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HomeMy WebLinkAbout24884AGREEMENT INFORMATION AGREEMENT NUMBER 24884 NAME/TYPE OF AGREEMENT MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC. DESCRIPTION FUNDING AGREEMENT/CONSTRUCT & COMPLETE A NEW CLASSROOM ANNEX AT 3515 S. DOUGLAS RD/FILE ID: 14315/R-23-0334 EFFECTIVE DATE February 22, 2024 ATTESTED BY NICOLE EWAN ATTESTED DATE 3/20/2024 DATE RECEIVED FROM ISSUING DEPT. 3/22/2024 NOTE DOCUSIGN AGREEMENT BY EMAIL CITY OF MIAMI DOCUMENT ROUTING FORM ORIGINATING DEPARTMENT: Office of Management & Budget DEPT. CONTACT PERSON: Gabriel Brito EXT. 305-416-1203 NAME OF OTHER CONTRACTUAL PARTY/ENTITY: Macedonia Missionary Baptist Church of Miami, Inc. (MFE) IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? ❑ YES ® NO TOTAL CONTRACT AMOUNT: $397,118.00 FUNDING INVOLVED? ® YES ❑ NO TYPE OF AGREEMENT: ❑ MANAGEMENT AGREEMENT ❑ PROFESSIONAL SERVICES AGREEMENT ® GRANT AGREEMENT ❑ EXPERT CONSULTANT AGREEMENT ❑ LICENSE AGREEMENT ❑ PUBLIC WORKS AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ INTER -LOCAL AGREEMENT ❑ LEASE AGREEMENT ❑ PURCHASE OR SALE AGREEMENT OTHER: (PLEASE SPECIFY): MIAMI FOR EVERYONE GRANT AGREEMENT PURPOSE OF ITEM (BRIEF SUMMARY): Approval of the Miami For Everyone Grant Agreement with Macedonia Missionary Baptist Church of Miami, Inc. (District 2 project) for the construction and completion of a new classroom annex, to include parking lot improvements, security fencing/gate, and digital audio equipment. COMMISSION APPROVAL DATE: 7/27/2023 FILE ID:14315 ENACTMENT NO.: R-23-0334 IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN: ROUTING INFORMATION Date PLEASE PRINT AND SIGN APPROVAL BY DEPARTMENTAL DIRECTOR March 8, 2024 I 15:18:51 EST PRINT: MARIE SIGNATURE: "MAGGIE" GOUIN �DocuSfgnetl by: ,_ ; SUBMITTED TO RISK MANAGEMENT March 8, 2024 I 15:29:26 EST PRINT: ANN%I SIGNATUR it L&RPE DocuSignetl by: : Fro1,,, " �°qs SUBMITTED TO CITY ATTORNEY /� EDT PRINT: VIC SIGNATURE: It6M1 DEZ DocuSignetl by: „ March 15, 2024 I 15:12:28 RECEIVED BY CFO/ ASSISTANT CITY MANAGER March 19, 2024 I 08:49:49 EDT PRINT: LA SIGNATURE: PRINT: ARTHU`I SIGNATURE FOAM DocuSignetl by: �sruvi" 'N`oRRGA V. by: QV utiv Nerianq//,v •'- 856 C F 6 C 372 D D 42 A APPROVAL BY CITY MANAGERDocuSignetl March 19, 2024 I 11:17:01 EDT ATTESTED BY CITY CLERK March 20, 2024 I 08:44:33 EDT PRINT: TODD SIGNATURE B. HANNON �DocuSfgnetl by: 1B,fig47,A3,D4„_ PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE EXECUTION BY THE CITY MANAGER City of Miami MFE Funding Agreement CITY OF MIAMI MIAMI FOR EVERYONE FUNDING AGREEMENT This MIAMI FOR EVERYONE AGREEMENT ("Agreement") is entered into this 22nd day of February. 2024 by and between the CITY OF MIAMI, a municipal corporation of the State of Florida, located at 444 SW 2nd Avenue, Miami, FL 33130 ("CITY"), and MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC. a Florida not for profit corporation, located at 3515 SOUTH DOUGLAS ROAD, MIAMI FL ("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 Miami For Everyone ("MFE") Program to assist communities facing the long-term complications resulting from declared emergencies and to address the specific needs of the most vulnerable residents and businesses, through a strategy of focusing the provision of support towards priority areas of need that will further stabilize economic conditions within City Districts; and WHEREAS, the RECIPIENT submitted a Request for MFE Funding to the City; and WHEREAS, the CITY adopted Resolution No. R-23-0334 on July 27th, 2023, wherein the CITY approved providing funds to the RECIPIENT in the not to exceed amount of Three Hundred Ninety Seven One Hundred Eighteen dollars ($397,118.00) ("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 shall commence on February 26, 2024 and shall continue until February 26, 2025. 3. TERM EXTENSION: In the event that RECIPIENT believes that they will not be able to complete the purpose(s), program(s), initiative(s), and/or activity(ies) (as defined in Exhibit "B") City ofMiami MFE Funding Agreement by end of the original TERM, the RECIPIENT may submit a written request for no more than two (2) additional six (6) month time extensions beyond the current TERM, and said request(s) may be withheld or conditioned, in the CITY'S sole discretion. The request for the time extension must be in writing and submitted to the CITY no later than sixty (60) calendar days prior to the expiration of the original or extended TERM. 4. 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), programs), initiative(s), and activity(ies) (as defined in Exhibit "B"), and as disbursed in the manner hereinafter provided. 5. USE QF 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 Three Hundred Ninety Seven Thousand One Hundred Eighteen dollars ($397,118.00). B. Payment shall be made on a reimbursement basis 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 (ACI) 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". 6. COMPLIANCE WITH POLICIES AND PROCEPj7RESi RECIPIENT understands #L.t Fl.a .. . eF kl,� F.. d. i. ...i�1®tea t �eciGc :�prrrtirwvurcl lupins, LiorciinioF.t[1.LiVG mina contracting guidelines, audit, and other requirements affecting the activities being (funded by the MFE 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 the foregoing, RECIPIENT represents and warrants that City ofMiami MFE Funding Agreement it will comply with, and the Funds will be used in accordance with, all applicable federal, state, and local codes, laws, rules and regulations. 7. 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 at 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 Al 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 regarding 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 arnounts City ofMiami MFE Funding Agreement disbursed pursuant to this Agreement. e) 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 suns 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 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. 8. 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. 9. COMPLIANCE WITH FEDERAL. STATE AND LJ)CAL LAWSz 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. 10. RELIGIOUS ORGANIZATIONS/CONSTITUTIONAL PROHIBITION: If the RECIPIENT is or was created by a religious organization, the RECIPIENT agrees that all Funds, in accordance with the First Amendment of the United States Constitution, particularly regarding the relationship between church and State, and as a general rule, may not be used for primarily non secular activities or provided to primarily religious entities for primarily non secular activities. 11. JN])E,MNVICATION: 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 attoruny's fccs) 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 City of Miami MFE Funding Agreement 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 R_ECIPIENT'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 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. 12. REVERSION OF ASSETS: Upon the expiration, termination, or cancellation of this Agreement, any unspent MFE Grant funds shall immediately revert to the possession and ownership of the CITY and RECIPIENT shall transfer to the CITY all unused MFE Grant funds at the time of such expiration, termination, or cancellation. 13. REFAULT; If RECIPIENT fails to comply with any term or condition of this Agreement, or fails to perform any of its obligations hereunder, then RECIPIENT ghat] 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 City ofMiami MFE Funding Agreement 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. 14. CITY'S TERMINAJON 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 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. 15. REMEDIES FOR INTONCOMMIAIKEz, 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 MFE Program Funds awarded to the RECIPIENT. City of Miami MFE Funding Agreement (4) Withhold further MFE Program funding for the RECIPIENT. (5) Take all such other remedies that may be legally available. 16. MARICETING: 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. 17. IN,SUR • CE: 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 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. 18. 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 19. 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. 20. CERTIFICATIONS REGARDING DEBARMENT. SUSPENSION. AND )THER RESPONSILITY 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, City &Miami MFE Funding Agreement 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 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 ordefault. 