HomeMy WebLinkAbout24339AGREEMENT INFORMATION
AGREEMENT NUMBER
24339
NAME/TYPE OF AGREEMENT
LITTLE HAITI FC, INC.
DESCRIPTION
ANTI -POVERTY INITIATIVE FUNDING AGREEMENT/LITTLE
HAITI SOCCER CLUB/FILE ID: 7435/R-20-0152/MATTER ID: 23-
793/#79
EFFECTIVE DATE
March 29, 2023
ATTESTED BY
TODD B. HANNON
ATTESTED DATE
3/29/2023
DATE RECEIVED FROM ISSUING
DEPT.
4/4/2023
NOTE
cNN
1$2
41
j .6.
CITY OF MIAMI
DOCUMENT ROUTING FORM
ORIGINATING DEPARTMENT: Office of Grants Administration
DEPT. CONTACT PERSON: Malissa T. Sutherland
NAME OF OTHER CONTRACTUAL PARTY/ENTITY: Little Haiti FC, Inc.
EXT. 1005
L
IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? ❑ YES ❑ NO
TOTAL CONTRACT AMOUNT: $ 25,000 FUNDING INVOLVED? ❑ YES ❑ NO
TYPE OF AGREEMENT:
❑ MANAGEMENT AGREEMENT
❑ PROFESSIONAL SERVICES AGREEMENT
❑ GRANT AGREEMENT
❑ EXPERT CONSULTANT AGREEMENT
❑ LICENSE AGREEMENT
OTHER: (PLEASE SPECIFY) API
❑ PUBLIC WORKS AGREEMENT
❑ MAINTENANCE AGREEMENT
❑ INTER -LOCAL AGREEMENT
E LEASE AGREEMENT
❑ PURCHASE OR SALE AGREEMENT
PURPOSE OF ITEM (BRIEF SUIVIMARI'); The attached API Agreement packet is being routed for review/signature. The API allocation
from the Mayor's Office to Little Haiti FC, Inc. for S25,000 and does not require Commission approval.
COMMISSION APPROVAL DATE: / /
FILE ID:
ENACTMENT NO.:
IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN:
ROUTING INFORMATION
Date
PLEASE PRINT AND SIGN
APPROVAL BY DEPARTMENTAL DIRECTOR
3/20/23
PRINT:LILLIAN BLONDET
J-
SIGNATURE: � is> _�.,�'
SUBMITTED TO OFFICE OF MANAGEMENT AND
BUDGET
PRINT:MARIE GOUIN
SIGNATURE:
SUBMITTED TO RISK MANAGEMENT
PRINT: ANN-MARLF0SHAABEyGomez,
ez,GomFrankFranek
Date: 2023.03.2014:57:50
SIGNATURE:-04'00'
SUBMITTED TO CITY ATTORNEY Matter ID: 23-793
D.G.S.
3/23/23
PRINT: VIC ORIA MENDEZ
SIG -'?,:. - '
APPROVAL BY ASSISTANT CITY MANAGER
'5Iqe)/3
P T:LA'RYS G
SIGNATURE:
RECEIVED BY CITY MANAGER
3
)21Z/
PRINT: A R GA V
SIGNATURE:
1) ONE ORIGINAL TO CITY CLERK,
2) ONE COPY TO CITY ATTORNEY'S OFFICE,
3) REMAINING ORIGINAL(S) TO ORIGINATING
DEPARTMENT
PRINT:
SIGNATURE:
PRINT:
SIGNATURE:
PRINT:
SIGNATURE:
PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE
EXECUTION BY THE CITY MANAGER
Date:
Send to:
Program/Project Title:
Recipient's Name:
Recipient's Address:
2T
Invoice Number: Co ED
City of Miami
Office of Grants Administration
444 SW 2nd Ave., Pi Floor
Miami, FL 33130
L -rfle Hrrti
11 / al
F c_
3)09
o
1 hereby request payment in the amount of S 0for expenses incurred in relation to
the City of Miami Anti -Poverty Initiative Activity/Program/Services provide below.
Number of People
Served/Location of
Services
o
Service Description
F e C./1/4-e
4-1 Prie? 5-, t ye/44 t
TOTAL: $ • "
certify that the Program/Service was provided in accordance to the approved Program/Project as
described in the API Funding Request Form and that expenses were incurred hi the provision of said
Prograrngervice.
411111
# ortze4 Representative
Signature
biOrl 1-C41-seCet4
e Name
-1 rr--
Title:
CITY OF MIAMI
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
This ANTI -POVERTY INITIATIVE AGREEMENT ("Agreement") is entered into
this J9V4 day of /l/iA "1', 20023 by and between the CITY OF MIAMI, a
municipal corporation of the State of Florida, located at 444 SW 2ndAvenue, Miami, FL 33130
("CITY"), and Little Haiti FC, Inc. , a Florida not for profit corporation, located at
1151 NE 210 Terrace, Miami, FL 33179 ("RECIPIENT"). The CITY and the RECIPIENT may each
be referred to as a "Party" and may collectively be referred to as the "Parties."
WHEREAS, the City created the Anti -Poverty Initiative ("API") to address poverty based
on a strategy of focusing the provision of support towards the City's residents achieving self-
sufficiency; and
WHEREAS, the RECIPIENT submitted a Request for API Funding to the City; and
WHEREAS, the CITY adopted Resolution No. R- 20 _ 0152 on May 14 , 20 20 ,
wherein the CITY approved providing funds to the RECIPIENT in the not to exceed amount of
Twenty Five Thousand dollars ($ 25,000 .00) ("Funds"), attached
and incorporated as Exhibit "A", as applicable; and
WHEREAS, the CITY agrees to enter into this Agreement with the RECIPIENT to set
forth the terms and conditions relating to the use of the Funds by the RECIPIENT.
NOW, THEREFORE, in consideration of the mutual covenants and promises herein
contained, the Parties agree as follows:
TERMS
1. RECITALS: The recitals are true and correct and are hereby incorporated into and made
a part of this Agreement.
2. TERM: The term of this Agreement shallcommence on February 27 , 2023 and
shall continue until February 27 , 2024.
3. GRANT OF FUNDS: Subject to the terms and conditions set forth herein and
RECEIPIENT'S compliance with all of its obligations hereunder, the CITY hereby agrees to make
available to the RECIPIENT the Funds to be used for the purpose(s), program(s), initiative(s), and
activity(ies) (as defined in Exhibit "B"), and as disbursed in the manner hereinafter provided.
