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HomeMy WebLinkAbout23063AGREEMENT INFORMATION AGREEMENT NUMBER 23063 . NAME/TYPE OF AGREEMENT LITTLE HAVANA ACTIVITES AND NUTRITION CENTER DESCRIPTION GRANT AGREEMENT / ELDERLY SERVICES- CDBG FUNDS OF $48,252.00 FY 2019-20 / MATTER ID:20-212 / #93 EFFECTIVE DATE March 3, 2020 ATTESTED BY NICOLE EWAN ATTESTED DATE 3/3/2020 DATE RECEIVED FROM ISSUING DEPT. 3/16/2020 NOTE CITY OF MIAMI DOCUMENT ROUTING FORM ORIGINATING DEPARTMENT: HOUSING AND COMMUNITY DEVELOPMENT DEPT. CONTACT PERSON: Monica Galo EXT. 1976 Little Havana Activities and Nutrition NAME OF OTHER CONTRACTUAL PARTY/ENTITY: Center IS THIS AGREEMENT AS A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? TOTAL CONTRACT AMOUNT: $ 48,252.00 FUNDING INVOLVED? TYPE OF AGREEMENT: D MANAGEMENT AGREEMENT ❑ PROFESSIONAL SERVICES AGREEMENT ® GRANT AGREEMENT ❑ EXPERT CONSULTANT AGREEMENT ❑ LICENSE AGREEMENT OTHER: (PLEASE SPECIFY): ❑YES ®YES ❑ PUBLIC WORKS AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ INTER -LOCAL AGREEMENT ❑ LEASE AGREEMENT ❑ PURCHASE OR SALE AGREEMENT ® NO ❑ NO PURPOSE OF THE ITEM (BRIEF SUMMARY): Amendment to provide additional CDBG funding to the existing CDBG Public Service Agreement between Little Havana Activities and Nutrition Center. for the implementation of Elderly Meals in D3. Total contract amount is $48,252 and the term is from 10/1/2019 to 09/30/2020. For additional information please see Resolution attached. COMMISSION APPROVAL DATE: 11/21/2019 `I/FILE ID: 6502 ✓ ENACTMENT No.: 19-0483 IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN: sTT } ROUTING INFORMATI Date PLEASE PRINT AND SIGN APPROVAL BY DEPARTMENTAL DIRECTOR Ge r /Roberto Tazoe SUBMITTED TO RISK MANAGEMENT r 2 7A) 4 G `t SUBMII�'FE TO CITYT0R E C a 0 vvPrt— ra net ed. tidy w Victoria Men , City Attor ey A "Sandra APPROVAL BY ASSISTANT C1TYC MANAGER 40/L 7 p pro ,GC,p� / Ze � ili0 Bri em , FO APPROVAL BY DEPUTY CITY MANAGER Joseph Napoli RECEIVED BY CITY MANAGER 1) ONE ORIGINAL TO CITY CLERK, 2) ONE COPY TO CITY ATTORNEY'S OFFICE, 3) REMAINING ORIGINAL(S) TO ORIGINATING DEPARTMENT PRINT: SIGNATURE: PRINT: SIGNATURE: PRINT: SIGNATURE: PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE EXECUTION BY THE CITY MANAGER CITY OF MIAMI, FLORIDA DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANT ("CDBG") AMENDMENT #1 This Amendment to the Agreement between the City of Miami (CITY), a municipal corporation of the State of Florida, and Little Havana Activities and Nutrition Centers of Dade County, Inc., Florida not for profit corporation (SUBRECIPIENT) is entered into this 3 day of , 2020. RECITALS WHEREAS, the CITY and SUBRECIPIENT have heretofore entered into an agreement, executed on November 20, 2019 (AGREEMENT), which sets forth the terms and conditions pursuant to which the CITY provided SUBRECIPIENT the sum of $40,752.00 in Community Development Block Grant (CDBG) funds to carry -out Public Service activities, as authorized by the Miami City Commission through Resolution No. 19-0343; and WHEREAS, pursuant to Resolution No. 19-0483, which was adopted on November 21, 2019, the Miami City Commission authorized the allocation of additional funds in the sum of $7,500.00 in CDBG funds to continue to carry -out Public Service activities; and WHEREAS, except as specifically modified hereby, all funds are subject to the same terms and conditions contained in the AGREEMENT; NOW, THEREFORE, in consideration of the mutual covenants and obligations herein set forth, the parties understand and agree as follows: 1. Exhibit B of the AGREEMENT (Work Program) is amended to the new Exhibit B, attached hereto and incorporated herein. 2. Exhibit C of the AGREEMENT (Compensation and Budget) is amended to the new Exhibit C, attached hereto and incorporated herein. 