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HomeMy WebLinkAboutAG 17-016I I RETURN TO: Sarah Bridgeford EXT: 2651
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV: CD /CS
2. ORIGINATING STAFF PERSON: _SARAH BRIDGEFORD EXT: 2651 3. DATE REQ. BY:
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT
❑ REAL ESTATE DOCUMENT
❑ ORDINANCE
❑ CONTRACT AMENDMENT (AG #):
❑ OTHER
❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ MAINTENANCE AGREEMENT
x HUMAN SERVICES / CDBG
❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ RESOLUTION
❑ INTERLOCAL
5. PROJECT NAME: REACH OUT HOMELESS SHELTER
6. NAME OF CONTRACTOR: _CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
ADDRESS: TELEPHONE
E -MAIL: FAX:
SIGNATURE NAME: TITLE
7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE X ALL
OTHER REFERENCED EXHIBITS x PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
8. TERM: COMMENCEMENT DATE: 01/01/2017 COMPLETION DATE: 12/31/2018
9. TOTAL COMPENSATION $ 49,500.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES ❑ NO W YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE BY (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
❑ PURCHASING: PLEASE CHARGE TO: 001- 7300 - 083 - 562 -10 -410
10. DOCUMENT /CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW
• R C, I'N (II-
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE:
COUNCIL APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: I /5 -420/ a- DATE REC °D: i/.944/A01-4—
$ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ LAW DEPARTMENT
O- SfGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
INITIAL / DATE SIGNED
❑ ASSIGNED AG# AG# -0 1 (o
❑ SIGNED COPY RETURNED
COMMENTS:
DATE SENT: Vet /) }
Vecleral Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway.. com
HUMAN SERVICES AGREEMENT
FOR
REACH OUT HOMELESS SHELTER
This Human Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal
corporation ( "City "), and Catholic Community Services of Western Washington, a Washington nonprofit
corporation ( "Agency "). The City and Agency (together "Parties ") are located and do business at the below
addresses which shall be valid for any notice required under this Agreement:
CATHOLIC COMMUNITY SERVICES OF
WESTERN WASHINGTON:
Dan Wise
100 23rd Avenue South
Seattle, WA 98144
(206) 324 -5401
danw @ccsww.org
The Parties agree as follows:
CITY OF FEDERAL WAY:
___1_ 1 • 1 r
5
•alway.com
1. TERM. The term of this Agreemen 1, 2017 and terminating on
December 31, 2018 ( "Term "). Funding for ti ipon satisfactory Agreement
performance during the first year of the Agree] -eement may be extended for
additional periods of time upon the mutual wr
2. SERVICES. The Agency shall perfo: hibit A, attached hereto and
incorporated by this reference ( "Services "), in al practices for other similar
services within the Puget Sound region in effeL ............ Jcl viVCS die penormea to me City's satisfaction, within the
time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee. The Agency warrants that it
has the requisite training, skill, and experience necessary to provide the Services and is appropriately accredited and licensed by
all applicable agencies and governmental entities, including but not limited to obtaining a City of Federal Way business
registration. Services shall begin immediately upon the effective date of this Agreement. Services shall be subject, at all times,
to inspection by and approval of the City, but the making (or failure or delay in making) such inspection or approval shall not
relieve the Agency of responsibility for performance of the Services in accordance with this Agreement, notwithstanding the
City' s knowledge of defective or non - complying performance, its substantiality or the ease of its discovery.
3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party
thirty (30) days' written notice at its address set forth above. The City may terminate this Agreement immediately if the Agency
fails to maintain required insurance, breaches confidentiality, or materially violates Section 12, and such may result in
ineligibility for further City agreements.
4. COMPENSATION.
4.1 Amount. In return for the Services, the City shall pay the Agency an amount not to exceed a maximum amount
and according to a rate or method as delineated in Exhibit B, attached hereto and incorporated by this reference. The City shall
reimburse the Agency only for the approved activities and in accordance with the procedures as specified in Exhibit B. The
Agency shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction resulting from this
Agreement.
HUMAN SERVICES AGREEMENT - 1 4/2015
CITY OF
.'.�,�.., Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway. com
4.2 Method of Payment. On a quarterly basis, the Agency shall submit to the City an invoice for payment on a form
provided by the City along with supporting documentation for costs claimed in the invoice and all reports as required by this
Agreement. Payment shall be made on a quarterly basis by the City only after the Services have been performed and within
forty -five (45) days after the City's receipt and approval of a complete and correct invoice, supporting documentation, and
reports. The City will use the quantity of Services actually delivered, as reported on the Agency's reports, as a measure of
satisfactory performance under this Agreement. The City shall review the Agency' s reports to monitor compliance with the
performance measures set forth in Exhibit A. Should the Agency fail to meet the performance measures for each quarter, the
City reserves the right to adjust payments on a pro rata basis at any time during the term of this Agreement. Exceptions may be
made at the discretion of the City's Human Services Manager in cases where circumstances beyond the Agency's control impact
its ability to meet its service unit goals and the Agency has shown reasonable efforts to overcome these circumstances to meet its
goals. If the City objects to all or any portion of the invoice, it shall notify the Agency and reserves the option to pay only that
portion of the invoice not in dispute. In that event, the Parties will immediately make every effort to settle the disputed portion.
