HomeMy WebLinkAboutAG 19-246 - Hospitality House RETURN TO: Sarah Bridgeford EXT: 2651
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: CD/CS
ORIGINATING STAFF PERSON:—_SARAH BRIDGEFORD EXT: 2651 3. DATE REQ.BY:
TYPE OF DOCUMENT(CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT(E.G,RFB,RFP,RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
x PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT x HUMAN SERVICES/CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT(E.G BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACTAMENDMENT(AG#): ❑ INTERLOCAL
❑ OTHER
PROJECT NAME: HOSPITALITY HOUSE
NAME OF CONTRACTOR:_HOSPITALITY HOUSE
ADDRESS: TELEPHONE
E-MAIL: FAX:
SIGNATURE NAME: TITLE
EXHIBITS AND ATTACHMENTS:X SCOPE,WORK OR SERVICES X COMPENSATION X INSURANCE REQUIREMENTS/CERTIFICATE X ALL
OTHER REFERENCED EXHIBITS X PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
TERM: COMMENCEMENT DATE: JANUARY 1,2019 COMPLETION DATE: DECEMBER 31,2020
TOTAL COMPENSATION$ $20,000.00 (INCLUDE EXPENSES AND SALES TAX,IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE-ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE:❑YES ❑NO IF YES,MAXIMUM DOLLAR AMOUNT: $ '
IS SALES TAX OWED ❑YES ❑NO IF YES,$ PAID BY:❑CONTRACTOR❑CITY
RETAINAGE: RETAINAGE AMOUNT: ❑RETAINAGE AGREEMENT(SEE CONTRACT) OR ❑RETAINAGE BOND PROVIDE
x PURCHASING: PLEASE CHARGE TO: 001-7300-083-562-10-410
0. DOCUMENT/CONTRACT REVIEW INITIATD REVIEWED INITIAL/DATE APPROVED
❑ PROJECT MANAGER
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW ffIF
1. COUNCIL APPROVAL(IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: /f
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
2. CONTRACT SIGNATURE ROUTING r p�LT
,VSENT TO VENDOR/CONTRACTOR DATE SENT: `�/,�?3 c J! DATE REC'D: / " 1T
AT7ACH: SIGNATURE AUTHORITY, INSURANCE CERT -ICATE.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
❑ LA 7i'PAR_1_N1FNT 20 %C 201 cj
GNATORY(MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG# AG
❑ SIGNED COPY RETURNED DATE SENT:
;OMMENTS:
1/2018
CITY OF CITY HALL
All
Fe d e ra I Way 33325 8th Avenue South
Federal Way.WA 98003-6325
(253) 835-7000
www cityoffederalway com
HUMAN SERVICES AGREEMENT
FOR
HOSPITALITY HOUSE
This Human Services Agreement("Agreement")is made between the City of Federal Way,a Washington municipal
corporation("City"),and Hospitality House,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:
HOSPITALITY HOUSE: CITY OF FEDERAL WAY:
Sheenah Randolph Sarah Bridgeford
1419 SW 150th St. 33325 8th Ave. S.
Burien, WA 98166 Federal Way, WA 98003-6325
425-876-9576 (telephone) (253) 253-835-2651 (telephone)
(253) 253-835-2609 (facsimile)
sheenahr.hos italit house ail.com sarah.bridgeford@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.
HUMAN SERVICES AGREEMENT - 1 - 3/2017
` CITY OF CITY HALL
F33325 d e ra l Way 33325 8th Avenue South
'i[G7 Federal Way.WA 980038003
-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, 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 Nan-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 - 3/2017
CITY OF CITY HALL
Fe d e ra I Way 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 1.1niP, of 1_"[�i 1)1111 y. 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 - 3/2017
` CITY OF CITY HALL
Fe d e ra l Way 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 - 3/2017
` CITY 47F CITY HALL
Fe d + ra I Way 33325 8th Avenue South
�3 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 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]
HUMAN SERVICES AGREEMENT - 5 - 3/2017
CITY OF CITY HALL
4S
Federal
�� � 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:
0 t
Jim Ferrel ayor Vepqanie Courtney, CM City Clerk
APPROVED AS TO FORM:
DATE: I I (�L- /1,1.,L
+�J. Ryan Call, City Attorney
HOSPITALITY HOUSE:
i'
By: _ i C"t o r.-- �.
