HomeMy WebLinkAbout23787AGREEMENT INFORMATION
AGREEMENT NUMBER
23787
NAME/TYPE OF AGREEMENT
MEN OF IMPACT DEVELOPMENT CENTER, INC.
DESCRIPTION
ANTI POVERTY INITIATIVE FUNDING
AGREEMENT/REHABILITATION PROGRAM FOR CITIZENS ON
PROBATION OR HOUSE ARREST/FILE ID: 7435/R-20-
0152/MATTER ID: 22-134/#19
EFFECTIVE DATE
February 15, 2022
ATTESTED BY
TODD B. HANNON
ATTESTED DATE
2/15/2022
DATE RECEIVED FROM ISSUING
DEPT.
2/18/2022
NOTE
CITY OF MIAMI
DOCUMENT ROUTING FORM
a3161
ORIGINATING DEPARTMENT: Office of Grants Administration
DEPT. CONTACT PERSON: Malissa T. Sutherland EXT. 1005
NAME OF OTHER CONTRACTUAL PARTY/ENTITY: Men of Impact Development Center, Inc
IS THIS AGREEMENT A RESULT OF A COMPETITIVE PROCUREMENT PROCESS? 0 YES ❑ NO
TOTAL CONTRACT AMOUNT: $ 10,000 FUNDING INVOLVED? ❑ YES ❑ NO
TYPE OF AGREEMENT:
❑ MANAGEMENT AGREEMENT
❑ PROFESSIONAL SERVICES AGREEMENT
❑ GRANT AGREEMENT
❑ EXPERT CONSULTANT AGREEMENT
❑ LICENSE AGREEMENT
OTHER: (PLEASE SPECIFY) API
❑ PUBLIC WORKS AGREEMENT
❑ MAINTENANCE AGREEMENT
0 INTER -LOCAL AGREEMENT
❑ LEASE AGREEMENT
❑ PURCHASE OR SALE AGREEMENT
PURPOSE OF ITEM (BRIEF SUMMARY): The attached agreement is being routed for review/signature. The API allocation from the Mayor's
Office to Men of Impact Development Center. Inc. for $10,000 and does not require Commission approval.
COMMISSION APPROVAL DATE: / /
FILE ID:
ENACTMENT NO.:
IF THIS DOES NOT REQUIRE COMMISSION APPROVAL, PLEASE EXPLAIN:
ROUTING INFORMATION
Date
PLEASE PRINT AND SIGN
APPROVAL BY DEPARTMENTAL DIRECTOR
1/19/22
PRINT:LILLL&N BLONDET
SIGNATURE: 'Fia.e,, a ;
SUBMITTED TO OFFICE OF MANAGEMENT AND
BUDGET
PRINT:MARIE GOUIN
SIGNATURE:
SUBMITTED TO RISK MANAGEMENT
1/19/22
PRINT: ANN-MARIE SHARPE
Gomez, .,..,.��„,x ,,�,
SIGNATURE: Frank ""`_�... ° """`
SUBMITTED TO CITY ATTORNEY 22-134
D.J.G.
PRINT: VICTORIA MENDEZ
�jG%ry
SIGMA t
APPROVAL BY ASSISTANT CITY MANAGER
' I1�J/1").---
PRINT:FERNANDO CASAMAYOR
SIGNATUI
RECEIVED BY CITY MANAGER
PRINT: ARTHUR N0�2?�
SIGNATURE:
PRINT:
SIGNATURE:
PRINT:
SIGNATURE:
PRINT:
SIGNATURE:
1) ONE ORIGINAL TO CITY CLERK,
2) ONE COPY TO CITY ATTORNEY'S OFFICE,
3) REMAINING ORIGINAL(S) TO ORIGINATING
DEPARTMENT
PLEASE ATTACH THIS ROUTING FORM TO ALL DOCUMENTS THAT REQUIRE
EXECUTION BY THE CITY MANAGER
CITY OF MIAMI
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
This ANTI -POVERTY INITIATIVE AGREEMENT ("Agreement") is entered into
this /Z1-74h day of y�h;-?",?,-Li , 20 22 by and between the CITY OF MIAMI, a
municipal corporation of the State of Florida, located at 444 SW 2ndAvenue, Miami, FL 33130
("CITY"), and Men of Impact Development Center, Inc. ' a Florida not for profit corporation, located at
I76'0 NW 4lst Avenue, Miami Gardens, FI 33055 ("RECIPIENT"). The CITY and the RECIPIENT may each
be referred to as a "Party" and may collectively be referred to as the "Parties."
WHEREAS, the City created the Anti -Poverty Initiative ("API") to address poverty based
on a strategy of focusing the provision of support towards the City's residents achieving self-
sufficiency; and
WHEREAS, the RECIPIENT submitted a Request for API Funding to the City; and
WHEREAS, the CITY adopted Resolution No. R- 20 _ 0152 on May 14 20 20
wherein the CITY approved providing funds to the RECIPIENT in the not to exceed amount of
Ten Thousand dollars ($ 10,000 .00) ("Funds"), attached
and incorporated as Exhibit "A", as applicable; and
WHEREAS, the CITY agrees to enter into this Agreement with the RECIPIENT to set
forth the terms and conditions relating to the use of the Funds by the RECIPIENT.
NOW, THEREFORE, in consideration of the mutual covenants and promises herein
contained, the Parties agree as follows:
TERMS
1. RECITALS: The recitals are true and correct and are hereby incorporated into and made
a part of this Agreement.
2. TERM: The term of this Agreement shall commence on November 29 , 2021 and
shall continue until November 29 , 2022.
3. GRANT OF FUNDS: Subject to the terms and conditions set forth herein and
RECEIPIENT' S compliance with all of its obligations hereunder, the CITY hereby agrees to make
available to the RECIPIENT the Funds to be used for the purpose(s), program(s), initiative(s), and
activity(ies) (as defined in Exhibit "B"), and as disbursed in the manner hereinafter provided.
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API Funding Agreement
Men of Impact Development Center, Inc.
4. USE OF FUNDS: The Funds shall be used by the RECIPIENT as described in the
Scope of Work, attached and incorporated herein as Exhibit "B" and the Budget, attached and
incorporated herein as Exhibit "C" submitted by the RECIPIENT to the CITY.
DISBURSEMENT OF FUNDS:
A. The CITY shall provide Funds to the RECIPIENT in the not to exceed amount of
Ten Thousand dollars ($ 10,000 .00).
B. Payment shall be made in accordance with the schedule as set forth in Composite
Exhibit "D".
C. The RECIPIENT shall provide the CITY with a City of Miami Request for Payment
Form attached and incorporated as Composite Exhibit "D" prior to any disbursement of funds
by the CITY.
Prior to any disbursement of funds by the CITY the RECIPIENT will need to provide a
valid and executed W9 form and completed City of Miami Supplier Direct Deposit
(ACH) Authorization Form, as applicable.
D. The RECIPIENT shall provide the CITY a Close -Out Report, in similar format as
Exhibit "F", at the end of the program, summarizing the services, programs and/or activities
described in the Scope of Work as Exhibit "B" and included in the Budget as Exhibit "C".