4.3 Final Invoice. The Agency shall submit its final invoice by the date indicated on Exhibit B. If the Agency's
final invoice, supporting documentation, and reports are not submitted by the last date specified in Exhibit B, the City shall be
relieved of all liability for payment to the Agency of the amounts set forth in said invoice or any subsequent invoice; provided,
however, that the City may elect to pay any invoice that is not submitted in a timely manner
4.4 Budget. The Agency shall apply the funds received from the City under this Agreement in accordance with the
line item budget set forth in Exhibit B. The Agency shall request in writing prior approval from the City to revise the line item
budget when the cumulative amount of transfers from a line item in any Project/Program Exhibit is expected to exceed ten
percent (10 %) of that line item. Supporting documents are necessary to fully explain the nature and purpose of the revision, and
must accompany each request for prior approval. All budget revision requests in excess of 10% of a line item amount shall be
reviewed and approved or denied by the City in writing.
4.5 Non- Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this
Agreement for any future fiscal period, the City will not be obligated to make payments for Services or amounts incurred after
the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Services for which
funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies.
5. INDEMNIFICATION.
5.1 Agency Indemnification. The Agency agrees to release, indemnify, defend, and hold the City, its elected
officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all claims,
demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities,
taxes, losses, fines, fees, penalties expenses, attorney' s fees, costs, and/or litigation expenses to or by any and all persons or
entities, including, without limitation, their respective agents, licensees, or representatives arising from, resulting from, or in
connection with this Agreement or the performance of this Agreement, except for that portion of the claims caused by the City's
sole negligence. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in
the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the
concurrent negligence of the Agency and the City, the Agency's liability hereunder shall be only to the extent of the Agency's
negligence. Agency shall ensure that each subcontractor shall agree to defend and indemnify the City, its elected officials,
officers, employees, agents, representatives, insurers, attorneys, and volunteers to the extent and on the same terms and
conditions as the Agency pursuant to this paragraph. The City's inspection or acceptance of any of Agency's work when
completed shall not be grounds to avoid any of these covenants of indemnification.
5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Agency waives any
immunity that may be granted to it under the Washington State industrial insurance act, Title 51 RCW, solely for the purposes
of this indemnification. Agency's indemnification shall not be limited in any way by any limitation on the amount of damages,
compensation or benefits payable to or by any third party under workers' compensation acts, disability benefit acts or any other
benefits acts or programs. The Parties further acknowledge that they have mutually negotiated this waiver.
HUMAN SERVICES AGREEMENT 2 4/2015
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway. com
5.3 City Indemnification. The City agrees to release, indemnify, defend and hold the Agency, its officers, directors,
shareholders, partners, employees, agents, representatives, and subcontractors harmless from any and all claims, demands,
actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, losses,
fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including
without limitation, their respective agents, licensees, or representatives, arising from, resulting from or connected with this
Agreement to the extent solely caused by the negligent acts, errors, or omissions of the City.
5.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement with
respect to any event occurring prior to such expiration or termination.
6. INSURANCE. The Agency agrees to carry insurance for liability which may arise from or in connection with the
performance of the services or work by the Agency, their agents, representatives, employees or subcontractors for the duration of
the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows:
6.1. Minimum Limits. The Agency agrees to carry as a minimum, the following insurance, in such forms and with
such carriers who have a rating that is satisfactory to the City:
a. Commercial general liability insurance covering liability arising from premises, operations, independent
contractors, products - completed operations, stop gap liability, personal injury, bodily injury, death, property damage, products
liability, advertising injury, and liability assumed under an insured contract with limits no less than $1,000,000 for each
occurrence and $2,000,000 general aggregate.
b. Workers' compensation and employer's liability insurance in amounts sufficient pursuant to the laws of
the State of Washington;
c. Automobile liability insurance covering all owned, non - owned, hired and leased vehicles with a
minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for bodily
injury, including personal injury or death, and property damage.
6.2. No Limit of Liability. Agency's maintenance of insurance as required by the agreement shall not be
construed to limit the liability of the Agency to the coverage provided by such insurance, or otherwise limit the City's
recourse to any remedy available at law or in equity. The Agency' s insurance coverage shall be primary insurance as
respect the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall be excess of the
Agency' s insurance and shall not contribute with it.
