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HomeMy WebLinkAbout23481AGREEMENT INFORMATION AGREEMENT NUMBER 23481 NAME/TYPE OF AGREEMENT LITTLE HAVANA ACTIVITIES & NUTRITION CENTER OF DADE COUNTY, INC. ' DESCRIPTION CDBG AGREEMENT/MEDICAL/SCREENING GERIATRIC PROGRAM TO ELDERLY/FILE ID: J-92-542/R-92-0513 EFFECTIVE DATE March 16, 1993 ATTESTED BY WALTER FOEMAN ATTESTED DATE 3/16/1993 DATE RECEIVED FROM ISSUING DEPT. 3/17/1993 NOTE DOCUMENT LOG FORM/CITY MANAGER'S OFFICE 1 Name ,of party(ies): Document type: Purpose: Faciltiy:. Date(s): Contact Person (questions): Dan Fernandes Telephone: 2 4 5 4 Contact Person (delivery): pan Fernandes Telephone: 2 4 5 4 Li t Little Havana Activities -arid Nutrition Centers of Dade County, Inc./Pro-Salud Program Agreement To provide a medical/screening geriatric program Pro-Salud to elderly City of Miami residents. July 1;11992 through 'June 30. 1993 EXPENSE/REVENUE $49.800 ACCOUNT(s) JE S(s) Authorized by Resolut' n No. 92-513 OR Approved by: Budget D rector (IF GENERAL FUNDS) CIP Administrator (IF CIP FUNDS) (IF C.D. FUNDS) Comm.Dev.Director _X_ All City requirements have been met and the document(s) is(are) ready for execution Dep . D' e• o �iPesignee Init. DEPT. DIRECTOR OR DESIGNEE ACM/Advisor DATE 3-12-93 i•nat re Signa ure Date -3/*3 Date - Rec. by Mgr's Office: L3//0 5j -Signed by Manager: (.25 i!A F -Attested by City Clerk: C..3/4 S -3 -Returned to dept./office: LV/ 7 A3 ORIGINAL TO CITY CLERK: v // -) /'2 REV. 9-20-91 CITY OF MIAMI, FLORIDA COMMUNITY DEVELOPMENT BLOCK GRANT AGREEMENT THIS AGREEMENT entered into this ✓07 day o 19_t,i between the City of Miami, a municipal corporation of the State of Florida, (hereinafter referred to as the "CITY"), and LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER OF DADE COUNTY, INC., aFlorida. not for profit corporation, (hereinafter referred to as the "CONTRACTOR"). FUNDING SOURCE: Interest to be Earned from Tax Anticipation Notes TERM OF THE AGREEMENT: July 1 1992 through June 30. 1993 AMOUNT: S49.800 VENDOR NUMBER: 044209 TAX IDENTIFICATION NO.: 23-7378008 EXECUTIVE DIRECTOR: Josefina Carbonell ADDRESS: 700 S.W. 8 Street. Miami, Florida 33130 TELEPHONE NO.: 858-0887 NOW, THEREFORE, in consideration of the mutual covenants and obligations herein set forth, the parties understand and agree as follows: ARTICLE I 1.0 BASIC REOUIREMENTS As a necessary part of this Agreement, the following documents must be approved by the City prior to its execution and must be on file with the. Department of Community Development: 1.1 Corporate Resolution authorizing execution of this Agreement. 1 1.2 Work Program (approved by the CITY). The Work Program submitted by the CONTRACTOR to the CITY will become an attachment to this agreement and shall include the following: 1. A description of the work to be performed; and 2. A schedule for completing the work; These items shall be in sufficient detail to provide a sound basis for the CITY to effectively monitor performance by the CONTRACTOR under this agreement. 1.3 Budget Summary, to include: completion of CONTRACTOR's Program/Line-Item Budget/Expenditure Justification, Total Actual and Projected Funds Disclosure, and Staff Salaries Schedule (on forms supplied by the CITY); budget for program -generated revenues; copies of all subcontracts and/or management services Agreements funded in whole or in part under this Agreement. 1.4 Certificate of Insurance which reflects CONTRACTOR's current liability insurance, naming the CITY as primary or additional insured as determined by the Risk Management Division of the CITY; current Workers' Compensation insurance; current Fidelity Bond (applicable for all persons who are authorized to receive and disburse funds under this Agreement); and other coverage as deemed necessary, if applicable (i.e. automobile insurance). 1.5 CONTRACTOR's Corporate Seal (to be affixed to Signatory Page, and Corporate Resolution). 2 1.6 Copy of CONTRACTOR's Article of Incorporation,, Charter and Bylaws. 1.7 List of Present Principal Governing Board Officers and Members of the Board (names, addresses and telephone numbers). 1.8 List of Key Staff Persons, with their titles, who will carry out this program. 1.9 Completion of Authorized Representative Statement. 1.10 Completion of Statement of Accounting System. 1.11 A letter from an independent Certified Public Accountant which expresses the opinion that the CONTRACTOR's internal controls are adequate to safeguard the organization's assets. 1.12 Copy of last Audit Report as performed by an independent C.P.A. 1.13 Corporate Personnel Policies and Procedures. 1.14 Job Description and Resumes for all positions funded in whole or in part under this Agreement. 1.15 Acceptance of Office of Management and Budget (OMB) Circular A-110, Attachments "A" (Cash Depositaries), "B" (Bonding and Insurance), "C" (Retention and Custodial Requirements for Records), "F" (Standards for Financial Management Systems), "H" (Monitoring and Reporting Progress Performance), If N (Property Management Standards), and "0" (Procurement Standards), as modified by 24 CFR Part 570.502 (b), "Applicability of Uniform Administrative Requirements," of the Community Development Block Grant (CDBG) Program regulations, Final Rule, and provided as an attachment to this Agreement (Attachment I). 1.16 Copy of last Income Tax Return (IRS Form 990). ARTICLE II 2.0 RECORDS TO BE MAINTAINED 2.1 CONTRACTOR shall establish and maintain sufficient records to enable the CITY to determine whether the CONTRACTOR has met the requirements of this part. At a minimum, the following records are needed: (a) Records providing a full description of each activity assisted (or being assisted) with CDBG funds, including its location (if the activity has a geographical locus), the amount of CDBG funds budgeted, obligated and expended for the activity, and the'provision in 24 CFR Subpart C under the CDBG Program regulations which it is eligible. (b) Records demonstrating that each activity undertaken meets one of the criteria set forth in 24 CFR 570.208 of the CDBG Program regulations. Where information on income by family size is required, the CONTRACTOR may substitute evidence establishing that the person assisted qualified under another program having income qualification criteria at least as restrictive as that used in the definitions of "low and moderate income person" and "low and moderate income household" as set 4 forth by 24 CFR 570.3; or the CONTRACTOR may substitute a copy of a verifiable certification from the assisted person that his or her family income does not exceed the applicable income limit established in accordance with 24 CFR 570.3; or the CONTRACTOR may substitute a notice that the assisted person is a referral from a state, to refer individuals it determines to be low and moderate income persons based on HUD's criteria and agrees to maintain documentation supporting these determinations. Such records shall include the following information. (1) For each activity determined to benefit low and moderate income persons, the income limits applied and the point in time when the benefit was determined. (2) For each activity determined to benefit low and moderate income persons based on the area served by the activity: (i) The boundaries of the service area; (ii) The income characteristics of families and unrelated individuals in the service area; and (iii) If the percent of low and moderate income persons in the service area is less than 51 percent, data showing that the area qualifies. under the exception criteria set forth at (3) 570.208(a)(1)(ii); For each activity determined to benefit low and moderate income persons because the activity involves a facility or service designed for use by a limited clientele consisting exclusively or predominantly of low and moderate income persons: (i) Documentation establishing that the facility or service citizens, spouses, is designed for and used handicapped persons, abused children, the by senior battered homeless, illiterate persons, or migrant farm workers, for which the regulations provide presumptive benefit to low and moderate income persons; or (ii) Documentation describing how the nature and, if applicable, the