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Home My WebLink AboutAG 19-207 - Somali Youth & Family RETURN TO: Joseph Adriano EXT: 2650 CITY OF FEDERAL WAY LAW DEPARTM EI�, ' l (�U'l 11 1(-) FO 1<1v,fi 1. ORIGINATING DEPT./DIV: CD/CS 2. ORIGINATING STAFF PERSON: Joseph Adriano EXT: 2650 3. DATE REQ.BY:9/27/19 4. TYPE OF DOCUMENT(CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT(E.G.,RFB,RFP,RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT A HUMAN SERVICES/CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT(E.G.BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT(AG#): ❑ INTERLOCAL ❑ OTHER S. PROJECTNAME: SYFC CITY SUPPORT PROGRAM 6. NAME OF CONTRACTOR: SOMALI YOUTH AND FAMILY CLUB ADDRESS: 19550 International Blvd,Suite B106,SeaTac,WA 98188 TELEPHONE 425-207-8297 E-MAIL:asha@syouthclub.org FAX: SIGNATURE NAME: TITLE Executive Director 7. EXHIBITS AND ATTACHMENTS:19 SCOPE,WORK OR SERVICES It COMPENSATION R INSURANCE REQUIREMENTS/CERTIFICATE A ALL OTHER REFERENCED EXHIBITS O PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: 01/01/2019 COMPLETION DATE: 12/31/2020 9. TOTAL COMPENSATION$10,000.00 (INCLUDE EXPENSES AND SALES TAX,IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE:OYES ONO IF YES,MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED OYES ONO IF YES,$ PAID BY:❑CONTRACTOR❑CITY RETAINAGE: RETAINAGE AMOUNT: ❑RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDED D PURCHASING: PLEASE CHARGE TO: 119-7300-961-514-60-442 10. DOCUMENT/CONTRACT REVIEW INITIA DATE REVIEWED INITIAL/DATE APPROVED ❑ PROJECT MANAGER 9��7UI ❑ DIRECTOR ❑ RISK MANAGEMENT (IFAPPLICABLE) ❑ LAW ZQ S��p zo 2 3 Sao 2O1q 11. CO UN C I L AP P RO VA L(IF APPLICAB LE) COMMITTEE APPROVAL DATE: COUNCIL APPROVALDAI'I : 12. CONTRACT SIGNATURE ROUTING G(a 14 ( 5 1 , ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: ` DATE RECD: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (Include dept.support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.) INITIAL/DATE SIGNED LAW DEPARTMENT 0 Oct 2 0 ATORY(MAYOR OR DIRECTOR) CITY CLERK ASSIGNED AG# A SIGNED ON RETURNED DATE SENT: COMMENTS: 2/2017 ` CITY OF CITY HALL ,.; Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 tvww crryoffederalway.coin HUMAN SERVICES AGREEMENT FOR SYFC CITY SUPPORT PROGRAM This Human Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Somali Youth and Family Club, 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: SOMALI YOUTH AND FAMILY CLUB: CITY OF FEDERAL WAY: Asha Mohamed Joseph Adriano 19550 International Blvd., Suite B106 33325 8th Ave. S. SeaTac, WA 98188 Federal Way, WA 98003-6325 (425) 207-8297 (telephone) (253) 253-835-2651 (telephone) asha@syouthclub.org joseph.adriano@cityoffederalway.com The Parties agree as follows: 1. TERM. The term of this Agreement shall be for a period commencing on January 1, 2019 and terminating on December 31, 2020 ("Term"). Funding for the second year of the Agreement is contingent upon satisfactory Agreement performance during the first year of the Agreement term and upon funding availability. This Agreement may be extended for additional periods of time upon the mutual written agreement of the City and the Agency. 2. SERVICES. The Agency shall perform the services more specifically described in Exhibit A, attached hereto and incorporated by this reference ("Services"), in a manner consistent with the accepted professional practices for other similar services within the Puget Sound region in effect at the time those services are performed to the 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. TTT- !A 1T f1 TTl1TfY A 11T TTA .fT1TT 1 1//1/11/'I CITY OF CITY HALL A%: Fe d e ra I Way Feder 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 Community 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 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 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. 