6.3. Additional Insured, Verification. The City shall be named as additional insured on all commercial general
liability insurance policies. Concurrent with the execution of this Agreement, Agency shall provide certificates of insurance
for all commercial general liability policies attached hereto as Exhibit C and incorporated by this reference. At the City's
request, Agency shall furnish the City with copies of all insurance policies and with evidence of payment of premiums or
fees of such policies. If Agency's insurance policies are "claims made," Agency shall be required to maintain tail coverage
for a minimum period of three (3) years from the date this Agreement is actually terminated or upon project completion and
acceptance by the City.
6.4 Survival. The provisions of this Section shall survive the expiration or termination of this Agreement.
7. CONFIDENTIALITY. All information regarding the City obtained by Agency in performance of this Agreement shall
be considered confidential subject to applicable laws. Breach of confidentiality by the Agency may be grounds for immediate
termination. All records submitted by the City to the Agency will be safeguarded by the Agency. The Agency will fully
cooperate with the City in identifying, assembling, and providing records in case of any public records disclosure request.
8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design
specifications, records, files, computer disks, magnetic media or material which may be produced or modified by Agency while
performing the Services shall belong to the City upon delivery. The Agency shall make such data, documents, and files available
to the City and shall deliver all needed or contracted for work product upon the City's request. At the expiration or termination
of this Agreement all originals and copies of any such work product remaining in the possession of Agency shall be delivered to
the City.
HUMAN SERVICES AGREEMENT 3 4/2015
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway.. com
9. BOOKS AND RECORDS. The Agency agrees to maintain books, records, and documents which sufficiently and
properly reflect all direct and indirect costs related to the performance of the Services and maintain such accounting procedures
and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Agreement.
These records shall be maintained for a period of six (6) years after the termination of this Agreement and may be subject, at all
reasonable times, to inspection, review or audit by the City, its authorized representative, the State Auditor, or other
governmental officials authorized by law to monitor this Agreement.
10. INDEPENDENT CONTRACTOR. The Parties intend that the Agency shall be an independent contractor and that the
Agency has the ability to control and direct the performance and details of its work, the City being interested only in the results
obtained under this Agreement. The City shall be neither liable nor obligated to pay Agency sick leave, vacation pay or any
other benefit of employment, nor to pay any social security or other tax which may arise as an incident of employment. Agency
shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the Services and work and shall utilize all protection necessary for that purpose. All work shall be done at
Agency's own risk, and Agency shall be responsible for any loss of or damage to materials, tools, or other articles used or held
for use in connection with the work. The Agency shall pay all income and other taxes due except as specifically provided in
Section 4. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide
a secondary or incidental benefit to the Agency, shall not be deemed to convert this Agreement to an employment contract.
11. CONFLICT OF INTEREST. It is recognized that Agency may or will be performing services during the Term for
other parties; however, such performance of other services shall not conflict with or interfere with Agency' s ability to perform
the Services. Agency agrees to resolve any such conflicts of interest in favor of the City. Agency confirms that Agency does not
have a business interest or a close family relationship with any City officer or employee who was, is, or will be involved in the
Agency's selection, negotiation, drafting, signing, administration, or evaluating the Agency's performance.
12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made possible
by or resulting from this Agreement or any subcontract, there shall be no discrimination by Agency or its subcontractors of any
level, or any of those entities' employees, agents, sub - agencies, or representatives against any person because of sex, age (except
minimum age and retirement provisions), race, color, religion, creed, national origin, marital status, or the presence of any
disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in
relationship to hiring and employment. This requirement shall apply to, but not be limited to, the following: employment,
advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including
apprenticeship. Agency shall comply with and shall not violate any of the terms of Chapter 49.60 RCW, Title VI of the Civil
Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Part 21, 21.5
and 26, or any other applicable federal, state, or local law or regulation regarding non - discrimination.
13. GENERAL PROVISIONS.
13.1 Interpretation and Modification. This Agreement, together with any attached Exhibits, contains all of the
agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no prior statements or
agreements, whether oral or written, shall be effective for any purpose. Should any language in any Exhibits to this Agreement
conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective captions of the Sections
of this Agreement are inserted for convenience of reference only and shall not be deemed to modify or otherwise affect any of
the provisions of this Agreement. Any provision of this Agreement that is declared invalid, inoperative, null and void, or illegal
shall in no way affect or invalidate any other provision hereof and such other provisions shall remain in full force and effect.
Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of the Agreement
and compliant with the terms of the Agreement, is hereby ratified as having been performed under the Agreement. No provision
of this Agreement, including this provision, may be amended, waived, or modified except by written agreement signed by duly
authorized representatives of the Parties.
13.2 Assignment and Beneficiaries. Neither the Agency nor the City shall have the right to transfer or assign, in
whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If the non-
HUMAN SERVICES AGREEMENT - 4 - 4/2015
CITY F
O
� Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway com
assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the
Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This
Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have
any right of action or interest in this Agreement based on any provision set forth herein.
13.3 Compliance with Laws. The Agency shall comply with and perform the Services in accordance with all
applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions, regulations,
rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation of the City's Ethics
Resolution No. 91 -54, as amended, occurs as a result of the formation or performance of this Agreement, this Agreement may
be rendered null and void, at the City's option.
13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which performance
is a factor. Adherence to completion dates set forth in the description of the Services is essential to the Agency's performance of
this Agreement. Any notices required to be given by the Parties shall be delivered at the addresses set forth at the beginning of
this Agreement. Any notices may be delivered personally to the addressee of the notice or maybe deposited in the United States
mail, postage prepaid, to the address set forth above. Any notice so posted in the United States mail shall be deemed received
three (3) days after the date of mailing. Any remedies provided for under the terms of this Agreement are not intended to be
exclusive, but shall be cumulative with all other remedies available to the City at law, in equity or by statute. The failure of the
City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any
option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect. Failure or delay of the City to
declare any breach or default immediately upon occurrence shall not waive such breach or default. Failure of the City to declare
one breach or default does not act as a waiver of the City's right to declare another breach or default. This Agreement shall be
made in, governed by, and interpreted in accordance with the laws of the State of Washington. If the Parties are unable to settle
any dispute, difference or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim,
shall be by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington,
unless the parties agree in writing to an alternative process. If the King County Superior Court does not have jurisdiction over
such a suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the
personal jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are
an inconvenient forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal
costs and attorney's fees and expenses incurred in defending or bringing such claim or lawsuit, including all appeals, in addition
to any other recovery or award provided by law; provided, however, however nothing in this paragraph shall be construed to
limit the Parties' rights to indemnification under Section 5 of this Agreement.
13.5 Execution. Each individual executing this Agreement on behalf of the City and Agency represents and warrants
that such individual is duly authorized to execute and deliver this Agreement. This Agreement may be executed in any number
of counterparts, each of which shall be deemed an original and with the same effect as if all Parties hereto had signed the same
document. All such counterparts shall be construed together and shall constitute one instrument, but in making proof hereof it
shall only be necessary to produce one such counterpart. The signature and acknowledgment pages from such counterparts may
be assembled together to form a single instrument comprised of all pages of this Agreement and a complete set of all signature
and acknowledgment pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement
shall be the "date of mutual execution" hereof.
[Signature page follows]
HUMAN SERVICES AGREEMENT - 5 4/2015
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway com
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY:
DATE: d2/3//1
CATHOLIC COMMUNITY SERVICES OF
WESTERN WASHINGTON:
By:
Printed Name:
Title:
DATE: / /t, `(7
STATE OF WASHINGTON )
COUNTY OF KING
ss.
ATTEST:
lerk, Stephanie Co
APPROVED AS TO FORM:
y, CMC
Acting City Attorney, J. Ryan Call
On this day personally appeared before me to me known to be the
\i 1(S2, Q ►mil 11 ' of G.I�c [ jC Mi ll i k'1/1 C.e$ that executed the foregoing
instrument, and acknowledged the said instrument to be tht free and voluntary act and deed of said corporation, for
the uses and purposes therein mentioned, and on oath stated that he /she was authorized to execute said instrument
and that the seal affixed, if any, is the corporate seal of said corporation.
GIVEN my hand and official seal this
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My commission expires j `?J
HUMAN SERVICES AGREEMENT - 6 - 4/2015
CITY OF
4.- Federal Way
EXHIBIT A
SERVICES
Project Summary
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway com
The Agency shall provide winter shelter in the City of Federal Way. The Agency shall ensure that services
provided with funding under this Agreement are made available to Federal Way residents.
Performance Measures
A. Number Served
The Agency agrees to serve, at minimum, the following unduplicated number of Federal Way residents with
Human Services funds:
B. Units of Service
The Agency agrees to provide, at minimum, the following units of service by quarter:
1st
Quarter
JAN. —
MARCH
2nd
Quarter
APRIL —
JUNE
2nd
Quarter
APRIL —
JUNE
4th
Quarter
ter
OCT. —
DEC.
3rd
Quarter
JULY —
SEPT.
4th
Quarter
OCT. —
DEC.
