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HomeMy WebLinkAboutR-2004-094 summer food program RESOLUTION NO. 2004-094 A RESOLUTION OF THE CITY OF DANIA BEACH, FLORIDA, AUTHORIZING THE PROPER CITY OFFICIALS TO APPLY FOR, ACCEPT IF AWARDED, AND EXECUTE AN AGREEMENT WITH THE FLORIDA DEPARTMENT OF EDUCATION UNDER THE 2004 SUMMER FOOD PROGRAM, PERTAINING TO A PROPOSED AGREEMENT BETWEEN THE BROWARD COUNTY SCHOOL BOARD AND THE CITY OF DANIA BEACH, IN CONJUNCTION WITH THE GRANT AWARD, TO PROVIDE LUNCHES AND SNACKS DURING THE 2004 SUMMER CAMP PROGRAMS AT C.W. THOMAS PARK AND P.J. MELI PARK, UNDER THE SUPERVISION OF THE CITY OF DANIA BEACH PARKS AND RECREATION DEPARTMENT; CONFIRMING THAT SPECIAL CONDITIONS EXIST IN ORDER TO SECURE SUCH SERVICES WITH THE BROWARD COUNTY SCHOOL BOARD, WITHOUT COMPETITIVE BIDDING AND WITHOUT ADVERTISEMENT FOR BIDS, PROVIDING FOR CONFLICTS; FURTHER, PROVIDING FOR AN EFFECTIVE DATE. WHEREAS, the Charter of the City of Dania Beach, Part III, Article 3, Section 4, Subsection 0), provides that during unusual conditions or emergencies, the City Commission may, by resolution, authorize the purchase by the City Manager of �\ designated supplies, services, equipment and materials in amounts in excess of fifteen thousand dollars ($15,000.00) without competitive bids and without advertisement for bids; and WHEREAS, the City Manager has determined that it is advantageous for the City of Dania Beach to apply for funding through the Florida Department of Education 2004 Summer Food Program grant; and WHEREAS, specific requirements of the grant must be met and these services can be provided by the Broward County School Board for the 2004 Summer Camp Programs; and WHEREAS, this grant will be no less than $31,678 for lunches and snacks to be provided to 250 children at both C.W. Thomas Park and P.J. Meli Park; and WHEREAS, the City Manager has determined that the contract with the Broward • County School Board will be contingent upon an award of the Florida Department of RESOLUTION NO. 2004-094 Education 2004 Summer Food Program grant and will be for the term of June, 2004 to • August, 2004; NOW, THEREFORE, BE IT RESOLVED BY THE CITY COMMISSION OF THE CITY OF DANIA BEACH, FLORIDA: Section 1. That the City Commission of the City of Dania Beach, Florida, approves the application, acceptance if awarded, and execution of the Florida Department of Education 2004 Summer Food Program grant in conjunction with an Agreement to be executed by the City with the Broward County School Board for lunches and snacks at both C.W. Thomas Park and P.J. Meli Park for the summer camp programs, a copy of which grant application is attached as Exhibit "A" to this Resolution. Section 2. That the proper City Officials are authorized to execute the grant Agreement, if awarded, and, subsequently, the Agreement with the Broward County School Board and the City Manager and City Attorney are authorized to make minor revisions to such Agreements as are deemed necessary and proper and in the best interest of the City. Section 3. That upon execution of the grant agreement and an agreement with • Broward County School Board, the Finance Director is authorized to appropriate the budget by the award amount in both the grant revenue and the expenditure accounts. Section 4. That all resolutions or parts of resolutions in conflict with this resolution are repealed to the extent of such conflict. Section 5. That this resolution shall be in force and take effect immediately upon its passage and adoption. PASSED AND ADOPTED on May 25th, 2004. "OR —L=MfISSIONER M 2 RESOLUTION NO. 2004-094 ATTEST: ROLL CALL: COMMISSIONER ANTON - YES COMMISSIONER CHUNN- YES LOUISE STILSON COMMISSIONER FLURY-YES CITY CLERK VICE-MAYOR MIKES - YES MAYOR MCELYEA - YES APPROVED AS TO FORM AND CORRECTNESS: BY: ( IIA4 THdM S'd. 'AW,SBRO CITY ATTORNEY • • 3 RESOLUTION NO. 2004-094 SUMMER FOOD SERVICE AGREEMENT THIS AGREEMENT is made and entered into as of this (a Z O(1 by and between THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA (hereinafter referred to as "SBBC"), a body corporate and political subdivision of the State of Florida, whose principal place of business is 600 Southeast Third Avenue, Fort Lauderdale, Florida 33301 and CITY OF DANIA BEACH (Hereinafter referred to as"CITY"), a municipal corporation of the State of Florida. WHEREAS, the CITY is desirous of obtaining food services for a Summer Food Program (hereinafter referred to as "Program") from SBBC and SBBC is willing to provide such services. NOW, THEREFORE, in consideration of the premises and of the mutual covenants contained herein and the sum of Ten Dollars ($10.00) and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,the Parties hereby agree as follows: ARTICLE 1 -RECITALS 1.01 Recitals. The Parties agree that the foregoing recitals are true and correct and that such recitals are incorporated herein by reference. ARTICLE 2-SPECIAL CONDITIONS 2.01 Effective Date. The effective date of this Agreement shall be June 14, 2004. 