3. Maximum Compensation for the AGREEMENT is increased to $48,252.00. 2016.1.2 1 IN WITNESS WHEREOF, the parties hereto have caused this First Amendment to be executed by their respective officials thereunto duly authorized on the date above written. AUTHORIZED REPRESENTATIVE: ///#7 Name: Ra el Iglesi Date: Title: President CITY OF MIAMI, a municipal Corporation of the State of Florida I2-114 N oPtEaa,,V City Manager APPROVED REQUIRE ate. CE Ann- arie Sham= Date: Dir ctor, Risk Management APPROVED BY DEPARTMENT OF HOUSING & COMMUNITY DEVELOPMENT George Me 'ah Date: Director, Department of Housing & Community Development SUBRECIPIENT Little Havana Activities and Nutrition Centers of Dade County, Inc. 700 SW 8 St Miami, Florida 33130 a Florida not -for -profit corporation ATTEST: Name:Luis Title: Secretary Corporate Seal: ATTEST: ibAt07-e) Date: iet"..Tod B. Hannon City Zd2-0 at: APP' : E l • S TO FORM AND ESS: ndez Attorney RFrr 41,20 -2 i z �L'ItZo Date: 2016.1.2 2 Little Havana Activities & Nutrition Centers of Dade County, Inc. Manuel Marrero Rafael Iglesias Mario Luis del Valle Lourdes M. Madariaga Luis M. Borges Alberto Balido Chairman President and CEO Vice Chair Treasurer Secretary Director Rafael Villaverde Founder Elisa De Velasco Director RESOLUTION RESOLUTION AUTHORIZING EXECUTION OF CONTRACTS WITH the City of Miami and Little Havana Activities & Nutrition Centers of Dade County, Inc. for the purpose of providing social services. WHEREAS, this Board desires to accomplish the objectives as outlined in the scope of services. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS of Little Havana Activities & Nutrition Centers of Dade County, Inc. approves the contract with the City of Miami for the purpose of providing congregate meal services in the amount of $48,252 for the contract period of 10/01/19 — 09/30/20 and authorizes Rafael Iglesias, President and CEO and/or Luis M Borges, Secretary to execute same for and on behalf of Little Havana Activities & Nutrition Centers of Dade County, Inc. THEREUPON, declare this resolution duly passed and adopted this 8th day of January, 2020. ATTEST Manuel Marrero Chairman of the Board CORPORATE SEAL OurPartners ELDER AFFAIRS UnIb.d Wog MIAM Mmb., *waxy M 700 S.W. 8TR Street, Miami, Florida 33130-3300 305-858-0887 - Fax: 305-854-2226 www.Lhanc.org City of Miami Legislation Resolution: R-19-0483 City Hall 3500 Pan American Drive Et. 33133 itii,nk.mlamigCv.com File Number: 6502 Final Action Date: 11/21/2019 A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S), AUTHORIZING THE TRANSFER OF COMMUNITY DEVELOPMENT BLOCK GRANT FUNDS IN THE AMOUNT OF.$98,960.00 FROM THE DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT TO THE AGENCIES :SPECIFIED IN EXHIBIT "A," ATTACHED AND INCORPORATED, FOR PUBLIC SERVICE ACTIVITIES; FURTHER AUTHORIZING THE CITY MANAGER TO NEGOTIATE AND EXECUTE ANY AND ALL NECESSARY DOCUMENTS, INCLUDING AMENDMENTS, EXTENSIONS, AND MODIFICATIONS, ALL IN FORMS ACCEPTABLE TO THE CITY ATTORNEY, SUBJECT TO ALL FEDERAL, STATE, AND LOCAL LAWS THAT REGULATE THE USE OF SUCH FUNDS FORSAID PURPOSE. WHEREAS, pursuant to Resolution No. 19-0343 adopted on September 12, 2019, the City Commission approved the allocation of Community Development Block Grant ("CIDBP") funds in the Public Service category for program year 2019,2020, which included an amount of $98,960.00 ('Funds") to the Department Of Housing and COmMunity Development ("Department"); and WHEREAS, there is a need to allocate these FUnda to the agencies specified in the Exhibit "A," attached and incorporated, for public service activities; and WHEREAS, the City of Miami's Administration recommends the transfer of the Funds from the Department to the agencies