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. 21. 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 Macedonia Missionary Baptist Church of Miami, Inc. 3515 S. Douglas Road Miami, Fl 33133 Attn: Carolyn Donaldson, Board Secretary and Financial Officer CITY City of Miami Office of Management & Budget 444 SW 2' Avenue, 5Th Floor Miami, FL 33130 Attn: Marie Gouin, Director City of Miami MFE Funding Agreement With copies to: Office of the City Attorney 444 SW 2nd Avenue, Suite 945 Miami, FL 33130 Attn: Victoria Mendez, City Attorney 22. 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 ofthe 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 ofthe contract. and destroy any duplicate public records that are exempt or confidential 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 TIIE CUSTODIAN OF PUBLIC RECORDS AT (305) 416-1800, PUBLICRECORDS@M.IAMIGOV.COM, AND 444 S.W. 2N° AVENUE, SUITE 945, MIAMI, FL 33130. 23. CONFLICT OF INTEREST: RECIPIENT has received copies of, andlor 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 City of Miami. MFE Funding Agreement 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. 24. GOVERNING I,AW VENt E. 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 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. 25. 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. 26. MISCEL ' NEOUS 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, City ofMiami MFE Funding Agreement 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. 27. 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. 28. $UQcESSQES AND ASSIGNS: This Agreement shall be binding upon the parties hereto, their heirs, executors, legal representatives. successors, or assigns. 29. 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. 30. NO THiR»IPARTY 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. 31. cONTIIrNGENCY 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. 32. 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" 33. AUTHORITYi Each person signing this Agreement represents and warrants that be or she is duly authorized and has legal capacity to execute and deliver this Agreement. Each party City ofM5arnF MFE Funding Agreement. 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 and that the Agreement is valid and legal agreement binding on suds party and enforceable in accordance with its terms. 34. +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. 35. 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. 36. 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] City of Miami MFE Funding Agreement IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by thei - - ti4egziffilflEdgctIlibitunto duly authorized, this the day and year above written. p—DocuSigned by: '— 18169471A31D411 Todd B. Hannon, City Clerk Date: March 20, 2024 1 08:44:33 EDT APPROVED AS TO FORM AND CORRECTNESS: —DocuSigned by: €F915.E6 F E0457... Victoria Mendez Date: City Attorney March 15, 2024 1 15:12:28 EDT ATTEST: er., WANDA DOUGLAS Notary Pudic - State of Florida Commission # HH 186078 ?r. eF,"' My Comm. Expires Oct 13, 2025 Bonded through National Notary Assn, Print Name: Title: doh, ,o4i.<6 "CITY" CITY OF MIAMI, a municipal corporation of the State of Florida —DocuSigned by: 4AAAIrNavru�a By: \—8 0CF6C37zra Arthur Noriega V, City Manager March 19, 2024 1 11:17:01 EDT ■. Date: APPROVED AS TO INSURANCE REQUIREMENT'S: ,—DocuSigned by: '-27395C6318214E7... Ann -Marie Sharpe, Director Date: Risk Management March 8, 2024 1 15:29:26 EST "RECIPIENT" Zcona of Miami, Inc. A Florida Not -For -Profit Corporation By: T e-frta chex. Baptist Church Print Name: Carolyn D. Donaldson Title: Finance Officer MIAMI FOR EVERYONE FUNDING AGREEMENT EXHIBIT A - CITY OF MIAMI RESOLUTION AGENDA ITEM COVER PAGE File ID: #14315 Resolution Sponsored by: Commissioner Alex Diaz de la Portilla, Commissioner Sabina Covo, Commissioner Joe Carollo, Commissioner Manolo Reyes, Commissioner Christine King A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S), PURSUANT TO SECTION 18-85(A) OF THE CODE OF THE CITY OF MIAMI, FLORIDA, AS AMENDED, BY A FOUR -FIFTHS (4/5THS) AFFIRMATIVE VOTE, AFTER AN ADVERTISED PUBLIC HEARING, RATIFYING, APPROVING, AND CONFIRMING THE CITY MANAGER'S FINDING(S), ATTACHED AND INCORPORATED AS EXHIBIT "B," THAT COMPETITIVE NEGOTIATION METHODS AND PROCEDURES ARE NOT PRACTICABLE OR ADVANTAGEOUS FOR THE CITY OF MIAMI ("CITY") AND WAIVING THE REQUIREMENTS FOR SAID PROCEDURES; AUTHORIZING THE ALLOCATION OF FUNDS FROM THE DISTRICT 2 SHARE OF THE CITY'S MIAMI FOR EVERYONE ("MFE") PROGRAM, ON A REIMBURSEMENT BASIS, IN A TOTAL AMOUNT NOT TO EXCEED THREE HUNDRED NINETY SEVEN THOUSAND, ONE HUNDRED EIGHTEEN AND 00/100 DOLLARS ($397,118.00) ("FUNDS") TO MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC, A FLORIDA NOT FOR PROFIT CORPORATION ("MACEDONIA"), IN ORDER TO CONSTRUCT AND COMPLETE A NEW CLASSROOM ANNEX AT THE MACEDONIA OWNED PROPERTY LOCATED AT 3515 S. DOUGLAS ROAD ("PROJECT") WHICH WILL, UPON COMPLETION, PROVIDE DEDICATED LEARNING SPACE FOR AFTER SCHOOL TUTORING AND SUMMER PROGRAMMING WHICH WILL EXPAND EDUCATIONAL OPPORTUNITIES AND IMPROVE THE READING ABILITY OF STUDENT'S PRE-K THROUGH 8TH GRADE, AND WILL FURTHER CREATE ADDITIONAL SPACE TO ACCOMMODATE OTHER COMMUNITY PROGRAMMING, SUBJECT TO ALL FEDERAL, STATE, AND LOCAL LAWS THAT REGULATE THE USE OF SUCH FUNDS FOR SAID PURPOSE; FURTHER AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE ANY AND ALL DOCUMENTS NECESSARY, ALL IN FORMS ACCEPTABLE TO THE CITY ATTORNEY, FOR SAID PURPOSE. City of Miami Legislation Resolution Enactment Number: R-23-0334 City Hall 3500 Pan American Drive Miami, FL 33133 www.miamigov.com File Number: 14315 Final Action Date:7/27/2023 A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S), PURSUANT TO SECTION 18-85(A) OF THE CODE OF THE CITY OF MIAMI, FLORIDA, AS AMENDED, BY A FOUR -FIFTHS (4/5THS) AFFIRMATIVE VOTE, AFTER AN ADVERTISED PUBLIC HEARING, RATIFYING, APPROVING, AND CONFIRMING THE CITY MANAGER'S FINDING(S), ATTACHED AND INCORPORATED AS EXHIBIT "B," THAT COMPETITIVE NEGOTIATION METHODS AND PROCEDURES ARE NOT PRACTICABLE OR ADVANTAGEOUS FOR THE CITY OF MIAMI ("CITY") AND WAIVING THE REQUIREMENTS FOR SAID PROCEDURES; AUTHORIZING THE ALLOCATION OF FUNDS FROM THE DISTRICT 2 SHARE OF THE CITY'S MIAMI FOR EVERYONE ("MFE") PROGRAM, ON A REIMBURSEMENT BASIS, IN A TOTAL AMOUNT NOT TO EXCEED THREE HUNDRED NINETY SEVEN THOUSAND, ONE HUNDRED EIGHTEEN AND 00/100 DOLLARS ($397,118.00) ("FUNDS") TO MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC, A FLORIDA NOT FOR PROFIT CORPORATION ("MACEDONIA"), IN ORDER TO CONSTRUCT AND COMPLETE A NEW CLASSROOM ANNEX AT THE MACEDONIA OWNED PROPERTY LOCATED AT 3515 S. DOUGLAS ROAD ("PROJECT") WHICH WILL, UPON COMPLETION, PROVIDE DEDICATED LEARNING SPACE FOR AFTER SCHOOL TUTORING AND SUMMER PROGRAMMING WHICH WILL EXPAND EDUCATIONAL OPPORTUNITIES AND IMPROVE THE READING ABILITY OF STUDENT'S PRE-K THROUGH 8TH GRADE, AND WILL FURTHER CREATE ADDITIONAL SPACE TO ACCOMMODATE OTHER COMMUNITY PROGRAMMING, SUBJECT TO ALL FEDERAL, STATE, AND LOCAL LAWS THAT REGULATE THE USE OF SUCH FUNDS FOR SAID PURPOSE; FURTHER AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE ANY AND ALL DOCUMENTS NECESSARY, ALL IN FORMS ACCEPTABLE TO THE CITY ATTORNEY, FOR SAID PURPOSE. WHEREAS, on April 13, 2023, pursuant to Resolution No. R-23-0178, the City of Miami ("City") created the Miami For Everyone ("MFE") Program to assist communities facing the long- term complications resulting from declared emergencies and to address the specific needs of the most vulnerable residents and businesses, through a strategy of focusing the provision of support towards priority areas of need that will further stabilize economic conditions within City Districts; and WHEREAS, Macedonia Missionary Baptist Church of Miami, Inc., a Florida Not For Profit Corporation ("Macedonia"), is a not -for -profit organization who operates the Macedonia Missonary Baptish Church of Miami, the oldest African -American Baptist church in Miami -Dade County and provide various social services daily to the West Grove Community and other surrounding communities at large; and WHEREAS, Macedonia submitted a grant application, attached and incorporated as Exhibit "A," in order to construct and complete a new classroom annex at the Macedonia owned property located at 3515 S. Douglas Road ("Project"); and WHEREAS, upon completion of the Project, the new classroom annex will allow Macedonia to provide a dedicated learning space for afterschool tutoring and summer programming