Printed Name: She c r-tiL'1- r 4za.pxelol
Title: e XQ Cv k V t -Di r'e.c �p t
DATE: '1 1 2(of J j
STATE OF WASHINGTON )
) ss.
COUNTY OF KING ) n
On this day personally appeared before me Fj����U� A . �QO rj2� to me known to be the
exewl iye,TitecA x _ of 9ousc- that executed the foregoing
instrument, and acknowledged the said instrument to be the 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 26 day of r r ` 12019.
��,�•,�� gl�''lr Notary's signature
A ry
Notary's printed name -tri or_C*
� �.+1y�115�55111
Notary Public in and for the State of Washington.
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HUMAN SERVICES AGREEMENT - 6 - 3/2017
` CITY OF CITY HALL
Federal ■ �y l� Feder 8th Avenue South
1V■lYJ Federal Way,WA 98003-6325
(253) 835-7000
www cityoffederalway.com
EXHIBIT A
SERVICES
Proiect Summary
The Agency shall provide culturally sensitive, safe shelter for single homeless women for up to 90 days. 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 4th
Quarter Quarter Quarter Quarter Total
JAN.— APRIL— JULY— OCT.—
MARCH JUNE SEPT. DEC.
No. of unduplicated Federal
Way pci-sons assisted in 2019 1 1 1 1 4
No. of unduplicated Federal
Way persons assisted in 2020 1 1 1 1 4
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. Bed Nights 25 25 25 25 100
2. Meals 178 178 178 178 712
3. Case Management 4 5 5 5 19
2020
1. Bed Nights 25 25 25 25 100
2. Meals 178 178 178 178 712
3. Case Management 4 5 5 5 19
HUMAN SERVICES AGREEMENT - 1 - HSA Exh 5/2017
` ;7y OF CITY HALL
Fe d e ra I Way 33325 8th Avenue South
Federal Way,WA 98003-6325
(253) 835-7000
www Wyoffederalway-com
C. Definition of Services
1. Bed Nights: The number of shelter bed nights provided. Average stay is 60 days, but clients may stay up to
90 days.
2. Meals: The number of meals provided.
3. Case Management: Hours of case management provided including goal setting.
D. Performance Measure(s)
Outcome(s) to be reported:
1. Individuals will have improved access to housing/shelter.
2. Individuals will have improved self-sufficiency.
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.
& 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 5/2017
` e1Tv of CITY HALL
Fe d e ra I Way Feder 8th Avenue South
Way 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.
King County FY 2018 Income Limits Summary
(effective 4/1/2018)
FY 2018
Median Income Income 1 2 3 4 5 6 7 8
King County Limit Person Persons Persons Persons Persons Persons Persons Persons
Category j
Extremely
Low
(30%) $22,200 $25,700 $28,900 $32,100 $34,700 $37,250 $39,850 $42,400
Income
Limits
Very Low
$103,400 (50%)
Income $37,450 $42,800 $48,150 $53,500 $57,800 $62,100 $66,350 $70,650
Limits
Low
(80%) $56,200 $64,200 $72,250 $80,250 $86,700 $93,100 $99,550 $105,950
Income
Limits
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.
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 5/2017
` CITY QFCITY HALL
Federal ■ ��r/■ay 33325 8fh Avenue South
� Federal Way.WA 98003-6325
(253) 835-7000
www atyoffederalway.com
EXHIBIT B
COMPENSATION
PP'€DjeC# Pit7C��i�.