specified in..ExhiOit "A," attached and incorporated, for public service activities; NOW; THEREFORE; BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI; FLORIDA: Section 1. The recitals and findingS contained in the Preamble to this Resolution are adopted by referencoand incorporated as if fully set forth in this Section. Section 2. The transfer of the Funds from the Department to the agencies specified in Exhibit "A," attached and incorporated, forpublio service activities is authorized.' Section 3. The City Manager is authorized' to negotiate and execute any and all necessary documents, including amendments, extensions, and modifications, all in forms acceptable to the City Attorney, subject to all federal, state, and local laws that regulate the use OftuOh funds for said purpose. 4 The herein authorization is further tithject tp ctinIpliapcd with all'requirements that maybe imposed by the City Attornqy, including but net limited to, those prescribed by applicable City Charter and Code 'Provisions: Cliyhf 11/1Iaml Page 1 of 2 6502 (Revialon: ) Printed On: 11/26/2019 File.ID: 6502 EnaatinentNumbef: R-19-0483 • Section 4. This Resolution shall become effective°immediately upon its adoption and. signature of the Mayor2" APPROVED AS TO FORM AND:CQRRECTNESS: oria endez, ; _ity Attorne " :10/11/201.9 2 If'the Mayor-does"not sign this_Resolution, itshall;become effective at the- end ;of ten_t1o) calehdar days from the date it was:passed and adopted: If the Mayor vetoes this_ Res_ olution, it shall become effective Immediately-uponoverride_of the veto by: the' City Commission..• 'Cify"_ofMiamiPage 2 of 2 File ID: 6502 (Revision: ).Printed on:_1.1/26/2019, ATTACHMENT "A" CITY -OF MIAMI DEPARTMENTOF HOUSING AND COMMUNITY DEVELOPMENT CDEG PUBLICSERVICE'FUNDS FROM TO ,ACTIVITY FUNDED AMOUNT DEPARTMENT OF. HOUSING AND COMVIUMTY DEVELOPMENT, Family Action Network Movement, Inc: Youth Services • $ 31,970.00 De Hgstos Senior Center Elderly Meals $ 2,500.00 Josefa Perez de Cstro kidney Foundation, Inc: Elderly Meals $ 2,500.00 uttle Havana Activities 44 Nutrition center of DadeCounty, Inc. Elderly Nleals - - - •$ 7,500.00 De P artment of Resiliance and Public"Works Sidewalks and Spot Drainage' $ 54,490.00 Total 'F5,Allocation,' $ 98,960.60 EXHIBIT B — WORK PROGRAM ELDERLY SERVICES Scope of Services: 1. SUBSUBRECIPIENT understands that the National Objective for this activity is assistance to low to moderate income persons by serving a limited clientele as defined in 24 CFR 570.208(a)(2) and that the HUD matrix code associated with this activity is 05A (Senior Services). 2. SUBRECIPIENT will provide Elderly meals and related services to eligible program participants from October 1, 2019 to September 30, 2020 with funding from the 2019-20 SSG Program Year. 3. SUBRECIPIENT will provide 1,215 Congregate Meals and/or _0 Homebound Meals a. Congregate Meals Program: Provide a nutritionally balanced meal, Monday through Friday, to 5 eligible participants, at the following location(s): Address: Little Havana Activities & Nutrition Centers of Dade County, Inc. 700 S.W. 8th Street Miami, FL 33130 b. Homebound Meals Program: Ensure delivery of a nutritionally balanced hot meal, Monday through Friday, to 0 eligible participants at their home address. Other tasks to be performed by the SUBRECIPIENT in connection with the provision of meals and related services include, but are not limited to, the following: 4. Perform eligibility determination: A. Only elderly individuals meeting the following criteria will be considered eligible program participants: a. Must be a resident of the City of Miami b. Must be a member of a low -to moderate income household c. Must be at least 62 years of age B. SUBRECIPIENT must keep in file proof of the