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Home My WebLink AboutAG 20-605 - Andrea Becker DDS PSmwtrlqlq,,�,� CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM *RIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT . ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE REQ. BY— AS AP TYPE OF DOCUMENT (CHECK ONE): El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) 0 PUBLIC WORKS CONTRACT 11 SMALL OR LIMITED PUBLIC WORKS CONTRACT El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT El GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CDBG E] REAL ESTATE DOCUMENT Ei SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) El ORDINANCE F-1 RESOLUTION El CONTRACTA NT (AG#):_ El INTERLOCAL X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT NGREEMENT . PROJECT NAME:—' CARES ACT GRANT—ROUND 2 NAME OF CONTRACTOR: ANDREA BECKER DDS PS ADDRESS: 118SW330THST#205,FEDERALWAY E-MAIL: ABECKFRDDS@LIVE.COM SIGNATURE NAME: ANDREA BECKER WA 98023-6185 T ELEPHONE: (253) 517-3477 TITLE: SEE ATTACHED EXHIBITS AND ATTACHMENTS: Ll SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El A OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS I COMMENCEMENT D. SEEATTACHEDAGREEMENT COMPLETION DATE - TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 ($1000.00) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: 1:1 YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED El YES X NO IF YES, $ — PAID BY: 0 CONTRACTOR 0 CITY RETAINAGE: RETAINAGE AMOUNT: 1:1 RETAINAGE AGREEMENT (SEE CONTRACT) OR [I RETAINAGE BOND ROVIDED 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 0 PROJECT MANAGER DZIRECTOR 0 RISKMANAGEMENT (IFAPPLICABLE) El LAW 1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: 2. CONTRACT SIGNATURE ROUTING 11 SENT TO VENDOR/CONTRACTOR DATE SENT: DATE C'D: El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS El CREATE ELECTRONIC REMINDER/NOTIFICATION 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 D LAW DEPARTMENT A &RG<ATORY (MAYOR OR DIRECTOR) El CITY CLERK 0 ASSIGNED AG# AG :OMMENTS: 'Ile 1/2020 CITY OF CrTY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 Federal Way (253) 835-7000 urww cityoffederalway com CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT WITH ANDREA BECKER DDS PS This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Andrea Becker DDS PS, a Washington corporation ("Grantee"). The City and Grantee (together "Parties") are located and do business at the below addresses which shall be valid for any notice ANDREA BECKER 118 SW 330th St # 205 FEDERAL WAY, WA 98023-6185 CITY OF FEDERAL WAY: asymalm Federal Way, WA 98003-6325 (253) 835-2414(telephone) (253) 835-2509 (facsimile) 1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions described herein. X" tAll-le" 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 F-•- •. • depaid all taxes and government fees due up to the date of execution of this grant agreement; d) Grantee's business employs no more than the equivalent of ten (10) full-time employees (20,800 man-hours total for all employees per year); e) Grantee's net revenues do not exceed more than $1.5 million per year; f) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue Service; g) Due to COVID-1 , Grantee business (check all that apply): XWas required by state or local order to close E] Was forced to lay off employees due to reduced patronage Incurred over $1,000 in COVID-19 related expenses El Experienced 10-50% lost revenue 9 Experienced over 50% lost revenue 2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes: a) Mortgage or Rent b) Personal Protection Equipment CARES ACT BUSINESS GRANT AGREEMENT - I - CITY OF Fedeml VWty c) Insurance d) Utilities e) MarketinV f) Payroll CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 wwwatyoffedei-alwaycom Grantee agrees to retain receipts documenting use of grant funds and will provide them 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 rnay 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 V 4,krvtn_�cmount not to exceed One Thousand and NO/100 Dollars ($1,000.00). 4.2 Non -A unds are not appropriated or allocated for payment pprgpriation of Funds. If sufficient f under this Agreement for any fiscal period, the City will not be obligated to make payments under this agreement. 5.1 Grantee hidenwifidation. 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 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 these covenants of indemnification. 5.2 Industrial Insurance Act Waiver. 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 a&s or any other benefits acts or programs. The Parties further acknowledge that they have mutually negotiated this waiver. 5.3 CM ItiddippAcation. The City agrees to release, indemnify, defend and hold the Grantee, its C17Y HALL 33325 9th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 msw cityoffederalway corn 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, -2 agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the exten! 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. 1 0 1 11 1 kk - 6.1 hiteWrdtation and Modificatin. 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. I ir! 111 It -g -M 1 11 m us I I (A U.) I I I I to a [W. I I uJ I a I I I tom 6"r.1% I to) I ywu E 18 1 116 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 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 CARES ACT BUSINESS GRANT AGREEMENT -3- CITY HALL 33325 Sth Avenue South Federal Way, WA 98003-6325 (253) 835-7000 w cityoffederalway coo together i shall constituteone instrument, but . • proof . _i.'. it shallonly 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. ANDREA ECKER DDS PS: By: �. Printed e: Title. ATE: ry «� W Ps License Information: Expiration date Entity name: ANDREA BECKER DDS PS Business name: ANDREA BECKER DDS PS Entity type: Professional Service Corporation UI #: 604-127-738 Business ID: 001 Location ID: 0002 Location: Active Location address: 118 SW 330TH ST STE 205 FEDERAL WAY WA 98023-6185 Mailing address: 118 SW 330TH ST STE 205 FEDERAL WAY WA 98023-6185 Excise tax and reseller permit status: Click here Secretary of State status: Click here Endorsements Endorsements held at this location License # Count Dental X-ray/CT/ Pan/Ceph Federal Way General Business 00 -101345 -00 -BL X -Ray: Dental/Podiatric[Veterinary Governing People May include governing people not registered with Secretary of State Governing people Title BECKER,ANDREA Registered Trade Names Registered trade names 0, View Additional Locations New search Back to results Status Expiration date First issuanCE Active May -31-2021 Sep -29-2017 Active I May -31-2021 Jan -14-2000 Active May -31-2021 Sep -29-2017 # H - , 0 1 1 . * I Working together to fund Washington's future First issued Sep -21-2017