The Agency shall apply the following funds to the project in accordance with the Line Item Budget Summary,
detailed below. The total amount of reimbursement pursuant to this Agreement shall not exceed Twenty
Thousand and 00/100 Dollars ($20,000.00).
A. City of Federal Way Funds 2019 2020
City of Federal Way General Fund: $10,000.00 $10,000.00
Total City of Federal Way Funds: $10,000.00 $10,000.00
B. Line Item Budget 2019 2020
Personnel Services (detail below) $10,000.00 $10,000.00
Office or Operating Supplies
Rent &Utilities
Communications
Travel and Training
Other(specify):
Client Travel
Administration(Overhead)
Total Clity of Federal Way Funds: $10,000.00 $10,000.00
C. Personnel Detail
Position Title Position Full Annual Salary Position Full HS Funds
Time and Benefits Time Equivalent
Equivalent HS Funded
Case Manager 1.0 $40,089.00 0.13 $5,000.00
Case Manager 0.75 $26,130.00 0.14 $57000.00
Total: 1 $66,219.00 1 $10,000.00
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 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 5/2017
` CITY OF CITY HALL
Fe d e ra l Way 33325 8th Avenue South
Federal Way,WA 98003-6325
(253) 835-7000
www Wyoffederalway-com
Estimated Quarterly Payments:
2019
1 st Qtr $2,500.00
2nd Qtr $2,500.00
3rd Qtr $2,500.00
4th Qtr $2,500.00
2020
1 St Qtr $2,500.00
2nd Qtr $2,500.00
3rd Qtr $2,500.00
4th Qtr $2,500.00
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 5/2017
MINUTES
Hospitality House Board Meeting
July 19, 2018
Present:Jane Lindley, Janeil Post, Emi Knowlton, Carol Hodges Brockway, Nadine Onstot, Peggy
Meyer, Sheenah Randolph
Absent: Barbara Atkinson, Terry Halvorson, Melissa Nelson
Minutes from the June 7, 2018 meeting were distributed. Correction was noted by Janeil:
Action was corrected to read "Janeil Post moved that the board review the budget to see if
there is money available." It was moved, seconded and voted to approve the corrected
minutes.
Action: It was moved, second and approved to accept Sheenah Randolph as the new Executive
Director under the contract that was distributed at the meeting. Welcome Sheenah!! Peggy
Meyer has sent out letters announcing Sheenah to sponsor churches, organizations and
volunteers.
Executive Director Report: Sheenah Randolph
1. Financials—June records have not been reconciled due to conflicts in scheduling a
meeting between Sheenah, Barbara Atkinson and Natalie Reber. The books look to be
correct and on target with the budget. A few new donations have come in to increase
income.
2. Staffing— Internal staff hours have been rearranged and increased to cover Sheenah's
previous position. Sheenah is interviewing applicants to complete overnight coverage.
Action: A motion was made, seconded and approved to accept Sheenah Randolph as a Fiscal
Agent for Hospitality House. This action allows her to access HH banking and to change names
on Hospitality House funding contracts.
Strawberry Festival: The event was successful. The Board plans to continue participation in the
future.
Newsletter/Communication: A discussion was held about the advisability of a quarterly
newsletter. Thanks to Emi, information about HH has increased on our website and Facebook.
We will continue to explore whether or not this is adequate to help our constituents feel
connected to what is happening at HH. An overnight volunteer has expressed interest in
meeting more staff, Board members and other volunteers. This might be something that fits
into a Meal Coordinator meeting.
Walk for the Women: Plans are being made and volunteers are filling in for the various tasks for
the event on September 15. Board members should plan on being there by 9:00 to set up. A
final planning/organizational meeting for the Walk is tentatively scheduled for Aug. 16.
Next Board Meeting/Strategic Planning: Sheenah and Peggy are working to set up a planning
retreat for current and new board members. The tentative dates are Sept. 29 or Oct. 6,
depending on scheduling of a facilitator and board members availability.