information listed below demonstrating that each program participant is eligible to receive program benefits: a. Proof of living in the City of Miami b. Proof of age SUBRECIPIENT may replace program participants who stop receiving program benefits by providing the information required in items 3.a and b for the new participant. SUBRECIPIENT will not invoice the CITY until the proposed participant is certified as eligible by the CITY. 5. At all times, maintain facilities in conformance with all applicable codes, licensing, and other requirements for the operation of an elderly center and/or provision of meals. The facilities must be handicapped accessible. 6. Procure meals in a manner that provides, to the maximum extent, practical, open and free competition and in compliance with 24 CFR 84.40-48. 7. As part of the congregate meal program, provide a range of structured social and cultural activities. 8. As part of the homebound meal program, ensure that meals are delivered in a timely manner. 9. Maintain program and financial records documenting the eligibility, attendance, provision of services, and SUBRECIPIENT expenses relative to the elderly individuals receiving meals services as a result of the assistance provided through the CDBG program. 10. SUBRECIPIENT will provide the following program reports to the City: a. A monthly report for the services provided to eligible participants in a form provided by the CITY. This report must include the date range when services were provided, the name of the client(s), the last five digits of the client's social security number and the number of days served. This form must be signed by the Program Manager and Executive Director. b. A final Close -Out (financial report) and inventory report. c. A final. performance report. 2 Signature f Autho ed Officer STATE OF - tez-t Di COUNTY OF 1--4. 4.4. The foregoing instrument was.a.c.kaewledged b o e me by means of LI physical presence�I 1 or online notarization, this "la"cJ at by ea et j(gst f iohett�e of o icer or agent, title of officer or agent) of LL Q "4. Ar l;4;�t 41/11 t" 'isle of corporation), a fr (state or p ace of irico ora�io orpo a ion;"% b is of the corporation. is personally known to me —Ors -as produced (type of identification) as identification. s e [Notary Seal] (Signature of person taking acknowledgment) (Name typed, printed or stamped) Notary Public State of Florida Berta Luisa Rua no My Commission GG 133920 low Expires 09/13/2021 EXHIBIT COMPENSATION AND BUDGET A. ThetinaXifniiin compensation under this Agreement shall be $ 48 252.00. B. SUBRECIPIENT's Itemized Biidget, Cost Allocation, Budget Narrative, Staff Salaries Schedule are attached hereto and made part of this Agreement. C. Requests for payment should be made at least on, a monthly basis. Reimbursement requests should be submitted to the CITY within thirty (30) calendar days after the indebtedness has been incurred in a form provided by the Department Failure to comply with these time frames for requesting reimbursement/payment may result in the rejection of those invoices within the reimbursement package which do not meet these requirements. D. Each written request for payment shall contain a statement declaring and affirming that services described in Exhibit B Scope of Services Were provided to certified, program participants and in accordance with the approved Work Program and Program Budget All 'documentation in support of each request shall be subject to review and approval by the CITY at the time the requestis made. E. All expenditures milk be verified with a copy of the original invoice and a copy of a check or Other form of payment which was used to pay that specific invoice. Within 60 days of submitting each reimbursement request, copies of