2.02 Term. The term of this Agreement shall be from June 14, 2004 through August 4,2004. 2.03 Meals Provided.SBBC will provide the SCHOOL meals that meet the minimum meal pattern requirements for the Program as to components and portion sizes. The meals will be delivered by SBBC in a timely manner to the sites listed on Exhibit"A". 2.04 Meal Rates. SBBC will deliver unitized meals, inclusive of milk, to the CITY for the following rates: Lunch: $1.90 per meal. Snack: $ .55 per meal. 1 2.05 Meal Reports. SBBC's Food and Nutrition Services Department will maintain full and accurate records specifying menu records and identifying the amount of food prepared and the daily number of meals delivered by type. SBBC will provide meal reports to the CITY promptly at the end of each month. SBBC will retain such records for a period of three (3) years from the date of receipt of final payment under this agreement (or longer, if SBBC has been notified of an audit in progress). Upon request, SBBC will make all accounts and records pertaining to the Program available to representatives of the United States Department of Agriculture and the General Accounting Office for audit or administrative review at a reasonable time and place. 2.06 Meal Invoices. SBBC's School Food Accounting Department will send an invoice to the CITY each month setting forth the amounts payable to SBBC for the meals provided. The invoice shall be based upon food delivery reports generated by SBBC's Food and Nutrition Services Department. The CITY will pay SBBC the invoiced amount within ten (10) days of receipt of the invoice. SBBC's records regarding the delivery of meals and the CITY's Program participation shall be open to inspection and audit by the CITY and its designees upon reasonable advance notice. 2.07 Audits. With regard to any inspection or audit of records pursuant to this Agreement, each party agrees that the other party and its designee(s) shall have full access to inspect and copy any records reasonably necessary for the conduct of such inspection and audit. Such inspection shall be conducted at the place where such records are usually kept and during normal business hours. The Parties agree that all records maintained concerning the duties, responsibilities and obligations imposed under this Agreement shall be kept in Broward County, Florida. Each party agrees to provide a reasonable sufficient workspace • for the use of the inspecting or auditing party's personnel during such inspection or audit. Each party agrees to cooperate with the inspecting or auditing party and its designee(s) during the course of an inspection or audit. The costs of any such inspection or audit shall be borne by the party requesting the inspection or audit. 2.08 Indemnification. Each party agrees to be fully responsible for its acts of negligence, or its agent's acts of negligence when acting within the scope of their employment and agrees to be liable for any damages resulting from said negligence. ARTICLE 3-GENERAL CONDITIONS 3.01 No Waiver of Sovereign Immunity. Nothing contained in this Agreement is intended to serve as a waiver of sovereign immunity by any agency to which sovereign immunity may be applicable. 3.02 No Third Party Beneficiaries. The Parties expressly acknowledge that it is not their intent to create or confer any rights or obligations in or upon any third person or entity under this Agreement. None of the parties intend to directly or substantially benefit a third party by this Agreement. The parties agree that there are no third party beneficiaries to this Agreement and that no third party shall be entitled to assert a claim against any of the parties based upon this Agreement. Nothing herein shall be construed as consent by an agency or political subdivision of the State of Florida to be sued by third parties in any manner arising out of any contract. 3.03 Non-Discrimination. The Parties shall not discriminate against any employee or participant in the performance of the duties, responsibilities and obligations under this 2 Agreement because of race, age, religion, color, gender, national origin, marital status, disability or sexual orientation. 3.04 Termination. This Agreement may be canceled by either party during the term hereof upon thirty (30) days written notice to the other parties of its desire to terminate this Agreement. 