Respectfully submitted,
Nadine Onstot, Secretary
Coming Up:
-Sheenah out of town, July 25th to August 1St
- Peggy out of town August 10th to August 14th
- Meal Coordinators meeting Monday, August 13th
-Walk planning meeting August 16th
- Peggy out of town August 24th to September 1St
- Walk for the Women Saturday, September 15th
- Next board meeting Saturday September 29th, or Saturday October 6th
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r,■ ■ RTW�CA 'E OF COVERAGE >w a ,I=eDaie:.` n4ltdiQOi
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTAT IVE OR PRODUCER,AND THE CERT IFICATE HOLDER_
IMPORTANT If the certificate holder is an ADDITIONALW INSURED the policy(les)must be endorsed. If SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER COMPANIES AFFORDING COVERAGE
GENERAL LIABILITY
Clear Risk Solutions American Alternative Insurance Corporation,et al.
451 Diamond Drive
Ephrata,WA 98823 AUTOMOBILE LIABILITY
American Alternative Insurance Corporation, et al.
INSURED- - .•
PROPERTY
Hospitality House American Alternative Insurance Corporation,et al,
15003 14th Ave SW MISCELLANEOUS PROFESSIONAL LIABILITY
Burien,WA 98166 Princeton Excess and Surplus Lines Insurance Company
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
WD. IM E A4 .. fr
POLICY NUhTBER POLICYEFF POLICY EXP DESCRIP71ON -Did
,+rr U■ ..'• - 'DATE HATE - . rq... ■.
T
COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-09 06/01/2018 06/01/2020 PER OCCURRENCE $5,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $10,000,000
INCLUDES STOP GAP PRODUCT-CO MP/OP $5,000,000
PERSONAL&ADV INJURY $5,000,000
1U ABILITY IS SUBJECT TO A S5-0,�Jr0 SI,PAYA3LE FROM PROGRAM FUNDS i ANNUAL POOL AGGREGATE $50.000,000
AUTOMOBILE E IABILITY
ANY AUTO N1-A2-RL-0000013-09 06/01/2018 06/01/2020 COMBINED SINGLE LIMIT $5,000,000
fLtASIL-.`Y IS SUBJECT TO A$50.000 SIR PAYABLE=P._}P;I PR':;CRAiA FUNDS) ANNUAL P.^_xG'L A•GGRFi3ATE NONE
PROPERTY
N1-A2-RL-0000013-09 06/0112018 06/01/2020 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC EXCLUDED
FLOOD PER OCC EXCLUDED
PROPERTY IS St18_JEC7 Ti-,A!50.000 SIR PAYABLE FROM PF0CP,Sr•.S I'I_INDS1 ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N 1-A3-RL-0000060.09 06101 r20 i 8 06/0112(M,) PER CLAIM Sr,[iC}0,000
(LIABILITY IS SUBJECT TO A 55.).�JOG SIR PAYABLE FROM PROGRAM FUNDS} ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATION 51 LOCATIONS;VEHICLES I SPECIAL ITEMS
Regarding Human Services Agreement pertaining to safe shelter for single homeless women. City of Federal Way is named as
Additional Insured regarding this agreement only and is subject to policy terms,conditions,and exclusions.Additional Insured
endorsement is attached.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLI CY PROVISIONS.
CERTIFt_CA_T;G 06I&K 7 1_-_•. .. .. ._ _ _. � � AU7H�RIZ�9.REPRE$ENiAiIV�_ „_ - ,_ _ _
Attn:Sarah Bridggefard
City of Federal Way
33325 8th Avenue South
Federal Way,WA 98003-6325
3518488
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED— DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program(NPIP)
Policy Number Endorsement Effective
N1-A2-RL-0000013-09 6/1/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following,
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization(Additional Insured): As Per Schedule on file with Clear Risk Solutions,Underwriting Administrator
Attn:Sarah Bridgeford
City of Federal Way
33325 8th Avenue South
Federal Way,WA 98003-6325
Regarding Human Services Agreement pertaining to safe shelter for single homeless women.City of Federal Way is named as
Additional Insured regarding this agreement only and is subject to policy terms,conditions,and exclusions.Additional Insured
endorsement is attached.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions,Definitions
and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above
Schedule.Such Person or Organization is an Insured only with respect to liability for Bodily Injury,Property Damage,or
Personal and Advertising Injury caused in whole or in part by your acts or omissions or the acts or omissions of those
acting on your behalf.
