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HomeMy WebLinkAbout23549AGREEMENT INFORMATION AGREEMENT NUMBER 23549 NAME/TYPE OF AGREEMENT HAITIAN TASK FORCE, INC. DESCRIPTION AMENDMENT #1 TO CDBG AGREEMENT/NEIGHBORHOOD ECONOMIC DEVELOPMENT AGREEMENT/J-92-167/R-92.190.1 EFFECTIVE DATE January 6, 1993 ATTESTED BY WALTER FOEMAN ATTESTED DATE 1/6/1993 DATE RECEIVED FROM ISSUING DEPT. 1/7/1993 NOTE '0' 11':t CITY OF MIAMI, FLORIDA ECONOMIC DEVELOPMENT COMMUNITY BASED /O�NIZATII� (CBO) THIS AGREEMENT entered into this day 19, between the City of Miami, a municipal corp.() State of Florida, (hereinafter referred to as the "CITY"), and Haitian Task Force, Inc., a Florida not for profit corporation, (hereinafter referred to as the "CONTRACTOR"). FUNDING SOURCE: Eighteenth (18th) Year Community Development Block Grant Funds TERM OF THE AGREEMENT: July 1, 1992 to June 30, 1993 AMOUNT: $ 50,000.00 TAX IDENTIFICATION NO.: 59-2255547 EXECUTIVE DIRECTOR: Mr. Yves Vielot ADDRESS: 5925-27 N.E. 2nd Avenue, Mezzanine, Miami, Florida 33137 TELEPHONE NO.: (305) 751-9783 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 REQUIREMENTS 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. \i/1.1 Corporate .Resolution authorizing execution of this Agreement. REVIEW, PLEASE 1:1Ua i:, AS Ej,2 .. 1.2 Work Program (approved by the'CITY). The Work Program submitted by the CONTRACTOR to the CITY became an attachment to this agreement and shall include the following: ✓1. A description of the work to be performed; 2. A schedule for completing the work; and 3. A budget. 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. 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 �y`. additional insured as determined by the Risk Management y• tt\I - 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. y/`-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), "N" (Property Management Standards), and (Procurement Standards), as modified by 24 CFR Part 570.502 (b), "Applicability of Uniform Administrative Requirements," of the Community Development Block Grant (CDBG) Program -3- 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), (Property Management Standards), and (Procurement Standards), as modified by 24 CFR Part 570.502 (b), "Applicability of Uniform Administrative Requirements," of the Community Development Block Grant (CDBG) Program -3- 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 forth by 24 CFR 570.3; or the CONTRACTOR may substitute a copy of a verifiable certification from the assisted -4- 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 570.208(a)(1)(ii); For each activity determined to benefit low and moderate income persons based on the creation of (3) -5- jobs, the recipient shall provide the documentation described in either (i) or (ii) below. (i) Where the recipient chooses to document that at least 51 percent of the jobs will be available to low and moderate inco-me persons, documentation for each assisted business shall include: (A) A copy of a written agreement containing: (1) A commitment by the business that it will make at least 51 percent of the jobs available to low and moderate income persons and will provide training for any of those jobs requiring special skills or education; (2) A listing by job title of the permanent jobs to be created indicating which jobs will be available to low and moderate income persons, which jobs require special skills or education, and which jobs are part-time, if any; and (3) A description of actions to be taken by the recipient and business -6- to ensure that low and moderate income persons receive first consideration for those jobs; and (B) ,A listing by job title of the permanent jobs filled and which jobs of those were available to low and moderate income persons, and a description of how first consideration was given to such persons for those jobs. The description shall include what hiring process was used; which low and moderate income persons were interviewed for a particular job; and which low and moderate income persons were hired. (ii) Where the recipient chooses to document that at least 51 percent of the jobs will be held by low and moderate income persons, documentation for each assisted business shall include: (A) A copy of a written agreement containing: (1) A commitment by the business that at least 51 percent of the jobs, on a full-time equivalent basis, will be held by low and moderate income persons; and (2) A listing by job title of the permanent jobs ,to be created, identifying which are part-time, if any; (B) A listing by job title of the permanent jobs filled and which jobs were initially held by low and moderate income persons; and (C) For each such low and moderate income person hired, the size and annual income of the person's family prior to the person being hired for the job. (4) For each activity determined to benefit low and moderate income persons based on the retention of jobs: (i) Evidence that in the absence of CDBG assistance jobs would be lost; (ii) For each business assisted, a listing by job title of permanent jobs retained, indicating which of those jobs are part-time and (where it is known) which are held by low and moderate income persons at the time the CDBG assistance is provided. Where applicable, identification of any of the retained jobs (other than those known to be held by low and moderate income persons) which are projected to become available to low and moderate -8- income persons through job turnover within two years of the time CDBG assistance is provided. Information upon which the