3.05 Records. Each Party shall maintain its own respective records and documents associated with this Agreement in accordance with the records retention requirements applicable to public records. Each Party shall be responsible for compliance with any public documents request served upon it pursuant to Section 119.07, Florida Statutes, and any resultant award of attorney's fees for non-compliance with that law. 3.06 Entire Agreement. This document incorporates and includes all prior negotiations, correspondence, conversations, agreements and understandings applicable to the matters contained herein and the Parties agree that there are no commitments, agreements or understandings concerning the subject matter of this Agreement that are not contained in this document. Accordingly, the Parties agree that no deviation from the terms hereof shall be predicated upon any prior representations or agreements, whether oral or written. 3.07 Amendments. No modification, amendment, or alteration in the terms or conditions contained herein shall be effective unless contained in a written document prepared with the same or similar formality as this Agreement and executed by each party • hereto. 3.08 Preparation of Agreement. The Parties acknowledge that they have sought and obtained whatever competent advice and counsel as was necessary for them to form a full and complete understanding of all rights and obligations herein and that the preparation of this.Agreement has been their joint effort. The language agreed to herein expresses their mutual intent and the resulting document shall not, solely as a matter of judicial construction, be construed more severely against one of the parties than the other. 3.09 Waiver. The parties agree that each requirement, duty and obligation set forth herein is substantial and important to the formation of this Agreement and, therefore, is a material term hereof. Any party's failure to enforce any provision of this Agreement shall not be deemed a waiver of such provision or modification of this Agreement. A waiver of any breach of a provision of this Agreement shall not be deemed a waiver of any subsequent breach and shall not be construed to be a modification of the terms of this Agreement. 3.10 Compliance with Laws. Each party shall comply with all applicable federal and state laws, codes, rules and regulation in performing its duties, responsibilities and obligations pursuant to this Agreement. 3.11 Governing Law. This Agreement shall be interpreted and construed in accordance with and governed by the laws of the State of Florida. Any controversies or legal problems arising out of this Agreement and any action involving the enforcement 3 or interpretation of any rights hereunder shall be submitted to the jurisdiction of the State courts of the Seventeenth Judicial Circuit of Broward County, Florida. 3.12 Binding Effect. This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective successors and assigns. 3.13 Assignment. Neither this Agreement nor any interest herein may be assigned, transferred or encumbered by any party without the prior written consent of the other party. There shall be no partial assignments of this Agreement including, without limitation, the partial assignment of any right to receive payments from SBBC. 3.14 Force Majeure. Neither party shall be obligated to perform any duty, requirement or obligation under this Agreement if such performance is prevented by fire, hurricane, earthquake, explosion, wars, sabotage, accident, flood, acts of God, strikes, or other labor disputes, riot or civil commotions, or by reason of any other matter or condition beyond the control of either party, and which cannot be overcome by reasonable diligence and without unusual expense ("Force Majeure"). In no event shall a lack of funds on the part of either party be deemed Force Majeure. 3.15 Place of Performance. All obligations of SBBC under the terms of this Agreement are reasonably susceptible of being performed in Broward County, Florida and shall be payable and performable in Broward County, Florida. . 3.16 Severability. In case any one or more of the provisions contained in this Agreement shall for any reason be held to be invalid, illegal, unlawful, unenforceable or void in any respect, the invalidity, illegality, unenforceability or unlawful or void nature of that provision shall not effect any other provision and this Agreement shall be considered as if such invalid, illegal, unlawful, unenforceable or void provision had never been included herein. 