1. In performance of your ongoing operations;or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement;or
2. Declarations for this policy,
whichever is less.These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Includes copyrighted material of the Insurance Services Office,Inc.,with its permission.
RL 2163 12/12 Page 1 of 1
3518489
CITY OF CITY HALL
Federal Way Feder 8th Avenue South
Federal Way,WA 98003-6325
(253) 835-7000
www cifyoffederalway.com
City of Federal Way
Human Services Contract for 2019-2020 General Fund
Authorized Signatures for Invoices
authorize the following individuals to sign invoices and quarterly reports on behalf of:
�l o S a t L \,-1 �"i 1 l r,�)S t: .................__ (Contracting Agency),
for
the following: ",S e.- A - . l'(Program Title).
r �
Authorizing C
Signature: S P ,nth KOA-n dO 1..71j
(must be signed by (Printed Name) (Title)
person who signs
the contract,
generally, /
Executive Director) .
(Signature) (Da ie)
Additional
Authorized
Signature: l M Q C c, g
(Printed Name) `-„J (Title)
2-4. 6
(Signature) ( te)
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.
12/20/2019 Corporations and Charities System
BUSINESS INFORMATION
Business Name:
HOSPITALITY HOUSE
UBI Number:
602 020 977
Business Type:
WA NONPROFIT CORPORATION
Business Status:
ACTIVE
Principal Office Street Address:
1419 SW 150TH ST, BURIEN, WA, 98166, UNITED STATES
Principal Office Mailing Address:
1419 SW 150TH ST, BURIEN, WA, 98166, UNITED STATES
Expiration Date:
03/31/2021
Jurisdiction:
UNITED STATES, WASHINGTON
Formation/Registration Date:
03/14/2000
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
CHARITABLE
REGISTERED AGENT INFORMATION
Registered Agent Name:
HOSPITALITY HOUSE
Street Address:
1419 SW 150TH ST, BURIEN, WA, 98166-1712, UNITED STATES
Mailing Address:
GOVERNORS
Title Governors Type Entity Name First Name Last Name
GOVERNOR INDIVIDUAL BARBARA ATKINSON
GOVERNOR INDIVIDUAL PEGGY MEYER
GOVERNOR INDIVIDUAL SHEENAH RANDOLPH
https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 1/1
3/14/2019 Corporations and Charities System
BUSINESS INFORMATION
Business Name:
HOSPITALITY HOUSE
UBI Number:
602 020 977
Business Type:
WA NONPROFIT CORPORATION
Business Status:
ACTIVE
Principal Office Street Address:
1419 SW 150TH ST,BURIEN,WA,98166,UNITED STATES
Principal Office Mailing Address:
1419 SW 150TH ST,BURIEN,WA,98166,UNITED STATES
Expiration Date:
03/31/2019
Jurisdiction:
UNITED STATES,WASHINGTON
Formation/Registration Date:
03/14/2000
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
CHARITABLE
REGISTERED AGENT INFORMATION
Registered Agent Name:
NATALIE REBER
Street Address:
1419 SW 150TH ST,BURIEN,WA,98166-0000,UNITED STATES
Mailing Address:
GOVERNORS
Title Governors Type Entity Name First Name Last Name
GOVERNOR INDIVIDUAL NATALIE REBER
GOVERNOR INDIVIDUAL BARBARA ATKINSON
GOVERNOR INDIVIDUAL PEGGY MEYER
hftps://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 1/1