5. COMPLIANCE WITH POLICIES AND PROCEDURES: RECIPIENT understands
that the use of the Funds is subject to specific reporting, record keeping, administrative and
contracting guidelines, audit, and other requirements affecting the activities being funded by the
API Funds for the Scope of Work. RECIPIENT covenants and agrees to comply with such
requirements, and represents and warrants to the CITY that the Funds shall be used in accordance
with all of the requirements, terms and conditions contained therein, as the same may be amended
during the term hereof. Without limiting of the foregoing, RECIPIENT represents and warrants
that it will comply with, and the Funds will be used in accordance with, all applicable: federal,
state, and local codes, laws, rules and regulations.
6. RECORDS, INSPECTIONS, REPORTS/AUDITS AND EVALUATION: To the
extent required by law, the Inspection and Audit provisions set forth in Sections 18-101 and
18-102 of the Code of the City of Miami, Florida, as amended ("City Code"), are deemed as
being incorporated by reference herein and additionally apply to this Agreement. The CITY shall
have the right to conduct audits of RECIPIENT'S records pertaining to the Funds and that
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API Funding Agreement
Men of Impact Development Center, Inc.
reasonable times, and for a period of up to three (3) years following the termination ofthis
Agreement, audit, or cause to be audited, those books and records of the RECIPIENT
which are related to RECIPIENT'S performance under this Agreement. RECIPIENT agrees to
maintain all such books and records at its principal place of business for a period of three (3)
years after final payment is made under this Agreement. The CITY may also, and the
RECIPIENT shall permit, the CITY and other persons duly authorized by the CITY to inspect all
Agreement records, facilities, goods, and activities of the RECIPIENT which are in any way
connected to the activities undertaken pursuant to the terms of this Agreement, and/or
interview any clients, employees, subcontractors or assignees of the RECIPIENT as
requested by the CITY. At the request of the CITY, the RECIPIENT shall transmit to the
CITY written statements of the RECIPIENT's official policies on specified issues relating to the
RECIPIENT's activities.
RECIPIENT understands, acknowledges, and agrees that:
a) The CITY must meet certain record keeping and reporting requirements with regard to the
Funds and that in order to enable the CITY to comply with its record keeping and reporting
requirements, RECIPIENT shall maintain all records as required by the CITY; and
b) At the CITY's request, and no later than thirty (30) days thereafter, RECIPIENT shall
deliver to the CITY such reports and written statements relating to the use of the Funds as
the CITY may require from time to time; and
c) All costs and expenses of the activities described in Exhibit "C" shall be at actual cost
with no markups; and
d) RECIPIENT'S failure to comply with these requirements or the receipt or discovery (by
monitoring, evaluation, or audit) by the CITY of any inconsistent, incomplete, or
inadequate information shall be grounds for the immediate termination of this Agreement
by the CITY and the immediate reimbursement to the CITY of any and all funds or amounts
disbursed pursuant to this Agreement.
RECIPIENT represents and warrants to the City that: (i) it possesses all qualifications,
licenses and expertise required for the performance of the Scope of Work; (ii) it is not delinquent
in the payment of any sums due to the City, including payment of permit fees, occupational
licenses, etc., nor in the performance of any obligations to the City; and (iii) all personnel assigned
to perform the Scope of Work are and shall be, at all times during the term hereof, fully qualified
and trained to perform the tasks assigned to each.
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API Funding Agreement
Men of Impact Development Center, Inc.
Any inconsistent, incomplete, or inadequate information, either received by the CITY or
obtained by the CITY, shall constitute cause for the CITY to terminate this Agreement.
7. AWARD OF AGREEMENT: RECIPIENT represents and warrants to the CITY that
it has not employed or retained any person or company employed by the CITY to solicit or
secure this Agreement and that it has not offered to pay, paid, or agreed to pay any person any fee,
commission, percentage, brokerage fee, or gift of any kind contingent upon or in connection with,
the award of this Agreement.
8. COMPLIANCE WITH FEDERAL. STATE AND LOCAL LAWS: RECIPIENT
understands that agreements between private entities and local governments are subject to certain
laws, codes, rules and regulations, including, without limitation, laws pertaining to public records,
conflict of interest, record keeping, etc. The Parties agree to comply with and observe all applicable
laws, codes and ordinances as they may be amended from time to time.
9. INDEMNIFICATION: RECIPIENT shall indemnify, defend and hold harmless the
CITY and its officials, employees (collectively referred to as "Indemnitees") and each of them
from and against all loss, costs, penalties, fines, damages, claims, expenses (including attorney's
fees) or liabilities (collectively referred to as "Liabilities") by reason of any injury to or death of
any person or damage to or destruction or loss of any property arising out of, resulting from, or in
connection with (i) the negligent performance or non-performance of the Services contemplated
by this Agreement (whether active or passive) of RECIPIENT or its employees or subcontractors
(collectively referred to as "RECIPIENT") which is directly caused, in whole or in part, by any
act, omission, default or negligence (whether active or passive or in strict liability) of any of them,
or (ii) the failure of the RECIPIENT to comply materially with any of the requirements herein, or
the failure of the RECIPIENT to conform to statutes, ordinances, or other regulations or
requirements of any governmental authority, local, federal or state, in connection with the
performance of this Agreement even if it is alleged that the CITY, its officials and/or employees
were negligent. RECIPIENT expressly agrees to indemnify, defend and hold harmless the
Indemnitees, or any of them, from and against all liabilities which may be asserted by an employee
or former employee of RECIPIENT, or any of its subcontractors, as provided above, for which the
RECIPIENT's liability to such employee or former employee would otherwise be limited to
payments under state Workers' Compensation or similar laws. RECIPIENT further agrees to
indemnify, defend and hold harmless the Indemnitees from and against (i) any and all Liabilities
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API Funding Agreement
Men of Impact Development Center, Inc.
imposed on account of the violation of any law, ordinance, order, rule, regulation, condition, or
requirement, related directly to RECIPIENT's negligent performance under this Agreement,
compliance with which is left by this Agreement to RECIPIENT, and (ii) any and all claims, and/or
suits for labor and materials furnished by RECIPIENT or utilized in the performance of this
Agreement or otherwise. This provision shall survive the termination or expiration of this
Agreement, as applicable.
RECIPIENT understands and agrees that any and all liabilities regarding the use of any
subcontractor for Services related to this Agreement shall be borne solely by the RECIPIENT
throughout the duration of this Agreement and that this provision shall survive the termination or
expiration of this Agreement, as applicable.
10. REVERSION OF ASSETS: Upon the expiration, termination, or cancellation of this
Agreement, any unspent API Grant funds shall immediately revert to the possession and ownership
of the CITY and RECIPIENT shall transfer to the CITY all unused API Grant funds at the time of
such expiration, termination, or cancellation.
