ADMINISTRATOR USE ONLY

CONTRACT SUMMARY FORM

City Primary Contact: Julio Brea Vendor: Diversified Group Consulting

Secondary Contact: Contact: Neal de Jesus
Public Works & Engineering Address: 5722 S.flamingo Road, Suite 416
Department:
Phone Number: 305 -224 4842
- City: Cooper City State: FL Z
33330

Dept. Fax: 305 -224 4789

- Phone: 954-699 0588
-
Primary Email: jbrea @cityofhomestead.com Fax:

Secondary Email: E mail:

- nealdj @comcast.net

1. Type of Agreement (Ex: Maintenance, Consulting, etc.):Professional Services

2. Does this agreement replace an existing contract: Yes [ M *
If yes prior Contract #: _

3.Briefly explain the purpose or description of the scope of service of this Contract:

Fire consulting services as needed for the TemiDorary Police Department

4. Is Insurance required?K'
[ Yes [: ji No * Ifyes, who is required to have it?vendor
Please note it is the Departments responsibility to acquire Risk Approval)

5. Term of Contract: Start Date: upon execution End Date: upon completion

6. Total Value of Contract: $00

24999.
, Paid to : [ji City *' Vendor

7. Monies are due: Circle

( 017e) VM011thly QI Quarterly Ui Annually Other: upon invoice

S. How much money is due or owed per circled item above: $ per Invoice

9. Account Number(s):
I 043.5 1-3~
o VV I
10. If monies are paid to City, does Vendor pay Sales Tax (7 %): U Yes ; No

11. Do Late Fees Apply? U Yes ii No Percentage of Late Fees/ How much:
TBD
12. All agreements involving payment to vendor must be accompanied by a requisition. Req. #
n05 1vz ,le a
C 4; "
I Shp Q
- /

City of Homestead * 650 N.E.22 Terrace, Homestead, FL 33033

 David Wolpin
13. Was this agreement drafted/ reviewed by a City Attorney? [a No WIYes: If yes, whom?
Right to Audit"clause included: 1:1 No Ki Yes: If not, please obtain City Manager's
authorization. The "Right to Audit"clause is included in the RFQ201307 agreement.
City Manager's Authorization: Finance Authorization:

Please note it is the Departments responsibility to acquire Legal approval)

14. Other than the expiration of this agreement; are there any other dates that you want to be notified by e m
- ail
on? : * Yes No; if yes, please list dates and reason on lines below:

15. Was this item approved by Council? we

If yes, please provide complete packag/

16. Would you like the agreement sent mail or by FedEx. Regular Mall
If by FedEx please provide account nu

Form Prepared By: sherry Auer Date: /

Dept. Head Approval: Date:

HR Dept. Approval (Employee related contrVcts): tJ A

/ te:

Risk Management: J o,;

hzoI/ Date:

LT.S Approval (for Technology Contracts) Date:

Procurement & Contracts - Date: ', - , 27A_

l

For Official Use Only

Completed & Appropriate Packet Submitted to Procurement on: of

J,q 1 &
Reviewed By: bn Contract No. 15 -P V- I

Review: Date:1`
(
Final Revicw.m Date:

City of Homestead * 650 N.E.22 Terrace, Homestead, FL 33033