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 TTT- ! A 1T f1T TT- A /1 T1T -- I � 1. 1/ ` CITY OF CITY HALL 33325 �.. Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederatway com 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. TTT- ! A l - TT- A lI TlT -- 1 11� - ` CITY OF CITY HALL Fe d e ra I Way 33325 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederalway corn 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. TTT- K A T.T IYT YT- A /1 T\ Kl - A 1 1. 1- ` CITY OF CITY HALL Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederatway coin 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-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 perforin 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 may be 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] T TT A T.T C'ITT- A l'1T TTA !T1TT r I /I-'I- ` clry of CITY HALL Fe d e ra I Way Feder 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: ATTEST: Jim Ferrell, ay r SVph6ie Courtney, CMC, 0 Clerk APPROVED AS TO FORM: DATE: J. Ryan Call, City Attorney SOMALI YOUTH AAD ILY CLUB: .. By: Printed Name: A S IJA kA , M/A t M e CA Title: txe, ��1 (e DATE: STATE OF WASHINGTON ) F KING ) ss. COUNTY O Alo jj G M P ) � �Shw On this da personally appeared before meto me known to be the of Som a, C that executed the foregoing instrument, and acknowledged the said instrument to be the free nd 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 day of 0040 %� , 20)� Notary's signature Notary's printed name ' r 6( ", RTT< Notary Public in and fot the State of Washington. My commission expires BRANDON KELLEY Notary Public State of Washington My Commil,.,io�n Ixl7ir�;s July T TT- .T A l T -T TT!'IT("'1 A ` CITY OF CITY HALL 33325 Alk Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederalway com EXHIBIT A SERVICES Proiect Summary The Agency shall provide case management services and connection to resources. 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: 1st 2nd 3rd 01 Quarter Quarter Quarter Quarter Total JAN.— APRIL— JULY— OCT.— MARCH JUNE SEPT. DEC. No. of unduplicated Federal Way persons assisted in 2019 3 3 3 4 13 No. of unduplicated Federal Way persons assisted in 2020 3 3 3 4 13 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN.— APRIL— JULY— OCT.— MARCH JUNE SEPT. DEC. 2019 1. Case Management 3 3 3 4 13 2. Training/Workshops/Classes 3 3 3 4 13 2020 1. Case Management 3 3 3 4 13 2. Training/Workshops/Classes 3 1 3 1 3 1 4 1 13 TTT TA ! A IT (ITTT TT lIT("'1 A /-1TTTl1 1-1 TT 1 T- A T 1 �/illy� ` Clry of CITY HALL ..� Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederalway.com C. Definition of Services 1. Case Management: case management is measured by the number of people engaged with case management and includes assessment of client strengths and obstacles, creation of individualized goals, care coordination, and referral services. 2. Training/Workshops/Classes: Measured by the number of persons participating. Sessions include life skills training, employment/training opportunities, and assistance with applying for state and federal benefits. D. Performance Measure(s) Outcome(s)to be reported: 1. Improved resource knowledge. 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. T TT Tl1 1 A lT 1 /'I-- -TT TT- A T 1 r/--- ` CITY OF CITY HALL �, Fe d e ra I Way Feder 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. 