11. DEFAULT: If RECIPIENT fails to comply with any term or condition of this
Agreement, or fails to perform any of its obligations hereunder, then RECIPIENT shall be in
default. Upon the occurrence of a default hereunder the CITY, in addition to all remedies available
to it by law, may immediately, upon written notice to RECIPIENT, terminate this Agreement
whereupon all payments, advances, or other compensation paid by the CITY to RECIPIENT while
RECIPIENT was in default shall be immediately returned to the CITY. RECIPIENT understands
and agrees that termination of this Agreement under this section shall not release RECIPIENT
from any obligation accruing prior to the effective date of termination. Should RECIPIENT be
unable or unwilling to commence to perform the Services within the time provided or
contemplated herein, then, in addition to the foregoing, RECIPIENT shall be liable to the CITY
for all expenses incurred by the CITY in preparation and negotiation of this Agreement, as well as
all costs and expenses incurred by the CITY in the procurement of the Services, including
consequential and incidental damages.
12. CITY'S TERMINATION RIGHTS: The CITY shall have the right to terminate this
Agreement, in its sole discretion, at any time, by giving written notice to RECIPIENT at least
five (5) business days prior to the effective date of such termination. In such event, the CITY shall
pay to RECIPIENT compensation for services rendered and expenses incurred prior to the
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City of Miami
API Funding Agreement
Men of Impact Development Center, Inc.
effective date of termination. In no event shall the CITY be liable to RECIPIENT for any
additional compensation, other than that provided herein, or for any consequential or incidental
damages.
13. REMEDIES FOR NONCOMPLIANCE: The CITY retains the right to
terminate this Agreement at any time prior to the completion of the services required pursuant to
this Agreement without penalty to the CITY. In that event, notice of termination of this
Agreement shall be in writing to the RECIPIENT, who shall be paid for those services performed
prior to the date of its receipt to the notice of termination. In no case, however, shall the CITY
pay the RECIPIENT an amount in excess of the total sum provided by this Agreement.
It is hereby understood by and between the CITY and the RECIPIENT that any payment
made in accordance with this Agreement to the RECIPIENT shall be made only if the
RECIPIENT is not in default under the terms of this Agreement. If the RECIPIENT is in default,
the CITY shall not be obligated and shall not pay to the RECIPIENT any sum whatsoever.
If the RECIPIENT fails to comply with any term of this Agreement, the CITY may take
one or more of the following courses of action:
(1) Temporarily withhold cash payments pending correction of the deficiency by
the RECIPIENT, or such more severe enforcement action as the CITY
determines is necessary or appropriate.
(2) Disallow (that is, deny both the use of funds and matching credit) for all or part
of the cost of the activity or action not in compliance.
(3) Wholly or partially suspend or terminate the current API Program Funds
awarded to the RECIPIENT.
(4) Withhold further API Program funding for the RECIPIENT.
(5) Take all such other remedies that may be legally available.
14. MARKETING: RECIPIENT shall consult with the City Manager, or his or her
designee, regarding all uses and displays of the recognition of the CITY. The CITY shall have the
right to approve the form and placement of all acknowledgements, which approval shall not be
unreasonably withheld.
15. INSURANCE: The required Insurance, as approved by the City of Miami
Department of Risk Management shall be provided by the RECIPIENT and all such proof shall be
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City of Miami
API Funding Agreement
Men of Impact Development Center, Inc.
attached as an Exhibit to this Agreement. Those entities/individuals required to be listed as
additional insured by the Department of Risk Management shall be included on all insurance
certificates and furnished by the RECIPIENT.
RECIPIENT shall, at all times during the term hereof, maintain insurance coverage in
accordance with Exhibit "E" attached and incorporated by this reference. All such insurance,
including renewals, shall be subject to the approval of the City for adequacy of protection and
evidence of such coverage shall be furnished to the City on Certificates of Insurance indicating
such insurance to be in force and effect and providing that it will not be canceled during the
performance of the services under this contract.
Execution of this Agreement is contingent upon the receipt of proper insurance documents.
16. NONDISCRIMINATION: RECIPIENT represents and warrants to the City that
RECIPIENT does not and will not engage in discriminatory practices and that there shall be no
discrimination in connection with RECIPIENT's performance under this Agreement on account
of race, color, sex, religion, age, handicap, marital status or national origin. RECIPIENT further
covenants that no otherwise qualified individual shall, solely by reason of his/her race, color, sex,
religion, age, handicap, marital status or national origin, be excluded from participation in, be
denied services, or be subject to discrimination under any provision of this Agreement.
17. ASSIGNMENT: This Agreement shall not be assigned by RECIPIENT, in whole or
in part, without the prior written consent of the CITY, which may be withheld or conditioned, in
the CITY'S sole discretion.
18. CERTIFICATIONS REGARDING DEBARMENT. SUSPENSION. AND OTHER
RESPONSIBILITY MATTERS: RECIPIENT certifies to the best of its knowledge and belief
that it and its principals:
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from covered transactions by any Federal, State, or local
agency.
b) Have not within a three (3) year period preceding the adoption of the Resolution,
attached and incorporated as Exhibit "A", as applicable, been convicted of or had a
civil judgement rendered against them for the commission of fraud or a
criminal offense in connection with obtaining, attempting to obtain, or
performing a public (Federal, State, or local) transaction or contract under a public
transaction; violation of Federal
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API Funding Agreement
Men of Impact Development Center, Inc.
or State antitrust statutes or falsification or destruction of records, making false
statements, or receiving stolen property;
c) Are not presently indicted for or otherwise criminally or civilly charged by a
government entity (Federal, State, or local) with commission of any of the offenses
enumerated in paragraph 16.b of this certification; and
d) Have not within a three (3) year period preceding the adoption of the Resolution,
attached and incorporated as Exhibit "A", as applicable, had one or more
public transactions (Federal, State, or local) terminated for cause or default.
Where the prospective primary participant is unable to certify to any of the statements in
this certification, such prospective participant shall submit an explanation to the CITY and the
CITY shall have the right to, in the CITY's sole discretion, to not enter into or terminate this
Agreement.
19. NOTICES: All notices or other communications required under this Agreement shall
be in writing and shall be given by hand -delivery or by registered or certified U.S. Mail, return
receipt requested, addressed to the other party at the address indicated herein or to such other
address as a party may designate by notice given as herein provided. Notice shall be deemed given
on the day on which personally delivered; or, if by mail, on the fifth day after being posted or the
date of actual receipt, whichever is earlier.
RECIPIENT
Men of Impact Development Center, Inc.
17610 NW 41 st Avenue
Miami Gardens, F133055
Attn: Olden Reese
CITY
City of Miami
Office of Grants Administration
444 SW 2nd Avenue, 5th Floor
Miami, FL 33130
Attn: Lillian Blondet, Director
With copies to:
Office of the City Attorney
444 SW 2nd Avenue, Suite 945
Miami, FL 33130
Attn: Victoria Mendez, City Attorney
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City of Miami
API Funding Agreement
Men of Impact Development Center, Inc.
20. PUBLIC RECORDS: Pursuant to the provisions of Section 119.0701. Florida
Statutes, RECIPIENT must comply with the Florida public records laws, specifically the
RECIPIENT must:
A. Keep and maintain public records that ordinarily and necessarily would be required
by the public agency in order to perform the service.
