The URL can be used to link to this page

Home My WebLink AboutAG 20-305 - Washington Jaw and Facial SurgeryEmi RETURN TO: TIM JOHNSON ME CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM , ORIGINATING DEPT./DIV- EC,ONOMICDEVELOPMENT 01WGINATING STAFF PERSON: _IRA �QnSON � EXT: 2412 1 DATE REQBY.' ASAP Ei PUBLIC WORKS CONTRACT 'Ei SMALL OR LIMITED PUBLIC WORKS CONTRACT • PROFESSIONAL SERVICE AGREEMENT Ei MAINTENANCE AGREEMENT • GOODS AND SERVICE AGREEMENT Cl HUMAN SERVICES/ CDBG Ei REAL ESTATE DOCUMENT 11 SECURITY DOCUMENT (E.G BOND RELATED DOCUMENTS) o ORDINANCE El RESOLUTION [3 CONTRACTAMENDMENT(AG#): 0 E%ITERLOCAL X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT PROJECTNAME: CARESAcrGRANr—RouNDI NAME OF CONTRACTOR: JAW AND DENTAL IMPLANT CENTER ADDRESS: 33801 1 STAVES, #311, FEDERALWAY, WA, 98003 TELEPHONE: (425)301-9609 450#0ky E-MAIL: 33801WA@GMAIL,COM SIGNATURE NAME: Guo Guo TITLE: SEE ACHED EXHD31TS AND ATTACHMENTS: 11 SCOPE, WORK OR SERVICES El COMPENSATION C1 INSURANCE REQUIREMENTS/CERTIFICATE 11 ALL OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN D REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETIONDATE: TOTAL CO (INCLUDE EXPENSES AND SALES TAX, IF ANY) Two THOUSAND AND NOII 00 ($2,00000) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: El YES XNO IF YES, MAXIMUM DOLLAR AMOUNT:$____,_ IS SALES TAX OWED El YES X NO IF YES, $ PAID Br El CONTRACTOR El CITY RETAINAGE: RETAfNAGF AMOUNT: RETAINAGE AGREEMENT (SEE CONTRACT) OR [I RETAINAGE BOND PROVIDE El PURCHASING: PLEASE CHARGE TO. 001-1800-990-518-10-490 Project Code# 267662-25060 0. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL/ DATE APPROVED 0P JECT MANAGER l!]ZIROECTOR 11 RISKMANAGEMENT (IFAPPLICABLE) 11 LAW 1. COUNCIL APPROVA-L (IF APPLICABLE) SCHEDULED COMMITTEE DATE: Comm= APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 0 SENT TO VENDOR/CONTRACTOR DATE SENT: DATE El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS El 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 0 LAW DEPARTMENT NED BYLAW 0148�io ORY (MAYOR OR DIRECTOR) 11 CITY CLERK El ASSIGNED MIM -5,00-14 1/2020 CITY OF ,A, F;6dem I CITY HALL 33325 8th Avenue South �11 T�F UMV-7MY 71n, WITH WASHINGTON JAW AND FACIAL SURGERY This Grant Agreement C'Agreemenf) is made between the City of Federal Way, a Washington municip corporation ("Cityand Washington Jaw and Facial Surgery, a professional linuted liability comp C'Grantee"). The City and Grantee (together 'Tarties") are located and do business at the below address which shall be valid for any notice required under this Agreement: Wei Guo, 33801 IST AVE S,#311 EFITIF"a 4,L_W141y,1U11,&1"__1 (425) 301-9609 (telephone) 33801wa@gmail.com The Parties agree as follows: to) _C1_TY OF FEDERAL WAY: Ade Ariwoola 33 325 8th Ave. S. Federal Way, WA 98003-6322' (253) 835-2520 (telephone) (253) 835-2509 (facsiraile) ade.afiwoola@cityoffederalway.com ---------- - 1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions Lescribed herein. 2.1 MLarranties. The Grantee warrants the following, wbich 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 pandernic 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). 0 Grantee's net revenues do not exceed more than $1.5 mon per year g) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue Service h) Due to COVID-1 9, Grantee business (check all that apply): �:roqulrIxf by state or local order to close s hfd6d to �# o#*Oloyees due to reduced patronage Incurred over S 1�000 'in COVID- 19 related expenses li4crienadI:l 10.60% lost revenue EXpetiddded over 50% lost revenue VMITXAFTTQ�� 0" OF CITY HALL 33325 Sth Y Avenue South Federai Way, WA 98003-6325 (253) 836-7000 2.2 Us of funds: Granteeaffirms that grant fbnds Will be used for the following purposes: 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 them to the City or its designee upon request. 