Page 1
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
4. USE OF FUNDS: The Funds shall be used by the RECIPIENT as described in the
Scope of Work, attached and incorporated herein as Exhibit "B" and the Budget, attached and
incorporated herein as Exhibit "C" submitted by the RECIPIENT to the CITY.
DISBURSEMENT OF FUNDS:
A. The CITY shall provide Funds to the RECIPIENT in the not to exceed amount of
Twenty Five Thousand dollars ($ 25,000 .00).
B. Payment shall be made in accordance with the schedule as set forth in Composite
Exhibit "D".
C. The RECIPIENT shall provide the CITY with a City of Miami Request for Payment
Form attached and incorporated as Composite Exhibit "D" prior to any disbursement of funds
by the CITY.
Prior to any disbursement of funds by the CITY the RECIPIENT will need to provide a
valid and executed W9 form and completed City of Miami Supplier Direct Deposit
(ACH) Authorization Form, as applicable.
D. The RECIPIENT shall provide the CITY a Close -Out Report, in similar format as
Exhibit "F", at the end of the program, summarizing the services, programs and/or activities
described in the Scope of Work as Exhibit "B" and included in the Budget as Exhibit "C".
5. COMPLIANCE WITH POLICIES AND PROCEDURES: RECIPIENT understands
that the use of the Funds is subject to specific reporting, record keeping, administrative and
contracting guidelines, audit, and other requirements affecting the activities being funded by the
API Funds for the Scope of Work. RECIPIENT covenants and agrees to comply with such
requirements, and represents and warrants to the CITY that the Funds shall be used in accordance
with all of the requirements, terms and conditions contained therein, as the same may be amended
during the term hereof. Without limiting of the foregoing, RECIPIENT represents and warrants
that it will comply with, and the Funds will be used in accordance with, all applicable federal,
state, and local codes, laws, rules and regulations.
6. RECORDS. INSPECTIONS, REPORTS/AUDITS AND EVALUATION: To the
extent required by law, the Inspection and Audit provisions set forth in Sections 18-101 and
18-102 of the Code of the City of Miami, Florida, as amended ("City Code"), are deemed as
being incorporated by reference herein and additionally apply to this Agreement. The CITY shall
have the right to conduct audits of RECIPIENT'S records pertaining to the Funds and that
Page 2
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
reasonable times, and for a period of up to three (3) years following the termination ofthis
Agreement, audit, or cause to be audited, those books and records of the RECIPIENT
which are related to RECIPIENT'S performance under this Agreement. RECIPIENT agrees to
maintain all such books and records at its principal place of business for a period of three (3)
years after final payment is made under this Agreement. The CITY may also, and the
RECIPIENT shall permit, the CITY and other persons duly authorized by the CITY to inspect all
Agreement records, facilities, goods, and activities of the RECIPIENT which are in any way
connected to the activities undertaken pursuant to the terms of this Agreement, and/or
interview any clients, employees, subcontractors or assignees of the RECIPIENT as
requested by the CITY. At the request of the CITY, the RECIPIENT shall transmit to the
CITY written statements of the RECIPIENT's official policies on specified issues relating to the
RECIPIENT's activities.
RECIPIENT understands, acknowledges, and agrees that:
a) The CITY must meet certain record keeping and reporting requirements with regard to the
Funds and that in order to enable the CITY to comply with its record keeping and reporting
requirements, RECIPIENT shall maintain all records as required by the CITY; and
b) At the CITY's request, and no later than thirty (30) days thereafter, RECIPIENT shall
deliver to the CITY such reports and written statements relating to the use of the Funds as
the CITY may require from time to time; and
c) All costs and expenses of the activities described in Exhibit "C" shall be at actual cost
with no markups; and
d) RECIPIENT'S failure to comply with these requirements or the receipt or discovery (by
monitoring, evaluation, or audit) by the CITY of any inconsistent, incomplete, or
inadequate information shall be grounds for the immediate termination of this Agreement
by the CITY and the immediate reimbursement to the CITY of any and all funds or amounts
disbursed pursuant to this Agreement.
RECIPIENT represents and warrants to the City that: (i) it possesses all qualifications,
licenses and expertise required for the performance of the Scope of Work; (ii) it is not delinquent
in the payment of any sums due to the City, including payment of permit fees, occupational
licenses, etc., nor in the performance of any obligations to the City; and (iii) all personnel assigned
to perform the Scope of Work are and shall be, at all times during the term hereof, fully qualified
and trained to perform the tasks assigned to each.
Page 3
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
Any inconsistent, incomplete, or inadequate information, either received by the CITY or
obtained by the CITY, shall constitute cause for the CITY to terminate this Agreement.
7. AWARD OF AGREEMENT: RECIPIENT represents and warrants to the CITY that
it has not employed or retained any person or company employed by the CITY to solicit or
secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee,
commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with,
the award of this Agreement.
8. COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS: RECIPIENT
understands that agreements between private entities and local governments are subject to certain
laws, codes, rules and regulations, including, without limitation, laws pertaining to public records,
conflict of interest, record keeping, etc. The Parties agree to comply with and observe all applicable
laws, codes and ordinances as they may be amended from time to time.
9. INDEMNIFICATION: RECIPIENT shall indemnify, defend and hold harmless the
CITY and its officials, employees (collectively referred to as "Indemnitees") and each of them
from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's
fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of
any person or damage to or destruction or loss of any property arising out of, resulting from, or in
connection with (i) the negligent performance or non-performance of the Services contemplated
by this Agreement (whether active or passive) of RECIPIENT or its employees or subcontractors
(collectively referred to as "RECIPIENT") which is directly caused, in whole or in part, by any
act, omission, default or negligence (whether active or passive or in strict liability) of any of them,
or (ii) the failure of the RECIPIENT to comply materially with any of the requirements herein, or
the failure of the RECIPIENT to conform to statutes, ordinances, or other regulations or
requirements of any governmental authority, local, federal or state, in connection with the
performance of this Agreement even if it is alleged that the CITY, its officials and/or employees
were negligent. RECIPIENT expressly agrees to indemnify, defend and hold harmless the
Indemnitees, or any of them, from and against all liabilities which may be asserted by an employee
or former employee of RECIPIENT, or any of its subcontractors, as provided above, for which the
RECIPIENT's liability to such employee or former employee would otherwise be limited to
payments under state Workers' Compensation or similar laws. RECIPIENT further agrees to
indemnify, defend and hold harmless the Indemnitees from and against (i) any and all Liabilities
Page 4
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or
requirement, related directly to RECIPIENT's negligent performance under this Agreement,
compliance with which is left by this Agreement to RECIPIENT, and (ii) any and all claims, and/or
suits for labor and materials furnished by RECIPIENT or utilized in the performance of this
Agreement or otherwise. This provision shall survive the termination or expiration of this
Agreement, as applicable.