aimed at expanding educational opportunities and improve the reading ability of local students Pre-K through 8th grade, and will further create additional space for community programming; and WHEREAS, the new annex space is estimated to serve between one hundred (100) to two hundred (200) residents on a weekly basis; and WHEREAS, the City's District 2 Commissioner ("Commissioner") wishes to provide grant funds from the Commissioner's share of the City's MFE Program funds in an amount not to exceed Three Hundred Ninety Seven Thousand, One Hundred Eighteen and 00/100 Dollars ($397,118.00) ("Funds") for the Project; and WHEREAS, pursuant to Section 18-85(a) of the Code of the City of Miami, Florida, as amended ("City Code"), the City Manager has made a written finding, attached and incorporated as Exhibit "B," that competitive negotiation methods and procedures are not practicable or advantageous for the City's provision of the Funds for the Project; and WHEREAS, the City Manager is requesting authority from the City Commission to negotiate and execute any and all documents necessary, all in forms acceptable to the City Attorney, for the allocation of the Funds for the Project; 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. Pursuant to Section 18-85(a) of the City Code, by a four -fifths (4/5ths) affirmative vote, after an advertised public hearing, the City Manager's written finding, attached and incorporated as Exhibit "B," that competitive negotiation methods and procedures are not practicable or advantageous for the City's provision of the Funds for the Project and waiving the requirements for said procedures, are hereby ratified, approved, and confirmed. Section 3. The City Manager is authorized' to allocate the Funds from the Commissioner's share of the City's MFE Program funds to Macedonia for the Project. Section 4. The City Manager is further authorized' to negotiate and execute any and all documents necessary, modifications, and amendments, all in forms acceptable to the City Attorney, for said purpose. Section 5. This Resolution shall become effective immediately upon its adoption and signature of the Mayor.2 1 The herein authorization is further subject to compliance with all requirements that may be imposed by the City Attorney, 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. APPROVED AS TO FORM AND CORRECTNESS: 7718/2023 MIAMI FOR EVERYONE FUNDING AGREEMENT EXHIBIT B — SCOPE OF WORK Insert Pages 2, 3, & 4 from Miami For Everyone Funding Request Form DocuSign Envelope ID: 37B91FD6-F1D6-495F-80CE-18BDF62F16A2 . 1ty of Miami Miami For Everyone Program Funding Request Form ORGANIZATION AND PROGRAM/PROJECT INFORMATION Organization History and Background Information: The organization of Macedonia plays a pivotal role in South Florida's history because it was the first African American church on the South Florida mainland (Miami -Dade County) organized by blacks in 1895. Although the area is a historically marginalized community, the West Grove is home to a historic black community, which remains mobilized and connected despite the grossly evident economic and social effects of Jim Crow. We continue to boldly emphasize our heritage and recognize the importance of the preservation of our great church as we provide services daily to the West Grove Community and other surrounding communities at large. Is your program/project providing direct services to residents of the City of Miami? YesENoE 100-200 Number of residents your entity will serve: Frequency of Service: Age Group Served: Weekly NI ages * School Ages (PreK-8th grade) Is your program/project related to a declared emergency in the City of Miami? Yes ■❑No ❑ Name of Declared Emergency: Covid-19 Pandemic Q 1 of 2020 Date of Official Declaration: Is your program/project impacting one of Miami's afflicted communities? Yes ■❑ No❑ Geographic Area Served (specific to this project/program) District Served (1, 2, 3, 4, 5, Citywide) District 2 Little Bahamas of Coconut Grove (West Grove) Neighborhood/Community being served: Program/Project Priority area (Select one): n Affordable Housing • Educational Programs for children, youth, and adults Elderly meals, direct financial assistance, transportation, recreational and health/wellness related activities Direct financial assistance, food assistance (gift card programs, voucher programs) At -risk youth or youth summer job programs Page 2 of 6 Return this form to: gbrito@miamigov.com (March 28, 2023) DocuSign Envelope ID: 37B91FD6-F1D6-495F-80CE-18BDF62F16A2 . 1ty of Miami Miami For Everyone Program Funding Request Form nTransportation services and programs nJob development, retention and training programs nHomeless Services nFood Distribution programs riClimate Resiliency Improvements nEssential supplies, during a State of Emergency, natural disaster, or economic crisis nAllowable Infrastructure Improvement per program purpose and guidelines Page 3 of 6 Return this form to: gbrito@miamigov.com (March 28, 2023) DocuSign Envelope ID: 37B91 FD6-F1 D6-495F-80CE-18BDF62F16A2 City of Miami Miami For Everyone Program Funding Request Form Program/Project Title: Macedonia Missionary Baptist Church (MMBC) - Classroom Annex Project Project/Program Description: Construction and completion of the new classroom annex, including all MEP installation, exterior lot and security upgrades, digital and audio system installation, and interior furnishings. We remain cautious in our construction plans and upgrades, ensuring we maintain the historic significance of our sacred house of worship. Program Start Date: July 2023 Program End Date: August 2024 Please describe how this program/project and funding will assist the community overcome the adverse effects of the declared emergency: The Macedonia target is to reduce or eliminate the achievement gap experienced by children from the socioeconomic environment in Wesl Grove. The construction of the dedicated classroom annex and educational program foundation addresses the challenges specific to Covid-19 which worsened a learning gap in the community. The combined efforts of the Macedonia after school tutoring program and the summer reading programs is to use these facilities to expand and enhance our reading program. We quickly recognized that because of Covid-19 challenges, the academic regression that our kids experienced was severe and may be irreparable in some cases, we will more than triple our outreach with this expansion. IMPACT AND PERFORMANCE: Describe overall expected outcomes and performance measures for this project/program: Our program is designed to cultivate healthy futures for families and youth in the Wesl Grove and surrounding communities that attend. Our mission is accomplished through identifying challenges and building collaborations that develop strengths for those needs Our after -school tutoring and summer program provides targeted and intensive instructional intervention in an effort to assist students in achieving reading competency. The program is designed to improve the reading ability of student's Pre-k through 8lh grade. The new classroom annex is needed due to the lack of space at the current site. In addition, the new space will provide vital meeting space for additional programming, community organizations, and gatherings. Please attach additional pages to the back of this packet, if the space above is not sufficient. Page 4 of 6 Return this form to: gbrito@miamigov.com (March 28, 2023) Property Search Application - Miami -Dade County https://www.miamidade.gov/Apps/PA/propertysearch/#/report/summary t • OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 01-4121-007-5880 Property Address: 3515 DOUGLAS RD Miami, FL 33133-5707 Owner MACEDONIA MISSIONARY BAPTIST CH Mailing Address PO BOX 29 MIAMI, FL 33133-0000 PA Primary Zone 5700 DUPLEXES - GENERAL Primary Land Use 7144 RELIGIOUS - EXEMPT : RELIGIOUS Beds / Baths / Half 0/0/0 Floors 2 Living Units 0 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 5,236 Sq.Ft Lot Size 9,000 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2023 2022 2021 Land Value $832,500 $567,000 $382,500 Building Value $223,580 $223,889 $197,295 XF Value $0 $0 $0 Market Value $1,056,080 $790,889 $579,795 Assessed Value $566,361 $514,874 $468,068 Benefits Information Benefit Type 2023 2022 2021 Non -Homestead Cap Assessment Reduction $489,719 $276,015 $111,727 Religious Exemption $566,361 $514,874 $468,068 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description FROW HOMESTEAD PB B-106 LOT D LESS ST & LOT E BLK 33 LOT SIZE IRREGULAR Generated On : 7/13/2023 Taxable Value