Total
No. of unduplicated Federal
Way persons assisted in 2017
16
0
382
0
0
16
32
No. of unduplicated Federal
Way persons assisted in 2018
16
0
0
382
16
32
B. Units of Service
The Agency agrees to provide, at minimum, the following units of service by quarter:
C. Definition of Services
1. Shelter/Number of Bednights: Number of bednights provided to homeless men and women in Federal Way.
HUMAN SERVICES AGREEMENT 1
HSA Exh 1/2017
lst Quarter
JAN. —
MARCH
2nd
Quarter
APRIL —
JUNE
3rd
Quarter
JULY —
SEPT.
4th
Quarter
ter
OCT. —
DEC.
Total
2017
1. Shelter/Number of Bednights
382
0
0
382
764
2018
1. Shelter/Number of Bednights
382
0
0
382
764
C. Definition of Services
1. Shelter/Number of Bednights: Number of bednights provided to homeless men and women in Federal Way.
HUMAN SERVICES AGREEMENT 1
HSA Exh 1/2017
4.- Federal Way
D. Performance Measure(s)
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835-7000
www cityoffederalway com
Outcome(s) to be reported:
1. Individuals and /or families will have secure housing, which includes permanent
housing, transitional housing, and moving in with family or friends.
Records
A. Project Files
The Agency shall maintain files for this project containing the following items:
1. Notice of Grant Award.
2. Motions, resolutions, or minutes documenting Board or Council actions.
3. A copy of this Agreement with the Scope of Services.
4. Correspondence regarding budget revision requests.
5. Copies of all invoices and reports submitted to the City for this project.
6. Bills for payment with supporting documentation.
7. Copies of approved invoices and warrants.
8. Records documenting that costs reimbursed with funding provided under this Scope are allowable.
Such records include, but are not limited to:
■ for personnel costs, payroll for actual salary and fringe benefit costs.
• for staff travel, documentation of mileage charges for private auto use must include: a)
destination and starting location, and b) purpose of trip; and
• for copy machine use, postage, telephone use, and office supplies when these costs are shared
with other programs and no invoice is available, log sheets or annotated invoices.
HUMAN SERVICES AGREEMENT 2 HSA Exh 1/2017
QTY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www.cityoffederalway.com
9. Documentation of client income. The Agency agrees to use the HUD Income Guidelines to report
income of clients served under this Agreement. Income guidelines may be adjusted periodically by
HUD. The Agency agrees to use updated Income Guidelines which will be provided by the City.
King County FY 2016 Income Limits Summary
Median
FY 2016
Income
Income
1
2
3
4
5
6
7
8
King
Limit
Person
Persons
Persons
Persons
Persons
Persons
Persons
Persons
County
Category
Extremely
Low
(30 %)
$19,000
$21,700
$24,400
$27,100
$29,300
$32,580
$36,730
$40,890
Income
Limits
Very Low
$90,300
(50 %)
$59,600
Income
$31,650
$36,150
$40,650
$45,150
$48,800
$52,400
$56,000
0
Limits
Low
(80 %)
Income
$48,550
$55,450
$62,400
$69,300
$74,850
$80,400
$85,950
$91,500
Limits
Reports and Reporting Schedule
The Agency shall collect and report client information to the City quarterly and annually on a Service Unit
Report to be provided by the City in the format requested by the City.
The Agency shall submit an Annual Demographic Data Report. The agency shall collect and retain the data
requested on this form from the persons served through this contract. Data should be tracked in an ongoing
manner and submitted annually no later than January 15 in the format requested by the City.
The Agency shall implement and track at least one measurable outcome for the program as presented in the
application. Changes to the outcome presented in the application must be approved by the City prior to
implementation. The Agency shall report the results of its outcome measure(s) annually on the Annual Outcome
Data Report to be submitted by January 15 in the format requested by the City.
Public Information
In all news releases and other public notices related to projects funded under this Agreement, the Agency will
include information identifying the source of funds as the City of Federal Way Human Services General Fund
Program.
HUMAN SERVICES AGREEMENT - 3 - HSA Exh 1/2017
44._ Federal Way
EXHIBIT B
COMPENSATION
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalwaycom
Project Budget
The Agency shall apply the following funds to the project in accordance with the Line Item Budget Summary.
The total amount of reimbursement pursuant to this Agreement shall not exceed Forty -Nine Thousand and Five
Hundred 00 /100 Dollars ($49,500.00).