RECIPIENT understands and agrees that any and all liabilities regarding the use of any
subcontractor for Services related to this Agreement shall be borne solely by the RECIPIENT
throughout the duration of this Agreement and that this provision shall survive the termination or
expiration of this Agreement, as applicable.
10. REVERSION OF ASSETS: Upon the expiration, termination, or cancellation of this
Agreement, any unspent API Grant funds shall immediately revert to the possession and ownership
of the CITY and RECIPIENT shall transfer to the CITY all unused API Grant funds at the time of
such expiration, termination, or cancellation.
11. DEFAULT: If RECIPIENT fails to comply with any term or condition of this
Agreement, or fails to perform any of its obligations hereunder, then RECIPIENT shall be in
default. Upon the occurrence of a default hereunder the CITY, in addition to all remedies available
to it by law, may immediately, upon written notice to RECIPIENT, terminate this Agreement
whereupon all payments, advances, or other compensation paid by the CITY to RECIPIENT while
RECIPIENT was in default shall be immediately returned to the CITY. RECIPIENT understands
and agrees that termination of this Agreement under this section shall not release RECIPIENT
from any obligation accruing prior to the effective date of termination. Should RECIPIENT be
unable or unwilling to commence to perform the Services within the time provided or
contemplated herein, then, in addition to the foregoing, RECIPIENT shall be liable to the CITY
for all expenses incurred by the CITY in preparation and negotiation of this Agreement, as well as
all costs and expenses incurred by the CITY in the procurement of the Services, including
consequential and incidental damages.
12. CITY'S TERMINATION RIGHTS: The CITY shall have the right to terminate this
Agreement, in its sole discretion, at any time, by giving written notice to RECIPIENT at least
five (5) business days prior to the effective date of such termination. In such event, the CITY shall
pay to RECIPIENT compensation for services rendered and expenses incurred prior to the
Page 5
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
effective date of termination. In no event shall the CITY be liable to RECIPIENT for any
additional compensation, other than that provided herein, or for any consequential or incidental
damages.
13. REMEDIES FOR NONCOMPLIANCE: The CITY retains the right to
terminate this Agreement at any time prior to the completion of the services required pursuant to
this Agreement without penalty to the CITY. In that event, notice of termination of this
Agreement shall be in writing to the RECIPIENT, who shall be paid for those services performed
prior to the date of its receipt to the notice of termination. In no case, however, shall the CITY
pay the RECIPIENT an amount in excess of the total sum provided by this Agreement.
It is hereby understood by and between the CITY and the RECIPIENT that any payment
made in accordance with this Agreement to the RECIPIENT shall be made only if the
RECIPIENT is not in default under the terms of this Agreement. If the RECIPIENT is in default,
the CITY shall not be obligated and shall not pay to the RECIPIENT any sum whatsoever.
If the RECIPIENT fails to comply with any term of this Agreement, the CITY may take
one or more of the following courses of action:
(1) Temporarily withhold cash payments pending correction of the deficiency by
the RECIPIENT, or such more severe enforcement action as the CITY
determines is necessary or appropriate.
(2) Disallow (that is, deny both the use of funds and matching credit) for all or part
of the cost of the activity or action not in compliance.
(3) Wholly or partially suspend or terminate the current API Program Funds
awarded to the RECIPIENT.
(4) Withhold further API Program funding for the RECIPIENT.
(5) Take all such other remedies that may be legally available.
14. MARKETING: RECIPIENT shall consult with the City Manager, or his or her
designee, regarding all uses and displays of the recognition of the CITY. The CITY shall have the
right to approve the form and placement of all acknowledgements, which approval shall not be
unreasonably withheld.
15. INSURANCE: The required Insurance, as approved by the City of Miami
Department of Risk Management shall be provided by the RECIPIENT and all such proof shall be
Page 6
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
attached as an Exhibit to this Agreement. Those entities/individuals required to be listed as
additional insured by the Department of Risk Management shall be included on all insurance
certificates and furnished by the RECIPIENT.
RECIPIENT shall, at all times during the term hereof, maintain insurance coverage in
accordance with Exhibit "E" attached and incorporated by this reference. All such insurance,
including renewals, shall be subject to the approval of the City for adequacy of protection and
evidence of such coverage shall be furnished to the City on Certificates of Insurance indicating
such insurance to be in force and effect and providing that it will not be canceled during the
performance of the services under this contract.
Execution of this Agreement is contingent upon the receipt of proper insurance documents.
16. NONDISCRIMINATION: RECIPIENT represents and warrants to the City that
RECIPIENT does not and will not engage in discriminatory practices and that there shall be no
discrimination in connection with RECIPIENT's performance under this Agreement on account
of race, color, sex, religion, age, handicap, marital status or national origin. RECIPIENT further
covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex,
religion, age, handicap, marital status or national origin, be excluded from participation in, be
denied services, or be subject to discrimination under any provision of this Agreement.
17. ASSIGNMENT: This Agreement shall not be assigned by RECIPIENT, in whole or
in part, without the prior written consent of the CITY, which may be withheld or conditioned, in
the CITY'S sole discretion.
18. CERTIFICATIONS REGARDING DEBARMENT. SUSPENSION. AND OTHER
RESPONSIBILITY MATTERS: RECIPIENT certifies to the best of its knowledge and belief
that it and its principals:
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from covered transactions by any Federal, State, or local
agency.
b) Have not within a three (3) year period preceding the adoption of the Resolution,
attached and incorporated as Exhibit "A", as applicable, been convicted of or had a
civil judgement rendered against them for the commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State, or local) transaction or contract under a public
transaction; violation of Federal
Page 7
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
or State antitrust statutes or falsification or destruction of records, making false
statements, or receiving stolen property;
c) Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (Federal, State, or local) with commission of any of the offenses
enumerated in paragraph 16.b of this certification; and
d) Have not within a three (3) year period preceding the adoption of the Resolution,
attached and incorporated as Exhibit "A", as applicable, had one or more
public transactions (Federal, State, or local) terminated for cause or default.
Where the prospective primary participant is unable to certify to any of the statements in
this certification, such prospective participant shall submit an explanation to the CITY and the
CITY shall have the right to, in the CITY's sole discretion, to not enter into or terminate this
Agreement.
19. NOTICES: All notices or other communications required under this Agreement shall
be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return
receipt requested, addressed to the other party at the address indicated herein or to such other
address as a party may designate by notice given as herein provided. Notice shall be deemed given
on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the
date of actual receipt, whichever is earlier.