location of the facility or service establishes that it is used predominantly by low and moderate income persons; or (iii) Data showing the size and annual income of the family of each person receiving the benefit. (c) Equal Opportunity Records containing: (1) Data on the extent to which each racial and ethnic group and single -headed households and ethnic group and single -headed households (by gender of 6 household head) have applied for, participated in, or benefited from, any program or activity funded in whole or in part with CDBG funds. Such information shall be used only as a basis for further investigation as to compliance is required to attain or maintain any particular statistical measure by race, ethnicity, or gender in covered programs. (2) Documentation of actions undertaken to meet the requirements of 24 CFR 570.607(b) which implements section 3 of the Housing Development Act of 1968, as amended (12 U.S.C. 1701U) relative to the hiring and training of low and moderate income persons and the use of local businesses. (d) Financial records, in accordance with the applicable requirements listed in 24 CFR 570.502. (e) Records required to .be maintained in accordance with other applicable laws and regulations set forth in Subpart K of 24 CFR. 2.2 As a necessary part of this Agreement, the CONTRACTOR shall provide the following documents to the Department of Community Development, in accordance with the requirements of the Agreement: A. Final Expenditure Report to be submitted no later than thirty (30) days after contract expiration. B. Certified Independent Audit to be submitted sixty (60) 7 days after contract expiration. CONTRACTORS receiving monies from the Department of Community Development must allocate in its budget sufficient funds to secure an annual independent audit which must include the expression of an opinion on the Contractor's financial statements, and a compliance letter stating whether the CONTRACTOR is in conformity with federal grant regulations (Office of Management and Budget Circular A-110 Attachment I). Said audit must be submitted no later than sixty (60) days after the expiration of the Community Based Organization Agreement with the Department of Community Development. The City of Miami's Department of Internal Audits and Reviews shall have the authority to review CONTRACTOR's records, including programmatic records and books of account, for a period of up to three (3) years from the termination date of the Agreement. All books of account and supporting documentation should be kept by the Contractor at least three (3) years for audit purposes. ARTICLE III 3.0 PROCEDURES 3.1 TIME OF PERFORMANCE The term of this Agreement shall be from July 1, 1992, to June 30, 1993. 8 3.2 CITY AUTHORIZATION For the purpose of this Agreement, the City of Miami Department of Community Development (hereinafter the "DEPARTMENT") will act on behalf of the CITY in the fiscal control, programmatic monitoring, and modification of this Agreement, except as otherwise provided by this Agreement. 3.3 ENTIRE AGREEMENT This instrument and its attachments constitute the only. Agreement of the parties hereto relating to said grant and correctly sets forth the rights, duties, and obligations of each to the otheras of .its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 3.4 OBLIGATION OF CONTRACTOR The CONTRACTOR shall carry out the services as prescribed in its Work Program (Attachment II), which is attached and incorporated herein and made a part of this Agreement, in a lawful, and proper manner, satisfactory to the CITY, in accordance with the written policies, procedures, and requirements as prescribed in this Agreement, as set forth by the U.S. Department of Housing and Urban Development (HUD) and the City of Miami Department of Community Development. 3.5 POLICIES AND PROCEDURES MANUAL CONTRACTOR is aware and accepts the Policies and Procedures Manual (Attachment III) for Community Based Organizations as 9 the official document which outlines the fiscal, administrative and Federal guidelines and which shall regulate the day-to-day operations of the CONTRACTOR, which is attached and incorporate herein and made a part of this Agreement. 3.6 BONDING AND INSURANCE CONTRACTOR shall maintain insurance and bonding coverages acceptable to the CITY's Risk Management. Division of the Personnel. Management Department. Prior to commencing any activity under this Agreement, the CONTRACTOR shall furnish to the CITY certificates of insurance and bonding indicating that the CONTRACTOR is in compliance with the provisions of this article. CONTRACTOR shall provide the following coverages: (a) Insurance coverage that reflects sound business practices acceptable to the CITY's Department of Risk Management. (b) Fidelity bonding for all persons handling funds received or disbursed under this Agreement in an amount equal tc or greater than the maximum amount of cash held at any one time. CITY shall be a primary additional insured on all insurance policies and there shall be no exclusions in such policies to override the CITY coverage. (c) Current liability insurance shall be rated by A.M. Best's as to "A" Classification and "V" as tofinancial - 10 - size. Compliance with the foregoing requirements shall not relieve the CONTRACTOR of its liability and obligations under this section or under any other section of this Agreement. 3.7 LEVEL OF SERVICE Should start-up time for a program be required or any delays in service occur, the Department of Community Development is to be notified in writing immediately, giving all pertinent details and indicating when service shall begin and/or continue. It is understood and agreed that the level of services, activities, and expenditures by the CONTRACTOR, in existence prior to the initiation of services hereunder, shall be continued and shall not be reduced in any way as a result of this Agreement. Programs funded through this Agreement shall not result in the displacement of employed workers, impair existing contracts for services, or result in the substitution of funds allocated under this Agreement for other funds in connection with work which would have been performed in the absence of this Agreement. 3.8 OTHER PROGRAM REOUIREMENTS (a) CONTRACTOR shall carry out its Work Program in compliance with all Federal laws and regulations described in Subpart K of the CDBG Program regulation (24 CFR 570.600-612), (Attachment I). (b) CONTRACTOR shall not assume the CITY's environmental responsibilities described at •24 CFR 570.604 of the CDBG Program regulations, and the CITY's responsibility for initiating the review process under Executive Order 12372 (Attachment I). 3.9 PROGRAM INCOME Program income means gross income received by the CONTRACTOR which has been directly generated via the use of CDBG funds. When such income is generated by an activity that is only partially assisted with CDBG funds, the income shall be prorated to reflect the percentage of CDBG funds used. Program income generated by CDBG funded activities shall be retained by CONTRACTOR and shall by used to only undertake those activities specifically approved by the CITY on the Work Program. All provisions of this Agreement shall apply to such activities. Any program income on hand when the Agreement expires or received after such expiration shall be paid to the CITY, as required by 24 CFR 570.503(b)(8) of the CDBG Program regulation. CONTRACTOR shall submit a Program Income Report on a monthly basis along with the required monthly Work Program Status Report. The Program Income Report will identify CDBG activities in which income was derived and how income has been utilized. 