job turnover projections were based shall also be included in the record; (iii)For each retained job claimed to be held by a low and moderate income person, information on the size and annual income of the person's family; (iv) For jobs claimed to be available to low and moderate income persons based on job turnover, a description covering the items required for "available to" jobs in paragraph (5) of this section; and (v) Where jobs were claimed to be available to low and moderate income persons through turnover, a listing of each job which has turned over to date, indicating which of those jobs were either taken by, or available to, low and moderate income- persons. For jobs made available, a description of how first consideration was given to such persons for those jobs shall also be included in the record. (5) For each activity determined to aid in the prevention or elimination of slums or blight based on addressing one or more of the conditions which qualified anarea as a slum or blighted area; -9- (i) The boundaries of the area; and (ii) A description of the conditions which qualified the area at the time of its designation in sufficient detail to demonstrate how the area met the criteria in 570.208(b)(1). (6) For each activity determined to aid in the prevention or elimination of slums or blight based on the elimination .of specific conditions of blight or physical decay not located in a slum or blighted area: (i) A description of the specific condition of blight or physical decay treated; and (ii) For rehabilitation carried out under this category, a description of the specific conditions detrimental to public health and safety which were identified and the details and scope of the CDBG assisted rehabilitation by structure. (7) For each activity determined to aid in the prevention or elimination of slums or blight based on addressing slums or blight in an urban renewal area, a copy of the Urban Renewal Plan, as in effect at the time the activity is carried out, including maps an supporting documentation. (a) Records which demonstrate compliance with 24 CFR 570.505 regarding any change of use of -10- real property acquired or improved with CDBG assistance. (b) Records which demonstrate compliance with the requirements in 570.606 regarding acquisition, displacement, relocation, and replacement housing. (C) Equal Opportunity Records containing: (1) Data indicating the racial/ethnic character of each business entity receiving a contract or subcontract of $25,000 or more paid, or to be paid, with CDBG funds, data indicating which of those entities are women's business enterprises as defined in Executive Order 12138, the amount of the contract or subcontract, and documentation of recipient's affirmative steps to assure that minority business and women's business enterprises have an equal opportunity to obtain or compete for contracts and subcontracts as sources of supplies, equipment, construction and services. Such affirmative steps may include, but are not limited to, technical assistance open to all businesses but designed to enhance opportunities for these enterprises and special outreach efforts to inform them of contract opportunity. Such steps shall not include preferring any business in the award of any contract or subcontract solely or in part on the basis of race or gender. —11— (2) 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 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. 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: (3) A. Final Expenditure Report to be submitted no later than thirty (30) days after contract expiration. B. Certified Independent Audit to be submitted one hundred twenty (120) days after end of corporate fiscal year. 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-133). 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. 3.2 CITY AUTHORIZATION For the purpose of this Agreement, the City of Miami Department of Community Development (hereinafter the -13- "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 other as of its date. Any prior agreements, promises, negotiations, or representations not expressly set forth in this Agreement are of no force or effect. 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 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. -14- 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 original 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 Risk Management Division of the Personnel Management Department. (b) Fidelity bonding for all persons handling funds received or disbursed under this Agreement in an amount equal to or greater than the amount of the City grant. City shall be named as Loss Payee. (c) Current liability insurance shall be in amount of not less than $500,000 General Aggregate which shall include Fire Legal. City shall be named as Primary Additional Insured and there shall be no exclusions in such policies to override the CITY coverage. (d) Contractor shall provide the CITY with proof of Automobile Liability Coverage in an amount of not less than $100,000 Bodily Injury and Property Damage combined, if Contractor is to be reimbursed for mileage by the CITY. -15- (e) The Contractor shall obtain Workers' Compensation and Employers' Liability coverageas per statutory requirement. 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 REQUIREMENTS (a) CONTRACTOR shall comply with its obligations as described in its Management By Objectives (MBOs) (Attachment IV) which is attached and incorporated herein and made a part of this Agreement. -16- (b) 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). 