Information 2023 2022 2021 County Exemption Value $566,361 $514,874 $468,068 Taxable Value $0 $0 $0 School Board Exemption Value $1,056,080 $790,889 $579,795 Taxable Value $0 $0 $0 City Exemption Value $566,361 $514,874 $468,068 Taxable Value $0 $0 $0 Regional Exemption Value $566,361 $514,874 $468,068 Taxable Value $0 $0 $0 Sales Information Previous Sale I Price OR Book -Page Qualification Description The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp Version: Macedonia %fissionary qiaptist C!turcft of Miami, Inc. 3515 Douglas Road, Miami, FL 33133 Tel. (305) 445-6459 mail: info a7macedoniambcmiami.cam Web: www.macedoniambcmiami.com Reverend Lance (B. (Balky Sr., Pastor (Board of (Directors Chairperson, its. Loretta 5, Whittfe Chairman, (Deacon &3oard, Mr. gliichaetDouglas Tincture C}fcer, 9rts. Caro4n a (Dona&son SENT TO: COMMISSIONER KEN RUSSELL— CITY OF MIAMI DISTRICT 2—VIA EMAIL Dear Commissioner Russell: tt is my sincere prayer that this correspondence reaches you in the best of health and uplifting spirit. On the fourth Sunday in October, Macedonia Missionary Baptist Church of Miami, Inc. reached yet another historic milestone as we celebrated one hundred and twenty-seven years (127 years). As the oldest African American Church in Miami -Dade County, founded by blacks in 1895, we continue to boldly emphasize our heritage and recognize the importance of the preservation of our church. We, therefore, come before you humbly seeking your financial assistance in the preservation and restoration of this great church. God has blessed us in securing grant funds at the State level under the African -American Cultural and Historic Grant. However, in addition to the State funding not covering the full cost of all the much -needed repairs we also discovered that the funds are restricted to external repairs at the church and the construction of the new classroom building only. Since you have had on occasion visited the church, I believe you would agree it is readily apparent that much needed internal/external repairs are also required. The recent rainy season, yet again with both leaking windows and roof has just made the situation worst. Because we are a proud congregation that extends our love, care, and concern throughout the entire community, you are reminded that the church is often used by many of the local organizations as a meeting place also. In addition, we have fed and tutored many community children with our summer camps and after -school programs; the community's homeless; assisted in addressing housing and food insecurities and stood firm in assisting families with life hardships. When the Covid virus offered its challenges, we continued our history of outreach forming collaborations/partnerships with TGHt, Ransom Everglades, Joshua's Heart Foundation, CHI, CGEN, CGNWC, HOATA among others to participate in; Farm Share drive -up food distributions, weekend meal delivery, Covid-19 walk-up testing, personal care items distribution, disinfectant/sanitizing supplies, and despite the challenges successfully continued the MCOM . Macedonia gk1issianary Baptist Church of Miami, Inc. 3515 Douglas Road, Miami, FL 33133 Tel. (305) 445-6459 mail: infoamecedoniamlbcmiami,com Web: www.macedonialnbcmiami.com rverenacLance 03. Baitcy Sr., (Pastor (Board of Directors Chairperson, ,Ws. Loretta S. 'Whitttc Chairman, Deacon Boarr4 tr. lii -haef Douguis (Finance officer, .4s. Caro55m (D. Vonatdson Summer Reading Camp founded in 1984, creating a stimulating safe environment for our children while offering culturally relevant programs and educating on the impact of social injustice in these trying times. The primary reason for the classroom annex is our current shared space inhibits the full effectiveness of one-on-one or small group tutoring that is needed for our children who's learning loss has been further exacerbated by academic regression due to Covid-19 challenges. Yes, our doors have been open and remain open to assist this community in every possible positive way. Attached is a copy of our budget which identifies a shortfall in the amount of $388,144 to complete the repairs needed in three areas: building and completion of the classroom annex, repairs, and renovations to the exterior of the church and upgrades, repairs, and renovations to the interior of the church. We remain cautious in our repairs and upgrades ensuring that we maintain the historic significance of our sacred house of worship. The church is steep in history starting with the rectangle shape pointing east to west. This practice of east to west consideration in the affairs of (life and death) (sunrise/sunset) prevailed in the African diaspora and continues as a tradition in our culture. Thanking you in advance for your consideration and support. Warmest Regards, Carolyn D. Donaldson Board Secretary/Finance Officer Mobile {305) 519-7100 Carolyn9453@gma!I,corn With God MI things are possible! WOW Macedonia Missionary Baptist Church of Miami, fnc 3515 Douglas Road, Miami, F1,33133 Tel. (305) 445-6459 Email: info@ rnacedenlambcmiami,com Web: www.macedoniambcmiami.com cc: Reverend Lance B. Bailey, Sr. Pastor Form W _9 (Rev_ October 2018) Department of the Treasury Internal Revenue Service rn so 0 pf Request for Taxpayer Identification Number and Certification ■ Go to www-ir.govIFormW9 for instructions and the latest information. 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC. 2 Business name/disregarded entity name, if different from above Give Form to the requester. Do not send to the IRS. 3 Check appropriate box for federal tax classification of the person whose name Is entered on sine 1. Check only one of the following seven boxes. QIndividual/sole proprietor or l� l C Corporation 0 S Corporation 0 Partnership 0 trustfestate single -member LLC ❑ Limited Ilability company. Enter the tax classification (Ce-C corporation, S=S corporation, Partnership) i Note! Checlt the appropriate box in the Ilse above for the tax ciassfficatlon of the singiegmember owner. Ito not check LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the Lt.0 is another LLC that is riot disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that is disregarded from the owner should check the appropriate box for the tax classlficatlon of Its owner. D Other (sea instructions) ■ 4 Exemptions (codes apply only to certain entitles, not individuals: sea instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting coda Of any) f..appGas ranomonR ma enfned ourtskfro the U.S.} 5 Address (number. street, and apt. or suits no.) See instructions. 3515 S. DOUGLAS ROAD City, state, and ZIP code MIAMI, FL 33133 7 List account numbers) here {optional} Requester's name and eddress (optional) MTh Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on fine 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 1, later. For other entitles, it is your employer identification number (EiN), 1f you do not have a number, see How toget a T7N,, 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. Social security number or Employer Identification number 5 9 1 7 D 5 7 9 9 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 (1 F S) that l 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 l 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 lIndividual retirement arrangement (IRA), and generally, payments atflertltsn in#afest and dividends, youare not required #o sign the ce catlan yoprovide your correct TIN. See the instructions for Part II, later. Sign Here Signature of U.S. person ■ General Instructions Section references are to the irttBrrtel 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.xrs.govIFormW9. 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 (IT1N), adoption taxpayer identlttoatlon number (ATIN), or employer Identification number (EIN), to report on an Information return the Mount paid to you, Or ether 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 10oe-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) Fcsrr', 14S9-A (acquioiticn o€ abandonment of aocured property) Use Form W-9 only if you are a U.S, person (including a resident alien), to provide your correct TIN. tf you do not return Fomt W-9 to .the requester with a TiN, you might be subject to backup withholdfrrg. See What is backup withholding, later. Cat. No. t 0231 x Form W-9 (Rev. 1 n-2O1 S) MACEDONIA MISSIONARY BAPTIST CHURCH PASTOR'S OFFICE CLASSROOM STORAGE Upgraded and made more functional for slarage with shelving. Also includes Air Handling units FINANCE OFFICE STORAGE CLASSROOMS FOR SUMMER READING j AND AFTER SCHOOL PROGRAMS I KITCHEN FELLOWSHIP FEAR Replace all doors, floors and windows HISTORIC CORNER STONE NEW CURTAINS RESURFACE RAPSTIMAI. POOL REPAIR STAIN GLASS WINDOWS NEW RESTROOMS ADA compliant Previously the AV room. New AV room above restraoms EXISTING RESTROOMS UPGRADED ADA Compliant LEGEND vvmorLfit Aft duu E11-4loOt'M COOT ICI. ono - Emma ROM W 14 BOB - 11f.6 Cr BEI?M4 COMM el. SLOG aT' - CfrloF {d RAE £ - 004*4 4148101` 174,E - 0*440 M i1i.