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HomeMy WebLinkAboutK-16 Resolution: Accepting Byrne Grant FundingCity of ~Vl iami ~ard ~ens 1515-200 NW 167`h Street Miami Gardens, Florida 33169 Date: November 28, 2007 Fiscal Impact: No ^ Yes X (If yes, explain in Staff Summary) Funding Source: General Fund Contract/P.O. Requirement: Yes o No^ Sponsor Name/Department: R. Farmer Aqenda Cover Paqe Mayor Shirley Gibson Vice Mayor Barbara Watson Councilman Melvin L. Bratton Councilman Aaron Campbell Jr. Councilwoman Sharon Pritchett Councilman Oscar Braynon II Councilman Andr~ Williams Public hearing ^ Ordinance ^ 1st Reading ^ Advertising requirement: RFP/RFQ/Bid # Title Quasi-Judicial ^ Resolution X 2nd Reading ^ Yes ^ No X A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MIAMI GARDENS, FLORIDA, AUTHORIZING THE CITY CLERK AND CITY MANAGER TO EXECUTE AND ATTEST RESPECTIVELY, AN AGREEMENT AND ALL ATTENDANT DOCUMENTS WITH THE MIAMI DADE COUNTY DEPARTMENT OF HUMAN SERVICES TO ACCEPT BYRNE GRANT FUNDING FOR THE ENHANCEMENT OF THE RECORDS UNIT AT THE MIAMI GARDENS POLICE DEPARTMENT, IN THE AMOUNT OF $15,352.00; PROVIDING FOR A MATCH OF CITY FUNDS IN THE AMOUNT OF $5117.00; PROVIDING FOR INSTRUCTIONS TO THE CITY CLERK; PROVIDING FOR THE ADOPTION OF REPRESENTATIONS; PROVIDING AN EFFECTIVE DATE. Staff Summary In an effort to provide greater access of police services to the residents of Miami Gardens, staff submitted a proposal for the purchase of an additional OSSI Module that will allow citizens, businesses, and visitors to the City of Miami Gardens the ability to obtain police reports online through the Department's Records Management System and agency web site. The attached resolution authorizes the City Manager to enter into a contract with the Miami Dade County Department of Human Services to accept Byrne Grant funding for the enhancement of the Records Unit at the Miami Gardens Police Department. The program budget for this year's grant is $15,352 with a 25% agency match in the amount of $5,117, for a total project amount of $20,4~Q . , K-16) CONSENT AGENDA Accepting Byrne Grant Funding Recommendation: It is recommended that the Council approve the attached resolution authorizing the City Manager to receive the aforementioned funding and enter into this agreement in order to enhance the Police Records Unit's level of service to citizens, businesses, and visitors to the City of Miami Gardens. RESOLUTION No. A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF MIAMI GARDENS, FLORIDA, AUTHORIZING THE CITY CLERK AND CITY MANAGER TO EXECUTE AND ATTEST RESPECTIVELY, AN AGREEMENT AND ALL ATTENDANT DOCUMENTS WITH THE MIAMI DADE COUNTY DEPARTMENT OF HUMAN SERVICES TO ACCEPT BYRNE GRANT FUNDING FOR THE ENHANCEMENT OF THE RECORDS UNIT AT THE MIAMI GARDENS POLICE DEPARTMENT, IN THE AMOUNT OF $15,352.00; PROVIDING FOR A MATCH OF CITY FUNDS IN THE AMOUNT OF $5117.00; PROVIDING FOR INSTRUCTIONS TO THE CITY CLERK; PROVIDING FOR THE ADOPTION OF REPRESENTATIONS; PROVIDING AN EFFECTIVE DATE. WHEREAS, in an effort to provide greater access of police services to the residents of Miami Gardens, staff submitted a proposal for the purchase of an additional OSSI Module that will allow citizens, businesses, and visitors to the City of Miami Gardens the ability to obtain police reports online through the Police Department's Records Management System and agency web site, and WHEREAS, the Miami Dade County Department of Human Services has been awarded Byrne Grant funding for the enhancement of the Records Unit at the Miami Gardens Police Department in the amount of $15,352.00, and WHEREAS, the City will be required to provide with a 25% match of funds which equates to $5,117.00, for a total project amount of $20,469.00, NOW THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF MIAMI GARDENS, FLORIDA, AS FOLLOWS: Section 1. ADOPTION OF REPRESENTATIONS: The foregoing Whereas Resolution No. paragraphs are hereby ratified and confirmed as being true, and the same are hereby made a specific part of this Resolution. Section 2. AUTHORIZATION: The City Council for the City of Miami Gardens hereby authorizes the City Manager and City Clerk to execute and attest respectively, an Agreement and all attendant documents with the Miami Dade County Department of Human Services to accept Byrne Grant funding for the enhancement of the records unit at the Miami Gardens Police Department, in the amount of $15,352.00. Furthermore, the City Council authorizes a match of city funds in the amount of $5117.00. Section 3. INSTRUCTIONS TO THE CITY CLERK: The City Clerk is hereby authorized to obtain three (3) fully executed copies of the subject Agreement, with one to be maintained by the City; with one to be delivered to the Miami-Dade County Department of Human Services, and with one directed to the Office of City Attorney. Section 4. EFFECTIVE DATE: This Resolution shall take effect immediately upon its final passage. PASSED AND ADOPTED BY THE CITY COUNCIL OF THE CITY OF MIAMI GARDENS AT ITS REGULAR MEETING HELD ON DECEMBER 12th, 2007. SHIRLEY GIBSON, MAYOR ATTEST: RONETTA TAYLOR, CMC, CITY CLERK Prepared by SONJA KNIGHTON DICKENS, ESQ. City Attorney Resolution No. SPONSORED BY: DANNY O. CREW, CITY MANAGER MOVED BY: SECONDED BY: VOTE: Mayor Shirley Gibson (Yes) (No) Vice Mayor Barbara Watson (Yes) (No) Councilman Aaron Campbell Jr. (Yes) (No) Councilman Oscar Braynon, II (Yes) (No) Councilman Andre Williams (Yes) (No) Councilwoman Sharon Pritchett (Yes) (No) Councilman Melvin Watson (Yes) (No) 270406_1 MIAMI-DADE COUNTY DEPARTMENT OF HUMAN SERVICES CONTRACT This Contract, made this day nf 20Ul, by a~ui between Miami-Dade County, a political subdivision of the State nf Fiorida (hereinafter referred to as "Cnunty"} through its Department of Human Services (hereinafter referred to as "DepartmenY'), located at 2525 N.W. 62~ Street, Suite 4228 - Miami, FL 33147, and the C(TY OF MIAMI GARDENS located in Miami-Dade County, Flarida (hereinafter referred to as "Provider"), provides the terms and conditions pursuant to which the Provider shall prnvide a Criminal Justice Record Improvement Project. WHEREAS, the County has been awarded federal funds fram the Drug Control and System Improvement Formula Grant Program under Public Law 100-69d, the Federal Anti-D~uy Abuse Act of 1988, hereinafter refer~ed to as the ACT; and WHEREAS, the Provide~ warrants and represents that it pnssesses the legal authority to ente~ into this Agreement by way of resolution, motion ar similar action that has been duly adnpted or passed as an nfficial act nf the Prdvider's governing body, authorizing the execution of the Cnntract, including all understandings and assurances cnntained herein, and authorizing the person identified as the official representative of the Provide~ to carry out on behalf of the Provider all of the duties and responsibilities set forth in this Contract; and WHEREAS, this Contract shall be deemed effective upon award of grant funds by the State of Fforida Department of Law Enforcement, Office of Criminal Jus#ice Grants to Miami-Dade Caunty or when this Contract has been duly executed by both parties, whichever is later; and WHEREAS, the County is desirous of supporting an expansian of the services prnvided by the Criminal Justice Record Emprovement Project by prnviding a portio~ of the federal funds awarded to Miami-Dade County to the Criminal Justice Record Improvement Project; and WHEREAS, the County as contractor/grantee for the State of Florida is authorized to purchase said services fnr the Criminal Justice Record Improvement Project as an aliawable activity under the ACT; and W HEREAS, the County requires the above-mentioneci services from the Provider in order to fulfill its' contractual obligations under the aforementioned grant, NOW, THEREFORE, for arid in consideration ai the mutual covenants recorded herein, the parties hereto agree as follows:. . I. AMOUNT PAYABLE Subject to available funds, the maximum amount payable for services rendered under this Contract, shall not exceed $15,352 Both pa~ties agree that should available County funding be reduced, the amount payable under this Agreement may be proportionately reduced at the option of the County. Page 1 of 12 il. SCOPE OF SERVICES. The Prnvider agrees to render services in accordance with the Scope nf Services incorporated herein and attached hereto as Attachment A. III. EFFECTIVE 7ERM The effective terrr~ of this Agresment shall be from October 1, 2QU7 through September 30, 2008. !V. CASH MATCH REQUIREMENT. TFie Provider shall maintain sufficient financial resnurces to meet the expenses incurred during the period between the prnvision nf services and payment by the County, including the required 25% Cash Match, and provide all equipment and suppfies required for the provision nf services. V. REQUIR~MENTS RELATED TO USE OF ANTI-DRUG ABUSE FUNDS UNDER THE DRUG CONTROL AND SYSTEM IMPROVEMENT PROGRAM A. ReQUirements of the Anti-Drug Abuse Act. The Provider agrees to abide by all of the requirements of #he Anti-Drug Abuse Act of 1988 under the Drug Contral and SysEem lmprovement Formu{a Grant Rrogram, ir~cluding Rule Chapter 96-61 of the Florida Administrative Code Furthermore, the Florida Department of Law Enforcernent, Susiness Support Program, Office of Criminal Justice Grants, Edward Byrne Memorial State and Local Law Enforcement Assistance Formuia Grant Program Application fnr ~unding Assistance and all laws, rules, regulatinns relating thereto are incorporated herein by reference as if fully set forth. B. Su lantin . The Provider agrees that funds received under this Contract shall be utilized to supplement, nnt supplant state or local funds, and will be used to increase the amounts of such funds that would, in the absence of grant funds, be made available fnr anti- drug law enfarcement activities, in accordance with Rule Chapter 98-61.On6 (5), florida Administrative Code. VI. CnNTINUITY nF SERVIGES. Provider agrees to provide optimal cantinuity of services by assu~ing that services are pravided by the same person whenever possible and, if not, by a qualified replacement when necessary. VII. PROGRAM CUNTACT. Provider shall designate a contract coordinator who shall be responsible for: 1) monitoring the Provider's compliance with the terms of this Contract and; 