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. (c) -17- 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, $50,000.00 as maximum compensation for the services provided during the term of this agreement. The CITY shall compensate the CONTRACTOR for all expenditures made in accordance with —18— the schedule set forth in the budget which is attached hereto and made a part hereof. 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. 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 -19- review and approval by the CITY. All line -item changes must be made prior to the end of the term of the Agreement. D. 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. E. CONTRACTOR must submit the final request for payment to the CITY within 30 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. F. 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. 4.2 GENERATED REVENUES: CONTRACTOR is required to generate revenues in the amount of sixteen thousand five hundred dollars ($16,500, by June 30, 1993, from approved revenue generating projects. These funds are to be used in lieu of an advance on the fiscal 1993-94 City contract and to offset any other administrative -20- expense not paid by the City CDBG grant. Funds generated by grants (federal, state and local) will be considered generated revenues. In the event that GRANTEE fails to generate the above mentioned revenues by June 30, 1993, future contracts with the GRANTEE will not be negotiated or considered. GRANTEE must submit proper documentation supporting the expenditure of such program generated funds as per the Program/Line-Item Budget Expenditure Justification. 4.3 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. 4.4 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. 4.5 CONTINGENCY CLAUSE -21 - 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. 4.6 SEPARA'TION OF CHURCH/STATE In accordance with First Amendment Church/State principles, CDBG assistance may not be used for religious activities or 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 REQUIREMENTS 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 f•or 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 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. -24- 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 725- 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 Haitian Task Force, Inc. 5925-27 N.E. 2nd Avenue, Mezz. Miami, Fla. 33137 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 -26- such laws, then same shall be deemed severable, and in either• event, the remaining terms and provisions of this Agreement shall remain unmodified and in full force and effect. 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 directingand authorizing the person identified as the official representative of the -27— 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. A'1TY IRAI CITY CLERK ATTEST: CORIdATE SECRE ARY(1 WITNESS: APPROVED AS TO CITY OF MIAMI, a municipal Corporation of the State of Florida CESAR H. ODIO CITY MANAGER CONTRACTOR: Haitian Task Force, Inc. 5925-27 N. E. 2nd Avenue Mezzanine Miami, Florida 33137 404-er-z�. PRES'DENT SEAL APPROVED AS TO FORM AND INSURANCE REQUIR .MEETS: CORRECTNESS: JAN S. CHH DIRECTOR RISK MANAGE NT DErARTMENT A. Q UZN CITY ATTQ S, III e(� WHEREAS, CORPORATE RESOLUTION The il/ctt./%Aid T4SJ( Fnr'c-e Jvc 1 desires to enter into an agreement with the City of Miami; and WHEREAS, the Board of Directors at a duly held corporate meeting has considered the matter in accordance with the By -Laws of the corporations; NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS that the president, and secretary are hereby authorized and instructed to enter into a contract in the 'name and on behalf of this corporation with the City of Miami upon the terms contained in the proposed contract to which this resolution is attached. DATED this 3( day of , 194Z. BOA D OF DIRECT RS CHAIRPERSON SEAL N J-92-167 3/12/92 99— I00.1 • RESOLUTION NO. "° A RESOLUTION, WITH ATTACHMENT(S), AUTHORIZING THE CITY MANAGER TO SUBMIT THE ATTACHED APPROVED GRANT PROGRAM FINAL STATEMENT TO THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD) REQUESTING FUNDS IN THE AMOUNT OF $13,156,000 FOR THE CITY'S PROPOSED COMMUNITY DEVELOPMENT PROGRAM DURING 1992-1993; FURTHER AUTHORIZING THE CITY MANAGER, UPON APPROVAL OF SAID GRANT BY HUD, TO ACCEPT THE SAME AND EXECUTE THE NECESSARY IMPLEMENTING AGREEMENTS, IN A FORM ACCEPTABLE TO THE CITY ATTORNEY AND SUBJECT TO APPLICABLE CITY CODE PROVISIONS. BE IT RESOLVED BY THE COMMISSION OF THE CITY OF MIAMI, FLORIDA: SECTION 1. The City Manager is hereby authorized to submit the attached approved Grant Program Final Statement to the U. S. Department of Housing and Urban Development (HUD) for the City's proposed Community Development Program during 1992-1993. SECTION 2. The City Manager, as Chief Administrative Officer for the City of Miami, upon approval of the above Grant by HUD, is hereby authorized toaccept the grant and, upon receipt of same, to execute the necessary agreements to implement the 1992-1993 Community Development Program, in a form acceptable to the City Attorney and subject to applicable City Code provisions. SECTION 3. This Resolution shall become effective immediately upon its adoption. % 4 • 11 C N fil a'i 5) v w r CITY COMMISSION MEETING OF MAR 12192 Resolution No. 92•— 190.1 • 41, c q PASSED AND ADOPTED this 12th 1992. ATTEST: • MA HIRAI, CITY CLERK BUDGETARY REVIEW: day of March VIER L. SU:REZ, OR COMMUNITY DEVELOPMENT REVIEW: MANOR