A. City of Federal Way Funds
2017
2018
City of Federal Way General Fund:
$24,750.00
$24,750.00
Total City of Federal Way Funds:
$24,750.00
$24,750.00
B. Line Item Budget
2017
2018
Personnel Services (detail below)
$24,750.00
$24,750.00
Office or Operating Supplies
$38,363.00
$24,750.00
Rent & Utilities
.65
$38,363.00
Communications
Travel and Training
Other (specify):
Client Travel
Administration (Overhead)
Total City of Federal Way Funds:
$24,750.00
$24,750.00
C. Personnel Detail
Position Title
Position Full
Time Equivalent
Annual Salary
and Benefits
HS Funds
Site Manager
.65
$38,363.00
$24,750.00
Total:
.65
$38,363.00
$24,750.00
Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly
and are due on the following dates:
1st Quarter: April 15 or within 10 days of notice to proceed, whichever is later;
2nd Quarter: July 15;
3rd Quarter: October 15; and
4th Quarter: Final Reimbursement Request and Service Unit Report forms due January 8; Demographic Data
Report and Annual Outcome Data Report with supporting documentation due January 15.
The Agency shall submit Reimbursement Requests in the format requested by the City. Reimbursement
Requests Invoices shall include a copy of the Service Unit Report and any supporting documents for the billing
period.
HUMAN SERVICES AGREEMENT - 4 HSA Exh 1/2017
�Fecferal Way
Estimated Quarterly Payments:
2017
1st Qtr
2nd Qtr
3rd Qtr
4th Qtr
2018
1St Qtr
2nd Qtr
3rd Qtr
4th Qtr
$6,187.50
$6,187.50
$6,187.50
$6,187.50
$6,187.50
$6,187.50
$6,187.50
$6,187.50
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway com
Expenses must be incurred prior to submission of quarterly reimbursement requests. Proof of expenditures must
be attached to the reimbursement request for invoice to be approved.
Quarterly reimbursement requests shall not exceed the estimated payment without prior written approval from
the City. Estimated quarterly payments are contingent upon meeting or exceeding the above performance
measure(s) for the corresponding quarter. This requirement may be waived at the sole discretion of the City
with satisfactory explanation of how the performance measure will be met by year -end on the Service Unit
Report.
Conditions of Funding
The Agency agrees that it will meet the specific funding conditions identified for the Agency and acknowledges
that payment to the Agency will not be made unless the funding conditions are met.
HUMAN SERVICES AGREEMENT 5 - HSA Exh 1/2017
CITY OF
} %.. Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway corn
City of Federal Way
Human Services Contract for 2017 -2018 General Fund
Authorized Signatures for Invoices
I authorize the following individuals to sign invoices and quarterly reports on behalf of:
Catholic Community Services of Western Washington (Contracting Agency), for
the following: Reach Out Homeless Shetler (Program Title).
Authorizing
Signature:
(must be signed by
person who signs
the contract,
generally,
Executive Director)
11 111N:et-
(Printed Name)
(Signature)
(Title)
//BOO?
(Date)
Additional
Authorized
Signature:
Additional
Authorized
Signature:
(Printed Name) (Title)
(Signature) (Date)
(Printed Name) (Title)
(Signature) (Date)
Note: It is the responsibility of the contractor to inform the City of Federal Way if they wish to add a
name to or delete names from this list.
Management Protocol 5.0
(Formerly Known as Legal Protocol)
Catholic Community Services of Western Washington
Updated August 1, 2016
The CCSWW Management Protocol has been established in accordance with the By -Laws and Articles of
Incorporation of Catholic Community Services of Western Washington (CCS) to ensure the proper function
of Catholic Community Services of Western Washington and the due authorization of all actions taken by
employees for the benefit of, and in the name of, the Corporation.
Corporate Officers and others designated by the CCSWW President (Designees *) are responsible for
ensuring that all business transactions within their agency /system meet all of the requirements outlined in
this protocol. Corporate Officers and Designees will receive a letter authorizing their actions /responsibilities
under this protocol.
For purposes of this protocol, the Corporate Officers are named below:
Michael Reichert CCSWW President
Irene Ward CCSWW Executive Vice President and Chief of Operations
Peter Bernauer CCSWW Vice President and Chief Financial Officer
Bill Hallerman CCSWW Vice President and Agency Director
Denny Hunthausen CCSWW Vice President and Agency Director
Peter Nazzal CCSWW Vice President and Director of Long Term Care System
Will Rice CCSWW Vice President and Agency Director
Mary Stone Smith CCSWW Vice President and Director of Family Behavioral Health System
Josephine Tamayo Murray CCSWW Vice President for Public Policy
Kim Williams CCSWW Vice President and Director of Human Resources
Rosemary Zilmer CCSWW Vice President of Fund Development
The implementation goals of the protocol are highlighted below:
1. Ensure that actions taken in the name of CCS are in compliance with our stated mission and objectives
and the teachings of the Roman Catholic Church as interpreted and proclaimed by the Roman Catholic
Archbishop of Seattle;
2. Ensure that CCS's existence and benefits are maintained;
3. Ensure that CCS is acting lawfully and has adequate assets and insurance to cover any problems and
risks which may arise in relationship to the actions taken and for the protection of the persons acting
on behalf of CCS; and
4. Ensure that appropriate policies and procedures are in place to ensure effective and efficient
functioning of the organization.