B. Provide the public with access to public records on the same terms and conditions
that the public agency would provide the records and at a cost that does not exceed the cost
provided in this chapter of the Florida Statutes or as otherwise provided by law.
C. Ensure that public records that are exempt or confidential and exempt from public
records disclosure requirements are not disclosed except as authorized by law.
D. Meet all requirements for retaining public records and transfer, at no cost, to the
CITY all public records in possession of the RECIPIENT upon termination of the contract
and destroy any duplicate public records that are exempt or confidential and exempt from
public records disclosure requirements.
E. All records stored electronically must be provided to the CITY in a format that is
compatible with the information technology systems of the CITY.
IF THE RECIPIENT HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
RECIPIENT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING TO
THIS CONTRACT, CONTACT THE CUSTODIAN OF PUBLIC RECORDS
AT (305) 416-1800, PUBLICRECORDS@MIAMIGOV.COM, AND 444 S.W.
2"D AVENUE, SUITE 945, MIAMI, FL 33130.
21. CONFLICT OF INTEREST: RECIPIENT has received copies of, and/or is familiar
with, the following provisions regarding conflict of interest in the performance of this Agreement
by RECIPIENT. RECIPIENT covenants, represents and warrants that it will comply with all such
conflict of interest provisions including, but not limited to:
(a) the Code of the City of Miami, Florida, Chapter 2, Article V; and
(b) Miami -Dade County Code, Section 2-11.1.
22. GOVERNING LAW, VENUE, AND FEES: This Agreement shall be construed
and enforced according to the laws of the State of Florida. Venue in all proceedings shall be in
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API Funding Agreement
Men of Impact Development Center, Inc.
Miami -Dade County, Florida and the parties explicitly agree to the use of this venue. The term
"proceedings" shall include, but not be limited to, all meetings to resolve the dispute, including
voluntary arbitration, mediation, or other alternative dispute resolution mechanism. The parties
both waive any defense that venue in Miami -Dade County is not convenient. In any civil action or
other proceedings between the parties arising out of the Agreement, each party shall bear its own
attorney's fees.
23. WAIVER OF JURY TRIAL: Neither the RECIPIENT, nor any assignee,
successor, heir or personal representative of the RECIPIENT, nor any other person or entity, shall
seek a jury trial in any lawsuit, proceeding, counterclaim or any other litigation procedure based
upon or arising out of any of the Agreement and/or any modifications, or the dealings or the
relationship between or among such persons or entities, or any of them. Neither the RECIPIENT,
nor any other person or entity will seek to consolidate any such action in which a jury trial has
been waived with any other action. The provisions of this paragraph have been fully discussed by
the parties hereto, and the provisions hereof shall be subject to no exceptions. No party to this
Agreement has in any manner agreed with or represented to any other party that the provisions of
this paragraph will not be fully enforced in all instances.
24. MISCELLANEOUS PROVISIONS:
A. Title and paragraph headings are for convenient reference and are not a part of this
Agreement.
B. No waiver or breach of any provision of this Agreement shall constitute a waiver
of any subsequent breach of the same or any other provision hereof, and no waiver shall be
effective unless made in writing.
C. In the event of conflict between the terms of this Agreement and any terms or
conditions contained in any attached documents, the terms of this Agreement shall control.
D. Should any provision, paragraph, sentence, word or phrase contained in this
Agreement be determined by a court of competent jurisdiction to be invalid, illegal or otherwise
unenforceable under the laws of the State of Florida or the City of Miami, such provision,
paragraph, sentence, word or phrase shall be deemed modified to the extent necessary in order to
conform with such laws, or if not modifiable, then same shall be deemed severable, and in either
event, the remaining terms and provisions of this Agreement shall remain unmodified and in full
force and effect or limitation of its use.
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API Funding Agreement
Men of Impact Development Center, Inc.
25. NON-DELEGABILITY: The obligations undertaken by the RECIPIENT pursuant to
this Agreement shall not be delegated or assigned to any other person or firm, in whole or in part,
without the CITY'S prior written consent, which may be withheld in the CITY'S sole discretion.
26. SUCCESSORS AND ASSIGNS: This Agreement shall be binding upon the parties
hereto, their heirs, executors, legal representatives, successors, or assigns.
27. INDEPENDENT CONTRACTOR: RECIPIENT, its contractors, subcontractors,
employees, and agents shall be deemed to be independent contractors, and not agents or employees
of the CITY, and shall not attain any rights or benefits under the civil service or pension programs
of the CITY, or any rights generally afforded its employees; further, they shall not be deemed
entitled to Florida Workers' Compensation benefits as employees of the CITY.
28. NO THIRD -PARTY BENEFICIARY RIGHTS: No provision of this Agreement shall,
in any way, inure to the benefit of any third parties so as to constitute any such third party a
beneficiary of this Agreement, or of anyone or more of the terms hereof, or otherwise give rise to
any cause of action in any party not a party hereto.
29. CONTINGENCY CLAUSE: Funding for this Agreement is contingent on the
availability of funds and continued authorization for program activities and the Agreement is
subject to amendment or termination due to lack of allocated and available funds, reduction or
discontinuance of funds or change in laws, codes, rules, policies or regulations, upon thirty (30)
days' notice.
30. RECIPIENT CERTIFICATION: The RECIPIENT certifies that it possesses the legal
authority to enter into this Agreement pursuant to authority that has been duly adopted or passed
as an official act of the RECIPIENT'S governing body, authorizing the execution of this
Agreement, including all understandings and assurances contained herein, and directing and
authorizing the person identified as the official representative of the RECIPIENT to act in
connection with this Agreement and to provide such information as may be requested. The
aforementioned authorization for the RECIPIENT is attached and incorporated as Exhibit "G"
31. AUTHORITY: Each person signing this Agreement represents and warrants that he
or she is duly authorized and has legal capacity to execute and deliver this Agreement. Each party
represents and warrants to the other that the execution and delivery of the Agreement and the
performance of such party's obligations and the certifications hereunder have been duly authorized
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API Funding Agreement
Men of Impact Development Center, Inc.
and that the Agreement is valid and legal agreement binding on such party and enforceable in
accordance with its terms.
32. CONSTRUCTION: Should the provisions of this Agreement require judicial or arbitral
interpretation, it is agreed that the judicial or arbitral body interpreting or construing the same shall
not apply the assumption that the terms hereof shall be more strictly construed against one party
by reason of the rule of construction that an instrument is to be construed more strictly against the
party which itself or through its agents prepared same, it being agreed that the agents of both parties
have equally participated in the preparation of this Agreement.
33. ENTIRE AGREEMENT: This instrument and its attachments constitute the sole and
entire agreement between the parties relating to the subject matter hereof and correctly sets forth
the rights, duties, and obligations of each to the other as of its date. Any prior agreements,
promises, negotiations, or representations not expressly set forth in this Agreement are of no force
or effect. No modification or amendment hereto shall be valid unless in writing and executed by
properly authorized representatives of the parties hereto.