RANA, DIRECTOR FRANK CA AgEDA,/DI'ECTOR DEPARIE OF BUDGET DEPT. OF COMMUNITY DEVELOPMENT PREPARED AND APPROVED BY: ALBERTINE B. SMITH CHIEF ASSISTANT CITY ATTORNEY FINANCE REVIEW: CARLOS GARCIA, DT/RECTOR DEPARTMENT OF FINANCE APPROVED AS TO FORM AND CORRECTNESS: fair /rl�// QV NN i,ES, IrII . • CITY ATTO' �EY ABS/gfa/csx/M2825 -2- 92- 190'1 0 • Attachment I CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT 18TII YEAR CDBG PROPOSALS HOUSING PROJECTS RECOMMENDATIONS TA NAME OF PROJECT Amount: Initial C.D. Requested Staff Board Final Department of Development and ]lousing $2,000,000 $2,000,000 $1,000,000 $1,000,000 Department of Plannin Building & Zoning (Code Enforcement) 300,000 375,000 ' 200,000 200,000 A Allapattah Business Development Authority 43,270 50,000 50,000 E Tacolcy CDC 50,000 50,000 50,000 50,000 L East Little Havana CDC 60,000 50,000 50,000 50,000 0 St. John Community Development Corporation 50,000 50,000 50,000 50,000 CW CODEC, Inc. 60,000 50,000 50,000 50,000 E Little Haiti Housing Association 50,000 50,000 50,000 50,000 W Wynwood Community Economic Development 75,000 75,000 75,000 CW Senior Crime Watch Program 66,983 55,000 55,000 55,000 CW Florida Housing Cooperative 42,249 50,000 50,000 50,000 D DDA-Homeless Housing Facility 1,300,000 CW HOPE, Inc. 25,000 CW Dude County HUD 879,000 CW Greater Miami Neighborhoods 250,000 100,000 100,000 100,000 CW New Day Outreach Center 161,000 CW South Pointe Family & Children 170,000 CW Tri-City Community Association 81,862 50,000 80,000 80,000 SUB -TOTAL: $5,664,364 $2,880,000 $1,860,000 $1,860,000 i2-- i30 -1- A L L L E M CW CW CW A u 0 D D D D D c 0 E W W CW CITY.OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT' 18T11 YEAR CDI3G PROPOSALS NAME OF PROJECT New Washington Heights CDC New Washington Heights/ Hotel Soft Costs Martin Luther King LDC (Sonic Administration) 100,000 Little Havana Development Auth. 50,000 Small Business Opportunity Center 50,000 Latin Quarter Association 50,000 Greater Biscayne Boulevard Chamber (CBBC) 50,000 CBBC Administration for area Improvement Project 130,996 MDCC-Entrepreneurial Consulting Services 150,00 Miami Capital Development, Inc. - Administration 250,000 Miami Capital Development, Inc. - Revolving Loan Fund 2,000,000 Miami Capital Development, Inc. - Revolving Loan Fund for EDA 125,000 Allapattah Business Development Authority Edgewater Economic Development Corporation 50,000 Park West. Association, Inc. 50,000 Downtown Miami Business Assoc. 60,000 MDCC-Wolfson Campus 1,500,000 DDA-Information KIOSKS 25,000 DDA-Commercial Facade Program 100,000 DDA-Economic Development Incentive Fund 500,000 Coconut Grove LDC 950,000 0vertown Advisory Board 80,000 Haitian Task Force 50,000 Wynwood Community E.D.0 (WCEDC) 100,000 WCEDC- Trade Zone 4,000,000 Target Area - Mini UDAG ECONOMIC DEVELOPMENT PROJECTS Amount Requested $50,000 Deportment of Development (Southeast/Overtown Administration L Little ]Haiti Project Reserve Fund W Wynwood Project Reserve Fund 50,000 RECOMMENDATIONS Initial C.D. Staff Board $50,000 $50,000 50,000 50,000 50,000 50,000 Final $50,000 100,000 100,000 50,000 50,000 50,000 50,000 50,000 50,000 50,000 250,000 250,000 1,750,000 1,000,000 50,000 50,000 50,000 50,000 50,000 50,000 50,000 1,000,000 250;000 1,000,000 50,000 50,000 50,000 50,000 1,000,000 300,000 300,000 50,000 50,000 50,000 50,000 50,000 . 50,000 50,000 50,000 100,000 100,000 495,800 250,000 '250,000 200,000 200,000 250,000, 250,000 - 0 - - 0 - - 0 - 200,000 - 0- -0- -0- 100,000 SUB -TOTAL: $10,820,996 $3,245,800 $3,700,000 $3,800,000 -2- CITY OF MIAMI DEPARTMENT OF COMMUNITY DEVELOPMENT 18TI1 YEAR CDBG PROPOSALS . PHYSICAI, IMPROVEMENTS RECOIIMENDA'TIONS . Amount Initial C.D. TA NAME OF PROJECT Requested Staff Board Final D DDA Flagler Street Landscape $20,000 $20,000 20,000 0 DDA Overtown/ParkWest Improvements 200,000 200,000 -• 0 - 0 DDA ParkWest Linear Park 200,000 200,000 -• 0 - Department of Public Works/ Street Improvements 2,190,000 945,138 945,138 945,138 New Fire Station No. 5 1,500,000 E Department of Public Works/ Biscayne Beautification 125,000 125,000 125,000 125,000 L Manuel Artime Community Center 100,000 100,000 100,000 100,000 W One Art, Inc., Center Renovation 125,000 75,000 75,000 L CCS/Little Havana Child Care 45,812 45,812 45,812 45,812 W CCS/San Juan Day Care 400,000 C Grove Family health Center 565,000 25,000 125,000 125,000 CW Greater Miami Youth Services Corps. 172,000 65,000 65,000 65,000 CW Greater Miami Youth Serviceu Corps. 25,000 25,000 25,000 25,000 W holy Cross Day Care 450,000 L Miami Mental Health 199,685 .CW Weing&rt School Improvements (Proposal Submitted Late) 100,000 PLANNING DEPARTMENT A Wagner Creek Dredging C Franklin Avenue Cemetery Security L Northeast Cluster Revitalization L Cuban Martyrs Wall I. Tower Theater Renovation Latin Quarter Specialty Center 927,000 50,000 150,000 40,000 200,000 250,000 50,000 50,000 50,000 -3- c 2-- 190,1 TA M 0 0 PLANNING DEPARTMENT RECOM1MENDATIONS NAME OF PROJECT N.W. 15th Avenue Planters N.W. 3rd Avenue Improvement N.W. 3rd Avenue Facade ' IIISTORIC PRESERVATION 0 Black Archives/Lyric Theater U CCSA/Greater Bethel Church Committee Center 0 Old historic Fire house No. A C L L 0 M CD CD CI) CD PARKS DEPARTMENT Curtis Park Improvements Grund Avenue Park Building; Renovation Eaton Park/New Construction Henderson Park Building Replacement Shenandoah Park Field Lighting Gibson Park Improvements Clemente Put•lc Picnic Facilities African Square Improvements Amount Requested 45,000 250,000 100,000 • 515,625 2,494,975 100,000 50,000 275,000 50,000 50,000 100,000 100,000 50,000 50,000 SUB -TOTAL: :1;12,265,097 Neighborhood Jobs Program Contingency Social Programs Administration TA: A = ALLAPATTAII E = EDISON W = WYNWOOD TOTALS: 175,000 - 0 - 4,643,756 2,631,000 $36,200,213 C = COCONUT GROVE I, = LITTLE IIAVANA Initial, C.D. Staff Board 45,000 45,000 100,000 250,000 100,000 100,000 50,000 50,000 275,000 50,000 50,000 - 0 - 100,000 275,000 50,000 50,000 50,000 100,000 50,000 50,000 50,000 50,000 $2, 250, 950 $3,045,950 175,000 175,000 1,973,250 2,631,000 1,973,250 2,401,800 13,156,000 13,156,000 Final 45,000 250,000 100,000 50,000 275,000 50,000 50,000 50,000 100,000 50,000 50,000 $2,645,950 . 