2) whenever the County so requests, meeting with County staff to review such compliance. VIII. INDEMNIFICATION BY THE PRC?VtDER. The Provide~ sha{I indemnify and hold harmless the County and ifs officers, employees, agents arid instrumentalities from any and all fiability, losses or darriages, including attorneys' fees and costs of defense, which the County or its officers, employees, agents or instrumentalities may incur as a resuft of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating tn or resulting from the performance of this Cnntract by the Pravider or its emp{oyees, agents, servants, partners, principals or subcontractnrs Provicler shafl pay all claims and losses in connectian therewith and shall investigate and defend all claims, suits or actinns of any kind or nature in the name of the County, where applicabls, including appellate proceedings, and shall pay all costs, judgments, and attorney's fees which may issue thereon. Provider expressly understands and agrees that any i~surance protection required by this Contract r~r o#herwise provided by Provider shall in no way fimit the responsibility to indemnify, keep and save harmless and defend the County or its officers, employees, agents and instrumentalities as Ange 2 of 12 herein prnvided. The provisions of this section or indemnification shall survive the expiration or termination of this Contract. IX, INSURANCE. If Provider is an agency ~r a political subdivision of the Sta#e as defined by section 768 28, Flnrida Statutes, the Provider shall furnish the County, upon request, written verification of liability protectian in accnrdance with sectinn 768.28, Florida Statutes. No#hing herein shall be construed to extend any party's liability beyond that provided in sectian 768.28, Flnrida Statutes. X. LICENSURE AND CERTIFICATION. The Provider shall ensure that all other licensed professionals providing Criminal Justice Record Impravement services shall have approp~iate training and experience in the field in which he/she practices and abide by afl applicable State and Federal faws and regulations and ethical standards consis#ent with those established for his/her prnfession. Ignorance on the part of the Prnvider shall in no way ~elieve it from any of its responsibilities in this regard, XI. CONFLICT OF INTEREST. 7he Provider agrees to abide by and be gaverned by Miami- Dade County Ordinance No. 72-82 (Cnnflict nf Interest Ordinance cndified at Section 2-11.1 et al. af the Code of Miami-Dade County), as arriended, which is incorporated herein by reference as if fully set forth herein, in connection with its Cantract obligations hereunder. XI1. CIVIL RIGHTS. The Prnvider agrees to abide by Chapter 11A of the Code of Miami- Dade County ("County Code"), as amended, which prohibits discrimination in employment, housing and public accommodations; Title VII of the Civil Rights Act of 1966, as amended, which prohibits discrimina#iUn in emplayment and public accommodation; the Age Discriminatior~ Act of 1975, 42 U.S.C., § 2000 d as amended, which prohibits discrimination in emplayment because of age; Section 504 of the Rehabilitation Ac# of 1973, 29 U.S C. § 794, as amended, which prohibits discrimination on the basis of disability; and the Americans wifh Disabilities Act, 42 U.S C. § 12103 et seq., which prohibits discrimination in empioyment and accommndation because of disability. !t is expressly understood that upon receipt of evidence o# discriminatian under any nf these laws, the County shall have the right to terminate this Contract. It is further understood that the Provider must submit an affidavit attesting that it is not in violation of the Americans with Disability Act, the Rehabilitation Act, the Federal Transit Act, 49 U.S_C. § 1612, and the Fair Housing Act, 42 U.S.C. § 3601 et seq. If the Provider or any owner, subsidiary, or other firm affiliated with or related to #he Prnvider, is fnund by the respnnsible enforcement agency, the Courts or the County to be in violation of these Acts, the County will conduct no further business witt~ the Provider. Any contract entered into based upon a false affidavit shall be voidable by the County_ If the Prnvider violates any of the Acts during the term of any Contract the Provider has with the County, such contract shall be voidable by the County, even if the Provider was not in violation at the time it subrnitted its affidavit. The Provider agrees that it is in cnmpliance with the Domestic Violence Leave Ordinance, codified as § 11A-60 et seq, of the Miami-Dade County Cade, which requires an emplayer, who in the regular course of business has fifty (50) or more employees working in Miami-Dade County for each working day during each of twenty {20) or more calendar work weeks tn provide domestic violence leave to its emplnyees Failure to comply with this Incal law may be grounds for vaiding or terminating this Contract or for commencement of debarment proceedings against Provider. Page3of12 Xltl. NOTICES. Notice under this Contract shall be sufficient if made in writing and delivered personally or sent by mail or by facsimile to the parti~s at the foilnwing addresses or to such other address as either party may specify: If to the COUNTY~ If to the PROVIDER' Miami-Dade County Department of Human Services 2525 NW 62nd Street, Suite 4225 Miami, Florida 33147 Attention: Ms Michaela Doherty Miami Gardens Police Department 1515 NW 167 Street, Bldg 7 Miami Gardens, FL 33169 Attention: Mr Paul Miller XIV. AUTONUMY. Both parties agree that this Contract recngnizes the autonnmy of and stipulates or implies no affiliation between the contracting parties. It is expressly understood and intended that the Provider is oniy a recipient of funding support and is not an agent or instrumentality of the Cnunty. Furthermore, the Provider's agents and ernpfoyees are nnt agents or employees of the County. XV. BREACH UF AGREEMENT: COUNTY REMEDIES. A. Breach. A breach by the Provider shall have occurred under this Cor~tract ifi~ (1 j The Provider fails fo prnvide services outlined in the Scape of Services (Attachment A) within the effective term nf this Cnntract; (2) the Provider ineffectively or improperly uses the funds allocated under this Contract; (3) the Provider fails tn submit, or submits incorrect nr incomplete pronf of expenditures to support reimbursement requests or faiis to submit or submits incomplete or incorrect detailsd repUrts of expenditures or finaf expenditure repnrts; (4) the Prnvid~r does not submit or submits incomplete or incorrect required reports; (5) the Prnvider refuses to allow the County access to records or refuses to allaw the Caunty to monitnr, evaluate and review the Prnvider's program; (6) the Provider discriminates under any of the laws outlined in Section XII of this Cnntract; (7) the Pravider fails to prnvide Domestic Violence Leave to its employees pursuant to local law; {8} the Provider falsifies nr violates the provisions of the Drug Free Workplace Affidavit (Attachment D); (9) the Provider attemp#s to meet its obligatians under this Contract through fraud, misrepresentation or material misstatement; {10) the Provider fails to correct deficiencies found during a monitoring, evaluation or review within the specified tir~~e; (11) the Provider fails to meet any of the terms and conditions of the Miami- Dade County Affidavits (Attachment D); (12) the Provider fails to meet any of the terms and conditions nf any obligation under any contract or otherwise or any repayment schedule to any of i#s agencies or instrumentalities; ar (13) the Provider fails to fulfill in a timely and proper manner any and all of its obligations, covenants, agreements and stipulations in this Contract Waiver of breach of any prnvisions of this Contract shali not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this Contract. B. County Remedies. If the Provider breaches this Contract, the County may pursue any or afl of the follawing remedies~ Page =1 of l2 1. The County may terminate this Cnnt~act by giving written notice tn the Provider of such terminatinn and specifying the effective date thereaf at least five (5) days be#ore tha effective date of termination~ In the event nf termination, the County may: (a) request the returri nf all finished nr unfinished documents, data studies, surveys, drawings, maps, models, photographs, reparts prepareci and ~secured by the Provider with County funds under this Cantract; (b) seek reimbursement of County funds allncated to the Provider under this Contract; (c) terminate or car~cel any other contracts entered into between the Cnunty and the Provider. The Prnvider shall be responsible for all direct and indirect costs associated with such terminatinn, iricluding attorney's fees; 2. The County may suspend payment in whole or in part under this Contract by prnviding written notice to the Provider af such suspension and specifying the sffective date thereof, af least five (5} days befnre the effective date of suspension. If payments are suspended, the County shall specify in writing the actions that must be taken by the Provider as conditinn precedent ta resumption of payments and shall specify a reasonable date for compliance The Cnunty may aiso suspend any payments in whole or in part under any other contracis entered into between the Cnunty and the Provider. The Provider shall be respansible for all direct and indirect costs associa#ed with such susper~sion, including attorney's fees; 3. The Caunty may sesk enfarcement of this Con#ract including but not limited to ~fing action with a cnurt of appropriate jurisdictinn The Provider shall be responsible for all direcf and indirect cnsts associated with such enfor~cement, including attorney's fees; 4. The County may debar the Provider from future Cnunty contracting; 5, If, fnr any reason, the Prnvider should attempt to meet its obligations under this Contract through f~aud, rnisrepresentation or materiaf misstatement, the County shall, whenever practicable terrriir~ate this Contract by giving written notice tn the Provider of such terrnination and specifying the effecfive date there~f at least five (5) days before the effective date of such termination. The County may terminate or cancef any other contracts which such individual or en#ity has with the County. Such individual or entity shall be