- OOM GasiorR f• ELL -AR Coo V EIOtor 400 4T L►- into R. -RIM PILL IPF 55£ 416 elm Rawl.. • - Nal4400 l40 IP see V ilr - SOWS PLY M O9 wA - Room mina. 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AGW'el45cALT iQ 4014 Nes MOM 1141 10 W 4'PI® LEMAN MO IPA= Or our, 4 CW'ii4E F WARM 4ELa 'war tW MSC u ' xs Ci MCa.fIGN.' manW wan TART r=6 a#1' 14 OM 423 00 411 1O id ma-1 eT W mow.. 04 AS A5 04 `T WOW.- eO MARI RLRs L7 manta .f410.S *. 00 44 M1aerAL S ONOP466 Tr_5 TO M Sr `'le I Rel40s STATE Moos Or S4Ea00 A.n i.VP4Y w *WOOS 5t17 PI4M1 f214 S4AME BE K1 VR/ AffNS1: 41HE P'-49 ELEMOSC0000 12.0S LAOATIGII: US 111WY p -- 141 BOM OF CA L 3GIVYL si 42 AVE -» ]Y it1T 44 CA. GESPWRIO)14: ?I{ 14011._ 40 AI/11~1 4*4*4 W acre. CASIWG OF L '4.1TT H1240612. 70: L N=6E6110. W4i0NP1Y 14.1C- CTS4r0H ufle 444014 4TL':.o 40K 2C44,e12022 Jd1 .191. 4 4.0,541 CRMI.1 wr: AJIREL 606 FILL Wi1DOFA 14941O1417 9EF^T 1 Cr T MIAMI FOR EVERYONE FUNDING AGREEMENT EXHIBIT C — BUDGET Insert Page 5 from Miami For Everyone Funding Request Form DocuSign Envelope ID: 37B91 FD6-F1 D6-495F-80CE-18BDF62F16A2 City of Miami Miami For Everyone Program Funding Request Form FUNDING REQUEST INFORMATION: Amount Requested: $ $397,1 18 Explain how the City of Miami's Miami For Everyone funding will be utilized: See attached backup. Itemize MFE funding related to expenditures below: Personnel Salaries & Wages: $ Personnel Benefits $ Space Rental: $ Utilities (Electricity, Phone, Internet): $ Supplies: $ Equipment $ Marketing: $ Transportation (Participants): $ Meals (Participants): $ Professional Services (List each): $ Construction (attach schedule of costs): $ Other (please describe): Other (please describe): Other (please describe): Page 5 of 6 Return this form to: gbrito@miamigov.com (March 28, 2023) DocuSign Envelope ID: 37B91 FD6-F1 D6-495F-80CE-18BDF62F16A2 Funding Request Form Backup DocuSign Envelope ID: 37B91 FD6-F1 D6-495F-80CE-18BDF62F16A2 Funding Request Information Amount Requested: $397,118 Explain how the City of Miami's Miami For Everyone funding will be utilized: The construction of the new classroom annex will be adjoined to the existing structure on two levels. This new building extension will provide dedicated learning space for afterschool and summer programming, offices, and community meeting space. The budget breakdown below highlights the associated costs of the new construction: Concrete Work for Classroom Addition $ 23,030 Masonry Work for Classroom Addition $ 10,699 Site Work for Classroom Addition $ 1,600 Metal Work for Classroom Addition $ 5,327 Wood & Plastics Work for Classroom Addition $ 28,560 Doors & Windows for Classroom Addition $ 9,200 Interior Finishes for Classroom Addition $ 11,800 Duct Work / HVAC for classrooms $ 17,447 Install Exterior Lighting System $ 21,000 Paving & Parking Lot Improvements $ 22,500 Exterior stucco wall repairs and reinforcement $ 6,800 Repair Drive Gate Openings $ 4,250 Repair Security Fencing $ 6,750 Renovate current bathrooms on first floor and bring to ADA code $ 25,000 Exterior painting $ 5,000 Repair Entire Perimeter Fence $ 1,300 Mechanical, Electrical, Plumbing (MEP) for renovation and new construction $ 42,300 Architectural / Engineering Services $ 38,497 Contractor Fees for Classroom Addition Construction, General Conditions $ 56,041 Furnish classroom annex - furniture, equipment, wall mount room divider $ 14,500 Digital Audio -Visual Equipment and Sound System $ 45,517 Total $ 397,118.00 MIAMI FOR EVERYONE FUNDING AGREEMENT COMPOSITE EXHIBIT "D" MFE AGREEMENT COMPOSITE EXHIBIT PAYMENT SCHEDULE 1. The CITY shall pay the RECIPIENT, an amount not to exceed THREE HUNDRED NINETY SEVEN THOUSAND ONE HUNDRED EIGHTEEN dollars $397,118.00 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. Request for Payments must be accompanied by all required backup documentation, including but not limited to, invoices, cancelled checks, bank statements, timesheets, payroll stubs, engineering plans, permits, enviromentals, inspection reports, approved payment applications, programmatic reports, progress photos, and attendance logs. 4. 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. 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. MFE Request for Payment Form Date: Invoice Number: Send to: City of Miami Office of Management & Budget 444 SW 2nd Ave., 5th Floor Miami, FL 33130 Program/Project Title: Macedonia Missonary Baptist Church - Classroom Annex Project Recipient'sName: MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC Recipient's Address: 3515 S. DOUGLAS ROAD MIAMI, FL 33133 I hereby request payment in the amount of $ for expenses incurred in relation to the City of Miami's Miami For Everyone Activity/Program/Services provide below. Number of People Served/Location of Services Description Rate Amount TOTAL: $ I certify that the Program/Service was provided in accordance to the approved Program/Project as described in the MFE Funding Request Form and that expenses were incurred in the provision of said Program/Service. Authorized Representative Type Name Signature Title: Date MIAMI FOR EVERYONE FUNDING AGREEMENT EXHIBIT E - INSURANCE REQUIREMENTS *Grantee shall provide the City with certificates of insurance in accordance to Exhibits El and E2. EXHIBIT E-1 INSURANCE REQUIREMENTS FOR A CERTIFICATE OF INSURANCE CONSTRUCTION REQUIREMENTS MACEDONIA MISSIONARY BAPTIST CHURCH OF MAIM, INC. I. Commercial General Liability a. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Personal and Adv. Injury $ 1,000,000 Products/Completed Operations $ 1,000,000 b. Endorsements Required City of Miami listed as additional insured Contingent & Contractual Liability Premises and Operations Liability Explosion, Collapse and Underground Hazard Primary Insurance Clause Endorsement Completed Operations extended for (3) years after project completion II. Business Automobile Liability a. Limits of Liability Bodily Injury and Property Damage Liability Combined Single Limit Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 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 $1,000,000 for bodily injury caused by an accident, each accident $1,000,000 for bodily injury caused by disease, each employee $1,000,000 for bodily injury caused by disease, policy limit IV. Umbrella Policy (Excess to Follow Form) A. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $2,000,000 Aggregate $2,000,000 City of Miami listed as an additional Insured. Coverage is excess follows form Over all liability policies contained herein. V Payment and Performance Bond City listed as Obligee VI. Builders' Risk $TBD Causes of Loss: All Risk -Specific Coverage Project Location Valuation: Replacement Cost Deductible: $5,000 All other Perils 5% maximum on Wind/Hail and Flood City of Miami listed as loss payee A. Coverage Extensions: As provided by carrier The above policies shall provide the City of Miami with written notice of cancellation or material change from the insurer not less than (30) days prior to any such cancellation or material change, or 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. AC[1RDf CERTIFICATE OF LIABILITY INSURANCE �� DATE(MM/DDIYYYY) 11/07/2023 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER S d eFcflm HENRY WAHL INSURANCE AGENCY C7 417 S SUMMERLIN AVE CDC) ORLANDO, FL 32801 CONTACT JESICA ESTELA BUCIO NAME: A/CO No Ext): 407-895-5285 (pIC No): 407-895-5260 EDORILSS: JESICA@INSUREWITHHENRY.