175,000 1,973,250 2,401,800 13,156,000 CW = CITYWIDE D = DOWNTOWN M = MODEL CITY 0 = OVERTOWN 92 ' .190.1 -4- Ti7`4`.;1 ,.F. r_+1 F. 0/19/1,+92 i_:9. 9 FROM EMPIRE III . / t'ur(is c L;/ w •i f_ER :i .1:L.t i..}.E OFNS U PNCF !ISSUE DATE; 6/ ira/?2 I-`1:'LJJ.'L11. i` ;This -certificate is issued as a matter of i. form - I a"•: !o-t onl.y.and.confers no ri K hts upcfr: th-e certi- ErapIi r e :insurance Agency Inc i 'f i c^.'+: e h i_1 3,^Gisr. This certificate does not amend; 6353 Bird Road 'extenc or alter the coveY-age aj"ford below. Miarni, FL 331n3 i '.- -• - 305-662--6000 DODO 1-IAI If N i i-!g;K FORCE._ .NE% MIAMI R FL. ni / C:DNt=AN I E ; AFFORDING .COVERAGE i i -..r.. _ 0 _A ,'L llL i Y INDEMNITY EXCHANGE E k FIDELITY & DEPOSIT i FIT Fr i_- ii_.=I ?fir: D ii_r•iIEicy E L:OVEh:Atib: tr'S._• is to S_e'-ta.j''y that policies of insurance listed below have been issued to the named i'r;sc3, for the policy period indicated; notwithstand- ing any rgr'r.+lt"rt :r term cored. of any contract or other document with respect to which this certificate may be issued or may pertain; the insurance afforded by the policies de'_•cr- ed herein is subject to all the terms; e?;CiuE-.icrrrc,; and conditions of such dCrd J.c:.^3 e=. Limits shown may'have been reduced by na td t-i.irn CL! rYPE r1F rN 1fRAM.:;- i l'•LLT. Y' i•UOjEi-R 1err' .L'tiiEir=XP DA EigLL L.iMI Tci IN "ii-ilwU RND LENE.R. -L. LIABILITY 1 C 0c,.' tt'r" JtE>tit;-rs/l..,r•rCr. > A LK J CL'N-i f C? _ AL 1 C >✓lL1..FOMOIP,T L:_-, L I i=•1 .{ L I -'- Y E 3Rny ' W ;,. 13 i\k:ri-"i_: W fit?''_ i t.,l t = = ! L Uti )P';Rig'_-: ' ? 6/ i' / 3a 1 3eiarapR Liah L. 3 E C; r ,. '7,:i .— - f? i-. �� •�i •{ i _—.—..W---,—.,.. j AND E!'1t ° L'L1':' : i } O°fl-?E FI DEL'!•TY EinND !GENERAL ?GO 1 'ia; ,it_)0 ! PRD-CMP/op APiGis iPER & HD)T .iN,Iiyi i E 1CH CtCCUREtNC.1 i •x35Ll0 !FIRE DAMAGE i $ i MED EXPENSES h iC L... fG 300 E'/19/53181/F-ii$ iP..D. i 3$ 1 t //C'CCt.?r i St a'b ut';:'r"y i `=i-i `r/ '✓= 4 /a4/ 9.; 's -•t.JS.ta 0',.''.> EIYiPLOY1:E D I_ EHc!NES i.'f t i } escription _i .:er aticr>`✓i _r<ca ions/veiticie / - trictions/sepci al items s OF P IP;M'. if a.•rL` .Ut-t - ajN i , 0. Cs.. L.. E. . PS ADDITIONAL INSUREDS , ..NCELLi--' .^.•i-tr., i , C i of thT a bov ' - inQ n r: ;at. - t . C • I F.. • :'f 1 6F is i :j' f • i- TheTravelers jam' The Travelers Insurance Companies Hartfora. CT 06183-4040 WORKERS COMPENSATION AND EMPLOYERS LIABILITY PuLIC r TYPE AR INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER (6K-UB-417K457-7-91) NEW-91 INSURER: THE TRAVELERS INDEMNITY COMPANY NCCI CO CODE: 113h7 1. INSURED: ' PRODUCER: HAITIAN TASK FORCE INC 5925 NE 2ND AVENUE MIAMI FL 33137 Insured is A CORPORATION INTERNATIONAL INS CENTER 13775 S W 145 COURT MIAMI FL 33186 Other work places and identification numbers are shown on the schedule(s) attached. 2. The policy period is from 12-25-91 to 12-25-92 12:01 A.M. at the Insured s mailing address. 3. A. WORKERS COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compensation Law of.the state(s) listed here: FL B. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident: 100,000 Each Accident Bodily In4ury by Disease: 500,000 Policy Limit Bodily Injury by Disease: 100,000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: AL, AZ, AR, CT, DE, DC, FL, GA, IL, IN, IA, KS, KY, LA, MA, MI, MS, M0, NE, NH, NC, RI, SC, SD, TN, VA, VT D. This policy includes these endorsements and schedules: WC000202 (00) -001 WC000316 (00) -001 WC090404 (00) -001 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY DATE OF ISSUE: 02-05-92 KK OFFICE: ORIND 870 DISTRICT: C-06 PRODUCER: INTERNATIONAL INS CENTER 27F5W ST ASSIGN: FL rn stmnimmom WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TheTravelersj. The Travelers Insurance Companies (Each A Slock Insurance Company) Hartford,Connecticut T ieTrave1ersj i.:::r:iRtti:A. 1 ,airfrrlt•➢ZAti.:0;fe.WA.rr•A HAITIAN TASK FORCE INC 5925 NE 2ND AVENUE MIAMI FL 33137 Insured is A CORPORATION POLICY NUMBER NEW-91 INTERNATIONAL INS CENTER 13775 S W 145 COURT MIAMI FL 33186 Other work places and identification numbers are shown on The schedule (s) a t ta.:h-'d . 2. The policy period is from 12-25-91 to 12-25-92 12:01 A.M. at the Insured's mailing address. 4. WORKERS COMPENSATION INSURANCE: Part One of the policy applies th.•, Wn-k. . ' -,,,.,.. , •-,., ',I.