2018 HUD INCOME GUIDELINES King County, Washington Effective June 1, 2018 30%MEDIAN 50%MEDIAN 80% MEDIAN FAMILY EXTREMELY VERY LOW- LOW- SIZE LOW-INCOME INCOME INCOME 1 $22,500 $37,450 $56,200 2 $25,700 $42,800 $64,300 3 $28,900 $48,150 $72,250 4 $32,100 $53,500 $80,250 5 $34,700 $57,800 $86,700 6 $37,250 $62,100 $93,100 7 $39,850 $66,350 $99,550 8 $42,400 $70,650 $105,950 2019 HUD INCOME GUIDELINES King County, Washington Effective June 28, 2019 30%MEDIAN 50%MEDIAN 80% MEDIAN FAMILY EXTREMELY VERY LOW- LOW- SIZE LOW-INCOME INCOME INCOME 1 $23,250 $38,750 $61,800 2 $26,600 $44,300 $70,600 3 $29,900 $49,850 $79,450 4 $33,200 $55,350 $88,250 5 $35,900 $59,800 $95,350 6 $38,550 $64,250 $102,400 7 $41,200 $68,650 $109,450 8 $43,850 $73,100 $116,500 The Agency agrees to use updated Income Guidelines which will be provided by the City. 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. TTT Tl ! A 1T ['1T TT/'IT A lV T1 TAT TTI.- - A - 1 ` CITY OF CITY HALL A* ..- Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederalway coin 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. TTY TA ! A A T -T-/ - A /-1T TTA ,fTATT A T- A ` CITY OF CITY HALL ...'�.....- Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederatway coin EXHIBIT B COMPENSATION Project Budget The Agency shall apply the following funds to the project. The total amount of compensation pursuant to this Agreement shall not exceed Ten Thousand and 00/100 Dollars ($10,000.00). A. City of Federal Way Funds 2019 2020 City of Federal Way General Fund: $5,000.00 $5,000.00 Total City of Federal Way Funds: $5,000.00 $5,000.00 Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly and are due on the following dates: 1 st 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 6; Demographic Data Report and Annual Outcome Data Report with supporting documentation due January 15. The Agency shall submit payment requests in the format requested by the City. Payment requests shall include a copy of the Service Unit Report. Estimated Quarterly Payments: 2019 1st Qtr $1,250.00 2nd Qtr $1,250.00 3rd Qtr $1,250.00 4th Qtr $1,250.00 2020 1st Qtr $1,250.00 2nd Qtr $1,250.00 3rd Qtr $1,250.00 4tn Qtr $1,250.00 Quarterly payment 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. TTTTA ! ANT f1 T TATTT!'YTl1 AlVT AT N1 r - A T 1 r// -/ - CITY OF CITY HALL Ask Fe d e ra I Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederalway com EXHIBIT C INSURANCE CERTIFICATE T TT- ! A l T (Y T 1T- A --A -- / T- A SOMAL-2 OP IDRIH Plf, Gs ea DATE(MMIDDNYYY) 05/31/2019 THIS Clakilllc,;'!E IS ISSUED ABA MATTER Ur INFORNiAJION ONLY AND CONFERS NO RIGHT—, IIP(W THE CEK'i'!!.ICATE HOLDER. THIS CERTIFII P. jQES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CUVLI�'AGE AFFO)!')ED BY THE POLICIES BELOW ll CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IW:IJRER(S), AUTHORIZED REPRE,'>i NiA'1`IV[ OR PRODUCER,AND THE CERTIFICA'l E HOLDER. IMPORTA;,'e: ll4hi certificate holder Is an ADDITIONAL INSURED,the policy(ios)must have ADDITIONAL INS!)s\;,I--provisions or b::endorsed. 1 If SUBROGATION is WAIVED,subject to the terms and conditions of the policy,certain policies may requiro -s :n,;;;rsement. Asl,.cement on this certificate noes not confer rishts to the certificate holder In lieu of such:-iidorsement(sj_ PRODUCER 425-255-2486 CtiN,.CT Ruth Hubbard,CISI IW HUB INSURANCE AGENCY ,!w,ir 425-255,,,486 1102 Bronson Way North m) P.0.Box 796 tu',it 161@b i�o it 1,:;Iwi 1,I't Renton,WA 98067-0796 Ruth Hubbard,CiSR,CPIW �_ i �i,(S)TFOVDING COVERAGE NIC 0 hire&Casualty 24066 INSURED 8:6enei at Insurance Co of Am Somali Youth&Family C b e R560 I,WA 188nterinfional Blvd W1 06 '!MIRERC: atac COO! F,,AGES CE-i�(fFi(-J`,l1 REVISION NL)rvIBrR: THI`3 CERTIFY THAT T1HF P01,10! OF SEI OW HAVE BEEN ISSUED TO THE INSURED NALILD AI OW F."i'R Tll[: rliZIC)", INDIC,% -D. N( �N 1,d�QUIREMENI I; 1�' OF, OF ANY CON_HACT Of, 0111ER NT VVf�f CEPTI, '_ATF ',AY RE J) I if: -,Py PERTAIN, TFIL !)I 1,,RDED BY THE POLICiFl, DFSCRIBED f IEREIN IS „WRA C f 0 :,;IJt_',I!i('3;G IES.LIMB'S SHOWN !;AVE BEENREDUCED BY PAID ILAMIS. 1IN$F(i POLICY EFF LTR 7ri- !'!!