RECIPIENT
Little Haiti FC, Inc.
1151 NE 210 Terrace
Miami, FL 33179
Attn: Gomez Don Laleau
CITY
City of Miami
Office of Grants Administration
444 SW 2nd Avenue, 5th Floor
Miami, FL 33130
Attn: Lillian Blondet, Director
With copies to:
Office of the City Attorney
444 SW 2nd Avenue, Suite 945
Miami, FL 33130
Attn: Victoria Mendez, City Attorney
Page 8
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
20. PUBLIC RECORDS: Pursuant to the provisions of Section 119.0701. Florida
Statutes, RECIPIENT must comply with the Florida public records laws, specifically the
RECIPIENT must:
A. Keep and maintain public records that ordinarily and necessarily would be required
by the public agency in order to perform the service.
B. Provide the public with access to public records on the same terms and conditions
that the public agency would provide the records and at a cost that does not exceed the cost
provided in this chapter of the Florida Statutes or as otherwise provided by law.
C. Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed except as authorized by law.
D. Meet all requirements for retaining public records and transfer, at no cost, to the
CITY all public records in possession of the RECIPIENT upon termination of the contract
and destroy any duplicate public records that are exempt orconfidential and exempt from
public records disclosure requirements.
E. All records stored electronically must be provided to the CITY in a format that is
compatible with the information technology systems of the CITY.
IF THE RECIPIENT HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
RECIPIENT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO
THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS
AT (305) 416-1800, PUBLICRECORDS@MIAMIGOV.COM, AND 444 S.W.
2" AVENUE, SUITE 945, MIAMI, FL 33130.
21. CONFLICT OF INTEREST: RECIPIENT has received copies of, and/or is familiar
with, the following provisions regarding conflict of interest in the performance of this Agreement
by RECIPIENT. RECIPIENT covenants, represents and warrants that it will comply with all such
conflict of interest provisions including, but not limited to:
(a) the Code of the City of Miami, Florida, Chapter 2, Article V; and
(b) Miami -Dade County Code, Section 2-11.1.
22. GOVERNING LAW, VENUE, AND FEES: This Agreement shall be construed
and enforced according to the laws of the State of Florida. Venue in all proceedings shall be in
Page 9
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
Miami -Dade County, Florida and the parties explicitly agree to the use of this venue. The term
"proceedings" shall include, but not be limited to, all meetings to resolve the dispute, including
voluntary arbitration, mediation, or other alternative dispute resolution mechanism. The parties
both waive any defense that venue in Miami -Dade County is not convenient. In any civil action or
other proceedings between the parties arising out of the Agreement, each party shall bear its own
attorney's fees.
23. WAIVER OF JURY TRIAL: Neither the RECIPIENT, nor any assignee,
successor, heir or personal representative of the RECIPIENT, nor any other person or entity, shall
seek a jury trial in any lawsuit, proceeding, counterclaim or any other litigation procedure based
upon or arising out of any of the Agreement and/or any modifications, or the dealings or the
relationship between or among such persons or entities, or any of them. Neither the RECIPIENT,
nor any other person or entity will seek to consolidate any such action in which a jury trial has
been waived with any other action. The provisions of this paragraph have been fully discussed by
the parties hereto, and the provisions hereof shall be subject to no exceptions. No party to this
Agreement has in any manner agreed with or represented to any other party that the provisions of
this paragraph will not be fully enforced in all instances.
24. MISCELLANEOUS PROVISIONS:
A. Title and paragraph headings are for convenient reference and are not a part of this
Agreement.
B. No waiver or breach of any provision of this Agreement shall constitute a waiver
of any subsequent breach of the same or any other provision hereof, and no waiver shall be
effective unless made in writing.
C. In the event of conflict between the terms of this Agreement and any terms or
conditions contained in any attached documents, the terms of this Agreement shall control.
D. Should any provision, paragraph, sentence, word or phrase contained in this
Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise
unenforceable under the laws of the State of Florida or the City of Miami, such provision,
paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to
conform with such laws, or if not modifiable, then same shall be deemed severable, and in either
event, the remaining terms and provisions of this Agreement shall remain unmodified and in full
force and effect or limitation of its use.
Page 10
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
25. NON-DELEGABILITY: The obligations undertaken by the RECIPIENT pursuant to
this Agreement shall not be delegated or assigned to any other person or firm, in whole or in part,
without the CITY'S prior written consent, which may be withheld in the CITY'S sole discretion.
26. SUCCESSORS AND ASSIGNS: This Agreement shall be binding upon the parties
hereto, their heirs, executors, legal representatives, successors, or assigns.
27. INDEPENDENT CONTRACTOR: RECIPIENT, its contractors, subcontractors,
employees, and agents shall be deemed to be independent contractors, and not agents or employees
of the CITY, and shall not attain any rights or benefits under the civil service or pension programs
of the CITY, or any rights generally afforded its employees; further, they shall not be deemed
entitled to Florida Workers' Compensation benefits as employees of the CITY.
28. NO THIRD -PARTY BENEFICIARY RIGHTS: No provision of this Agreement shall,
in any way, inure to the benefit of any third parties so as to constitute any such third party a
beneficiary of this Agreement, or of anyone or more of the terms hereof, or otherwise give rise to
any cause of action in any party not a party hereto.
29. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the
availability of funds and continued authorization for program activities and the Agreement is
subject to amendment or termination due to lack of allocated and available funds, reduction or
discontinuance of funds or change in laws, codes, rules, policies or regulations, upon thirty (30)
days' notice.
30. RECIPIENT CERTIFICATION: The RECIPIENT certifies that it possesses the legal
authority to enter into this Agreement pursuant to authority that has been duly adopted or passed
as an official act of the RECIPIENT'S governing body, authorizing the execution of this
Agreement, including all understandings and assurances contained herein, and directing and
authorizing the person identified as the official representative of the RECIPIENT to act in
connection with this Agreement and to provide such information as may be requested. The
aforementioned authorization for the RECIPIENT is attached and incorporated as Exhibit "G"
31. AUTHORITY: Each person signing this Agreement represents and warrants that he
or she is duly authorized and has legal capacity to execute and deliver this Agreement. Each party
represents and warrants to the other that the execution and delivery of the Agreement and the
performance of such party's obligations and the certifications hereunder have been duly authorized
Page 11
City of Miami
API Funding Agreement
Little Haiti FC, Inc.
and that the Agreement is valid and legal agreement binding on such party and enforceable in
accordance with its terms.