-. .,c 'h., stat.e (sl 1 �.tnr+ h:,r.. FL 3. EMPLOYERS LIABILITY INSURANCE: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our - liability under Part Two are: Bodily Injury by Accident: 100,000 Each Accident Bodily Injury by Disease: 500,000 Policy Limit Bodily Injury by Disease: 100,000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to the states, if any, listed here: AL, AZ, AR, CT, DE, DC, FL, GA, IL, IN, IA, KS, KY, LA, MA, MI, MS, M0, NE, NH, NC, RI, SC, SD, TN, VA, VT D. This policy includes these endorsements and schedules: WC000202 (001 -OCR i WC000 3 16 (00) -001 WC090404 (00) -001 4. the premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All required information is subject to verification and change by audit to be made ANNUALLY DATE OF ISSUE: 02-05-92 KK OFFICE: ORIND 870 DISTRICT: C-06 PRODUCER: INTERNATIONAL INS CENTER 27F5W ST ASSIGN: FL • U TheTravelers j'' The Travelers Insurance Companies WORKERS COMPENSATION (Each A Stock Insurance Company) AND Hartford, CT 06183-4040 EMPLOYERS LIABILITY POLICY CLASSIFICATION SCHEDULE CLASSIFICATIONS INFORMATION PAGE WC 00 00 01 ( A) POLICY NUMBER (6K-UB-417K457-7-91) PREMIUM BASIS ESTIMATED RATES ESTIMATED CODE TOTAL ANNUAL PER $100 OF ANNUAL NO REMUNERATION REMUNERATION PREMIUM SEE EXTENSION OF INFORMATION PAGE - SCHEDULE(S) TOTAL ESTIMATED ANNUAL STANDARD PREMIUM $ 861 PREMIUM DISCOUNT NONE 0900-09 EXPENSE CONSTANT 140 ASSIGNED RISK FLAT SURCHARGE 2677 TOTAL ESTIMATED PREMIUM 1268 DEPOSIT AMOUNT DUE 1268 MINIMUM PREMIUM: $ 167 FIELD A/R (WC I P) #: DATE OF ISSUE: 02-05-92 KK ST ASSIGN: FL OFFICE: ORIND 870 DISTRICT: C-06 PRODUCER: INTERNATIONAL INS CENTER 27F5W COUNTERSIGNED -AGENT TheTravelers' j The Travelers Insurance Companies (E)ch s'o, !ns1J^3occ Company` Hari oru, l.I ub I83-4U40 WORKERS COMPENSATION AND • _iv1PLOYEF S LIABILITY POLICY EXTENSION OF INFO PAGE -SCHEDULE WC 00 00 01 ( A) POLICY NUMBER (6K-UB-417K457-7-91) INSURER: THE TRAVELERS INDEMNITY COMPANY 11347-FL INSURED'S NAME: HAITIAN TASK FORCE INC PREMIUM BASIS ESTIMATED RATES ESTIMATED TOTAL ANNUAL PER $100 OF ANNUAL CLASSIFICATIONS CODE REMUNERATION REMUNERATION PREMIUM LOCATION 001 01 FEIN 592255547 ENTITY CD 001 HAITIAN TASK FORCE INC 5925 NE 2ND AVENUE MIAMI FL 33137 CLERICAL OFFICE EMPLOYEES- NOC 8810 146000 0.59 861 nrImmimm EXPERIENCE MODIFICATION NONE MODIFIED PREMIUM $ NONE TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 861 PREMIUM DISCOUNT NONE 0 EXPENSE CONSTANT 140 ASSIGNED RISK FLAT SURCHARGE 267 TOTAL ESTIMATED PREMIUM 1268 DEPOSIT AMOUNT DUE 1268 DATE OF ISSUE: 02-05-92 KK ST ASSIGN: FL SCHEDULE NO: 1 OF LAST TheTravelers' j The Travelers Insurance Companies WORKERS COMPENSATION (Each A Stock Insurance Company) AND Hartford, CT 06183-4040 EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 02 02 (00)-001 POLICY NUMBER (6K-UB-417K457-7-91) MARITIME EXCLUSION ENDORSEMENT The policy does not cover bodily injury to a master or member of the crew of any vessel. DATE OF ISSUE: 02-05-92 KK ST ASSIGN: FL PAGE 1 OF LAST TheTravelers j�' The Travelers Insurance Companies Hartford, CT 06183-4040 WORKERS COMPENSATION ANn EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 00 03 16 (00) -001 POLICY NUMBER (6K-UB-417K457-7-91) EMPLOYERS LIABILITY INSURANCE ENDORSEMENT C. Part Two (Employers Liability Insurance), C. Exclusions is amended by replacing exclusion 7 with this exclusion. This insurance does not cover: 7. damages arising out of coercion, criticism, demotion, evalua- tion, reassignment, discipline, defamation, harassment, humili- ation, discrimination against or termination of any employee, or any personnel practices, policies, acts or omissions. DATE OF ISSUE: 02705-92 KK ST ASSIGN: FL PAGE 1 OF LAST o= The'Iravelers` j The Travelers Insurance Companies WORKERS COMPENSATION (Each A Stock insurance Company) AND Hartford, CT 06183-4040 F:MPI r1vcRc 1 I9PTI IT" n'.)l._l`. ENDORSEMENT WC 09 04 04 (00)-001 POLICY NUMBER (6K-UB-417K457-7-91) FLORIDA ASSIGNED RISK PREMIUM SURCHARGE ENDORSEMENT This endorsement is added to Part 5 (Premium). It explains the premium you will pay for the insurance afforded by this policy with respect to operations in Florida. 1. This policy is subject to an assigned risk flat charge of $267. 2. If your premium for Florida is at least equal to $4,000, the entire standard premium for Florida is subject to an assigned risk premium surcharge of 15%. DATE OF ISSUE: 02-05-92 KK ST ASSIGN: FL PAGE 1 OF LAST The Travelers Insurance Companies (Each a Stock Insurance Company) Hartlord, Connecticut \VORKERS (:O.•1PENSA"►'lo . \\l) F:.\1l'L01 E:IZS LIABILITY INSI RANC'I•: 1)01.1C'1 In return for the pa\'ment of the premium and subject to all terms of this policy. we agree V01.1 a. 1n110\\*. C}:\[:RAl. SECTION A. The Policy. This policy includes at its effective date the Information Page and all endorsements and schedules listed there. It is a contract of insurance between you (the employer named in item 1 of the Information Page) and us (the insurer named on the Information Page). The only agreements relating to this insurance are stated in this policy. The terms of this policy may not be changed or waived except by endorsement issued by us to be part of this policy. B. Who Is Insured You are insured if you are an employer named in item 1 of the Information Page. If that employer is a partnership, and if you are one of its partners, you are insured, but only in your capacity as an employer of the partnership's employees. C. 'Workers Compensation Lal% Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in item 3.A. of the Information Page. It includes any amendments to that law which are in effect during the policy period. It does not include the provisions of any law that provide nonoccupational disability benefits. D. State State -means any state of the United States of America, and the District of Columbia. E. Locations This policy covers all of your workplaces listed in items 1 or 4 of the Information Page; and it covers all other workplaces in item 3.A. states unless you have other insurance or are self -insured for such work places. PART ONE -WORKERS COMPENSATION INSURANCE .A. How This Insurance Applies This workers compensation insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death. 