�URANCE POLIC: O=, WVD IMMIn0ryYYy):,?P?M X COMMERCIAL A it-NERALLIABILITY CLAMS-MADE FX]OCCUR X BLA2059735185 05120/20191:05/2012020: R 2L DAI.1AC; fr L I) ......... LED F.XF,fAn 1,000,000 GE LAG111 TIE LIMIT APTUES PER. 3,000,000 X POLICY j _ _ LOC ca: 3,000,000 QTHFR A AUTOMOBILE LIABILITY tl ll 1,000,0001 NYALITO BAA2059735185 05J2012019;05120/2020 (ANNED SCHEDULED AUTOS.1ILY AUTOS r y,o� N9 PRR,O;L Y DAMAGE X HAMS ONLY ipf! 1f:`,.z!,.r1t)_ 7 1 Fr - UMBRELLA LIAR HOCCUR EA�:h 0(;(:.Ui1RCNCL E' EXCESS LIAB CLAJM64AADE AI{ CATE— DED I I RETENTIONS A WORKERS COMPENSATION 1 AND EMPLOYERS'LIABILITY �IATU;L ANY PROPRIETORfPARTNERIEXECUTIVE i BLA2059735185 06/20/2019 05120/2020 F1 0 ACCIDENT 00, OIFICIE EM R EXCLUDED? NIA (Mlmdaforyln NH) WA STOP GAP _'�t rASf_161 FA Ft.!;'[OYEEif ye8l 110001000 &set"under PERATIONS below F L D!SE AM fly I IMIT S �D RIPTION OF 0 2,000,0001 B PROFESSIONAL LP7746379C 05/20/2019�0512012020 Incident 1,000,000' !LIABILITY Agg Limit 3,000,000' DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,play be attached If more space Is required) American Fire&Casualty Policy#BLA2059735185 includes Sexual Misconduct with limits of$1,000,000'Each occurrence/$3,000,000 Aggregate Certificate holder Is named as an additional insured subject to policy terms and conditions. Form CG2026 CERTIFICATE HOLDER ANCELLATION CITYFED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Federal Way ACCORDANCE WITH THE POLICY PROVISIONS, 33325 8th Ave S Federal Way,WA 98003 AUTHORIZED REPRESENTATIVE 4eL, .v� ACORD 26(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CITY OF Federal Way 33325 81h Avenue South, Federal Way, WA 98003 ®New Vendor❑ Update Form To add your business to our vendor file or update information,please complete this form and mail or fax it to the address/fax number below. Business Information �l (For office use only)VN#: C� Business Name: U MCL t �OLk4+\ a n � 1Q C l U b Contact Name: so,�d Q a i 1 m I Location Address: IgSCjQ I rqef nabaaaj ?JW,B1V,6_'ITY/STATE SM_JdtC LAS14Zip Code 1� Mailing Address(if different): CITY/STATE J Zip Code Phone#: Fax#: ( ) - E-Mail: Sa d Qahra U , O Business Type Please Check One) Corporation ❑ - - - - - - - - Federal ID#(9 digits) Partnership ❑ - - - - - - - - Federal 1D#(9 digits) Government Agency ❑ - - - - - - - a Federal ID#(9 digits) Non-Profit X - n - -3 - 4- - - 3 - _? - C) Federal ID#(9 digits) Sole Proprietor ❑ - - - - - - - - Federal ID#(9 digits)or Social Security Number What is the official name registered with the I.R.S.for the above number? J 1 Gu Jo If you are not a corporation,is your Business subject to 1099 reporting? Yes ❑No State of Washington U.B.I.# Federal Way Business License#: Will you provide supplies or services to the City of Federal Way? ❑Supplies Services City of Federal Way Staff/Department Contact Name: Signature(LJS Person including a Date: US resident alien) For information call: 253.835.2525 or Fax: 253.835.2509 or E-mail: Accountspayable@cityoffederalway.com Form Request for Taxpayer Give Form to the (Rev October 201 B) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name as shown on your income tax return).Name is required on this line;do not leave this fine blank. - •nd r�tv_Cul name/disregarded 2 Business a entity name,if different from above I�55'D In rna�rt�c� I V ►a T l� 1too m 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1,Check only one of the 4 Exemptions(codes apply only to ZM certain entities,not individuals;see following seven boxes. instructions on page 3): a c ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate o V) single-member LLC Exempt payee code(if any) 6 c OL 0 ❑ Limited liability company.Enter the tax classification(C=C corporation,S-S corporation,P=Partnership)►_ p Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any) — another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that fl is disregarded from the