32. CONSTRUCTION: Should the provisions of this Agreement require judicial or arbitral
interpretation, it is agreed that the judicial or arbitral body interpreting or construing the same shall
not apply the assumption that the terms hereof shall be more strictly construed against one party
by reason of the rule of construction that an instrument is to be construed more strictly against the
party which itself or through its agents prepared same, it being agreed that the agents of both parties
have equally participated in the preparation of this Agreement.
33. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and
entire agreement between the parties relating to the subject matter hereof and correctly sets forth
the rights, duties, and obligations of each to the other as of its date. Any prior agreements,
promises, negotiations, or representations not expressly set forth in this Agreement are of no force
or effect. No modification or amendment hereto shall be valid unless in writing and executed by
properly authorized representatives of the parties hereto.
34. COUNTERPARTS AND ELECTRONIC SIGNATURES: This Agreement may be
executed in any number of counterparts, each of which so executed shall be deemed to be an
original, and such counterparts shall together constitute but one and the same Agreement. The
parties shall be entitled to sign and transmit an electronic signature of this Agreement (whether
by facsimile, PDF or other email transmission), which signature shall be binding on the party
whose name is contained therein. Any party providing an electronic signature agrees to promptly
execute and deliver to the other parties an original signed Agreement upon request.
[Remainder intentionally left blank; Signature page to follow]
Page 12
City of Miami
AN Funding Agreement
Little Haiti FC, Inc.
IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed
by their respective officials thereunto duly authorized, this the day and year above written.
ATTEST:
"CITY"
CITY OF MIAMI, a municipal
corporation of the Sta e of Florida
By:
Cter D e: Arthur Noriega V, ity Manager Date:
tan la03.•
APPROVED AS TO FORM AND APPROVED AS TO INSURANCE
CORRECTNESS: REQUIREMENTS:
Digitally signed by Gomez,
Gomez, Frank Datek2023.03.2014:58:10
04'00'
Victoria Mendez ( Date
City Attorney Matter ID: 23-793
D.G.S.
ATTEST:
3/23/23 Ann -Marie Sharpe, Director Date:
Risk Management
Print Name: ► HT PrA'Tik
Title: "t ne hRE+R
"RECIPIENT"
Little Haiti FC, Inc.
A Florida Not-For-P. ofit Corporation
By:
Print Naive:
Title:
Page 13
Y2
2/23/23, 2:29 PM Detail by Entity Name
DIVISION OF CORPORATIONS
'f
1 Vrgi � i r rJ) ( I.} ,\, i,. r r
.�, ry lll:t.t[tl . heir of F+orid°
Department of State / Di,,is cn of Corporations / Search Records / Search by Entity Name /
Detail by Entity Name
Florida Not For Profit Corporation
LITTLE HAITI FC INC
Filing Information
Document Number
FEI/EIN Number
Date Filed
State
Status
Last Event
Event Date Filed
Event Effective Date
Principal Address
1151 NE 210 Terrace
MIAMI, FL 33179
Changed: 04/21/2021
Mailing Address
1151 NE 210 Terrace
MIAMI, FL 33179
N15000001083
47-2754120
01/26/2015
FL
ACTIVE
AMENDMENT
05/01/2015
NONE
Changed: 04/21/2021
Registered Agent Name & Address
Laleau, Gomez
1151 NE 210 Terrace
MIAMI, FL 33179
Name Changed: 04/24/2017
Address Changed: 04/21/2021
Officer/Director Detail
https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial&searchNameOrder=LITTLEHAITIFC .. 1/3
2/23/23, 2:29 PM Detail by Entity Name
Name & Address
Title Co -President
LALEAU, GOMEZ
1151 NE 210 Terrace
MIAMI, FL 33179
Title Secretary, Treasurer
ARMAND, JEAN
PO Box 380335
MIAMI, FL 33238
Title Co -President, Fundraising Committee Chairman
KAUDERER, MALLORY
300 NE 71 Street
MIAMI, FL 33138
Title VP
Prunier, Samuel
PO Box 380335
M IAM I, FL 33238
Title VP, Public Relations
Santangelo, Pat
PO Box 380335
MIAMI, FL 33238
Title VP, Fundraising Committee Member
Jean -Mary, Reginald, Father
PO Box 380335
M IAM I, FL 33238
Annual Reports
Report Year Filed Date
2021 04/20/2021
2021 04/21/2021
2022 04/18/2022
Document Images
04/1812022 —ANNUAL REPORT
04/21/2021—AMENDEDANNUAL REPORT
04/20/2021 —ANNUAL REPORT
04/20/2020 —ANNUAL REPORT
03113/2019 —ANNUAL REPORT
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=EntityName&directionType=Initial8searchNameOrder=LITTLEHAITIFC .. 2/3
2/23/23, 2:29 PM
03/2012018 —ANNUAL REPORT
04/24/2017 —ANNUAL REPORT
0510312016 —ANNUAL REPORT
05/01/2015 —Amendment
01126/2015 — Domestic Non -Profit
• Detail by Entity Name
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
View image in PDF format
vkn' C.nrnnr,itioni
://search.sunbiz.org /Inq uiryfCorporationSearch/SearchResultDetail?inq ui rytype= Ent tyName&directionType=lnitial&searchNameOrder=UTTLEHAITIFC ... 3/3
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT A - CITY OF MIAMI RESOLUTION
City of Miami
Legislation
Resolution
Enactment Number: R-20-0152
City Hall
3500 Pan American Drive
Miami, FL 33133
www.miamigov.com
File Number: 7435 Final Action Date:5/14/2020
A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S),
AMENDING THE ANTI -POVERTY INITIATIVE ("API") GUIDELINES TO ALLOW FOR
THE PURCHASE OF ESSENTIAL SERVICES DURING A DECLARED STATE OF
EMERGENCY, TO ALLOW FOOD DISTRIBUTIONS, AND TO CLARIFY THAT IN
ADDITION TO CITY OF MIAMI ("CITY") DEPARTMENTS, THE OFFICES OF CITY
ELECTED OFFICIALS SHALL QUALIFY AS ELIGIBLE RECIPIENTS OF API FUNDS;
FURTHER RATIFYING, CONFIRMING, AND APPROVING, PURSUANT TO SECTION
18-72(B)(20) OF THE CODE OF THE CITY OF MIAMI, FLORIDA, AS AMENDED,
THAT ALLOCATIONS OF API FUNDS IN AN AGGREGATE AMOUNT OF FIFTY
THOUSAND DOLLARS ($50,000.00) OR LESS IN ANY SINGLE CITY FISCAL YEAR
TO ANY SINGLE ENTITY PURSUANT TO THE API GUIDELINES SHALL NOT
REQUIRE CITY COMMISSION APPROVAL; AUTHORIZING THE CITY MANAGER TO
EXECUTE ANY AND ALL NECESSARY DOCUMENTS, ALL IN A FORM
ACCEPTABLE TO THE CITY ATTORNEY, FOR SAID PURPOSE.