3.17 Notice. When any of the parties desire to give notice to the other, such notice must be in writing, sent by U.S. Mail, postage prepaid, addressed to the party for whom it is intended at the place last specified; the place for giving notice shall remain such until it is changed by written notice in compliance with the provisions of this paragraph. For the present, the Parties designate the following as the respective places for giving notice: To SBBC: Superintendent of Schools The School Board of Broward County, Florida 600 Southeast Third Avenue Fort Lauderdale, Florida 33301 4 r With a Copy to: Director of Food and Nutrition Services • 7720 West Oakland Park Boulevard, Suite 204 Sunrise,Florida 33351 To CITY: Ian Fiorey Recreation Program Manager(Aquatics) 2901 S.W. 52 Street Dania Beach, FL 33312 3.18 Captions. The captions, section numbers, article numbers, title and headings appearing in this Agreement are inserted only as a matter of convenience and in no way define, limit, construe or describe the scope or intent of such articles or sections of this Agreement, nor in any way effect this Agreement and shall not be construed to create a conflict with the provisions of this Agreement. 3.19 Authority. Each person signing this Agreement on behalf of either party individually warrants that he or she has full legal power to execute this Agreement on behalf of the party for whom he or she is signing, and to bind and obligate such party with respect to all provisions contained in this Agreement. I • 5 IN WITNESS WHEREOF, the Parties hereto have made and executed this • Agreement on the date first above written. FOR SBBC (Corporate Seal) THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA ATTES Carole L. Andrews, Chair 7 Approved 4Attome F nklin L 1,Tr erinte ent of Sch Pa School Bo • • 6 FOR CITY _ {Corporate Seal) CITY OF DANIA BEACH By � ATTEST: C. K. Ivan Pato,'C' M ger (Pl se Print) —ATI, � Thom s J.Ans ro,&'�� c y (Signature) Louise Stilson, City Clerk Witness (please print) (Signature) Witness (please print) (Signature) The Following Notarization is Required for Every Agreement Without Regard to Whether the School Chose to Use a Secretary's Attestation or Two(2) Witnesses. STATE OF COUNTY OF 6evc-cl� The foregoing instrument was acknowledged before me this day of .20 by s �T �.b�� tf of Name of Person on behalf of the corporation/agency. -Name of Cofporation or Agency Hem is personally known to me or-produced as Type of identification identification and did/did not first take an oath. �f My Commission Expires: 0 7 119�o)-pQ, �%���-�-�-✓� � (��2�e-� Signature-Notary Public (SEAL) Printed Name of Notary MIRIAM NASSER 20 'jotary Public, State of Florida Notary's Commission No. My comm. exp. July 9, 2007 Comm. No. DD 230214 7 Exhibit A CITY OF DANIA BEACH P.J. Meli Park 2901 SW 52 Street Dania, FL 33006 • • 8 Agenda Request Form City of Dania Beach Agenda Item: Date of Commission meeting: 5/25/2004 Description of Agenda Item: Resolution approving Summer Food Program Commission action being requested: Adopt Resolution or Ordinance ® Expenditure ❑ Award BID/ RFP ❑ Presentation ❑ General approval of item ❑ Continued from meeting Other(Please explain) '�f � Summary eXplanation and background Staff is requesting approval to apply for, accept if awarded and execute an agreement with the Florida Department of Education, 2004 Summer Food Program. This grant will enable the City to provide lunch • and snack throughout the summer months to children within the Community. If awarded this grant, staff is requesting approval to enter into an agreement with Broward County School Board to provide these meals, which will meet or exceed all the nutritional criteria of the grant. Attachedexhib�ts and additionalbackup materials (Please hst)', ., Resolution - electronic attachment Florida Department of Education Projected Budget Reimbursement- paper attachment Broward County School Board agreement/contract- paper attachment For purchasing requests ONLY Department: Amount: Fund: General: ❑ Water: ❑ Sewer: ❑ Stormwater: ❑ Grants: ® Capital: ❑ Account Name: Account Number: Submitted by: btemchuk Date: 5/14/2004 Department Director: btemchuk Date: 5/14/2004 Admin. Services Director: Date: Finance Director: Patricia Varney Date: 5/14/2004 • City Manager: Ivan Pato Date: 5/17/2004 1 Exhibit A CITY OF DANIA BEACH P.J. Meh Park 2901 SW 52 Street Dania, FL 33006 8 THE SCHOOL BARD OF BR®WARD COUNTY, FLORIDA 600 SOUTHEAST THIRD AVENUE•FORT LAUDERDALE,FLORIDA 33301-3125•TEL 754-321-0000 Barbara Leslie.R.D. SCHOOL BOARD Director CAR L.ANDREWS Food and Nutrition tion$ErVICOS STEPHANIE ARMA KRAFT,ESQ 7720 W.Oakland Park Blvd.,#204 Vice Chair JUDIE S.BUDNICK Sunrise,FL 33351 DARLA L.CARTER BEVERLYA.GALLAGHER PHONE: 754-321-0215 ROBERT D.PARKS,Ea D FAX: 754-321-0235 MARTY RUBINSTEIN LOIS WEXLER BENJAMIN J.WILLIAMS April 7, 2004 Ian Fiorey Recreation Program Manager (Aquatics) 2901 S.W. 52nd Street Dania, FL 33004 Dear Mr. Holloway: Enclosed please find three copies of the agreement for the School Lunch and Snack Program for the current year. Please return all three copies with the appropriate signatures (printed and signed), notarization and corporate seal, to Food and Nutrition Services. As soon as the agreement is finalized, we will return an original to you. In order that we may