34. COUNTERPARTS AND ELECTRONIC SIGNATURES: This Agreement may be
executed in any number of counterparts, each of which so executed shall be deemed to be an
original, and such counterparts shall together constitute but one and the same Agreement. The
parties shall be entitled to sign and transmit an electronic signature of this Agreement (whether
by facsimile, PDF or other email transmission), which signature shall be binding on the party
whose name is contained therein. Any party providing an electronic signature agrees to promptly
execute and deliver to the other parties an original signed Agreement upon request.
[Remainder intentionally left blank; Signature page to follow]
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City of Miami
API Funding Agreement
Men of Impact Development Center, Inc.
IN WITNESS Vir'HEREOF, the parties hereto have caused this instrument to be executed
by their respective officials thereunto duly authorized, this the day and year above written.
ATTEST:
Todd B. H
lerk Date:
15 (at)g--
APPROVED AS TO FORM AND
CORRECTNESS:
Victoria 116(endez Date:
City Attorney 22-134 D.J.G.
ATTEST:
:7i0,70') /6.04,
Print Name: L}!Ih%C0J2.�
Title: 60J'f
"CITY"
CITY OF MIAMI, a municipal
corporation of t �,. State of Florida
y:
Arthur Noriega City Manager D : te:
APPROVED AS TO INSURANCE
REQUIREMENTS:
Gomez,
Frank
Digitally signed by
Gomez, Frank
Date: 2022.01.19 15:34:22
-05'00'
15 'Li/
Ann -Marie Sharpe, Director Date:
Risk Management
"RECIPIENT"
Men of impact Development Center, Inc.
A Florida Not -For -Profit Corporation
By:
Print Name:Olden Reese
Title: President
Page 13
11/29/21, 1:19 PM Detail by Entity Name
DIVISION OF CORPORATIONS
Department of State / Mision of Corporations / Search Records / Search by Entity Name /
Detail by Entity Name
Florida Not For Profit Corporation
MEN OF IMPACT DEVELOPMENT CENTER, INC
Filing Information
Document Number N15000011425
FEI/EIN Number 47-5224962
Date Filed 11/20/2015
State FL
Status ACTIVE
Last Event REINSTATEMENT
Event Date Filed 01/05/2017
Principal Address
17610 NW 41ST AVENUE
MIAMI GARDENS, FL 33055
Mailing Address
17610 NW 41ST AVENUE
MIAMI GARDENS, FL 33055
Registered Agent Name & Address
REESE, OLDEN R
17610 NW 41ST AVENUE
MIAMI GARDENS, FL 33055
Name Changed: 01/05/2017
Officer/Director Detail
Name & Address
Title P
REESE, OLDEN R
17610 NW 41ST AVENUE
MIAMI GARDENS, FL 33055
Title Treasurer
REESE, LASHON
17610 NW 41ST AVENUE
MIAMI GARDENS, FL 33055
httpsJ/search.sunbiz.org/Inq uirylCorporationSearch/SearchResultDetail?inq uirytype=EntityName&di recti onType= 'nit al&searchNameOrder=M EN IMPACTDEV... 1/2
11/29/21, 1:19 PM Detail by Entity Name
Title Secretary
Reese, Cierra G
3840 NW 213TH STREET
Miami Gardens, FL 33055
Annual Reports
Report Year Filed Date
2019 04/11/2019
2020 02/10/2020
2021 01/11/2021
Document Images
01/11/2021 — ANNUAL REPORT View image in PDF format
O2110/2020 — ANNUAL REPORT View image in PDF format
04/11/2019 — ANNUAL REPORT View image in PDF format
02/26/2018 — ANNUAL REPORT View image in PDF format
01/05/2017 — REINSTATEMENT View image in PDF format
11/20/2015 — Domestic Nor. -Profit View image in PDF format —J
https://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetai I?inq uiryiype= Ent tytJanle&di recti onType= Initial &searchN ameOrder=MENIMPACTD EV... 2/2
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT A - CITY OF MIAMI RESOLUTION
T. Sutherland, Malissa
From: Quintero, Lazaro
Sent: Monday, November 22, 2021 4:17 PM
To: Srpastorreese@gmail.com
Cc: Pascual, Nikolas; T. Sutherland, Malissa
Subject: API Guidelines and Documentation
Attachments: API Guidelines and Funding Request form.pdf
Good afternoon Pastor,
As discussed with Mayor Suarez please complete the attached for 10k towards the "Men of Impact" program. Malissa
copied herein will work with you on the documentation should any questions arise.
Thank you,
Lazaro Quintero
Director of Constituent Affairs
Office of Mayor Francis X. Suarez
3500 Pan American Drive
Office (305)250-5300
CeII (786)556-0995
Iauintero®a miamigov.com
1
City of Miami
Legislation
Resolution
Enactment Number: R-20-0152
City Hall
3500 Pan American Drive
Miami, FL 33133
www.miamigov.com
File Number: 7435
Final Action Date:5/14/2020
A RESOLUTION OF THE MIAMI CITY COMMISSION, WITH ATTACHMENT(S),
AMENDING THE ANTI -POVERTY INITIATIVE ("API") GUIDELINES TO ALLOW FOR
THE PURCHASE OF ESSENTIAL SERVICES DURING A DECLARED STATE OF
EMERGENCY, TO ALLOW FOOD DISTRIBUTIONS, AND TO CLARIFY THAT IN
ADDITION TO CITY OF MIAMI ("CITY") DEPARTMENTS, THE OFFICES OF CITY
ELECTED OFFICIALS SHALL QUALIFY AS ELIGIBLE RECIPIENTS OF API FUNDS;
FURTHER RATIFYING, CONFIRMING, AND APPROVING, PURSUANT TO SECTION
18-72(B)(20) OF THE CODE OF THE CITY OF MIAMI, FLORIDA, AS AMENDED,
THAT ALLOCATIONS OF API FUNDS IN AN AGGREGATE AMOUNT OF FIFTY
THOUSAND DOLLARS ($50,000.00) OR LESS IN ANY SINGLE CITY FISCAL YEAR
TO ANY SINGLE ENTITY PURSUANT TO THE API GUIDELINES SHALL NOT
REQUIRE CITY COMMISSION APPROVAL; AUTHORIZING THE CITY MANAGER TO
EXECUTE ANY AND ALL NECESSARY DOCUMENTS, ALL IN A FORM
ACCEPTABLE TO THE CITY ATTORNEY, FOR SAID PURPOSE.