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : State Farm Mutual Automobile Insurance Company 25178 INSURED NEIEL GROUP, LLC 4314 BLONIGEN AVE ORLANDO, FL 32812 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADD INSD SUB WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MMIDD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PERSONAL PROPERTY $ AUTOMOBILE X LIABILITY ANY AUTO OWNED ONLY HIRED AUTOS ONLY X X SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y Y J68 5175-D21-59B 10/21 /2023 04/21 /2024 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY(Per accident) $ PROPERTY DAMAGE (Per accident) $ NON -OWNED LIABILITY $ 1,000,000 UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER $ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF MIAMI IS INCLUDED AS ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT ON A PRIMARY AND NON-CONTRIBUTORY BASIS. CONTIGENT & CONTRACTUAL LIABILITY INCLUDED AS PER POLICY FORMS. PREMISES AND OPERATIONS LIABILITY INCLUDED AS PER POLICY FORMS. EXPLOSION, COLLAPSE AND UNDERGROUND HAZARD INCLUDED AS PER POLICY FORMS. PRIMARY INSURANCE CLAUSE ENDORSEMENT INCLUDED AS PER POLICY TERMS. COMPLETED OPERATIONS EXTENDED FOR (3) YEARS AFTER PROJECT COMPLETION AS LONG AS THIS POLICY IS RENEWED FOR (3) YEARS. (30) DAYS NOTICE OF CANCELLATION EXCEPT FOR (10) DAYS FOR NON-PAYMENT. CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI 444 SW 2ND AVE, 4TH FLOOR MIAMI, FL 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jesica Estela Bucio ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 1001486 132849.14 04-13-2022 GENERAL LIABILITY, AGGREGATE, UMBRELLA, WORKERS COMPENSATION AND ENDORSEMENTS ACORd CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYW) 09/29/2023 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, 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 Roe Insurance Inc. 9851 State Road 54 New Port Richey FL 34655 CONTACT Gertrude Rosencrans NAME: PHONE (727) 376-0030 IFAX (727) 376-2262 (A/C. No. Ext): (A/C, No): E-MAIL trudy@roeiins.com ADDRESS: y� INSURER(S)AFFORDING COVERAGE NAIC # INSURER A: James River Insurance INSURED Neiel Group, LLC 4314 Blonigen Ave Orlando FL 32812 INSURER B : Evanston Insurance Company INSURER c : American Builders Insurance Company 11240 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISED CERT 23-24 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/WYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y 00129198-1 03/26/2023 03/26/2024 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENII X AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO ❑ LOC OTHER: ECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 Employee Benefits $ 0 AUTOMOBILE _ LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED _ SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y Y COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person)- $ BODILY INJURY (Per accident)- $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE Y Y EZXS3130107 09/15/2023 03/26/2024 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED I I RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YI N N N/A VVCV023690306 03/15/2023 03/15/2024 XI STATUTE I I OTH- ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1O0Q000 $ , DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Miami is included as additional insured as required by written contract on a primary & non-contributory basis. Contigen & Contractural Liability included as per policy forms. Premises and Operations Liability included as per policy forms. Explosion, Collapse and Underg ound Hazard included as per policy forms. Primary Insurance Clasue Endorsement included as per policy terms. Completed Operations extended for (3) years after project completion as long as this policy is renewed for (3) years. (30) Days notice of cancellation except for (10) days for non-payment. CERTIFICATE HOLDER CANCELLATION I City of Miami 444 SW 2nd Ave, 4th Floor Miami FL 33130�_a-c,f,-0'' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 001291981 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization{s}: Location And Description Of Completed Operations City of Miami 444 SW 2nd Ave 4th Floor Miami, FL 33130 3515 Douglas Rd Coconut Grove, FL. 33133 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property dam- age" caused, in whole or in part, by "your work" at the location designated and described in the sched- ule of this endorsement performed for that additional insured and included in the "products -completed operations hazard". THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS SECTION II — Who Is An Insured is amended to include any person or organization you are required to include as an additional insured on this policy by written contract or written agreement in effect during this policy period and executed prior to the "occurrence" of the "bodily injury" or "property damage." The insurance provided to the Additional Insured under this endorsement is limited as follows: 1. The person or organization is only an additional insured with respect to liability arising solely out of "your work" or "your product" which is imputed to the Additional Insured. 2. In the event that the Limits of Insurance provided by this policy exceed the Limits of Insurance required by the written contract or written agreement, the insurance provided by this endorsement shall be limited to the Limits of Insurance required by the written contract or written agreement. This endorsement shall not increase the Limits of Insurance stated in the Declarations. 3. This insurance does not apply to "bodily injury" or "property damage" arising out of "your work" or "your product" included in the "products — completed operations hazard" unless you are required to provide such coverage by written contract or written agreement but only for the period of time required by the written contract or written agreement and only for "bodily injury" or "property damage" that occurs during the policy period arising out of "your work" or "your product". 4. Any coverage provided by this endorsement to an Additional Insured shall be excess over any other valid and collectible insurance available to the Additional Insured whether primary, excess, contingent or on any other basis. 5. Where no coverage under this policy shall apply for the Named Insured, no coverage or defense shall be afforded to the Additional Insured. 6. This insurance does not apply to "bodily injury" or "property damage" arising out of the sole negligence of the Additional Insured. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CB5202US 01-17 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. PRIMARY AND NON CONTRIBUTORY ENDORSEMENT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS Name Of Additional Insured Person(s) Or Organization(s): As required by written contract. If no entry appears above, this endorsement applies to all Additional Insureds covered under this policy. Any coverage provided to an Additional Insured under this policy shall be excess over any other valid and collectible insurance available to such Additional Insured whether primary, excess, contingent or on any other basis unless a written contract or written agreement specifically requires that this insurance apply on a primary and noncontributory basis. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CB5204US 01-17 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARFEULLY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT This endorsement modifies insurance provided under the following: ALL COVERAGE PARTS The Company agrees to waive any right of recovery against any person or organization, as required by written contract, because of payments we make for injury or damage which is limited to liability directly caused by "your work" which is imputed to such person or organization. ALL OTHER TERMS AND CONDITIONS OF THE POLICY REMAIN UNCHANGED. CB5203US 01-17 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule "ALL WRITTEN CONTRACTS THAT REQUIRE A WAIVER OF SUBROGATION" This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective: Policy No. WCV 0236903 06 Endorsement No. Insured NEIEL GROUP LLC Premium $16,468.00 Insurance Company American Builders Insurance Company Countersigned by WC 00 03 13 (Ed. 4-84) © 1983 National Council on Compensation Insurance. EXHIBIT E-2 INSURANCE REQUIREMENTS MACEDONIA MISSIONARY BAPTIST CHURCH OF MIAMI, INC. MIAMI FOR EVERYONE GRANTEE REQUIREMENTS I. Commercial General Liability b. Limits of Liability Bodily Injury and Property Damage Liability Each Occurrence $1,000,000 General Aggregate Limit $ 2,000,000 Personal and Adv. Injury $ 1,000,000 Products/Completed Operations $ 1,000,000 c. 