schedule this item to be placed on the School Board Agenda, we would appreciate your returning the completed agreements by April 19, 2004. If you are not able to meet this deadline, please notify our office of the date when you expect to return the agreements to us. Please call Marie Windsor at 754-321-0215 with this information-. Please note the Food and Nutrition Services Department will provide service up to and including Wednesday,August 4, 2004. Sincerely, Barbara Leslie Director BL:jw Enclosure Transforming Education:One Student at A Time Broward County Public Schools Is An Equal Opportunity/Equal Access Employer Florida Department of Education " & Session("SponsorTitleDsc") & " SFSP Budget Page 1 of 2 Applications > Applications: 2004 Sponsor Budget Version 0 Agreement Number Sponsor Name 04-0993 City of Dania Adult Meal Information Will meals be sold to non-program adults? Yes C No Will meals be provided to program adults? { Yes h',, No Operating Reimbursement (Max. Rate) Meal Total Meals" Rate Total Breakfast 0 $1.3800 $0.00 Lunch 11,925 $2.4100 $28,739.25 Snack 11,925 $0.5600 $6,678.00 Supper 0 $2.4100 $0.00 Total $35,417.25 Administrative Reimbursement (Max. Rate) Meal Total Meals" Rate Total Breakfast 0 $0.1075 $0.00 Lunch 11,925 $0.2100 $2,504.25 Snack 11,925 $0.0550 $655.88 Supper 0 $0.2100 $0.00 Tota 1 $3,160.13 Operating Costs Food Cost: $ 25,078.50 Non Food Supplies Cost: $ 0.00 Contracted Food Costs: $ 0.00 Operational Personnel (Prep, Serving, Supervision and Clean-Up): $5,440.50 Facility Expenses: $ 0.00 Equipment Rental: $ 0.00 Transportation : $ 0.00 Cost for program adult meals: $ 0.00 Other: $ 0.00 Total Operating Costs $30,519.00 Administrative Costs Management Salary: $627.44 Monitor Salary: $0.00 Clerical Support Salary: $531.96 Printing, Postage, Phone: $ 0.00 Office Supplies: $ 0.00 Communication: $ 0.00 Transportation: $ 0.00 Audit Costs/ Legal Fees: $ 0.00 Other: $ 0.00 Total Administrative Costs $1,159.40 Projected Reimbursement Operational $30,519.00 Administrative $1,159.40 Total Projected Reimbursement $31,678.40 http://fnmcnpwebprd.fldoe.org/floridaprd/Sfsp/BudgetDetail.asp?MenultemId=21&Mode=... 5/17/2004 Florida Department of Education " & Session("SponsorTitleDsc") & " SFSP Budget Page 2 of 2 '*Meal information displayed is based on'application values from the last time the budget was saved. Created By: 04-0993 on: 05/13/2004 Modified By: 04-0993 on 05/14/2004 Back ik Back to Budget List. Code Description Type 2306 Amount for'Expected federal reimbursement for administration' should not exceed the Warning administrative cost budget. T5093 http://fmncnpwebprd.fldoe.org/floridaprd/Sfsp/BudgetDetail.asp?Menultemld=21&Mode=... 5/17/2004 " Florida Department of Education - Sponsor Site Application Page 1 of 3 Applications > Applications: View Site Application 2003 - 2004 Revision # 0 Agreement Number Sponsor Name Site Name ® 04-0993 City of Dania Patrick J. McIi Park____ Street Address 1. Address 1: 2901 S.W. 52ND. ST. 2. Address 2: 3. City: DANIA County: BROWARD State: FL Zip: 33004 4. Is this site: t74� Urban Rural Site Supervisor Title First Name Last Name 5. Name: Ms. Terri Weech 6. Email: tweech@ci.dania-beach.fl.us 7. Title: Coordinator 8. Phone: (954) 924-3694 Ext: Fax: (954) 924-3629 Alternate Contact Title First Name Last Name 9. Name: Ms. Mehgan Heaps 10. Phone: (954) 924-3625 Ext: Fax: (954) 924-3629 Eligibility Information 11. Indicate method for determining Site Eligibility (select one): Open Sites (�! Open Site (7, Open Restricted (7 Special Restricted Open (h Continuous School Calendar Name of Qualifying School: Attucks Middle 72.30% Census Tract No. Block Group No. Enrolled Sites ( Closed Enrolled Camps: r" Residential Camp (` Non-Residential Camp Projected number of children enrolled: Projected number of children eligible for free and reduced meals: Income Eligibility Forms are: (7= Collected (7- On file (7-, Other Certified Sites (7, Migrant College Program: (,-, NYSP (National Youth Sports Program) (7 CROP (College Reach Out Program) r" Upward Bound Method of Meal Preparation http://fnmcnpwebprd.fldoe.org/floridaprd/Sfsp/SiteApp.asp?Menultemld=21&Mode=V&S... 5/19/2004 Florida Department of Education - Sponsor Site Application Page 2 of 3 12. Indicate method for Preparing Meals (select one): Self Prep On-Site Self Preparation t" Satellite Self Preparation Vended (F School Food Authority Vended C. Food Service Management Company Vended Site Operating [days and Dates 13. Operating Dates Beginning Date 06/11/2004 Ending Date 08/13/2004 14. Days of the week meals are served Sun Mon Tue Wed Thu Fri Sat �' ry—J, �' 15. Number of Operating Days Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Total 0 0 0 0 0 0 0 0 14 21 10 0 45 Hours Meals Served 16. Times meals are served and Average Daily Attendance Meal Begin End ADA Max Breakfast 0 ® A.M. Snack 0 Lunch 11:00 am 01:00 pm 140 150 P.M. Snack 03:00 pm 04:00 pm 140 150 Supper 0 Meal Service 17. Meals transported to this site? C- Yes f ' No If Yes, complete the information below. Food Preparation Facility Name: Hollywood Hills High School Phone: (954) 985-5225 Personnel / Monitoring Information 18 If site is new, Sponsor Representative who conducted pre-operational visit: Date of Pre-operational visit: 19. Site Personnel working with the SFSP: Number of Persons r 1-3 6, > 3 Number of Hours t" 1-4 f > 4 Miscellaneous Questions 20. Arrangements have been made for food service during i!, Yes No inclement weather. 