WHEREAS, pursuant to Resolution No. 14-0362 adopted on September 23, 2014, the
City Commission established the Anti -Poverty Initiative Program ("API") to address poverty
through a strategy of focusing the provision of support towards the goal of having City of Miami
("City") residents achieve self-sufficiency; and
WHEREAS, pursuant to Resolution No. 15-0106 adopted on March 12, 2015, the City
determined that the most effective means of allocating API funding among the City Commission
Districts should be based on the level of poverty within each District; and
WHEREAS, pursuant to Resolution No. 16-0044 adopted January 28, 2016, all API
funding recipients are required to execute an agreement with the City that addresses the scope
of services, performance measures, invoicing, conflicts of interest, and other material terms that
may be applicable for the use of any funds; and
WHEREAS, the Novel Coronavirus ("COVID-19") pandemic and the related economic
impacts has brought to Tight the need to expand the allowable uses of API funds to include food
distributions consistent with the needs identified by this Resolution; and
WHEREAS, during a declared State of Emergency or natural disaster, it is also
appropriate to allow for the use of API funds for essential supplies that may be necessary; and
WHEREAS, the City Commission ratifies, confirms and approves that pursuant to
Section 18-72(b)(20) of the Code of the City of Miami, Florida, as amended ("City Code"),
allocations of API funds in an aggregate amount of fifty thousand dollars ($50,000.00) or less in
any single fiscal year to any single entity pursuant to the API guidelines shall not require City
Commission approval; and
WHEREAS, the API guidelines already include City Departments as eligible recipients
and the City Commission wishes to clarify that the offices City elected officials shall also be
included as eligible recipients;
NOW, THEREFORE, BE IT RESOLVED BY THE COMMISSION OF THE CITY OF
MIAMI, FLORIDA:
Section 1. The recitals and findings contained in the Preamble of this Resolution are
adopted by reference and incorporated herein as if fully set forth in this Section.
Section 2. The City Commission hereby amends the API guidelines to allow for the use
of API funds for food distributions.
Section 3. The City Commission hereby amends the API guidelines to allow for the use
of API funds to purchase essential supplies during a State of Emergency, natural disaster, or
other economic crisis.
Section 4. The City Commission hereby amends the API guidelines to clarify that
elected official offices shall be an eligible recipients of API funding.
Section 5. The City Commission hereby ratifies, confirms, and approves pursuant to
Section 18-72(b)(20) of the City Code, that allocations of API funds in an aggregate amount of
fifty thousand dollars ($50,000.00) or Tess in any single City fiscal year to any single entity
pursuant to the API guidelines shall not require City Commission approval.
Section 6. The City Manager is authorized' to execute any and all necessary
documents, all in a form acceptable to the City Attorney, for said purpose.
Section 7. This Resolution shall become effective immediately upon its adoption and
signature of the Mayor.2
APPROVED AS TO FORM AND CORRECTNESS:
I The herein authorization is further subject to compliance with all legal requirements that may be
imposed, including but not limited to, those prescribed by applicable City Charter and City Code
provisions.
2 If the Mayor does not sign this Resolution, it shall become effective at the end of ten (10) calendar days
from the date it was passed and adopted. If the Mayor vetoes this Resolution, it shall become effective
immediately upon override of the veto by the City Commission.
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT B — SCOPE OF WORK
Insert Pages 2 & 3 from Anti -Poverty Funding Request Form
City of Miami
Anti -Poverty Initiative Program
Funding Request Form
ORGANIZATION AND PROGRAM/PROJECT INFORMATION
Organization History and Background Information:
This is a re-entry program that targets citizens who are currently on probation or house arrest.
This program aims to stop additional crimes and/or violence from being committed by these individuals,
eliminate the risk of them being rearrested, becoming drug abusers or spousal abusers, and/or becoming
prey to other pitfalls that could potentially cause them to be removed once again from society.
Is your program/project providing direct services to residents of the City of Miami? Yes❑✓ No❑
Number of residents your entity will serve: 10
Frequency of Service: Twice a week
Age Group Served: 18 & Up
Is your program/project impacting one of Miami's disadvantaged communities? Yes ❑✓ No
Geographic Area Served (specific to this project/program)
District Served (1, 2, 3, 4, 5, Citywide) 3
Neighborhood/Community being served: Overtown, Liberty City
Program/Project Priority area (Select one):
nEducational Programs for children, youth and adults
U Crime Prevention
n Elderly meals, transportation, recreational and health/wellness related activities At-
nrisk youth or youth summer job programs
n Transportation services and programs
n Job development, retention and training programs
n Homeless Services
❑ Food Distribution
n Essential supplies, during a State of Emergency, natural disaster, or economic crisis
Page2of5
Return this form to: mtrevino@miamigov.com
(Last Revised May 15, 2020)
City of Miami
Anti -Poverty Initiative Program - Funding Request Form
Program/Project Title: Men of Impact Development Center, Inc.
Project/Program Description:
This rehabilitation program gives citizens who are on probation or house arrest
an opportunity to close the revolving doors of imprisonment and the opportunity to stop repeated offenses due to their inability to find
employment. This program aids with finding employment and help the citizens improve their job interviewing skills. They will also
gain spiritual, emotional and mental guidance to support their transition and integration back to their families and neighborhoods.
Program Start Date: 9/1/2019 Program End Date: Ongoing
Please describe how this program/project and funding will alleviate poverty within the City of
Miami?
This program is aimed to protect the general public form harm (criminal, environmental, etc.) by preventing future crimes/victims,
reduce recidivism by increasing or improving economic activity with sustainable employment,
and contribute to state taxing system.
IMPACT AND PERFORMANCE:
Describe overall expected outcomes and performance measures for this project/program:
Self worth and Self-sufficiency - they should be able to function in society by becoming viable and productive citizens.
Communication is established with the probation officers, employers and spouses. Monthly progress reports are
submitted to the probation officers so they can see the positive impact the program is having on the returning citizens.
We will provide zip code lists to the City as proof that we aided 10 City of Miami residents.
Please attach additional pages to the back of this packet, if the space above is not sufficient.
Page 3 of 5
Return this form to: mtrevino@miamigov.com
(Last Revised May 15, 2020)
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT C — BUDGET
Insert Page 4 from Anti -Poverty Funding Request Form
City of Miami
Anti -Poverty Initiative Program - Funding Request Form
FUNDING REQUEST INFORMATION:
Amount Requested: $ 10,000
Explain how the City of Miami Anti -Poverty funding will be utilized:
Next Level Faith Center will be used as the headquarters for the program. Each citizen will receive
counseling (individual and/or group setting), mentoring and training/job preparation classes.
They will also be required to attend Sunday services, bible study and outreach activities.
Itemize API funding related to expenditures below:
Personnel Salaries & Wages: $6,240
Personnel Benefits $
Space Rental: $1,000
Utilities (Electricity, Phone, Internet): $_
Supplies: $2,000
Marketing: $760
Transportation (Participants): $
Meals (Participants): $
Professional Services (List each):
Other (please describe):
Other (please describe):
Other (please describe):
Page 4 of 5
Return this form to: mtrevino@miamigov.com
(Last Revised May 15, 2020)
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
COMPOSITE EXHIBIT "D"
API AGREEMENT
COMPOSITE EXHIBIT "D"
PAYMENT SCHEDULE
1. The CITY shall pay the RECIPIENT, an amount not to exceed Ten Thousand Dollars
$10,000.00
for the services provided pursuant to this Agreement.
2. Request for Payments should be submitted to the CITY in a form provided by the City and
included in this Exhibit as Request for Payment Form.