the cancelled checks or other CITY approved documents evidencing the payments by the SUBRECIPIENT, for which reimbursement was requested, ishall be submitted. In the event that an invoice is paid by various funding souices, the copy of the invoice must indicate the exact amount (allocation) paid by various funding sources equaling the total &the irivoice. No miscellaneous categories shall be accepted as a line -item budget. F. The SUBRECIPIENT must submit the final request for payment to the CITY within ten (10) Calendar days following the termination date of this Agreement If the SUBRECIPIENT fails to comply with this requirement, the SUBRECIPIENT shall forfeit all rights to payment and the CITY shall not honor atiy request submittd thereafter. G. Any payment due under this Agreement may be. withheld pending the receipt:and approval by the CITY of all reports due from the SUBRECIPIENT as a part of this Agreement and any •niOdificatioag thereto. H. During the termhereof arid for a period of five (5) years following the date of the last payment made hereunder, the CITY shall have the right to review and audit the time records and related records of the SUBRECIPIENT pertaining to any payments by the CITY. -2 Name: Rafa- Iglesias Title: President & CEO 01/07/2020 Date CITY OF MIAMI DEPARTMENT OF HOUSING & COMMUNITY DEVELOPMENT AGENCY: PERIOD FUNDING SOURCE BUDGET NARRATIVE BY LINE ITEM Little Havana Act. & Nut. Centers of Dade County 2019-2020 Community Development ITEM DESCRIPTION AMOUNT PERSONNEL Mayra Albelo, Director of Transportation 2084/pp x 24pp x 4% $2,001 Josefina Padron, Kitchen Aide 1000/pp x 24pp x 22% $5,280 Francisco Borrego, Driver 759/pp x 24pp x 23.4% $4,263 Olga Barrios, Site Coordinator 780/pp x 24pp x 25.7% $4,811 Belkis Gonzalez, Bookkeeper 2002.04/pp x 24pp x 3% $1,441 Xenia Palenzuela, Case Worker 917/pp x 24pp x 31.65% $6,965 Sub -Total Personnel $24,761 FRINGES FICA 24,761 x .0765 $1,894 Group Insurance Humana 446.22 x 12 months x 3 employees $16,064 Humana (Vision/Dental) 27.82 x 12 months x 3 employees $1,002 TransAmerica 22.92 x 12 months x 3 employees, less $11 $814 Total Fringes $19,774 TOTAL PERSONNEL $44,534 CONTRACTUAL TOTAL CONTRACTUAL $0 COMMODITIES Congregate Meals 1,215 meals at $3.06 per meal $3,718 TOTAL COMMODITIES $3,718 • TOTAL BUDGET $48,252 AGENCY: CITY OF MIAMI BUDGET FORM II DEPARTMENT OF COMMUNITY DEVELOPMENT STAFF SALARY FORECAST Little Havana Activities and Nutrition Centers of Dade County Inc. PERIOD COVERING: __ 10/1/19-9/30/20 Employee Name Position Title Social Security Ethnicity Type of Employee Pt/Ft Period Budgeted Pay Periods Annual Gross Salary Total Salary Per Pay Period Percent of Salary Charged to City Total Amount Charged to City Mayra Albelo Director of Nutrition Dept. Hispanic Pt 24 $ 22,008.00 $ 917.00 31.65% $ 6,965.53 $24,761.22 AIstNI;T: Little navana Act. tk Nut. l;enters rerioa being host A rerloa tieing cost Allocated: rerioa being Lost E Effective Date 10/1/2019 1/1/2019 1/1/2019 1/1/2019 Line -Item Description % CDBG % C-2 % C-1 % SSG cyo 101 STAFF SALARIES 1% 17,544.00 10.00 360,747.00 30.11 390,064.00 64% 750,811.00 10.73 40,715.00 10.00 201 STAFF FICA 2% 1,342.00 24.23 22,366.31 26.7 24,183.97 64% 46,550.00 3.3 716.45 200 STAFF MICA - 5,230.83 22.68 5,655.93 65% 10,887.00 32.8 2,398.55 15 204 STAFF GROUP HEALTH INS. 8% 18,148.00 75,756.87 41.75 81,913.44 67% 157,670.00 12.4 4,366.00 TOTAL 37,034.00 34.23 464,101.02 121.24 501,817.34 2.60 965,918.00 59.23 48,196.00 25.00 250 PROFESSIONAL SERVICES*Cost of Food 0% 3,718.00 25.8 910,132.00 9.25 591,728.00 57% 1,501,860.00 4.38 65,144.00 10 301 GEN. LIABILITY INS. 0% - 14.14 6,023.00 14.14 18,405.00 67% 24,428.00 15.71 3,712.00 12 350 TELEPHONE 0% - 10.88 11,446.00 10.88 13,008.00 63% 24,454.00 