1. Bodily injury by accident must occur during the policy period. 2. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. B. We Will Pay We will pay promptly when due the benefits required �_— of you by the workers compensation law. `_— C. We Will Defend We have the right and duty to defend at our expense any claim, proceeding or suit against you for benefits payable by this insurance. We have the right to investigate and settle these claims, proceedings or suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. D. We Will Also Pay We will also pay these costs, in addition to other amounts payable under this insurance, as part of any claim, proceeding or suit we defend: 1. reasonable expenses incurred at our request, but not loss of earnings; )3) 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amount payable under this insurance; 3. litigation costs taxed against you; 4. interest on a judgment as required by law until we offer the amount due under this insurance; and 5. expenses we incur. E. Other Insurance We will not pay more than our share of benefits and costs covered by this insurance and other insurance or self-insurance. Subject to any limits of liability that may apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance will be equal until the loss is paid. F. Payments You Must Make You are responsible for any payments in excess of the benefits regularly provided by the workers compensation law including those required because: 1. of your serious and willful misconduct; 2. you knowingly employ an employee in violation 'of law; 3. you fail to comply with a health or safety law or regulation; or 4. you discharge, coerce or otherwise discriminate against any employee in violation of the workers compensation law. If we make any payments in excess of the benefits regularly provided by the workers compensation law on your behalf, you will reimburse us promptly. C. Recovery From Others We have your rights, and the rights of persons entitled to the benefits of this insurance, to recover our payments from anyone liable for the injury. You will do everything necessary to protect those rights for us and to help us enforce them. H. Statutory Provisions these statements apple where they are required h. \. hrt�� r'n : n iniurcd ‘1.01.kei- and US. •A. nuticr of the injury kvhen you have notice. four default or the bankruptcy or insolvency or you or your estate will not relieve us of our duties under this insurance after an injury occurs. 3. \Ve are directly and primarily liable to any person entitled to the benefits payable by this insurance. Those persons may enforce our duties; so may an agency authorized by law. Enforcement may be against us or against yok and us. 4. Jurisdiction over you is jurisdiction over us for purposes of the workers compensation law. We are bound by decisions against you under that law, subject to the provisions of this policy that are not in conflict with that law. 5. This insurance conforms lip the par!• ! 11;•• . a. benefits pavahle by this im.ur:un•_• b. special taxes. payments into st:LL.irit} ui other special funds. and ass,:»mcnt., payable by us under that law. 6. Terms of this insurance that conflict with the workers compensation law are changed by this statement to conform to that law. Nothing in these paragraphs relieves you of your duties under this policy. PART TWO-EMJ'l..O\ ERS 1..!ABILITY INSURANCE A. How This Insurance Applies This employers liability insurance applies to bodily injury by accident or bodily injury by disease. Bodily injury includes resulting death. 1. The bodily injury must arise out of and in the course of the injured employee's employment by you. 2. The employment must be necessary or incidental to your work in a state or territory listed in item 3.A. of the Information Page. 3. Bodily injury by accident must occur during the policy period. 4. Bodily injury by disease must be caused or aggravated by the conditions of your employment. The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the policy period. 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by disease must be brought in the United States of America, its territories or possessions, or Canada. B. We Will Pay We will pay all sums you legally must pay as damages because of bodily injury to your employees, provided the bodily injury is covered by this Employers Liability Insurance. The damages we will pay, where recovery is permitted by law, include damages: I. for which you are liable to a third party by reason of a claim or suit against you by that third party to recover the damages claimed against such third party as a result of injury to your employee; 2. for care and loss of services; and 3. for consequential bodily injury to a spouse, child, parent, brother or sister of the injured employee; provided that these damages are the direct consequence of bodily injury that arises out of and in the course of the injured employee's employment by you; and 4. because of bodily injury to your employee that _ arises out of and in the course of employment, claimed against you in a capacity other than as employer. C. Exclusions This insurance does not cover: 1. liability assumed under a contract. This exclusion does not apply to a warranty that your work will be done in a workmanlike manner; 2. punitive or exemplary damages because of bodily injury to an employee employed in violation of law; 3. bodily injury to an employee while employed in violation