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 Owned/Scheduled Autos Including Hired, Borrowed or Non -Owned Autos Any One Accident $ 1,000,000 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 E&O Liability Limits of Liability Each Claim $1,000,000 Policy Aggregate $1,000,000 Retroactive date included as applicable 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. GRANTEE INSURANCE REQUIREMENTS - MACEDONIA MBC MIAMI, INC. AC 0� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/7/2023 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Sovereign Insurance Group 920 Cassatt Road Suite 100 Berwyn PA 19312 CONTACT Nicole Nichols NAME: (A/CNN Ext): (800) 222-4478 1 jn/c, No): (610) 535-6810 E-MAIL nnichols@sovinsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Guideone Elite Insurance Company 42803 INSURED Macedonia Missionary Baptist Church of Miami Inc 3515 S Douglas Rd Miami FL 33133 INSURER B : Amtrust North America INSURER C : INSURER D : INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER: 23-24 GL w/AI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD DDL SUER WVD POLICY NUMBER ( POLICY PM/DDYYT POLICYYT ( POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y 001275976 09/24/2023 09/24/2024 EACH OCCURRENCE $ 1,000,000 X CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY OTHER: JECT PRO-❑ LOC GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 $ AUTOMOBILE _ X LIABILITY ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY X _ _/ SCHEDULED AUTOS NON -OWNED AUTOS ONLY 001829494 12/31/2022 12/31/2023 COMBINED SINGLE LIMIT $ 1,000,000 (Cu—,.‘,.iJm it) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ,,/N ANY PROPRIETOR/PARTNER/EXECUTIVE (Mantl OFFICEtory NH)ER EXCLUDED? ❑ f yes, describe under DESCRIPTION OF OPERATIONS below TWC4333067 10/10/2023 10/10/2024 X PER I I OTH- STATUTE ER $ 1,000,000 E.L. EACH ACCIDENT ACCIDENTin E' D'�E°E E° E^^R' ^„Fg— E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder (City of Miami) is listed as additional insu ed on a primary and non-contributory basis in acco dance with contract. CERTIFICATE HOLDER CANCELLATION City of Miami 444 SW 2 Avenue Miami FL 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRAl1ON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 �t'rir ^- L''.vr 1v.:, ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS (Continued) GUIDEONE. INSURANCE Policy Number: 001275976 ADDITIONAL COVERAGES Director And Officer Llablllty Coverage Director And Officer Liability Each Claim Limit $ 1,000,000 Director And Officer Liability Aggregate Limit $ 1,000,000 Deductible $ 2,500 Legal Expense Reimbursement Coverage Legal Expense Reimbursement Each Incident Limit $ 15,000 Legal Expense Reimbursement Aggregate Limit $ 45,000 Deductible $ 1,000 Religious Expression Coverage Religious Expression Each Claim Limit $ 1,000,000 Religious Expression Aggregate Limit $ 1,000,000 Religious Expression Legal Expenses Reimbursement — Hourly Limit $ 250 Religious Expression Legal Expenses Reimbursement — Each Incident Limit $ 150,000 Religious Expression Legal Expenses Reimbursement — Aggregate Limit $ 300,000 Sexual Misconduct Liability Coverage Sexual Misconduct Liability Each Claim Limit $ 250,000 Sexual Misconduct Liability Aggregate Limit $ 500,000 Sexual Misconduct Medical Expense Limit $ 10,000 Violent Incident Response Coverage Violent Incident Aggregate Limit $ 300,000 Individual Counseling Expenses Each Person Limit $ 2,500 Medical Expenses Each Person Limit $ 50,000 Individual Expenses Aggregate Limit $ 200,000 Ao o ,o GuideOne Elite Insurance Company GUIDEONE`" INSURANCE 1111 Ashworth Road, West Des Moines, IA 50265 www.guideone.com 877-448-4331 • COMMERCIAL PROPERTY DECLARATIONS - STATEMENT OF VALUES Policy Number: 00-1275-976 Named Insured: Agent Information: MACEDONIA MISSIONARY BAPTIST CHURCH OF SOVEREIGN INSURANCE GROUP MIAMI INC Agent Number: 09BBT Policy Period: 09/24/2023 to 09/24/2024 Al 12:01 A.M. Standard Time at the mailing address shown in the Common Policy Declarations. In INSTRUCTIONS 1. The values shown on the attached page(s) of this Statement of Values form must be the Replacement Cost Values (100%) or the Actual Cash Value (100%), and should reflect the basis of coverage for each Building, Personal Property of the Insured, or both. 2. The values shall be submitted to the Insurance Company and shall be subject to its acceptance. 3. This Statement of Values shall not include the values desired for Business Income and/or Extra Expense coverage. 4. Nothing contained in these Instructions shall be construed as changing in any manner the conditions of the policy. 5. The Company may require this Statement of Values to be signed by the Insured, or in the case of firms, by a partner or an officer. I� ACKNOWLEDGEMENT AND ACCEPTANCE This Statement of Values form is filed with the designated insurance company shown above. All values submitted are correct to the best of my knowledge and belief. Printed Name Title Signature SEE SIGNATURE ON FILE Date (Authorized Representative) THE COMMERCIAL PROPERTY DECLARATIONS - STATEMENT OF VALUES FORM(S) A PART OF THE COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS. i. Legal Action Against Us You may not bring any legal action against us involving loss: (1) Unless you have complied with all the terms of this insurance; (2) Until 90 days after you have filed proof of loss with us; and (3) Unless brought within two years from the dale you "discovered" the loss. If any limitation in this condition is prohibited by law, such limitation is amended so as to equal the minimum period of limitation provided by such law. j. Liberalization If we adopt any revision that would broaden the coverage under this insurance without additional premium within 45 days prior to or during the Policy Period shown in the Declarations, the broadened coverage will immediately apply to this insurance. k. Other Insurance If other valid and collectible insurance is available to you for loss covered under this insurance, our obligations are limited as follows: (1) Primary Insurance When this insurance is written as primary insurance, and: (a) You have other insurance subject to the same terms and conditions as this insurance, we will pay our share of the covered loss. Our share is the proportion that the applicable Limit Of Insurance shown in the Declarations bears to the total limit of all insurance covering the same loss. (b) You have other insurance covering the same Toss other than that described in Paragraph k.(1)(a), we will only pay for the amount of loss that exceeds: (i) The Limit of Insurance and Deductible Amount of that other insurance, whether you can collect on it or not; or (ii) The Deductible Amount shown in the Declarations; © Insurance Services Office, Inc., 2015 CR 00 20 11 15 Page 10 of 19 I. Travel Accident Benefit We will pay a travel accident benefit to the named insured if your "directors or officers" suffer a "travel accident injury" or death while traveling on a "commercial transportation carrier" in the course or scope of performing duties of your business during the policy period. The travel accident benefit will not be payable if the cause of the "travel accident injury" was: a. An intentional act by the insured; b. An act of suicide or attempted suicide; c. An act of war; or d. A disease process. The limit of insurance for this coverage is $50,000 per policy period for all insureds combined. J. Travel Delay Reimbursement We will reimburse your "directors or officers" for any "non -reimbursable expenses" they incur as a result of the cancellation of any regularly scheduled business travel on a "commercial transportation carrier". The limit of insurance for this coverage is $1,500 per policy period for all insureds combined. A seventy-two (72) hour waiting period deductible applies to this coverage. II. LIMITS OF INSURANCE 1. When coverage is provided by this endorsement and another coverage form or endorsement attached to this policy, the greater limits of liability or limits of insurance will apply. In no instance, however, will multiple limits apply to coverages which may be duplicated within this policy. Additionally, if this policy and any other coverage part or policy issued to you by us, or any company affiliated with us, apply to the same occurrence, offense, accident or loss, the maximum limits of liability or limits of insurance under al! such coverage parts or policies combined will not exceed the highest applicable limits of liability or limits of insurance under any one coverage part or policy. 2. This insurance is excess over any other applicable insurance whether primary, excess, contingent or on any other basis. When this insurance is excess, we will have no duty to defend the insured against any "suit" if any other insurer has a duty to defend the insured against that "suit". If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. 