21. Food is held at proper temperature or served within l+ Yes f No one hour of delivery. http://fnmcnpwebprd.fldoe.org/floridaprd/Sfsp/S 1teApp.asp?Menultemld=21&Mode=V&5... 5/19/2004 Florida Department of Education - Sponsor Site Application Page 3 of 3 22. Leftovers are refrigerated or returned to preparation Yes (7 No kitchen. 23. Access to means of communication? 0:, Yes No 24. Site personnel will notify sponsor of necessary meal {: Yes t"` No count or menu adjustments for sites. Certification I certify this site has been visited, the information on this form is true and correct to the best of my knowledge and that this site meets eligibility requirements as defined in 7 CFR 225. I understand this information is being given in connection with the receipt of federal funds; and that deliberate misrepresentation may subject me to prosecution under applicable state and federal statutes. Created By: 04 0993 on: 05/13/2004 Modified B � .. y. 04-0993 on. 05/14/2004 < Site Li St Back to Site Application List. SFSP - F2 ESE 197 • http://fnmcnpwebprd.fldoe.org/floridaprd/Sfsp/SiteApp.asp?Menultemld=21&Mode=V&S... 5/19/2004 Florida Department of Education - Sponsor Site Application Page 1 of 3 Applications > Applications: View Site Application 2003 - 2004 Revision # 0 Agreement Number Sponsor Name Site Name • 04-0993 City of Dania C.W. Thomas _ Street Address 1. Address 1: 800 N.W. 2ND ST. 2. Address 2: 3. City: DANIA County: BROWARD State: FL Zip: 33004 4. Is this site: Ctl Urban Rural Site Supervisor Title First Name Last Name 5. Name: Ms. Mehgan Heaps 6. Email: mheaps@ci.dania-beach.fl.us 7. Title: Manager 8. Phone: (954) 924-3692 Ext: Fax: Alternate Contact Title First Name Last Name 9. Name: Ms. Bonnie Temchuk 10. Phone: (954) 924-3613 Ext: Fax: (954) 921-2604 Eligibility Information 11. Indicate method for determining Site Eligibility (select one): Open Sites i7tf Open Site (7, Open Restricted (7 Special Restricted Open (7, Continuous School Calendar Name of Qualifying School: COLLINS ELEM 89.8011/o Census Tract No. Block Group No. Enrolled Sites (7 Closed Enrolled Camps: Residential Camp (7, Non-Residential Camp Projected number of children enrolled: Projected number of children eligible for free and reduced meals: Income Eligibility Forms are: (7 Collected t*� On file r, Other Certified Sites C Migrant College Program: (7, NYSP (National Youth Sports Program) f E CROP (College Reach Out Program) ( Upward Bound Method of steal Preparation http://fmncnpwebprd.fldoe.org/floridaprd/Sfsp/SiteApp.asp?Menultemld=21&Mode=V&S... 5/17/2004 Florida Department of Education - Sponsor Site Application Page 2 of 3 12. Indicate method for Preparing Meals (select one): Self Prep r On-Site Self Preparation (7 Satellite Self Preparation Vended t� School Food Authority Vended C`° Food Service Management Company Vended Site Operating Bays and Dates 13. Operating Dates Beginning Date 06/11/2004 Ending Date 08/13/2004 14. Days of the week meals are served Sun Mon Tue Wed Thu Fri Sat 15. Number of Operating Days Oct Nov Dec Jan Feb Mar Apr May Jun Jul AugSep Total 0 0 0 0 0 0 0 0 14 21 10 0 45 Flours Meals Served 16. Times meals are served and Average Daily Attendance Meal Begin End ADA Max Breakfast 150 A.M. Snack 0 Lunch 11:30 am 12:00 pm 125 150 P.M. Snack 02:30 pm 03:00 pm 125 150 Supper 0 Meal Service 17. Meals transported to this site? (7Z Yes C`, No If Yes, complete the information below. Food Preparation Facility Name: Hollywood Hills High School Phone: (954) 985-5225 Personnel / Monitoring Information 18 If site is new, Sponsor Representative who conducted pre-operational visit: Date of Pre-operational visit: 19. Site Personnel working with the SFSP: Number of Persons C'3 1-3 rt > 3 Number of Hours C`_ 1-4 6' > 4 Miscellaneous Questions 20. Arrangements have been made for food service during rt, Yes C No inclement weather. 