owner should check the appropriate box for the tax classification of its owner. y Other(see instructions)► COW (Applies 10 accounts m mtafnedo t.,de Me U S) Address(number,street,and apt,or suite no.)See instructs s. Requester's name and address(optional) Iq gilt Rib 6 Cit ,state,and 21P code 20_ QC A 7 List account number(s here(optional) Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box,The TIN provided must match the name given on line 1 to avoid social security number backup withholding.For individuals,this is generally your social security number(SSN).However,for a l resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN, later. or Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and LEmployer identification number Number To Give the Requester for guidelines on whose number to enter. 9 — O Certification Under penalties of perjury,I certify that: 1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and 2.1 am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding;and 3.1 am a U.S.citizen or other U.S.person(defined below);and 4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct. Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends onuggni return.For real estate transactions,item 2 does not apply.For mortgage interest paid, acquisition or abandonment of secured property,ca a of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not requ' o certification,but you must provide your correct TIN.See the Instructions for Part II,later. Sign Signature of [ ' Here U.S.person► Date► / ( •Form 1099-DIV(dividends,including those from stocks or mutual General Instructions funds) Section references are to the Internal Revenue Code unless otherwise .Form 1099-MISC(various types of income,prizes,awards,or gross noted. proceeds) Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other related to Form W-9 and its instructions,such as legislation enacted transactions by brokors) after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions) Purpose of Form •Forrn i 09�f I:(I ,ei chant card and third pw 1 notwo)k imnsactions) An individual or entity(Form W-9 requester)who is required to file an •Forni I O) (home mortgage interest),109f1 E(student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T(tuiiion) identification number(TIN)which may be your social security number •Form 1099 (; i(eOed debt) (SSN),individual taxpayer identification number(ITIN),adoption .Form 1099-A(;i.c(,uisition or abandonment of secured property) taxpayer identification number(ATIN),or employer identification number (EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident amount reportable on an information return.Examples of information alien),to provide your correct TIN. returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might •Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding, later. Cat.No.10231X Form W-9(Rev.10-2018) ` CITY of CITY HALL Federal Way 33325 8th Avenue South Federal way, V+IA 98003-6325 (253) 835-7000 wi m c ityoffederalway com City of Federal Way Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf of: t l "1 (Contracting Agency), for the following: �,Sh a Djj-, (Program Title). Authorizing � v` Signature.- (must ignature.(must be signed by (Printed Name) (Title) person who signs the contract, generally, Executive Director) - d (Sign ure (Date) ......................................................................................._.................................................................................................................................................................................................................................................................... Additional Authorized Signature: (Printed Name) (Title) (Signature) (Date) Additional Authorized Signature: (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.