3 10 REPORTS, AUDITS AND EVALUATIONS The CONTRACTOR shall comply with the Federal Directive required by the U.S. Department of Housing and Urban Development (USHUD) to document that program activities are provided for the benefit of low to moderate income persons. In accordance with the Code of Federal Regulations 24 CFR Part 570.506, records shall be maintained for each activity to determine that services benefit low and moderate income persons. At the request of CITY,, CONTRACTOR shall transmit, to CITY written statements of CONTRACTOR's official policy on specified issues relating to CONTRACTOR's activities. CITY may carry out monitoring and evaluation activities, including visits and observations by CITY staff; CONTRACTOR shall ensure the cooperation of its employees and Board members in such efforts. Any inconsistent, incomplete, or inadequate information either received by the CITY or obtained through monitoring and evaluation by the CITY, shall constitute good cause for the CITY to terminate this Agreement at any time thereafter. ARTICLE IV 4.0 FUNDING 4.1 COMPENSATION A. CITY shall pay CONTRACTOR, as maximum compensation for the services required pursuant to Article II hereof, S49.800. B. CITY shall have the right to review and audit the time records and related records of CONTRACTOR pertaining to any payments by CITY. C. With a written request from GRANTEE, CITY may advance 1/6th of the appropriated funds to Contractor. The advance shall be justified as follows: one-half (1/2) in nine (9) equal installments commencing in the third month of this Agreement and continuing through the eleventh month of this Agreement; one-half (1/2) in the twelfth and final month of this Agreement. This method of justifying the advance may be amended by the DEPARTMENT. Funds shall not be advanced by the CITY if the CONTRACTOR is in default under this Agreement. D. All payments shall be reimbursements for expenditures incurred only during the term of this Agreement, and in compliance with the previously approved Line -Item Budget. Such written request shall contain a statement declaring and affirming that all expenditures were made in accordance with the approved budget. All documentation in support of such request shall be subject to approval by CITY at the time the request is made and all invoices are required to be paid by CONTRACTOR prior to submission. All reimbursements must be in line -item form and be in accord with this Agreement. All expenditures must be verified by original invoice with a copy of the check which was used to pay that specific invoice. Within 60 days of submitting reimbursement request, copies of the cancelled checks shall be submitted. In the event that an invoice is paid by various funding sources, a copy of the invoice may be submitted but must indicate the exact amount paid by various funding sources equaling the total of the invoice. No miscellaneous categories shall be accepted as a line item in the budget. Request for line -item changes are allowable, with prior review and approval by the CITY. All line -item changes must be made prior to the end of the term of the Agreement. E. 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. Failure to comply may result in the rejection for repayment of those invoices within the reimbursement package which do not meet this requirement. F. CONTRACTOR must submit the final request for payment to the CITY within la calendar days following the expiration date or termination date of this Agreement. If the CONTRACTOR fails to comply, all .rights to payment are forfeited and the CITY shall not honor any request submitted after the aforesaid agreed upon period. G. Any payment due under this Agreement may be withheld pending the receipt and approval •by the CITY of all reports due from the CONTRACTOR as a part of this contract and any modifications thereto. A 4.2 FINANCIAL ACCOUNTABILITY CITY reserves the right to audit the records of CONTRACTOR at any time during the performance of this Agreement and for a period of three years after final payment is made under this Agreement. CONTRACTOR agrees to provide all financial and other applicable records and documentation of services to CITY. Any payment made shall be subject to reduction for amounts included in the related invoice. which are found by CITY, on the basis of such audit, not to constitute allowable expenditures. Any payments made to CONTRACTOR are subject to reduction for overpayments on previously submitted invoices. 4.3 RECAPTURE OF FUNDS CITY shall reserve the right to recapture funds when the CONTRACTOR shall fail (i) to comply with the terms of this Agreement or (ii) to accept conditions imposed by CITY at the direction of the federal, state and local agencies. 4.4 CONTINGENCY CLAUSE Funding for this Agreement is contingent on the availability of funds and continued authorization for program activities and is subject to amendment or termination due to lack of funds or authorization, reduction of funds, and/or change in regulations. 4.5 SEPARATION OF CHURCH/STATE In accordance with First Amendment Church/State principles, CDBG assistance may not be used for religious activities or 1 provided to primarily religious entities for any activities, including similar activities, as directed by 24 CFR 570.200(j). CONTRACTOR shall comply with this provision when entering into subcontracts. ARTICLE V 5.0 GENERAL REOUIREMENTS 5.1 INDEMNIFICATION CONTRACTOR, shall pay on behalf of, and save CITY harmless from and against any and all claims, liabilities, losses, and causes of action which may arise out of CONTRACTOR's activities under this Agreement, including all other acts or omissions to act on the part of CONTRACTOR, including any person acting for or on its behalf; from and against any relevant orders, judgements, or decrees which may be entered against the CITY; and from and against all costs, attorney's fees, expenses, and liabilities incurred by the CITY in the defense of any such claims or in the investigation thereof. 5.2 AMENDMENTS No amendments to this Agreement shall be binding on either party unless in writing and signed by both parties. 5.3 OWNERSHIP OF DOCUMENTS All documents developed by CONTRACTOR under this Agreement shall be delivered to CITY by said CONTRACTOR upon completion of the services required pursuant to this Agreement and shall become the property of CITY, without restriction or limitation on its use. CONTRACTOR agrees s that all documents maintained and generated pursuant to this contractual relationship between CITY and CONTRACTOR shall be subject to all provisions of the Public Records Law, Chapter 119, Florida Statutes (Attachment I). It is further understood by and between the parties that any document which is given by CITY to CONTRACTOR pursuant to this Agreement shall at all time remain the property of CITY and shall not be used by CONTRACTOR for any other purposes whatsoever without the written consent of CITY. 5.4 AWARD OF AGREEMENT CONTRACTOR warrants that it has not employed or retained any person 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 employed by the CITY any fee, commission percentage, brokerage fee, or gift of any kind contingent upon or resulting from the award of this Agreement. 5.5 NON-DELEGABILITY The obligations undertaken by the CONTRACTOR pursuant to this Agreement shall not be delegated or assigned to any other person or firm unless CITY shall first consent in writing to the performance or assignment of such services or any part thereof by another person or firm. 5.6 CONSTRUCTION OF AGREEMENT This Agreement shall be construed and enforced according to the laws of the State of Florida. 5.7 OBLIGATION TO RENEW Upon expiration of the term of this Agreement, CONTRACTOR: agrees and understands that CITY has no obligation to renew this Agreement. 5.8 TERMINATION OF CONTRACT 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 CITY. In that event, notice of termination of this Agreement shall be in writing to CONTRACTOR, 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 CITY pay CONTRACTOR an amount in excess of the total sum provided by this Agreement. It is hereby understood by and between CITY and CONTRACTOR that any payment .made in accordance with this Section to CONTRACTOR shall be made only if said CONTRACTOR is not in default under the terms of this Agreement. If CONTRACTOR is in default, then CITY shall in no way be obligated and shall not pay to CONTRACTOR any sum whatsoever. It is also understood that in accordance with 24 CFR 85.43- 44 of the CDBG rules and regulations, suspension or termination may occur if CONTRACTOR fails to comply with any term of this Agreement,or if the CITY deems it convenient to terminate it. 5.9 REVERSION OF ASSETS Upon expiration of this Agreement, the CONTRACTOR shall transfer to the CITY any CDBG funds on hand at the time of expiration and any accounts receivable attributable to the use of CDBG funds. Any real estate property that was acquired or improved by CONTRACTOR in whole or in part with CDBG funds in excess of $25,000 shall be either: A. Used to meet one of the three (3) CDBG National Objectives set forth by 24 CFR 570.208 of the CDBG Program regulations, until five (5) years after expiration of this Agreement, or such longer period of time as determined appropriate by the City; or B. Disposed of in a manner resulting in the CITY being reimbursed in the amount of the current fair market value of the property less any portion thereof attributable to expenditures of non-CDBG funds for acquisition of, or improvements to, the property. 