12.52 3,240.00 16 360 ELECTRICAL SRVS. 0% - 45 13,379.00 57% 13,379.00 370 GARBAGE 0% - 25 829.00 25 9,478.00 58% 10,307.00 380 WATER & SEWER 0% - 45 1,118.00 63% 15,000.00 411 BLDG. MAINTENANCE 0% - 41.71 14,940.00 51% 14,940.00 8.81 2,604.00 521 OFFICE SUP. STAFF*Extermination 0% - 45 25,124.00 57% 25,124.00 (BELOW $500.00) 0% 55.81 52,448.00 56% 52,448.00 TOTAL 3,718.00 5.82 928.430.00 291.79 739,628.00 5.28 1,681,940.00 41.42 74,700.00 38.00 TOTAL 1% 40,752.00 1,392,531.02 1,241,445.34 60% 2,647,858.00 122,896.00 Nerioo Being c;ost Allocates: 1U-1-ZU1y / U-:SU-LUZU 1 /1 /2019 7/1/2019 7/1/2019 MDC (A -I) % LSP % HRN % Total 83,239.00 12.87 78,809.00 16.29 199,692.00 34% 402,455.00 100% 1,170,810.00 7,567.00 13.92 4,886.16 28.55 12,380.90 34% 24,952.00 100% 72,844.00 9.68 1,142.73 19.84 2,895.53 35% 5,836.00 100% 16,723.00 11.89 15,761.80 21.56 39,938.40 25% 60,067.00 100% 235,885.00 90,806.00 48.36 100,599.69 86.24 254,906.84 1.29 493,310.00 4.00 1,496,262.00 158,430.00 12.57 189,864.00 25 702,433.00 43% 1,115,871.00 100% 2,621,449.00 12.16 2,873.00 16.14 5,635.00 33% 12,220.00 100% 36,648.00 1,750.00 12.4 3,207.00 24.8 6,415.00 37% 14,612.00 100% 39,066.00 14.5 3,402.00 28.49 6,686.00 43% 10,088.00 100% 23,467.00 14.72 2,475.00 28.89 4,857.00 42% 7,332.00 100% 17,639.00 14.4 280.00 28.09 546.00 38% 9,000.00 100% 24,000.00 13.47 3,984.00 27.2 8,045.00 49% 14,633.00 100% 29,573.00 15.54 6,874.00 27.65 12,229.00 43% 19,103.00 100% 44,227.00 14.19 14,719.00 30 26,591.00 44% 41,310.00 100% 93,758.00 160,180.00 123.95 227,678.00 236.26 773,437.00 3.72 1,244,169.00 9.00 2,929,827.00 250,986.00 328,277.69 1,028,343.84 39% 1,737,479.00 4,426,089.00 Exhibit G INSURANCE 'COVERAGE REQUIREMENTS FOR PUBLIC $ERV10ES & ECONOMIC DEVELOPMENT The City Of Miami requires all subredpientsio Maintain the Insuranvetage as s .below; I. Corruterciai General Liability (Primary & NOn-COiltributory) A. Limits of Liability Bodily Injury & Property Damage Liability Each Occurrence $300,000 General Aggregate Limit . $600,000 Personal & Adv. Injury $300,000 FDroductst Completed Operations $300,000 13. .Erideratiments 'Required • City of Miami included listed as additional insured (endorsement required) :Contingent Llability/CorittactUal Liability Promisee & Operations Liability Explosion, Collapse, & Underground Hazard (If applicable) II. Business Automobile Liability A. Linnits.of Liability Bodily Injury & Property barnage Liability Owned. Autos/Scheduled Autos Including coveragefor Hired & Non-cWned autos COmblned .Single Limit . $300,000 Split Limits Bodily Injury $100,00043,00,000 Property Damage $50;000 B, EndorSeMerits Required City of Miami included as Additional Insured 111. Worker's Compensation Limits of Liability Statutory -State of Florida • Employer's Liability A. Limits of Liability $100;000 for bodily injury caused by an accident, each accident. $100,000 for bodily injyryoaused by disease, each ernployee. $100,000 for bodllyinjury caused by disease, IV. Professional Liability (If applicable) EaCh Claim Policy Aggregate $250,000 $250,000 fit? *el qn 3/872012 Effective FY2012-291$ Page 1 of 2 Exhibit G THE DEPARTMENT OF RISK MANAGEMENT RESERVES THE RIGHT TO SOLICIT ADDITIONAL INSURANCE COVERAGE AS MAY BE APPLICABLE IN CONNECTION TO 'PARTICULAR RISK; OR'SCOPE OF SERVICES The above policies shall provide theCity of Miami With written "notice of cancellation in acCOrdanCe with policy provisions. Companies authorized to do bu§ineSs in the State of Florida, With the fo bwing qualifications, shall issue all Insurance policies required aboVe: The company must be rated nOJest 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. BeAcernpany, Oldwick, New Jersey or its equivalent: All policies and/or certificates � insurance are subject to review and Verification by the City of Miami Risk Management Department prior to insurance approval. 