responsible for all direct or indirect costs associated with such termina#ion or cancellatian, including attorney's fees Any individual or entity whn attempts ta maet its contractual obligations with the Cnunty through fraud, rnisrepresentatian or material misstatement may be disbarred from County contracting for up tn five (5) years; 6. Any other remedy available at law or equity. C. The County Manager is authorized to terrninate this Contract on behalf of the County, D. Damaqes Sustained. Notwithstanding the abave, the Provider shall ~nt be relieved of liability to the County for damages sustained by the County by virtue of any breach of the Contract, and the County may withhold any payrnents to the Provider until such time as the exact amount pf damages due the County is determined. The Provider shall be responsible for all direct and indirect casts associated with such action, including attorney's fees. XVI. TERMINATION BY EITHER PARTY. Bath parties agree that this Contract may be terminated by eithe~ party he~etn by written notice to the other party of such int~nt to terminate Page S of 12 at least sixty (60) days prior to the effective date of such termination. The County Manager is authorized to terminate this Contract on behalf of the County, XVII. PROJEGT BUDGET AND PAYMENT PROCEDURES. The Prnvider agrees that all expenditures or casts shall be made in accordance with the Budget which is attached herein and incorporated hereto as Attachment B. A. Budqet Variance. Funds may be shifted between approved line items, not to exceed fifteen percent (15%) of the total budget, without a written amendmerit. Variances greater than fifteen pe~cent (15%) in any approved line i#em shall require a written amendment approved by the Department. B. Recapture Funds. At the conclusion of the third quarter and upnn submission of the Quarterly Performance Report and Invoice, the County will review the Prnvider's Year-To- Date expenditures, 1. Municipalities repo~ting remaining balances which exceed expenditure levels for nnrmal program operations must submit a pfan with the Third Quarter Report which documents thnse steps the municipality will take in the Fourth Quarter to fully expend the contract by the end of the pragram year. 2. This expenditure plan must be approved by the Cnunty. 3. Where the municipality does not anticipate full expenditures by the enci of the program year, the County will recapture the anticipated unexpended amount for use in another program, without a formal amendment process. C. Pa ment Prncec~ures. The County agrees to pay the Provider for services rendered under this Contract based on the line item budget incorporated herein and attached hereto as Attachment B. The pa~ties agree that this is a cost-basis Contract and fhe Provider shall be paid through reimbursement payment for allowable expenses on the budget approved under this Contract (see Attachment E3} The Provider agrees to invoice the County fo~ each Criminal Justice Record Improvement using the Quarterly Project Performance Report 8~ Invoice as it appears in Attachment C, and to do so on a quarterly basis, as stated in Section XIX. 6.1. The Quarterly Project Performance Repnrt & Invoice shall be prepared in a manner in accordance with the form provided in Attachment C The final Quarterly PrajeCt Perforrnance Report & Invoice shall be submitted by October 15, 2008. D. The Provider agrees to mail al1 invoices to the address listed above, Section XIII. E The County agrees to review invoices and ta inform the Provider nf any questions. Payments shall be mailed to the Provider by the County's Finance Department. F, Nn pavment nf subcontractnrs. In no event shall county funds be advanced direc#1y to any subcontractor hereunder. XVI11. INVENTORY - CAPITAL EQUtPMENT AND REAL PROPERTY. A. Acauisition of Propertv. The Provide~ is required to be prudent in the acquisition and management of pro~erty with federal funds Expenditure of funds for the acquisition of Page6of12 at least sixry (60) days prior to the effective date of such termination. The County Manager is authorized to terminate this Contract on behalf of the County. XVIt. PROJECT BUDGET AND PAYMENT PROC£DURES. The Provider agrees that all expenditures nr casts shall be made in accordance with the Budget which is attached herein and incnrpnrated hereto as Attachment B. A. Budqet Variance. Funds may be shifted between approved line items, not to exceed fifteen percent {15%) of the total budget, without a written amendment. Variances grea#er than fifteen percent (15%) in any apprnvsd line item shall require a written amendment approved by the Department B. Recapture Funds. At the cnnclusi~n of the third quarter and upan submission of the Quarterly Performance Report and Invnice, the County will review the Provider's Year-To- Uate expenditures. 9 Municipalities repnrting remaining balances which exceed expenditure levels for normal program aperations must submit a plan with the Third Quarter Report which documents thnse steps the municipality will take in the Fourth Quarter to fully expertd the contract by the end of the prngram year. 2. This expenditure plan must be appraved by the County. 3. Where the municipality dnes not anticipate full expendi#ures by the end of the program year, the County will recapture the anticipated unexpended amount for use in another program, withouf a formai amendment process. C, Pavment Procedures. The Cnunty agrees to pay the Prnvider for services rendered under this Contract based an the line item budget incorporated herein and attached heretn as Attachment B. The pa~ties agree that this is a cos#-basis Contract and the Provider shall be paid through reimbursement payment for allowable expenses on the budget apprnved under this Contract (see Attachment 8). The Provider agrees to invnice the County for each Criminal Justice Record Improvement using the Quarterly Project Performance Report & Invoice as it appears in Attachrnent C, and to do so an a quarterly basis, as stated in Section XIX. 8.1. 7he Quarterly Pr~oject Performance Report & invoice shall be prepared in a manner in accordance with the form provided in Attachment C. The final Quarterly Prnject Performance Report & Invoice shalE be submitted by Octnber 15, 2008. D. The Provider agrees to mail all invoices to the address listed above, Sectinn Xlli E The County agrees to review irwnices and to inform the Provider of any questions, Payments shall be mailed to the Provider by the County's Finance Department. F. No gavment of subcontractnrs In no event shall county funds be advanced directly to any subcontractor hereunder. XVtil. lIVVENTURY - CAPITAl. EQUfPMENT AND REAL PROPERTY. A. Acquisition of Prflqe~tv. The Pravider is required to be prudent in the acquisition and management nf proper#y with federal funds Expenditure of funds for the acquisifion of Page 6 of 12 new praperty, when suitable property required for the successful execution of projects is already available within tt~e Provider nrganizatinn, wiil be considered an unnecessary expenditure. B. Screenin . Careful screening should take place befnre acquiring property in order to ensure that it is needed with particular consideration given tn whether equipment already in the pnssessinn ~f the Provider nrganizatinn can meet identified needs. While there is no prescribed standard for such review, the Provider procedures may establish levels of review dependent on factnrs such as the cost nf the propnsed equipment and the size of the Provider organization. The establishment of a screening cnmmittee may facilitate the process; however, the Pravider may utilize other management techniquss which it finds effective as a basis for dete~mining that the property is needed and that it is not already within the Provider's organization The County must ensure that the screening referenced above takes place and that the Provider has an effective system fnr property management. The Provider is hereby informed that if the Caunty is made aware that the Provider doss nnt employ an adequate property management system, project costs associated with the acquisition of the prnperty may be disallnwed. C. Loss, Damage or Theft ~f Equpment. The Provider is responsible for replacing or repairing the prnperty which is willfully or negligently lost, stoien, damaged or destroyed. Any loss, damage, or theft af the prope~ty must be investigated and fully documented and made part of the official project recards D. Eauipment, Acauired with Crime Control Act Block/Formula Funds. Equipment acquired shall be used and managed to ensure that the equipment is used for crirninal justice purposes. E. Managerr~ent. The Provider's procedures for managing equipment (including replacement), whether acquired in whofe or in part with project funds, will, at a minimum, meet the following requirements: 1) Property records must be maintained which include descriptian of prnperty, serial number or other identification number, source of the property, identification of who holds the Eitle, acquisition date, costs of the property, percentage of County participation in the cnst of the property (Federal funds), Incation of property, use and condition of the property, disposition data including the date of disposal and sale price; 2) a physical inventary of the property must be taken and the results recanciled with the property recnrds at least nnce every 2 years; 3) a con#rol system must exist to ensure adequate safeguards to prevent loss, damage or theft nf the property Any lnss, damage, or theft shal! be investigated by the Provider as appropriate; 4) adequate maintenance proeedures must exist to keep the property in gand cnnditinn; and 5) if the Pravider is autharized or required to sell the property, proper sales procedures must be established to ensure the highest possible return. F Retention of Propertv Records. Records for equipment, nonexpendable personal property, and real property shall be retained for a perind nf 3 years frnm the date of the disposition or replacement or transfer at the discretion nf the County. If any litigation, claim, or audit is started before the expiration of the 3-year period, the records shall be retained until a11 litigation, claims, or audit findings involving the records have been resolved. XIX. RECURDS, REPURTS. MUNtTORING AUDITSLAND EVALUATION STUDIES. The Provider shall keep ~ecords of program services in sufficient detail to provide any reports that may be requested by the County. Page 7 oj 12 A. Records. All prngram records will be retained by the Provider for nat less than three (3) years beyond the term of this Agreement. In accordance wi#h cantract requirements from the State of Finrida, records for the Criminal Justice Record tmprovement Project services must reflect: The names of staff providing services as described in Attachment A 2 The dates and number of hours the staff provided services. The dates of S~NICf:S and activities and the names of program participants in attendance to such as described in Attachment A. 4 The recards of all other prog~am services provided under this Agreement B. Reportinq Reauirements. 