3. The RECIPIENT must submit the final request for payment to the CITY within 30 calendar
days following the expiration date or termination date of this Agreement in a form provided by
the CITY. If the RECIPIENT fails to comply with this requirement, the RECIPIENT shall
forfeit all rights to payment and the CITY shall not honor any request submitted thereafter.
4. Schedule of payments to RECIPIENT will be as follows: One time payment
5. Any payment due under this Agreement may be withheld pending the receipt and approval by
the CITY of all reports and information due from the RECIPIENT as a part of this Agreement
and any modifications thereto.
Date: 1/13/22
API Request for Payment Form
Invoice Number: 2022113
Send to: City of Miami
Office of Grants Administration
444 SW 2nd Ave., 5th Floor
Miami, FL 33130
Program/Project Title:
Recipient's Name:
Recipient's Address:
Men of Impact Development Center, Inc.
Olden Reese
1073 NW 121 st Way
Coral Springs, FL 33071
I hereby request payment in the amount of $ 10,000 for expenses incurred in relation to
the City of Miami Anti -Poverty Initiative Activity/Program/Services provide below.
Number of People
Served/I, cation of
Services
Service Description
Rate
Amount
10/
2275 NW 62nd Street
Miami, Florida 33147
This rehabilitation program gives citizens who
are on probation or house arrest. This program
aids with finding employment and help the
citizens improve their job interviewing skills.
They will aslo gain spiritual, emotional and
mental guidance to support their transition and
integration back to their family & neighborhood.
$10,000
TOTAL: $ 10,000
I certify that the Program/Service was provided in accordance to the approved Program/Project as
described in the API Funding Request Form and that expenses were incurred in the provision of said
Program/Service.
ka„
Authorized Representative
Signature
1/13/22
Date
Olden Reese
Type Name
President
Title:
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT E — INSURANCE REQUIREMENTS
I. Commercial General Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Each Occurrence $300,000
General Aggregate Limit $600,000
Personal and Adv. Injury $300,000
Products/Completed Operations $300,000
B. Endorsements Required
City of Miami listed as additional insured
Contingent & Contractual Liability
Premises and Operations Liability
Primary Insurance Clause Endorsement
II. Business Automobile Liability
A. Limits of Liability
Bodily Injury and Property Damage Liability
Combined Single Limit
Scheduled Autos
Including Hired, Borrowed or Non -Owned Autos
Any One Accident $ 300,000
B. Endorsements Required
City of Miami listed as an additional insured
III. Worker's Compensation
Limits of Liability
Statutory -State of Florida
Waiver of Subrogation
Employer's Liability
A. Limits of Liability
$100,000 for bodily injury caused by an accident, each accident
$100,000 for bodily injury caused by disease, each employee
$500,000 for bodily injury caused by disease, policy limit
IV. Professional Liability/Errors and Omissions Coverage (if applicable)
Combined Single Limit
Each Claim
General Aggregate Limit
Retro Date Included
$ 250,000
$ 250,000
The above policies shall provide the City of Miami with written notice of cancellation or
material change from the insurer in accordance to policy provisions.
Companies authorized to do business in the State of Florida, with the following qualifications,
shall issue all insurance policies required above:
The company must be rated no less than "A-" as to management, and no less than "Class V"
as to Financial Strength, by the latest edition of Best's Insurance Guide, published by A.M.
Best Company, Oldwick, New Jersey, or its equivalent. All policies and /or certificates of
insurance are subject to review and verification by Risk Management prior to insurance
approval.
DEVELOPMENT CENTER
President 2275 NW 62nd Street
Sr. Pastor Olden Reese Miami, Florida 33147
January 13, 2022
To: Malissa Sutherland
RE: Men of Impact Development Center
In response to the previous correspondence regarding the auto insurance requirement, I wish to
reiterate that Men of Impact Development Center, Inc does not own vehicles. In addition, no
personal vehicles will be utilized in connection with this grant.
In regard to worker's compensation, be advised that we have 2 corporate officers and 1 employee
which makes us exempt so we do not carry worker's compensation insurance.
4,64i r-
Sr. Pastor Olden Reese
Website: Menofimpact.net
(305) 982-8506
biz
2950 Buskirk Ave Suite
300 Walnut Creek, CA.
94597, USA
Nice Work
You're covered!
Dear Olden Reese
Good news. Your General Liability with Hiscox is now in place.
Named Insured Men Of Impact
Policy Number HSX2GL105602-01
Policy Hiscox GL (v2.0)
Coverage General Liability $1,000,000 / $2,000,000
Insurance Period 12:01 A.M. on Oct 22 2020 to 12:00 A.M. on Oct 22 2021
All your business details that you supplied to us are included, see the "Your Declarations" section. We recommend having a
quick check of these details, and if anything is wrong, incomplete or out-of-date let us know soon so that changes can be
made.
While you're reading, you might want to also make yourself familiar with our terms and conditions.
If you run into any problems or just need a hand with something, one of our team will be happy to help, just give us a call on
1-877-900-9998 or drop us a line at support@bizinsure.com.
Thanks for choosing Bizlnsure, we appreciate your business.
Yours Sincerely
Daniel Scott
8izlnsure LLC; CA RBA: Simple, Smart, Bizlnsure Insurance Agency LLC; NY DBA: Bizlnsure Services LLC; NH DBA: Simple, Smart, Bizinsure
Insurance Agency; PA DBA: Bizinsure Services LLC
State and DC ins. License numbers can be found at'
econn
US DECLARATION - Terms and Conditions
I, the undersigned, declare and confirm as follows
1. I am authorized to complete this application and purchase this insurance on behalf of the persons
and/or entities included in this application (including all partners, principals, directors, officers,
board members, trustees, or employees) and I understand that the information provided so far are
my representations and will become part of the application attached to the policy issued.
2. The business listed on this application is not controlled or owned by any other firm, corporation or
entity and for the entire period of time that I have owned and controlled the business, I have not
sold, purchased or acquired, discontinued, merged into or consolidated with another business.
3. I understand that the limits of liability I have selected represent the total amount available to pay
judgments, settlements, and claim expenses (e.g., attorney's fees) incurred in the defense of any
claims, and that any amounts which exceed these limits are not covered. I understand that
judgments, settlements and claims expenses incurred are subject to the deductible amount, and
that the deductible amount must be paid before any payments are made by the insuring
company. Some coverage may not be subject to a deductible and no payments are required for
the insuring company to make payments. Details regarding the deductible are outlined in the
policy wording.
4. I hereby acknowledge and understand that Defense Costs are subject to Retention Amounts and
may reduce and completely exhaust the Limits of Liability. If Defense Costs exhaust the Limits of
Liability, the Insurer shall have no further obligation for Defense Costs or for any judgment or
settlement.
5. I understand that the Professional Liability (Errors and Omissions) coverage (if applicable) is a
claims -made policy. Therefore, if coverage is provided, it shall apply only to claims made against
my business and reported during the policy period or applicable extended reporting period.
Claims made prior to the inception of the policy will not be covered.
