities or commodities required to register in the United States, the District of Columbia, or a U.S. commonwealth or possession 7—A futures commission merchant registered with the Commodity Futures Trading Commission 8—A real estate investment trust 9—An entity registered at all times during the tax year under the Investment Company Act of 1940 10—A common trust fund operated by a bank under section 584(a) 11—A financial institution 12—A middleman known in the investment community as a nominee or custodian 13—A trust exempt from tax under section 664 or described in section 4947 Form W-9 (Rev. 10-2018) Page 4 The following chart shows types of payments that may be exempt from backup withholding. The chart applies to the exempt payees listed above, 1 through 13. IF the payment is for ... THEN the payment is exempt for... Interest and dividend payments All exempt payees except for 7 Broker transactions Exempt payees 1 through 4 and 6 through 11 and all C corporations. S corporations must not enter an exempt payee code because they are exempt only for sales of noncovered securities acquired prior to 2012. Barter exchange transactions and patronage dividends • Exempt payees 1 through 4 Payments over $600 required to be reported and direct sales over $5,0001 Generally, exempt payees 1 through 52 Payments made in settlement of payment card or third party network transactions Exempt payees 1 through 4 1 See Form 1099-MISC, Miscellaneous Income, and its instructions. 2 However, the following payments made to a corporation and reportable on Form 1099-MISC are not exempt from backup withholding: medical and health care payments, attorneys' fees, gross proceeds paid to an attorney reportable under section 6045(f), and payments for services paid by a federal executive agency. Exemption from FATCA reporting code. The following codes identify payees that are exempt from reporting under FATCA. These codes apply to persons submitting this form for accounts maintained outside of the United States by certain foreign financial institutions. Therefore, if you are only submitting this form for an account you hold in the United States, you may leave this field blank. Consult with the person requesting this form if you are uncertain if the financial institution is subject to these requirements. A requester may indicate that a code is not required by providing you with a Form W-9 with "Not Applicable" (or any similar indication) written or printed on the line for a FATCA exemption code. A —An organization exempt from tax under section 501(a) or any individual retirement plan as defined in section 7701(a)(37) B—The United States or any of its agencies or instrumentalities C—A state, the District of Columbia, a U.S. commonwealth or possession, or any of their political subdivisions or instrumentalities D—A corporation the stock of which is regularly traded on one or more established securities markets, as described in Regulations section 1.1472-1(c)(1)(i) E—A corporation that is a member of the same expanded affiliated group as a corporation described in Regulations section 1.1472-1(0)(1)(i) F—A dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or any state G—A real estate investment trust H—A regulated investment company as defined in section 851 or an entity registered at all times during the tax year under the Investment Company Act of 1940 I —A common trust fund as defined in section 584(a) J—A bank as defined in section 581 K—A broker L—A trust exempt from tax under section 664 or described in section 4947(a)(1) M—A tax exempt trust under a section 403(b) plan or section 457(g) plan Note: You may wish to consult with the financial institution requesting this form to determine whether the FATCA code and/or exempt payee code should be completed. Line 5 Enter your address (number, street, and apartment or suite number). This is where the requester of this Form W-9 will mail your information returns. If this address differs from the one the requester already has on file, write NEW at the top. If a new address is provided, there is still a chance the old address will be used until the payor changes your address in their records. Line 6 Enter your city, state, and ZIP code. Part I. Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. If you are a resident alien and you do not have and are not eligible to get an SSN, your TIN is your IRS individual taxpayer identification number (ITIN). Enter it in the social security number box. If you do not have an ITIN, see How to get a TIN below. If you are a sole proprietor and you have an EIN, you may enter either your SSN or EIN. If you are a single -member LLC that is disregarded as an entity separate from its owner, enter the owner's SSN (or EIN, if the owner has one). Do not enter the disregarded entity's EIN. If the LLC is classified as a corporation or partnership, enter the entity's EIN. Note: See What Name and Number To Give the Requester, later, for further clarification of name and TIN combinations. How to get a TIN. If you do not have a TIN, apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local SSA office or get this form online at www.SSA.gov. You may also get this form by calling 1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer Identification Number, to apply for an ITIN, or Form SS-4, Application for Employer Identification Number, to apply for an EIN. You can apply for an EIN online by accessing the IRS website at www.irs.gov/Businesses and clicking on Employer Identification Number (EIN) under Starting a Business. Go to www.irs.gov/Forms to view, download, or print Form W-7 and/or Form SS-4. Or, you can go to www.irs.gov/OrderForms to place an order and have Form W-7 and/or SS-4 mailed to you within 10 business days. If you are asked to complete Form W-9 but do not have a TIN, apply for a TIN and write "Applied For" in the space for the TIN, sign and date the form, and give it to the requester. For interest and dividend payments, and certain payments made with respect to readily tradable instruments, generally you will have 60 days to get a TIN and give it to the requester before you are subject to backup withholding on payments. The 60-day rule does not apply to other types of payments. You will be subject to backup withholding on all such payments until you provide your TIN to the requester. Note: Entering "Applied For" means that you have already applied for a TIN or that you intend to apply for one soon. Caution: A disregarded U.S. entity that has a foreign owner must use the appropriate Form W-8. Part IL Certification To establish to the withholding agent that you are a U.S. person, or resident alien, sign Form W-9. You may be requested to sign by the withholding agent even if item 1, 4, or 5 below indicates otherwise. For a joint account, only the person whose TIN is shown in Part I should sign (when required). In the case of a disregarded entity, the person identified on line 1 must sign. Exempt payees, see Exempt payee code, earlier. Signature requirements. Complete the certification as indicated in items 1 through 5 below. Form W-9 (Rev. 10-2018) Page 5 1. Interest, dividend, and barter exchange accounts opened before 1984 and broker accounts considered active during 1983. You must give your correct TIN, but you do not have to sign the certification. 2. Interest, dividend, broker, and barter exchange accounts opened after 1983 and broker accounts considered inactive during 1983. You must sign the certification or backup withholding will apply. If you are subject to backup withholding and you are merely providing your correct TIN to the requester, you must cross out item 2 in the certification before signing the form. 3. Real estate transactions. You must sign the certification. You may cross out item 2 of the certification. 4. Other payments. You must give your correct TIN, but you do not have to sign the certification unless you have been notified that you have previously given an incorrect TIN. "Other payments" include payments made in the course of the requester's trade or business for rents, royalties, goods (other than bills for merchandise), medical and health care services (including payments to corporations), payments to a nonemployee for services, payments made in settlement of payment card and third party network transactions, payments to certain fishing boat crew members and fishermen, and gross proceeds paid to attorneys (including payments to corporations). 5. Mortgage interest paid by you, acquisition or abandonment of secured property, cancellation of debt, qualified tuition program payments (under section 529), ABLE accounts (under section 529A), IRA, Coverdell ESA, Archer MSA or HSA contributions or distributions, and pension distributions. You must give your correct TIN, but you do not have to sign the certification. What Name and Number To Give the Requester For this type of account: Give name and SSN of: 1. Individual 2. Two or more individuals (joint account) other than an account maintained by an FFI 3. Two or more U.S. persons (joint account maintained by an FFI) 4. Custodial account of a minor (Uniform Gift to Minors Act) 5. a. The usual revocable savings trust (grantor is also trustee) b. So-called trust account that is not a legal or valid trust under state law 6. Sole proprietorship or disregarded entity owned by an individual 7. Grantor trust filing under Optional Form 1099 Filing Method 1 (see Regulations section 1.671-4(b)(2)(i) (A)) The individual The actual owner of the account or, if combined funds, the first individual on the account"' Each holder of the account The minor2 The grantor -trustee The actual owner"' The owner3 The grantor* For this type of account: Give name and EIN of: 8. Disregarded entity not owned by an individual 9. A valid trust, estate, or pension trust 10. Corporation or LLC electing corporate status on Form 8832 or Form 2553 11. Association, club, religious, charitable, educational, or other tax- exempt organization 12. Partnership or multi -member LLC 13. A broker or registered nominee The owner Legal entity° The corporation The organization The partnership The broker or nominee For this type of account: Give name and EIN of: 14. Account with the Department of Agriculture in the name of a public entity (such as a state or local government, school district, or prison) that receives agricultural program payments 15. Grantor trust filing under the Form 1041 Filing Method or the Optional Form 1099 Filing Method 2 (see Regulations section 1.671-4(b)(2)(i)(B)) The public entity The trust List first and circle the name of the person whose number you furnish. If only one person on a joint account has an SSN, that person's number must be furnished. 2 Circle the minor's name and furnish the minor's SSN. 3 You must show your individual name and you may also enter your business or DBA name on the "Business name/disregarded entity" name line. You may use either your SSN or EIN (if you have one), but the IRS encourages you to use your SSN. ° List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the personal representative or trustee unless the legal entity itself is not designated in the account title.) Also see Special rules for partnerships, earlier. *Note: The grantor also must provide a Form W-9 to trustee of trust. Note: If no name is circled when more than one name is listed, the number will be considered to be that of the first name listed. Secure Your Tax Records From Identity Theft Identity theft occurs when someone uses your personal information such as your name, SSN, or other identifying information, without your permission, to commit fraud or other crimes. An identity thief may use your SSN to get a job or may file a tax return using your SSN to receive a refund. To reduce your risk: • Protect your SSN, • Ensure your employer is protecting your SSN, and • Be careful when choosing a tax preparer. If your tax records are affected by identity theft and you receive a notice from the IRS, respond right away to the name and phone number printed on the IRS notice or letter. If your tax records are not currently affected by identity theft but you think you are at risk due to a lost or stolen purse or wallet, questionable credit card activity or credit report, contact the IRS Identity Theft Hotline at 1-800-908-4490 or submit Form 14039. For more information, see Pub. 5027, Identity Theft Information for Taxpayers. Victims of identity theft who are experiencing economic harm or a systemic problem, or are seeking help in resolving tax problems that have not been resolved through normal channels, may be eligible for Taxpayer Advocate Service (TAS) assistance. You can reach TAS by calling the TAS toll -free case intake line at 1-877-777-4778 or TTY/TDD 1-800-829-4059. Protect yourself from suspicious emails or phishing schemes. Phishing is the creation and use of email and websites designed to mimic legitimate business emails and websites. The most common act is sending an email to a user falsely claiming to be an established legitimate enterprise in an attempt to scam the user into surrendering private information that will be used for identity theft. Form W-9 (Rev. 10-2018) Page 6 The IRS does not initiate contacts with taxpayers via emails. Also, the IRS does not request personal detailed information through email or ask taxpayers for the PIN numbers, passwords, or similar secret access information for their credit card, bank, or other financial accounts. If you receive an unsolicited email claiming to be from the IRS, forward this message to phishing@irs.gov. You may also report misuse of the IRS name, logo, or other IRS property to the Treasury Inspector General for Tax Administration (TIGTA) at 1-800-366-4484. You can forward suspicious emails to the Federal Trade Commission at spam@uce.gov or report them at www.ftc.gov/complaint. You can contact the FTC at www.ftc.gov/idtheft or 877-IDTHEFT (877-438-4338). If you have been the victim of identity theft, see www.IdentityTheft.gov and Pub. 5027. Visit www.irs.gov/IdentityTheft to learn more about identity theft and how to reduce your risk. Privacy Act Notice Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District of Columbia, and U.S. commonwealths and possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a TIN to the payer. Certain penalties may also apply for providing false or fraudulent information. FY2019 Continuum of Care (CoC) Program Affidavits and Declarations ATTACHMENT D "Affidavits and Declarations" Miami -Dade County's Affidavits and Declarations M IAM I•DADE; COUNTY Miami -Dade County requires each party desiring to enter into a contract with Miami -Dade County to; (1) Sign an affidavit as to certain matters and (2) make a declaration as to certain other matters. This form contains both Affidavit forms for matters requiring the entity to sign under oath and Declaration forms for matters requiring only an affirmation or declaration for other matters. Each section of this form must be read, and initialed in the top right hand box indicating acceptance and/or compliance with the County's policy related to the particular affidavit. For affidavit sections that you do not believe are applicable to your organization, please indicate this by placing "Q" in the box next to N/A. ALL SECTIONS MUST BE COMPLETED THE FOLLOWING MATTERS REQUIRE THE ENTITY TO SIGN AN AFFIDAVIT UNDER OATH: STATE OF ( COUNTY OF ( COUNTRY OF ( Before me the undersigned authority appeared (Print Name), who is personally known to me or who has provided as identification and who did swear to the following: That he or she is the duly authorized representative of (Name of Entity) (Address of Entity) Post Office addresses are not acceptable. Federal Employment Identification Number (hereinafter referred to as the contracting "entity"), and that he or she is the entity's (Sole Proprietor)(Partner)(President or Other Authorized Officer) That he or she has full authority to make this affidavit, and that the information given herein and the documents attached hereto are true and correct; and That he or she says for the following fifteen (16) Affidavits and Declarations: ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 1 of 11 Miami -Dade County's Affidavits and Declarations 1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT (SECTION 2-8.1 OF THE COUNTY CODE) Pertains O N/A O Initial (_) If the contract or business transaction is with a corporation, the full legal name and business address shall be provided for each officer and director and each stockholder who holds directly or indirectly five percent (5%) or more of the corporation's stock. If the contract or business transaction is with a partnership, the foregoing information shall be provided for each partner. If the contract or business transaction is with a trust, the full legal name and address shall be provided for each trustee and each beneficiary. The foregoing requirements shall not pertain to contracts with publicly traded corporations or to contracts with the United States or any department or agency thereof, the State or any political subdivision or agency thereof or any municipality of this State. All such names and address are outlined below: Post Office addresses are not acceptable. (Full Legal Name, Address, % Ownership) (Full Legal Name, Address, % Ownership) (Full Legal Name, Address, % Ownership) (Full Legal Name, Address, % Ownership) The full legal names and business address of any other individual suppliers, laborers, or lenders) who have, or will have, any the contract or business transaction with Miami Dade County (other than subcontractors, material person, interest (legal, equitable beneficial or otherwise) in are: required herein, or who knowingly discloses false to five hundred dollars ($500.00) or imprisonment Post office addresses are not acceptable Any person who willfully fails to disclose the information information in this regard, shall be punished by a fine of up in jail for up to sixty (60) days or both. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 2 of 11 Miami -Dade County's Affidavits and Declarations 2. MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT (COUNTY ORDINANCE 90-133, AMENDING SECTION 2.8-1; SUBSECTION (d)(2) OF THE COUNTY CODE) Pertains O N/A O Initial (_) Except where precluded by Federal or State laws or regulations, each contract or business transaction or renewal thereof which involves the expenditure of then thousand dollars ($10,000) or more shall require the entity contracting or transaction business to disclose the following information. The foregoing disclosure requirements do not apply to contracts with the United States or any department or agency thereof, the State or any political subdivision or agency thereof or any municipality of this State. Does your firm have a collective bargaining agreement with its employees? 0 Yes ❑ No Does your firm provide paid health care benefits for its employees? 0 Yes 0 No Provide a current breakdown (number of persons) of your firm's work force and ownership (below): White: Males Females Black: Males Females Hispanic: Males Females Asian: Males Females American Native: Males Females Aleut (Eskimo): Males Females ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 3 of 11 Miami -Dade County's Affidavits and Declarations 3. MIAMI-DADE COUNTY AFFIRMATIVE ACTION / NONDISCRIMINATION OF EMPLOYMENT, PROMOTION AND PROCUREMENT PRACTICES (COUNTY ORDINANCE 98-30 CODIFIED AT 2-8.1.5 OF THE COUNTY CODE) Pertains O N/A O Initial () Pursuant to Miami -Dade County's Ordinance No. 98-30, Section 2-8.1.5, entities with annual gross revenue in excess of $5,000,000 seeking to contract with the County shall, as a condition of receiving a County contract, have: 1) a written affirmative action plan which sets forth the procedures the entity utilizes to assure that it does not discriminate in its employment and promotion practices and 2) a written procurement policy which sets forth the procedures the entity utilizes to assure that it does not discriminate against minority and women -owned businesses in its own procurement of goods, supplies and services. Such affirmative action plans and procurement policies shall provide for periodic review to determine their effectiveness in assuring the entity does not discriminate in its employment, promotion and procurement practices. The foregoing, not withstanding, corporate entities whose board of directors are representative of the population make-up of the nation shall be presumed to have non-discriminatory employment and procurement policies, and shall not be required to have a written affirmative action plan and procurement policy in order to receive a County contract. The foregoing presumption may be rebutted. The requirements of this section may be waived upon written recommendation of the County Manager that it is in the best interest of the County to do so and approval of the County Commission by majority vote of the members present. Based on the above, please complete the affidavit as directed and return the completed affidavit along with a cover letter on your company's letterhead, listing the company's address, phone and fax numbers, and any required documents, to: Miami -Dade County, Department of Procurement Management Affirmative Action Plan Unit 111 NW 1st Street, l3th Floor Miami, FL 33128 Yes 0 No O My company has an affirmative action plan and procurement policy and is available for review. Yes 0 No 0 My company has annual gross revenues in excess of $5,000,000. Therefore, our company's affirmative action plan and procurement policy is available for review. Yes 0 No 0 My company has annual gross revenues less than $5,000,000. If at any time the Miami Dade County has reason to believe that any person or firm has willfully and knowingly provided incorrect information or made false statements, the County may refer the matter to the State Attorney's Office and/or other investigative agencies. The County may initiate debarment and/or pursue other remedies in accordance with Miami -Dade County policy and/or applicable federal, state and local laws. 4. MIAMI-DADE COUNTY CRIMINAL RECORD AFFIDAVIT (SECTION 2-8.6 OF THE COUNTY CODE) Pertains 0 N/A 0 Initial (_) The individual or entity entering into a contract or receiving funding from Miami -Dade County 0 has 0 has not, as of the date of this affidavit, been convicted of a felony during the past ten (10) years. An officer, director, or executive officer of the entity entering into a contract or receiving funding from Miami -Dade County 0 has 0 has not as of the date of this affidavit been convicted of a felony during the past ten (10) years. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 4of11 Miami -Dade County's Affidavits and Declarations 5. PUBLIC ENTITY CRIMES AFFIDAVIT (SECTION 287.133(3)(a), FLORIDA STATUTES) Pertains O N/A 0 Initial (_) The individual or entity entering into a contract or receiving funding from Miami -Dade County understands the following: That a "public entity crime" as defined in Paragraph 287.133 (1) (g) Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state of the United States of America, including but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state of the United States of America and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. That "Convicted" or "conviction" as defined in Paragraph 287.133 (1) (b) Florida Statutes means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal state trial court of record relating to charges brought by indictment or information after July 1,1989, as a result of a jury verdict, non - jury trial, or entry of plea of guilty or nolo contendere. That an "affiliate" as defined in Paragraph 287.133 (1) (a) Florida Statutes means a) a predecessor or successor of a person convicted of a public entity crime; or b) an entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime. The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. That a "person" as defined in Paragraph 287.133 (1) (e) Florida Statutes means any natural person or entity organized under the laws of any state or of the United States of America with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, partners, shareholders, employees, members and agents who are active in the management of an entity. Based on information and belief, the statement as marked below, is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies by applying the individual initials near the box). 0 Neither the entity submitting this sworn statement nor any of its officers, directors, executives, partners, shareholders, employees, members or agents who are active in the management of the entity, nor an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months. 0 The entity submitting this sworn statement or one or more of its officers, directors, executives, partners, shareholders, employees, members or agents who are active in the management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime within the past 36 months; and 0 yes an additional statement is applicable or 0 no an additional statement is not applicable. 0 The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity has been charged with and convicted of a public entity crime within the past 36 months. However, there have been subsequent proceedings before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the "Convicted Vendor List". The individual or entity entering into a contract or receiving funding from Miami -Dade County understands that he or she is required to inform the public entity prior to entering into a contract in excess of the threshold amount provided in Section 287.017 Florida Statues for Category 2 of any change in the information contained in this form. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 5 of 11 Miami -Dade County's Affidavits and Declarations 6. MIAMI-DADE EMPLOYMENT FAMILY LEAVE AFFIDAVIT (County Ordinance No.142-91 codified as Section 11A-29 et. seq of the County Code) Pertains 0 N/A 0 Initial (_) That in compliance with Ordinance No. 142-91 of the Code of Miami -Dade County, Florida, an employer with fifty (50) or more employees working in Dade County for each working day during each of twenty (20) or more calendar work weeks, shall provide the following information in compliance with all items in the aforementioned ordinance: An employee who has worked for the above firm at least one (1) year shall be entitled to ninety (90) days of family leave during any twenty-four (24) month period, for medical reasons, for the birth or adoption of a child, or for the care of a child, spouse or other close relative who has a serious health condition without risk of termination of employment or employer retaliation. The foregoing requirements shall not pertain to contracts with the United States or any department or agency thereof, or the State of Florida or any political subdivision or agency thereof. It shall, however, pertain to municipalities of this State. 7. MIAMI-DADE COUNTY DISABILITY NONDISCRIMINATION AFFIDAVIT (County Resolution R-385-95) Pertains 0 N/A 0 Initial (_) That the above named firm, corporation or organization is in compliance with and agrees to continue to comply with, and assure that any subcontractor, or third party contractor under this project complies with all applicable requirements of the laws listed below including, but not limited to, those provisions pertaining to employment, provision of programs and services, transportation, communications, access to facilities, renovations, and new construction in the following laws: The Americans with Disabilities Act of 1990 (ADA), Pub. L. 101-336,104 Stat. 327, 42 U. S. C. 12101-12213 and 47 U. S. C. Sections 225 and 611 including Title I, Employment; Title II, Public Services; Title III, Public Accommodation and Services Operated by Private Entities; Title IV, Telecommunications; and Title V, Miscellaneous Provisions: The Rehabilitation Act of 1973, 29 U.S.C. Section 794: The Federal Transit Act, as amended 49 U .S. C. Section 1612: The Fair Housing Act as amended, 42 U.S.C. Section 3601-3631. The foregoing requirements shall not pertain to contracts with the United States or any department or agency thereof, or the State or any political subdivision or agency thereof or any municipality of this State. 8. MIAMI-DADE COUNTY REGARDING DELINQUENT AND CURRENTLY DUE FEES OR TAXES (Sec. 2-8.1(c) of the County Code) Pertains 0 N/A 0 Initial (_) Except for small purchase orders and sole source contracts, that above named firm, corporation, organization or individual desiring to transact business or enter into a contract with the County verifies that all delinquent and currently due fees or taxes -- including but not limited to real and property taxes, utility taxes and occupational licenses -- which are collected in the normal course by the Dade County Tax Collector as well as Dade County issued parking tickets for vehicles registered in the name of the firm, corporation, organization or individual have been paid. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 6 of 11 Miami -Dade County's Affidavits and Declarations 9. CURRENT ON ALL COUNTY CONTRACTS, LOANS AND OTHER OBLIGATIONS Pertains O N/A 0 Initial (_) The individual entity seeking to transact business with the County is current in all its obligations to the County and is not otherwise in default of any contract, promissory note or other loan document with the County or any of its agencies or instrumentalities. 10. DOMESTIC VIOLENCE LEAVE (Resolution 185-00; 99-5 Codified At 11A- 60 Et. Seq. of the Miami -Dade County Code). Pertains 0 N/A O Initial (_) The firm desiring to do business with the County is in compliance with Domestic Leave Ordinance, Ordinance 99- 5, codified at 11A-60 et. seq. of the Miami Dade County Code, which requires an employer which has in the regular course of business fifty (50) or more employees working in Miami -Dade County for each working day during each of twenty (20) or more calendar work weeks in the current or proceeding calendar years, to provide Domestic Violence Leave to its employees. 