2. All certificates of insurance must be provided for review and approval prior to the effective date of the agreement and/or the date when services are provided and/or construction Is started, as determined by the Dept. of Risk Management. 3: Compliance with the foregoing requirements shall not relieve the applicant of its liability and obligations underthe Agreement; 4. Applicant shall apply and obtain any other Insurance coverage that the City may require for the execution of the agreement. 5. Applicants; projects and entities awarded funding for any construction related projects will be subject to additional Insurance requirements for the applicant, contractors and subcOntraCtOrS, as determined by the City of Miami, In order to meet all local, state, and federal regulations and requirements. .RevlOd oil 3iev,2912 Effppllyp .E))2012401a - Pagq :2 of 9 DL ACCPRb® CERTIFICATE OF LIABILITY INSURANCE ik.....----- DATE(MM/DD/YYW) 12/17/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON, THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Insurance Marketers - Miami 2600 S Douglas Road Suite 712 Coral Gables FL 33134 License#: L100460 CONTACT NAME: Evarist Milian Jr. PHONE FAX (A/C. No. Ext): 305-442-9507 (A/c, No): 305-447-8527 ADDRESS: emilian@insurancemrkt.com INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: New Hampshire Insurance Company 23841 INSURED LITTHAV-01 Little Havana Activities and Nutrition Centers of Dade County 700 S.W. 8th Street Miami FL 33130 • INSURER B: National Union Fire Ins. Co. Pittsburgh PA 19445 INSURER C: Associated Industries Insurance Company, Inc. 23140 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 596048734 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 IUBR LTR TYPE OF INSURANCE ADDL NSR SWVD POLICY NUMBER POLICY EFF (MM/DD/YYYY ,,(MM/DD POLICY EXP / LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 01-LX-062648073-1 C 1/1/2019 3/31/20 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED (Any one person) $ 5,000 ERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE —1 POLICY LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE X LIABILITY _ X _AUTOS SCHEDULED AUTOS NON -OWNED 01-CA-01 •ylii\� (^\ IIU1^\\' `` _ ^ �/- I 1/1 2019 3/31/2020 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ 1,000,000 PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 29-UD-016698909-3 1/1/2019 3/31/2020 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ DED 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 Y) N N /A TWC3792558 4/13/2019 4/13/2020 X WC STATU- TORY LIMITS OTH- FR E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Social Service Organization providing range of services to seniors in South Florida. Subject to the terms, conditions and exclusions listed in the policies. General Liability policy includes attached endorsement: Social Services General Liability Enhancement Endorsement which includes under Additional Insured- .. by Contract, Agreement or Permit and Primary & Non -Contributory if Required by written contract or written agreement prior to loss and currently in effect during the term of this policy. , Automobile Liability policy includes attached Form 118368(1/15)-Social Services Auto Enhancement Endorsement includes- Additional Insured by - Contract,Agreement or Permit if the written contract or written agreement has been executed or permit issued prior to the bodily injury or property damage. . CERTIFICATE HOLDER CANCELLATION City of Miami 444 SW 2nd Avenue 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 ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. 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