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HomeMy WebLinkAboutAG 20-644 - Northwest Vision & Learning CenterRETURN TO: Tim Johnson EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TTM JOHNSON EXT: 2412 3. DATE REQ. BY: ASAP
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 ❑ HUMAN SERVICES/ CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
5. PROJECT NAME: CARES ACT GRANT — ROUND 2
6. NAME OF CONTRACTOR: NORTHWEST VISION & LEARNING CENTER PLLC (DBA CURTIS R BAXSTROM, OD)
ADDRESS: 1705S324 TH PL, FEDERAL WAY WA 98003 T ELEPHONE: (253) 661-6005
E-MAIL: BAXSTROM@EARTHLINK.NET
SIGNATURE NAME: CURTIS BAXSTROM TITLE:. SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETION DATE:
9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) TWO THOUSAND AND NO/100 ($2,000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED
❑ YES X NO IF YES, $
RETAINAGE: RETAINAGE AMOUNT:
PROVIDED
PAID BY: ❑ CONTRACTOR ❑ CITY
❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND
❑ PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 Proiect Code 4267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ FR9JEft MANAGER
M-ERRECTOR
❑ RISK MANAGEMENT (IFAPPLICABLE)
❑ LAW
11. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ 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
❑ LAYDEPARTMENT N/
NATORY (MAYOR OR DIRECTOR) r
❑ CITY CLERK
❑ ASSIGNED AG# AG#
COMMENTS:
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[. r, ...�..L .9e,ti_L.z.0
1/2020
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253)835-7000
www. cityoffederabmy com
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
NORTHWEST VISION & LEARNING PLLC
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Northwest Vision & Learning PLLC, a professional limited liability company
("Grantee"). The City and Grantee (together "Parties") are located and do business at the below addresses which
shall be valid for any notice required under this Agreement:
NORTHWEST VISION & LEARNING PLLC:
CURTIS BAXSTROM
1705 S 324th PI
FEDERAL WAY, WA 98003-8504
(253) 661-6005 (telephone)
The Parties agree as follows:
CITY OF FEDERAL WAY:
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2414 (telephone)
(253) 835-2509 (facsimile)
T . . .-. .. m . .
com
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's business employees 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-19, Grantee business (check all that apply):
❑ Was required by state or local order to close
❑ Was forced to lay off employees due to reduced patronage
❑ Incurred over $1,000 in COVID-19 related expenses
❑ 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:
a) Mortgage or Rent
b) Personal Protection Equipment
CARES ACT BUSINESS GRANT AGREEMENT - 1 -
7/2020
CITY OF
Federal Way
c) Insurance
d) Utilities
e) Marketing
f) Payroll
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 635-7000
WWW a1yolYedera4way com
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 may
recover all disbursed grant funds and terminate this agreement.
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 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. INDEMNIFICATION.
5.1 Grantee Indemnification. 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 acts or any other benefits acts or programs. The Parties further acknowledge
that they have mutually negotiated this waiver.
CARES ACT BUSINESS GRANT AGREEMENT -2-
7/2020
2-
7/2020
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
WWW cityOffeds Amy- corn
5.3 Cily 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. GENERAL PROVISIONS.
6.1 Int retation and Modification. 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.
6.2 Enforcement. 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 pasted in the United States mail shall be deemed received three (3) days after the date ofmailing. 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 Supeiior 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, nothing in this paragraph shall be construed to limit the Parties' rights to indemnification under Section
5 of this Agreement.
CARES ACT BUSINESS GRANT AGREEMENT -3-
7/2020
3-
7/2020
CI T V or
Federal Way
CITY MALL
3332± 3e+ Avenuo SOulh
Fede+ra;Way. %V- 98003-F'325
!253 i 335-707
6.3 )rxecution. Each individual executing this Agmemcni on behalf of the City and Grantee represents
ind ,warrants that such individual is duly :stitiwrjzcd to cxecutc mid deliver this /1tsncinen1. This Agreement may
ITL' exccuied in wig nwrzber of cvtmterlxarLs, each cif which shall be dccmcd an original and ►+.�ith the game effect
as ifatI Panics hereto had sigm:d the same; clot -un tent Ali such counterparts shall be oomstrued together and shall
mmstitute one instrument. but in making proof hereof it shat) only be necessary to produce one such counterpart.
The signature and acknowledgment pages firam such coemterpmts may be assembled together to form a single
tredntn>ent comprised of all pages of this Agrccmcm and a caomplcte set of all signature and acknowlodgmcrit
pages. 'Thc date upon which the last of all ol'the Parties have executed a counterpart of this Agreement shall be
the `date of mutual execution" hereof.
IN WITNESS, the Parties e:xe nde this Agreement below, effective the last date written below.
CITY O FEDERAL WAY:
Ji rrc . Mayor
DATE: ////
a/4:? O
NORTI I WEST VISION & LEARNING CENTER PI.I.C:
By:
Printed Mame: C4,Anr 6,,, rnw"
Title: ow%e--
DATE: 11- 9 . W
C'ARF.S ACT RtlSINFSS GRANT AGREEMENT -4-
72020
4..,2020
9/29/2020 Washington State Department of Revenue
. , ,,' ��,Cton I -,
f Business Lookup
License Information: New search Back to results
Entity name: NORTHWEST VISION & LEARNING CENTER PLLC
Business name: CURTIS R.BAXSTROM OD
Entity type: Professional Limited Liability Company
UBI #: 602-599-784
Business ID: 001
Location ID: 0002
Location: Active
Location address: 1705 S 324TH PL
FEDERAL WAY WA 98003-8504
Mailing address: 1705 S 324TH PL
FEDERAL WAY WA 98003-8504
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 dal
Federal Way General Business 93 -103611 -00 -BL Active Mar -31-2021 Dec -01-1999
Governing People May include gov ming people not registered with Seemary o(State
Governing People Title
8AX5TROM, CURTIS
View Additional Locations
The Business Lookup information is updated nightly. Search date and time: 9/29/2020 11:24:25 AM
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