3. Tt9M1tjAJM. 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. p 4. GRANT AMOUNT 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 Two Thousand and NO/100 Dollars ($2,000.00). 4.2 Nbgt4ppophatiwn of Funds. If sufficient fimds are not appropriated or allocated for payment under this Agrepment for any fiscal period, the City will not be obligated to make payments under this agreement. kJ! 5.1 GfAftteelq&19�60_ 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 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 liabty fbr 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 ts elected officials officers. M 0_�10��fMtWu;cTie. volunteers to the extent and on the same terms and conditions as the Grantee pursuant to this pa0grapit. The City's inspection or acceptance of any of Grantee's work when comoWe4 shall not be grounds to avoid any of these covenants of indemnification. 5.2 Industrial LV_uL4go Agt_]MA�� It ii specifically and expressly understood that the Grantee I waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51 All, AA, i PT f % 0 1114. for • 4A�CITY, OF 'CITY HALL OPM a 33325 Sth Avenue South veaeml vl��Y Federal Way, WA 98003-6325 (253) 835-7000 wmk000do"** corn represents and warrants that such individual is duly authorized to executeand deliver this Agreement. Agreement may be executed in any number of counterparts, each of which shall be deemed an original and wi the same eff�ct as if all Parties hereto had signed the same document. All such counterparts shall be constru tog4er AM A4 constitute 666 instrum04 Wt in making proof hereof it shall •® be necessary to pr* one such counterpart. The signature and acknowledgment •a®^ fromi such counterparts may be ass , "I together to form a single instrument comprised of all pages of this Agreement and a complete set of signature and acknowledgment pages. i upon which the last of t: the Parties have executed 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. By: Printed Name: Title: DATE: Services Business Lookup JAW AND DENTAL IMPLANT CENTER License Information: New search Back to results Entity name: WEI GUO, D.M.D., M.D., PLLC Business name: JAW AND DENTAL IMPLANT CENTER Entity type: Professional Limited Liability Company UI #: 602-993-321 Business ID: 001 Location ID: 0001 Location: Active Location address: 33801 1 ST WAY S STE 311 FEDERAL WAY WA 98003-4548 Mailing address: 33801 1 ST WAY S STE 311 FEDERAL WAY WA 98003-4548 Excise tax and reseller permit status: Click here Secretary of State status: Click here Endorsements Endorsements held at this location License # Count Details Status Expiration date First issuance Dental X-ray/CT/ Pan/Ceph 1 Active Feb -28-2021 Nov -15-2017 Federal Way General Business 10 -104151 -00 -BL Active Feb -28-2021 Oct -01-2010 X -Ray: Dental/Podiatric/Veterinary Active Feb -28-2021 Nov -15-2017 Governing People may include governing people not registered with Secretary of State Governing people Title GUO, WEI Registered Trade Names Registered trade names Status First issued JAW AND DENTAL IMPLANT CENTER Active Feb -22-2012 WASHINGTON JAW AND FACIAL SURGERY Active Feb -22-2012 WOODINVILLE ORAL & MAXILLOFICIAL SURGERY Active May -08-2018 View Additional Locations The Business Lookup information is updated nightly. Search date and time: 7/25/2020 1:48:32 PM hftps://secure.dor.wa.gov/gteunauth/,/#326