5.10 GENERAL CONDITIONS A. All notices or other communications which shall or may be given pursuant to this Agreement shall be in writing and shall be delivered by personal service, or by registered mail addressed to the other party at the address indicated herein or as the same may be changed from time to time. Such notice shall be deemed given on the day on which personally served; or, if by mail, on the fifth day after being posted or the date of actual receipt, whichever is earlier. CITY OF MIAMI CONTRACTOR 3500 Pan American Drive Miami, Fla. 33133 Little Havana Activities and Nutrition Centers of Dade County, Inc. 700 S.W. 8 Street Miami, Florida 33130 B. Title and paragraph headings are for convenient reference and are not a part of this Agreement. C. In the event of conflict between the terms of this Agreement and any terms or conditions contained in any attached documents, the terms in this Agreement shall control. D. 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. E. Should any provisions, paragraphs, sentences, words or phrases 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 provisions, paragraphs, sentences, words or phrases shall be deemed modified to the extent necessary in order to conform with such laws, or if not modifiable to conform with such laws, then same shall be deemed severable, and in either event, the remaining terms and provisions of - 21 - this Agreement shall remain unmodified and in full force and effect. 5.11 INDEPENDENT CONTRACTOR CONTRACTOR and its 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 Ordinances of the CITY or any rights generally afforded classified or unclassified employees; further, they shall not be deemed entitled to the Florida Worker's Compensation benefits and an employee of the CITY. 5.12 SUCCESSORS AND ASSIGNS This Agreement shall be binding upon the parties herein, their heirs, executors, legal representatives, successors, and assigns. ARTICLE VI 6.0 CONTRACTOR CERTIFICATIONS CONTRACTOR certifies that: It possesses the legal authority to enter into this Agreement by way of a resolution, motion, or similar action that has been duly adopted or passed as an official act of the CONTRACTOR's governing body, authorizing the execution of the Agreement, including all understandings and assurances contained herein, and directing and authorizing the person identified as the official representative of the CONTRACTOR to act in connection with the Agreement and to provide such additional information as may be required. IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed by the respective officials thereunto duly authorized on the first date above written. CITY OF MIAMI, a municipal Corporation of the State of Florida ATTEST: TTY H I CITY CLERK ATTEST: CORPORATE SECRETARY I Josefina Carbonell CESAR H. ODIO CITY MANAGER CONTRACTOR: Little Havana Activities and Nutrition Centers of Dade County, Inc., a Florida not for profit corporation 700 S.W. 8 Str Miami, Flo GUARANTEE in consideration of the City of Miami's execution of the foregoing Agreement, the undersigned, guarantee the performance of the terms and conditionsin said Agreement required to be performed by the CONTRACTOR including but not limited to the provisions relating to default, assurances, and certifications. Dated this 17 day of September , 1992, Josefina Carbonell , an individual By - 23 - Josefina Carbonell , individually WITNESS: APPROVED AS TO INSURANCE REOUIREMENTS: Sujan S. Chhabra, Director Risk Management Department APPROVED AS TO FORM AND CORRECTNESS: A. QU, NN J CITY ATTO CORPORATERESOLUTION;-- : . WHEREAS, the Board of Directors of 4TTLEIHAVANA ACTIVITIES AND • , NUTRITION CENTERS OF DADE COUNTY, Inc hai:ikamined terms,! conditions, and obligations of the proposed contract with the ,• • „ CITY OF MIAMI for PRO-SALUD Program WHEREAS, the Board of Directors at a' duly held corporate meeting have considered the matter in accordance with the By -Laws of the corporation; • • ' • NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS OF LITTLE HAVANA ACT. & NUT. CENTERS•- , -*thatthe CHAIRMAN ., . . . ..-, and SECRETARY are hereby authorized and instructed to enter into a contract in the name of, and on behalf of this corporation, with the CITY 0 F MIAMI for PROL-SALUD Program .., . 1 in accordance with the contract documents:'furnished by the City ; • of Miami, and for the price and upon the terms and payments contained in the proposed contract submitted by the City of Miami. .:.:1.-' ..,1i.: .'• -- ' .,.. • ,-,--1-;- ...• .. - -1-•- 41-'. . -,. --.. - •,--1','-i,,,- .;-13:, IN WITNESS WHEREOF, this' 29 ' dayof .SePtember, 1992 CORPO TE SECRETARY Jose ,catirio Ferrer, M.D. " .-.,,':,t- , — ' •• • . — . ."- .-',.--..!,i' -: • . • ,-, ::,, , - 1 ,.• .. . •i-,:: , - • -_-•-...,.., %-.- . '' -CHAIRMAN, Board of Directors • -„. 1•Yf-- 3 il-- : -- , Frank ParedeS, • • 7 — LITTLE HAVANA ACTIVITIES AND NUTRITION CENTERS OF DADE COUNTY, INC. Work Program Specifications for the.Pro-Salud July 1, 1992 - June 30, 1993 RECOGNIZING THAT: (i) The Agency as a whole and through its combined sources of funding operates a comprehensive geriatric nutrition program for elderly Dade County residents at multiple sites; (ii) The Agency has established a medical screening/medication control prevention project for elderly citizens of the City of Miami at Little Havana Activities and Nutrition Centers of Dade County, Inc. (LHANC); (iii) Tax Anticipation Notes are being provided to secure services for City of Miami elderly residents, and to support the total operations of the Pro-Salud Program; The following work program specifications are for the operation of the medical/screening geriatric Program Pro-Salud: I. PROGRAM will provide medical screening and education to a minimum of 425 unduplicated elderly City of Miami residents by the end of the contract term: A. All persons served (unduplicated) will be 55 years of age or older (computed as date of birth at first service during contract term) and spouses under the age of 55 medically indigent. B. 248 "program days" will be provided by the end of the contract term. "Program Days" defined as operational days during which clients receive program services. C. Services to be provided to clients bythe program are as follow (Note: It is recognized that program services are provided on an as -needed -or -desired basis and as such, no quantitative service level requirements have been set for each individual service unit component. 1 1. ACTIVITIES AND OTHER SOCIAL SERVICES a. Medical Screening - will be provided to clients on an as -needed -or -desired basis. In all cases, the client's specific medical condition will be stated in the client's file, a plan of action to be undertaken will be identified and the services rendered documented. Counseling may be provided at the Center or Clinic site. b. Medical Education - will be provided on a monthly basis by nurse and/or clinical clerk. This service will translate the principles of geriatric medical conditions and medication control through effective communication at the LHANC City of Miami sites. c. Health Information/Referral Services - be provided on an as -needed -or -desired either a one-to-one basis or through contacts, i.e., private physicians. will be noted in client files. will also basis, on telephone Referrals D. PROGRAM will operate from 9:00 a.m. to 4:00 p.m., Monday through Friday, (excluding holidays). II. PROGRAM will maintain complete, updated, and accurate records for each client served, and will utilize the following forms to document services rendered which include: A. Intake Form (will include name, address, social security number and date of birth) B. Release of Medical Information Form C. Contact/Appointment Log(s) D. Outreach Log(s) E. Medical Information/Condition F. Referrals: Listings, i.e., private physicians (if applicable) III. PROGRAM will complete a monthly activity report (see attached form), and will submit it to the Social Programs Division, Department of Community Development, City of Miami, by the tenth working day of the following month. A. Number of unduplicated City of Miami persons served during the month: 1. # of City of Miami residents over 55 2. # of City of Miami residents under 55, but spouses of otherwise eligible clients must be medically indigent. 