21. Food is held at proper temperature or served within ry Yes r No one hour of delivery. http://fnmcnpwebprd.fldoe.org/floridaprd/Sfsp/SiteApp.asp?Menultemld=2I&Mode=V&S... 5/17/2004 Florida Department of Education - Sponsor Site Application Page 3 of 3 22. Leftovers are refrigerated or returned to preparation �= Yes (7) No kitchen. • 23. Access to means of communication? C= Yes C= No 24. Site personnel will notify sponsor of necessary meal rF, Yes f" No count or menu adjustments for sites. Certification I certify this site has been visited, the information on this form is true and correct to the best of my knowledge and that this site meets eligibility requirements as defined in 7 CFR 225. I understand this information is being given in connection with the receipt of federal funds; and that deliberate misrepresentation may subject me to prosecution under applicable state and federal statutes. Created By: 04-0993 on: 05/14/2004 Modified By: 04-0993 on: 05/14/2004 List Back to Site Application List. SFSP - F2 ESE 197 http://fnmcnpwebprd.fldoe.org/floridaprd/Sfsp/SiteApp.asp?MenultemId=21&Mode=V&S... 5/17/2004 J N aa) E m m T C t0 C m N O1`� m L ) N y O y 0 0 O E L- (Ca O C . V m m o a C N o0 m 0 O m Q a O N N p O m O c9 co p C m N y O N a . VV o E 0 m N E-o.E - N 3.0 c cm y E ` c a c aci o>� o c o m FWWpq A L m N c N E v w m w°L a E ° ° a"�_a E c a m "'� N m d Q �) a �Q:� NaL= m.4r U E °' m Ea 31� U m. 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E 'E -0 c N E O a - C z a L Q > m -OLcl: o_ L CL 3 IEW E C C C U N O ON ~ 1 7 dW Q am Mpp_ NCC Q 7 E O E N fn N O U. - C O (c, Ucn O o 0 7 C-p�m C O 01- C m m p 3 Off•- U P Y .QQ 7 N i j > L N�"�•0 N N w C C U N m E a° U N r H c O E C 2 N m m O c 'm L � m c c nm mm a N m O y N� O > .L...r c 0 Q L (9 C C a L m ° U O C U L - m v = n._ ,� O C m m (o O maoa" mac - m - C c n'-> m � Ea= � L� > n � � o Eo L 'O l6 C Co'a --c m d N U c m L a c L L 3 Q �O L Co o N m 0.- E N L O N C N w U U 7 3 : Q,► m p co Fo U N O�N 2 z O E E cc 7 E C p.N `y E p cLi y w U C O n m m 7 m m m N n N N >_ Q (��nn O vl •VL 7~ my tv°� Eac°- 3 � a: Z Ec @ N aaii6 ` aE >��2 O VV 3 E a m n Ornc o c> z c mL ° E `° c N °' c m ° O O N N 7 m c t- ° m c E ° N- CL m E c o o n7 aE w. o- N E E � o m ` OfmOo O ' O 3 - w m 3 jrnamQEN a aD�om2cn � c �C ' momu U7 U) E L 4:-o c N C O O " QC 2 d C Om ON -c -0 C (0 (0 N N t7n Ly C O C N E O) m U 7 m O N Q E ,cp c E c U (n:S Q a m _ c a A n p E 3 C L L E E 1O o c N m aci3a~ m cmE = om N m day °L mEmTzEo3 �- U (m c m C N�.? o- N 8,Q C O O E 7 O E m O)E Q O0 O E M w m 0 0) C V > Q C N N ,p N N U f0 - NCNma a� o7oE O C 7 CpM L`t ani� a L u),r cl n CD nn N m U U H 3...�2 HO oW (nQ m c U) N N V U a O- T O O` m w lL 0 w(n FLORIDA DEPARTMENT OF EDUCATION FOOD AND NUTRITION MANAGEMENT SUMMER FOOD SERVICE PROGRAM FOR CHILDREN FREE MEAL POLICY STATEMENT The ©-r .naoi,CL lelp-acx Agreement Number: 04- 013 9 3 assures Food and Nutrition Management Services that all children in attendance are served the same meal(s) at no charge, regardless of race, color, sex, disability, age or national origin, and there is no discrimination in the course of the food service. Assurance is hereby given that we made available to the informational media serving the area(s) from which our Institution draws its attendance, a public release announcing the policy as stated above. 1,3o c2 Sig atur of Sponsor R presentative Date Signature of State Representative Date • �111E S� SFSP-S3 Revised 12/03 ��� Please return completed compliance review and supporting documents to: Food and Nutrition Management FLORIDA DEPARTMENT OF EDUCATION Florida Department of Education FOOD AND NUTRITION MANAGEMENT 325 Wesl Gaines Street,Room 1032 SUMMER FOOD SERVICE PROGRAM FOR CHILDREN Tallahassee,Florida 32399 0400 17(850)245-0481, Suncom2050461 PREAWARD NONDISCRIMINATION COMPLIANCE REVIEW FORM Retain a copy for your files. Completion of the form is required by FNS Instruction 113- Name and Address of Sponsor: 8 issued by the U.S. Department of Agriculture in order to () ;-" at^ L-,an%C� Ica c..� participate in the Summer Food Service Program for no "I n, & c-ti (51V4 Children. Failure to complete this form will result in a denial Gm N , CL 3 300q- of the Summer Food Service Program application. Please Answer the Following Questions I. Estimated ily Meal Partici ation by Racial/Ethnic Grou : Meal White Black Asian/ American Indian Type Non- Non- Hispanic Pacific or Multiracial TOTAL Hispanic Hispanic Islander Alaskan Native Breakfast A.M. Supplement Lunch 50 50 2-0 20 140 P.M. Supplement 50 20 ZO 1 40 Supper II. Describe efforts to be used to assure that minority populations have an equal opportunity to participate: ha,,►an&cool s are re-�2 ;re -� gaL4-� a- N�,1diS�r►nnina��z,n r�iC v� 5umm� 5�� I�as beep -I�a►r acco�d►.Ir��1 rued a.rf_ kLIA -44�t; 0-1� 6%s 0 III. Describe efforts to be used to contact minority and grassroots organizations about the opportunity to participate: i ► I, u a u . 