Exhibit_H_Youth_Protection_Compliance_Certification.pdf

CITY OF DORAL

EXHIBIT H

YOUTH PROTECTION COMPLIANCE CERTIFICATION

ITN No. 2026-25 — Youth Soccer Programming at Doral Central Park

Required pursuant to Section 2.5.6 of the Solicitation. Submit on or before [January 31] of each year, before the first season under any renewal or extension, and within five (5) business days of any change rendering a prior certification inaccurate.

PART 1 — PROVIDER INFORMATION

Provider / Legal Entity Name:

Authorized Officer (Name & Title):

Address:

Phone / Email:

Certification Period: From:

Certification Period – From: To:

PART 2 — CERTIFICATIONS

The undersigned authorized officer of the Provider certifies, under penalty of perjury pursuant to § 92.525, Florida Statutes, that each of the following is true and correct as of the date signed:

☐ 1. All Covered Personnel (as defined in Section 2.5.1 of the Solicitation) have successfully completed FDLE/FBI Level 2 fingerprint-based background screening in accordance with Section 2.5.2, and results have been furnished to the City's designated representative.

☐ 2. No Covered Personnel is registered, or required to register, as a sexual offender or sexual predator in any jurisdiction, and no Covered Personnel has been found guilty of, pled guilty or nolo contendere to, or been adjudicated delinquent for any offense listed in § 435.04(2), Florida Statutes, or a substantially similar offense in another jurisdiction (Section 2.5.3).

☐ 3. National Sex Offender Public Website (NSOPW) and FDLE Sexual Predator/Offender registry searches have been performed for every Covered Personnel member before each season and at least [annually], and results are retained (Section 2.5.2(D)).

☐ 4. City-approved photo identification badges meeting the Exhibit C specifications have been issued to all Covered Personnel, are current, and are worn at all times at City Facilities (Section 2.5.4).

☐ 5. The Provider's written youth protection policy is in effect, has been approved by the City, and includes the two-adult rule, electronic communication limits, restroom/locker room procedures, an annually signed code of conduct, and complaint/allegation response procedures (Section 2.5.5(A)).

☐ 6. All Covered Personnel have completed training on recognizing and reporting child abuse and on the youth protection policy before the first season and [annually] thereafter; training records are maintained (Section 2.5.5(B)).

☐ 7. All Covered Personnel understand their mandatory reporting obligations under § 39.201, Florida Statutes, including reporting to the Florida Abuse Hotline (1-800-96-ABUSE) and notifying the City.

☐ 8. The attached roster of all badged Covered Personnel is complete and current, including screening dates, badge expiration dates, and roles (Section 2.5.4(C)).

☐ 9. All arrests, charges, credible allegations, complaints, and incidents involving minors and any Covered Personnel during the preceding certification period are disclosed in Part 4 below (or none have occurred).

☐ 10. The Provider is in full compliance with all other requirements of Section 2.5 of the Solicitation.

PART 3 — ROSTER OF BADGED COVERED PERSONNEL (attach continuation pages as needed) List every badged Covered Personnel member. Additional rows may be added or a separate roster attached.

No. Full Name Role Level 2

Screening Date Registry Search Date

Badge No. Badge Expiration

PART 4 — DISCLOSURE OF INCIDENTS

Describe all arrests, charges, credible allegations, complaints, and incidents involving minors and any Covered Personnel during the certification period, and the action taken (24-hour removal/notification per Section 2.5.3(C) where applicable). If none, write “NONE.” Use continuation pages if necessary.

PART 5 — ACKNOWLEDGMENT AND SIGNATURE

I understand that this certification is submitted under penalty of perjury pursuant to § 92.525, Florida Statutes; that any false, incomplete, or inaccurate statement constitutes a material breach of the Agreement entitling the City to suspend Program activity, require removal of personnel, withhold season approval, and/or terminate the Agreement for default without opportunity to cure (Section 2.5.7); and that the City may audit all screening, registry, training, and badging records at any time.

Signature of Authorized Officer:

Date: ______________________________

Printed Name: ______________________________ Title: ______________________________ Notarized / Witnessed by (if required by the City):

Date: ______________________________

Received by (City use only):

Date: ______________________________

Supporting documentation attached: ☐ Screening results ☐ Registry search records ☐ Training records ☐ Youth protection policy ☐ Badge roster Bracketed items [ ] to be finalized by the City before issuance. Statutory citations to be confirmed by the City Attorney.