3. # of low -to -moderate income clients 4. # of Males (White Non -Latin, Black Non -Latin, Latin, Other) 5. # of Females (White Non -Latin, Black Non -Latin, Latin, Other) 6. Female Head of Households B. Number of outreach/health education units during the month C. Number of Program days for the month D. Number of clients withdrawn/terminated during the month E. Number of active clients at end of month IV. PROGRAM will maintain complete, updated and accurate records during the contract term, and will retain them in the Little Havana Activities and Nutrition Centers of Dade County, Inc., 700 S.W. 8th Street, Miami, Florida 33130: Work Program signed and submitted (with Attachments) to the City as par of the Tax Anticipation Notes Contract on this /f day of 1992. WITNESS NOTA Y PUBLIC SIG TURE , SEAL AND STAMP NOTARY PUBLIC STATE OF FLORIDA MY C THRU ;. OP, EXP. FEB.20,1995 GENERAL INS. UND. -3 Jos fina Ca :o esident Little Hay. a ,i es and Nu'ritio• C nte• of Dade Co •t In . 700 S.W. 8 h St et Miami, Florida 33130 CORPORATE' RESOLUTION WHEREAS, the Board of Directors of LITTLE's$AVANA ACTIVITIES AND NUTRITION CENTERS OF DADE COUNTY, Inc has examined terms, conditions, and obligations of the proposed contract with the CITY OF MIAMI for PRO-SALUD Program WHEREAS, the Board of Directors at a duly held corporate meeting have considered the matter in accordance with the By -Laws of the corporation; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS OF LITTLE HAVANA ACT. & NUT. CENTERS that the CHAIRMAN and SECRETARY are hereby authorized and instructed to enter into a contract in the name of, and on behalf of this corporation,* with the CITY OF MIAMI for PRO-SALUD Program in accordance;with the contract documents furnished by the City of Miami, andifor the price and upon the terms and payments contained in the proposed contract submitted by :the City of • Miami. IN WITNESS WHEREOF, this 29 CORPORATE SECRETARY Jose Porfirio Ferrer,,M.D. day -of September, 1992 CHAIRMAN, _Board of 'Directors G �Guardian Property & Casualty Insurance Co. COMMERCIAL PACKAGE POLICY -` COMMON POLICY D�CLARATIQN5 & Miami. Florida 33126 - i POLICY 4UME1ER \CPP 205271 tNAMED INSURED AND MAILING ADCF,-ESS POLICY PERIOD 12:01 AM 1/1/92 1/31/93 AGENTS NUMBER 1'_:31 AN STANDARD TI'E 91031 LITTLT:- HAVANA .ACTIVITIES AND ,NUTRITION CENTER OF DADE CTY 730 SW A ST MIAMI FL 3 313 ) D25 CLOG AGENTS NAME - AND (ADDRESS EXCLUSIVE UNDERWRITER'S INC 5o43 NUJ 7TM STREET S!JITE 65J MIAMI _ FL 33125 #4 5) CATHOLI ...:3,i+!UNITY SERVJC E - INC 9990 NE AVE `4IAMT SHORES FL 33136 IN RETURN FOR TH_ PAYMENT. OF THE PRE?1TUMr. AND SUBJECT TO ALL THE TER4S OF THE COVERAGE PART;/POLICIES ATTACHED,. 4E AGREE 'WITH YOU TO PROVIDE T:1E INSURANCE DESCRIBED THEREIN. . COUINTERSIGNED BY RIEP? SFNTATIVE) (DATE) PAGE- 3 �.14T - �' Guardian Property Q Casualty Insurance Co COMMERCIAL FIRF. y1/ Miami, Florida 33126 ✓.' (tE 1EWAL D :CLARATI04. • 7,3 POLICY NUMBER POLICY PERIOD 12:01 AM CPP 2t15271 1/31/97 1/01/93 1:2: 1 AM STANDARD' TIME /NAMED ,INSURED AND MAILING ADDRESS LITTLE- HAVANA ACTIVITIES AND NUTRITION CENTER OF- DADE .CTY 7:1 0 S1 H ST - 'tIAMI FL 33133 AGENT'S NUMEE? AGENT'S NAME AND • ADDRESS J 11- OCATION ADDRESS(ES): 1 833 6ST • MIAMI BEACH FL 33139 EXCLUSIVE- U:NDER4RITER'S IMC 5041 NY 7TN' ST EET SUITE 650 FL 33126 • 16 720-7_ ' ti 3 ST • KIAaII COVERAGES: ITEM LOC NUM NUM 1 1 5LE 4UW 1 DESCRIPTION: COVERAGE DESCRIPTION BUILDINGS CLASS PROT CODE CLASS r;34.4 02 TERR N U 7 032 CONST MTH LIMIT CODE IN2DEMNITY mm FL 3113C 'MAX PERIOD EXT PERIOD. INDEMNITY ' INDEMNITY COVERED LIMIT OF DED. CAUSES - COIN INFL INSURANCE AMOUNT OF LOSS PERCENT GUARD :545J.00:). PREMIUM 7.5rj3 SPECIAL 3.0):Y 0.05% $2.093.n0 ITEM LOC BLE NUM NUM NUS! 2 1 1 DESCRIPTION: COVERAGE DESCRIPTION PERS PROPERTY CLASS PROT CODE CLASS 0344 G?. LIMIT OF INSURANCE $255,003 TERR NUM 032 ITEM LOC ZLt: NUM NUM NUM 3 .16 1 DESCCRIPTION: COVERAGE DESCRIPTION, CLASS PROT CODE CLASS 3039 ' 02 LIMIT OF INSURANCE CONST MTH LIMIT 'CODE INDEMNITY RN MAY: PERIOD INDEMNITY COVERED DED. CAUSES COIN INFL AMOUNT OF -LOSS , PERC7NT S!UARD EXT PERIOD INDEMNITY PREMIUM $500 SPECIAL 30.f r% $237.O TE2R NUM 012 CONST MTH. LIMMIT CODE INDEMNITY -JN. MAX PERIOD INDEMNITY - COVERq.D DED. CAUSES COIN INFL AMOUNT OF LOSS PERCENT ";'•JA' ) EXT PERIOD INDEMNITY • -PREMIUM 3UILDIN6 S ei:J:; FPLCIAL ?_►.•;; PAGE 4 �_ Guardian Property & Casualty Insurance Co ( COMMERCIAL FIRE G • Miami, Florida 33126 f POLICY NUMBER POLICY PERIOD 12:01 AM `CPP 235271 (E4EWAL DECLARATION! 1/01/92 1/31/93 12:01 AM STANDARD TI%1 "NAMED INSURED AND MAILING `ADDRESS LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER OF DADE CTY 73" . sw 3 ST MIAMII FL 33133 "N AGENT'S NAME AND• ADORES AGENT'S NVMBER ')1001 CFORMS AND EyDOPSFAENTS APPLICABLE 4 - EXCLUSIVE IJ DEURITER'S INC 5..40 NV 7TH STREET SUITE 650 MIAMI FL 33126 TO THIS COVE': ?ART: ITEM 1 1 1 1 1 1 ENDORSEMENT NO. EDITION DATE CP O01 1 10-91 CP 009C 37-33 CP 0125 10-91 CP 0435. 11-5 CP 103' 13-91 CP 1135 11-85 DESCRIPTI:. BLDG & PERSONAL PROPR COIF COMA PROPERTY.CONDITIONS FL CHG CONDO ADDTL BLD(G FUNCTIONAL 1? :f'LACMNT COST CAUSES OF LISS SPECIAL - WATERCRAFT EXCLUSION PREMIUM TOTAL ADVANCF PREMIUM $5,900.0 ?AU GGuardian � Property & Casualty Insurance Co • Miami. F33126 COMMERCIAL GENERAL LIA?. (ENEWAL DECLARArIOV POLICY NUMBER CPP 2 ;5271 POLICY PERIOD 12:01 AM Ai;_NT"i NUMBER 1/31/92 1/11/93 12:0 AM STAMDAPD TI k . "1001 'NAMED INSURED AND MAILING ADDRESS LITTLE HAVANA ACTIVITIES A4D NUTRITION CENTER OF - DADE CTY' 700 SW 3 ST MIAMI FL 3313: AGENT'S I NAME I AND I AIrPESS EXCLUSIY! U4DE VRITETt' S •INC - 5 J4O NW 7T4 STREET SUITE 65!: MIAMI FL 33126 LIMITS OF INSURANCE GENERAL AGGREGATE LIMIT(OTHER THAN PRODUCTS -COMPLETED OP:ERATION ) . . :r50i.!iM PRODUCTS-COMPLET=D OPERATIONS AGGREGATE LIMIT EXCLUD.':C PERSONAL' 1 ADVERTISING INJURY LIMIT S51^i+)Ot EACH OCCU'REiJCE LL'9IT 1:500,1 FIRE DAMAGE LI' T (ANY ONE FIFE) 1;55,11 MEDICAL EXPENS '.i:JIT (ANY ONE PERSON) 55,- LOCATION ADDRESS(E ): 2 500 W 44 PL 3 2'P J'J 13 AVE HIALEAH• 4 3667 S MIAMI AVE MIA!I 6 450 SW 5 ST - r'7IA I 8 11250 SW-197 ST MIAMI .10 191 NW 75 ST MIAMI 12 ' 970 SW 1 ST MIAMI 14 1043 SN 29 CT MIA+MI 17 7^.) SW R ST MIAMI FL 33012 FL 33133 FL 3313') FL 33177. FL 33150 FL 331128 FL 33135 FL 33130 ti MIAMI - FL 33125 5 5949 NW 7 ST MIAMI FL .33116 7 nri NU 13 AVE 4IA741_ FL 33125 9 533 COLLINS AV MIA1I REACH FL 33139 11 1063C SW 4 ST MIAMI FL 33174 13 1497 NW 7 ST MIAMI FL 33125 15 95C NW 95 ST MIAMI- FL 33150 PAGE 6 -i G �_. Guardian Property & Casualty Insurance Co. !- Miami, Florida 33126 . Pai4c COM:MMERCIAL GENERAL LIAO. litENEMAL DECLARATION (COP 2C5271 1/11/92 1/331/93 12:31 AM STANDARD TIME 31%1 POLICYNUMBER POLICY PERIOD 12:01 AM AGENT'S NUMPE . NAMEQ INSURED LITTLE: HAVANA .ACTIVITIES AHD' AND NUTRITION CEN7 R. OF ). DE CTY MAILING 70 SSW 3 ST ADDRESS ' 7 AMI FL 37130 (COVE+? 1 :' \ AGENTS NAME AND . ADDRESS EXCLUSIVE UNDERWRITER'S INC 5043 NW 7TH STREET SUITE 65') MIAMI -FL 33126 ITEl L.0 CLASSIFICATION DESCRIPTION , CLASS EXPOSURE TERR 1 1 3UILDI' iS ON PRF.!IISF..S — am OR OFFICE: 61215 550.3 1 NOC — INCLUDING PR)DUCTS AND/OR COMPLETED OPERATIONS LIA'1IL'7'f P!;F?9I!!4 . . . S3,714.: ITEM LOC CLASSIFICATION DESCRIPTION CLASC EXPO:MR TER'I c'. 1 JARZHOUS' S — PRIVATE — INCLUDING 1 PRODUCTS AND/OR COMPLETED O?ERATION3 LIABILITY P.