* For purposes of the CCS Management Protocol, "Designees" referred to in this document must be
named by the President of CCS.
A. Contracts and Program Agreements
Corporate Officers or Designees, as appointed by the President, are responsible for the evaluation
Page 1 of 10
of all new and revised contracts, as well as any contracts being renewed. Contracts are legal
instruments between CCS and other legal entities which bind CCS in any way to perform services,
purchase goods, etc. Contracts are evaluated to ensure they meet the mission of CCS and that they
are fiscally sound. The contract review process outlined in this protocol applies not only to CCS
contracts but also to contracts which apply to separate legal entities affiliated with CCS. When
completing a Contract Review Cover Sheet for contracts associated with these entities, identify the
correct legal entity that is party to the contract.
Contracts fall into two (2) categories. They include those contracts which must be approved by the
CFO and reviewed by Retained Counsel prior to being signed and those which can be reviewed and
approved by Agency /System staff without any approval from CCSWW staff.
At the initiation of the contract review process, a complete copy of all contracts will be forwarded
to the CCSWW Operations Coordinator. This requirement extends to all contracts regardless of
whether or not they must be approved by the CFO and reviewed by Retained Counsel. Those
contracts which can be reviewed and approved by Agency /System staff without any approval from
CCSWW staff are forwarded to the CCSWW office as an "FYI" only.
The following is a summary of both contract approval processes:
• Contracts needing approval by CCSWW staff prior to being signed
The following types of contracts must be submitted to the CCSWW Office and approved by the
CFO and reviewed by Retained Counsel prior to being signed:
• New contracts with new funders (new contracts with current funders do not need to be
reviewed by CCSWW);
• Contracts for new services not currently done elsewhere in the organization — this applies
even if the funder is not new;
• New leases;
• All construction contracts;
• Agreements for LLC's;
• Agreements that require Corporate Resolution;
• Agreements that require a Certificate of Action of the President;
• Any amendments to the above.
These contracts cannot be signed until they are approved by the CFO and reviewed by
Retained Counsel. During the review of contracts for new agency services, the contract will also
be forwarded to our insurer, Arthur J. Gallagher, to ensure coverage. Any problems arising from
the final review will be coordinated between the Corporate Officer, the Regional Chief of
Operations or Operations Director and the CCSWW office. (If there are any service related
concerns in a contract, these should be submitted to the Executive Vice President for
review /discussion prior to initiation of the general contract review process.)
• Contracts which can be approved by Agency /System Directors or Designees
The following types of contracts will be reviewed by Agency /System Directors, or designees,
and will be forwarded to the CCSWW Operations Coordinator as an "FYI" only:
Page 2 of 10
,4D®
—. CERTIFICATE OF LIABILITY INSURANCE
DATE (MM /DD/YYYY)
6/30/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
Arthur J. Gallagher Risk Management Services, Inc.
777 108th Ave NE, #200
Bellevue WA 98004
CONTACT
NAME: Stephen Erni
PHONE 425 454 3386 FAX , Nol; 425 -451 -3716
(A/C No,F ,'t)
ADDRESS: Stephen_Erni @ajg.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A :Underwriters at Lloyd's London
15792
INSURED CORPOFT -01
Corporation of the Catholic Archbishop of Seattle
Catholic Community Services LP 310;
100 23rd Ave. S
Seattle WA 98144
INSURERB:Old Republic Union Insurance Compan
31143
INSURER C :State National Insurance Company, I
12831
INSURER D :
$1,000,000
INSURER E :
$1,000,000
INSURER F :
CERTIFICATE NUMBER: 900914560
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSD
SUBR
W VD
POUCY NUMBER
POLICY EFF
(MM/DD/YYYY)
POLICY EXP
MI
(MDD/YYYY)
LIMITS
A
x
COMMERCIAL GENERAL LIABIUTY
BP1023016
7/1/2016
7/1/2017
EACH OCCURRENCE
$1,000,000
DAMAGE TO
PREMISES EaEoccur ence)
$1,000,000
CLAIMS -MADE X OCCUR
MED EXP (My one person)
$Nil
PERSONAL & ADV INJURY
$1,000,000
GE
X
GENERAL AGGREGATE
$1,000,000
'L AGGREGATE
POLICY
OTHER:
LIMIT APPLIES
PRO-
JECT
PER:
LOC •
PRODUCTS - COMP/OP AGG
$1,000,000
$
A
AUTOMOBILE
X
X
LIABILITY
ANY AUTO
ALL QED
HIRED AUTOS
X
SSC�HEEDULED
NON -0WNED
AUTOS
BP1023016
7/1/2016
7/1/2017
COMBINED SINGLE LIMIT
(Ea accident)
$
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