WHEREAS, pursuant to Resolution No. 14-0362 adopted on September 23, 2014, the
City Commission established the Anti -Poverty Initiative Program ("API") to address poverty
through a strategy of focusing the provision of support towards the goal of having City of Miami
("City") residents achieve self-sufficiency; and
WHEREAS, pursuant to Resolution No. 15-0106 adopted on March 12, 2015, the City
determined that the most effective means of allocating API funding among the City Commission
Districts should be based on the level of poverty within each District; and
WHEREAS, pursuant to Resolution No. 16-0044 adopted January 28, 2016, all API
funding recipients are required to execute an agreement with the City that addresses the scope
of services, performance measures, invoicing, conflicts of interest, and other material terms that
may be applicable for the use of any funds; and
WHEREAS, the Novel Coronavirus ("COVID-19") pandemic and the related economic
impacts has brought to light the need to expand the allowable uses of API funds to include food
distributions consistent with the needs identified by this Resolution; and
WHEREAS, during a declared State of Emergency or natural disaster, it is also
appropriate to allow for the use of API funds for essential supplies that may be necessary; and
WHEREAS, the City Commission ratifies, confirms and approves that pursuant to
Section 18-72(b)(20) of the Code of the City of Miami, Florida, as amended ("City Code"),
allocations of API funds in an aggregate amount of fifty thousand dollars ($50,000.00) or Tess in
any single fiscal year to any single entity pursuant to the API guidelines shall not require City
Commission approval; and
WHEREAS, the API guidelines already include City Departments as eligible recipients
and the City Commission wishes to clarify that the offices City elected officials shall also be
included as eligible recipients;
NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF
MIAMI, FLORIDA:
Section 1. The recitals and findings contained in the Preamble of this Resolution are
adopted by reference and incorporated herein as if fully set forth in this Section.
Section 2. The City Commission hereby amends the API guidelines to allow for the use
of API funds for food distributions.
Section 3. The City Commission hereby amends the API guidelines to allow for the use
of API funds to purchase essential supplies during a State of Emergency, natural disaster, or
other economic crisis.
Section 4. The City Commission hereby amends the API guidelines to clarify that
elected official offices shall be an eligible recipients of API funding.
Section 5. The City Commission hereby ratifies, confirms, and approves pursuant to
Section 18-72(b)(20) of the City Code, that allocations of API funds in an aggregate amount of
fifty thousand dollars ($50,000.00) or Tess in any single City fiscal year to any single entity
pursuant to the API guidelines shall not require City Commission approval.
Section 6. The City Manager is authorized' to execute any and all necessary
documents, all in a form acceptable to the City Attorney, for said purpose.
Section 7. This Resolution shall become effective immediately upon its adoption and
signature of the Mayor.2
APPROVED AS TO FORM AND CORRECTNESS:
ria i ` f dez. City ttor
The herein authorization is further subject to compliance with all legal requirements that may be
imposed, including but not limited to, those prescribed by applicable City Charter and City Code
provisions.
2 If the Mayor does not sign this Resolution, it shall become effective at the end of ten (10) calendar days
from the date it was passed and adopted. If the Mayor vetoes this Resolution, it shall become effective
immediately upon override of the veto by the City Commission.
T. Sutherland, Malissa
From: Pascual, Nikolas
Sent: Wednesday, February 15, 2023 11:24 AM
To: T. Sutherland, Malissa
Subject: Re: API Approval inquiry: Little Haiti FC, Inc.
Hey Melissa,
They were asked to reduce the amount to 25k.
All the best,
-Nikolas Pascual
From: T. Sutherland, Malissa <MTrevino@miamigov.com>
Date: Wednesday, February 15, 2023 at 11:15 AM
To: Pascual, Nikolas <NPascual@miamigov.com>
Cc: Pat Santangelo <Itpatmiami@gmail.com>, 'JONEL25@HOTMAIL.COM' <JONEL25@HOTMAIL.COM>,
glaleau@dadeschools.net <glaleau@dadeschools.net>
Subject: API Approval inquiry: Little Haiti FC, Inc.
Good Morning Nik,
Hope all is well. Please advise if there is a pending API Funding Request awaiting approval for this entity?
Regards,
Malissa T. Sutherland, MPA, PMP
Administrative Assistant II
Office of Grants Administration
City of Miami
444 SW 2nd Ave., 5th Floor, Miami, FL 33130
T: 305-416-1005
1
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT B — SCOPE OF WORK
Insert Pages 2 & 3 from Anti -Poverty Funding Request Form
City of Miami
Anti -Poverty Initiative Program
Funding Request Form
ORGANIZATION AND PROGRAM/PROJECT INFORMATION
Organization History and Background Information:
LHFC has been serving the youth of Little neighborhood in the city of Miami for over
8 years.. LHFC has approximately 200 children, boys and and girls from the ages of
5-9 years old in addition of two semi professional teams (UPSL). In the past 6 years
100% of the youth participating graduated high school. 80% went to higher education
Is your program/project providing direct services to residents of the City of Miami? YesE✓ No❑
Number of residents your entity will serve:
Frequency of Service:
Age Group Served:
200 Children
4 days Per week
5-19 Years old
Is your program/project impacting one of Miami's disadvantaged communities? Yes ❑✓ No
Geographic Area Served (specific to this project/program).
District Served (1, 2, 3, 4, 5, Citywide) 5
Neighborhood/Community being served: Little Haiti, Liberty City
Program/Project Priority area (Select one):
❑ Educational Programs for children, youth and adults
• Crime Prevention
❑ Elderly meals, transportation, recreational and health/wellness related activities At-
❑ risk youth or youth summer job programs
❑ Transportation services and programs
❑ Job development, retention and training programs
❑ Homeless Services
I Food Distribution
❑ Essential supplies, during a State of Emergency, natural disaster, or economic crisis
Page 2 of 5
Return this form to: mtrevino@miamigov.com
(Last Revised May 15, 2020)
City of Miami
Anti -Poverty Initiative Program - Funding Request Form
Program/Project Title: Little Haiti FC, Inc
Project/Program Description: LHFC is a Free Youth Soccer Program for Boys and Girls
raging from 5-19 Yrs old. All neighborhood children and welcomed free of charge. LHFC
LHFC consists of Competitive Level U8,U10, U12,U15,U17,U19 plus Two UPSL
Teams. LHFC is a premier program within Florida and Beyond. LHFC competes successfully with every regional program, and provides academic support to every youth
Program Start Date: March 1, 2023 Program End Date: March 1, 2024
Please describe how this program/project and funding will alleviate poverty within the City of
Miami?