`.EMIUM .. $.346.'.' ITEM' LOC CLASRIFIC?TION DESCRIPTION CLASS EXPOSUn. TERR 3 1 CLU)S — CIVIC, SERVICE OR SOCIAL — 41562 75:i') 1 HAVING BUILDINGS OR PREMISES OWNED INCLUDING PRODUCTS AND/OR COMPLETED OPERATIONS LIABILITY PRErMIUM . . . ITEM LOC CLASSIFICATION DESCRIPTION CLASS EXPOSURE TERR. 4. 2 CLUBS — CIVIC, SERVICE OZ SOCIAL — 41 562 2148rI 1 HAVING BUILDINGS OR PRE.FMISES OWNED INCLUDING PRODUCTS AND/OR COMPLETED OP5RATI ONS LIABILITY PREMIUM; . `>;2, ? 79.'00 'ITEM LOC CLASSIFICATION DESCRIPTION - - CLASS' EXPOSURE TER 5' 3 CLUJS -- CIVIC, SERVICE .OR SOCIAL 41662 • 3500 1 HAVING 3UILDINGS OR PREMISES OWNED — INCLUDING PRODUCTS AND/OR COF PLETED OPERATIONS • LIABILITY PREMIUM . . 12,976.0' : I.TE!4. LOC CLASSIFICATION D!:SCRIPTIONN CLASS YPO SU2% TER? 6 4 CLU 3S — CIVIC,: SERVICE OR SOCIAL — 41552 HAVING BUILDINGS OR PREMISES OYNFD —.. INCLUDING PRODUCTS APaD/CP CUMPLETE0 OPE.4ATIO'1 • )'NV % • .1., 3gardian Property & Casualty Insurance Co C3 it1ERCIAL GENERAL LIA`�. G �' rliami, Flcrida 33126 (1EMEHAL DECLARATION POLICY NUMBER POLICY PERIOD 12:01 AM AGENT'S NUM2ER \CPP ?O5271 1/11/72 1/J1/43 12:J1 Ark STANDARD NAMED INSURED AND MAILING ADDRESS LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER OF ')ADE CTY 70C1 SW :Z S T M/A''' FL 3313:3 (AGENT'S NAME AND , ADDRESS l \ XCLUSIVI..-!1NDER:'JfITER'S INC 5042 NV 7T4 STREET SUITE 65;;- MIA}!I FL 33126 ITEM LOC :...ASIFICATION DESCRIPTION CLASS EXPOSURE TERR 7 5 rLU3S — CIVIC, SER'IICE OR SOCIAL — - 41667 3776 1 HAVING 3IUILDINGS OR PREMISES (MED INCLUDING P'ODJCTS AND/OR COMPLETED OPERATIONS LIABILITY . . . . �3,211.0 ITEM LOC CLASSIFICATION DESCRIPTION CLASS EXPOSURE TEE! 8 • 6 CLUBS — CIVIC, SERVICE OR SOCIAL — Al ASS' 13662 1 HAVING 3UILDINGS OR PREMISES O' ' D — INCLU9I4G PRODUCTS AND/OR CO !PLETED OPERATIONS LtA3ILITY PRE'1IU!R . . $11,613.0O ITEM LOC CLASSIFICATION DESCRIPTION CLASS EXPOSURE TERR 9 7 CLUUS — CIVIC, SERVICE OR SGCIAL — 41662 23O 1 HAVING BUILDINGS OR PREMISES OWNED — INCLUDING PRODUCTS AND/OR COMPLETED OPERATIONS. LIABILITY YR EMIU 4 . . . . Sip-M. 00 ITEM LOC CLASSIFICATION DESCRIPTION 10 8 CLUBS — CIVIC,- SERVICE 'OR SOCIAL — HAVING 3UILDINGS 0R PREMISES OWHED. - INCLUDING PRODUCTS AND/OR COMPLETED OPERATIONS. CLASS EXPOSURE TERR 4166' ' 3000 ' ' 1 LIA.ZILITY PREFI'J1 . . . 2,551.0J ITEH LOC CLASSIFICATION DESCRIPTION CLASS EXPOSURE TERR ' 11 4 CLUNS — CIVIC, S►:RVICE OR SOCIAL — 61661 460n 1 HAVING 1'3UILDINaS O; PREMISES.OWNED — INCLUDING PRODUCTS AND/OR CO�°PL�ETED OPERATIONS - LIA1IL?TY PRE9I'J . . . . 154,:: i.7; ITEM LOC CLASSIFICATION DESCRIPTION CLASS ENPO3IJRF T^RR 12 10 CLUB S — CIVIC. -SERVICE OR ."-.!)CI.AL — 41R62 1''S'_ 1 HAV:.'sr ?JIL')ItN,S 01 PREMIS (M'D — !N! P :CDUCT3 AND/O, i 31 1A7Z. _i'If, PAGE 8 ',.Guardian Property & Casualty Insurance Co \ COMMERCIAL GENERAL -LIA?. : Miami, Florida 33126 , 6NEWAL 1)lsCLARkrION . . . l POLICY NUMBER \CPP 2C5271 POLICY PERIOD 12:01 AM AGENT'S NUMBER 1 / -l1 / 92 1 /?1 /93 12:01 AN 7M IDARD TIME Q1 G;'1 INSURED LITTLE HAVANA ACTIVITIES AND � AGE`�T.S s XCLUSIVI: • UNDER;I'UTER' S INC NAME AND, NUTRITION CENTER OF DADE CTY ; 3043 NV 7TH STREET SUITE b5': MAILIN3 73 3 S 4 .8 ST III � MIAMI FL 33126 ADDRESS MIAMI FL 3313.3 `-- 4 4 L-.;. ILITY PREMIUM . . 114;1•57.1.0O ITEM LOC CLASSIFICATION DESCRIPTION CLASS EXPOSURE TERR 13 11 CLUas — cIVIC, SERVICE OR SOCIAL — 41562 24u' 1:. HAVIN1G BUILDINGS OR PREMISES OWNED — INCLUDIMG PRODUCTS AND/OR COMPLETED OPERATIONS LIABILITY PREMIUM! . . . ITE11 LOC-CLASSIFICATION DESCRIPTION CLASR 'EXPOSURE TERR 14 12 CLUBS — SOCIAL, CIVIC OR SERVICE — ''+166'.. 310O 1 HAVING BUILDINGS 01 PREMISES OWNED INCLUDING PRODUCTS AND/OR COMPLETED OPERATIONS LIABILITY PREMIUM . . $2,636.03 ITEM LOC CLASSIFICATION DESCRIPTION CLASS EXPOSURE TERR 15 13 CLUBS .- CIVIC, SERVICE OR SOCIAL — 41662 176!:,2. 1 HAVING BUILDINGS 01 PREMISES OWNED INCLUDING PRODUCTS AND/OR COMPLETED OPERATIONS LIABILITY PREf1IUI . . 1:14,96 a.0 ITEM LOC CLASSIFICATION DESCRIPTIONN - CLASr EXPOSURE TERR 16 14 CLUBS — CIVIC, SERVICE OR SOCIAL - 41662 30U0 1 HAVING BUILDINGS 0R PREMISE 0aJN7 !) — _ INCLUDING PRODUCTS AND/OE' COMPLETED .OPERATIONS. LIABILITY PREMIUM . . . . $2,551.0 ITEM LOC CLASSIFICATION -DESCRIPTION • CLASR - `EXPOSURE T±:11R 17 15 CL'JZS — CIVIC,- SERVICE OR SOCIAL — 4165? 1^. 1 HAVING BUILDINGS Or( PREMISES OWNED — INCLIIDIN1G PRODUCTS -A? D/OR COMPLETED OPERATIONS LIABILITY PREMIUM . . . t1,531.UO �,a nKiw.cr 1 Gordian Property & Caeualty Insurance. Co VAGL 9 Miami, Florida 33126 ENEWAL DECLARATION POLICY NUMCER POLICY PERICD 12:01 AM CPP 235271. 1/01/9? 1/)1/93 :31 AM STANDARD TI'2 NAMED INSURED AND MAILING \.ADDRESS LITTLE HAVANA ACTIVITIES ► ND NUTRITION CENTER OF DADE CTY 700 SW 3 ST MIAM.I FL 3313i AGENT'S NUMBER LAGENT'S NAME AND . ADDRESS I EXCLUSIVE UNDERWRITER'S INC 5U4O N4 7T3_ STREET SUITE 65:1 MIAMI FL 3112 i ITEM LOC CLASSIFICATION DESCRIPTION 13 16 WAREHOUSES -PRIVATE .(INCLUDING PRODUCTS AND/OR COMPLETED O"ERATION. WITHIN THE GENERAL AGGREGATE) •" CLASS EXPOSURE TERR .637 ,5- 36a) 1 • LIABILITY PEMIUM ITEM LOC CLASSIFICATION D =SCi� r?TION 19 16 BUILDI'J3S OR PREMISES-3,V1K/OFFICE/MERC OR MANUFACTURING -(LESSOR'S RISK ONLY) (INCLUDING PRODUCTS :iNn/Oh COMPLETED OPERATIONS WITHI`I GENERAL AGGREGATE) $41 6.10 CLASS EXPOSURE TERR 61217 2500 1 LIA;3ILITY. PRE SIUM . • ITEM LOC CLASSIFICATION DESCRIPTION 20 1 DAY CARE CENTERS LIABILITY CLASS 41714 • $353. flu EXPOSURE TERR 33 1 PREMIIJM . . . ITEM LOC CLASSIFICATION DESCRIPTION 21 17 DAY CARE :CENTERS ▪ 12,089.03 CLAS ` EXPOSURE TERR 41716 75 1 LIABILITY PREMIUM . . . ▪ $4,744.0;) FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART: ITE?4 1 1 1 1 ENDORSEMENT NO CG 0001 C6 2026 CG 2104 CG 2144 C6 2146 EDITION DATE •11-33 , 11-85 11-85 11-35 U1-37 DESCRIPTIDN COMA GNL LIAf3 COVER FORM ADDTL INS DESIG PERSON EXCL PROD COM/OPS HAZA^D LIMIT OF .COY TO D _SIGNATTE ABUSE OR MOLESTATION EXCL.' PREMIUA TOTAL. ADVANCE PREMIUM S75,130.00 XNronm LrXON ma 'RISK4D4971Q .2 FE:IN 52„ 1.2 6 29 Usurer: 0ovarnaantal Risk inauraece Trust 1f 4 4 . The Insuredt.Little Sayan* Aetivitiea t ?lutrielon Centers of Dade County, Iuo. X Corporation (froze-rrutit) . Mailing Address: 700 S.W. 1th st. Municipality Miami, 1,1 22139 Physical Addraasf 2. "The policy period is from April 13. 1992 to . pr11_1L..._1993 ' at the insured's wailing address.' The Annivaraary stating Data is kern 12. 3. A. Workers' Compensation Insurance: Part On* of the policy applies to the Warkars' Conpenaation Labial the atat.i slated here: FLORIDA S. ! ployers Liability Inaurancet Part Two of the policy applies to work in each state listed io Item_3.A. The liwits of our liability under Part Two are: bodily Injury by Acoid.nt $104.40 snob aooid•et Bodily Injury by Disease •s500,00 policy limit Bodily Injury by fliaeaae $1QQ,0QQ each employe. C. Other state* Insurance' Part Thrae of the policy applies to the state., if any, h. r.' MOWN. listed D. This policy includes these .ndoraementa and achadulaaf 4. The premium. for this policy will be detarrtinad by our Manuals of Rules, Classifications, Rates and Latina Plana. All ia.fnrnatinn raqutrad halau i a at.h1wnt Co verification auA nhanuo by audit. Classification! Code Premium Basin Rate Par No. Total Eetima ed $100 of Annual Remuneration Remuneration SEE ATTACHED Total Estimated Annual Premium $ . NL.aimu. Praaium $600.00 s:rpens• Constant Q Countersigned byf Estimated Annual Premium Diok Andoraon 1+ Aaaoa., Lem. MLemi jl • April l3. _1992 • 000/001 MITT (10/90) :!'emJ um :summary RISK AND INSURANCE SERVICES CORP. Guarantee Cost Plan Member Serviacs Quotation 000()7-000" Napo : LITTLE NAVANA ACTZVITIEB t NUTRITION : CENTERS OF DADE COUNTY INC. Addraaa ATTN: ARTURO : 700 S.H. 8TH STREET City : MIAMI , FL 33130 Contact : DANIA RAMOS Agency : DICK ANDERSON 6 ASSOCIATES, INC. Phones : 305-596-0500 305-098-2610 nennrt ,Ddte 04/13/92 Policy Ragin 04/13/92 Policy End 04/13/93 Anm.Uate, nate 04/11/92 00230-000 Guarantees Cost Plan Premium Calculation 1. Manual - Rating Year 1992 39,024 2. Increased Employers Liability Coverage . • 3. Other Additions 39,024 4. Experience ModitiCation -4,293 04/13/92-04/13/93 0.89 5. Estimated Modified Premium 34,731 6. Drug -Free Program Credit - 0 7. FCCPAP 8. Premium Deviation p.00% _ 0 9. Stock Carrier's Discount 3,241 10. Airplane Seats 11. Estimated Direct Premium 31,490 12. Expense Constant i• 14n Estimated Total Premium 31.,6i0 Employer's Liability Limits: Accident 100,000 Disease (policy) 500,000 Individual Classifications Llaaa Codes Description •7380 .DRIVERS/CHAUFFEURS/11 Esc.iivat.ed Disease (employee) 100,000 Payroll 'Rate Estimated Employees. Manual Full Part • 8810 CLERICAL OFFICE ENPL 9015 BUILDINGS NOC - OPER 160,520 .1.067,270 99,200 12.54 0.72 10.2A 21,133 7,684 -10,207 13 80 12 0 0, 0 Totals.... 