$
B
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
821600 0785428
7/1/2016
7/1/2017
EACH OCCURRENCE _
$5,000,000
AGGREGATE
$5,000,000
$
DED
RETENTION $
A
C
WORKERS COMPENSATION
ANDEMPLOYERS'LIABIUTY
ANY PROPRIETOR/PARTNER /EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
YIN
N/A
BP1023016
NDE- 0864110 -16
7/1/2016
7/1/2016
7/1/2017
7/1/2017
x PER
STATUTE
OTH
ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
Limits shown for insurer A & B are inclusive of defense and insured retention
Coverage only extends for claims arising out of Catholic Community Services fulfillment of its obligations as outlined in the contract
agreements between The City of Federal Way and Catholic Community Services for both the Reach Out and After Hours Voucher Programs
for the term of the certificate. (Ref cont # 08 -289, 10 -171)
CERTIFICATE HOLDER
CANCELLATION
City of Federal Way
I
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
tll
ACORD 25 (2014/01)
© 1988-2014 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
ENDORSEMENT attaching to and forming part of Policy No. BP1023016
NAMED ASSURED: Corporation of the Catholic Archbishop of Seattle
Effective date of this endorsement: July 01, 2016
Endorsement No. 14
GENERAL POLICY CONDITIONS ENDORSEMENT —
INCLUDING PRIMARY NON - CONTRIBUTORY
CERTIFICATES OF INSURANCE:
It is hereby understood and agreed that holders of Certificates of Insurance issued against this Policy that
are shown as Additional ASSUREDS are added to this Policy pursuant to the terms of this Policy as
described in GENERAL POLICY DEFINITION 1.
Where Certificates of Insurance are requested for Additional ASSUREDS who do not fall within GENERAL
POLICY DEFINITION 1, prior agreement of Underwriters and subsequent endorsement of this Policy is
required
GENERAL POLICY DEFINITION 1. ASSURED is stated as follows -
1. ASSURED means not only the NAMED ASSURED as stated on the Declaration Page, but
also includes any past, present or future: agencies, subsidiaries, affiliates, institutions and
societies owned by or operated by the NAMED ASSURED, officials, members of boards or
commissions, trustees, directors, officers, partners, volunteers, student teachers, or
employees of the NAMED ASSURED while acting within the scope of their duties as such,
and any person, organization, trustee or estate to whom the NAMED ASSURED is obligated
by virtue of a written contract or agreement to provide insurance such as is offered by this
policy, but only in respect of operations by or on behalf of the NAMED ASSURED.
GENERAL POLICY CONDITION 20. WAIVER OF SUBROGATION is stated as follows —
20. WAIVER OF SUBROGATION: This policy shall not be invalidated if the ASSURED, by
written agreement, has waived or shall waive its right of recovery from any party for loss or
damage covered hereunder: provided that any such waiver is made prior to the occurrence
of said loss or damage.
MORTGAGORS, LOSS PAYEES & LENDER LOSS PAYEES:
It is understood and agreed that GENERAL POLICY CONDITION 12. of this policy is deleted and replaced
with the following:
12. MORTGAGORS, CREDITORS & LOSS' PAYEES: Where required by written contract,
the interest of any mortgagor, creditor or loss payee on property covered by this policy is
included as if a separate endorsement were attached hereto to the extent of the amount of
mortgage, loan or interest in property held by the ASSURED as of the date of loss subject
to the limits of liability set forth in this policy.
PRIMARY NON - CONTRIBUTORY:
It is also agreed that, only where required by written contract between the NAMED ASSURED and the
Certificate holder, this insurance shall be considered primary to any insurance held by the Certificate holder
and theirs shall be excess.
Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and
conditions in the policy to which this Endorsement is attached.
ENDORSEMENT attaching to and forming part of Policy No. BP1023016
NAMED ASSURED: Corporation of the Catholic Archbishop of Seattle
Effective date of this endorsement: July 01, 2016
MUNICIPALITY PERMITS:
Further, where required by written contract or evidenced in the insurance requirements of a permit issued
by a municipality at the request of the NAMED ASSURED, that municipality shall be added to this policy
as an Additional ASSURED but only as respects liabilities arising out of the subject matter of the written
contract or issued permit and then only for liabilities arising from actions by or on behalf of the NAMED
ASSURED.
Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and
conditions in the policy to which this Endorsement is attached.