6. I understand the General Liability coverage (if applicable) is an occurrence based policy.
Therefore, if coverage is provided, it shall apply only to occurrences that take place during the
policy period. Occurrences that took place prior to the inception of the policy are excluded.
7. I understand that knowledge of any circumstances that may lead to a claim being made against my
business will be excluded from coverage if such a claim is made.
8. I understand that I have had the opportunity to read and understand the Policy Wording and any
and all applicable Endorsement Wording.
9. I certify that all responses provided in this application are true and complete, that no material
facts have been omitted, misstated or suppressed, and that all necessary inquiries have been
made to ensure such. I understand that a copy of my application answers will be emailed to me
subsequent to payment being made. If my application responses were provided to Bizlnsure over
the phone, I agree to review this information and notify Bizlnsure immediately if any application
answers do not conform with my understanding of what was represented to Bizlnsure.
10. I accept Bizlnsure's compensation practices as outlined in the Compensation Notice which can be
viewed at the following: https://www,bizinsure.com/compensation-disclosure-statement/ .
11. I have read the information above and confirm it is correct. By checking this box continuing and
providing the premium payment I agree that I am entering into a binding agreement with the
insurance carrier(s) I am purchasing coverage from.
12. I understand that when a policy is paid in installments and a down payment is required up to 25%
of the premium and 100% of the fees are due today and that these may be fully -earned (i.e. non-
refundable if the policy is subsequently cancelled).
13. I acknowledge that any coverage I receive as a result of this application for the policy I am
purchasing today is solely for the activities performed by my business as Job Counselor
14. I accept that when a policy is paid in full, Bizlnsure will attempt to auto -renew it 30 days before
expiration using method of payment on file.
Any person who knowingly and with intent to injure, defraud or deceive any insurer files a statement
of claim or an application containing any false, incomplete, or misleading information is guilty of a
felony of the third degree.
Name: Olden Reese
Position: president
Your Declarations
What you told us on October 22 2019
It is important that you check the information you have given us and notify us of any changes or corrections. This is an important part
of your duty of disclosure.
What is your occupation?
Including yourself, how many full-time, part-time, and temporary employees does your
business have? (Do not include subcontractors.)
What is your business's estimated gross revenue during the next 12 months for this
location?
Approximately when did you start your business? (mm/yyyy)
Legal Entity Name (Business Name)
Legal Entity Type
What is the total number of credit types shown in the list below which you currently use
to finance your business?
• Business loans,.including Small Business Administration (SBA) loans, mortgages, lines
of credit, etc.
• Business credit cards
• Overdraft lines of credit of $5,000 or more
• Long-term (30 days+) vendor/supplier accounts of $5,000 or more
• Auto or equipment leases (in excess of $5,000 of total value)
Job Counselor
1
$10,000
Jan 2017
Men Of Impact
Individual/Sole Proprietor
0
Business address: 17610 North West 31stAve, MIAMI
GARDENS, FL 33055
Is your Mailing Address different from the Street Address? No
Does your business use a written contract or statement of work? Always
For the next 12 months, what is your estimated payroll expense for yourself, your full-
time, part-time, and temporary employees? (Do not include subcontractors.) $10,000
Does your business conduct any of the following activities?
• Mental health counseling
• Medical counseling (in -patient or out -patient)
• Substance abuse counseling
• Social work
• Family/marriage counseling
In the last five (5) years have there been any claims of breach of professional duty made
against you, your business, or your business' current or former partners, principals,
directors or employees?
Are you aware of any circumstances which, after investigation, may result in a claim
against your business or any of its (current or former) partners, principals, directors or
employees?
Is your business operated out of your home?
Do you or your business supply, manufacture, or distribute any tangible goods or
products?
Does your business perform any design, construction, installation, removal, or physical
repair of any property or tangible good?
Does your business conduct any of the following activities :
• Automotive repair or sales
• Food service/restaurant operations (not applicable for mobile food services)
• Healthcare/medical services
• Retail operations(not applicable for retail operation and mobile food services)
No
No
No
No
No
No
No
Add Terrorism Risk Insurance Act (TRIA)? No
In the last five (5) years has a third party ever made a claim against your business? No
Are you aware of any reason why someone may make a claim against your business? No
Has an insurance company ever cancelled your company's General Liability policy, or has No
an insurance company ever declined to renew your General Liability policy?
Add Waiver of Subrogation?
Add Primary and Noncontributory Wording?
Add Business Property and Equipment Coverage?
Add Hired or Non -Owned Auto Coverage?
Do you require a certificate holder or an additional insured to be issued an Acord form?
Please add additional insured
No
No
No
No
Yes
Name
Email j Address
I
Display
Suburb
Zip
code
The City of
Miami
i 444 SW 2nd
mtrevino@miamigov.com j Ave
MIAMI, FL
33130
Please confirm that contract to all Additional Insureds has been verified
As of today's date, does your company have Professional Liability Insurance currently in
force and paid for?
Do you currently have a General Liability policy in force?
No
Yes
Yes
Standard
Wording
True
J.
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT F — CLOSE-OUT REPORT
The Close Out Report must be completed at the end of the program.
City of Miami
Anti -Poverty Initiative Program Close -Out Report
Date: Allocation Amount:
Program/Project Title:
Recipient's Name:
Recipient's Address:
Please provide the information in reference to all the services provided with the City of Miami Anti -Poverty
Initiative:
Program Start Date and End Date
Program/Project Priority Area
Description of Project/Activity/Service
District where Project/Activity/Service were
Provided
District 1, District 2, District 2, District 3, District 5 and/or
Citywide
Location of Project/Activity/Service (ie. Site,
neighborhood, area)
Total Number of People Served
Frequency of Project/Activity/Service
I certify that the Program/Service was provided in accordance to the City of Miami Anti -Poverty Initiative Program
Guidelines
Signature
Date
Type Name
Title:
Return to:
City of Miami
Office of Grants Administration
444 SW 2nd Ave., 5' Floor
Miami, FL 33130
ANTI -POVERTY INITIATIVE
FUNDING AGREEMENT
EXHIBIT G - RECIPIENT'S CORPORATE RESOLUTION
CORPORATE RESOLUTION
Men of Impact Development Center, Inc. not for profit corporation
WHEREAS , , a Florida , desires to enter
into a Agreement with the City of Miami, a copy of which is attached hereto; and
WHEREAS, the Board of Directors at a duly held corporate meeting has considered the
matter in accordance with the Articles and By -Laws of the not -for -profit corporation;
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF DIRECTORS
that Olden Reese are/is hereby authorized and instructed to enter
into the Agreement and undertake the responsibilities and obligations as stated in such
proposed Agreement in the name and on behalf of this corporation with the City of Miami
upon terms and conditions contained in the proposed Agreement to which this resolution is
attached.
DATED this
ATTEST:
at
41t2P
PORPraal-r)e) 7ORATE SECRETARY
day ofI4 & -,2( /.
Print Name: LL *YY) K)v.,o,x)e.
e4-
PRESIDENT
Print Name:
(CORPORATE SEAL)
abidyi