3. Limits of Insurance identified in the Schedule above are not excess of, but are in addition to, the applicable Limits of Liability or Limits of Insurance stated in the Declarations. III. DEFINITIONS For the purposes of this endorsement, the following definitions apply: A. "Abuse" means any actual, threatened, or alleged act, error, omission, conduct or misconduct that a claim or "suit" alleges": Includes copyrighted material of Insurance Services Office, Inc., with its permission. GIL 09 04 03 19 Copyright 2019 GuideOne Insurance Page 4 of 8 AC R CERTIFICATE OF LIABILITY INSURANCE DATE (MMYDDIYYYY) 10108/2023 THIS CERTIFICATE IS ISSUED AS 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 have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the po icy, 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 Sovereign Insurance Group 920 Cassatt Road Suite 100 Berwyn PA 19312 CONTACT Nicole Nichols NAME: iP.aH'ONE 051: (800) 222-4478 INC No); (610) 535-6810 ElA1unnichols@sovinsurance.com ADDRLSS: E {NSURERIS) AFFORDING COVERAGE NAIC # INSURER A, GuideOne Insurance Company INSURED Macedonia Missionary Baptist Church of Miami Inc 3515 S Douglas Rd Miami FL 33133 INSURERB: INSURER C : INSURER D : INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 22-23 AUTO w1AI REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLIC ES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRINSD TYPE OFIN5URANCE AODL SUER WVO POLICY NUMBER POLICYEFF (MMlODM'YY) POLICY EXP (MMIDDYYYY) LIMITS COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL &ADV INJURY $ GENERALAGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER_ POLICY 1 I jECT 1 I LOC OTHER: PRODUCTS - COMP/OR AGG $ $ A AUTOMOBILE /1 >< LIABILITY ANYAUTO OWNED AUTOS ONLY HIRES AUTOS ONLY �/ /� SCHEDULED AUTOS NON -OWNED AUTOS ONLY Y 001829494 12/31/2022 12/31/2023 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,009 BODILY INJURY (Per person} $ BODILY INJURY per accident) $ PROPERTY DAMAGE (Per accident) $ Underinsured motorist $ INCLUDED UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE CU RRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE 1 1 OFFICER/MEMBER EXCLUDED, (Mandatory in NH) !ryes, describe under DESCRIPTION OF OPERATIONS below N 1 A PER OTH- STATUTE ER EL EACH ACCIDENT $ EL. DISEASE - EA EMPLOYEE $ EL. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (ACORD t0k, Additional Remarks Schedule, may be attached it more space is required) Certificate holder is an additional insured. CERTIFICATE HOLDER CANCELLATION City or Miami 444 SW 2nd Ave Miami FL 33130 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE1' I At(rlj:,r g Nr ), , ACORD 25 (2016/03) i © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDITIONAL COVERAGES Ref a Deecrildon illeticalpayments Coverage Code YEDAM Fofm No. Edition Dee, Lint 1 1 000 LiMii 2 Lint 3 Deductible AMain' Deductible Type Amain Ref a Description PIP-8a Ic Coverage Cafe PIP - form No. Edrtlun Dais MIN 1 10.DIG t.lmtt 2 Limit 3 Deductitee Amount DYdiJC ibee Type Prer tes Ref i Description DeATH BENEFITS Coverage Code DTEEN Form No. _ [a1Jon Cla'a LItnR 1 SACO LIM 2 Limit 3 Deductible Amount Deducible Type Premium Ref * Dercription Uninsured motarl t combined single lrnn Coverage Code UAeCSTL Form No. Edit on Data Linet 1 t,DD0,0D0 thin[ 2 Urea 3 Deductible Amount CloactDle Type Ammer) Raft DeecrTQtton - - Coverage Code Form No. Endow Dade Lhntll 1 Lrret 2 Limit 3 Deductible Amami °educate Typt Prorates Ref* Description Coverage Code farm No. Edrlion Dots Limit 1 Linn 2 Lrnit 3 Deductble Amount tt DodUcaile Type PrarnFYn Ref t DwKYiption Coverage Code FOrrri No. EIn0n Date LIrn t 1 Limit 2 Limit 3 Deductible Amount Deductible Type Animas Ref• Description Coverage Code Form No. Edam Date Limit 1 Lail 2 Limit 3 Deductible Amount Dedicatee Type Premium Ref DIsalptkn Ccrvera4e Code Form No. Edition Date UlId 1 Limit 2 Limit 3 Deductbie Amount Deductible Type Prerntum Ref 8 ' Deeds pain Coverage Code Form No. Edition Date Ulait 1 2 Unit 3 Deductible Amaad Del ic1Lle Type Premium Mitt Ref a DeeorriptIon CWerage Code form No. Mali Date Ling 1 LIMN 2 Limit 3 Deductible Amount Deducible Type Premium DFADTLCY Copyright 2001, a.MS Services. Inc Technology Insurance Company, Inc. A Stock Insurance Company WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY Ncci Code: 39071 1. Insured: Macedonia Missionary Baptist Chinch of Miami Inc 3515 S Doue1as Rd Miami, FT_ 33133 Other workplaces not shown above: None Producer: Matra- 1 ighr Agency, Inc. 920 Cassia Road, Suite 100 Berwyn, PA 19312 WC990001 B 1 of 5 INFORMATION PAGE Policy Number: TWC4333067 Individual Partnership X Corporation or Federal Tax 1I): 591705798 Risk Id: Renewal of: New 2. Ilie policy period is from 10/10/2023 to 10/10/2024 12:01 a.m. at the insureds mailing address. A. Workers Compensation Instn'auce: Part One of the policy applies to the Workers Compensation Law of the slates listed here: Florida B. Employers Liability Insurance: Marl Two of the policy applies to work m each state listed in new 3.A. The hunts of our liability under Part Two are: Slate Bodily Injury by Accident Bodily Injury by Disease Bodily Injury by Disease $1,000,000 each accident $1,000,000 policy limit $1,000,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WY and State(s) Desiguated in Item 3.A D. This policy includes these endorsements and schedules: See Extension of Information Page 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plar[s. All information required below is subject to verification and change by audit. See kxteusion of Information Page TOTAL ESTIMATED ANNUAL PREMIUM 708 STATE ASSESSMENT 0 TOTAL ESTIMATED COST 708 Minimum Premium 319 Deposit Premium 708 Issue Date: 10/10/2023 Countersigned by: Authorized Representative MIAMI FOR EVERYONE FUNDING AGREEMENT EXHIBIT F — CLOSE-OUT REPORT The Close Out Report must be completed at the end of the program. City of Miami Miami For Everyone Program Close -Out Report Date: Program/Project Title: Recipient's Name: Allocation Amount: Macedonia Missonary Baptist Church - Classroom Annex Project MACEDONIA MISSONARY BAPTIST CHURCH OF MIAMI, INC. Recipient's Address: 3515 S. DOUGLAS ROAD, MIAMI, FL 33133 Please provide the information in reference to all the services provided with the City of Miami Miami For Everyone program: 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) Project KPI (Ex. # People, Households Served, workers/students enrolled) Frequency of Project/Activity/Service over the period of performance Narrative describing overall results (How the program has helped the community recover from the declared emergency.) I certify that the Program/Service was provided in accordance to the City of Miami Miami For Everyone Program Guidelines Signature Date Type Name Title: Return to: City of Miami Office of Management and Budget 444 SW 2nd Ave., 5' Floor Miami, FL 33130 MIAMI FOR EVERYONE FUNDING AGREEMENT EXHIBIT G - RECIPIENT'S CORPORATE RESOLUTION Macedonia Missionary Baptist Church of Miami, Inc. 3515 Douglas Road, Miami, FL 33133 Tel. (305) 445-6459 mail: info@macedoniambcmiami.com Web: www.macedoniambcmiami.com Reverend Lance B. Bailey Sr., Pastor Board of Directors Chairperson, 14s. Loretta S. Whittle Chairman, Deacon Board, 514r. Uv[ichaefDouglas Finance Officer, UVLs. Carolyn D. Donaldson CORPORATE RESOLUTION WHEREAS, Macedonia Missionary Baptist Church of Miami, Inc. desires to enter into an Agreement with the City of Miami, for an allocation of funds from the District 2 share of the City's MIAMI FOR EVERYONE ("MFE") GRANT PROGRAM a copy of which is attached hereto; and WHEREAS, the Board of Directors, at a duly held corporate meeting, has considered the matter in accordance with the By -Laws of the corporation; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS that, Carolyn D. Donaldson is hereby authorized and instructed to enter into an 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 the terms contained in the proposed Agreement to which this resolution is attached. ATTEST: Corporate Secretary Print Name: Carolyn D. Donaldson DATED this 26TH day of October 2023. Signature: Print Name: Loretta Scippio-Whittle Title: Chairperson of the Board of Directors (Corporate Seal) Olivera, Rosemary From: Brito, Gabriel Sent: Friday, March 22, 2024 5:40 PM To: Lee, Denise; Olivera, Rosemary; Ewan, Nicole; Hannon, Todd Subject: Executed Grant Agreement - Miami For Everyone - Macedonia Missionary Baptist Church of Miami, Inc. Attachments: DocuSign_MFE_Agreement_-_Macedonia_Missionar.pdf RE: MFE Grant Agreement — Macedonia Missionary Baptist Church of Miami, Inc. Hello All, Please find attached a fully executed copy of the above reference Grant Agreement from DocuSign that is to be considered an original for your records. GabrielJ. Brito CIP Budget Coordinator Office of Management & Budget 444 SW 2 Avenue, 5th Floor Miami, Florida 33130 Phone: 305.416.1203 Gbrito@miamigov.com i