1,335,094 Premium Subject To Audit 39,024 105 0 June 27, 1991 TO: Mr. Joe Mustrovito Department of Labor and t=aupluvulent Security Division of Workers Compensation Bureau of Self -Insurance Suite 239, Forrest Building 2728 Centerview Drive Tallahassee, FL 323'99-0666 This is to ccrtify that the Guvcl uulentul Risk Insurance Trust hereby accepts coverage of all workers' compensation liabilities for the below named employer on all covered accidents on and niter the effective date: Little Havana. Actjviiirt ,l' NlrtritinOitiss of Datie_CtttlnL!:. 2O .S., WV _tit.h.. Nliltnti, FI ..3.3139 Covered by policy number r )S?. effective ApriLll. 1991.. / •,1 r.. f ! ..t By,_ - •- Title Ailmity tr;uor William D. Griffin Governmental Risk Insurance Trust cc: Little Havana Activities g: Nutrition Centerx of Dade County. Inc. Dick Anderson 8 Assoc., Inc. • • IKt' 9SI.,,, 2 16140 Iruicvilli tlJAtit • ti,iilc illtl • Sir11ii . rt. i P. Box l-')ti • iarl,oia, I' I. k•t'V1.1;o:i ;a, 7. Guardian Property & Casualty Insurance Co COMM AUTO — STANDARD PIMO+t—P-Ot CY tLARATIO RATIOt4 Miami, Florida 33126 j.. POLICY NUMBER POLICY PERIOD 12:01 AM BA 248342 1/01/92 1/01/93 12:01 AM STANDARD TIME NAMED INtURED AND MAILING AC5DRESS LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER .OF DADE CNTY 700 SW 9 ST MIAMI FL 33130 J AGENT'S NUMBER t1 iif�1 , AG/ ENT'S. . EXCLUSIVE UNDERWiaTF.R'S INC NAME 50413 NW 7TH STRE.T -SUITE 650 AND , MIAMI . FL 33126 ADDRESS 004 FOR VEH 05 005 FOR VEH it 18 SOUTH FLORIDA EMPLOYMENT AND TRAINING CONSORTION 7220 N& 36 ST 8300 - MIAMI FL 33166 OXFORD RESOURCES CORP 270 SOUTH SERVICE RD MPLVILLE NY 10747 MORTGAGEE(S): ..... -------- MT/ LOAN NUMBER a001 FOR VEH 8 18 NAME AID ADDRESS BOX LEASING CORP .270 SOUTH SERVICE ROAD MELVILLE NY 10747 IN ' RETURN . FOR THE PAYMENT OF THE .PREMIUM•• AND SUBJECT TO ALL' THE TERMS OF .THE COVERAGE PARTS/POLICIES ATTACHED. WE AGREE WITH YOU TO PROVIDE -THE INSURANCE DESCRIBED:THEREIN.. COUNTERSIGNED my (AUK . ' ED REPRESENTATIVE) (DATE) Guardian Property & Casualty Insurance Co COMM o.UTO — STANDA. !) G Miami. Florida 33126 OHPIO!T POLICY DEC LARATLONS - �lEW •USINESS DECLARATION • POLICI NUMBER POLICY PERIOD 12:01 AM • AGENT'S NUMBER BA' 248342 1/01/92 1/31/93 12:C1 AN STANnARD TINE ;1iir1 rNAMEO INSURED AND MAILING tADDRESS LITTLE HAVANA ACTIVITIES NUTRITION CENTER OF DADE 700 SW g ST - MIAMI FL 3313C AND AGENT'S EXCLUSIVE UNDERWRITER'S INC CNTY 4 - 4 NAME 5040 NW 7TH STREET SUITE 65-) AND. ' . . MIIAMI .FL 33126 - J ADDRESS - (THE NAMED —INURED IS CUVRIi I N CIVIC ORGANIZATION 1• COVERAGES: 1THIS POLICY'CONSISTS OF -THE FOLLOWING COVERAGE PARTS/POLICIES FOR PREMIUM IS INDICATED. THIS PREMIUM MAY BF SUPJECT TO ADJUSTMENT. 1 COVERAGE PAP.T/POLICY ATTACHED COMMERCIAL -AUTO COVERAGE WHICH A PREMIUM i 5 6, 275. 0C • ESTIMATED TOTAL PREMIUM • `g56,275..!1(� COMMON FORMS THAT APPLY TO ALL COVERAGE. PARTS: ENDORSEMENT NO BJP 190 CA 0001 CA C128 CA 702_8 CA'2210 IL'0003 C A , 0267 DA6 EDITION DATE 11-85 12-90 06-90 0 6— 91 11-90 06-89 06-90- 0 5-91 DESCRIPTION . POLICY 'JACKET" BUSINESS AUTO COV PARTS CHANGES IN POLICY —FL FLA EMERGENCY VEH PERS INJURY PROT END • CALCULATION' OF. PREMIUM FLA CHANGES--CANC-& NCNREN CONFORMING P- I -P END ADDITIONAL INSUREDCS): raw r--rr410r414r01.1M-rrrrr. AI# INTEREST 001 FOR 'VEH 32 002 FOR VEH N3 003 FOR 'YEN 04 NAME AND ADDRESS' CITY OF MIA?1I 275 NW 2 ' ST ' 4IAM1I -• FL 33128 CITY OF SVEETVATER- 51m SM 109 AVE . PMIA!!I FL 33174 CITY OF MIAMI BCH 1700 CONVENTION CENTER DR ATAi I BCH FL 33139 .O ,� nxir,•. • , G _ Guardian Property & 'Casualty Insurance Co. 1; •`Miami, Florida 33126 COMM AUTO—STANDAND. EW BUSINESS DECLARATION POL+:'; NUMBER POLICY PERIOD 12:01 AM HA 248342 • 1/01/92 1/01/93 AGENT'S NUMBER 12:01 AR STANDARD TIME 01OG1 NAMED INSURED AND MAILING ADDRESS LITTLE HAVANA, ACTIVITIES AND NUTRITION CENTER OF DADE CNTY 7C0 SW AST MIAl1I FL 33130 (AGENT'S NAME AND ADDRESS EXCLUSIVE UNDERWRIMIS INC 5040 NW 7TH STREET SUITE 550 MIAMI FL 33126 ITEUT➢0—SCHEDULE OF COVERAGES AND COVERED AUTOS THIS POLICY PROVIDES THE DESCRIBED.COVERAlES-ONLY FOR THOSE AUTOS BY THE ENTRY -OF ONE OR MORE OF- THE SYMBOLS FROM THE COVERED AUTO DESIGNATION SYMROL"SECTION OF THE BUSINESS"AUTO COVERAGE FORM. COVERAGES - COVERED AUTO SYMBOLS LIMIT OF INSURANCE PREMIUM LIABILITY: CSL 7 500.000 P/ACC. S51,736.00 PERSONAL INJURY $10.000.O0. PER .PERSON ADDED PERS INJURY. $784.0C UNINSURED 13! MOTORISTS 100,000 P/PERS. 3C0.000 P/ACC. S7C3.00 COMPRPHFNSIVE 7 ACTUAL CASH VALUE OR COST OF REPAIR. WHICHEVER IS LESS. MI.NUS.THE DEDUC- TIBLE SHOWN IN ITEM THREE F('f't F:ACH COVERED AUTO. $1.076.GC COLLISION 7 ACTUAL CASH -VALUE OR COST OF REPAJ . WHICHEVER IS LESS, MINUS THE DFDIir— TIBLE SHOWN IN ITEM THREE FOR CAC" COVERED AUTO. ITEM THREE—.SCHEDULE•OF COVERED AUTOS AND COVERAGES $1.91 C.0C YEN NO. 001 002 003 004 005 006 007 MODEL YEAR 80 80 80 $0 80. 85 85 DESCRIPTION . CHEVS/W 8 PASS CHEVS/W 8 PASS DODGVAN 14 :PASS DODGVAN 14 PASS DODGVAN 14 PASS CHEVBUS 23 PASS CHEVBUS 23 PASS CLASS _ ORIG COST VEHICLE ID AGE TE II CODE! • 8,500 :1 C35J230560 6 033 6310 Ii.500 1L35JAJ 221427 • 6 • 033 6?10 8.000-V36KTAX111938 6 033 681V 8.0001136KTAXII919 6 033 6810 8.000 'V36KTAX112006 - 6 033 6P10 30.000 1GRKP32MIS333O280 6 033 6E10 30.00f 1GBKp32M0F3337298 6 - )33 6811'• CPPRA (12-8R) r. Guardian Property & Casualty Insurance Co. COMM AUTO —STANDARD • •Miami, Florida 33126 ( ♦ ♦ E'.I BUSINESS DECLARATION POLICY NUMBER 3A 248342_ POLICY PERIOD 12:01 AM 1/01/92 1/01/93 12:01 AM STANDARD TIME AGENT'S NUMBER 01301 NAMED INSURED AND MAILING ADDRESS LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER OF DADE CNTY 700 SW E ST MIA II FL 33130 1 AGENT'S 1101:1 83 CNEVHUS 23 PASS 009 . R5 010 85 011 83 012 80 013 SO 014 78 J15 88 016 E7 017 88 018 92 019 90 020 90. COVERAGES: VEH < HO. 001 002 003 004' 005 006 007 008 009 010 011 012 013 014. 015 016 017 018 019 020. CHEVBUS 23 PASS CHEVBUS 23 PASS DODGVAN 14 PASS DODGVAN 14' PASS DODGVAN 14 PASS CHEV;3US 23 PASS DODGVAN 14 PASS DODGVAN 14 PASS FORDTRUCK FORDCROWN VICTORIA FORAVAYNE. FORDWAYNE: NAME AND ADDRESS EXCLUSIVE UAIDFRHRITER'S INC 5040 NW 7TH STREET SUITE 650 - - MIAHI FL 33126 30,0017 .1 GICK13 s 4). f1 F.5 33 1171 30.000 30,000 8.500 8.500 8,000 10,000 12.000 9.000 10.300 23,000 32.473 32.473 BI LIMIT 500.OGO 5 00.0 00 500.000 500.000 500.000 500.000 500.000 500.000 500.000 500.000. 500.000 500.000 500.000. 500,000 500.000 5no.aaa 500.000 500.000 500.000 500.000 VEH <----NEDICAL PAYMENTS .. > NO.. LIMIT PREMIUM 001 .16VKP32#13F3330247 6 1GVKP32M9F33303 6 2ESW31470K33241 6 V36KTAX111945 . ' 6 V36KTAX111935 6 CEL3380102294 6 2VSWV31W80K148236 5 2V5W831W411K26343 6 1 FDRE37HXJ HA77142 5 2FACP74W6NX137086 1 1 FDKE37GELHB08838 3 1FDXF37GELHBC8837 3 LIADILITY 8I PREMIUM $2.168.00 $2,168.00 $2.360.00 $2.360.00 X2.360.00 13,247.00 $3.247.00- 13.247.00 $2.647:00 $2.647.00 $2.360.DO $2.360.3C $2,360.01! $2.647.GC S2,360.00 $2.360.00 $2.353.00 S1,897.00 $3.247.00. $3.247.00 U3S 6310 U33 6R10 033 6810 C33 6810 033 6810 U33 6810. 033 6810 033 6310 033 6810 033 8019 033 4193 U33 6810 033 6810 PD LIMIT PD PREMIUM < UNINSURED MOTORISTS------> PI LIMIT 8I PREMIUM 100.000' 300.000 $34.00 �PP�� r'T7—x-p1 t'Abt Guardian Property & Casualty Insurance Co ( COMM AUTO -STANDARD Miami, Florida 33126 EW" BUSINESS DECLARATION POLICY NUMBER POLICY PERIOD 12:01 AM `BA 248342 1/01/92 ..1131/93 AGENTS NUMBER 12.01 AM STANDARD TIME 01001 NAMED INSURED AND MAILING `ADDRESS LITTLE HAVANA.ACTIVITIES AND NUTRITION CENTER .,OF DADE CNTY 700 SW 8 ST MIAMI . FL "33130 AGENTS NAME 9ND, ADDRESS EXCLUSIVE UNDERWRITER'S INC 5040 NW 7TH STREET SUITE. 