04/19/2000 Agreement
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BRANCH OFFICE
3117 OVERSEAS HIGHWAY
MARAlHON, FLORIDA 33050
TEL. (305) 289~27
FAX (305) 289-1745
CLERK OF THE CIRCUIT COURT
MONROE COUNTY
500 WHITEHEAD STREET
KEY WEST, FLORIDA 33040
TEL. (305) 292-3550
FAX (305) 295-3660
BRANCH OFFICE
88820 OVERSEAS HIGHWAY
PLANTATION KEY, FLORIDA 33070
TEL. (305) 852-7145
FAX (305) 852-7146
MEMORANDUM
DA TE:
July 6, 2000
TO:
James Malloch, Director
Community Services
ATTN:
Sandy Molina
Pamela G. Hanco ./1..~
Deputy Clerk U
FROM:
At the April 19, 2000, Board of County Commissioner's meeting the Board granted
approval and authorized execution of the forms - Certification Regarding Lobbying and
Certification Regarding Debarment, Suspension, and other Responsibility Matters Primary
Covered Transactions concerning the operation of the Summer Youth Employment and Training
Program.
Enclosed please find the original Certifications for your handling. Should you have any
questions, please do not hesitate to contact this office.
Cc: County Administrator w/o documents
County Attorney
Finance
File
03/30/00 10:37 FAX
~002
.<
,
cm11FICATION REGAImING LOBB~G
CERTIFICADON FOR CONTRACTS, GRANTS, LOANS, AND COOPERATIVE
AGREEMENTS
. The undersigned. a:rtifies. to the best of his or her knowledge and belief. tbat:
(1) No Federal appropriated ftmds have been paid or will be paid. by or on behalf of the
undersigned. to any person for infhleDcing or attempting to iDtluence an officel" or employee of an
agency. a Member of Congress. an officer or employee of Congrcss. or an employee of a Member
of Congress in connection with die aWUding of any Feclera1 coatract, the mAlrillg of any Federal
grant. the a~ of any Fcdcra1loan, me earmiDg into of. any cooperative agreemcnt. aod the
extenSion, C()Dfiftuation. renewal. amelJdment, or modi6catioo of any Federal C04tlaet, pant, loan,
or coopet &live agr<<JJ1II:I1I.
(2) If any funds otbcr tban Federal &p9lopriated funds have been paid or will be paid to any
person for infh.1l'!I1citlJ or attempting to iDf1ucD:c an officer or employcc of any ageDCY. a Member
of Congress. an officer or employee of Congress. or an employee of a Member of Congress in
co~on wirh this Federal contraCt. gram. loan, or cooperative agreemem. the undersigned iiball
complete and submit Standard Fonn-UL. -Disclosure Form to Report Lobbying. R in acx:mdaDce
with m iDst:rucUoos.
(3) The undersigDed sba1l rc:quiIe that the JaD&ua8e of this certification be included in the award
docwneJItlt for anR subawaIds at an tiers (iDcludiDg subcontracts. subgrmts and comracts under
grants. loaDs, and cooperative ~nts) and tbat an. subrecipicnts sbaIl certify and disclose
accordingly.
This ccrtifration is a material representation of fact upon which relim:e was placed when this
transaCtion was made or entered into. Submi~ion of this certification is a prerequisite for tml1ci1ll or
corcring into this ttaDSaCtioD imposed by Section 13S2. Title 31, U.S. Code. Any person who fails
to file the required certification shall be subject to a civil peoalty of not less than SlO.(xx) ao4 DOt
more than 5100.000 for each m:h fa.i1ure.
Monroe County Board of County COIIIIII.issionr- 3'
GranteelConttaCU>f Orpnization
Summer Youth/VIA Youth
Shir1ey Freeman, Mayor
Name of Cmifying Official
ProgramITtde
cS~-F~ ~~/~ Pare
In these instances, R All.. in a;~ll~eB iI.fleW<> be clarified to show tba.t it applies
(0 covered contractIgram ~ans~'$IllO.000 (per OMB).