11. MIAMI-DADE COUNTY EMPLOYMENT DRUG -FREE WORKPLACE AFFIDAVIT (County Ordinance No. 92-15 codified as Section 2- 8.1.2 of the County Code) Pertains 0 N/A 0 Initial (_) That in compliance with Ordinance No. 92-15 of the Code of Miami -Dade County, Florida, the above named person or entity is providing a drug -free workplace. A written statement to each employee shall inform the employee about: 1. danger of drug abuse in the workplace; 2. the firm's policy of maintaining a drug -free environment at all workplaces; 3. availability of drug counseling, rehabilitation and employee assistance programs; 4. penalties that may be imposed upon employees for drug abuse violations. The person or entity shall also require an employee to sign a statement, as a condition of employment that the employee will abide by the terms and notify the employer of any criminal drug conviction occurring no later than five (5) days after receiving notice of such conviction and impose appropriate personnel action against the employee up to and including termination. Compliance with Ordinance No. 92-15 may be waived if the special characteristics of the product or service offered by the person or entity make it necessary for the operation of the County or for the health, safety, welfare economic benefits and well-being of the public. Contracts involving funding which is provided in whole or in part by the United States or the State of Florida shall be exempted from the provisions of this ordinance in those instances where those provisions are in conflict with the requirements of those governmental entities. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 7 of 11 Miami -Dade County's Affidavits and Declarations 12. ATTESTATION REGARDING DUE AND PROPER ACKNOWLEDGEMENT OF COUNTY FUNDING SUPPORT Pertains 0 N/A O Initial (_) By initialing this subsection and accepting County funds, the above named firm, corporation, organization or individual agrees to abide by the grant contract requirement to recognize and acknowledge Miami -Dade County's grant support in a manner commensurate with all contributors and sponsors of its activities at comparable dollar levels. 13. MIAMI-DADE COUNTY RESOLUTION NO. R-630-13 REQUIRING A DETAILED PROJECT BUDGET, SOURCES AND USES STATEMENT, CERTIFICATIONS AS TO PAST DEFAULTS ON AGREEMENTS WITH NON -COUNTY FUNDING SOURCES, AND DUE DILIGENCE CHECK Pertains 0 N/A O Initial (_) Pursuant to Miami -Dade County Resolution No. R-630-13, requiring a detailed project budget, sources and uses statement, certifications as to past defaults on agreements with non -county funding sources and due diligence check prior to the County Mayor or County Mayor's designee recommending a commitment of Miami -Dade County funds to Social Services, Economic Development, Community Development, and Affordable Housing Agencies and Providers. The undersigned entity certifies, to the best of his or her knowledge and belief, that: 1. Within the past five (5) years, neither the Agency nor its directors, partners, principals, members or board members: (i) have been sued by a funding source for breach of contract or failure to perform obligations under a contract; (ii) have been cited by a funding source for non-compliance or default under a contract; (iii) have been a defendant in a lawsuit based upon a contract with a funding source. Please list any matters which prohibit the Agency from making the certifications required and explain how the matters are being resolved (use separate sheet if necessary): 14. MIAMI-DADE COUNTY RESOLUTION No. R-478-12 NOT TO USE PRODUCTS OR FOODS CONTAINING "PINK SLIME" Pertains 0 N/A 0 Initial (_) Pursuant to Miami -Dade County Resolution No. R-478-12, the undersigned certifies, not to use meat products containing "Pink Slime" in food provided or served as part any food program; urging all who provide food services or operate a food program to immediately discontinue using meat products containing "pink slime" in food provided or served in these programs. ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 8of11 Miami -Dade County's Affidavits and Declarations 15. MIAMI-DADE COUNTY REQUIRED LOBBYIST REGISTRATION FOR ORAL PRESENTATION Section 2-11.1(i)(2) CONFLICT OF INTEREST AND CODE OF ETHICS ORDINANCE Pertains O N/A 0 Initial (_) All lobbyists shall register with the Clerk of the Board of County Commissioners within five (5) business days of being retained as a lobbyist or before engaging in any lobbying activities, whichever shall come first. Every person required to so register shall: 1. Register on forms prepared by the Clerk; 2. State under oath his or her name, business address and the name and business address of each person or entity which has employed said registrant to lobby. If the lobbyist represents a corporation, the corporation shall also be identified. Without limiting the foregoing, the lobbyist shall also identify all persons holding, directly or indirectly, a five (5) percent or more ownership interest in such corporation, partnership, or trust. Registration of all lobbyists shall be required prior to January 15 of each year and each person who withdraws as a lobbyist for a particular client shall file an appropriate notice of withdrawal. 3. Prior to conducting any lobbying, all principals must file a form with the Clerk of the Board of County Commissioners, signed by the principal or the principal's representative, stating that the lobbyist is authorized to represent the principal. Failure of a principal to file the form required by the preceding sentence may be considered in the evaluation of a bid or proposal as evidence that a proposer or bidder is not a responsible contractor. Each principal shall file a form with the Clerk of the Board at the point in time at which a lobbyist is no longer authorized to represent the principal. ❑ By initialing here, the principals or principal's representative have filed with the Clerk of the Board of County Commissioners stating that a lobbyist is authorized to represent the principal. 4. Any public officer, employee or appointee who only appears in his or her official capacity shall not be required to register as a lobbyist. 5. Any person who only appears in his or her individual capacity for the purpose of self -representation without compensation or reimbursement, whether direct, indirect or contingent, to express support of or opposition to any item, shall not be required to register as a lobbyist. 6. Any person who only appears as a representative of a not -for -profit corporation or entity (such as a charitable organization, or a trade association or trade union), without special compensation or reimbursement for the appearance, whether direct, indirect or contingent, to express support of or opposition to any item, shall register with the Clerk as required by the Ordinance subsection, but, upon request, shall not be required to pay any registration fees. The Clerk of the Board of County Commissioners shall notify the Commission on Ethics and Public Trust of the failure of a lobbyist or principal to file a report and/or pay the assessed fines after notification. A lobbyist or principal may appeal a fine and may request a hearing before the Commission on Ethics and Public Trust. A request for a hearing on the fine must be filed with the Commission on Ethics and Public Trust within fifteen (15) calendar days of receipt of the notification of the failure to file the required disclosure form. The Commission on Ethics and Public Trust shall have the authority to waive the fine, in whole or part, based on good cause shown. The Commission on Ethics and Public Trust shall have the authority to adopt rules of procedure regarding appeals from the Clerk of the Board of County Commissioners. Except as otherwise provided in subsection of the Ordinance, the validity of any action or determination of the Board of County Commissioners or County personnel, board or committee shall not be affected by the failure of any person to comply with the provisions of this subsection(s). (Ord. No. 00-19, § 1, 2-8-00; Ord. No. 01-93, § 1, 5-22- 01; Ord. No. 01-162, § 1, 10-23-01; Ord. No. 03-107, § 1, 5-6-03) ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 9 of 11 Miami -Dade County's Affidavits and Declarations 16. Disclosure SUBCONTRACTOR / SUPPLIER LISTING (ORDINANCE 97-104) Pertains 0 N/A 0 Initial (_) This form, or a comparable form meeting the requirements of Ordinance 97-104, must be completed by all bidders and proposers on Miami -Dade County contracts for purchase of supplies, materials or services, including professional services which involve expenditures of $100,000.00 or more, and all bidders and proposers on County or Public Health Trust construction contracts which involve expenditures of $100,000.00 or more. This form or a comparable form meeting the requirements of Ordinance 97-104, must be completed and submitted even though the bidder or proposer will not utilize subcontractors or suppliers on the contract. The bidder or proposer should enter the word "NONE" under the appropriate heading, in those instances where no subcontractors or suppliers will be used on the contract. A bidder or proposer who is awarded the contract shall not change or substitute first tier subcontractors or direct suppliers or the portions of the contract work to be performed or materials to be supplied from those identified except upon written approval of the County. Business Name and Address of First Tier Subcontractor/Subconsultant Principal Owner Scope of Work to be Performed by Subcontractor/Sub consultant (Principal Owner) Gender Race Business Name and Address of Direct Supplier Principal Owner Supplies/Materials/Services to be Provided by Supplier (Principal Owner) Gender Race I certify that the representations contained in this Subcontractor/Supplier Listing are to the best of my knowledge true and accurate. Signature of Authorized Representative Date ( ) ( ) Print Title Print Name (Duplicate if additional space is needed) ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 10 of 11 Miami -Dade County's Affidavits and Declarations MIAMMADE : COUNTY I have carefully read this entire 11-page document entitled, "Miami -Dade County's Affidavits and Declarations" and agree to; (1) sign an affidavit as to certain matters and (2) make a declaration as to certain other matters. This form contains both Affidavit forms for matters requiring the entity to sign under oath and Declaration forms for matters requiring only an affirmation or declaration for other matters. BY SIGNING AND NOTARIZING THIS PAGE YOU ARE ATTESTING TO AFFIDAVITS AND DISCLOSURES 1-16 MIAMI-DADE COUNTY AFFIDAVITS SIGNATURE PAGE By: Signature of Witness or Secretary Seal Signature of Affiant Date , 20 Federal Employer Identification Number Printed Name of Affiant and Name of Agency Address of Agency SUBSCRIBED AND SWORN TO (or affirmed) before me this day of , 20 He/She is personally known to me or has presented as identification. Type of identification Signature of Notary Serial Number Print or Stamp Name of Notary Expiration Date Notary Public — State of County of Notary Seal ATTACHMENT D "Miami -Dade County Affidavits and Declarations" Page 11 of 11 FY 2019 Continuum of Care (CoC) Program Consolidated Financial Records Performance Reports ATTACHMENT E "Financial Records & Performance Reports" Request for Amendment / Modification / for US HUD Grant Funded Continuum of Care (CoC) Programs Includes Legacy Programs under the CoC Supportive Housing Programs (SHP) Shelter Plus Care Programs (S+C) Single Room Occupancy for the Homeless (SRO) 24 CFR 578.105 Grant and Project Changes - The recipient or subrecipients may not make any significant changes to a project without prior US HUD approval, evidenced by a grant amendment signed by HUD and the Recipient. Significant changes include a change of recipient, a change of project site, additions or deletions in the types of eligible activities approved for a project, a shift of more than 10% from one approved eligible activity to another, a reduction in the number of units, and a change in the subpopulation served. By signing this report, the duly authorized Project Sponsor/ Provider/Subrecipient Official signature below certifies to the best of their knowledge and belief that the report is true, complete and accurate and is for the purposes and objectives set forth in the terms and conditions of the federal award; and are aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject the duly authorized official to criminal, civil or administrative penalties for fraud, false statements, false claims or other offense. Print Name and Title of Authorized Project Sponsor/Provider/Subrecipient Official: Signature & Date(mm/dd/yyyy): Reviewed by Miami -Dade County and forwarded to US HUD for Request to Approve (greater than 10% shift in funds between categories or significant change) CHANGE IN PROJECT SPONSOR Do Not Sign - for Miami -Dade County ONLY Signature & Date(mm/dd/yyyy): Reviewed and Approved by Miami -Dade County; information forwarded to US HUD (less than 10% shift in funds between categories). Do Not Sign - for Miami -Dade County ONLY Signature & Date(mm/dd/yyyy): Reviewed and NOT Approved by Miami -Dade County - Do Not Sign - for Miami -Dade County ONLY see attached letter for reasons for disapproval. Signature & Date(mm/dd/yyyy) Program Name: ( Grant Number: ( Financial Information for CoC Programs Instructions for budget amendment / modification request: 1. Attach the eSnaps documents in Word Format previously provided for the applicable budget chart. The charts should include a Summary chart; and all applicable detailed supportive services, operations, leasing, rental assistance. Project administration charts are not applicable. Reformat the far right -side column in the chart to reflect the budget modified or amendment requested. 2. Attach the eSnaps documents in Word format for summary of program. Reformat the far right -side column in the chart to reflect the budget request. 3. Type below or within the applicable Word -formatted eSnaps budget chart - a detailed budget narrative- the justification for the line -item change. Also if there is a change in match amount - a new letter of match commitment is required. 4. Assemble with a cover letter on agency letterhead summarizing the requested budget revisions and certifying that the level and standards of care provided to the program participants will not be adversely affected and attach page one of this document. 5. Review, sign and submit the paper original to Miami -Dade County Homeless Trust, 111 NW 1st Street, 27th Floor, Suite 310, Miami, Florida 33128 Attention: Terrell Ellis, Contracts Manager. Agency Letterhead Date Attention: Assigned Contracts Officer Miami -Dade County Homeless Trust Suite 310, 27th Floor 111 NW 1st Street Miami, Florida 33128 Subject: FY 2019 US HUD CoC Program FL0000L4D001912, Program Name Name of Agency is respectfully submitting for your review and release of payment of the enclosed Consolidated Financial Record and Reports for the above subject program. We request reimbursement in the amount of $0.00 for the month(s) of Month. yyyy The following documents included in this report are outlined below: O Cover Letter O Performance Report - 0625 HUD Monthly HMIS-generated Progress Report (MPR) O Homeless Trust CoC Invoice O HUD Form 27053-A SNAPS Request Voucher for Grant Payment O Summary and Compliance Report O Attachment E - Program Income Report O Supporting documents for invoice requirements and match including invoices, cancelled checks, payroll, time and effort logs, and, if applicable, copies of Tenant paid utility bills consistent with utility allowance, documentation of match expenditure compliance consistent with OMB Omni or Super Circular and 24 CFR 578. The value of the match demonstrated is $0.00. The amount of program income (if applicable) is $0.00. This is an adjustment # () for the month(s) of Month(s). yyyy. On behalf of our homeless community members who benefit from this program, we thank you for your time and assistance. Please call (305) 000-0000 extension 0 or email addressCtdomain.com with any concerns or comments about this reimbursement package. Sincerely, Name Title Enclosures US HUD CoC PROGRAM REIMBURSEMENT REQUEST PROVIDER NAME: PROGRAM NAME: GRANT NUMBER: FL0000L4D001912 SERVICE PERIOD: Month(s) YYYY 0 ADJUSTMENT # ( ) �; ��' COUNTY Amount this Invoice LEASING Leasing- Units - Leasing -Structure - LEASING TOTAL: I $ - RENTAL ASSISTANCE Rental Assistance - Permanent Tenant -Based RA - Rental Assistance - Permanent Sponsor -Based RA - Rental Assistance - Permanent Rapid Re -housing - RENTAL ASSISTANCE TOTAL: I $ - SUPPORTIVE SERVICES 1. Assessment of Service Needs - 2. Assistance with moving costs - 3. Case Management ' - 4. Child Care - 5. Education services - 6. Employment Assistance - 7. Food - 8. Housing / Counseling Services - 9. Legal services - 10. Life Skills training - 11. Mental Health Services - 12. Outpatient Health Services - 13. Outreach Services - 14. Substance Abuse Treatment - 15. Transportation - 16. Utility Deposits - 17. Operating costs for SSO only - SUPPORTIVE SERVICES SUBTOTAL: I $ - OPERATING COSTS 1.Maintenance and Repair - 2.Property Taxes and Insurance - 3.Replacement Reserve - 4.Building Security - 5.Electricity, Gas and Water - 6.Furniture - 7.Equipment (Lease/Buy) - OPERATING COSTS SUBTOTAL: I $ - HMIS HMIS generated activities I - HMIS SUBTOTAL: I $ - PROJECT ADMINISTRATION Project Administration Costs I - ADMINISTRATION SUBTOTAL:I $ - INVOICE REQUEST Amount this Invoice TOTAL $ - By signing this report, I certify to the best of my knowledge and belief that the report is true, expenditures, disbursements and cash receipts are for the purposes and objectives set forth federal award. I am aware that any false, fictitious, or fraudulent information or the omission criminal, civil or administrative penalties for fraud, false statements, false claims Prepared this (date) complete and accurate and the in the terms and conditions of the of any material fact, may subject me to or other offense. (title) Certified by: (signature), LOCSNRS U. S. Department of Housing SNAPS Special Needs Assistance Program and Urban Development Request Voucher for Grant Payment Office of Community Planning and Development See Instructions and Public Reporting Burden Statement on back OMB Approval No. 2535-0102 Name of Agency - Name of program 1. Voucher Number: 2. LOCCS PGM AREA: SNAPS HPAC IHP 3. Period Covered by this Request: (dates) 4. Type of Disbursement: Partial Final 5. Voice Response No. (5 digits, hyphens, 5 more) 6. Grantee Organization's Name: 7, Grant No: FL0000L4D001912 8. Grantee Organization's TIN: 9. Line Item no. 10. Tyne of Funds Requested Amount: (round to nearest dollar) 1010 Acquisition $ - 1020 Rehabilitation $ - 1021 New Construction $ - 1022 Substantial Rehabilitation $ - 1023 Moderate Rehabilitation $ - 1030 Operating Cost $ - 1040 Rental Assistance $ - 1050 Supportive Services $ - 1051 HMIS Costs $ - 1060 Administrative Cost $ - 1062 CoC Planning Costs $ - 1070 Child Care $ - 1080 Employment Assistance $ - 1090 Relocation $ - 1100 Leasing $ - 1110 Repair & Maintenance $ - 1111 Prevention (RH) $ - 1112 Capacity Building (RH) $ - 1120 Other: $ - VoucherTotal: $ - I hereby certify that all the information stated herein, as well as any information provided in the accompaniment herewith, is true and accurate. Warning: HUD will prosecute false claims and statements. Conviction may result in criminal penalties. (18 U.S.C. 1001.1010,1012; 31 U.S.C. 3729, 3802) 11. Name & Phone Number (including area code) of the Authorized I12. Signature: 113, Date of Request: Person who called SNAPs System VRS: Privacy Statement: Public Law 97-255, Financial Integrity Act, 31 U.S.C. 3512, authorizes the Department of Housing and Urban Development (HUD) to collect all the information (except the Social Security Number (SNN)) which will be used by HUD to protect disbursement data from fraudulent actions. The Housing and Community Development Act of 1987, 42 U.S.C. 3543, authorizes HUD to collect the SSN. The data are used to ensure that individuals who no longer require access to Line of Credit Control System (LOCCS) have their access capability prompt deleted. Provision of the SSN is mandatory. HUD uses it as a unique identifier for safeguarding LOCCS from unauthorized access. Failure to provide the information requested may delay the processing of your approval for access to LOCCS. This information will not be otherwise disclosed or released outside of HUD, except as permitted by law. form HUD-27053-A Summary and Compliance Report MIAMI-DADE Agency Name: Program Name: Grant #:FL0000L4D001912 COUNTY FY 2019 US HUD COC SUMMARY AND COMPLIANCE REPORT MIA�1 COUNTY Month of Service: mm/yyyy O Adjustment # Duration: 00/00/2020 - 00/00/2021 ACTUAL MONTHLY PROGRAM EXPENSE INVOICE MATCH PROGRAM INCOME EXPENDITURES MONTHLY BENCHMARK AMOUNT TOTAL YEAR GRANT AMOUNT LEASING Leasing Units $ - $ ^ Leasing Structures - - - - Leasing Units - - - - Subtotal $ - $ - $ - $ - TOTAL LEASING $ - $ - $ - $ - RENTAL ASSISTANCE Rental Assistance Units $ - $ - PH Tenant -Based RA - - - - PH Project -Based RA - - - - PH Sponsor -Based RA - - - - TH Tenant -Based RA - - - - TH Project -Based RA - - - - TH Sponsor -Based RA - - - - Rental Administration costs - - - - Subtotal - $ - $ - $ - $ - TOTAL RENTAL ASSISTANCE $ - $ - $ - $ - SUPPORTIVE SERVICES 1. Annual Assessment FTE $ - $ ^ staff salary % - - - - Taxes & Fringe - - - - Subtotal $ - $ - $ - $ - 2. Assistance Moving Costs $ - $ - Supplies to transition - - - moving expenses - - - Subtotal $ - $ - $ - 3. Case Management FTE $ - $ - staff salary % - - - Taxes & Fringe - - - Obtaining benefits - - - Subtotal $ - $ - $ - 4. Child care $ $ - Childcare vouchers $ - $ - $ - Meals and Snacks in childcare $ - $ - $ - Subtotal $ - $ - $ - 5. Education Services FTE $ - $ staff salary % - - - Taxes & Fringe - - - education supplies - - - Subtotal $ - $ - $ - 6. Employment / Training FTE $ - $ staff salary % - - - taxes & fringe - - - Computer training - - - Eligible job Stipends - - - Subtotal $ - $ - $ - 7. Food $ - $ Providing meals - - - Summary and Compliance Report Groceries - - - Subtotal $ - $ - $ - 8. Housing search FTE $ ^ $ ^ staff salary % - - - - Taxes & Fringe - - - - Landlord mediation - - - - Rental application fee - - - - Credit counseling - - - - Subtotal $ - $ - $ - $ - 9.Legal services FTE $ - $ ^ staff salary % - - - - Taxes & Fringe - - - - Subtotal $ - $ - $ - $ - 10. Life Skills Training FTE $ - $ staff salary % $ - $ - $ - $ - Taxes & Fringe $ - $ - $ - $ - Subtotal $ - $ - $ - $ - 11. Mental health services FTE $ $ " staff salary % - - - - Taxes & Fringe - - - - Subtotal $ - $ - $ - $ - 12.Outpatient health FTE $ - $ staff salary % - - - - Taxes & Fringe - - - - Subtotal $ - $ - $ - $ - 13.Outreach Services FTE $ - $ " staff salary- Taxes & Fringe - - - - Subtotal $ - $ - $ - $ - 14. Substance Abuse FTE $ - $ ^ staff salary % - - - - Taxes & Fringe - - - - supplies - - - - Subtotal $ - $ - $ - $ - 15. Transportation $ - $ Van/ gas/ maintenance - - - - Bus Tokens - - - - Subtotal $ - $ - $ - $ - 16. Utility deposits $ - $ " one-time fee - - - - Subtotal $ - $ - $ - $ - 17. Direct provisions of $ $ ^ Operational costs for SSO only - - - - Subtotal $ - $ - $ - $ - TOTAL SUPPORTIVE SERVICES $ - $ - $ - $ - OPERATIONS 1. Maintenance & Repair FTE $ - $ staff salary % - - - - Taxes & Fringe - - - - supplies - - - - Subtotal $ - $ - $ - $ - 2. Property taxes, insurance $ - $ tax - - - - insurance - - - - Subtotal $ - $ - $ - $ - 3. Reserve Replacement $ - $ major systems reserve $ - $ - $ - $ - 4. Building security FTE $ - $ ^ Summary and Compliance Report staff salary % $ - $ - $ - $ - Taxes & Fringe $ - $ - $ - $ - subcontracted security $ - $ - $ - $ - Subtotal $ - $ - $ - $ - 5. Electricity, gas and water $ - $ - utilities - - - - Subtotal $ - $ - $ - $ - 6. Furniture $ - $ - furniture- Subtotal $ - $ - $ - $ - 7. Equipment $ - $ - operational equipment - - - Subtotal $ - $ - $ - $ - TOTAL OPERATION $ - $ - $ - $ - HMIS COSTS HMIS $ - $ - costs incurred Not the Lead HMIS $ - $ - $ - $ - $ - $ - $ - $ - TOTAL HMIS COSTS $ - $ - $ - $ - PROJECT ADMINISTRATION Project Administration FTE $ - $ - staff salary % $ - $ - $ - $ - staff salary % $ - $ - $ - $ - Taxes & Fringe $ - $ - $ - $ - Travel to monitor $ - $ - $ - $ - 3rdParty Administration $ - $ - $ - $ - Audit $ - $ - $ - $ - Administrative office space $ - $ - $ - $ - CoC Training $ - $ - $ - $ - TOTAL ADMINISTRATION $ - $ - $ - $ - ACTUAL MONTHLY PROGRAM EXPENSE INVOICE MATCH PROGRAM INCOME EXPENDITURES MONTH BENCHMARK AMOUNT TOTAL YEAR GRANT AMOUNT TOTAL $ - $ - $ - $ - $ - $ By signing this report, I certify to the best of and cash receipts are for the purposes and fraudulent information or omission of any Prepared this my knowledge and belief that the report is true, complete and accurate and objectives set forth in the terms and conditions of the federal award. I am material fact, may subject me to criminal, civil or administrative penalties claims or other offense. (mm/dd/yyyy) (signature), (title) the expenditures, disbursements aware that any false, fictitious, or for fraud, false statements, false Certified by: (print) MIAMI-DADE COUNTY FY 2019 US HUD CoC EXPENDITURE REPORT Agency Name: Program Name: Grant # FLOOOOL4D001912 MIAMICIADE Duration: 01/01/2020-12/31/2020 COUNTY LEASING RENTAL ASSISTANCE SUPPORT OPERATIONS HMIS ADMIN TOTAL MATCH DATE SUBMITTED DATE PAYMENT RECEIVED eSnaps Budget $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 month 1 - - - - - - - - month 2 - - - _,rr _ - - - month 3 - - ez: } �- ' d* - - - month 4 •r/ f• /, 1 � , month 5 - - '}rr�/ .4 . rrf rr month 6 - - - - - - - - month 7 - - - - - - - - month 8 - - - - - month 9 - - - - - month 10 - - _ - - - - - month 11 - - - - - - - - month 12 - - - - - SUBTOTAL $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL REMAINING $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 % USED #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! % REMAINING #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! REPORTING AGENCY GRANT NUMBER: SERVICE MONTH: AND PROGRAM NAME: TOTAL MONTHLY PROGRAM INCOME ntann COUN TOTAL GTD PROGRAM INCOME $ 905.00 January-20 3,615.00 n �. �a�•, ~�d� �?� a�, a , �r �:.:,.,r w ~"» 2 „:: �x«~:.��, ��� :: � :\' '�, ���av � : �u � , : �r x �� � � : NMI � a � .: x x:: a : � � w :: � .. x ,, . , .. :,,: � �,A v � a x . wr a sr M: '�: ::. 1,:. ,��.o-M �v .:\, ::.: W„ `�`., 'V rY d'. s: ar 0 w'; va " \ : x, " . :. ::,, :.. �r ,w. ;'u""? : :. t f a 4� . +S ., w x , :�d, a � �� a :, xx..� t„ � x t � x �',,, m�"�„\�r��„�"aw�: �x �wd, x` \,� . m� � , � ',,. , :: y.� r� � x� � �.�: � � �+ ,: ��,.ud��. �:.: x�,w ar.r;�'..'`���.�°`::�;��:.�,. a`'rp�:,'�„�'u1`+,.�Mua'�+n ,,',. �M�\:� ��..,.. ,�:,.`',s�"rr�^dd"dHwW������,�'v�'„�r'�"w\�m�r�'`. ,.:.. .. :., x. ^ r :.;,,, w^ w.:' �d.., � r�,. \..:a w,k, ,: .: � ,:w d ,.�, <:� .all, ��W��Y:�„�'e��1. W.Gr�:r ��'r HS'm`: Bld/unit address AMIS # Tenant Name Total Annual Adjusted Income Total Monthly Adjusted Income 30% adjusted or 10% gross ACTUAL AMOUNT %Contribution Grant -to -Date (GTD) Contribution CLIENT DIRECT LANDLORD / PROVIDER 1 1A (in 3 months) last name, first $ 4,200.00 $ 350.00 $ 105.00 $ 245.00 $ 105.00 30% $ 315.00 2 1B (new in program) last name, first $ 12,000.00 $ 1,000.00 $ 300.00 $ 700.00 $ 300.00 30% $ 300.00 3 2A (in 6 months) last name, first $ 21,600.00 $ 1,800.00 $ 540.00 $ 1,300.00 $ 500.00 28% $ 3,000.00 4 2B last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 5 3A last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 6 3B last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 7 4A last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 8 4B last name, first r��� - $1- f $ $ - $ - #DIV 0! / $ jf� - 9 5A last name, first � i'/ ' f• •i,'f / 0 ,, - i - 10 5B last name, first 4/ 1 off $ $ #DIV/0! $ 11 last name, first {F/ $ - $ - #DIV/0! $ - 12 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 13 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 14 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 15 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 16 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 17 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 18 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 19 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 20 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 21 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - 22 last name, first $ - $ - $ - $ - $ - #DIV/0! $ - COMPLETE ONLY IF APPLICABLE - Occupancy charges and rent collected from program particpants are program income and may be used as provided under 24 CFR 578.97 a LEASE or OCCUPANCY AGREEMENT MUST BE IN PLACE Miami -Dade County Homeless Tru :i� Income Determination. .�ent�:��tlatlo�� �. �'`,�ENT E firms raxra/lat.,W2WtRaffe±5 ,14.—life '+ 1 22.,S, ara.Ks.