of law with your actual knowledge or the actual knowledge of any of your executive officers; 4. any obligation imposed by a workers compensation, occupational disease, unemployment compensation, or disability benefits law, or any similar law; 5. bodily injury intentionally caused or aggravated by you; 6. bodily injury occurring outside the United States of America, its territories or possessions, and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or Canada who is temporarily outside these countries; 7. damages arising out of the discharge of, coercion of, or discrimination against any employee in violation of law. D. We Will Defend We have the right and duty to defend, at our expense, any claim, proceeding or suit against you for damages payable by this insurance. We have the right to investigate and settle these claims, proceedings and suits. We have no duty to defend a claim, proceeding or suit that is not covered by this insurance. We have no duty to defend or continue defending after we have paid our applicable limit of liability under this insurance. ) Ieasonaule expeiiJes ILIUM ICU (I1 U1II I CtjLIL L, UUL not loss of earnings: for appeal bonds i11 ht'nfl (Inio,1111•: II1 I" Ihl` I111111 elf our hahrht) untie, llll.� iII ii1 .l... 3. litigation costs taxed against you: 4. interest on a judgement as required by km: until we offer the amount due under this insurance: and 5. expenses we incur. F. Other lnsurance We will not pay more than our share of damages and costs covered by this insurance and other insurance or self-insurance. Subject to any limits of liability that apply, all shares will be equal until the loss is paid. If any insurance or self-insurance is exhausted, the shares of all remaining insurance and self-insurance will be equal until the Toss is paid. G. Limits of Liability Our liability to pay for damages is limited. Our limits of liability are shown in item 3.B. of the Information Page. They apply as explained below. 1. Bodily Injury by Accident. The limit shown for `bodily injury by accident -each accident' is the most we will pay for all damages covered by this insurance because of bodily injury to one or more employees in any one accident. A disease is not bodily injury by accident unless it results directly from bodily injury by accident. ttho sustain hodil� iniurt h, li�l ,r. I I li nil employee' is the most \Vt• will pay for ;III (i,llna`es because VI hod*. Ilitui 1 ill III •'..:� I, any one employee. Ifodily injury by disease (toes not include disease that results directly from a bodily injury by accident. 3. We will not pay any claims for damages after we have paid the applicable limit of our liability under this insurance. H. Recovery From Others We have your rights to recover our payment from anyone liable for an injury covered by this insurance. You will do everything necessary to protect those rights for us and to help us enforce them. I. Actions Against Us There will be no right of action against us under this insurance unless: 1. You have complied with all the terms of this policy; and The amount you owe has been determined with our consent or by actual trial and final judgement. This insurance does not give anyone the right to add us as a defendant in an action against you to determine your liability. PART THREE -OTHER STATES INSURANCE A. How This Insurance Applies 1. This other states insurance applies only if one or more states are shown in item 3.C. of the Information Page. 2. If you begin work in any one of those states and are not insured or are not self -insured for such work, the policy will apply as though that state were listed in item 3.A. of the Information Page. PART FOUR -YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be covered by this policy. Your other duties are listed here. I. Provide for immediate medical and other services required by the workers compensation law. 2. Give us or our agent the names and addresses of the injured persons and of witnesses, and other information we may need. 3. We will reimburse you for the benefits required by the workers compensation law of that state if we are not permitted to pay the benefits directly to persons entitled to them. B. Notice Tell us at once if you begin work in any state listed in item 3.C. of the Information Page. 3. Promptly give us all notices,demands and legal papers related to the injury, claim, proceeding or suit. 4. Cooperate with us and assist us, as we may request, in the investigation, settlement or defense of any claim, proceeding or suit. 5. Do nothing after an injury occurs that would interfere with our right to recover from others. 6. Do not voluntarily make payments, assume obligations or incur expenses, except at your own cost. PART FIVE -PREMIUM A. Our Manuals All premium for this policy will be determined by our manuals of rules, rates, rating plans and classifications. We may change our manuals and apply the changes to this policy if authorized by law or a governmental agency regulating this insurance. B. Classifications Itert-t 4 of the Information Page shows the rate and premium basis for certain business or work • In +fitness NI hereof, tt&, eompan, has caused this policy to be signed by its ('resident and .`'rcretar) at IIart ford, ( onnucticut, and countersigned on t e information page by a duly authorized agent of the company. 't N•(• 00 00 001001 CP-334) Edition 4-84 Printed in U.S A. ))-8-0 ""deludes copyright miner ial of the Council on Com- pensation Insurance, used with its permission. (.'I98? National Council on Compensation Insurance.'•