Over the past 5 years, 100% of the children graduated high school and 80% went to higher education. The program has been proven as
an alternative N gang. ethanol Mosier. and teen pngnancy. eunng the peat 12mone¢ none ofae mambas of this pmpam ane known naanb ra orgattga. Note h. a loon aanotcE and Noe have not bon any unplanned pn-gnanoes \k'c also pre den on
Many of our players receive full scholarships to college and some lucrative professional soccer contracts improving the chances that they will avoid poverty.
IMPACT AND PERFORMANCE:
Describe overall expected outcomes and performance measures for this project/program:
The expected outcome is 100% of the current high school seniors in the program will graduate high school and 80% of the high school seniors will go on to higher education.
LHFC will provide the city with the names of the current high school students in the program and proof of graduation from high school and document which institutions of higher education they will be attending.
Please attach additional pages to the back of this packet, if the space above is not sufficient.
Page 3 of 5
Return this form to: mtrevino@miamigov.com
(Last Revised May 15, 2020)
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT C — BUDGET
Insert Page 4 from Anti -Poverty Funding Request Form
City of Miami
Anti -Poverty Initiative Program - Funding Request Form
FUNDING REQUEST INFORMATION:
Amount Requested: $25,000
Explain how the City of Miami Anti -Poverty funding will be utilized:
We will effectuate the purchase of game and practice uniforms,soccer balls,nets
field equipments,coaches,stipends,league/tournaments registrations, club registration
club insurance,referee fees,Transportation,and player's passes
Itemize API funding related to expenditures below:
Personnel Salaries & Wages: $3,000/Month
Personnel Benefits $
Space Rental: $
Utilities (Electricity, Phone, Internet): $
Supplies: $10,000
Marketing: $2,000
Transportation (Participants): $6,000
Meals (Participants): $4,000
Professional Services (List each):
Other (please describe):
Other (please describe):
Other (please describe):
Page 4of5
Return this form to: mtrevino@miamigov.com
(Last Revised May 15, 2020)
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
COMPOSITE EXHIBIT "D"
API AGREEMENT
COMPOSITE EXHIBIT "D"
PAYMENT SCHEDULE
1. The CITY shall pay the RECIPIENT, an amount not to exceed Twenty Five Thousand
$25,000 for the services provided pursuant to this Agreement.
2. Request for Payments should be submitted to the CITY in a form provided by the City and
included in this Exhibit as Request for Payment Form.
3. The RECIPIENT must submit the final request for payment to the CITY within 30 calendar
days following the expiration date or termination date of this Agreement in a form provided by
the CITY. If the RECIPIENT fails to comply with this requirement, the RECIPIENT shall
forfeit all rights to payment and the CITY shall not honor any request submitted thereafter.
4. Schedule of payments to RECIPIENT will be as follows: One time payment
5. Any payment due under this Agreement may be withheld pending the receipt and approval by
the CITY of all reports and information due from the RECIPIENT as a part of this Agreement
and any modifications thereto.
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT E - INSURANCE REQUIREMENTS
I. Commercial General Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Each Occurrence $300,000
General Aggregate Limit $600,000
Personal and Adv. Injury $300,000
Products/Completed Operations $300,000
B. Endorsements Required
City of Miami listed as additional insured
Contingent & Contractual Liability
Premises and Operations Liability
Primary Insurance Clause Endorsement
II. Business Automobile Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Combined Single Limit
Scheduled Autos
Including Hired, Borrowed or Non -Owned Autos
Any One Accident $ 300,000
B. Endorsements Required
City of Miami listed as an additional insured
III. Worker's Compensation
Limits of Liability
Statutory -State of Florida
Waiver of Subrogation
Employer's Liability
A. Limits of Liability
$100,000 for bodily injury caused by an accident, each accident
$100,000 for bodily injury caused by disease, each employee
$500,000 for bodily injury caused by disease, policy limit
IV. Professional Liability/Errors and Omissions Coverage (if applicable)
Combined Single Limit
Each Claim
General Aggregate Limit
Retro Date Included
$ 250,000
$ 250,000
The above policies shall provide the City of Miami with written notice of cancellation or
material change from the insurer in accordance to policy provisions.
Companies authorized to do business in the State of Florida, with the following qualifications,
shall issue all insurance policies required above:
The company must be rated no less than "A-" as to management, and no less than "Class V"
as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M.
Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of
insurance are subject to review and verification by Risk Management prior to insurance
approval.
A' DATE (MMIDOlYYYY)
1 ,,� . CERTIFICATE OF LIABILITY INSURANCE, 05:2512022
THIS. CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE' OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER,
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to
the certificate holder in lieu of such endorsement(s).
PRODUCER CAME:ONTACT
N
Sa;3lsr & Company, Inc. i PHONE 1 FAX
! tac No ExtlL 800-622-7370 i A•c..t1Q1 803-250 4017
A"RIAIL
0 E trisha@Y-;sadters 0rts.LOm
I ADDRESS: t f� t
3014 Devine Street, : PRODUCER
i 'qfS OhgRIP :
CalUmbis, SC, 29250
INSURERtSi AFFORDING COVERAGE } -NAIC R
6YSURED SSi f Program Management Inc. INSURER A : A:eor.rl 1 Sp:xialty Inr',a,:x Celanany' 2c'89ti
Little Haiti FC Inc.
I INSURER B :
INSURER C :
PO Bcx 380335 I-
! INSURER D :
FL,
Miarni, 33238
I INSURER E:
' INSURER F:
COVERAGES
CERTIFICATE NUMBER: A-SP-SU-22-05-24-253540
REVISION NUMBER:
TNIS IS to' CERTIFY THAT THE POLICIE'a OF iNSUF:-NS;E LISTED 9£LOW HAVE BEEN :SSUE0 TO : rE INSURBo NA^AEO ABOVE FOR THE PCLUCt' ?<_.R CO INDICATED. NO Rrri1^orANONG A#Y REOt;tREuENr• TERM CR
CONOEriOf3 OF my CCNTR'CT OR OTHE40O.0051ENT wCH R'E...P::CT TO WHICH TH:» CERT'FIOATS F tAAY BE ISSiJAOOR MAY PERTAIN, THE `."iSUR,M CE ...,FORDED 6Y THE PGL 01ES OESCRIBEO HEREIN IS SUBJECT rOALL
1H£ Tfi M6, EXCLUSIONS ANO CONDITIONS OF SJCH.PCLUClES. :JOTS SMOAVN MAY 4AV5 SEEN REDUCED 3Y PAID CLANS.
dS.INSIR
TYPE OF INSURANCE
AC
I L
M
RCP 1r:Y NUM4GR
MarrY,NNYI
a w'm
LIMITS
A
GENERAL
X
i LARILITY
C,^,M AER:CA.. ^GENERAL LIABILITY
Y
t4
S0OIOGLo00001-00
05/2512022
05/25,/202s
EACH CC'r: t3RR=yCE i $ 1 000 Q(}�, {,•'Q .