+c4.10. gt1.4,0'11Cr:'Atag=09.01: Participant/ i-IMIS: Unit/Address: 1) 2) $ 3) 4 5] 13) 14) 17) 18) 19) 20) Adjusted income. Total Income Adjustments (add lines 5, 6, 11, 1.3 14) Adjusted Income (subtract line 15 from lhle 3) Resident Rent Determination inconre exclusion .r:11an1,1cal GrOSS Income Calculating Adjusted Income Dependent /llowanc:es 'robe!. oLt Dependents Multiply lire 4, ITy'080 (Child Cure Allowance) Cbffld Care Allowance Enter anticipated ullr'eitr1Gr.rr'secl Child (.'17r'e eXpenses Ucsabled Assistance Allowance Disabled Assistance kixpertses Multiply Line by 0,03 Subtract Lire 8 from Line y Amount earned by household rrlerrll.3ef';w; which t,vos dependent upon 1)i,srlblerl assistance expense _.._ _. n ter the Lesser" A f1101-; n t: o j 1 1!Th: 9 01' ..1.0 Methceil Expenses / Elderly Household Allowance Medical` expo. r tses Dine 9 is less than irt'o, enter the amour f'r'orn line .12, otherwise add lines 7 rand 12 crrrei subtract line 8 • Elderly or Disabled Family Allowance enter. '400 Occupancy Amount Determinatiion" Program Income 30°r% of Monthly Adjusted Income (Divide Line.t6 by.12 & Multiply by 0.3) 10% of Monthly Gross Income (Divide Line 3 by 12 and Multiply by 0,10) /A WelJar"c� rent:, not applicable in State of Florida Resident Rent largest of line .17 or 18 Determining Occupancy A oun : for Units where lltilites are not included Utility A'ilioavarIce (published by PI-ICD) Resident Oc;cl.ilaclncy Charge Program r am Income Utilities Rehnbrts'errrent " * If the amount on line 22 is less than 0, change the minus to a plus. This is the amount that may be paid on behalf of the resident as a utility reimburs3nent, paid to the Utility Company directly or provide documentation of paid utilities. ff Project information aD€ Project Sponsor Agency Name Project Name Name of Progam Sample Grant Number Participant Information Last Name Lastname Address First Name first name UNIT # HMIS # xx- xx Unit # 103 leave blank if protected Monthly Duration of Lease & HAP contract MONTHLY FMR or Rent Reasonable "contract rent" Utility Allowance (if utilities not In this sample Tenant's rent calculated at 30% $125 per month / utilities not included in MONTHLY CONTRACT, RENT Tenant Portion 30% or 10% - allowance HAP Amount to Landlord included in lease) the Lease therefore, $125 - 69 = $ 994.00 $ 56.00 $ 938.00 Monthly 10/I:/14- 09/30/15 $ 994.00 $ 69.00 $56 $ 1,000.00 $ 56.00 $ 944.00 Monthly 10/1/15 - 09/30/16 $ 1,000.00 $ 69.00 Contract Year HAP Amount to Landlord Tenant Portion Total Rent July-15 $ 938.00 $ 56.00 $ 994.00 Augnst-15 $ 938.00 $ 56.00 $ 994.00 September-1S $ 938.00 $ 56.00 $ 994.00 October-15 $ 944.00 $ 56.00 $ 1,000.00 November-15 $ - $ $ - December-15 $ - $ - $ - January-16 $ - $ - $ - February-16 $ - $ - $ - March-16 $ - $ - $ - April-16 $ - $ - $ - May-16 $ - $ - $ - june-16 $ - $ - $ - Subtotal $ 3,758.00 $ 224.00 $ 3,982.00 FY 2019 Continuum of Care (CoC) Program Miami -Dade County Homeless Trust Annual Progress Report (APR) ATTACHMENT F "Annual Progress Report (APR)" Annual Progress Report (APR) for US HUD Grant Funded Continuum of Care (CoC) Programs On April 1, 2017, Continuum of Care (CoC) Program grant recipients report their CoC Program. Annual Performance Reports (APBs) in Sage HMIS Reporting Repository (Sage), Recipients will be required to upload CSV data from their HMIS to fulfill the APR reporting requirement in Sage, All Subrecipients are required to continue to submit the hard copy of the HMIS report as well as the supplemental pages until further notice. By signing this report, the duly authorized Project Sponsor/Provider /Subrecipient Official signature below certifies to the best of their knowledge and belief that the report is true, complete and accurate and is for the purposes and objectives set forth in the terms and conditions of the federal award; and are aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject the duly authorized official to criminal, civil or administrative penalties for fraud, false statements, false claims or other offense. Project Name Project Grant Number Print Name and Title of Authorized Project Sponsor/Provider/Subrecipient Official: Signature & Date (mm•/dd/yyyy]: Print Name & Title of Authorized Project Grant Official (MDCHT Executive Director or Designee): Do Not Sign -- for Miami -Dade County ONLY Signature & bate (to m/dd/yyyy): Supervisory Review and Entry- Print Name & Title Do Not Sign - for Mianxii-Dade County ONLY Signature & Date(rm/dd/yyyy): Updated March 31, 2017 Attachment F "Annual Progress Report (APR) Supplemental" Guidance was provided for e-snaps changes that Lwlere implemented to improve processing time; completing an "Applicant Profile"; and on Q3, QS, Q23, Q24, and Q 31 - please submit the UMIS generated APR as well. US HUD - ANNUAL PERFORMANCE REPORT (APR) CONTINUUM OF CARE (CoC) 1. Contact Information Project Name Recipient/Agency Name Grant Number Prefix (Mr., Mrs., Ms., Dr, etc.) First Name Middle Name Last Name Suffix (LCSW, MSW, Etc.) Title Street Address 1 Street Address 2 City State Zip Code E-mail address Phone Number Extension Fax Number 3. Project Information: Check the corn anent for the 1 ogram on which you are reoortin Continuum of Care Program (CoC) Rental Assistance (RA) Section 8 Moderate Rehabilitation ❑ Transitional Housing ❑Tenant -based Rental Assistance (TRA) ❑ Single Room Occupancy ❑ Permanent Housing for Homeless Persons with Disabilities ❑Project based Rental Assistance (PRA) ❑ (Sec. 8 SRO) ❑ Safe Haven ❑ Single Room Occupancy (SRO) • HMIS IN Innovative Supportive Housing ❑Sponsor -based Rental Assistance (SRA) ❑ Supportive Services Only Is this APR fulfilling the reporting obligation associated with a 20 or 1S-year use requirement? (Q) Number of Years in Operation: (LJ) Contract operating term or duration is from ( / /20 ) to ( / /20 ) 3. Project Information continued: Is this a Domestic -- Violence Program (Yes: or No) Was this project funded under a special initiative? If yes, what type? (Samaritan Bonus, Permanent Housing Bonus, Reallocation, Etc.) Amount of Contract or Award $ CoC Number and Name FL-600 Miami -Dade County Is this an APR for a grant that received a HUD- approved grant extension? (Yes. or No) Is this a final APR? (Yes or No) Attachment F "Annual Progress Report (APR) Supplemental" Financial information for CoC Programs t?31a1 CoC Financial DeveiolDment Expenditure Type CoC Program funds Expenditures Acquisition Rehabilitation New Construction Development - Subtotal $ . Q31a2 CoC Expenditures -- Supportive Services Report on all. CoC Program funds expended during the operating year on supportive services. If you have no expense for these items or these items were not included in your grant application enter "0" in each field on the question. Expenditures type (oC Program Funds Expenditures 1. Assessment of Service Needs $ 2. Assistance with Moving Costs $ 3. Case Management $ 4. Child Care $ 5. Education Services - $ 6: EmploymentAssistance $ 7. Food $ B. Housing/CouniselingServices $ 9. Legal Services $ 10. Life Skills $ 11. Mental Health Services $ 12. OutpatientHealth Services $ 13, outreach Services $ 14. Substance Abuse Treatment Services $ 15. Transportation $ 16, Utility Deposits $ Supportive Services Subtotals i• Attachment F "Annual Progress Report (APR) Supplemental" Q31a4 CoC Financial — Leasing, Rental Assistance, Operating, and Administration Total Expenses COC Funds Development $ Supportive Services $ Real Property Leasing $ Short -/Medium Term Rental Assistance $ Long-term Rental Assistance $ Operating Costs $ HMIS $ SUBTOTAL $ Administration - Provider $ Administration - Homeless Trust $ TOTAL Expenses plus Administration $ Cash Match $ In -Kind Match $ TOTAL Match $ Match TOTAL Expenditures and Match $ Program Income $ Attachment P "Annual Progress Report (APR) Supplementa Performance for CoC Programs 36: Standard Performance Measures Performance Measure (Measures are found in the eSn a ps (Exhibit 2) of the THUD application Exhibit6 A-C) (Target) # of Persons who were expected to accomplish this measure (eSnaps Budget Exhibit 2) # of total (Universal) persons who are is expected to accomplish this measure (eSnaps Budget Exhibit2) % expected to accomplish this measure (eSnaps Budget Exhibit2) Actual Target# of persons who accomplished this measure Reported in HMIS Actual # of total . (Universal) person to achieve this measure Reported in HMIS Actual % of personsto achieve this measure Reported In HMIS Persons exiting to permanent housing (subsidized or unsubsidized) duriltg the operating year. 11 16 69 % 19 20 i;.. 95 % '•i ';l ill ? 1).11 ! Housing Stability Measure Reported in HMIS Q36 . Total Income Measure Reported in HMIS Q36 Earned Income Measure Reported in HMIS Q36 Other — specify Reported in HMIS 37: Additional Perforrnance easures Performance Measure (Measures are found lit the eSnaps (Exhibit2) of the HUD application Exhiblt6 A-C) (Target) # of Persons who were expected to accomplish this measure (eSnaps Budget Exhibit 2) # of total (Universal) persons who are is expected to accomplish this measure (eSnaps Budget Exhibit 2) °%expected to accomplish this measure (eSnaps Budget Exhibit 2) Actual Target #ofpersons who accomplished this measure Reported in HMIS - Actual. # of total (Universal) person to achieve this measure Reported in HMIS Actual % of persons to achieve this measure Reported in HMIS * Utilization Rate or Vacancy Report Other Q40; Significant Program Accomplishments Describe in a brief narrative form (no more than 2,000 characters) any significant accomplishments achieved by your project during the reporting period: Q42: Additional Comments Describe in a brief narrative form (no more than 2,000 characters) based onyour experience during the last year any problems or explanations and or changes or need for technical advice or assistance. Attachment F "Annual Progress Report (APR) Supplemental" FY2019 Continuum of Care (CoC) Program CoC Monitoring Guidelines, Internal Wellness"Top Ten" List, Internal Wellness Checklist ATTACHMENT G "Internal Wellness Checklists" Attachment G "CoC Program Guidelines" Page 1 of 14 Miami -Dade County Homeless Trust CoC Program Guidelines Mia i-Dade County Homeless Trust Monitoring Team Information Staff: Date of Visit: CoC Program Subrecipient Agency and Program Information Subrecipient: Program Name: Subrecipient staff consulted: Grant Amount: Grant Number: Program Type: Li PSH RRH 0 TH fl SH El SSO 0 Legacy SPC RRH Number to be served: Number of chronic beds/units: Program serves; 0 Individuals 0 Families 0 Both CoC Program grant funds are used for: 0 Leasing (no match. required) 0 Rental Assistance 0 Operations 0 Supportive Services RMIS 0 Administration Is the Subrecipient a faith -based organization? 0 Yes 0 No CoC Matching funds f25%) required are: 0 Cash/Cash Equivalent 0 In Kind 0 N/A Is there an active restrictive covenant on one or more of the project's properties? 0 Yes 0 No Attachment G "CoC Program Guidelines" Page 2 of 14. PART 1: PROGRAM MONITORING: SUB RECIPIENT OPERATIONS: POLICIES AND PROCEDURES: Conflict of Interest 1. There are written standards of conduct governing the performance of covered persons engaged in the award and administration of contracts. 24 CFR § 578.95(a); 24 CFR § 578.103 (a) (11) 0 Yes 0 No 2. The Subrecipient has a general conflict -of -interest policy far staff and Board members 24 CFR § 578.95(c); 24CFR § 578.103(a)(11 0 Yes 0 No 3. lithe Subrecipient is an approved exception to the conflict of interest policy, the agency has documented the exception 24CFR § 578.103(a)(11) 0 Yes 0 No Involvement of homeless persons 1. There is at least one homeless/formerly homeless person is on the Board of Directors or equivalent policymaldng.entity. 24 CFR§ 578,75(g)(1) 0 Yes 0 No 2. The Subrecipient involves homeless individuals and. families through employment; volunteer services; or otherwise; in constructing, rehabilitation, maintaining; and operating the project, and in providing supportive services for the project, 24CFR § 578,75(g)(2) 0 Yes 0 No . Conffdentlalitr 1. The Subrecipient has written policies to ensure: Records containing protected identifying information of any individual / family receiving assistance will be kept confidential; O The location of any family violence project will not be made. public, except with the written. permission of the person responsible for operating the project; and o The location of any housing of any program participant will not be made public, except as provided in a preexisting privacy and as provided by law. 24 CFR § 578.103(b) (These policies are in addition to HMIS related confidentiality / security requirements) CD Yes 0 No Fair Rousing and Equal Opportunity 1. The Subrecipient has written nondiscrimination and, equal opportunity policies that apply to housing and employment. 24 CPR § 578.93 0 Yes 0 No 2. The Subrecipient has policies and procedures for providing reasonable accommodations and reasonable modifications for persons with disabilities. 24 CFR § 100.204(a), 28 CFR § 35.130(b)(7) 0 Yes 0 No Attachment G "CoC Program Guidelines" Page 3of14 3. The Subrecipient maintains copies of marketing, outreach, and other materials used to inform eligible persons of the program and these materials show that the agency markets their housing and supportive services to those least likely to apply in the absence of special outreach. 24 CFR §578.93(c)(1) O Yes O No . 4. The Subrecipient has policies and procedures in place to provide meaningful access for Spanish- speaking and other Limited English Proficiency persons to access the Subrecipient's programs and services, 72 federal regulation 2732 ❑ Yes 0 No 5, The Subrecipient provides program participants with information on rights and remedies available under applicable federal, State and local fair housing and civil rights laws. 24 CFR§578.93(c)(3) 0 Yes 0 No Drug -Free Workplace 1. The Subrecipient has a drug -free workplace policy statement which includes the requirement of notification to HUD if an employee is convicted for a criminal drug offense. 24 CFR § 84.13 O Yes 0 No • POLICIES AND PROCEDURES FOR COC GRANT FUNDED PROGRAM Number Served 1. The Subrecipient serves at least as many program participants as show in its application for assistance. 24 CFR § 578.51(h)(3) 0 Yes 0 No Termination Process 1. The Subrecipient has a written policy for termination of participation for violation of program policies or occupancy agreements. 24 CFR § 578.91(b) 0 Yes O No , Services Related to Housing Stability 1. The Subrecipient has a written policy for termination of participation for violation of program policies or occupancy agreements. 24 CFR § S78.91(b) 0 Yes 0 No Residential Supervisiort 1. The Subrecipient provides adequate residential supervision. 24 CFR§ 578.75(f) 0 Yes 0 No Program Fees 1. The Subrecipient does not charge participant's program fees. 24 CFR § 578.87(d) Program fees are notthe same as rent or occupancy rent; program participants may be charged rent for housing) -- 0 Yes (C No Attachment G 'CoC Program Guidelines" Page 4 of 14 Recordkeeping 1. The Subrecipient has systems in place to ensure that records related to CoC-funded programs are maintained for a 5-year period. 24 CFR § 578,103 a Yes 0 No REVIEW OF CoC PROGRAM PARTICIPANT FILES Eligibility: Homelessness 1. Each participant file contains verification of homelessness status at the time of program entry. 24 CFR § 578.103(a)(3) 24 CFR § 576.500(b) a Yes a No 2. The Subrecipient has written policies and procedures for documenting homelessness. Intake staff docuunent eligibility at intake; documentation is required for all persons seeking assistance; written policies state the evidence that may be relied upon to establish and verify homeless status. The Subrecipient snakes efforts to establish and verify homeless status and get the appropriate documentation. Uses Miami -Dade County's homeless verification forms. In order of preference: 1) Homeless coordinated outreach and assessment, 2) Third party documentation, 3) Intake worker observations, 4) Certification from. the person seeking assistance. 0 Yes 0 No . Eligibility: Disability 1. If the program provides PSI•l, each participant file contains verification of participant's disability. 24 CFR § 578.37(a) (1)(i)1) Verification from a professional who is licensed to diagnose and treat condition OR 2) Disability verified by the Social Security Administration (VA. disability check, or an SSDI check) 0 Yes 0 No . Eligibility, Chronic homelessness 1. the program has units dedicated to persons who are chronically homeless, participant files contain verification of chronic homelessness. 0 Yes C] No Service Assessment 1. The file contains participant assessments and service plans, updated at least annually. 24 CFR § 578.53(a) O Yes a No Services Provided and Costs 1. The file contains documentation of services provided and the agency tracks the amounts spent on those services, 24 Cf'R§ 578.103(a)(9) 0 Yes C] No Duration of Services 1. The file reflects that supportive services are made available throughout resident's entire time in the project. 24 CFR § 578,53(b) 0 Yes 0 No 2. Rapid rehousing: The file reflects that program participant meets with case manager not less than once per month. 24 CFR § 578,53(b)(4) 0 Yes 0 No Attachment G "CoC Program Guideline? Page 5 of 14 Participants Terminated from Program 1. Ha participanthas been terminated from the program, file includes documentation that the Subrecipientfollowed its written procedure for termination of assistance. 24 CFR § 578.103(a)(7J(iJ; 24 CFR § 578.91 0 Yes 0 No RENTAL ASSISTANCE OR LEASING (complete this section if the Subrecipient pays rental assistance or leasing costs fora unit that the program participant lives in) Rental Agreement / Lease 1. The program participant has an occupancy agreement or lease with the Recipient/Subrecipient or Landlord. 24 CFR § 578,77(a) For tenant and project based assistance; the program participant must be the tenant an the lease. For sponsor based assistance, lease between the Subrecipientanti the Landlord, sub -Lease between participant and Snbrecipien t 0 Yes O No 2. For project -based, sponsor -based, or tenant -based permanent housing (PH) rental assistance; initial lease must be at least one year, terminable for cause. The leases must be automatically renewable upon expiration for terms that are a minimum of one month tong, except on prior notice by either party, up to a maximum term of 24 months. 24 CFR § 578.51(I)(1) 0 Yes Cl No 3. For transitional housing, initial lease term must be at least one month. The lease must be automatically renewable upon expiration, except on prior notice by either party, up to a maximum term of 24 months. 24 CFR § 578.51(1)(2) 0 Yes O No Habitability 1. File includes documentation that units passed housing quality standards inspection prior to initial client move -in. 24 CFR § 578.75 (b); and 24 CFR 578.103(a)(8) ❑ Yes ❑ No 2. File includes documentation that unit has passed .annual housing quality standards inspections, including an inspection within the last 12 months. 24 CFR § 578.75(b) O Yes O No 3. Dwelling unit is correct size: The dwelling unit must have atleast one bedroom or living/sleeping room for each two persons, Children of opposite sex, other than very young children, may not be required to occupy the same bedroom or living / sleeping room. 24 CFR § S 78.(c) 0 Yes 0 No 4. For supportive housing for persons with disabilities; the Subrecipient trust make available meal preparation facilities for residents or provide meals 24 CFR § 578.75 (d) 0 Yes 0 No Attachment G "CoC Program Gu delines° Page 6 of 14 Unit Rents 1. Documentation that rents are reasonable in relation to rents charged in the same geographic area for comparable space 24 CFR § 578,49(b) 0 Yes 0 No 2. Rents do not exceed the HUD -determined Fair Market Rents (FMRs). This documentation must include chart show current year's FMRs, 24 CFR § 578.49(b)(4) 0 Yes ❑ No 3. Security deposit does not exceed two months' rent; in addition to the security deposit, the Subrecipient may also pay the final months' rent in advance 24 CFR § 578.49(b)(4) 0 Yes 0 No Annual Income 1. The file contains an income evaluation form completed by program participant and source documents verifying income and assets (or, if source documentation not available, 31'd party verification; or if 3rd party verification not available, written certification by program participant. 24CFR '578.103 a6 0 Yes O No 2. The file contains documents demonstrating that income Is re-examined annually. 24 CFR § 578.77(c (2 0 Yes 0 No Rent Calculation 1. The file contains the annual rent calculation, and the calculation is accurate. BEST PRACTICE: The file contains a printout of the HUD rent calculation 24 CFR.§578.103 0 Yes fl No ' 2. Is the participant charged rent (unless $0 income) and is the rent treated as program income? (required) 0 Yes 0 No 3. Is rent calculated initially, annually, and when there is any change in income? '0 Yes © No 4. Is there documentation of compliance of an eligible "utility allowance" The Subrecipient has received a copy of the Tenants paid utility bill for compliance. 0 yes 0 No Vacancies 1. The Subrecipient does not pay rent for more than 30 days for any unit that has been vacated, Rent may not be paid on the vacated unit again until there is a new occupant (NOT,: Brief periods of stays in institutions, not to exceed 90 days for each occurrence, are not considered vacancies). 24 CFR § 578.51(9) 0 Yes 0 No Attachment G "CoC Program Guidelines" Page 7 of 14 LEASING (complete this section ifthe Subrecipient leases buildings for the purpose of providing program services or if there is a unit lease agreement with a landlord) Rent Reasonableness (applies to rent for buildings or housing units) 1. Documentation that rents are reasonable in relation to rents charged in the same geographic area for comparable space. 24 CFR § 578.49(b) O Yes O No 2. Rents do not exceed rents charged for comparable units rented by the Subrecipient, 24 CFR § 578,49(b) 0 Yes O No 3. Security deposit does not exceed two months' rent; in addition to the security deposit, the Subrecipient may also pay the final months' rent in advance. 24 CFR § 578,49 (b) (4) 0 Yes Q No 4. The Subrecipient must have an occupancy agreement, and if applicable a sublease. 0 Yes ❑ No 5, Is rent calculated initially and when the tenant requests? 0 Yes O No • 6. Is the participant charged rent? (not required) 0 Yes ❑ No 7. Has an occupancy charge been imposed? (not required) If so, the charge cannot exceed the highest of 1) 30% of the households monthly adjusted income; 2) 10% of the households' monthly income, or; 3) The portion of the households` welfare assistance; if any that is designated for housing costs. (not applicable in the State of Florida) 0 Yes 0 No 8. Leasing funds are not used to lease units or structures owned by the Recipient, Subrecipient, their parent organization(s) or organizations that are members of a partnership where the partnership owns the structure. (Doesn't apply to rental assistance), 0 Yes 0 No REQUIRED POLICIES AND PROCEDURES FOR SPECIFIC PROGRAMS) CIRCUMSTANCES Participant Household Policies (complete this section for any program that serves families with children) 1. The age and gender of a child under age 18 must not be used as a basis for denying any participant household's admission to a project that receives funds under this part 0 Yes 0 No raith-based Activities (complete this section if the Subrecipient is a faith -based organization) 1. The Subrecipient serves all potential participants without regard to religious belief, refusal to hold a religious belief, or refusal to attend or participate in religious services. 24 CFR § 578.87(b)(1) 0 Yes 0 No 2. If the Subrecipient provides explicitly religious activities (including worship, religious instruction, or proselytizing), these activities are separate from HUD -funded activities and beneficiaries of HUD - funded activities are not required to participate, 0 Yes O No Attachment G "CoC Program Guidelines" Page 8 of 14 24 CFR § 578.87(b)(2) Projects involving acquisition, new construction, and rehabilitation 1. Records for acquisition, new construction, and rehabilitation must be retained for 15 years following the date the project is first occupied, or used, by program participants, 24 CFR § 578.103 (c)(2) D Yes ❑ No 2. If the project resulted in dislocation of any persons, the Subrecipient complied with the obligations of the Uniform Relocation Act? . 24 CFR § 578.83 D Yes D No 3. For projects including new construction or rehabilitation, do the Recipient's records show that Section 3 reports have been completed and submitted timely? 24 CFR § 578.99(i) 0 Yes D No Transitional Dousing 1. Participants do not regularly exceed 24 months in the program. 24 CFR § 578.79 0 Yes El No 2. When a participant is in the program for longer than 24 months, the file documents the need for extended participation. 24 CFR § 578,79 0 Yes 0 No 3. If participants stay longer than 24 months, is the number of participants with longer stays less than 50% of the total number served bythe project? 24 CFR § 578.79 0 Yes 0 No Transfer Due to Domestic Violence 1. Ifa program participant receiving tenant -based rental assistance has moved to a different CoC due to threat of imminent harm, the file must contain documentation of the domestic violence and imminent threat 0 Yes 0 No PART 2: FISCAL MONITORING INTERNAL. REVIEW Audit 1. Is the Subrecipient subject to the OMB A-133 single audit requirement? (Required if $5000,000 or more in aggregate Federal funds expended) D Yes ❑ NO 2. If subject to A-133 audit, has the Subrecipient provided its most recent audit and management letter? D Yes 0 No 3. If not bound by A-133 requirement, has the agency provided financial statements audited by a CPA? 0 Yes 0 No Board of Directors 1, Has the Subrecipient provided Miami -Dade County a list of the members of its Board of Directors? D Yes 0 No Authorized Check Signers 1. Has the Subrecipient provided Miami.Dade County with a list of authorized check signers? ❑ Yes 0 No Attachment G "CoC Program Guidelines" Page 9of14 Invoicing 1. The Subrecipient submits invoices on a monthly basis (on time or within time)? 0 Yes 0 No Procurement 1. The Subrecipient has a written procurement policy that meets the requirements of Miami -Dade County competitive procurement standards. 0 Yes O No 2, The Subrecipient retains copies of all procurement contracts and documentation of compliance with federal procurement requirements 24 CFR § 578.1.03(a)(16)(ill) ❑ Yes ❑ No Match L The Subrecipient has documentation of the source and use of contributions made to satisfy the 25% match requirements (match may be cash or in kind). Records must indicate the grant and fiscal year for which each matching contribution is counted. The records must show how the value placed on 3rd party in kind contributions was derived. Costs incurred by a partnering organization to provide "in kind" services to the pro gram participants must be documented by a MOU. Cash or any in kind contribution used as match for another grant is not an eligible in kind contribution used as match for another grant is not an eligible match. 24 CFR § 578.73, 24 CFR § 578.1.03 (a) (10), 24 CFR § 84,23 and 24 CFR § 578.23(c)(6) ❑ Yes 0 No 2. Match must be spent on eligible project costs (in the budget) 0 Yes 0 No 3. Where match is documented by MOU, the MOU must; establish the unconditional commitment • identify the service to be provided; identify the profession of the persons providing the service; and identify the cost of the service to be provided 0 Yes O No Internal Controls 1. The Subrecipient has written job descriptions for all' HUD -funded positions 0 Yes 0 No 2. The Subrecipient has written fiscal policies and procedures specifying approval authority for all financial transactions and guidelines for controlling expenditures 0 Yes 0 No 3. The Subrecipient has written procedures for recording financial transactions, and an accounting manual and chart of accounts 0 Yes 0 No Program Income 1.. is all program income spent on eligible costs? Rent and Occupancy charges are considered program income as is any utility allowances in rental programs 0 Yes 0 No 2. Es program income part of your match? Program income is not an eligible source of match. 0 Yes , 0 No • Attachment G "CoC Program Guidelines" Page 10 of 14 Indirect Costs 1, Does the organization use grant funds for indirect costs? 0 Yes ❑ No 2. Are the costs consistent with OMB Super Circulars as applicable 0 Yes 0 No DOCUMENTATION REVIEW Salary Documentation 1. Original timesheets -- signed; grant duties identified, if split time (copy in reimbursement package) 0 Yes 0 No 2, Payroll sheets 0 Yes 0 No 3, Cancelled checks to the employee 0 Yes 0 No 4. If time is divided between the CoC Programs and another funding source, review time distribution records supporting the allocation of charges among the sources. Staff time breakdown allocation chart 0 Yes 0 No Space / Utilities Documentation / Leases 1, Rental or lease agreement - signed by participant; valid lease period; correct rental amount n Yes ❑ No 2. Original invoices 0 Yes 0 No 3. Cancelled checks to the landlord/mortgagee; utility company, etc. 0 Yes 0 No 4. Unit inspection report(s); no longer than 1 year old 0 Yes 0No 5. Verification of what payment was used for (e,g. first month's rent, security deposit, etc.) 0 Yes 0 No Supplies 1. Purchase orders 0 Yes 0 No 2. Requisitions 0 Yes 0 No 3, Cancelled checks 0 Yes E No 4, Determine where supplies are being kept ❑ Yes 0No 5, Determine what cost objective is being used 0 Yes 0No Review Inventory list - any equipment shall be labeled as property of Miami -Dade County through its Homeless Trust 0 Yes 0 No VELENDERNIUMEA Attachment G "CoC Program Guidelines" Page 11 of 14 INTERNAL CONTROLS 1. Internal control questionnaire O Yes O No 2. Review organizational chart 0 Yes O No 3. Reviewjob descriptions/definitions of employees' duties 0 Yes 0 No 4. Review Subrecipient's system of authorization and supervision 0 yes 0 No 5. Ensure that there is a separation of duties (authorizing, recording and custody should be separate) O Yes O No 6, Review control over assets 0 Yes 0 No EVALUATION OF SELECTED TRANSACTIONS Is the expenditure allowable a. Is the expenditure necessary, reasonable and directly related to the grant? O Yes 0 No b. Is the expenditure authorized by the grant? 0 Yes O No Source documentation evaluation a. Were the expenditures incurred during the term of the grant? 