1. Quarterlv Proiect Performance Report and lnvoice. The Provider shall submit the Qua~terly P~oject Performance Report and Invoice to the Department of Human Services by January 15, April 15, July 15, and October 15, 2008 covering the Agr~eement activity for the previous quarter The Quarterly Project Performance Report and Invoice shall be submitted in the format and using the form attached hereta as Attachment C. 2. Other Renuired Reports. The Provider shall subrniE other reports as may be required by the Department of Human Services during the program year C. Chanqes to Repottinq Requirements. `fhe Provider understands that the Cnunty rnay at any time require changes in data collected, recnrds or reporting, as may be necessary and agrees to comply with any such modifications. D Monitorinq and Audit. The Provider shall make available far review, inspection, monitoririg or audit by the County without nntice during nnrmal business hnurs all financia! records and other prngram records and documents which relate to or have been p~oduced or crea#ed as a result of this Agreement 7he Provider shalf provide assistance as may be necessary to facilitate a financial/program audit when deemed necessary by the County to ensure cnmpliance with applicable accnunting and financial standards The Cnunty reserves the right to require the Provider to submit to an audit of the County's choosing. Furthermore, the Prnvider understands, it may be subject to an audit, random or otherwise, by the Office of the Dade County Inspector General or independent private sector inspector general retained by the Office of the Inspector General. E, Office of Miami-Dade Countv Inspector GeneraL Miami-Dade Cnunty has established the Office of the Inspector Gensral, which is empowered to perfarm random audits on all Cnunty cantracts throughout the duratinn of each contract. Grant recipients are exempt from paying the cast nf the audit, which is normally 1/4 nf 1% of the total contract amount. The Miami-Dade Coun#y Inspector General is authorized end empowered to review past, present and proposed County and Public heal#h Trust Programs, contracts, transactions, accounts, records, and programs In addition, the Inspector General has the power to subpoena witness, administer oaths, require the production of records and monito~ existing projects and prograrns. Monitoring of an existing praject or program may include a repnrt Ange 8 of 12 concetning whether the project is an time, witf~in budget and in compliance with plans, specifications and appiicable law. The Inspector Generai is empowered tn analyze the necessity af and reasonableness of proposed change orders to the Contract The ins~ector General is empnwered to retain the services of independent private sector inspectors general to audit, investigate, monitor, nversee, inspect and review nperations, activities, performance and prncurement process including but not limited to p~oject design, bid specifications, pr~pasal submittals, activities of the Provider, its officers, agents and employees, lobbyists, County staff and elected officials tn ensure compliance with cnntract specifications and #n detect fraud and co~ruptian Upnn ten (10) days prior written notice to the Provider from the Inspector General or IPSIG retained by the Inspector General, the Provider shaN make aN requested records and documents available to the Inspector Gensral or IPS(G for inspection and cnpying, The lnspector General and IPSIG shall have the right to inspect and copy alf documents and recnrds in tttie Prdvider's possession, custody nr control which, in the Inspector General or IPSIG's sole judgmen#, pertain to performance of the cnn#ract, including, but not limited to original estimate files, change order estimate fikes, worksheets, pro~nsals and Contracts from and with successful and unsuccessful subcontractors and suppliers, all project-related cnrrespondence, memoranda, instructions, financial documents, construction documents, propasal and contract dncuments, back-charg~ documents, all documer-ts and records which involve cash, trade or vofume discounts, insurance proceeds, rebates, nr dividends received, payroll and personnef records, and supporting documentation for the aforesaid documenfs and records. The provisions in this section shall apply to the Provider, its n~cers, agents, employees, subcontractors and supplisrs. The Provider shall incorporate the provisions in this section in all subcontracts and all other Contracts executed by the Prnvider in connection with the performance of the contract. Nothing in this cnntract shall impair any independent right of #he County to conduct audit ar investigative activities. The pravisions of this section are neither intended nor shall they be cnnstrued to impose any liability on the County by the Provider nr third pa~ties. F Independent Private Sector Inspectar General Reviews. Pursuant to Miami- Dade County Administrative Order 3-20, the Provider is aware that the County has the right to retain the senrices of an Independent Private Sector Inspector General ("IPSIG"), whenever the County deems it appropriate to dn so Upon written nntice from the County, the Provider shall make available tn the IPSIG retained by the Coun#y, al1 requested records and dacumentation pertaining to this agreement for inspection and copying. The County shall be responsibie fnr the payrnent of these IPSIG services, and under no circumstances shall the Provide~'s budget and any changes thereto approved by the County, be inclusive of any changes rela#ing to these IPSIG services.. The terms of this provision herein, apply tn the Provider, its officers, agents, emplnyees, subconsultants and assignees. Nothing contained in this provision shall impair any independent right nf the County to conduct an audit or investigate the operations, activities and performance of the Provider in connection with this Contract. The terms of this Sectiora shall not irr~pose any liability on the County by the Provider or any third party. Page 9 of 12 G. Evaluation Studies. The Prnvider• agrees tn participate in evaluation studies sponsnred by the administrative agent for these funds frorn the Finrida Department of Law Enforcement, Business Support Program, Office of Criminal Justice Grants. This participafion shall at a minimum include access tn the Provider's premises and records. XX. PRUHIBITED USE OF FUNDS. A. Adverse Actions or Proceedinq The Prdvider shall not utilize County funds to retain legal counsel for any action nr proceeding against the County or any of its agents, instrumentalities, employees or officials. The Prnvider shall nnt utilize County funds #o provide legal representation, advice or counsel tn any client in any action or proceeding against the County or any of its agen#s, instrumanta(i#ies, employees ar officials. B Reliqious Purqoses. Caunty funds shall not be used for religious purposes C. Comrnin~ling Funds. The Provider shali not cornmingle funds provided under this Contract with funds received frorr~ any other funding sources. XXI. MISCELLANEUUS. A. Contract. This Contract is the compiete and exclusive statement of all the arrangements between the Cnunty and the Provider regarding prnvision of the services described in Attachments A and B. Nothing herein shall alter, affect, modify, change or extend any other agreement between the Provider and the County unless specificaily stated herein. B. Amendments and Modifications. Except as othenivise enumerated herein, no amendment to this Contract shall be binding nn either pa~ty unless reduced to writing, signed by bnth parties, and apprnved by the County Manager. Provided, however, that the County may effect amendments to this Cantract without the written consent nf the Pr~vider, to conform this Cnntract to changes in the laws, directives, guidelines, and abjectives of County, State and Federal Gove~nments_ Any alterations, variations, amendments, or other modifications af this Contract, including but not limited to amount payable and effective term, shall only be valid when they have been reduced to writing, duly approved and signed by both pa~ties and attached to the nriginal of this Contract. The County and Provider mutually agree that arnendmen#s of the Scnpe of Service, line item budget of more than fifteen percent (15%) of the total budget set forth herein and other such revisions my be negotiated as written amendment to this Contract between the parties. The County Manager is authnrized to make amendments tn this Contract as described herein on behalf of the Cnunty. C Ownership of Data and Other Material. All reports, information documents, tapes and recordings, maps and other data and procedures developed, prepared, assembled or completed by the Provider in connection with the duties and responsibilities undertaken by the Provider in accordance with the terms of this Contract shall become the prope~ty of the County without restriction, reservation or limitation of their use and shall be made available ta the County by the Provider at any time upon request by the County. Upnn comple#ion of all work contemplated under this Contract, copies of al1 of the above data shail be delivered to the County upon request, Page 10 of 12 D. Cantract Guidelines. This Cnntract is made in the State of Florida and shall be governed accnrding to the laws nf the State of Flarida. Proper venue for this Contract shall be Miami-Dade County, ~'lorida. E. Publicitv. It is understood and agreed between the parties hereto that this