DAr,1, OE.I0 PREiMIBEE: I, 300 000•00
R=N T ED MITE ore Dremtsas i
CLAIMS -MADE i X ! OCCUR
`
MEC EXP tartyane*r,erson) is 5 000.00
X
INCLUDES ATHLETIC PARTICIPANTS
AGGREGATE LIMIT APPLIES PER:
PEE.SONA:. B ADV INJURY is 1,000,000.00
GENERAL
GE ER;;L AGGr2EGArc is 3.000.00Q,00
PRO!'UCTS - COMPIOP AGG I S 2,000,000.00
AUTOMOBILE
f ra`a'tT t'
COMBINED SINGLE LIMIT j
it:.r acla:ser.I I S
ANY AUTO f---' HIRED AUTOS
ALL
ALTOS
I SCHEOULED;
M I AUTOS
I .
OWMCD ( 1 NOt4-OWNED AUTO
11
BODILY INJURY (Per ,:e:Sanj
BODILY INJURY (Per accident; €S
:
+7
- I
€,CP_PTY DAMAGE.e
Pi,' accident*, `
i UMBRELLA IIAS t OCCi1R.
—..� EXCESS LfAB '
I k CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE S
DEDUCTIBLE
I RETENTION $
lg
,g
iMaIRKERSCCA4PerSAIION
ANDE4eKCYERSUASITY
ANYPRCti=' ^�rrcRP5J1T AEx3 LRii•E
oict5v4 ,8ER r.:,,GaLC' ?
Ableahayilmf)
11446, describe under '
SPECIAL PROVISIONS below
NIA
i "/C STAR:- 1 1 OTH- I
L^si.Y� 3:. S Fri.
`:L eACr; 1;CCJC'e.NT f $
. -. tI5EASE- EA =MPL OYSS �S
'Ew. DISEASE- POLICY UM !S
A
OTHER
Abuse/Maiestation
V
SQO19GL000001-00
05125/2022
05/25i2023
c acn Occurrence: $ 1,000,000.00 Agcregate: S 1,000,C50.00
DESCRIPTION OF OPERATIONS i LOCATIONS 1 VEHICLES (Attach AGGRO 101, Additional Remarks Schedule, If mare ;Dace is required)
L ability Policy Deductible: 50.00 Deductible for .Bodily Injury and $ 1000.00 per Property Damage Claim, ISO
Occurrence form CG 00 01 04 13 and Company's specific forms. Coverage for Participant Legal Liability requires that
every participant signs a waiver/release. The certificate holder is named as. Additional Insured with respect to (continued oh next page)
CERTIFICATE HOLDER
CANCELLATION
.CITY OF MIAMI
444. SW 2nd Ave
Miami, FL, 33130
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE V ALL 3E DELIVERED IN ACCORDANCE WMTH 31E POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
r ice'. -i J. !•. �.—<.._. _:�
Mark Di Perno
Arfnn'IF [gn4Cin'ii TI.,_ AreNon Arnon
?»POS.. "fnno er/Iors rnnann AT[ni.i AJ[ .i..1.&. ......n.,....t
IGENCY
I Sadler & Company, Inc.
1 POUCY NUMBER
j SO019GL000001-DO
CARRIER
I NAIL CODE
Accelerant Specialty insurance Company 16890
INAMED INSURED
Little Haiti FC Inc.
PO Box 380335
Miami,
IFL, 33238
EFFECTIVE DATE; 05/25/2022
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,4
FORM NUMBER: 25 FORM TITLE: Cert/f cate of Liability Insurance
negligent acts or omissions of the Narned Insured and only with respect to the Operations of the Insured during the coverage period.
RE: Registered Soccer participants: 05125/2022 - 0512512023:
ACORO 25 (20t6/031
The ACORD name and IoQo are registered mark of ACORD 019 38- 2009 ACORD CORPORATION. All rights reserved.
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT F — CLOSE-OUT REPORT
The Close Out Report must be completed at the end of the program.
City of Miami
Anti -Poverty Initiative Program Close -Out Report
Date: Allocation Amount:
Program/Project Title:
Recipient's Name:
Recipient's Address:
Please provide the information in reference to all the services provided with the City of Miami Anti -Poverty
Initiative:
Program Start Date and End Date
Program/Project Priority Area
Description of Project/Activity/Service
District where Project/Activity/Service were
Provided
District 1, District 2, District 2, District 3, District 5 and/or
Citywide
Location of Project/Activity/Service (ie. Site,
neighborhood, area)
Total Number of People Served
Frequency of Project/Activity/Service
I certify that the Program/Service was provided in accordance to the City of Miami Anti -Poverty Initiative Program
Guidelines
Signature
Date
Type Name
Title:
Return to:
City of Miami
Office of Grants Administration
444 SW 2nd Ave., 5th Floor
Miami, FL 33130
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT G - RECIPIENT'S CORPORATE RESOLUTION
CORPORATE RESOLUTION
WHEREAS, L irde 1+61-1T, F- C.
a Florida L L E- , desires to enter
into a Agreement with the City of Miami, a copy of which is attached hereto; and
WHEREAS, the Board of Directors at a duly held corporate meeting has considered the
matter is accordance with the Articles and By -Laws of the not -tor -profit corporation;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS
that Gomez Don Laleau
are/is hereby authorized and instructed to enter
into the Agreement and undertake the responsibilities and obligations as stated in such
proposed Agreement in the name and on behalf of this corporation with the City: of Miami
upon terms and conditions contained in the proposed Agreement to which this resolution is
attached.
DATED this
ATTEST:
Ti4 °":/4../s
CORPORATE S ECR.ETARY
day of
Print Name:'peat,/ n9
PS
MoLi o
PRESI
Print Nante:Gomez Dontaieau
�t*Rr°tif(r JUD rHEVADWEYGREY
* t Commtssian # GG 35325g
� * Expires August 12, 2023
r,OF Ft Baiatd Thra BON NotarySeNldu
(CORPORATE SEAL)
a(-t(