0 Yes O No b. Was the money actually paid out? 0 Yes O No c. Were the expenditures approved by the responsible Subrecipient officials ❑ Yes O No d. Is there adequate documentation to support the expenditures? ❑ Yes 0 No _ Does the Subrecipient maintain the appropriate records? Does the Subrecipient maintain the following? a. Chart of accounts O Yes O No b. Cash receipts journal O Yes O No c. Cash disbursements journal 0 Yes O No d. Payroll journal 0 Yes O No e. General ledger 0 Yes 0 No 1. Does the Subrecipient maintain documentation concerning its sources of funding 0 Yes O No Attachment G "CoC Program Guidelines' Page 12 of 14 •............. PART 3: HMIS MONITORING HMIS HOMELESS MANAGEMENT INFORMATION SYSTEMS HMIS Operations: Policy and Procedures 1, The Subrecipient has signed an HMIS Participation Agreement to use the HMIS license 0 Yes 0 No 2. Are the Subrecipient's HMIS Administers registered and approved to enter the data into the HMIS system 0 Yes Q No 3. The Subrecipient has designated an HMIS site Administrator(s), who is the Point of Contact for Miami -Dade County through its Homeless Trust as HMIS Lead Agency. 0 Yes 0 No 4. the Subrecipient has ensured that each HMIS user within its Organization has signed a user agreement stating full understanding.of user rules, protocols and confidentiality, 0 Yes 0 No Privacy 1. The Subrecipient has a Data Collection / Privacy Notice posted in English and Spanish at each intake location 0 Yes 0 No 2, The Subrecipient has a written Privacy Policy or uses the CoC's written Privacy Policy 0 Yes 0 No 3. If the Subrecipient has a web site, the Privacy Policy is posted to the web site, 0 Yes 0 No 4. The Subrecipient: has a signed authorisation for release of information form that it uses for any client for which the Subrecipient uses I-IMIS for data sharing 0 Yes 0 No 5. The Subrecipient ensures that all signed forms are locked in a designated location with limited access to staff 0 Yes c No 6. The Subrecipient has executed the Agency Sharing Data Agreement, if applicable (MOU?) 0 Yes 0 No 7. The Subrecipient has a written client complaint policy 0 Yes 0 No 8. The Subrecipient has established a process of tracking all filed complaints and can provide copies of complaints and resolutions to the HMIS Lead Agency if requested. 0 Yes 0 No Security 1. The Subrecipient maintains a list of active HMIS users 0 Yes O No 2. The Subrecipient regularly contacts the HMIS Lead when an employee leaves the Organization, in order to make sure that the person's HMIS account is disabled. 0 Yes 0 No 3. Are the Subrecipient's HMIS workstations located in secure locations or, if not, are the workstations manned at all times? 0 Yes 0 N o 4. Has the Subrecipient identified a person who will serve as the Organization's HMIS security officer? 0 Yes Attachment G "CoC Program Guidelines" Page 13 of 14 O No 5. Has the HIvIIS security officer completed an HMIS security self -certification within the last 12 months? O Yes 0 No 6. Does the Subrecipient have in place policies and procedures to protect hard copies (paper) with personal identifying information? O Yes ❑ No Data Quality At a minimum the Subrecipient collects the Universal Data Elements for every client entered and minimum data quality standards are met, 0 Yes 0 No The Subrecipient enters Client Basic Demographic Data into the HMIS system at a minimum within one week of intake 0 Yes 0 No The Subrecipient staff review monthly reports received from HMIS Program Administrator and addresses any issues noted. 0 Yes O No Attachment G "CoC Program Guidelines" Page 14 of 14 CONTINUUM OF CARE (CoC) PROGRAM INTERNAL WELLNESS "TOP TEN" LIST This "Top 'pen" checklist is a supplement to the CoC Internal Wellness Checklist. It is intended to highlight ten critical recordkeeping areas in the operation of the CoC Program Grantees are encouraged to utilize this resource to proactively monitor tho current "health" of their CoC grants. Prograiii 'artiejaant•Level Recordkeeping The oritieal records to be maintained for each program participant include; 1,, 0 Participant Eligibility 4, ❑ Housing Qualify Standards (HQS) Ensure documentation of a participant's homelessness Ensure structures or units assisted with CoC funds meet or at -risk of homelessness status and disability, If HQS at Jesse -up and are re.inspeoted at least annually applicable, is obtained at intake. thereafter. 24 CFR 576,500(b) or (c); 24 CFR 578.103(a)(3), (9), or (5); and 24 CFR103(a)(17) 24 CFR 578.75(b) and 24 CFR 578.103(a)(8) 2. 0 Leasing and Rental Assistance 5. ❑ Use of a Coordinated Entry System Requirements Ensure participants are assessed and referred usingthe Ensure rants charged for a structure or unit assisted CoC's coordinated assessment system. with leasing or rental assistance funds meet standards ofFMR or rent reasonableness, 24 CFR 578.23(c)(9) and 24 CPR 578.103(a)(17) 24 CFR 578.49 and 24 CFR 578.51 3. 0 Examination of Income .6. ❑ Use of Homeless Management Ensure partioipant income documentation is examined Information System (EMT,S) at intake and re-examined at least annually. Ensure participants are entered in the Coe's HMIS or a 24 CFR 578.77(b)(4) and 24 CFR 518,103(a)(6) comparable database, 24 CFR 576.500(b) or (c); 24 CFR 578.103(a)(3) General Recoudlceeping and Financial Files The critical records to bmaintained by each recipient and/or subrecipient ir,�lude: 7. ❑ Standard Operating Procedures Maintain policies and procedures for intake, program operation, recordlceeping, and subreoipient oversight/ monitoring to ensure that CoC fltnds are used appropriately, 24 CFR 578.103 a and 24 CFR 578,23 c 9. ❑ Match Sources and Uses Ensure grant funds, except leasing funds, are matched with no less than 25 percent of cash or in -kind contributions from other sources, 24 CFR 578.73 and 24 CFR578,103(a)(10) 8. ❑ Financial Policies and Procedures Maintain fiscal controls, accounting procedures, and procurement procedures to ensure that Coe fiends are used appropriately, *2 CFR Part 200 10. ■ Homeless Participation Enable homeless or formerly homeless persons the opportunity to participate in polloynaakiug on the board of directors or other equivalent polleymaking entity, 24 CFR 578,75(g)(1) and 24 CFR 578.103(a)(12) NOTE: Pot additional guidance, please refer to the following resource materials; (1) Homeless Emergency Assistance and Rapid Tratxs1tion to Housing; Continuum of Care Program CoC Regulations at 24 CFRPart 578, and (2) CPD Monitoring Handbook 6509,2 REV-6 CHO-2 at: http://poital.hud.goy/budportal/FIUA7sroqproarain offces/administration/hudclips/handboo1 g/..ppd/6509,2, ' (13LOCIC 8) If a recipient chooses to utilize this document for projects funded. ROO to the FY 2015 CoC competition, please refer to 24 CFR 578,103(1), 24 eiit Part 84 and 24 CY t Part 85 for applicable financial requirements. 1 Internal Wellness Checklist for the Continuum of Care (CoC) Program The Internal Wellness Checklist was developed in an effort to assist homeless providers to proactively implement its FY CoC grant(s), thereby ensuring compliance with applicable regulations codified at 24 CFR Part 578. It is also designed to assist with determining the current "health" status of this CoC grant. Grant recipients are strongly encouraged to utilize this checklist prior to submitting the required APR to the U. S. Department of Housing and Urban Development. Recipient Name: Project Name: Grant Term: 1 or 2 Yrs, Grant Number: Grant Amt.: Expiration Date: Date APR is Due to HUD: Date APR Submitted: (Not more than 90 days after the end of each CoC grants perforinanoe period) Generpl RRcoydlceeping 1, Executed Grant Agreement 24 CFR 578.23( c ) 2, Documentation of Grant Amendment (request and approval, if applicable) 24 CFR 578.105 3, Exeouted Grant Agreements with Subrecipients 24 CFR 578.23( c )(ii) 4. Documentation subreoipients are not debarred 24 CFR 578.23( c )(4)(v) 5. Documentation of annual monitoring of Subrecipients 24 CPR 578.23( c )(8) 6. Executed Memorandum of Understanding with Service Providers 24 CFR 578.73(c )(3) _ 7. Project Application should be maintained - ensure costs charged against the grant are consistent with the approved budget items identified in the application 24 CFR 578.59(a) 8. Documentation that Annual Performance Report was submitted timely 24 CFR 578.103(e) 9. Written CoC Program Policies and Procedures to include: 24 CFR 578.103(a) Intake/screening procedures 24 CFR 578.103(a)(3)and(4) Internal Wellness Checklist Page 2 Grant #: Personnel Policies and Procedures 2 CFR200.303, and 24 CFR 578.103(a) Termination Policy 24 CFR 578.91 Grievance Policy 24 CFR 578.91 Policy Privacy/Confidentiality Policy 24 CFR 578.103(b) Drug -Free Workforce Policy 24 CFR 5.105(d), 24 CFR 2424, 24 CFR 225 Policy identifying the involvement of homeless/formerly homeless individuals 24 CFR 578.23( a )(3) Domestic Violence Policy 24 CFR 578.23(c)(4)(i)(ii), 24 CFR 578.103(a)(17) Housing First Policy, if applicable HUD CPD Notice 14-02 10. Documentation of participation of homeless/formerly homeless individuals in policymalcing 24 CFR 578.75(g)(1) ^11. Documentation of compliance with environmental review requirements 24 CFR 578.99, 24 CFR 578.31 12. Documentation of compliance with fair housing requirements 24 CDR 578.87(b), 24 CFR 578.103(a)(14) and (17), 24 CFR 578.93( c )(1) 13. Documentation of other federal requirements (Le. lead based paint, Section 3, Section 504), if applicable 24 CFR 578.99, 24 CFR 35, 24 CFR 578.99(b) Financial Files 1. Written Financial Policies 2 CFR 200.302, 24 CFR 578.23(e )(5), 24 CFR 578.103(a) 2. Written Procurement Procedures 2 CFR 200.318 and 2 CFR 200.319 3. Written Conflicts of Interest Policy 2 CFR 200,317 and 2 CFR 200.318, 24 CFR 57&.95(a) 4. Documentation of match (25% of total Grant Amount less leasing) 24 CFR 578.73(a) 5. Documentation of Grant Expenditures (during grant teuu and for approved items in application) 24 CFR 578.37, 24 CFR 578,103 6, Documentation of Indirect Cost Rate Proposal, if applicable 24 CFR 578.63(b), 24 CFR 578.103(a)(17) Internal Wellness Checklist Grant #: Page 3 7. Documentation showing compliance with the Single Audit Act 24 CFR 578.99(g), 2 CFR 200 subpart F 8, Documentation showing quarterly draw requests 24 CFR 578.85(c )(3) 9. Documentation showing program income was expended prior to HUD draw requests, if applicable 24 CFR 578.97(b) Participant Program Files 1. Documentation participants are entered into HMS or a comparable database 24 C.1(R 578.103(a)(3) 2. Documentation participant was screened via centralized or coordinated assessment systems 24 CFR 578.23( c )(9) 3. Documentation of Homelesslness at intake 24 CFR 578.103(a)(3) _ 4. Permanent Supportive Housing -Documentation of disability 24 CFR 578.37(a)(i) 5. Transitional Housing- No more than 24 months of services provided except under documented extenuating circumstances 24 CFR 578.79 6. Documentation of ongoing assessment of services 24 CFR 578.75(e) 7. Documentation of examination of income (initial and recertification) 24 CFR 578.103(a)(7)(i) _ 8. Documentation of initial and follow-up Housing Quality Standards inspections 24 CFR 578.75(b)(2) 9. Leasing -Documentation that the unit/structure is not owned by recipient or subrecipient 24 CFR 578.49(a) 10. Leasing -Documentation lease is between agency and landlord 24 CFR 578.49(b)(5) 11. Leasing -Is there an occupancy agreement, lease or sublease in the file (for individual units)? 24 CFR 578.103(a)(17) 12. Leasing -Documentation of rent reasonableness for the period of approval for an assisted unit 24 CFR 578.49(b)(1) 13. Rents charged (including utilities) do not exceed HUD -pair Market Rents 24 CFR 578.49(b)(2) 14. Documentation supporting the correct/current utility allowance schedule is used 24 CFR. 578.103(a)(17), 24 CFR 578.49(a)(3) Internal Wellness Checklist Page 4 Giant #: 15, Leasing -Documentation of occupancy charges with annual income calculations 24 CFR 578,77, 24 CFR 578.99(b)(6) 16.. Rental -Documentation the participant has a an executed lease agreement with the landlord 24 CFR 578.77, 24 CFR 578.51(d)(e) 17. Rental -Documentation of rent reasonableness for the period of approval for an assisted unit 24 CFR 578,51(g) NOTE: For additional guidance, please refer to the following resource materials: (1) Homeless Emergency Assistance and Rapid Transition to Housing: Continuum of Care Program CoC regulations at 24 CFR Part 578, and (2) Monitoring handbook 6509,2 REV-6 CHG-2 that can be accessed at: httr)://portal.hud.aov/hudnortal/HUD?src=lprogram offices/ad ministration/hudciips/handbooks/cpd/6509.2. Completed by: Signature: Date: Typed/Printed Name: Titles This document is to be maintained in the applicable CoC project file. FY 2019 Continuum of Care (CoC) Program Incident Report ATTACHMENT H "Incident Report" INCIDENT REPORT A'1'IACHMENT N CHECK IF CRITICAL ❑ IDENTIFYING INFORMATION Reporting Party Phone # (305) Date of Incident / / Time of Incident : am/pm Reporting Party Name Contract Provider Name Program Name Provider Location Specific Category: (check all that apply) ❑ Allegation or wrongdoing ❑ Wrongdoing (as acknowledged by a third party designated to investigate these claims i.e. law enforcement detained individual, or DCF accepted abuse report) Specific Location/ address where incident occurred: TYPE OF INCIDENT CLIENT RELATED ❑ ALTERCATION 0 CLIENT DEATH ❑ CLIENT INJURY OR ILLNESS ❑ THEFT ❑ SEXUAL BATTERY 0 SUICIDE ATTEMPT ❑ PROPERTY DAMAGE 0 AB USE OR NEGLECT* 0 OTHER INCIDENT Specify 1 of 4 MIAMPDADE COUNTY ATTACHMENT N * Failure to report any known or suspected abuse of any kind of a child is a third-degree felony that may result in a prison sentence of 5 years, and a fine of $5,000 (Refer to Chapter 39 & 415 of the Florida Statutes). STAFF RELATED ❑ INAPPROPRIATE EMPLOYEE ACTS OR OMISSIONS THAT RESULT IN CLIENT INJURY, ABUSE, NEGLECT, OR DEATH ❑ FRAUD 0 THEFT ❑ BREACHES OF CONFIDENTIALITY OIMPROPER EXPENDITURE OR COMMITMENT OF PUBLIC FUNDS - OR -CONTRACT MISMANAGEMENT O COMPUTER RELATED MISCONDUCT OANY VIOLATION UNDER §435, F.S., TITLE XXXI, EMPLOYEE SCREENING, THAT WOULD RESULT IN DISQUALIFICATION FROM CLIENT CONTACT DUTIES ❑ FALSIFICATION OF OFFICIAL RECORDS ❑ MISUSE OF POSITION OR STATE PROPERTY, EMPLOYEES, EQUIPMENT, OR SUPPLIES FOR PERSONAL GAIN OR PROFIT ❑ FAILURE TO REPORT KNOWN OR SUSPECTED NEGLECT OR AB USE OF A CLIENT ❑ OTHER INCIDENT THAT WOULD BE A VIOLATION OF STATUTE, RULE, REGULATION OR POLICY Specify PARTICIPANT (S) / WITNESS (ES) 2 of 4 alum eehyr y ' .vet (exec E:l ! ATTACHMENT N (Please mark W or P for either Witness or Participant) Staff ID # or Client HMIS # CLIENT EMPLOYEE OTHER W / P ❑ ❑ ❑ ❑ Wor ❑ P ❑ ❑ ❑ ❑Wor❑P ❑ ❑ ❑ ❑ Wor ❑ P DESCRIPTION OF INCIDENT Give detailed account — who, what, where, when, why, how — add pages if necessary CORRECTIVE ACTION AND FOLLOW UP Immediate corrective action taken Is follow up action needed? ❑ Yes ❑ No If yes, specify INDIVIDUALS NOTIFIED Abuse Registry 1-800-962-2873 Applicable Law Enforcement Department Indicate name of person contacted, if report was accepted, the date and time if called or copy of report Incident Reports — The Subrecipient must report to Miami -Dade County Homeless Trust information related to any critical incidents occurring during the administration term of its programs. In addition to reporting this incident to the appropriate authorities the Subrecipient must within twenty-four (24) hours of any incident, submit in writing a detailed account of the incident. This incident report should be addressed to the Contract Officer or Administrative Officer assigned. This incident report should be addressed to Miami -Dade County Homeless Trust, 111 NW First Street, 27th Floor, Suite 310, Miami, Florida 33128; telephone (305) 375-1490 and facsmilie (305) 375-2722. 3 of 4 COUNT cilircr15 trelic E'cry+' x Definitions of Reportable Client Incidents ATTACHMENT N a. Altercation. A physical confrontation occurring between a client and employee or two or more clients at the time services are being rendered, or when a client is in the physical custody of the department, which results in one or more clients or employees receiving medical treatment by a licensed health care professional. b. Client Death. A person whose life terminates due to or allegedly due to an accident, act of abuse, neglect or other incident occurring while in the presence of an employee, in Homeless Trust contracted program facility. c. Client Injury or Illness. A medical condition of a client requiring medical treatment by a licensed health care professional sustained or allegedly sustained due to an accident, act of abuse, neglect or other incident occurring while in the presence of an employee, in a Homeless Trust contracted program. d. Other Incident. An unusual occurrence or circumstance initiated by something other than natural causes or out of the ordinary such as a tornado, kidnapping, riot, or hostage situation, which jeopardizes the health, safety and welfare of clients. e. Sexual Battery. Any allegation of a program participant or program staff intentionally touching a minor or another person without their consent. This includes incidents of inappropriate verbal offenses, incidents that occur outside of the residence, and incidents were the program participant was victimized by someone outside of the residence. Incidents involving a minor, person who is 60 or older, or someone who is disabled must be reported to the DCF. f. Abuse or Neglect. Any physical maltreatment of a child, disabled person, or someone age 60 or older. Any failure to act on the part of the parent or care taker, which results in harm to a child, disabled person, or someone age 60 or older. g. Suicide Attempt. An act which clearly reflects the physical attempt by a client to cause his or her own death while in the physical custody of the department or a departmental contracted or certified provider, which results in bodily injury requiring medical treatment by a licensed health care professional. h. Property Damage. An incident involving damage to property procured with Homeless Trust funding. 4 of 4 FY 2019 Continuum of Care (CoC) Program Real Property and Equipment Asset Inventory Report ATTACHMENT I "Real Property and Equipment Asset Inventory Report" M IAM I•DiA►UE COUNTY Real Property and Equipment Asset Inventory Equipment with an acquisition cost of greater than $5,000.00 per unit and all real property must be inventoried. Real property includes land, land improvements, structures and appurtenances, moveable machinery and equipment. Property and Property Improvement Record: Legal Description: Size: Date of Acquisition: Value at Time of Purchase: Owner's Name (if different than the Subrecipient]: Map: (attach map) indicate where property is in parcels 11ots or blocks and show adjacent streets and roads Equipment 1: Description of Property: Serial / ID Number: Acquisition Date: Cost: Vendor Name: % of Purchase Cost from Grant: Location of Property: Use and Condition of Property: Who Holds Title? Equipment 2: Description of Property: Serial / ID Number: Acquisition Date: Cost: Vendor Name: % of Purchase Cost from Grant: Location of Property: Use and Condition of Property: Who Holds Title? Equipment 3: Description of Property: Serial / ID Number: Acquisition Date: Cost: Vendor Name: % of Purchase Cost from Grant: Location of Property: Use and Condition of Property: Who Holds Title? *(please create additional pages as required) ATTACHMENT I "Miami -Dade County Real Property and Equipment Asset Inventory" FY2019 Continuum of Care (CoC) Program When the Subrecipient is the Housing Administrator (Leasing or Rental Assistance) ATTACHMENT J "Rental Assistance Forms" FY 2019 Continuum of Care (CoC) Program When Miami -Dade County is the Rental Administrator ATTACHMENT K "Rental Assistance Forms" M I A M I•DAD COUNTY November 17, 2020 Mr. Francis Suarez, Mayor The City of Miami 444 SW 2nd Ave Miami, FL, 33130 Homeless Trust 111 N.W. 1st Street • 27th Floor Suite 310 Miami, Florida 33128-1930 T 305-375-1490 F 305-375-2722 Re: FY 2019 US HUD Continuum of Care (CoC) Program - Sub -Recipient Agreement Dear Mayor Suarez: Attached, please find an electronic copy of the Sub -recipient Agreement and corresponding attachments between Miami -Dade County, through Miami -Dade County Homeless Trust and The City of Miami - Miami Homeless Assistance Program (MHAP) CE Consolidation Program for the 2019 US HUD CoC Program under grant number FL0211L4D001912. Please review the included contract execution instructions closely. Thereafter, the authorized agency signatory must sign and/or initial (as applicable) all marked sections of the Agreements and the relevant attachments. Miami -Dade County requires that the President/Chairman of the Board execute the Agreement on behalf of the agency. However, the Executive Director may execute the Agreement if approved by a resolution of the agency's Board. A copy of the applicable Board resolution(s) must be submitted with the Agreement. In addition, the agency must affix the corporate seal to the signature page of the Agreement or notarize it accordingly. All completed documents must be returned to the Homeless Trust office via email no later than November 25, 2020. Please do not add language or alter any of the content in the Agreement and corresponding attachments. Should you have any questions or concerns regarding this matter, please contact Kristen Joseph (Kristen.Joseph@ miamidade.gov), Administrative Officer 3, and Terrell Thomas Ellis (Terre11.E11is@ miamidade.gov), Manager, Homeless Trust Contracts Division. Thank you for your continued efforts with addressing the needed of the homeless of our community. Sincerely, Victoria L. Mallette Executive Director /kj cc: 2019 Continuum of Care (CoC) Grant File MIAM4 COUNTY FY 2019 United States Department of Housing and Urban Development (US HUD) Continuum of Care (CoC) Program Grantee: Miami -Dade County through its Homeless Trust And Subrecipient: The City of Miami for the Program Name: Miami Homeless Assistance Program (MHAP) CE Consolidation Grant #: FL0211L4D001912 INDEX Cover page ---page 1 Index ---page 2 Whereas and preamble ---page 3 1. Statement of Work a. Activities ---page 3 b. Time Schedule ---page 4 c. Budget ---page 4, 5, 6 2. Records and Reports a. Financial Management ---page 7 b. Records and Access to Records ---page 8 c. Public Records ---page 9 d. Encouraging Efficient Use of Information Technology and Shared Services ---page 10 e. Reports: i) Progress Reports; ii) APR; iii) Survey; iv) Participants' Application for Housing; v) Program Income; vi) Program Guidelines; vii) Audit; viii) Incident; ix) COOP through x) Mandatory Disclosures ---pages 10 through 13 3. Special and General Conditions a. Staff Responsibility ---page 13 b. Client Referral Process ---page 13 c. Documents to facilitate the Reimbursement of services ---page 13 d. Compliance with rules, guidelines of CoC Rental Assistance items i) through v)---page 13 e. VAWA Emergency Transfer Plan ---page 14 f. Performance Improvement Plans ---page 14 g. General Conditions i. Insurance; ii) Indemnification; iii) Certification and Representation; iv) Conflict of Interest; v) Affidavits--- pages 14 through 17 h. Civil Rights ---page 18 through 20 4. Suspension and Termination a. Suspension ---page 21 b. Termination ---page 21 through 23 5. Future Funding Applications ---page 23 6. Reversion of Assets a. Term of Commitment ---page 24 b. Repayment of Grant ---page 24 c. Prevention of Undue Benefit ---page 24 d. Revocation of License or Permit ---page 25 e. Declaration of Restrictive Covenant and Declaration of Restrictions ---page 25 7. Uniform Administrative Requirements a. Accounting Standards, Costs Principles and Regulations ---page 26 b. Retention of Records ---page 27 8. Additional Requirements Items a through gg ---pages 27 through 35 9. Religious Organizations ---page 36 10. Health Insurance Portability and Accountability Act (HIPAA)---page 36,37 11. Proof of Licensure / Certification and Background Screening a. Licensure / Certification ---page 37 b. Background Screening ---page 38 Signature ---page 39 Index of Attachments A through L---page 40 CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 2 Subrecipient Agreement between Miami -Dade County and The City of Miami for the FY 2019 US HUD CoC Program Grant #FL0211L4D001912 Miami Homeless Assistance Program (MHAP) CE Consolidation THIS AGREEMENT, entered this day of , 202 , by and between Miami - Dade County, on behalf of its Homeless Trust (HT) (hereinafter called the "Grantee"), and The City of Miami, (hereinafter referred to as the "Subrecipient") under this Agreement. WHEREAS, the Homeless Emergency Assistance and Rapid Transition to Housing Act of 2009 (HEARTH Act) amended the McKinney-Vento Homeless Assistance Act, consolidating three (3) separate reauthorized McKinney-Vento Homeless Assistance Programs, Supportive Housing Program (SHP), Shelter Plus Care (S+C) Program, and Section 8 Moderate Rehabilitation Single Room Occupancy (SRO) Program into a single grant program known as the Continuum of Care (CoC) Program. WHEREAS, the Grantee has applied for and received funds from the United States Department of Housing and Urban Development (US HUD) under the McKinney-Vento Homeless Assistance Act as amended by The HEARTH Act of 2009 (42 U.S.C. 11301, et seq.). WHEREAS, the Grantee agrees to comply with all requirements of this Agreement and to accept responsibility for such compliance by the Subrecipient to which it makes grant funds available; and NOW, THEREFORE, it is agreed between the parties hereto that; 1. Statement of Work a. Activities - The Subrecipient shall adhere to the "Continuum of Care Program Grant Agreement and Exhibit 1 Scope of Work for FY 2019 Competition", Attachment A, which is incorporated herein and governed by the Continuum of Care (CoC) Program rules and regulations (the "Rule"). The Subrecipient shall comply with all applicable federal, state and local laws, regulations and ordinances, including but not limited to 24 CFR Part 578, as may be amended, the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11301 et seq.) (the "Act"), as may be amended, the Consolidated and Further Continuing Appropriations Acts of 2013 and 2014 (The Consolidated Appropriations Act of 2014, Public Law 113-76, approved January 17, 2014 in the "FY 2014 HUD Appropriations Act") as well as with any other terms and conditions as HUD may have established in the applicable Notice of Funds Availability (NOFA) and with any applicable guidance, requirements and directives provided by US HUD and with any applicable guidance, requirements and directives provided by Miami -Dade County Homeless Trust. The Subrecipient shall carry out the activities specified in the "Scope of Service and US HUD eSnaps Documents" Attachment B. The Subrecipient shall also adhere to the Standards of Housing and Services as set forth in the "Miami -Dade County Homeless Trust Standards of Care", as may be amended from time to time and incorporated herein by reference. The CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 3 Subrecipient shall adhere to all applicable federal, state and local laws, regulations, rules and standards, as well as with the terms of this Agreement including all attachments. b. Time Schedule - The Grantee and the Subrecipient agree that this Agreement shall become effective on tune 1, 2020. This Agreement shall expire on May 31.2021, one (1) year from the effective date. Any cost incurred by the Subrecipient beyond this date will not be paid by the Grantee, except as specifically provided herein. Notwithstanding any provision herein to the contrary, certain requirements imposed on the Subrecipient by this Agreement and federal regulations may continue for a term of at least fifteen (15) years from the date of initial occupancy or service, as provided in this Agreement or as specified by law or regulation. The requirements of this Agreement shall remain in effect during any time period that the Subrecipient has control over any funds generated or provided in connection with this Agreement, including program income. c. Budget - The Grantee agrees, subject to the availability of funds and payment of funds to the Grantee by the United States Department of Housing and Urban Development and subject to the Subrecipient's compliance with all applicable laws and agreement terms as determined by the Grantee, to pay for contracted activities according to the terms and conditions contained within this Agreement, Subrecipient's application for the CoC Homeless Assistance Program, and the Subrecipients NOFA application documents as Project Sponsor and "Scope of Service and US HUD eSnaps documents" including the Budget incorporated herein as Attachment B, in an amount not to exceed $0.00 for Rental Assistance, $0.00 for Leasing, $650.020.00 for Supportive Services, $0.00 for Operations, $0.00 for HMIS costs and $45.500.00 for overall Project Administration Costs which added together equals an amount of $695.520.00 in TOTAL BUDGET. If the Grantee, Miami -Dade County through its Public Housing and Community Development Department (PHCD) or such other department or party as may be selected by Miami -Dade County Homeless Trust, is the Rental Administrator; then the Grantee shall pay the "CoC Program HAP Contract" Attachment K payments directly to Landlord, owner(s). The total amount awarded pursuant to this Agreement, in amount up to $0.00 for Rental Assistance funds has been allocated for use as eligible rental assistance payments on behalf of the Subrecipient's program participants. Pursuant to 24 CFR 578.59, the Grantee shall retain 50% of the Overall Project Administration Costs, except where limitations are imposed as may be applicable pursuant to 42 USC § 11383 (a). If applicable, the Subrecipient shall be reimbursed for capital funding on an incremental basis, based on the following completion benchmarks: 30%, 30%, 30% and 10% to be provided when a final Certificate of Occupancy is obtained from the developer, in accordance with any applicable laws and regulations. All other activities shall be paid on a reimbursement basis following the submission of a monthly invoice along with the appropriate supporting documentation. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 4 In accordance with federal requirements including 24 CFR Part 578.73, the Subrecipient agrees to provide match funds in an amount that represents no less than twenty-five percent (25%) cash or in -kind contributions on all eligible grant funds, except leasing. If in - kind services provided through a third party are used to fulfill part of the match, a fully - executed Memorandum of Understanding (MOU) between the Subrecipient and the third party that will provide the services must be submitted to the Grantee. The budget figures above represent the original line item totals as delineated in the "Continuum of Care Program Grant Agreement" Attachment A. The Subrecipient may propose to shift funds by less than 10% between eligible categories in the "Scope of Service and US HUD eSnaps Documents" Attachment B, if the appropriate match is provided, the administrative costs are not increased and the proposed shift is submitted in writing for the Grantee's consideration. The Grantee may, but is not required to, approve the proposed shift. Any approval must be in writing. As such, if Attachment B is modified as described above, the figures within the "eSnaps Application" may not match the contracted figures delineated in the "US HUD Grant Agreement." In accordance with 24 CFR 578 the Subrecipient is prohibited from moving more than 10% from one budget line item in a project's approved budget to another without written "US HUD grant amendment" and amendment to this Agreement. This is a Performance -based Agreement to deliver housing and or services to Subrecipient's Continuum of Care (CoC) program participants. The Subrecipient shall provide street outreach as Supportive Services Only for homeless persons, including chronically homeless persons under the Continuum of Care Program. The program's main office is located at 444 SW 2nd Avenue, 5th Floor, Miami, Florida 33136. The Housing and Services site is located at 444 SW 2nd Avenue, 5th Floor, Miami, Florida 33136. The Subrecipient shall provide services as outlined in the Attachments to this Agreement as required, pursuant to the FY 2019 US HUD CoC Program NOFA Competition as submitted in the project application, incorporated herein by reference. Availability of funds shall be determined in the Grantee's sole discretion. If this Agreement is for permanent supportive housing or permanent housing for eligible homeless individuals and /or homeless families; the Subrecipient agrees that, with some exceptions, no undocumented or illegal immigrants shall be eligible for services provided under this Agreement. Additionally, the Subrecipient shall comply with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), as may be amended and applicable law, in verifying citizenship, residency and immigration status of potential participants. The Subrecipient shall comply with The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), as may be amended and applicable law, in verifying citizenship, residency and immigration status of potential participants. The Subrecipient hereby acknowledges that PRWORA prohibits housing or services provided under this Agreement to undocumented or illegal immigrants. When the Grantee, Miami -Dade County through its Homeless Trust is the rental administrator of the CoC Program (also known as Tenant -Based, Sponsor -Based or Project - Based Rental Assistance). If this Agreement is for permanent supportive housing or CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 5 permanent housing for homeless participants, under the CoC Program and the Grantee, Miami -Dade County through its Homeless Trust is the rental administrator of payment of Housing Assistance Payment (HAP) Contracts the following rules, regulations, responsibilities apply: Agreement specifically for housing under Tenant -based or Sponsor - based, or Project -based Rental Assistance, it is the Subrecipient's responsibility to identify eligible rental units for eligible homeless program participants in partnership with the established CoC's Coordinated Outreach and Assessment System. The Landlord identified by the Subrecipient must enter into a "Housing Assistance Payment (HAP) Contract", Attachment K attached to this Agreement. When the Subrecipient is the rental administrator of payments of Housing Assistance Payment (HAP) Contracts for the Permanent Housing Tenant -Based, Sponsor -Based or Project Based Rental Assistance or Rapid Re -Housing CoC Program. If this Agreement is for permanent supportive housing or permanent housing for homeless participants, under the Legacy SHP or CoC Rental Assistance Program and the Subrecipient is the rental administrator of the "Housing Assistance Payments (HAP) Contracts" Attachment J, the following rules, regulations, and responsibilities apply: It is the Subrecipient's sole responsibility to identify eligible rental units for eligible homeless program participants in partnership with the established CoC's Coordinated Outreach and Assessment. It is the Subrecipient's sole responsibility to enter into a "Housing Assistance Payment (HAP) Contract" Attachment J with the eligible owner of each rental unit ("Landlord"). The Subrecipient must use the HAP Contract template forms in Attachment J attached to this Agreement when the Subrecipient contracts with the Landlord. The Subrecipient is responsible for ensuring the HAP Contract complies with all program requirements, terms and conditions of this Agreement, and applicable law. The Grantee, Miami -Dade County, shall not be a party to the HAP Contract. Should the Subrecipient desire or require any amendments to the HAP Contract template form; the Subrecipient shall advise the Grantee of the proposed amendment(s) and explain why the amendment(s) is desired or required prior to amending the HAP Contract template form. The Subrecipient is solely responsible for paying rent to the Landlords on time. The Subrecipient shall develop forms for Landlords' use in collecting late fees arising from Subrecipient's failure to pay a Landlord rent on time. The Subrecipient shall be solely responsible for payment of any late fee arising from any late rent payment(s) to Landlord(s). The Subrecipient shall indemnify the Grantee, Miami -Dade County, and pay all costs of defense, including attorneys' fees arising from or related to the HAP Contract and this provision. 2. Records and Reports a. Financial Management - The Grantee and the Subrecipient shall adhere to the requirements for financial reporting as required pursuant to the Federal Office of Management and Budget (OMB) Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225, and 230 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as may be amended or updated from time to time; 24 CFR Part 578, as may be amended or updated from time to time; and any other applicable laws, regulations and standards. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 6 Requests for payment shall be submitted to the Grantee by the fifteenth (15th) of the month in the following manner. All requests shall include supporting documentation for each line item, including payroll reports, time sheets, invoices, leasing agreements and shall be signed by the Executive Director, Financial Officer or other duly authorized fiscal agent of the Subrecipient in the forms incorporated herein as combined "Consolidated Financial Record and Reports", Attachment E. Reimbursement shall be provided only for eligible costs associated with the activities outlined in the budget contained within the "Scope of Service and US HUD e-Snaps Documents" Attachment B. Any reimbursement may be withheld or reduced by the Grantee if missing receipt of documents verifying the in -kind or cash match expenditures or compliance requirements are not met. Cash match or in -kind contributions must be used for the costs of activities that are eligible in the governing regulations. Any reimbursement may be withheld pending the receipt of approval by the Grantee of all reports and documents required herein, including but not limited to the submission of an accurate and complete Annual Performance Report (APR) "Performance Reports (Monthly and Annual) HMIS and Fiscal Report" Attachment F. The Subrecipient shall provide a certification statement for all annual financial reports and requests for payment which states the following: "By signing this report, 1 (insert name here) certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the federal award. I am aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or other offense." In no event shall the Grantee funds be advanced to any of the Subrecipient's subcontractors hereunder. The parties agree that the Subrecipient may request a revision, amendment, or modification of the schedule of payments or line item budget. However, such revisions, amendments or modifications shall be, in writing and subject to review and approval by the Grantee and, if applicable, by US HUD. If there is a request to shift greater than 10% of funds between funding activities, such requests shall be submitted to the Grantee no later than one hundred fifty j150) calendar days prior to the expiration of the grant. If the request is a shift of less than 10% of funds between funding activities, a modification or revision, shall be submitted to the Grantee no later than ninety (90) calendar days prior to the expiration of the grant. Failure to submit the appropriate supporting documentation in a timely manner may result in the inability of the Grantee to approve, revise, amend or modify the budget. A midterm financial analysis shall be conducted by the Grantee upon completion of the first six (6) months of the term set forth in this Agreement. This shall include, but is not limited to, an analysis of processed monthly requests for reimbursement and processed quarterly supplemental and/or adjustment requests for reimbursement. This analysis will be utilized to determine if the Subrecipient is compliant with expenditure rates and if there is a need for budget adjustments or reallocation of unspent and/or available funds. All requests for reimbursement from the Subrecipient which are applicable to this midterm period will be CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 7 accepted by the Grantee up to thirty (30) days after the final day of the midterm period of this Agreement. A final request for reimbursement from the Subrecipient will be accepted by the Grantee up to thirty (30) days after the expiration of this Agreement. If the Subrecipient fails to comply, all rights to payments will be forfeited if the Grantee so chooses. A final report of expenditures shall be submitted to the Grantee within thirty (30) calendar days from the termination or expiration of this Agreement. If after the receipt of such final report, the Grantee determines that the Subrecipient has been paid funds not in compliance with the Agreement, and to which the Subrecipient is not entitled, the Subrecipient shall be required to return such funds. However, if the Subrecipient submits documentation demonstrating that the expenditure was in compliance with this Agreement to the satisfaction of the Grantee, the funds shall not have to be returned. The Grantee shall have the sole and absolute discretion to determine if the Subrecipient is entitled to such funds and the decision of the Grantee in this matter shall be final and binding. b. Records and Access to Records - Agreement records are defined as any and all books, records, client files (including client progress reports, referral forms, case notes and other reports or work product), documents, information, data, papers, letters, materials, electronic storage data and media whether written, printed, electronic or electrical, however collected or preserved which is or was produced, developed, maintained, completed, received, or compiled by or at the direction of the Subrecipient or any subcontractor directly or indirectly related to the duties and obligations required by terms of this Agreement, including but not limited to financial books and records, ledgers, drawings, maps, pamphlets, designs, electronic tapes, computer drives, flash drives and diskettes or surveys. The Subrecipient shall maintain Agreement records that document all actions to comply with and that relate to this Agreement, including those on race, ethnicity, gender, disability and homeless status data; and those in accordance with generally accepted accounting principles, procedures, and practices as required in OMB Omni or Super Circular Uniform Administrative Requirements, Cost Principles and Audit Requirements for Federal Awards which shall sufficiently and properly reflect all revenues and expenditures of funds provided directly or indirectly by the Grantee pursuant to the terms of this Agreement which shall include but not limited to a cash receipt journal, cash disbursements journal, general ledger, and all such subsidiary ledgers as may be reasonably necessary. The Subrecipient shall provide to the Grantee, upon request by the Grantee, all Agreement records. The requested Agreement records shall become the property of the Grantee without restriction, reservation, or limitation of their use and shall be made available by the Subrecipient at any time upon request by the Grantee. The Grantee shall have unlimited rights to all books, articles, or other copyrightable materials developed in the performance of this Agreement. These unlimited rights include the rights of royalty -free, nonexclusive, and irrevocable license to reproduce, publish, or otherwise use, and to authorize others to use the work for public purposes. The Subrecipient shall ensure that the Agreement records shall at all times be subject to and available for full access and review, inspection, or audit by Grantee and Federal personnel and any other persons so authorized by the Grantee. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 8 The Subrecipient shall include in all the Grantee approved subcontracts, language outlining eligible substantive programmatic services, recordkeeping and audit requirements as detailed in this as detailed in this Agreement. This includes all subcontractors eligible to carry out substantive programmatic services as detailed in this Agreement. The Grantee shall, in its sole and absolute discretion, determine when services are eligible substantive programmatic services and subject to the audit and recordkeeping requirements described in this Agreement. These records shall be maintained pursuant to this Agreement. If the Subrecipient received funds from or is under regulatory control of other governmental agencies, and those agencies issue monitoring reports, regulatory examinations, or other similar reports, then the Subrecipient shall provide to the Grantee a copy of each report and any follow-up communications and reports immediately upon such issuance unless such disclosure is a violation of those agencies' rules. c. Public Records — Pursuant to Section 119.0701, Florida Statutes, the Subrecipient shall: i. Keep and maintain public records that ordinarily and necessarily would be required by the Grantee in order to perform the service; ii. Upon request from the Grantee's custodian of public records identified herein, provide the Grantee with a copy of the requested records or allow the public with access to the public records on the same terms and conditions that the Grantee would provide the records and at a cost that does not exceed the cost provided in the Florida Public Records Act, Miami -Dade County Administrative Order No. 4-48, or as otherwise provided by law; iii. Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of this Agreement's term and following completion of the services under this Agreement if the Subrecipient does not transfer the records to the Grantee; and iv. Meet all requirements for retaining public records and transfer to the Grantee, at no Grantee cost, all public records created, received, maintained and / or directly related to the performance of this Agreement that are in possession of the Subrecipient upon termination of this Agreement. Upon termination of this Agreement, the Subrecipient shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the Grantee in a format that is compatible with the information technology systems of the Grantee. For purposes of this Article, the term "public records" shall mean all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data processing software, or other material, regardless of the physical form, characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official business of the Grantee. In addition to penalties set for in Section 119.10, Florida Statutes, for the failure of the Subrecipient to comply with Section 119.0701, Florida Statutes, and this Article II, Section 2.1 (QQ) of this Agreement, the Grantee shall avail itself of the remedies set forth in this Agreement. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 9 If the Subrecipient has questions regarding the application of Chapter 119, Florida Statutes, to the Subrecipient's duty to provide public records relating to this Agreement, contact Miami -Dade County's Custodian of Public Records at: Miami -Dade County Homeless Trust 111 NW 1st Street, 27th Floor, Suite 310 Miami, Florida 33128 Attention: Victoria L. Mallette, Executive Director Email: vmallette@miamidade.gov d. Encouraging Efficient Use of Information Technology and Shared Services - in accordance with the May 2013 Executive Order on Making Open and Machine Readable the New Default for Government Information, OMB Omni or Super Circular 2 CFR Chapters I, Chapters II, Part 200, et al. Section 200.335 Methods for Collection, Transmission and Storage of Information; the Subrecipient is encouraged whenever practicable, to collect, transmit and store Federal award -related information in open and machine-readable formats. e. Reports - The Subrecipient shall submit to the Grantee the reports described below or any other document in whatsoever form, manner, or frequency as may be requested by the Grantee. These reports will be used for monitoring the progress, performance, and compliance with applicable Grantee and Federal requirements. Progress Reports - The Subrecipient shall submit a "Homeless Management Information System (HMIS) generated "Performance Report", Attachment F, along with a summary and the specified forms attached hereto as "Consolidated Financial Record and Reports", Attachment E. These reports may be revised or updated by the Grantee from time to time; and shall describe the progress made by the Subrecipient in achieving each of the objectives identified in "Scope of Service and US HUD eSnaps Documents" Attachment B. The reports shall explain the Subrecipient's progress including comparison of actual versus planned progress for the period. The reports are due by the fifteenth (15th) day of the following month. The requests for reimbursement, are also due by the fifteenth (15th) day following the close of the prior month. Subrecipients that are Domestic Violence Programs shall participate in a HMIS- equivalent system. Such Subrecipients shall provide proof to the Grantee of the utilization of an alternative system to compile all required data for the Performance Report. ii. Annual Performance Report - The Subrecipient shall submit a HMIS generated "US HUD CoC Annual Performance Report (0625-HUD-CoC-APR)" Attachment F, in addition to a complete and accurate report using supplemental "eSnaps CoC APR Financial and Performance Questions" provided by the Grantee Attachment F. The complete and accurate APR is due to the Grantee no later than thirty (30) days after the end of each operating year. The above referenced report may be substituted for any CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 10 other US HUD required Report if approved by US HUD and the Miami -Dade County Homeless Trust. iii. A Program Rating and Satisfaction Survey Report shall be conducted electronically utilizing a Miami -Dade County Homeless Trust generated survey tool. This tool will be issued in the month of May of each calendar year and survey results must be submitted to the Miami -Dade County Homeless Trust no later than forty-five (45) calendar days from the date of issuance. iv. When the Grantee, Miami -Dade County is the Rental Administrator: The Subrecipient shall submit a complete an accurate CoC Program "Participant Application for Housing" Package, Attachment K, including all supporting documentation for each eligible program participant accepted through the CoC's established Coordinated Outreach and Assessment HMIS system to Miami -Dade County Homeless Trust, 27th Floor, Suite 310, 111 NW First Street, Miami, Florida 33128. Pursuant to 24 CFR 578.77(c), the Subrecipient must examine program participants' income initially, and at least annually thereafter, to determine the amount of the contribution toward rent payable by the program participants. Adjustments to program participants' contribution toward the rental payment must be made as changes in income are identified. The Subrecipient is required for each program participant receiving assistance to notify the Grantee in writing of changes in the participants' income or other circumstances that affect the program participants' eligibility or need for assistance. The Subrecipient shall submit "Re -certification of Participation Application for Housing" Package Attachment K, no later than one hundred -twenty {120) calendar days before the expiration of term of the Lease Agreement and HAP Contract. The Re -certification application shall include documented evidence of the program participants' continued lack of sufficient resources and support networks necessary to retain housing without assistance from the CoC Program. When the Subrecipient is the Rental Administrator: The Subrecipient shall complete and maintain an accurate CoC Program "Participant Application for Housing" Package, Attachment J, including all supporting documentation for each eligible program participant accepted through the CoC's established Coordinated Outreach and Assessment HMIS system. Pursuant to 24 CFR 578.77(c), the Subrecipient must examine program participants' income initially, and at least annually thereafter, to determine the amount of the contribution toward rent payable by the program participants. Adjustments to program participants' contribution toward the rental payment must be made as changes in income are identified. The Subrecipient is required for each program participant receiving assistance to retain records for the Grantee's review, changes in the participants' income or other circumstances that affect the program participants' eligibility or need for assistance. The Subrecipient shall retain records of "Re -certification of Participation Application for Housing" Package Attachment J, no later than one hundred -twenty (120) calendar days before the expiration of term of the Lease Agreement and HAP Contract. The Re- certification application shall include documented evidence of the program participants' continued lack of sufficient resources and support networks necessary to retain housing without assistance from the CoC Program. v. Program Income - the income received by the Subrecipient directly generated by a grant -supported activity. Program income earned during the grant term shall be CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 11 retained and may either be 1) added to funds committed to the project by HUD and the recipient and used for eligible activities in accordance with the requirements pursuant to 24 CFR 578 or 2) used as match. Program Income is reported and submitted to the Homeless Trust monthly in the "Consolidated Financial Record and Reports", Attachment E. vi. A "CoC Homeless Assistance Program Guidelines" Attachment G shall be completed and retained by the Subrecipient. This report must be available upon request during any site visit or comprehensive monitoring or inspection as requested by the Grantee. This report is an informational guideline to assist in compliance to the CoC Homeless Assistance Program policies, procedures and requirements and regulations. vii. Audit Reports - Subrecipients shall submit an audit conducted in accordance with the provisions of Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225, and 230 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as applicable, and with 24 CFR 578.99(g) which provides that Subrecipients must comply with the audit requirements of OMB Circular A-133, "Audits of States, Local Governments, and Non-profit Organizations.". The Subrecipient shall provide such reports no later than one hundred -eighty (180) calendar days following the end of the Subrecipient's fiscal year, for each year during which this Agreement remains in force or until all funds earned from this Agreement have been so audited, whichever is later, provided that the Subrecipient has such an opinion prepared. The Subrecipient shall comply with any and all other applicable audit and reporting requirements. viii. Incident Reports - The Subrecipient must report to Miami -Dade County Homeless Trust information related to ay critical incidents occurring during the administration of its programs, using form "Incident Report" Attachment H. The following are identified as critical incidents as defined in CF-0P215-6 (Attachment H): • Child -on -Child Sexual Abuse • Child Arrest • Child Death • Adult Death • Elopement refers to court ordered clients that run away and do not return • Employee Arrest • Employee Misconduct • Escape • Missing Child • Security Incident - Unintentional • Significant Injury to Clients • Significant Injury to Staff • Suicide Attempt • Sexual Abuse/Sexual Battery CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 12 • Other. Any major event not previously identified as a reportable critical incident but has, or is likely to have, a significant impact on client(s), the Subrecipient, or Grantee. Such notification shall occur, within twenty-four (24) hours of the incident occurring. In addition, the Subrecipient shall report this incident to the appropriate authorities as well as submit in writing a detailed account of the incident. This Incident Report should be addressed to Miami -Dade County Homeless Trust's Disaster Coordinator, as well as the Subrecipient's assigned Contract Officer. The Subrecipient shall comply with the privacy, security and electronic transfer standards in transmittal of any Incident Report to comply with Health Insurance Portability and Accountability Act (HIPAA) in using appropriate safeguards to prevent non -permitted disclosures. This Incident Report shall be addressed to Miami -Dade County, Homeless Trust, Suite 310, 27th Floor, 111 NW 1st Street, Miami, Florida, 33128; (305) 375-1490 and facsimile (305) 375-2722. ix. The COOP Report - The Subrecipient shall submit a Continuity of Operations Plan (COOP), also known as an Agency Wide and Program Specific Disaster Plan in PDF format and emailed as an attachment to Miami -Dade County Homeless Trust's Disaster Coordinator and an original paper copy submitted no later than April 1st of each operating year. x. Mandatory Disclosure - The Subrecipient is required to disclose in a timely manner and in writing "all violations of Federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the Federal award". Failure to make the required disclosures can result in a number of actions, including suspension and or debarment. 3. Special and General Conditions - a. The Subrecipient's Staff members providing eligible services under this Agreement are listed in the budget section of the "Scope of Service, US HUD eSnaps Documents" Attachment B. The Subrecipient shall additionally submit job titles and job descriptions upon request. b. The Subrecipient shall follow the client referral process in the Scope of Service contained within the "Scope of Service and US HUD eSnaps Documents" Attachment B and through the Continuum of Care (CoC)'s Coordinated Outreach and Assessment system. The client referral process may be amended by the Grantee to meet changing priorities of the Continuum of Care. All referrals shall be made to the Subrecipient and accepted by the Subrecipient through the established Coordinated Outreach and Assessment and HMIS system. c. The Subrecipient shall provide any documentation necessary, such as the "W-9 Form" Attachment C, to facilitate the reimbursement of services. d. The Subrecipient shall comply with all rules, guidelines and regulations governing the CoC Rental Assistance program under 24 CFR 578, and any other applicable law, rules and regulations. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 13 i. Rental assistance projects must serve eligible program participants, including but not limited to retaining records of disability and homeless verification as part of the recordkeeping requirements. ii. Rental assistance funds are to pay Landlord owner(s) in the community the difference between the contract rent amount of the unit and the homeless participants' or tenants' contribution toward rent. The program participants' or tenants' contribution toward rent is determined by the type of program. Under tenant -based rental assistance, sponsor -based rental assistance, and project based rental assistance, program participants are required to pay rent to the landlord as determined under 24 CFR 578.77. It is important to note in all the US HUD CoC Programs, the program participants enter into a Lease with the Landlord. iii. The Subrecipient must consistently follow policies and procedures used by the CoC's established Coordinated Outreach and Assessment (HMIS) system in accepting referrals of eligible program participants pursuant to 24 CFR 578.7(a)(8). iv. The Subrecipient shall establish referral protocols, policies and procedures subject to approval by Miami -Dade County Homeless Trust in documenting rejection of program participants accepted from the CoC's established Coordinated Outreach and Assessment (HMIS) system, which must include at a minimum, assurances that such rejections are justified and that the program participants are able to access another suitable program within a reasonable amount of time. v. The Subrecipient shall establish protocols, policies and procedures subject to approval by Miami -Dade County Homeless Trust and consistent with Miami -Dade County Homeless Trust's CoC "Standards of Care" pertaining to termination of assistance to program participants. The Subrecipient may terminate assistance to program participants who violates program requirements. Termination does not bar the Subrecipient from providing further assistance at a later date to the same participants, individual or family (household). The protocol, policies and procedures must include at a minimum a formal process that recognizes the rights of individuals receiving assistance under due process of law. This process must also consist of: (1) Providing the program participant with a written copy of the program rules and the termination process before the program participant begins to receive assistance; (2) Written notice to the program participant containing a clear statement of the reason(s) for termination; (3) A review of the decision, in which the program participant is given the opportunity to present written or oral objections before a person other than the person (or a subordinate of that person) who made or approved the termination decision; and (4) Prompt written notice of the final decision to the program participant. The Subrecipient providing permanent supportive housing for hard -to -house populations of homeless persons must exercise judgment and examine all extenuating circumstances in determining when violations are serious enough to warrant termination so that program participants' assistance is terminated only in the most severe cases. e. The Subrecipient shall comply with the Violence against Women Reauthorization Act (VAWA) as well as with 24 CFR 5.200, as may be amended, and with all applicable provisions of 24 CFR Parts 5, 92, 200, 574, 576, 578, 880, 882, 883, 884, 886, 891, 960, 966, 982, and 983 and CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 14 with such administrative rules and policy guidance relating to VAWA as may exist, be adopted, or be amended from time to time, as may be applicable. f. The Subrecipient may be subject to a Performance Improvement Plan (PIP) at the discretion of the Grantee. g• General Conditions - The Subrecipient shall comply with all applicable federal, state and local laws, regulations and required policies, including but not limited to the Continuum of Care (CoC) Program Final Interim Rule, 24 CFR Part 578, as may be amended from time to time, the McKinney-Vento Homeless Assistance Act, as may be amended from time to time (42 U.S.C. 11301 et seq.) (the "Act") the Consolidated and Further Continuing Appropriations Acts of 2012, 2013, and 2014 the Homeless Definition Final Rule, published in the Federal Register on December 5, 2011, as may be amended from time to time; the "Continuum of Care Program Grant Agreement" Attachment A and all other federal requirements of this grant. The responsibility for knowledge of and compliance with all Federal and any other legal requirements is that of the Subrecipient. The Subrecipient shall also comply with any guidance provided by US HUD regarding this Agreement, program and the services offered hereunder, as well as with any guidance provided by US HUD applicable to this Agreement, program and the services offered hereunder. The Subrecipient shall abide and be governed by the requirements of the Americans with Disabilities Act (ADA). Subrecipient shall designate with its organization an ADA Coordinator to ensure that all requirements of the ADA and any related applicable regulations and requirements are met by the Subrecipient. In addition, the Subrecipient agrees to comply with the following requirements. Insurance - If the Subrecipient is the State of Florida or an agency or political subdivision of the State as defined by Section 768.28, Florida Statutes, the Subrecipient shall furnish the Grantee, upon request, written verification of liability protection in accordance with Section 768.28, Florida Statutes. The written verification shall be submitted to Miami -Dade County Risk Management, Internal Services Division, located on the 23rd Floor. 111 NW 1st Street, Miami. Florida 33128. Nothing herein shall be construed to extend any party's liability beyond that provided in Section 768.28, Florida Statutes. If the Subrecipient is a non -governmental entity said Subrecipient shall maintain required liability insurance coverage as noted below during this contract period. The Subrecipient shall maintain required liability insurance coverage as noted below at all times during this contract period. Public Liability Insurance on a comprehensive basis in an amount not less than $300,000 combined single limit for bodily injury and property damage. The Grantee must be shown as an additional insured with respect to this coverage, as evidenced by a Certificate of Insurance. Automobile Liability Insurance coverage for all owned, non -owned and hired vehicles used in connection with this Agreement in an amount not less than $300,000 combined single limit for bodily injury and property damage. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 15 Workers' Compensation Insurance for all employees of the Subrecipient as required by Florida Statutes 440. Flood Insurance shall be maintained as per the requirements in 24 CFR Part 583.330 (a). The insurance coverage required shall include these classifications, listed in standard liability insurance manuals, which most nearly reflect the operations of the Subrecipient. All insurance policies required above shall be issued by companies authorized to do business under the laws of the state of Florida, with the following qualifications: The company must be rated no less than "B" as to management, and no less than "Class V" as to financial strength by the latest edition of Best's Insurance Guide, published by A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the approval of Miami -Dade County Risk Management Division. Or Compliance with the foregoing requirements shall not relieve the Subrecipient of its liability and obligations under this section or under any other section of this Agreement. No modification or waiver of any of the aforementioned insurance requirements shall be made without thirty (30) days written advance notice to the Grantee, and is subject to the approval of Miami -Dade County Internal Services Risk Management Division. ii. Indemnification - The Subrecipient shall indemnify and hold harmless the Grantee and its past, present, and future employees and agents from and against any and all claims, liabilities, losses, and causes of action which may arise out of or relate to this Agreement, or which may arise out of actions or negligence, in whole or in part, of the Subrecipient, its officers, agents, employees, or assignees in the direct or indirect fulfillment of this Agreement. The Subrecipient shall pay all claims and losses of any nature in connection therewith, and shall defend all suits, in the name of the Grantee when applicable, and shall pay all costs and judgments which may issue thereon. It is expressly understood and intended that the Subrecipient is an independent contractor and is not an employee or agent of the Grantee. iii. Certifications and Representations - Pursuant to OMB 2 CFR Chapter I, Chapter II, Subpart C (200.208), the Subrecipient shall provide a certification statement for all annual financial reports and requests for payment that states the following: "By signing this report, I (duly authorized signature) certify to the best of my knowledge and belief that the report is true, complete and accurate and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or other offense." iv. Conflicts of Interest - The Subrecipient shall disclose to the Grantee in writing any possible or actual conflicts of interest or apparent improprieties relating to the Subrecipient under this Agreement. The Subrecipient shall make each disclosure in CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 16 writing to the Grantee immediately upon the Subrecipient's discovery of such possible conflict. The Grantee will then render an opinion which shall be binding on all parties. v. Affidavits - The Subrecipient shall complete, notarize and provide one (1) original set of "Miami Dade County Affidavits and Declarations 1 through 16", "Attachment D". One (1) original set of Affidavits will remain on file with Miami -Dade County Homeless Trust, two (2) full set of copies will be created and one (1) copy provided to Miami - Dade County Clerk of the Board and one (1) copy to the Subrecipient. 1. Miami -Dade County Ownership Disclosure Affidavit (Section 2-8.1 of Miami -Dade County Code "County Code"). 2. Miami -Dade County Employment Disclosure Affidavit (County Ordinance 90-133, Amending Section 2-8.1; Subsection (d) (2) of the County Code). 3. Miami -Dade County Affirmative Action / Non -Discrimination of Employment, Promotion and Procurement Practices (County Ordinance 98-30 codified at 2- 8.1.5 of the County Code). 4. Miami -Dade County Criminal Record Affidavit (Section 2-8.6 of the County Code). 5. Sworn Statement Pursuant to §287.133 Florida Statutes on Public Entity Crimes. 6. Miami -Dade Employment Family Leave Affidavit (County Ordinance 142-9 codified as Section 11A-29 et. seq of the County Code). 7. Miami -Dade County Disability Nondiscrimination Affidavit (County Resolution R- 385-95). 8. Miami -Dade County Regarding Delinquent and Currently Due Fees or Taxes (Section 2-8.1(c) of the County Code). 9. Miami -Dade County Current on all County Contracts, Loans and Other Obligations. (County Ordinance 99-162). 10. Miami -Dade County Domestic Violence Leave (11A-60 et. seq of the County Code). 11. Miami -Dade County Employment Drug Free Workplace Affidavit (County Ordinance 92-15 codified as Section 2-8.1.2 of the County Code). 12. Attestation regarding due and proper acknowledgement Miami -Dade County funding support. 13. Miami -Dade County Affidavit pursuant to Board of Miami -Dade County Commissioners Resolution No. R-630-13. Pursuant to "Board of Miami -Dade County Commissioners the Subrecipient will also submit a detailed project budget, and sources and uses statement as contained within "Scope of Service and US HUD eSnaps Documents", incorporated into Attachment B, which shall be sufficiently detailed to show: i) the total project cost; ii) the amount of funds to be used for administrative and overhead costs; iii) whether the funds under this Agreement will be 'gap' funds meaning that they would be the last remaining funds needed to ensure funding for the total project costs; iv) any profit (program income) to be made by the Subrecipient; and v) the amount of funds devoted toward the provision of the desired services or activities. 14. Miami -Dade County certification not to use "Pink Slime" in food programs or related housing programs providing food (County Resolution No. R-478-12) 15. Affidavit of Miami -Dade County Lobbyist Registration for Oral Presentation (County Ordinance Section 2-11.1(s) of the County Code), Lobbyist specifically includes the principal, as well as any agent, officer, or employee of a principal, regardless of whether such lobbying activities fall within the normal scope of employment of such agent, officer or employee. 16. Subcontract/Supplier Listing (Ordinance 97-104) CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 17 The Subrecipient understands that the Grantee has relied on the Subrecipient's aforementioned representations in entering into this Agreement. h. Civil Rights - The Subrecipient agrees to abide by Chapter 11A of the Code of Miami -Dade County ("County Code"), as may be amended, in the exercise of its police power for the public safety, health and general welfare, to eliminate and prevent discrimination in employment, family leave, public accommodations, credit and financing practices, and housing accommodations because of race, color, religion, ancestry, national origin, sex, pregnancy, age, disability, marital status, familial status, gender identity, gender expression, sexual orientation, or actual or perceived status as a victim of domestic violence, dating violence or stalking. It is further hereby declared to be the policy of Miami -Dade County to eliminate and prevent discrimination in housing based on source of income. Initials here DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 24 CFR Parts 5, 91, 92, 570, 574, 576, and 903 [Docket No. FR-5173-F-04] RIN 2501-AD33 Affirmatively Furthering Fair Housing - The Fair Housing Act (title VIII of the Civil Rights Act of 1968, 42 U.S.C. 3601-3619) declares that it is "the policy of the United States to provide, within constitutional limitations, for fair housing throughout the United States." See 42 U.S.C. 3601. Accordingly, the Fair Housing Act prohibits, among other things, discrimination in the sale, rental, and financing of dwellings, and in other housing -related transactions because of "race, color, religion, sex, familial status, national origin, or handicap." Initials here See 42 U.S.C. 3604 and 3605. Section 808(d) of the Fair Housing Act requires all executive branch departments and agencies administering housing and urban development programs and activities to administer these programs in a manner that affirmatively furthers fair housing. See 42 U.S.C. 3608. Initials here The Subrecipient agrees to abide and be governed by Title VI and VII, of the Civil Rights Act of 1964 (42 U.S.C. 2000 et seq.) and Title VIII of the Civil Rights Act of 1968, as amended, and Executive Order 11063, as may be amended, as well as with any applicable regulations, which provide in part that there will be no discrimination of race, color, gender/sex, religious background, ancestry or national origin in performance of this Agreement, in regard to persons served, or in regard to employees or applicants for employment or housing. It is expressly understood that upon receipt of evidence of such discrimination, the Grantee shall have the right to terminate this Agreement. Initials here Executive Order 11063 prohibits discrimination in the sale, leasing, rental, or other disposition of properties and facilities owned or operated by the federal government or provided with federal funds. Executive Order 12892, as amended, requires federal agencies to affirmatively further fair housing in their programs and activities, and provides that the Secretary of HUD will be responsible for coordinating the effort. Executive Order 12898 requires nondiscrimination in federal programs that affect human health and the environment as well as provides minority and low-income communities' access to public information and public participation. Executive Order 13166 requires federal agencies to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so LEP persons can have meaningful access to them. Executive Order 13217 requires federal agencies to evaluate their policies and programs to determine if any can be revised or CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 18 modified to improve the availability of community -based living arrangements for persons with disabilities. Initials here Awareness of the Joint Letter of clarification dated August 5, 2017 from United States Department of Justice, United States Department of Health and Human Services, United States Department of Housing and Urban Development reminding recipients of federal financial assistance that they should not withhold certain services based on immigration status when the services are necessary to protect life or safety. In the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 ("PRWORA"), Congress restricted immigrant access to certain public benefits, but also established a set of exceptions to these restrictions. It is understood that recipients of federal funding that administer programs that (i) are necessary for the protection of life or safety; (ii) deliver in -kind services at the community level; and (iii) do not condition the provision of assistance, the amount of assistance, or the cost of assistance on the individual (participant's) recipient's income or resources, that such programs are not subject to PRWORA's restrictions on immigrant access to public benefits and must be made available to eligible persons without regard to citizenship, nationality, or immigration status. 8 U.S.C. Section 1611(b)(1)(D); 1621(b)(4). Initials here It is further understood that the Subrecipient must submit affidavits attesting that it is not in violation of the American with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, as amended, (29 U.S.C. 794, et seq.), the Federal Transit Act, (49 U.S.C. 1612), and the Fair Housing Act, (42 U.S.C. 3601 et seq.), as may be amended, as well as with any applicable regulations. If the Subrecipient or any owner, subsidiary, or other firm affiliated with or related to the Subrecipient is found by the responsible enforcement agency, the Courts or Grantee to be in violation of these Acts, the Grantee shall conduct no further business with the Subrecipient. Any contract entered into based upon a false affidavit shall be voidable by the Grantee. If the Subrecipient violates any of the Acts during the term of any contract the Subrecipient has with Miami -Dade County, such contract shall be voidable by the Grantee, even if the Subrecipient was not in violation at the time the affidavit(s) were submitted. Initials here The Subrecipient agrees that it is in compliance with the Domestic Violence Leave, codified as (Article 8, Section 11A-60 et seq. of the County Code), as may be amended, which requires an employer, who in the regular course of business and has fifty (50) or more employees working in Miami -Dade County for each working day during each of the twenty (20) or more calendar work weeks to provide domestic violence leave to its employees. Failure to comply with this local law may be grounds for voiding or terminating this Agreement or for commencement of debarment proceedings against the Subrecipient. Initials here The Subrecipient agrees to abide and be governed by the Age Discrimination Act of 1975, (42 U.S.C. 6101 et seq.) and implementing regulations at (24 CFR Part 146), as may be amended, as well as with any applicable regulations, which provides in part that there shall be no discrimination against persons in any area of employment because of age. Initials here The Subrecipient agrees to abide and be governed by Section 504 of the Rehabilitation Act of 1973, as amended, (29 U.S.C. 794, et seq.) as may be amended, as well as with any applicable regulations, which prohibits discrimination on the basis of handicap. Initials here CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 19 The Subrecipient agrees to abide and be governed by the requirements of the Americans with Disability Act (ADA), as may be amended, as well as with any applicable law. Initials here Pursuant to 24 CFR 578.23, Subrecipient hereby certifies and agrees that: i. Subrecipient will maintain the confidentiality of records pertaining to any individual or family that was provided family violence prevention or treatment services through the project / program; ii. The address or location of any family violence project / program assisted under this part will not be made public, except with written authorization of the person responsible for the operation of such program and in accordance with any applicable state and local laws that prohibit disclosure of information relating to domestic violence centers; iii. Subrecipient will establish policies and practices that are consistent with, and do not restrict the exercise of rights provided by Subtitle B of Title VII of the McKinney-Vento Homeless Assistance Act, as amended, and other laws relating to the provision of educational and related services to individuals and families experiencing homelessness; iv. In the case of programs that provide housing or services to families, that Subrecipients will designate a staff person to be responsible for ensuring that children being served in the program are enrolled in school and connected to appropriate services in the community including early childhood programs such as Head Start, Part C of the individuals with Disabilities Education Act, and programs authorized under Subtitle B of Title VII of the McKinney-Vento Homeless Assistance Act as amended; v. The Subrecipient shall use the centralized or coordinated assessment system established by the Continuum of Care as set forth pursuant to 24 CFR 578.7(a) (8); vi. Subrecipient, its officers, and employees are not debarred or suspended from doing business with the federal government; and vii. Subrecipient will provide information, such as data and reports, as required by US HUD. Additionally, Subrecipient agrees: To establish such fiscal controls and accounting procedures as may be necessary to assure the proper disbursal of, and accounting for grant funds in order to ensure that all financial transactions are conducted, and records maintained in accordance with generally accepted accounting principles; ii. To take the educational needs of children into account when families are placed in housing and will, to the maximum extent practicable, place families with children as close as possible to their school of origin so as not to disrupt such children's education. A Subrecipient that serves families with school -age children shall have at least one program staff member, knowledgeable of the McKinney-Vento Education for Children and Youth Act requirements and shall comply with all requirements related to facilitation of educational opportunities consistent with Miami -Dade County Homeless Trust's Standards of Care incorporated herein by reference; iii. To comply with the provisions of 24 CFR 578.23(c) (9). iv. To follow the written standards for providing Continuum of Care assistance developed by the Continuum of Care, including the minimum requirements set forth in § 578.7(a)(9); and CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 20 v. To operate the project(s) in accordance with the provisions of the McKinney-Vento Act and all requirements under 24 CFR part 578; and to comply with such other terms and conditions as US HUD may establish by NOFA (Notice of Funding Availability). 4. Suspension and Termination a. Suspension - The Grantee may, for reasonable cause, temporarily suspend the operation and authority to obligate funds of the Subrecipient, under this Agreement, or withhold payments to the Subrecipient pending necessary corrective action by the Subrecipient or both. Reasonable cause shall be determined by the Grantee in its sole and absolute discretion and may include: i. Ineffective or improper use of any funds provided hereunder by the Subrecipient; ii. Failure by the Subrecipient to materially comply with any terms, conditions, representations or warranties contained herein; iii. Failure by the Subrecipient to submit any documents required by this Agreement; or iv. Incorrect or incomplete document submittal by the Subrecipient. b. Termination - Termination at Will - This Agreement, in whole or in part, may be terminated by the Grantee upon no less than fifteen (15) working days' notice when the Grantee determines that it would be in the best interest of the Grantee and / or the Subrecipient materially fails to comply with the terms and conditions of the award. Said notice shall be delivered by certified mail, return receipt request, or in person with proof of delivery. The Subrecipient shall have five (5) days from the day the notice was delivered to state why it is not in the best interest of the Grantee to terminate the Agreement. However, it is up to the discretion of the Grantee to make the final determination as to what is in its best interest. ii. Termination for Convenience - The Grantee or Subrecipient may terminate this Agreement, in whole or part, when both parties agree that the continuation of the activities would not produce beneficial results commensurate with the further expenditure of funds. Both parties shall agree in writing upon the termination conditions, including the effective date and in the case of partial termination, the portion to be terminated. However, if the Grantee determines in the case of partial termination that the reduced or modified portion of the grant will not accomplish the purposes for which the grant was made it may terminate the grant in its entirety. iii. Termination Because of a Lack of Funds - In the event funds to finance this Agreement become unavailable, the Grantee may terminate this Agreement upon no less than twenty-four (24) hours' notice in writing to the Subrecipient. Said notice shall be sent by certified mail, return receipt requested, or in person with proof of delivery. The Grantee shall be the final and sole authority in determining whether or not funds are available. iv. Termination for Breach - Upon terminating this Agreement under this section the Grantee, in its sole discretion, may require the Subrecipient to pay the Grantee any or all costs associated with termination of this Agreement, including but not limited to CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 21 transfer of the Subrecipient's obligations under this Agreement and or selection of a new Project Sponsor. The Grantee may terminate this Agreement, in whole or in part, when the Grantee determines in its sole and absolute discretion that the Subrecipient is not making sufficient progress in the performance of this Agreement as outlined in the "Scope of Services" contained within the "Scope of Service and US HUD eSnaps Documents" Attachment B or is not materially complying with any term or provision provided herein including but not limited to the following: 1. The Subrecipient ineffectively or improperly used or uses the Grantee funds allocated under this Agreement; 2. The Subrecipient failed or fails to furnish the Certificates of Insurance required by this Agreement or as determined by Miami -Dade County Internal Services Risk Management Division; 3. The Subrecipient failed or fails to furnish proof of Licensure, proof of Certification or proof of Background Screening required by this Agreement; 4. The Subrecipient failed or fails to submit detailed reports of expenditures or final expenditure reports or submits incompletely or incorrectly; 5. The Subrecipient failed or fails to submit required reports or submits incompletely or incorrectly; 6. The Subrecipient refused or refuses to allow the Grantee access to records or refused or refuses to allow the Grantee to monitor, evaluate and review the Subrecipient's program; 7. The Subrecipient discriminates under any of the laws outlined in this Agreement; 8. The Subrecipient failed or fails to provide Domestic Violence Leave to its employees pursuant to local law; 9. The Subrecipient falsifies or violates the provisions of a Drug Free Workplace Affidavit; 10. The Subrecipient attempted or attempts to meet its obligations under this Agreement through fraud, misrepresentation or material misstatement; 11. The Subrecipient failed or fails within a specified period, to correct deficiencies found during a monitoring, evaluation or review; 12. The Subrecipient failed or fails to meet the terms and conditions of any obligation under this Agreement or otherwise of any repayment schedule to the Grantee or any of its agencies or instrumentalities; 13. The Subrecipient failed or fails to meet any of the terms and conditions of the Miami -Dade County Affidavits; and 14. The Subrecipient failed or fails to fulfill in a timely and proper manner any and all of its obligations, covenants, agreements and stipulations in this Agreement. The Subrecipient shall be given written notice of the claimed breach and ten (10) business days to cure same. If the Subrecipient is not provided a written waiver of the breach by the Grantee, or if the Subrecipient remains in breach of this Agreement as determined by the Grantee, the Grantee shall initiate written notice to terminate and said notice will be to terminate effective within no less than twenty-four (24) hours. Said notice shall be sent by certified mail, return receipt requested, or in person with proof of delivery. Waiver of Breach or any provision of this Agreement shall not be construed to be a modification, or revisions of the terms of this Agreement. The provisions contained herein do not limit the rights to legal or equitable remedies or any other provision for termination by the Grantee under this Agreement. The Subrecipient shall be responsible for all direct and indirect costs associated with such termination CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 22 or cancellation, including attorney's fees. Any individual or entity who attempts to meet its contractual obligations with the Grantee through fraud, misrepresentation or material misstatement may be disbarred from Miami -Dade County contracting for up to five (5) years. 5. Notice Regarding Future Funding Applications Funding under this Agreement is provided by US HUD. The parties understand the Grantee, as the US HUD funding recipient, is responsible for review and approval of the funding application and response submitted to US HUD through the annual US HUD CoC Program Notice of Funding Availability (NOFA) application process. The Subrecipient agrees to timely notify the Grantee of the Subrecipient's intention not to be available to renew and continue operating or providing the program in its entirety as covered under this Agreement. Timely is defined as the earliest of either 1) six (6) months prior to this Agreement's expiration; or 2) upon request to confirm allocations in the Grant Inventory Worksheet (GIW) registration process of the anticipated annual application to US HUD CoC Program NOFA. If the Subrecipient is not available to apply for "renewal funding" or for the continuation of the program outlined in this Agreement, and failed to timely inform the Grantee as described herein, then the Grantee in its sole discretion may opt not to enter into future grant agreements with the Subrecipient. Further, in the event the Subrecipient will not be available to apply for renewal funding applicable to this Agreement, the Subrecipient agrees to ensure that housing is maintained for persons served by the Subrecipient under this Agreement after the expiration of this Agreement so that those persons do not become homeless. Notice from Subrecipient to Grantee pursuant to this section shall be delivered in writing by certified mail, return receipt request, or in person with proof of delivery, to the attention of Miami -Dade County Homeless Trust Executive Director. 