Provider is funded by Miami-Dade County. Further, by acceptance of these funds, the Provider agrees that events and printed dacuments funded by this Contract shall recognize the funding source as fnll~ws: This prngram was supported by a grant awarded to the Miami-Dade County Department nf Humar~ Services, the Florida Department of Law Enforcement (FDLE) and the U. S. Departrnent of Justice, Bureau of Justice Assistance (BJA). F. Subcantracts. The Provider agrees not to enter into subcontracts, retain consultants, or assign, transfer, convey, sublet, or otherwise dispose nf this Contract, or any or all of its rights, title or interest herein, nr its power ta execute such Contract without the prior written approval of the County and that all subcontractors or assignees shall be governed by the terms and conditions of this Contract If this Contract involves the expenditure of $100,000 or more by the County and the Provider intends to use subcontracto~s to provide the services listed in the Scope nf Services (Attachment A) nr suppliers to supply the materiafs, the Prdvider shall provide the names nf ttae subcontractors and suppliers on the forrri attached as Attachment E. The P~ovider ag~ees that it will nnt change nr substitute subcontractars or suppliers from #hose listed •in Attact~ment E withaut prior written approval of the Caunty. G. Headings, Use of Sinaular and Gender. Paragraph headings are for convenience on#y and are not intended tn expand or restrict the scope or substance of fhe provisions of this Contract. Wherever used herein, the singular shall include the plural and plural shall include the singular and pronouns shall be read as masculine, feminine or neuter as the context requires. H. Total of Contract/Severabilifv of Provisions. This twelve (12) page Contract with its recitals on the first page of the Cnntract and with its atkachments as referenced below contain all the terrns and cnnditions agresd upon by the parties: Attachment A: Scope of Services Attachment B: Budget Attachment C: Quarferly Project Performance Report & lnvoice Attachment U Miarni-Dade County Affidavits Attachment D1: Code nf Business Ethics AEtachment D2: Miami-Dade County Debarment Disclosure Affidavit Attachment D3: State Public Entities Crime Affidavit Attachment E. Prnvider's Disclnsure nf Subcontractors and Suppliers No other Contract, oral or otherwise, regarding the subject matter of this Contract shal! be deemed to exist or bind any of the parties hereto. If any provision of this Contract is held invalid ar void, the remainder of this Contract shall not be affected thereby if such remainder wnuld then cantinue to conform to the terms and requirement of applicable law. Page 11 of 12 IN WITNESS WHEREOF, the parties hereto have caused this Cnntract to be executed by their respective and duly authorized officers, the day and year first above written. Signature Name (typed} A7TEST: By: ATTEST: HARVEY RUVIN, CLERK By; Tit1e (Corporate Seal) MIAMI-UADE COUNTY, FL,4RIDA By: ay. DEPUTY CLERK GEORGE M BURGESS COUNTY MANAGER Page 12 of 12 SUMMARY OF ATTACHMENTS ATTACHMENT A Scope of Services/ Program Narrative ATTACHMENT B Program Budget ATTACHMENT C Quarterly Project Performance Repnrt & Inv~ice ATTACHMENT D Miami-Dade County Affidavits ATTACHMENT D1 Code of Business Ett~ics ATTACHMENT D2 Miami-Dade County Debarment Disclosure Affidavit ATTACHMENT D3 State Public Entities Crime Affidavit ATTACHMENT E Provider's Disclosure of Subcantractors and Suppliers ATTACHMENT A PROGRAM NARRATIVE Jurisdictinn Name~ Miami Gardens Address~ 1515 NW 167 Street, Bldg 7 Miami Gardens, FL 33169 Program Area~ Records Impravement Program Name: Records Improvement Contact Person: Raul Miller Contact Numbers: (305) 622-8000ex#. 2330 (O} (306)622-8045 (F) Program Dates: 10/0~/07 through 09/30/08 Target Populatian: City Residents Problem Identi~cation The Miami Gardens Police Department (MGPD) is a newly formed law enfarcement agency which will assume law enfnrcernent responsibilities on ~ecembe~ 1, 2007. In an effnrt tn address traditional prnblems associated with paper records management, MGPD has purchased a computer assisted records management system (Sungard OSSI). Traditional records management requires voluminous storage facilities and severa{ individuals to process records. Ir~ addition, citizens can usually only make requests through traditional non-technnlogical farmats Traditional formats require face to face or telephnne contact during business hours (9.00 a.m. to 5 00 p.m.) and governmental agencies are canfined tn the same restrictions as citizens The only mechanism that is availabfe to the citizen is to travel to the police facility to gather statistical information or obtain copies of police reparts. The additinnal complication is that nf processing time. Normal report processing time ranges from several days to several weeks. The use of Sungard OSSI will aflvw for the processing of reports quickly and make them readily avaikable. The implementation of this records management system will increase customer serviLe and enhance the depa~tment's efficiency. Prnqram Descripti~n In our continuing effort to promote and foster community relafions, we have recngnized the need #o make the police department's services more accessible to the community. The proposed OSSI Police-to-Citizen (P2C) Data Sharing system is an Internet-based snlution that prnvides timely information to users. The P2C camponent enables agencies to host a web-based portal for citizens #o retrieve, enter, and print reports The applic;ation is a br~wser-based snfutian that provides a cnnvenient means for citizens to perfnrm simple searches, download reports, and complete ap~Eications online Citizens can search accident r~eports, view the daily bulletin, view missing persons, view the agency's event calendar, and enter basic incident reporks The new computer based system will er~able rapid search, reduce s#orage capacity and permit redeplnyment of police resources The funding allntted in this grant will allow for the purchase of the software to irnplement this moduie, purchase of a computer to update the system and process citizen requests. Additinnally JAG funding wil! provide overtime for personnel within the records divisinn to update the website, process requests and service this component ot'the Records Management System. Ju~isdiction Name: Miami Gardens Address: 1515 NW 167 Street, Bidg 7 Miami Gardens, FL 33169 Prngram Area: Recnrds Irnprnvement Program Name: Records Improvement Contact Person: Paul Miller Contact Nurnbers: (305) 622-SOOOext 2330 (O) (305) 622-8045 (F} Program Dates: 10/01/Q7 through 09/30/08 Target Papulatidn: City Residents Prn osed Activities Planned Measures Mnnitorin Plan 15C20 To purchase Purchase OSSI P2C The Miarni Gardens Pnlice equiprnent fnr criminal justice computer systern, Depa~tment will cnntinually records improvement activifies accessc~ries and wireless update our records division in this project. services for the police and provide infnrmatinn departrnent. which is beneficial to the ~esidents. Purchase equipment and software to enable an information exchange between pnlice personnel and residents in order tn enable citizens to make online records request. Paul Miller, MGPD Michaela Dohert , DHS ATTACHMENT B PROGRAM BUUGET Jurisdiction Name: MIAMI GARDENS Program Area: Records Improvement Program Name: Records Improvement Salaries and Benefits, Totaf 1 Cierk X 3.5hrs/wk X 52 weeks X$28/hr Contractual Services, Total nperating Capital Uutlay, Total Police to Citizens Computer software Annuai service contract Computer workstalion Expenses,Total Total Budget Dade County will reimburse an amount not to exceed: The 25% CASH MATCN for this grant is: The source of the CASH MATCH is: Police Depaftment General Fund, Miami Gardens OCO level begins at $75U. Contact Person: Paui Miller 622-8Q00 x 2330 PH -- 622-8045 FX Program Dates: 10/01/07 - 09/3U/08 $5,096 $5,096 $0 $15,3T3 $12,500 $1,883 $990 $0 $20,469 $9 5,352 $5,117 10J9/2007, Mg$08 ATTACHMENT C Edward Byrne Memorial State and Loca! Law Enforcement Asslstance Formula Grant Program Drug Contro( and System Improvement Formula Grant Prograrn ~uarterly Project Performance Report RECORD IMPROVEMENT PROJECT PURPOSE AREA 158 (City) (Project Name) (Name of Person Complsting Forrn) (Titie) {Phone) STATE ID NUMBER: 2008-JAGC-DADE -2 -Q9-144 Re ort IVumber Quarte~l Period Re ort Due Dates 1 October 1- December 31 Janua 15 2 Janua 1- March 31 A ril 15 3 A rii 1- June 30 Jui 95 4 Jul 1- Se tember 30 October 15 Re ort Number Quarterl Period Re ort Rue Dates Note: Thase questlons that are directly related to your program have been high{ighted for your convenience. All quest€ons must be answered and explained in the NARRATIVE portion of this report. Any report not received by January 16; April 16; July 16; andlor October 16, wlll result in the issuance of a"Noncompliance Notice" and a delay or denial of Relmbursement Requests. m u~ r E ~ ~ ~ ~ n. ~' ~~ ~~aUi o ., U ~ O N .o ~ n. a O ~ ~ C ~ d ~ 'n O d ~ ~ 00 tV .U N E U t}iU~ F N N N N I-- N N ~ ~ .~+ T C N E > O ~ a E ~ n ~ ~ a~ U ,N .~ ~ c c U O ~ ~ O ~' Q cD N ~L ~ ~ ~ Q ~ ~ ~ ~ ~ .L] N G ~ ~, N C 0 C .~ N ~ ~ "- 0 ~ ~ °~`c m ~ a~ ~ 0 p `""' C N ~ O ~. :~ > ~p U ~ f0 C ~ U ~C p ,c0 aa 0 0 c U o ,~ ~, o ~ ~ vU, O a~ = ~ ~ ~~ m- .~ •3 ~ ~ '~ O co ~- ~ N 'C7 N ~ .C ~ 'r __ o ~ ~ ~~ ~ o ~ a v ~n o ~ vi L ~ ~ a~= f°~w ~ ? ~ ~ c a ~ o ~ Q„' .~ ~ ~ = C ~ Z U '~' ~ ~ m C ~~ ~ ~ O ~ c,~ O O ~N~-° ~ ~a~c a ~~a Edward Byrne Memoria! State and Loca/ Law Enforcement Asslstance Formula Grant Program SUMMARY STATEMENT OF QUARTERLY PROJECT COSTS (To Be Copisd on Jurisdiction Letterhead) Cit ; Date of Claim: Pro'ect Name: C:laim Nurr~ber: Tele hone: Claim Period: Name of Person Completing Form: { 3 ' ~ 7 ~ 1 { ~ 1. i' 9` {~j t +,.' ~ fal ~~ .p~ ' LA ;t yy "~ : „4 r~t.~ i'•~'!'i ,.{. i~ N"14 . eva%y~.'~*'e' ,...~+:y.~ 3`rt `E' ~t.~, i ."t .i~I'S . G .,Y k y ~i ~, ~ ]-a,. L'S'. ~t: ~ ; ~4 + :t''.'~Y. Y~~g,~~.t [,~iyl d' `1K ~~1'.~" jt ZS ~ ~~~~'svti'f~\~~"~'Tyr ~.~ ~J~ y ~.~~ ~L °R2 ' '0.1 " f~ ` " ° ~-~4 t ~ `~' ~ t v t $ ~" ~ f~~z ` ~~ n ~~.. " . y~ ...t,y z ~n. 2~ ~ .7-a.Bt ~' x:.,,~~, xx; S k : x ~ . a ~i ,..+._.. ~'.-d x r ~ c , .~~~."- ~:: ~:Y ~.v.~,u.a'm2:_..:vA~SiL~~" s~:`.i~4v'"i.... -..6 "'4G'id:!~"ay~+~ ~i7~.~xao:iE.^53:a7m'.