650 MIAMI FL 33126 - /UUz 003 004 005 006 007 008. 009 010 011 012 013 014 015 016 017 018 019 020 < COMPREHENSIVE ----------> VEH STATED DEDUCTIBLE PREMIUMS 001 500 $16.00 002 500 $16.00 003 500 . $12.00 004 500 $12.00 005 500 $12.00 006 500 $65.00 007 500 " $65-.00 008 500 •$65.00 009 - 0500 465.00 010 500 $65.0 0 011 500 $16.00 012 500 $16.00 013 . 500 $12.00 014 . 500 $16.06 ' 015 500. $27.00 016 500' . • $16.00 017 500 $83.00 018 500 1297.00 loosvalla 100.000 100.000 100.000 100.000 100.000 .100.000 100.000 100.000 100.000 100.000 100.000 100,000 100.000 100,000 .100,000 100,000 .100,600 300,7.00 300.001 300.000 300,000 300,000 300,000 300,000 300,000 300,Oni 300.000 '300,000 300,000 30C.Jf! ) 300.000 3 00..0 0 C 300.00C 300.000 300,000 300.000 COLLISION STATED DEDUCTIBLE 500 5U0 son 500 500 500 500 500 500 500 500 500 501 501 500 500 500 500 $34.00 - $34.01 $34.00 $34.00 $34.00 $34.00 $34.00 $34.01 $34.00 $34.00 :L34.00 $34.01 $34.00 $34.01 $34.00 $34.01 S 57.00 $34.00 $34.01) . > PREMIUM $27.00 $27.03 $22.00 $22.00 - $22.00 $117.00 $117.00 $117.00 $93.00 $93.00 $27.00 $27.00 - $22.09 $27.00 $43.00 $27.09 $179. 01 $543.00 \rave A titi Guardian Property , Casualty Insurarl;n Co `- COMM AUTO —STANDARD ,Miar'ni; Florida 33126 �k"cN BUSINESS DECLARATION • • _ICY NUMBER POLICY PERIOD 12:01 AM AGENT'S NUMBER 3A 248342 1/31/92 1/01/93 12:C1 AM STANDARD TIME 'NAMED INSURED AND MAILING ADDRESS LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER OF DADE CNTY 710. SW 8 ST • MIAMI FL 33130. AGENT NAME AND'S ADDRESS J EXCLUSIVE UNDERWRITER'S INC 5040 NW 7TH STRCET SUITE 651 MIAMI FL 3312AS - t;1 Y St 0 $1.Uu.00 YJD $179.00 020 50 $100.00 50C. $179.00 •<----PERSONAL INJURY PROTECTION---> VEH LIMIT DEDUCTI3LE PREMIUM 001 10.000 NONE $30.00 002 10,0^0 NONE $30.OQ 003 10.000 NONE133.00 004 10,000 NONE $33.00 005 10,000. NONE 1:33. C0 006 10.000 NONE 147.90 007 10,000 NONE 147.00 008 10.000 NONE $47.00 009 10,000 NONE-$38.00 010 10,00i1 NONE s3s.0" 011 10.000 NONE 133.00 012 10.0E 3 NONE $33.00 013 10.000 NONE 133.00 014 10.000 NONE 138.00 015 10.000 NONE $33.0C 016 10.003 NOS+!'_ $33.0Y 017 10.033 NONE T34.0C C18 10.000 NONE %77.0G 019 10,000 f►oNg $47.00. G20 10,000 NOME 147.PG ITE}I FOUR —_•HIRED OR BORROWED 'COVERED -AUTO COVERAGE AND PREMIUM" LIABILITY.COVERAGF: STATE PREMIUM. FL; •$47.00. • ITEM FIVE NON —'OWNERSHIP LIAIILITY FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART: PREMIUM 147.00 ITEM ENDORSEMENT N0. EDITION DATE DESCRIPTION 001 (3A 5 C5-89 CUSTOMIZIVG .EOUTP EXCL C:FPPA (1 2 Zits ) ,n,r•r Inrr- PREMIUM 4. r� Guardian Property & Casualty Insurance Co. COMM AUTO -STANDARD .`Miarni, Florida 33126 (NEW BUSINESS DECLARATION POLICY NUMBER POLICY PERIOD 12:01 AM BA 248342 • 1/01/92 .1/01/93 12:01 AK STANDARD 'TIME NAMED INSURED AND MAILING ADDRESS 1701 • CA 2001 001 001 001 001. .LITTLE HAVANA ACTIVITIES NUTRITION CENTER' OF DADE 700 SW 8 ST MIAMI AND CNTY FL * 3313*0 AGENT'S NUMBER o1©! 1 (AGENT'S NAME AND ADDRESS EXCLUSIVE' UMDER!JRITER'S INC -5040 NY 7TH STREET SUITE 651 MIAMI: - FL 33126 • CA 2172 CA.2178 CA 9923 CA 9944 12-90 06-91 10-87 01-87 12-90 ADDL INSURED -LESSOR - FLA U M.COV-NON STACKED SPLIT LIMIIT UM NON STACKE RENTAL REIMBURSEMENT COV "LOSS PAYABLE. CLAUSE • • - S66.an -ITEM SIX -.DRIVER INFORMATION DRIVER'NAME ROBERTO AGUIRRE MAGALI INES GARRIDO SOLEDAD - BADA AMOR- R PERFZ-D0RRf3FCKER • ELISA. MIARIA JIIARA XIOMARA NARANJO REYES ARTURO OCEGIJERA ESTRELLA CASTRO BENITEZ JOSEFINA GOMEZ CARBONELL • JORGE C DIAZ MIRIAM PIMENTEL BENITEZ • JUVENCIO 'VALDES JOSE MARTINEZ IRMA MARRnRO FERNANDE? ELICIO ELIJIO DIAZ ANTONIO ROSADO MARCO A-ALVAREZ ARACELIA LEO'N MONTIEL CARLOS .DAFNESSES BLANCA AGUILERA•ACOSTA RIGOBERTO GONZALEZ' JOSE L FERNANDEZ HERIBERTO CARRANZA HERBETH . DUARTE ;CARLOS RUIZ I LICENSE. .NUMBER A260720481700 G630549426210 A560782326090 P623720381390 J600213499450 R200954417660 0226000404?30 B532203447420 C615427507300 D200434404130 R532555418R7.0 V432420250640 M635420543880 F655413476270 'D200205404420 R230000380070 A416541391450 M4534012407840 D252100302470 A223061437910 G524720333889 F653432312460 C652320340960 D630320623880 R200100284290 • !TOTAL ADVANCE PREMIUM -356,27.5.00 CPPBA C12:87 EXHIBIT XVIII CITY OF MIAMI DEL'A1U11ENl' OF COMMUNITY DEVEIAPMENl' AGpNCY JlEaffii5FarA'1'JVE (S ) =WORMED '10 IlECI [ LEJNt) VISHURSE FULLS 1_ I1 SONS) 11U1]1 llL I1 '10 $1GN C1IEC1cS NAME: Frank Paredes • • '1'1'1'LE: Chairman of the Board 'IELEPI 1O1'1E : SIGNATURE: NAME: •Magaly Garrido '1'1'1'LE: Driver 858-0887 `11 LE['1 ZONE : S1GU(Y1URE: l}1/4._ 4 NAME: Josefina Carbonell President PEItSONL .) 1U111Q1IZEI) '1D RECEIVE CIThC NAME: Xiomara Reyes TITLE:. Driver • TELEPHONE: 8 5 8- 08 8 7,_ cwi,t - S IGNA'1URE : MAKE CHECKS PAYABLE '10 '111E ORDER OF: 4104 LITTLE HAVANA ACTIVITIES AND NUTRITION CENTERS OF DI\DE. V UH.Ty. , Inc. UAW: August 28, 1992 AGENCY: r STATEMENT OF ACCOUNTING SYSTEM • I am the chief financial officer.of LITTLE'HAVANA• ACTIVITIES AND NUTRITION CENTER OF• DADE .COUNTY, inc.and, in this capacity, !will be responsible.for providing financial services adequate to insure the es- tablishment and Maintenance of an accounting system for the use of these funds. • • The accounting system will have internal controls adequate to safeguard the assets. of -such Agency, check the accuracy and reliability.of accounting data, promote operating .efficiency and encourage compliance with prescribed management pglicies.of the Agency. • • (tignature of Chieginancial Officer) c)1/1-Yja) • 1 Dania Ramos . (Print Name) • • J-92-542 7/8/92 92— 513 RESOLUTION NO. A RESOLUTION, WITH ATTACHMENTS, ALLOCATING FUNDS IN THE AMOUNT OF $153,261 FROM ANTICIPATED INTEREST TO BE EARNED FROM TAX ANTICIPATION NOTES AS FOLLOWS: $103,461 TO THE CHRISTIAN COMMUNITY SERVICES AGENCY, INC./NEW LIFE FAMILY SHELTER FOR OPERATION OF SAID SHELTER FOR HOMELESS FAMILIES AND $49,800 TO THE LITTLE HAVANA ACTIVITIES AND NUTRITION CENTER -OF DADE COUNTY, INC. TO PROVIDE MEDICAL • SERVICES FOR ELDERLY PERSONS; FURTHER AUTHORIZING THE CITY MANAGER TO' EXECUTE INDIVIDUAL AGREEMENTS, IN SUBSTANTIALLY THE ATTACHED FORM, WITH THE AFOREMENTIONED AGENCIES. WHEREAS, the City Commission adopted Motion 92-186 on March 12, 1992, expressing its intent to allocate $103,461 from anticipated interest to be earned from tax anticipation notes to the New Life Family Shelter operated by Christian Community Services Agency, Inc.; and WHEREAS, the City Commission adopted Motion 92-188 on March 12, 1992, expressing its intent to allocate $49,800 from anticipated interest tobe earned from tax anticipation notes to the Little Havana Activities and Nutrition Centers of Dade County, Inc. to provide medical services for the elderly; NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI., FLORIDA: T(S) Ceii ! e 1i'te ED CITY COMMISSION MEETING OF JE!.!_ 1 6 1992 Resolution No. 92513 Section 1. The recitals and findings contained in the Preamble to this Resolution are hereby adopted by reference thereto and incorporated herein as if fully set forth in this Section. Section 2. Funds in the amount of $153,261 of anticipated interest to be earned from tax anticipation notes are hereby allocated as follows: ravua.�.i / t • v AMOUNT Christian Community Services Agency, $103,461 Inc./New Life Family Shelter Little Havana Activities and Nutrition_ -- 49,800 `Centers of Dade County, Inc./Medical Services Project Total Allocation $153,261 Section 3. The City Manager is hereby authorized to execute individual agreements, in substantially the attached form, with said agencies to implement their respective projects, subject to the conditions and limitations contained herein and in the City Code. Section 4. This Resolution shall become effective immediately upon its adoption. 1992. PASSED AND ADOPTED this 16th day of ATTES MAT Y HIRAI, CITY CLERK -2- XAVIE UAR , MAYOR 92- 513 BUDGETARY REVIEW: MANOHAR S. SU ASSISTANT CITY GER FINANCIAL REVIEW: 4111111eLl.- C UPI FIr• CE DEPARTMENT 7/24; r L S GARCIA, DIRECTOR ALBERTINE B. SMITH COMMUNITY DEVELOP '=; REV F K CA 'ANE , DIRECTOR DEPART NT OF C NITY DEVELOPMENT PREPARED AND APPROVED BY: CHIEF ASSISTANT CITY ATTORNEY APPROVED AS TO FORM AND CORRECTNESS: ��'ii'!1 A QUIIiN JO CITY ATTOR�TE7 M3061/ABS/sls -3- 31-4i51 92- 513