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Ot:8 NV 9-1nr 00
~033H HO.::l Q311J
03/30/00 10:38 FAX
~003
'\
CERTIFICATION REGARDING DEBARMENT, SUSPENSION. AND
OTHER
RESPON~n.rrv MATfE~ PRIMARY COVERED TRANSACTIONS
1. The service provider certifies to the best of its knowJedae and belief, that it and its
principals:
a. Arc not presently c1cbam:d. suspcoJcd. ploposed for debarmeDt, declared iDcligiblc.
or vohmtari1y acluded from covered ~ by any Federal department or
agcocy .
b. Have not witbin a tbree-year period ~~ this proposal been convictal of or had
a civil judgaDeDt JaJdeml against 1bcm for (XJItnI'Iiqioo of fraud or a crimiDal
offi:DSc in C\lIJDCCtion with obtaiDiDg. ~ to obIain, or performiDg a public
(Federal, SUIte, or local) uausaction or contraCt under a publiC 1Pn~ violation
of pPra1 or State antitrust lItJIhltj!$ or falsification or destruction of records, -1ri11g
false ~~t or receiving stolen property;
c. Arc not preseotly iDdicted for or otbcrwisc criminally or civilly charged by a
gmlt:l1J1.ucnl entity (Fedefa1, State, or local) with Nmlmi~sioD of any of the offenses
f!m~ated inparaaraph l.b oftbis c:ertification; aod
d. Have not within a tbree-ycar period ~iDg this applicationflh()p)Sal had ODe or
more public transaCtions (Federal. Slate, or local) terminated for cause or default.
2. Where the ~ primary participaDt is amble to certify to any of the statements in tbis
~ltifatioo. such prospcctivc participaDt sba1l submit an explanation to SFETC.
Monroe County Board of County COIIIIIlissioners
SERVICE PROVIDER AGENCY
Shirley Freeman, Kayor
NAME OF CERTIFYING OffiCIAL
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DATE r. I
OS.08.3111S
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SOUTH FLORIDA EMPLOYMENT AND TRAINING CONSORTIUM
3403 N. W" 82ND AVENUE, StnTE 300
MIAMI, FLORIDA 33122
SERVICE PROVIDER
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
5100 College Road
Key West, FL 33040
Contract #: WIA-YS'OO-ZS-OO
Effective Period of Performance: April 1, 2000 or the date signed by both parties, whichever last occurs,
through March 31, 2001.
Your organization has been selected for award of the contract for operation of a WIA Summer Youth
Training aDd Employment Program upon the condition that all documentation and elements that are
necessary for the filll contract package are incorporated by modification number WIA-YS'OO-ZS-01 into
this contract DO later than 60 days from the effective date of this ContraCt as noted above. The program is
described as follows:
TII1.E: WIA YOUID TOTAL
~icc PlOVidr:r Casu S 5f,837
Panicipmc Com (1lIis IIDClWlI iar:lucb S30 lJVlSp011IQOn fte pet tuaded slot) S 92,147
Tow S ISl,9S4
FIJI.Un. aGIOUIIl 8O~ ollhc IDlILl to be aW8t'd~ if llI1 aDDlicable ................... an: achieved.
II OF PARTlCIPAlfiS Woric &perienee .u
PmjecIs liLA
~ ~ J'rovidcr for
lilliusa)' Focus Caller lilA
l.imiIcd IlIICI1I5bip l1!A
1be awabcr of panicit-ms asswues dw aD dlC bea:bmIrb will be achieved UIII 10070 or d1e twWIg will be
awanlal.
SERVICE COMPOm:NT Allowable W1A YWlb 1ICIlYlDeS for liO days Ibmughaut Monroe CouDly. II<< JimilId to Ibe aWlmis 110= abltve.
AND LOCATION
PERIOD OF ....priIl. 2000 or date ~ by barb panics, whichc:Ycr lase omlrS. 1IIN MaIdl31. 2001.
PERFORMANCE
COMTJU\CT U:~
1'JVH:1
snn 2000
03/21/00 17:02 FAX
~OOJ
. .
Documentation which is required prior to contract execution includes documentation of licensing and
incorporation in the State of Florida, names and positions of Board of Directors, a recent audit report or
a certification of sound flScal management, incomelFICA tax cenif1C3tion and JRS identification number,
and all insurance and bonding policies. No contract may be executed if these documents have not been
submitted and no contract will be executed on a retroactive basis. In addition, the Service Provider will
be required to submit a listing of organizational responsibilities, personnel policies and procedures and
an affumativc action plan. A more extensive agreement will be submitted for your signature as soon as
possible. It is very important that you sign this prcliminaIy letter conrract and remm it to your TEe
Contracts Manager, to be received no later than March 31_.2000. If you have any questions please call
Maria Sierra, Assistant Director for Operations, or your assigned Contracts Manager at 305-594-7615.
The undersigned have the authority to legally bind by contract the entities they represent.
Sincerely,
Joseph Alfano
Executive Director Date
Representing the South Florida Employment and Training Consortium.
-x-~
Authorized Signature
Representing: MONROE COUNTY BOARD OF COUNTY COMMISSIONERS '
-3 /'3 '-~ /(;7(,)
,
Date
CotfTIlACT Ll:TTZa
PAaE1
Sn:TP 2000