~-i:.W~a.7.~ Si ~+'~`- .~~{~", ~ -. 1 Totai Federai Budget $ 2 Amount This Invoice $ (75°; of your curre~t claim) 3. Amount of Previous Invoices $ 4 Remaining Federal 8alance $ (Subtracl lines 2& 3 from line 1) Sub Object Budget Line Item Exceeds Federat Locai Category Code Calegories Disallowed Budget Funds Match Totals Salaries & Benefits Contractual Services Operaling/ Capital Equipment Expenses Total Ciaim We request payrnent in accordance with our contract agreemenl in lhe amount of 75% of the Totai Costs for this Claim $ (75%), the balance of costs, $ (25%), to be recorded as our in-kind contribution to comply with the locai match requirements Attached, pfease find the records which substantiate ihe above expenditures I cenify thai all of the costs have been paid and none of the items have been previously reimbursed Ail of the expenditures comply with the authorized budget and fall within the contractual scope of senrices and all pf the goods and services have been received, for which reimbursement is requested Respectiully submitted, Chief of Police/Other City Official Payment Approved, Miami pade County Miami Dade County Record Improvement Project Page 2 of 3 SUMMARY STAi"EMElVT OF QUARTERLY PROJEC7 CO5TS- Payroll Expenses City: Date of Claim: Project Name: Claim Number: Name Date of Type of Total OfficerlStaff Activitv Activitv' Hours '(Presentation. Parent Meeting. Field trip etc ) TOTAL HOURS . AT $ PER HOUR =$ I CERTIFY THAT PAYMENT FOR THE AMOUNT UF $ IS CORRECT OFFICER/STAFF SIGNATURE: OFFICER/STAFF SOCIAL SECURITY NUMBER: CHIEF OF POLICE/CITY OFFICIAL 51GNATURE: I VERIFY THAT THE A80VE SERVICES WERE PROVtDED: Note: Payroll registers, time sheets and OT slips, docu must be attached to process this Miami Dade Counry Record Improvement Project City: Project Name: Vendor Page 3 of 3 StJMMARY STATEMENT OF QUARTERLY PROdECT COSTS (Equipment, Supplies, Material Expenses) Date of Ciaim; Claim Number: Item Dale Check Description Paid Number Amount TOTAL AMOUN7 OF EXPENSES: NOTE: Copies ot aii involces and cancelled eheeks for this request must be attached to process payment ATTACHMENT D AT~I'ACHMEN~I D UEPARTMENT' ~F HUMAN SERVICES BYRNE GRANT ADMINISTRATI4N MIAMI-DADE C4UNTY AFFIDAVITS ?'he contracting individual nc enttty (governmental or othenvise) shall indicate by an "X" all affidavits that pertain to this contract and shall indicate by an "N/A" all affidavits that do not perta~n to this contract. All blank spaces must be ~lled. Ihe MIAMI-DADE C4UNTY OWNERSHIl' DISCLUSURE AFFIDAVIT~; MIAMI-DADE COUNT'Y EMPLOYMEN'T DISCLOSURE AFFIDAVTT; MIAMI-DADE CRIMINAL RECURD AFFIUAVIT: DISABILITY NUNDISCRIMINAIION AFPIDAVIT; and the PROJEC'T FRESH START AFFIDAVIT shall not pertain to cont~acts with the United States ar any of its departments or a~encies thereof; the State or any palitical subdivision or agency thereof or any municipality of this State. The MIAMI-DAUE FAMILY LEAVE AFFTDAVI~7 shall nnt pertain to contracts ~v~th tlie United States or any of~ its departments or agencies or the State of~Florida or any political subdivision or agency thereof; it shall, however, pertain to municipalities of'tlie State of~ T'lorida. All other contracting entities ar individuals shall read carefu#ly each affidavit to detern~ine whether or not it pertains to this contract. I~ , being first duly sworn state: Affiant Ihe full legal name and business address of the person(s) or entity contracting or transacting business ~vith Miami-Uade County are {Post Office addresses are not acceptable): Federal Employer ldentification Number {lf none, Social Security) Name of Entity, lndividual{s), Partners, or Corporation Doing Business As (if same as above, leave bla~~k) Street Address City State Zi~ Code 1 MIAMI-UADE COUNTY OV/NERSIIIP DISCLOSURE AFFIUAVTT (Sec. 2-8.1 of~the County Code) If [he Contract or business transaction is with a corporation, the full legal name and business address sliall be pro~ided f'or each officer and director and each stockholder who holds directly or indirectly five percent (5%} nr more nf the corparation's stnck. If the contraet or business transaction is with a partnership, the foregoing inf'ormation shall be provided for each partner If' the contract or business transaction is with a trust, the full legal name and address shall be provided for each trustee and each beneficiary. The foregoing requirements shall not pertain to contracts with publicly traded corporations or to contracts with the United States or any department or agency thereof, the State or any politica! subdivision or a~;ency thereof or any municipality of' this State All such names and addresses are (k'ost Office addresses are not acceptable): Full Le6a1 Name Address Ownership % % ~/o 1of5 2. The full legal names and business address of' any other individual (other than subcontractors, material men, suppliers, laborers, or lenders) who have, or will have, any interest (legal, equitable beneficial or othenvise) in the contract or business transaction ~~vith Dade County are (Post Office addresses are not acceptable): 3. A.ny person who willfully fails to disclose the inf'ormation required hec•ein, or who kno~vingly disclnses false infarmation in this regard, shall be punished by a fine of' up to five hundred dollars (~SOO.OQ) or imprisonrnent in the County jail for up to sixty (60) days or both. II, MIAMI-DADE COLTNIY EMPLOYMENT DISCLOSURE AFFIUAVIT (County Ordinance No. 90- 133, Amendin~ sec, 2,8-1; Subsection (d)(2) of the C~unty Code). Except where precluded by #ederai or State la~vs or regulations, each contract or business transaction or renewal thereof ~vhich invnlves the expenditure of ten thousand dollars ($10,000) or more shall require the entity contracting or transacting business to disclose the fbllowing infbrmation ~Ihe fore~oing disclosure rec~uirements do not apply to contracts with the United States or any department or abency thereof; the State or any political subdivision or agency thereof or any rnunicipality of this State. l Uoes your firm have a collective bar~aining agreerr~ent with its employees? Yes No 2 Does your firm pr~ovide paid healtlz care benefits f'or its employees? _ Yes ` No 3. Provide a current breakdown (nnmber of~persons) o#~your firm's work force and nwnership as to race, national ongin and gender: White; Males Females Asian: Ma}es Females Black: Males Females American Indian: Males Females Hispanics: Males Females Aleut (Lskimo): Males Females Males Females: Males Females III AFFIRMA~TNE ACTIUN/NONUISCRIMINATIUN OC LMPLOYMENT, PROMUTIUN AND PROCURL•MEN"I PRACTICL-S (County Ordinance 98-30 codified at 2-8.I.5 o#"the County (:ode ) In accordance with County Urdinance No 98-30, entities with annual gross revenues in e~ccess of" $S,OOQ,OOQ seekin~ to conn~act wittt the County shall, as a eondition of receiving a County contract, llave: i) a~vritten af#irmative action plan ~vhich sets forth the procedures the entity uti3izes to assure that it does not discriminate in its employment and promotion practices; and ii) a written procurement policy which sets forth the procedures the entity utilizes to assure that it does not discriminate against mmority and women-owned businesses in its own procurement nf goods, supplies and services. Such affirn~ative actian plans and procurement policies shall provide for per~odic review to determine their ef'fectiveness in assuring the entity does not discriminate m its employment, promotion and procurement practices. The foregoin~ not~~+ithstanding, corporate entities whose boards of directors are representative of the population make-up of the nation shall be presumed to have non-discriminatory employment and procurement policies, and shall not be required to have H~ritten affirmative action plans and procurement policies in order to receive a County coniract 'The foregoing presumption may be rebutted. ? of 5 The requirements of' Gounty Ordinance No. 98-30 may be waived upan the written recommendation of the County Manager that it is in the besE interest of the County to do so and upon approval af'the Board of County Commissioners by majority vote of'the members present. The firm does riot have annual gross revenues in excess of ~5,000,000.. The firm does have annual revenues in excess of' $5,000,000; ho~vever, iEs Board of Directars is representative of the population make-up of the nation and has submitted a~vritten, detailed listing of its Board of Directors, including the race or ethnicity of each board member, to the Gounty's Departrnent of' Business Devel4pment, 175 N.W, tst Avenue, 2Sih Floor, Miami, Fiorida 33128. ~Ihe firm has annual gross revenues in excess of~$5,000,000 and the firm does have a~vritten affirmative action plan and procurement policy as described above, ~vhich includes periodic reviews to determine effectiveness, and has submitted the plan and policy to the County's Department of' Business Uevelopment 175 N.W. IS' Avenue, 28th Floor~, Miami, Florida 33128; T~he firm does not have an affir-native action plan and/or a prncurement policy as described above, but has been granted a waiver. N. MIAMI-UAUE CULTNTY CItIMINAL RECORD AFFIDAVTT (Section 2-8.6 of'the County Code) The individual or entity entering into a contract or receiving f'unding from the County has has not as of'the date of this affidavit been convicted of a felony during the past ten (10) years. An officer, director, or executive of the entity enter~ing into a cnntract or rcceiving fur~ding from the County has has not as of~ the date af~ this affidavit been convicted oE' a felony during the past ten (10) ,years. V MIAMI-UAUE EMPLOYMENT URUG-FRLE WORKPLACE AFFIDAVTT (County Urdinance No. 92-15 codi€ied as Section 2-8.1.2 of the County Code) ~That in compliance with Ordinance No 92-15 of"the Code of~Miami-Dade County, Florida, the above named person or entity is providing a drug-free ~vorkplace A wr~itten statentent to each employee shall inform the employee about: danger of drug abuse in the workplace the firm's policy of' maintaining a drug-free environment at all tivorkplaces availability nf drug counseling, rehabilitatian and employee assistance pro~,~rams penalties that may be imposed upon employees for drug abuse violations The person or entity shall alsn require an employee to sign a statement, as a condition af~employment that the employee will abide by the terms and notify the employer of any criminal drug conviction occurrin~ no later than five (S) days after receiving notice of such conviction and impose appropriate personnel actinn a~ainst the employee up to and including ter~mination. Compliance with Ordinance No 92-IS may be waived if tl~e specia] charaeteristics of the product or service of'fered by the person or entity mal:e it necessary for the operation of the County or for the health, safety, ~~+elfare, economic benefits and well-being of the pubtic Contracts involving Eunding wllich is provided in whote ar in part Uy the United States or the State of Florida shall be exemptcd from the provisions of this ordinance in those instances ~;~here those provisions are in conflict with the requirements of those governmental entities. 