6. Reversion of Assets a. Term of Commitment - If the Subrecipient receives assistance for acquisition, rehabilitation, or new construction, then the Subrecipient shall agree to operate the "McKinney-Vento Act housing" or provide "McKinney-Vento Act services" in accordance with this Agreement and applicable laws, and regulations for a term of at least twenty (20) years or if applicable fifteen (15) years from the date of initial occupancy or date of initial service provision. If the United States, Department of Housing and Urban Development (US HUD) determines a project is no longer needed for use as homeless assistance housing or services, then US HUD may provide authorization to the Grantee on behalf of the Subrecipient to convert the project to a project for the direct benefit of low-income persons pursuant to a request for such use by the Grantee on behalf of the Subrecipient operating the project as Project Sponsor. The parties hereby agree to this provision shall survive the expiration or termination of this Agreement pursuant to 24 CFR 578.81 - The request for authorization to US HUD from the Grantee on behalf of the Subrecipient must be made while the project is operating as homeless housing or supportive services for homeless individuals and families, must be in writing, and must include an explanation of why the project is no longer needed to provide CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 23 transitional or permanent housing or supportive services. The primary factor in US HUD's decision on the proposed conversion is the unmet need for transitional or permanent housing or supportive services in the Continuum of Care's geographic area. b. Repayment of Grant - If the Subrecipient does not provide supportive housing or supportive services for twenty (20) years or if applicable fifteen (15) years following the date of initial occupancy or date of initial service provision pursuant to this Agreement, then the Grantee shall require repayment of the entire amount of the grant or partial repayment of the grant used for acquisition, rehabilitation, or new construction, unless conversion of the project has been authorized by US HUD pursuant to the terms in the Term of Commitment. The parties hereby agree this provision shall survive the expiration or termination of this Agreement. c. Prevention of Undue Benefit - Upon the sale or other disposition of a project assisted with acquisition, rehabilitation or new construction funds occurring before the expiration of the twenty (20) years or if applicable fifteen (15) year period, the Subrecipient must comply with such terms and conditions as US HUD and the Grantee may prescribe to prevent the Subrecipient from unduly benefiting from such sale or disposition. The Subrecipient shall return to the Grantee, upon the expiration or termination of the Agreement, any funds on hand, any accounts receivable attributable to those funds, and any overpayment due to unearned funds or costs disallowed pursuant to the terms of this Agreement that were disbursed to the Subrecipient by the Grantee. d. Revocation of License or Permit - Notwithstanding any provision of this Agreement to the contrary, revocation of any necessary license, permit, or approval by a governmental authority may result in immediate termination of this Agreement upon no less than twenty- four (24) hours' notice. Said notice shall be certified by mail or hand delivery. e. Declaration of Restrictive Covenant and Declaration of Restrictions - Where grant funds are used for acquisition, construction or rehabilitation under this Agreement, the Subrecipient shall record a Declaration of Restrictive Covenants, as well as a Declaration of Restrictions, in accordance with this section. The Declaration of Restrictive Covenants and the Declaration of Restrictions shall restrict the use of properties located at , in Miami -Dade County, Florida such that the properties must be operated for the provision of homeless housing and services for homeless persons in accordance with the provisions of (24 CFR Part 578, Code of Federal Regulations) and any other applicable laws or regulations for a term of at least twenty (20) years or if applicable fifteen (15) year period or for such other purposes as may be approved by the Grantee and US HUD. The Subrecipient agrees that the Declaration of Restrictive Covenants and the Declaration of Restrictions shall be signed by the Subrecipient, as well as the title owner of the subject property and any other relevant property interest holders, including but not limited to a lessee of the title holder subleasing the property to the Subrecipient. If the Subrecipient is not the title owner of the subject property, the Subrecipient shall be responsible for obtaining execution of the Declaration of Restrictive Covenants and the Declaration of Restrictions by the title owner and by any other parties required by US HUD. The Subrecipient shall be responsible for ensuring that any signatories required by US HUD sign the Declaration of Restrictive Covenants and the Declaration of Restrictions whether US HUD requires such CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 24 signatories by regulation or by guidance provided directly regarding the project and / or property covered under this Agreement. The Declaration of Restrictive Covenants executed by the Subrecipient and any other required parties and recorded by the Subrecipient must be approved by US HUD. The Subrecipient must provide US HUD with proof of recordation of the approved Declaration of Restrictive Covenants before funds for Rehabilitation or New Construction may be drawn down. Acquisition funds may be drawn down before proof of recordation is received by US HUD; however, no other grant funds will be available for draw down until US HUD is satisfied with the form and recordation of the Declaration of Restrictive Covenants. The Subrecipient agrees to inform any lender or grantor which has loaned or granted funds for the purchase of such properties or structure on the subject property or properties covered under this Agreement and obtain their consent to the recordation of and subordination to the "Declaration of Restrictive Covenants" and the "Declaration of Restrictions". Such consent shall be in a form acceptable to the Grantee. The parties hereby agree this provision shall survive the expiration or termination of this Agreement. 7. Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards a. Accounting Standards, Cost Principles and Regulations. The Subrecipient shall comply with applicable provisions of applicable Federal, State and County laws, regulations, and rules such as OMB Circular A-110, OMB Circular A- 21, and OMB Circular A-133 and with the Energy Policy and Conservation Act (Public Law 94-163) which requires mandatory standards and policies related to energy efficiency. If any provision of this Agreement conflicts with any applicable law or regulation, only the conflicting provision shall be modified to be consistent with the law or regulation or be deleted if modification is impossible. However, the obligations under this Agreement, as modified, shall continue and all provisions of this Agreement shall remain in full force and effect. ii. If the amount payable to the Subrecipient pursuant to the terms of this Agreement are in excess of $100,000, or such other amount as required by applicable law or regulation; the Subrecipient shall comply with all applicable stands, orders, or regulations issued pursuant to Section 306 of the Clean Air Act of 1970 (42 U.S.C. 1857(h), as amended: the Federal Water Pollution Control Act (33 U.S.C. 1251), as amended: Section 508 of the Clean Water Act (33 U.S.C. 1368); the environmental Protection Agency regulations (40 CFR Part 15); Executive Order 11738; and the Environmental Review Procedures and Regulations (24 CFR Part 58 and 24 CFR Part 583.230). The Subrecipient shall comply with all applicable laws and regulations governing this Agreement. b. The Subrecipient shall comply with the federal uniform administrative requirements and accounting standards cost principles and audit requirements according to OMB Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225 and 230, OMB Circular A-122, and 24 CFR 78 et seq., as may be applicable and any other applicable laws and regulations. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 25 Performance Measurements - The Subrecipient shall comply and report all performance objectives outlined in the "Scope of Service and US HUD eSnaps Documents" Attachment B and as outlined in the NOFA application and in the manner specified and outlined in this Agreement. ii. Additionally, the Subrecipient shall comply with the established United States Department of Housing and Urban Development's (USHUD) performance measures related to the Continuum of Care's (CoC) system performance. Specifically: 1. Measure 1: The Length of Time Persons Remain Homeless 2. Measure 2: The Extent to which Persons who Exit Homelessness to Permanent Housing Destinations Return to Homelessness 3. Measure 3: Number of Homeless Persons 4. Measure 4: Employment and Income Growth for Homeless Persons in CoC Program -funded Projects 5. Measure 5: Number of Persons who Become Homeless for the First Time 6. Measure 6: Homeless Prevention and Housing Placement of Persons Defined by Category 3 of HUD's Homeless Definition in CoC Program -funded Projects 7. Measure 7: Successful Placement from Street Outreach and Successful Placement in or Retention of Permanent Housing iii. HUD -funded agencies must have a minimum of 86% of the organization's total number of beds/units which are reported to HUD for the Miami -Dade County Continuum of Care (CoC) through the Housing Inventory Checklist, populated in the HMIS, regardless of whether the beds are funded by HUD or the Homeless Trust, whether or not funded by HUD or the Homeless Trust. iv. Internal Controls - The Subrecipient shall comply with internal control related federal statutes, regulations, and the terms and conditions of the federal award; evaluate and monitor and take prompt action when instances of noncompliance are identified including noncompliance identified in audit findings; and take reasonable measures to safeguard legally protected personally identifiable information and other information. These internal controls shall safeguard assets and provide reasonable assurance of compliance with federal statutes and regulations. v. Payment - The Subrecipient is required to report deviations from budget or project scope or objectives and request prior approvals from federal awarding agencies through the Grantee on any and all changes in scope or key persons and any other change to the program budget, in accordance with Omni or Super Circular 2 CFR Chapter I, and Chapter II, Parts 200, 215, 220, 225 and 230 and any other applicable laws and regulations. vi. Cost Sharing or Matching - For all federal awards, any shared costs or matching funds and all contributions, including cash and third party in -kind contributions, must be accepted as part of the non-federal entity's cost sharing or matching and such contributions shall meet all of the following criteria: 1. Are verifiable from the non-federal entity's records; 2. Are not included as contributions for any other federal award; CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 26 3. Are necessary and reasonable for accomplishment of project or program objectives; 4. Are allowable under Costs Principles of 2 CFR Part 200, et al. 5. Are not paid by the federal government under another federal award, except where the federal statute specifically provides that federal funds made available for such program can be applied to match or cost sharing requirements of other federal programs; 6. Are provided for in the approved budget when required by the federal awarding agency; and 7. Conform to 2 CFR Chapter II, Part 200.306, as applicable. c. Retention of Agreement Records The Subrecipient shall retain financial records, supporting documents, statistical records and all records pertinent to a federal award for a period of five (5) years from the date of submission of the final expenditure report or, for Federal awards that are renewed quarterly or annually, from the date of the submission of the quarterly or annual financial report, respectively, as reported to the federal awarding agency. 1. If any litigation, claim or audit is started before the expiration of the five (5)-year period, the records must be retained until all litigation, claims, or audit findings involving the records have been resolved and final action taken. If the Grantee or the Subrecipient has received or been given notice of any kind indicating any threatened litigation, claim or audit arising out of the services provided pursuant to the terms of this Agreement, the Retention Period shall be extended until such time as the threatened or pending litigation, claim or audit is, in the sole and absolute discretion of the Grantee, fully, completely and finally resolved. 2. Records for real property and equipment acquired with federal funds must be retained for a minimum five (5) years after final disposition. 3. Any leases or mortgages or similar documents or contracts with a term longer than five (5) years, must be retained for five (5) years beyond the end of the document's full term. 4. Records for program income transactions after the period of performance: The Subrecipient must report program income after the period of performance records pertaining to the earning of program income must be retained for five (5) years after the end of the non-federal entity's fiscal year in which the program income is earned. 5. The Subrecipient shall allow the Grantee or any persons authorized by the Grantee full access to and the right to examine any of the records pertinent to the Federal Award and this Agreement. 6. The Subrecipient shall notify the Grantee in writing both during the pendency of this Agreement and after its expiration as part of the final close out procedure of, the location and address where all the Agreement records will be retained. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 27 7. The Subrecipient shall obtain prior written approval by the Grantee for the disposal of any Agreement records before disposing of such records if it is within one (1) year after the expiration of the Retention Period. 8. Additional Requirements The Subrecipient shall comply with the following additional requirements: a. Client Rules and Regulations - The Subrecipient shall submit to the Grantee a copy of the Client Rules and Regulations that apply to all program or client participants referred to the Subrecipient pursuant to this Agreement. This copy is due within thirty (30) calendar days following the execution of this Agreement. b. Personnel Policies and Administrative Procedure Manuals - The Subrecipient shall submit detailed documents describing all the Subrecipient's policies and procedures for internal control, corporate, or organizational structure, property management, procurement, personnel management, accounting and fiscal information. This information shall be available to the Grantee upon request. c. Monitoring - The Subrecipient shall permit the Grantee and any other persons authorized by the Grantee to monitor, according to applicable regulations, all Agreement records, facilities, goods, services and activities of the Subrecipient which are in any way connected to the activities undertaken pursuant to the terms of this Agreement including interview of any participant, employee, subcontractor, or assignees of the Subrecipient. The Grantee shall monitor both fiscal and programmatic compliance with all terms and conditions of this Agreement including a review of beneficiaries, supportive services, housing, operating costs, program and performance progress, site habitability, participant eligibility, documentation for required match, record keeping, and compliance with circulars, administrative costs, technical assistance visits, and environmental review. The Subrecipient shall permit the Grantee to conduct site visits, participant assessment surveys, and other techniques deemed reasonably necessary to fulfill the monitoring function. If the Grantee monitors and there is a finding of deficiencies report; said report may be delivered to the Subrecipient, and if so delivered, the Subrecipient shall rectify all deficiencies cited within the period of time specified in the report. Pursuant to Board of Miami -Dade County Commissioners Resolution No. 630-13, Miami -Dade County Mayor or Mayor's designee may make unannounced, on -site visits during normal working hours to the Subrecipient's headquarters and / or any locations or site where the services contracted for are performed. d. Restrictions of Funds Use - The funds received under this Agreement (and any State or local government funds used to supplement this Agreement) may not be used to replace State or local funds previously used, or designated for use to assist homeless persons (24 CFR Part 578.87). The Subrecipient shall notify the Grantee of any additional funding received for any activity described in this Agreement, other than funding already noted in the "Consolidated Financial Record and Reports", Attachment E. Such notification shall be in writing and received by the Grantee within thirty (30) calendar days of the Subrecipient's notification by the funding source. e. Related Parties - The Subrecipient shall report to the Grantee the name, purpose and any other relevant information in connection with any transaction conducted between the CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 28 Subrecipient and a related party transaction. A related party includes, but is not limited to; a for -profit or nonprofit subsidiary or affiliate organization, and organization with overlapping boards of directors or any organization for which the Subrecipient is responsible for appointing members. The Subrecipient shall report this information to the Grantee upon forming the relationship or if already formed, shall report it immediately. Any supplemental information shall be reported in the Grantee required Agency Narrative and Progress Report which are addressed in Section 2 b. "Records and Access to Records". f. Required Meeting Attendance - From time to time, Grantee through Miami -Dade County Homeless Trust may schedule meetings and or training sessions to assist the Subrecipient in the performance of its contractual obligations or to inform the Subrecipient of new and or revised policies and procedures. Attendance at some of these meetings may be mandatory. The Subrecipient shall receive notice no less than three (3) business days prior to any meeting or training session that may require mandatory participation. A record of attendance shall be kept of meetings or training sessions where notice was given indicating the mandatory participation of the Subrecipient and the Subrecipient shall be monitored for compliance on that record of attendance. Failure to attend meetings or training sessions for which a mandatory notice has been provided can result in material non-compliance of the Agreement, up to and including Breach or Default. Proof of mandatory notice shall consist of fax record, certified mail, electronic confirmation and or verbal communication with the Agreement contact person or persons and other program administrative staff of the Subrecipient. The Subrecipient may select one or more employees from their Agency, directly involved in the Agreement program, as their representative at the meeting or training session; the participation of the Agreement contact person or persons is preferred. The Subrecipient may request waiver from a mandatory meeting. That waiver must be received no later than twenty-four (24) hours prior to the meeting date and time, and justification provided, including the reason the Subrecipient could not send any representative. The Grantee shall have absolute and final approval over any determination to waive mandatory attendance; and no more than two (2) mandatory attendance waivers shall be allowed during the term of this Agreement. The Subrecipient is encouraged to attend all meetings of Miami -Dade County Homeless Trust and or its Committees, as information relevant to their program or services may be discussed. g• Publicity and Advertisements - The Subrecipient shall ensure that all publicity and advertisements prepared and released by the Subrecipient, such as pamphlets and news releases already or indirectly related to activities funded pursuant to this Agreement, and all events carried out to publicize the accomplishments of any activity funded pursuant to this Agreement, recognize the Grantee as its funding source. h. Procurement - The Subrecipient shall use its own procurement procedures which shall comply with any and all applicable federal, state and local laws, ordinances and regulations including but not limited to 2 CFR 200.318 as applicable. The Subrecipient shall maintain oversight and ensure that its subcontracts perform in accordance with the terms, conditions, and specifications of their contracts or purchase orders. The Subrecipient shall make a positive effort to competitively procure supplies, equipment, construction and services necessary or related to carrying out the terms of this Agreement from minority and women owned businesses, as may be permitted by applicable law. If this Agreement involves the expenditure of $100,000 or more by Miami -Dade County, and the Subrecipient intends to use subcontractors to provide the services listed herein or suppliers CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 29 to supply the materials, the Subrecipient shall provide Miami -Dade County with the names of the "Subcontractor / Supplier Listing", Attachment D. Subrecipient agrees that it will not change or substitute subcontractors or suppliers from those listed without prior written approval of Miami -Dade County. Involvement of HUD -assisted individuals and families - per 24 CFR 578.23 (c)(3), the Subrecipient agrees to ensure to the maximum extent practicable, that individuals and families experiencing homelessness are involved, through employment, provision of volunteer services, or otherwise, in constructing, rehabilitating, maintaining and operating facilities for the project and in providing supportive services for the project. Further, per the Housing and Urban Development Act of 1968, as amended, (12 U.S.C. 1701u) to the greatest extent feasible, opportunities for training and employment, for services or programs covered under this Agreement, should be given to lower -income residents of HUD -assisted projects and contracts for work in connection with the project be awarded in substantial part to persons residing in the area of the project. Property - This section applies to equipment with an acquisition cost of greater than $5,000.00 per unit and all real property. 1) Any real property under the control of the Subrecipient that was acquired and or improved in whole or in part with funds from Grantee, or from Miami -Dade County and any equipment or property purchased for greater than $5,000.00, shall, upon expiration or termination of this Agreement, be disposed in accordance with instructions from the Grantee. Real Property is defined as land, including land improvements, structures, and appurtenances thereto, including moveable machinery and equipment. Equipment means tangible, non -expendable, personal property having a useful life of more than one (1) year and acquisition costs of greater than $5,000.00 per unit. 2) The Subrecipient shall list in the property records all equipment with an acquisition cost of greater than $5,000.00 per unit and all real property purchased in whole or in part with funds from the Grantee or from Miami -Dade County from this Agreement or from previous agreements. The property record shall include a legal description, size, date of acquisition, and value at time of purchase, owner's name if different than the Subrecipient, information on the transfer or disposition of the property, and map indicating where property is in parcels, lots or blocks and showing adjacent streets and roads. Notwithstanding documents required for reimbursement purposes, an additional copy of the purchase receipt for any property described above which was purchased using Grantee or Miami -Dade County funds must also be included in the reimbursement package along with the "Real Property and Equipment Asset Inventory" Attachment I in the month it was purchased. 3) All equipment with an acquisition cost of greater than $5,000.00 per unit and all real property shall be inventoried annually by the Subrecipient and an Annual Inventory Report submitted to the Grantee. This report shall include the elements listed above. Pursuant to 2 CFR 200.94, if the cost of computing devices (inclusive of accessories) falls below the lesser of the capitalization threshold of the nonfederal entity or $5,000, regardless of the length of useful life, the asset is a supply. k. Management Evaluations and Performance Reviews - The Grantee may conduct formal Management Evaluations and Performance Reviews of the Subrecipient following this expiration of this Agreement. The Management Evaluations will reflect the compliance of the Subrecipient with generally accepted fiscal and organizational standards and practices. The Performance Reviews will reflect the quality of service provided and value received of the funds using monitoring data such as progress reports, site visits, and participants' surveys. CoC Grant #FLO211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 30 1. Subcontracts and Assignments - The Subrecipient shall not assign this Agreement without the Grantee's written consent to the assignment. The Subrecipient shall ensure that all subcontracts and assignments; 1) Identify the full, correct and legal name of the party; 2) Describe the activities to be performed; 3) Present a complete and accurate breakdown of all price components; and 4) Incorporate provisions requiring compliance with all applicable regulatory and other requirements of this Agreement with any conditions of approval that the Grantee deems necessary. This applies only to subcontracts and assignments in which parties are engaged to carry out any eligible substantive programmatic service as set forth in this Agreement. The Grantee shall in its sole and absolute discretion determine when services are eligible substantive programmatic services subject to the audit and record keeping requirements described above. The Subrecipient shall ensure that all subcontracts and assignments which involve the expenditure of one hundred thousand dollars ($100,000.00) or more, comply with (Miami - Dade County Ordinance 97-104, § 1, 7-8-97), which shall require the entity contracting with Miami -Dade County to list all first tier subcontractors who will perform any part of the contract and all suppliers who will supply materials for the contract work directly to such entity. The contract shall also require the entity contracting with Miami -Dade County to report to Miami -Dade County the race, gender, and ethnic origin of the owners and employees of all such first tier subcontracts. This Agreement shall require the Subrecipient to provide Miami -Dade County the race, gender and ethnic information as soon as reasonably available and in any event prior to final payment under the contract. The Subrecipient shall not change or substitute subcontractors or suppliers from those listed except upon written approval of the County. The Subrecipient must provide the list of all first tier subcontractors and direct suppliers; see "Subcontractor / Supplier Listing" Attachment D. The Subrecipient shall incorporate into all consultant subcontracts this additional provision: "The Subrecipient is not responsible for any insurance or other fringe benefits for the consultant or its employees, (examples social security, income tax withholdings, retirement or leave benefits). The consultants assume full responsibility for the provision of all insurance and fringe benefits for themselves and their employees retained by the consultants in carrying out the Scope of Service provided in this subcontract". The Subrecipient shall be responsible for monitoring the contractual performance of all subcontracts. The Subrecipient shall receive written documentation prior to entering into any subcontract which contemplates performance of substantive programmatic activities, as such is determined as provided herein. The approval of the Grantee shall be obtained prior to the release of any funds to the Subrecipient for the subcontract. The Subrecipient shall receive written approval from the Grantee prior to either assigning or transferring any obligations or responsibilities set forth in this Agreement or the right to receive benefits or payments resulting from this Agreement. Approval by the Grantee of any subcontract or assignment shall not under any circumstances be deemed to provide for the incurring of any obligation by the Grantee in excess of the total dollar amount set forth in this Agreement. m. Consultant to the Grantee - The parties understand that in .order to facilitate the implementation of this Agreement, the Grantee may from time to time designate a development consultant to work with the Subrecipient. The Grantee's Consultant shall be considered the Grantee's designee with respect to all portions of this Agreement with the exception of those provisions relating to payment to the Subrecipient for services rendered. The Grantee shall provide written notification to the Subrecipient of the name, address and employee representatives of the Grantee's Consultant. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 31 n. Participation in the Homeless Management Information System (HMIS) - The Subrecipient agrees to participate in a Homeless Management Information System selected and established by the Grantee. Participation will include, but not be limited to, input of client data upon intake, daily updates of bed availability information, as well as updates to current and prior client's records upon client contact, and maintaining current data for statistical purposes. Subrecipients of Domestic Violence Programs with heightened privacy and confidentiality concerns are required to participate in an HMIS equivalent system to include the necessary stricter privacy and confidentiality standards. The Subrecipient understands that they are responsible for any ongoing costs to access the HMIS system. The Subrecipient agrees to abide by terms of any HMIS Agreements, which are incorporated herein by reference. The Subrecipient shall indemnify and hold harmless the Grantee and Miami -Dade County, its agents and instrumentalities from any and all liability, losses and damages arising out of or relating to this Agreement or the HMIS system. o. Miami -Dade County Inspector General review - The Subrecipient understands that Miami - Dade County, Office of the Inspector General may, on a random basis, perform audits on all Miami -Dade County contracts, throughout the duration of said contracts. p• q• Independent Private -Sector Inspector General review - The Subrecipient understands that Miami -Dade County Inspector General is also empowered to retain the services of Independent Private -Sector Inspector Generals, to audit, investigate, monitor, oversee, inspect and review operations, activities, performance and procurement processes including but not limited to project design, application and project specifications, proposals submittals, activities of the Subrecipient, its officers, agents and employees, lobbyists, Miami -Dade County staff, and elected officials to ensure compliance with contract specifications and to detect fraud and corruption. Renegotiation or Modification - The Subrecipient agrees that modifications to provisions of this Agreement shall only be valid, when in writing and signed by duly authorized representatives of all parties. In addition, the Subrecipient may not make any significant changes to an approved program without prior written approval by the Grantee. Significant changes include, but are not limited to, changes in the Project Sponsor, changes in the project site location, additions or deletions in types of program or funding activities outlined in 24 CFR 578.37 - 578.63 and the Notice of Funding Availability (NOFA) process approved in the Technical Submission for this program, or a shift of greater than ten (10) percentage points between approved funding activities, or a change in the population served, the number of population served, or any other changes deemed significant by the Grantee. Depending upon the nature of the change, the Grantee may require a new certification of consistency with the Consolidated Plan Certification from the United States Department of Housing and Urban Development. Any approval for changes is contingent upon United States, Department of Housing and Urban Development Field Office approval of the continuation of the Subrecipient's renewal ranking in the CoC NOFA application process. The parties agree to renegotiate this Agreement if the Grantee determines, in its sole and absolute discretion, that changes are necessary for reasons including but not limited to changes in Federal, State, County laws or regulations, or increases or decreases in funding allocations. The Grantee shall have final authority in determining funding availability for this Agreement caused by changes listed above. Notwithstanding the foregoing, the Grantee CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 32 retains all rights of suspension and termination set forth in other section(s) of this Agreement. r. Right to Waive - The Grantee may, for good and sufficient cause, determined by the Grantee in its sole and absolute discretion, waive provisions in this Agreement in writing or seek to obtain such wavier from the appropriate authority. All waiver requests from the Subrecipient must be in writing. Any waiver shall not be construed as a modification or revision to this Agreement. s. Disputes - In the event that an unresolved dispute exists between the Subrecipient and the Grantee, the Grantee shall refer the questions, including the views of all interested parties and the recommendation of the Miami -Dade County Homeless Trust, to the Miami -Dade County Mayor or the Mayor's designee for determination. The Mayor or Mayor's designee will issue a determination within thirty (30) calendar days of receipt and so advise the Grantee and the Subrecipient, or in the event additional time is necessary, the Grantee will notify the Subrecipient within the thirty (30) day period that additional time is necessary. The Subrecipient agrees that the determination of the Mayor or the Mayor's designee shall be final and binding on all parties. t. Proceedings - This Agreement shall be construed in accordance with the laws of the State of Florida and any proceedings arising between the parties in any manner pertaining or related to this Agreement shall, to the extent permitted by law, be held in Miami -Dade County, Florida. u. No Third Party Beneficiaries - This Agreement has no intended or unintended third party beneficiaries. v. Construction of the Agreement - This Agreement shall not be construed against the drafter of this Agreement. w. Sovereign Immunity - Nothing in this Agreement shall be considered a waiver of sovereign immunity. x. Notice and Contact - The Grantee's representative for this Agreement is Victoria L. Mallette, Executive Director, Miami -Dade County Homeless Trust. The Subrecipient's representative for this Agreement is . The project site location is . In the event that different representatives are designated by the Subrecipient after this Agreement is executed, or the Subrecipient changes the address of either the program site or principal office, the Subrecipient must notify the Grantee prior to such relocation and obtain all necessary approvals. Notice of the name of the new representative or new address will be rendered in writing to the Grantee within five (5) business days of the proposed change. The Subrecipient shall provide to the Grantee, prior to execution of this Agreement, the Subrecipient's Board Approval or Board Resolution designated authorizing signatories or their alternative to receive and expend funds, to execute agreements and subcontract agreements and to exercise modification, renewal and termination clauses contain within this Agreement. The resolution shall be updated and provided annually. CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 33 z. The Subrecipient shall provide the Grantee with a current list of the Subrecipient's Board of Directors and a Program -Specific Table of Organization, which includes all current job titles in PDF format and which shall be emailed as an attachment to Miami -Dade County Homeless Trust's Contract Manager Terrell T. Ellis within five (5) business days of execution of this Agreement. aa. Name and Address of Payee -When payment is made to the Subrecipient, it shall be directed to the name and address of the payee listed here: Subrecipient's Name: Address: bb. All Terms and Conditions Included - this Agreement and its Attachments A through K as referenced in the Index of Attachment, contain all the terms and conditions agreed upon by the parties. cc. Autonomy - Both parties agree that this Agreement recognizes the autonomy of and stipulates or implies no affiliation between the contracting parties. The parties acknowledge that the relationship of Grantee and Subrecipient is that of independent contractors and that nothing contained in this Agreement shall be construed to place Grantee and Subrecipient in the relationship of principal and agent, employer and employee, master and servant, partners or joint ventures. Neither party shall have, expressly or by implication, or represent itself as having, any authority to make contracts or enter into any agreements in the name of the other party, or to obligate or bind the other party in any manner whatsoever. dd. Severability of Provisions - If any provision of this Agreement is held invalid, the remainder of this Agreement shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of all applicable law. ee. Waiver of Trial - Neither the Subrecipient, subcontractor nor any other person liable for the responsibilities, obligations, services and representations herein, nor any assignee, successor heir or personal representative of the Subrecipient, subcontractor or any other such persons or entities shall seek a jury trial in any lawsuit, preceding, counterclaim or other litigation proceeding based upon or arising out of this Agreement, or the dealings or the relationship between or among the parties to this Agreement.. ff. Counties and Municipalities outside Miami -Dade County - The Subrecipient agrees to provide homeless housing within Miami -Dade County and further agrees to abide by, as well as to post this notice: Notice that all firms, corporations, organizations or individuals desiring to transact business or enter into a contract with Miami -Dade County for the provision of homeless housing and or homeless services swears, verifies, affirms and agrees that 1) they have not entered into any current contracts, arrangements of any kind, or understanding with any county, or municipality outside of Miami -Dade County to provide housing and services for homeless persons in Miami -Dade County who are transported to Miami -Dade County by or at the behest of such counties and municipalities outside Miami -Dade County; and 2) During the term of this contract, entities listed above will not enter into any such contract, arrangement of any kind or understanding provided however, Miami -Dade County Homeless Trust may, in its sole and absolute discretion, find and determine within sixty (60) days of an entity's request to waive the requirements of this section, that a proposed contract should not be prohibited hereby, as the best interests of the homeless programs undertaken by and CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 34 on behalf of Miami -Dade County would be served and Miami -Dade County would not be negatively affected by such contract, arrangement, or undertaking. gg. Compliance with all applicable Laws, Regulations, Ordinances, Policies and Standards - The Subrecipient agrees to comply with all applicable Federal, State, and local laws, regulations, ordinances, and standards including but not limited to any applicable requirements regarding payment and performance bonds and other requirements for public works, competitive bid and bid bond requirements, if applicable, as well as with requirements contained in the Grantee's "Continuum of Care Program Grant Agreement", Attachment A. The Subrecipient also agrees to sign and provide the Grantee with any required affidavits. Additionally, the Subrecipient shall comply with any and all guidance that Grantee receives from US HUD regarding this Agreement, the program and / or services covered herein, and clarification of existing laws and regulations 9. Religious Organizations Pursuant to 24 CFR Part 578.87, a primarily religious organization is eligible to receive US HUD funding, if the organization agrees to provide homeless housing and services in a manner that is free from religious influences as described in section 24 CFR Part 578.87 and in accordance with the following principles; a. It will not discriminate against any employee or applicant for employment on the basis of religion and will not limit employment or give preference in employment to persons on the basis of religion; b. It will not discriminate against any person applying for homeless housing or services on the basis of religion and will not limit such homeless housing or services or give preference to persons on the basis of religion; and c. It will provide no religious instruction or counseling, conduct no religious worship or religious services, engage in no religious proselytizing and exert no other religious influence in the provision of homeless housing and services funded hereunder. d. Alternative Provider - The Subrecipient shall incorporate into their policies and procedures, a written approved policy to refer, or transfer any program participant or prospective program participant of the Continuum of Care program who objects to the religious character of the provider. The policy and procedures shall be reviewed and subject to approval by Miami -Dade County Homeless Trust. At a minimum the policy and procedures shall include action to transfer or refer within a reasonably prompt time after the objection and undertake reasonable efforts to identify and refer the participant to an alternative provider to which the participant has no objection. Except for services provided by telephone, the Internet, or similar means, the referral must be to an alternative provider in reasonable geographic proximity to the organization making the referral. In making the referral, the Subrecipient shall comply with applicable privacy laws and regulations. The Subrecipient shall document any objections from program participants and prospective program participants and any efforts to refer such participants to alternative providers in accordance with the requirements of 24 CFR 578.103(a)(13). CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 35 The Subrecipient shall comply with the provisions of this section and with 24 CFR Part 578.87, as well as with any other applicable laws or regulations governing a primarily religious organization. 10. Health Insurance Portability and Accountability Act (HIPAA) Any person or entity that performs or assists Miami -Dade County with a function or activity involving the use or disclosure of Individually Identifiable Health Information (IIHI) and or Protected Health Information (PHI) shall comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as may be amended, and any applicable federal, state, county and local laws and policies, including by not limited to 24 CFR 578.103, 42 CFR Part 2, and Section 39.908, Florida Statutes, as may be applicable. HIPAA mandates for privacy, security and electronic transfer standards that include but are not limited to the following: a. Use of information only for performing services required by the contract or as required by law; b. Use of appropriate safeguards to prevent non -permitted disclosures; c. Reporting to Miami -Dade County of any non -permitted use or disclosure; d. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Subrecipient and provides reasonable assurances that IIHI and PHI will be held confidential; e. Making PHI available to the customer; f. Making PHI available to Miami -Dade County for an accounting of disclosures; g. Making internal practices, books and records related to PHI and IIHI available to Miami -Dade County for compliance audits and for other purposes as may be permitted by law; and h. PHI shall maintain its protected status regardless of the form and method of transmission (including paper and or electronic transfer of data). The Subrecipient must give its customers written notice of all privacy information practices including but not limited to description of the types of uses and disclosures that would be made with protected health information. 11. Proof of Licensure / Certification and Background Screening a. Licensure - If the Subrecipient is required by the State of Florida or Miami -Dade County or any federal, state or local law or regulation to be licensed or certified to provide the services or operate the facilities outlined in the Scope of Service contained within the "Electronic Review, Renewal Adjustment and HEARTH Renewal Application", Attachment B, the Subrecipient shall furnish to the Grantee a copy of all required current licenses or certificates. Examples of services or operations requiring such licensure or certification include but are not limited to childcare, day care, nursing homes, and boarding homes. If the Subrecipient fails to furnish the Grantee with the licenses, certificates or certifications required under this Section, the Grantee in its sole discretion, shall not disburse any funds until it is provided with such licenses or certifications. Failure to provide the required licenses or certification within sixty (60) days of execution of this Agreement may result in termination of this Agreement at the Grantee's discretion. b. Background Screening - The Subrecipient agrees to comply with all applicable federal, state and local laws, regulations, ordinances and resolutions regarding background screening of employees, volunteers, subcontractors and independent contractors. Subrecipient's failure CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 36 to comply with any applicable laws, regulations, ordinances and resolutions regarding background screening of employees, volunteers, subcontractors and independent contractors is grounds for a material breach and termination of this contract at the sole discretion of Miami -Dade County. The Subrecipient agrees to comply with all applicable laws, (including but not limited to chapters 39, 402, 409, 394,408, 393, 397, 943, 984, 985, 1012 and 435, Florida Statutes, and Section 943.04351, Florida Statutes, as may be amended from time to time), regulations, ordinances and resolutions regarding background screening of those who may work or volunteer directly with or in the vicinity of vulnerable persons as defined by Section 435.02 Florida Statutes, as may be amended from time to time. In the event criminal background screenings is required by law, the State of Florida and / or Miami -Dade County, the Subrecipient will permit only employees, volunteers, subcontractors and independent contractors with a satisfactory national criminal background check through an appropriate screening agency (i.e., the Florida Department of Juvenile Justice, Florida Department of Law Enforcement or Federal Bureau of Investigation) to work or volunteer in direct contact with or in the vicinity of vulnerable persons. The Subrecipient shall also comply with Section 943.059, Florida Statutes, regarding court - ordered sealing of criminal history records, and Section 943.0585, Florida Statutes, regarding court -ordered expunction of criminal history records, as may be applicable. The Subrecipient agrees to ensure that employees, volunteers, subcontracted personnel and independent contractors who work with vulnerable persons satisfactorily complete and pass Level 2 background screenings before working or volunteering with any vulnerable persons. The Subrecipient shall furnish Miami -Dade County with proof that employees, volunteers, subcontracted personnel, and independent contractors who work with vulnerable persons, satisfactorily passed Level 2 background screenings pursuant to Chapter 435 Florida Statutes, as may be amended from time to time. If the Subrecipient fails to furnish to Miami -Dade County proof that an employee, volunteer, subcontractor or independent contractor's Level 2 or other required background screening was satisfactorily passed and completed prior to that employee, volunteer, subcontractor or independent contractor working or volunteering with or in the vicinity of a vulnerable person or vulnerable persons, Miami -Dade County shall not disburse any further funds and this Agreement may be subject to termination at the sole discretion of Miami -Dade County. SIGNATURES CONTINUE ON NEXT PAGE CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 37 IN WITNESS WHEREOF, the parties have caused this thirty-eight (38) page Amendment to be executed by their respective and duly authorized officers the day and year first above written. WITNESSES: ENTITY: CITY OF MIAMI, FLORIDA A municipal corporation of The State of Florida By: By: TODD B. HANNON ARTHUR NORIEGA CITY CLERK CITY MANAGER Approved as to Form and Correctness: Approved as to Insurance Requirements: By: By: VICTORIA MENDEZ ANN-MARIE SHARPE CITY ATTORNEY RISK MANAGEMENT Affix Incorporation SEAL here ATTEST: Miami -Dade County, a political subdivision of The State of Florida HARVEY RUVIN, CLERK BY: DEPUTY CLERK CARLOS A. GIMENEZ (DATE) MAYOR See attached memorandum dated ( ) approved as to form and legal sufficiency Resolution #R-1249-19 CoC Grant #FLO211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 38 Attachment A - Attachment B - Attachment C - Attachment D - Attachment E - Attachment F - Attachment G - Attachment H - Attachment I - Attachment J - Attachment K - INDEX OF ATTACHMENTS Continuum of Care Program Grant Agreement & Exhibit 1 Scope of Service and US HUD eSnaps documents Form W-9 Request for Taxpayer Miami -Dade County Required Affidavits and Declarations Consolidated Financial Record and Reports - Excel Format Performance Reports (Monthly and Annual) CoC Internal Wellness Checklist and Guidelines "Incident Report" form "Real Property & Equipment Asset Inventory" form When Subrecipient is the Rental Administrator (Participant's Housing Application)* HAP & LEASE When Miami -Dade County is the Rental Administrator (Participant's Housing Application)* HAP & LEASE Attachment L - Place -setter - Leave Blank * The "CoC Participant Housing Application" contained therein, may be updated and amended from time to time and re -issued administratively CoC Grant #FL0211L4D001912, The City of Miami, Miami Homeless Assistance Program CE Consolidation Page 39 1111 MIAM[DADE AMENDMENT #2 OF THE AGREEMENT BETWEEN MIAMI-DADE COUNTY AND THE CITY OF MIAMI MEMORANDUM OF AGREEMENT PROGRAM PC-2021-MOA THE CITY OF MIAMI MEMORANDUM OF AGREEMENT (MOA) PROGRAM PC-2021-MOA AMENDMENT #2 OF THE AGREEMENT BETWEEN MIAMI-DADE COUNTY AND THE CITY OF MIAMI FOR THE MEMORANDUM OF AGREEMENT (MOA) PROGRAM GRANT NUMBER: PC-2021-MOA THIS AMENDMENT #2 OF THE AGREEMENT the "Agreement Amendment") is made as of 202 , by and between Miami -Dade County, through the Miami -Dade County Homeless Trust ("the County") and The City of Miami, a recipient of grant funds to serve homeless individuals, hereinafter referred to as the "P rovider. WITNESSETH: WHEREAS on May 2, 2019, the County and the Provider entered into a grant Agreement ("Agreement") which provides funding for the provision of emergency housing beds and supportive services to homeless individuals and families in Miami -Dade County. WHEREAS, on February 24, 2020, this Agreement was amended and extended for one (1) additional year pursuant to the terms of the Agreement; and WHEREAS, this Agreement provides for certain rights and responsibilities of the County; and WHEREAS, the Agreement allows for amendment and extensions at the sole discretion of the County; and WHEREAS, the County is desirous of amending the Agreement to extend said Agreement for one (1) additional year (2020-2021) pursuant to the terms of the Agreement. NOW, THEREFORE, be it resolved, for and consideration of the mutual agreements between the County and the Provider, which are set forth in this Amendment #2 of the Agreement, the receipt and sufficiency of which are acknowledged, the County and the Provider amend this Agreement as follows: ARTICLE I - Recitals The foregoing recitals are true and correct and constitute a part of this Amendment #2 of the Agreement. ARTICLE II - Ratification of the Agreement Other than expressly corrected or amended herein, all other terms and conditions of the Agreement shall remain in full force and effect. 2IPage THE CITY OF MIAMI MEMORANDUM OF AGREEMENT (MOA) PROGRAM PC-2021-MOA ARTICLE III - Amendments The Agreement is hereby amended as follows: Article 2 is replaced as follows: ARTICLE 2. AMOUNT PAYABLE Subject to available funds, the maximum amount payable for services rendered under this contract shall not exceed: • Memorandum of Agreement (MOA) $ 340,000.00 TOTAL AWARD $ 340,000.00 Both parties agree that should available Miami -Dade County funding be reduced, the amount payable under this contract may be proportionately reduced at the sole discretion and option of the County. All services undertaken by the Provider before the County's execution of this Contract shall be at the Provider's risk and expense. It is the responsibility of the Provider to maintain sufficient financial resources to meet the expenses incurred during the period between the provision of services and the payment by the County. The County, at its sole discretion, may allow Provider an advance of N/A once the Provider has submitted an appropriate request and submitted an invoice in the form required by the County. Article 3 is replaced as follows: ARTICLE 3. SCOPE OF SERVICES A. Services. The Provider shall render services in accordance with Scope of Services incorporated herein and attached hereto as Attachment A and A-1. The Provider shall implement the Scope of Services as described in Attachment A and A-1 in a manner deemed satisfactory to the County. Any modification or amendment to the Scope of Services shall not be effective until approved by the County and Provider in writing. B. Reimbursement of COVID-19 Expenditures. The County is instructing Provider to undertake protective measures to prevent or mitigate the spread of COVID-19 during the period in which public officials advise that COVID-19 special measures should be taken. The County will reimburse Provider for expenses incurred in taking such protective measures during such time period. Allowable COVID-19 expenditures are set forth in Scope for COVID-19 Expenditures incorporated herein and attached hereto as Attachment A-1. The County has sole discretion to determine if expenditures were made for the purpose of preventing or mitigating the spread of COVID-19 during the period in which public officials advised that COVID-19 special measures should be taken. Total reimbursement for incurred COVID-19 costs under this Agreement are subject to approval by the County and shall not exceed $n/a without the County's prior written approval. Payment processes and documentation requirements are set forth in Attachment A-2. 31Pa THE CITY OF MIAMI MEMORANDUM OF AGREEMENT (MOA) PROGRAM PC-2021-MOA Article 5 is replaced as follows: ARTICLE 5. EFFECTIVE TERM Both parties agree that the Effective Term of this Contract shall commence on October 1. 2020 and terminate at the close of business on September 30. 2021. Contingent on the existence of sufficient funding, performance and the approval of the County, this Contract may be extended at the County's sole discretion. The remaining language in the original Agreement remains unchanged. SIGNATURES APPEAR ON THE FOLLOWING PAGE THE CITY OF MIAMI MEMORANDUM OF AGREEMENT (MOA) PROGRAM PC-2021-MOA IN WITNESS WHEREOF, the parties have caused this five (5) page Amendment #2 of the Agreement to be executed by their respective and duly authorized officers the day and year first above written. WITNESSES: ENTITY: CITY OF MIAMI, FLORIDA A municipal corporation of The State of Florida BY: BY: TODD B. HANNON CITY CLERK ARTHUR NORIEGA CITY MANAGER Approved as to Form and Correctness: Approved as to Insurance Requirements: BY: BY: VICTORIA MENDEZ ANN-MARIE SHARPE CITY ATTORNEY RISK MANAGEMENT Affix Incorporation SEAL here ATTEST: Miami -Dade County, a political subdivision of The State of Florida HARVEY RUVIN, CLERK BY: DEPUTY CLERK DANIELLA LEVINE CAVA MAYOR DATE Affix Miami -Dade County Seal Here See memorandum dated ( ) approved as to form and legal sufficiency. M I A M I-DADE COUNTY January 4, 2021 Mr. Arthur Noriega, City Manager The City of Miami 444 SW 2"J Avenue Miami, Florida 33130 Homeless Trust 111 NW 1st Street • 27th Floor Miami, Florida 33128 T 305-375-1490 Re: 2020-2021 Primary Care Program Memorandum of Agreement (MOA) Program PC-2021-MOA miamidade.gov Dear Mr. Noriega: Enclosed, please find the Amendment #2 of the Agreement between Miami -Dade County, through Miami -Dade County Homeless Trust and The City of Miami for the following programs: Memorandum of Agreement (MOA) Program PC-2021-MOA The authorized agency signatory must sign the Agreement in blue ink along with the relevant attachments. Miami -Dade County requires that the President/Chairman of the Board execute the Agreement on behalf of the agency. However, the Executive Director may execute the Agreement if approved by a resolution of the agency's Board. A copy of the applicable Board resolution(s) must be submitted with the Agreement. In addition, the agency must affix the corporate seal to the signature page of the Agreements or notarize them accordingly. The Agreement may be returned back to the Homeless Trust office via emailed PDF scan no later than January 11, 2021. Please feel free to contact us at (305) 375-1490 if you any questions or require additional information. Thank you for your continued efforts with addressing the needed of the homeless of our community. Sincerely, 'ctoria L. Mallette Executive Director Enclosures Signature onfir s re it of the enclosed documents. 01/4/21 Signature of Ati&rized Agency Representative Dare Sergio Torres Printed Name of Agency Representative