2 r an-A re A '001 rJVI 'e r d a dlsplaue-A ai Ag Hark -Pxc'- firmsamd 64y Nall, IV. List federal agencies other than the U.S, Department of Agriculture that provide financial support to your organization: A Signa re of Sfonsor Representa ' e A-/4a 1.34 ©o Date Sign6d TILE 0SFSP-S1 - ��b we Contact: Parks and RecreationDepartrnent • 9 - a 100 W.Dania Beach Blvd. • - - o • Dania,Florida Bra,% Re FREE SUMMER LUNCH PROGRAM The City of Dania Beach will be participating in the Summer Food Service Program from June 13, 2004 through August 6, 2004. Nutritionally balanced meals will be provided to all children regardless of race, color, sex, disability, age, or national origin during summer vacation when school breakfasts and lunches are • not available. All children 18 years old and younger are eligible for meals at no charge and there will be no discrimination in the course of the meal service. The summer feeding sites will be located at Patrick J. Meli Park, 2901 S.W. 52nd Street, Dania Beach and C.W.Thomas Park, 800 N.W. 2rd Street, Dania Beach. Lunches will be provided Monday through Friday from 11 am to 1 pm. • n i REM 0 i9t FLORIDA May 13, 2004 Mr. Howard Rosen, Environmental Administrator Broward County Health Department 780 S.W. 24d' Street Ft. Lauderdale, FL 33315 Dear Mr. Rosen: The City of Dania Beach Parks and Recreation Department will participate in the Summer Food Services Program, administered by the Florida Department of Education,Food and Nutrition Management, Tallahassee, Florida, from June 14, 2004 through August 6, 2004. Pre-packaged meals will be transported in refrigerated trucks by an approved vendor. Meals that are transported will be refrigerated at each site until served. Site personnel will ensure all food items remain at acceptable temperatures before serving to children. 0 Approximately 5,500 nutritionally approved unitized meals and beverages will be served each day during this program. A Summer Food Service Program workshop has been scheduled for Thursday, June 10, 2004, from 5pm to 8pm, at Patrick J. Meli Park, 2901 S.W. 52°d Street, Dania Beach. The summer feeding sites will be located at Patrick J. Meli Park, 2901 S.W. 52"d Street, Dania Beach and C.W. Thomas Park, 800 N.W. 2"d Street, Dania Beach. Sincerely, Mehgan E. Heaps Sr. Rec. & Facility Program Manager "Broward's First City" 100 West Dania Beach Boulevard Dania Beach, Florida 33004 Phone: (954) 924-3600 www.ci.dania-beach.fl.us FLORIDA DEPARTMENT OF EDUCATION ® FOOD AND NUTRITION MANAGEMENT SUMMER FOOD SERVICE PROGRAM FOR CHILDREN Authorized Signature Form Institution Name: ( 14V O't bao;e c c.' - Agreement Number: ©q - O q Q;3 Please type or print the names,titles,and signatures of persons authorized to sign the claim for reimbursement. All authorized signers,authorized representatives,and program contacts must be legal employees of the institution. AUTHORIZED SIGNERS: me'kaan Re-C PrMro4ll °�ru 11±1 —L Type of Print Name Type or Mnt Title t-j&,Ka;jer Signature e.r-r► V�p.ec�� ec�ec��i . Type of Print Name _Type or PhAnt Title Si ure /for-' Ike rf- Z ,�1�3 � Type of Print Name Type or Print Title Signature Type of Print Name Type or Print Title Signature I certify that the persons above are authorized to sign the claim for reimbursement. AUTHORIZED REPRESENTATIVE: saw L Type or Print Name&Title of Authorized Representative Signature of Authoriz epresentative Date signed SFSP-F15 Page 1 of 1 12/03 FLORIDA DEPARTMENT OF EDUCATION FOOD AND NUTRITION MANAGEMENT SUMMER FOOD SERVICE PROGRAM FOR CHILDREN SFSP INTERNAL CONTROLS Federal and state requirements mandate that SFSP participants maintain any information pertaining to the program for three (3)years plus the current fiscal year. Failure to retain records is a serious deficiency. Refer to SFSP Administrative Guidance, Chapter 5 and 7 CFR 225.6 on regulations pertaining to recordkeeping regulations. Please list the name and address of the location where you will maintain SFSP records. Also give the name and the phone number of the individual(s)who can access these records: I.00AT70,xi : -T• R0.f �?`Ommvn�t�r (2v. q01 N.F. DaM�a &At k 1 FL 3300� (-ONTA(-7-S; ear W eec k (95y) q Zq-3(098 f4,C- ,,,, f-&ys (95q)9-2'q-3 cP 2s Give the specific location of the files(i.e.,"in the file cabinet in the director's office"): /.oc,�,4t d r`n 5MOL l l to-n-r4Ve O Ce (-o e-m) ►n e..l o.,.J be4wQe i res4r6-0m s . Will ALL records be maintained at the location above? Yes ❑ No If No,please list additional details about what years and where records are stored: Do you participate in the SFSP in an states other than Florida' ❑ Yes No If Yes,please indicate the other state(s)you currently have programs: I understand that if I no longer participate in the SFSP,I must still maintain SFSP records for three years, plus the current year. If an audit is being conducted,I will maintain the records longer than three years. _ �i4 boy Authorized Person Date SFSP-F14 Page 1 of 1 12/03