3 of' S VI. MIAMI-DA.DE EMPLOYMENT' FAMILY LEAVE AFFIDAVIT' (County Urdinance No. 142-91 codified as Section 11 A-29 et. seq of the Caunty Gode) That in compliance with Ordinance No. 142-91 of the Cade of' Miami-Dade County, Florida, an employer with fifty (50) nr more emplayees workins in Dade Counry for each warkir-~ day during each of twenry (2d) or more catendar work ~veeks, shall provide the follo~ving information in compliance with all items in the aforementioned ordinance: An employee who has wnrked for the above finm at ]east one (1) year shall be entitted to ninety (90) days of family leave during any twenty-four (24) montli period, for medical reasnns, fbr the birth or adoption of a child, or for the care nf a child, spouse or ~ther close relative who has a serious health condition ~vithaut risk of terminatinn of employment or employer reialiation. The foregoing requirements shall not pertain to contracts ~vith the United States or any department or agency thereof, or the State of Florida or any political subdivision or agency thereof. It sl~all, however, pertain to rnunicipalities of this State. VII. DISABILITY NON-DISCRIMINATION AFFIUAVI~T' (Coun ,ty Resolution R-385-95) That the above named firm, corporation or or~anization is in compliance ~vith and agrees to continue to comply evith, and assure that any subcontractor, or third party contractor under this project complies with all applicable requirements of the laws listed below including, but not limited to, those pravisions pertaining to employment, provision of' programs and services, transportation, communications, access to facilities, renovations, and ne~v canstruction in the follo~~~ing laws: Tlie Americans with Disabilities Aet of' 1990 (AUA}, Pub. L. 101-336, I04 Stat 327, 42 U.S.C. 12]O1-12213 and 47 U.S.C. Sections 225 and 61l includin~ Title I, Employment; ~Title II, Public Services; 'Title III, Public Accommodations and Services Operated by Private Entities; T'itle tV, Telecornmunications; and Title V, Miscellaneous Provisions; The Rehabilitation Act of 1973, 29 U.S~C. Sectian 794; Ihe Federal Transit Act, as amended 49 U.S.C. Section IG12; The Fair Housing Act as amended, 42 U,S.C. Section 3G02-3G31 Ihe foregoing requirements shall not pertain to contracts with the United States or any department or a~ency thereof; the State or any political subdivision or agency thereof or any municipality of'this State. VIII. MIAMI-DADE COUNII' REGARDING DELINQLTLNT ANU CURItENTLY DUF FEES OR '~ 7AXLS (Sec. 2-8.1(c) ofthe C:ounry Code) Except for small purchase orders and sole source canc~acts, that above named [irm, corparation, organization or individual desiring to transact business or enter into a contract with the Counry verifies that all delinquent and currently due fees or taxes -- including but not limited to real and property taxes, utility taxes and nccupational licenses -- ~vhich are coilected in tl~e norma3 course by the Uade County Tax Collector as well as Dade County issued parking tickets for vehicles registered in the name of the firm, corporation, organization or individual have been paid L`C CURRLNT UN ALL COUNTY CONT'RACTS, LOANS AND OT1-IL-R UBLIGATIONS The individual entity seeking to transact business ~vith the County is current in a!1 its obligations to the County and is not othen~ise in default of any contract, prnmissory note or other loan document with the County or any of" its agencies or inshvmentalities. 4 of5 X. PR07ECT FRESH START (Resolutions R-702-98 and 358-99) Any firm that has a contract with the County that results in actual payment of $500,000 or more shall contribute to Project Fresh Start, the County's Welfare to Work Initiative. However, if five percent (5%) of the firm's work force consists of indiv~duais ~vho reside in Miami-Dade Gaunty and who have ]ost or will lose cash assistance benefits {formerly Aid to Families with Dependent Children) as a resutt of'the Personal Responsibility and Work ~pportunity Reconciliation Act of 1996, the firm may request waiver from the requirements of R-702-98 and R-358-94 by submitting a waiver request affidavit ~I he foregoing requirement does not pertain to govemment entities, not for profit organizations or recipients of grant awards. Xl. UOMESIIC VIULENCE LEAVL (Resolution 185-00; 99-5 ~odified At t 1A-60 Et Seq. of' the ~ Miami-Dade County Code). The firm desiring to do business with the County is in compliance with Domestic Leave Urdinance, Ordinance 99-5, codified at 11A-60 et. seq. of~ the Miami Uade Cnunty Code, which requires an employer which has in the regular course of' business fifty {SU) or more employees working in Miami- Dade County for eacll working day during each of twenry (20) or more calendar work ~veeks in the current or proceeding cale~dar years, to pravide Domestic Violence Leave to its employees. I have carefully read this entire five (5) page document entitled, "Miami-Dade County Affidavits" and have indicated by an "X" all affidavits tllat pertain to this contract and have indicated by an "N/A" all affidavits that do not pertain to this contract. By: 200~ by (Signature of Affiant) SUBSCRIBED AND SWURN IO (or affirn~ed) bef'ore me this day of~ l:nown to me or has presented (Type of Identification) (Signature of Notary) (Print or Stamp of Notary) Notary Public - Stamp State of~ (State) (Date) He/She is personally as identification. (Serial Number) (Expiration Date) Notary Seal 5 of' S ATTACHMENT D1 hfl41tf1-AADE COUN7'}' FLORIAA Form A-12 Gode of Business Ethics ATTACNMENT D1 in accordance with Resolution R-994-99 each person or entity that seeks to do busi~ess with Miami-Dade County shatl adapt the Miami-Dade County/Greater Miami Chamber of Commerce Gode of Business Ethics as fo[lows: The Miami-Dade County/Greater Miami Chamber of Comrr~erce seeks to create and sustain an ethical business cfimate #or its mem~ers and the community by adopting a Code of Business Ethics, Miami-Dade County/Grea#er Miami Chamber nf Commerce encourages its members to incorpora#e the p~inciplss and practices nutlined here in their individual codes of ethics, which will guide their refationships with customers, clients and su~pliers. This Model Code can and should be prominently displayed at all business locations and may be incorpnrated into marketing materials. Miami-Dade CountylGreater Miami Chamber of Commerce believes that its members should use this Code as a model for the development of their organizations' business codes of ethics This Model Cnde is a statement c~f principles to help guide decisions and actions based on respect for the importance of ethical business standards in the community. Miami-Dade County/Greater Miami Chamber of Cnmmerce befieves the adoption of a meaningful code nf ethics is the respnnsibility of every business and professinnal organization. By affixing a signatur~e in the Proposal signature page, Form A-12, the PropQSer hereby agrees to compiy with the principles of Miami-[?ade CountylGreater Miami Chamber of Commerce Cade af Business Ethics. If the Proposer firm's code va~ies in any way the Proposer must identify the Bifference(s) on a separate document attached to Form A-12. Compliance with Government Rules and Requlations We trie undersigned f'roposer will properly maintain all records and post all licenses and certificates in prominent places easiiy seen by our employees and customers; • In de~lir~g with gavernment agencies and employees, we will conduct business in accordance with all applicable r~ules and regulations and in the npen; • We, the undersigned Pr~pflser~ will report cor~tract irregularities and othe~ improper nr unlawful business practices to the Ethics Commission, the Office nf Inspector General or appropriate law enforcement authnrities. Recruitment Selection and Compensatinn of Cnntractors Consultinq Vendors, and SuUpliers • We, the undersig~ed Proposer will avoid coriflicts of interest and disclose such conflicts when identified; • Gi#ts that compromise the integrity of a business transactinn are unacceptable; we wiil not kick back any portion of a contract payment to employees of the otF~er contracting party or accept such kic:kback. 10/9/2007 Page 1 of 3 Al41hf!