HomeMy WebLinkAboutAG 20-304 - Jackieboy DesignRETURN TO: TIM JOHNSON EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
I
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: - TIM JOHNSON EXT: 2412 3. DATE Q. BY: ASAP
TYPE OF DOCUMENT (CHECK ONE):
El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
1:1 PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
E] GOODS AND SERVICE AGREEMENT Ei HUMAN SERVICES/ CDG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE El RESOLUTION
El CONTRACT AMENDMENT (AG#):_ El INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANTAGREEMENT
PROJECT NAME:CARES ACT GRANT -ROUND
NAME OF CONTRACTOR: JACKIEBOY DESIGN
ADDRESS: 639 SW 299TH PL, FEDERAL WAY, WA, 98023 TELEPHONE: (206) 251-0318
E-MAIL: JAK15l4@GMAIL.COM
SIGNATURE NAME: TABALBAG TABALBAG TITLE: SEE ACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES 11 COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS 11 PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
I TERM: COMMENCEMENT DATE: EE ATTACHED AGREEMENT_- COMPLETION DATE -
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO1100 ($1,000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: El YES X NO IF YES, MAXIMUM DOLLAR AMOUNT:
IS SALES TAX OWED El YES X NO IF YES, $ PAID BY: El CONTRACTOR 11 CITY
RETAINAGE: RETAINAGE AMOUNT: _i_-.11 11 RETAMAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND PROVIDE
El PURCHASING: PLEASECHARGETO: 001-1800-990-518-10-490 P
0. DOCUMENT/CONTRACT REVIEW
1:1 PROJECT MANAGER
F-1 DIRECTOR
El RISKMANAGE MENT (IF APPLICABLE)
El LAW
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SCHEDULED COMMITTEE DATE:
SCHEDULED COUNCIL DATE:
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COMMITTEE APPROVAL DATE:
COUNCIL APPROVAL DATE:
0 SENT TO VENDOR/CONT RACTOR DATE SENT: DATE REC'D:----
11 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
El CREATE ELECTRONIC REMINDERINOTIFICATION FOR I 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
El LAW DEPARTMENT SIGNED By LAW 07-28-20
Ei SIGNATORY (MAYOR OR DIRECTOR)
El CITY CLERK
IT
0 ASSIGNED AG# AG—Of A4(
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'OMMENTS.
1/2020
CM OF
FOderal My
CITY HALL
33325 Sth Avenue South
Federal Way WA 98003-6325
(253) 835-7000
www o1yoffederalwqy coin
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WITH
JACKIEBOY DESIGN;
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Jackieboy Design, a sole proprietor ("Grantee"). The City and Grantee (together
"Partie,-* are located and do business at the below addresses which shall be valid for any notice re:*,uired under
this Agreement:
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Jackie Tabalbag
639 SW 299TH PL
FEDERAL WAY, WA 98023
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Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2520 (telephone)
(253) 835-2509 (facsimile)
---------------
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
2. CONDITIONS OF GRANT
2.1 Warranties. The Grantee warrants the following, which are pre -requisites for grant eligibility:
a)
Grantee operates a business physically located within the political boundaries of the City
of Federal Way-,
b)
Grantee maintains a current City of Federal Way business license
c)
Grantee has paid all taxes and government fees due up to the date of execution of this
grant agreement
d)
Grantee is not the recipient of other state or federal funding made available as a response
to the COVID- 19 pandemic
e)
Grantee's business employees no more than the equivalent of ten (10) full-time
employees (20,800 man-hours total for all employees per year).
f)
Grantee's net revenues do not exceed more than $1.5 million per year
g)
Grantee does not operate as a tax-exempt business as defined by the Internal Revenue
Service
h)
Due to COVID- 19, Grantee business (check all that apply):
E] Was required by state or local order to close
E] Was forced to lay off employees due to reduced patronage
E] Incurred over $ 1,000 in COI D- 19 related expenses
E] Experienced 10-50% lost revenue
Experienced over 50% lost revenue
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes:
MEMO,= �,, �111_ ]�M
CITY OF CITY HALL
33325 8th Avenue South
AN*' Federal Way, WA 98003-6325
Fe eral Way (253) 835-7000
www cityoffederalway. com
a) Mortgage or Rent
b) Personal Protection Equipment
c) Insurance
d) Utilities
e) Marketing
F) Payroll
Grantee agrees to retain receipts documenting use of grant funds and will provide the to the City or its
designee upon request.
3. TERMINATION. Should any of the conditions described in section 2.1, above, not be met, the City
may recover all disbursed grant funds and terminate this agreement.
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses
Grantee has incurred due to the COVID- 19 pandemic, the City shall provide a grant to the Grantee in an amount
not to exceed One Thousand and NO/I 00 Dollars ($ 1,000.00).
4.2 Non -Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment
under this Agreement for any fiscal period, the City will not be obligated to make payments under this
agreement.
5.1 Gran� Jndmnj�gafipp. The Grantee 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 exaenses to or bp anp and all Goersons or entiti s, including. without I
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 Grantee and the City, the Grantee's liability hereunder shall be
only to the extent of the Grantee's negligence. Grantee shall ensure that each sub -Grantee 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 Grantee pursuant to this paragraph. The
City's inspection or acceptance of any of Grantee's work when completed shall not be grounds to avoid any of
5.2 Industrial Insurance Act 11"Waillyle'r. It is specifically and expressly understood that the Grantee
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. Grantee'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.
CItY OF
A**
P6deml Way
CrTY HALL
33325 8th Avenue South
Federal Way,, WA 98003-6325
(253) 835-7000
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5.3 My Indemnification. The City agrees to release, indemnify, defend and hold the Grantee, its
officers, directors, shareholders, partners, employees, agents, representatives, and sub- contractors 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.
6.1 lhteWtqqO� god This Agreement 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. 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. 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.
10 -1
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6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
A IN, R METO-1
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As� Federal V%kiy
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CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
wwwo"ffedeialwaycom
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.
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OEX-EDERAL WAY:
Jmr rretw iviayor
DATE:
JACKIEBOY DESIGN:
By:
Printed Name:
Title: ()IAIYV,/Y'
DATE: 1�— I
Fl� �., �1160� �11.1 12�1 �ELJ�2
7/25/2020
Washington State Department of Revenuie
S.,ervices BUS4")E5 Lookup JACKIEBOY DESIGN
License Information:
eServices
Entity name: TABALBAG, JACKIE ALLENDA
Business name: JACKIEBOY DESIGN
Entity type: Sole Proprietor
UBI #: 603-181-306
Business ID: 001
Location ID: 0001
Location: Active
Location address: 639 SW 299TH PL
FEDERAL WAY WA 98023-3573
Mailing address: 639 SW 299TH PL
FEDERAL WAY WA 98023-3573
Excise tax and reseller permit status: Click here
Endorsements
Endorsements held at this location License Count Details
Federal Way General Business 17 -104845 -00 -BL
Governing People May include governing people not registered with Secretary of State
Governing people Title
TA ALA, JACKIE ALLENDA
Registered Trade Names
New search Back to results
Status Expiration date First issuance
Active Feb -28-2021 Oct -16-2017
Registered trade names Status First issued
JACKIEBOY DESIGN Active Feb -13-2012
The Business Lookup information is updated nightly. Search date and time: 7/25/2020 1:48:04 PM
https:Hsecure.dor.wa.gov/gteunauth/—,/#323 ill