-DADE COUNTY, FLORIDA Business Accountinq • All our financiai transactions will be properiy and fairiy recorded in a~propriate books of account, and there will be no ~aff the btinks" transactions or secret accounts. Promtitinn and Sales of Products and Services • Our products will comply with all applicable safety and yuality standards; • We, the undersign~d Proposer will prornote and advertise our business and its products nr services in a manner that is n~t misleading and does nnt falsely disparage nur competitors; • We, the undersigned Propaser will cnnduct business with government agencies and emplayees in a manner that avnids even the appearance of irnpropriety. Efforts tn curry politieal favoritism are unacceptable; • Our propnsal will be competitive, appropriate ta the request for proposals/qualifications documen#s a~d arrived at independently; • Any changes to contracts awarded will have a substantive basis and nat be pursued merely because we are the successful Proposer. • We, the undersigned Propaser will, to tr~e best of our ability, perfarm government cnntracts awarded at the price and under the #erms pravided fnr in the contract. We will not submit inflated invoices for gonds provided nr services perforrned under such cnntracts, and claims will ~e made only far work actually ~ertormed. We will abide by all cor~tracting and subcontracting regulations. • We, the undersigned Praposer will nnt, directly nr indirectly, offer to give a bribe or o#herwise channel kickbacks from contracts awarded, to government afficials, their family members o~ business associates, • We, the undersigned Proposer will not seek or expect preferential treatment on proposals based on nur par~icipatian in political campaigns. Public Life and P~litical Carr~paiqns • We, the undersigned Proposer encourage all emplnyees to participate in community life, public service and the political process to the extent permitted by law; • We, the undersigned Proposer encourage all employees to recruit, suppo~t and elect ethical and qualified public officials and engage them in dialoyue and debate about business and community issues to the exter~t permitted t~y law; • Our cnntributions to political parties, cnmmittees nr individuals will be made only in accordance with applicable laws and wi11 comply with all requirements for public disclnsure. All contributions made on behalf of the business must be reported to senior company management; • We, the undersigned Proposer will nat contribute to the campaigns of persons who are convicted felons or those who do nnt sign the Fair Campaign Practices Ordinance. ~ 0/9/2007 Page 2 of 3 A!l~tA11-DADECOUNT}; FLORID.1 ~ We, the undersigned Prnposer will not knowingly disseminate faise campaign information or suppnrt those who do. Pass-throucth Requirerr~ents • This Code prohibits pass-through payments whereby the prime firm requires that the MBE firm accepts payments as an MBE and passes ttuaugh those payments to another entity; Rental Space EQUipment and Staff Repuirements or Flat Overhead Fee Reauirements • This Code prohibits renta! space requirements, equipment requirements, staff requirements and/or flat averhead fee requirements, whereby the prime firm requires the MBE firm to rent space, equipment and/or staff from the prime firm or charges a filat overhead fee for the use of space, equipment, secretary, etc; MB~ Staff Utilizatinn This Code prahibits #he prime firm from requiring the MBE firm ta prnvide more staff trian is necessary and then utilizing the MBE staff for other work ta be p~rfnrmed by tha prime firm. This Code also requires that on any cnntract where MBE participatinn is purported, the contract shall specify essential terms including, but not limited to, a specific statement regarding the percent of participatinn planned for MBEs, the fiming of payments and when the work is to be pertormed. By. {Signature of Affiant) (Date) SUBSCRIBED AND SWORN TO (or affirmed) before me this day of 200` by is persor~ally knnwn to me or has presented as identification. (Signature of Notary) (Print or Stamp of Notary) (Type of Idenfification) He/She (Serial Number) (Expiration Da#e) 1019/20U7 Page 3 of 3 ATTACHMENT 02 Attachment D2 MIAMI-DAUE COUNTY DEBARMENT UISCLUSURE AFFIDAVIT (Ordinance 93-129, Section 1) I, being duly first sworn, upon aath deposes and says that the bidder of' this contract ar his agents, officers, principals, stockY~olders, subcontractors or their affiliates are not deba~Yed by Miami-Uade County. By: (Signature of Affiant) SUBSCRIBED AND SWORN TO (or affirmed) bef'ore me this 20U~ by is personally known to me or has presented as identification. (Signature of Notary) (Print or Stan3p of N~tary) Notary Public - Stamp State of' {State) (Type of Identification) (Date) day of (Serial Number) He/She --__ (E~piration Date) Notary Seal 5/O1 ATTACHMENT D3 Attaclxment D3 SWORN STATEM~NT PURSUANT TO S~CTION 287.1.33 (3) (a), FLORIDA STATUTCS, ON FUBLIC ~NTITY CRIMCS `f'HIS FORM MUST BE SIGIV~D AND SWORN 'I'O IN TH~ PRES~NCE OI' A IVOTARY PUBLIC OR O't'H~R OI+FICIAL AUTHORIZ~D T4 ADMINIS'T~~R OATHS 1. Tliis sworn stateme~it is submitted ta Mi1mi-Dade Countv ~y (pr~int individunl's ns~me nnd title) for~ {pi•int Nzn~e ot eritity submitting s~vorn stltement) ~vhosc business address is and if applic:~ble its Federat ~mployer ldentitic~tion Number (F~IN) is If` thc entity has aio F'EIN, include the Social Secarity Number of the individuul signing this sworn statement: 2. I understand thak a"public entity crime" as deCned in paragraph 287.133 (1)(g), Flori~a Statutes, n~eans a violation of ~qy state or federal (a~v by ~ person with respect to and directly relnted to tl~e trans:~ctions of business ~vith any public entity or with an ~gency or politica! su6division of any other st~te or ~vith ttxe United St:~tes, including, but not limited to, any bid or cantract for goods or services to be provi~ied to pubtic entity or ~gency or pofitical subdivision of s~ny other state or of tl~e United States 1nd involving antitrust, fr~aud, tlieft, bribery, coUusion, rlcketeering, conspiracy, or~ materiAl misinter•pretation. 3. I underst~nd tiiat "convicted" or "conviction" Rs de~ned in Parngr•aph 287.133 (1)(b), Fl~ridh Statutes, means 1 finding of guitt or a conviction of a public entity crime, ~vith or ~vithout an ldjudication oC guitt, in any federaI or• state tri~! court oC recorci relating to ch~rges brought by indictment or information nf"ter July 1, 1989, ~s s~ resuit of ~ jury vcrdict, non jury tr•ial, or entry of a ple:~ of guilty or nolo contendere. 4. I understand that an °`a[tililte" ~s detuaed io paragr~ph 287.133(1)(a), ~'loridu Stntutes, melns: 1. A predecessor or successor of a person convicted of n pablic entity crime; or 2. An entity under tl~e control of any natural person wl~o is nctive in tite ntanagement o! the entity and ~vl~o has been convitted of a public entity crime. 'Tl~e term "afCliate" includes tE~ose of~cers, directors, esecutives, partners, sharei~olders, empioyees, members, and agents wtto are active in ttte mnnlgement of ~n affilinte. The o~vnership ay one person of staares constiEuting a controiling interest in lnother person, or a pooling of eyuipment or income lmong persons Fvl~en not [or fair maricet value under An nrm's tength ngreement, shall be a pr•ima facie case tl~at one person conh•ols anot!-er person. A per•son Fvho knowingly enters inta n joint venture with n person ~vho I~as been convicted of a public entity crime in Florida during the preceding 36 months shalt be considered ~n a1'filiate. r of a 5. I under•stand thlt a'°person" as deGned ir~ Parugrupti 287.I33(i)(e), I~'lorida Statntes, means uny natura! Person or entity organized undcr ttie la~vs of any state or of the United States ~vitttin tl~e leg:~i power to enter into a binding contact and which bids ar zpplies to bid on contructs for the provision of goods or services let by a public entity, or ~vhich otherwise translcts or applies to transact business tivith a public entity. 'Tl~e tet~m "person" includes tl~ose ofticers, executives, pArtners, shareliolders, emptoyecs, memUers, And ugents ~vlto are :tctive in management ot' an entity. 6. Based on information nnd belief, the statement which I liave marked below is true in relution to the entity submitting tl~is sworn stntement. (Please indic~te ~vhich stntement applies.) Neitl~er the entity submitting ttiis sworn stntement, nor 1ny of its ofticers, directors, executives, pArfners, staareholders, employees, members, or agents ~vl~o ~re ~ctive in the man~gement of ti~e entity, nor ~ny aCfili:-te of the entity has been charged with and convicted ofi st public entity crime subsec~uent to July I,1989. Tl~e entity su6mitting this s~vorn stltement, or one or more of its ofGcers, directors, executives, part~~ers, sharehoiders, emptoyees, members, or agents ~vho are active in the munngement o1' tlic entity, nor any af~li:-te oC the entity has been ch~rged ~vith :-nd convicted oC u public entity crime snbsec~uent Eo 3uly 1, 1989. Howevcr, tliere h:~s been a subsequent proceeding before a He~ring Officer of tI~e State of Floridn, Division of Adnunistr~ative HeArings und the I'inai Order entered by the Hearing Ofticer determined tl~at it was not in tl~e public interest to place thc entity su6mifting tl~is s~vorn statement on tl~e convictect venc~or list. (att~c[~ ~ copy of tl~e final order). I UNDERS'I'AND TFIA'T' 'TH~ SUBNIISSIQN OF THIS FOR1~I 'TO TAE CONT[2ACI'ING OFFIC~R FOR TH~ PUBLIC ~NT'I'TY IDENfiIF[ED IN PAIZAGRAPH 1(ON~) ABOV~ IS ~'OR THAT PUBLIC EiV'TI'T'Y ONLY AND, fiHAT THIS FORM IS VALID THR4UGH D~C~MBER 31 OF 'I'IIE CAL~NDAR YEAR IN WHICH IT' IS ~IL~D. I ALSO UND~RSTAND THAT' I AM ItEQUIR~D 'TO INF01211~I THAT PUBLiC ENTITY PRTOR TO ~NT'ERING INTO A CONTRACT IN ~XCESS OI+ THE 'I~HRESHOLD AMOUNT PROVID~D IIV S~CTION 287.017 FLORIDA STATUT~ES FOR CA'TEGORY TWO OI' ANY CHANG~ IN 'TII~ INI'ORMA'I'ION C4NTAINED IN THIS FORM. (Signnture) S~vorn to attd subscribed beforc mc tl~is Person~lly knotivn OR Produced ldenti~cntion day of , 20 (7'ypc of Identi~cntion) Notary Public - State of My commission expires (Printed typed or stamped commissioned name of notary pubtic) 2 of~2 ATTACHMENT E AT'1'ACHMENT' E MIAMI-DADE DEPARTMENT OF HUMAN SERVICES BYRNE GRANT ADMINISTRATION PROVIDER'S DISCLOSURE OF SUBCONTRACTORS AND SUPPLIERS {Ordinance 97-104) Name of' Organization: Address: REQUIRED LISTING OF SUBC4NTRA.CTORS ON COUNTY CONTRACT In compliance with Miami-Uade County Urdinance 9'7-1 U4, the Provider must submit the list of' first tier subcontractors or sub-consultants whn witt perform any part of the Scope of~ Services Work, if' this Contract is fbr $100,000 or more. The Provider must complete this information. If' the Provider will nnt utilize subcontractors, then tl~e Provider must state "No subcontractors will be used"; do not state "N/A". NAI19G OF SUBCON'I RACTOR OR SUCi-CONSULT'ANT ADDRGSS Cl'T'Y AND STA'T E No subcontr•actors will be ased. REQUIRED LIST UF SUPPLIERS ON C4UNTY CONTR.A(:T In compliance with Miami-Uade County Ordinance 97-104, the Pr~ovider must submit a list nf'suppliers who will supply matecials for tile Scope of~ Services to the Provider, if this Contract is $100,000 or more. The Prnvider must fill out t11is infonnatioii. If' tlle Provider will not use sup~~liers, the Provider must state "No suppliers will be used", do not state "N/A". NAMG Of SUPPLIGR ADDRESS CITY AND StA'T'G No suppleers wili be used. I/iereGy certify tliat tlie for~egoi~ig i~rforni~tio~r is trr~e, cor~•ect and conrpletc~: Signatru•e oJAuiha-i~ed Rep~~ese~rtatil~e: Trtle: Fir~r~ Nair~e- :=lddress: Dare: Fer! ID No. Cit~~/ State/Zip Telephone~ ( ) Fax: ( ~ E'aruzil: