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AG 22-142 - MULTI-SERVICE CENTER (MSC)1. ORIGINATING DEPT./DIV: CD/CS 2. ORIGINATING STAFF PERSON: Bill Vadino EXT: 2420 3. DATE REQ. BY: 4, TYPE OF DOCUMENT (CHECK ONE): El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) El PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT o PROFESSIONAL SERVICE AGREEMENT [I MAINTENANCE AGREEMENT El GOODS AND SERVICE AGREEMENT A HUMAN SERVICES/ CDBG o REAL ESTATE DOCUMENT E SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) • ORDINANCE 0 RESOLUTION • CONTRACT AMENDMENT (AG#):_— DINTERLOCAL • OTHER 5. PROJECT NAME: Food and Clothing Bank 6. NAME OF CONTRACTOR: Multi -Service Center ADDRESS: TELEPHONE—..--,,, E-MAIL: F SIGNATURE NAME TITLE 7. EXHIBITS AND ATTACHMENTS: A SCOPE, WORK OR SERVICES Lw COMPENSATION [I INSURANCE REQUIREMENTS/CERTIFICATE 91" ALL OTHER REFERENCED EXHIBITS A PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS 9. TOTAL COMPENSATION $15,000 00 mmm (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: Ej YES A NO IF YES, MAXIMUM DOLLAR AMOUNT: $1 IS SALES TAX OWED t5YES ONO IF YES, $ PAID BY: El CONTRACTOR El CITY RETAINAGE: RETAINAGE AMOUNT:,_,,,,-_-----, o RETAINAGE AGREEMENT (SEE CONTRACT) OR Ei RETAINAGE BOND PROVIDED El PURCHASING: PLEASE CHARGE TO: 001-1100-020-513-10-410 10. DOCUMENT/CONTRACT REVIEW IN ITIAL/DATE REVIEWED INITIALLQATF-APPROVEQ A PROJECT MANAGER TB 12115/2022 El DIRECTOR m. D RISK MANAGEMENT (IF APPLICABLE) A LAW I- KVA 1 2 /1 612022 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: - n .. /a COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:--,--, El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS D CREATE ELECTRONIC REMINDS OTIFICATION 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 S GNED D LAW DEPARTMENT V It 12 11ex A SIGNATORY (MAYOR OR DIRECTOR) El CITY CLERK 1:1 ASSIGNED AG# AG# COMMENTS: Approved by Mayor Ferrell 1218/2022 2/2017 CITY OF CH­Y HALL 4 33325 8th Avenue South Federal Way Federal Way, WA 98003-6325 (253) 835-7000 vvww cltyoffederalway. com HUMAN SERVICES AGREEMENT FOR FOOD AND CLOTHING BANK corporation ("City"), and Multi -Service Center, a Washington nonprofit corporation ("Agency"). The City anf Agency (together "Parties") are located and do business at the below addresses which shall be valid for any notice required under this Agreement: Robin Cork 1200336 1h Street Federal Way, WA 98003 253-835-7678 (telephone) robinc@,mschelp.org "611WA Federal Way, WA 98003-6325 (253) 835-2420 (telephone) ovimly'kh4_1 1. TERM. The term of this Agreement shall be for a period commencing on December 1, 2022 and terminating on December 31, 2022 ("Term"). Funding for the second year of the Agreement is contingent upon satisfactory Agreement ,Performance during the first year of the Agreement term and unpon funding availability 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 r_. 191- a #11 M*J I ft M N 11472 11 TQ R ZRIM713IT1071 TU 14 W011 all applicable agencies and governmental entities, including but not limited to obtaining a City of Federal Way business registration. Services shall begin immediately —Won the effective date of this Agreement. Services shall be subJ,_e �. �' ` 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 ifthe Agency fails to maintain required insurance, breaches confidentiality, or materially violates Section 12, and such may result in ineligibility for further City agreements. 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 Exhi 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. W# I r-B I Lei 4,311 a) I I n I Gre HUMAN SERVICES AGREEMENT - I - 12/2022 4z CITY W Fbderal VVby CITY HALL 33325 8th Avenue South dw2PXz A-9W# (253) 835-7000 -vww cityoffederalway. corn le-Awlej le U11101'rus serymmirm I "Ifseq,17elif invoice,;7proTT eu, noviever, I ity filay elect to pay any invoice that is not submitted in a timely manner. 4.3 Budge . 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/Prograrn Exhibit is exDected to exceed ten -r- 1 a POMI IN "S 11 W I - #" I mom. CC -dJTJ OaVf"C�10_CS P, W, If %im I tic ILCIII U11141 F I I I ti I I a I I I -9ct rc-T V514111 1 C111M 1, 0 "1 reviewed and approved or denied by the City in writing. 4.4 No-Appropdati it of funds. If sufficient funds are not appropriated or allocated for payment under this funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies. I 5.1 A&�cv W&iunific6tiou. 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. Droceedin s. Jud entl-awards,, itiuries. ar-MUMM40 IN mIr-1.�W!Itto"iW-lA&V-r-i4,�W6141'.II.MW*U MAN A I It [Welf(0) I 117W.41 Q) I RMIR IOXOJ A UvAr I MIR 115 IN I NO 0- U W �-DT-Vf-n-fc7pi IF -yrfdffVC7 CXMWYII sole negligence. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in 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 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. Apg-elric 'h indemnification shall not be limited in aaban limitr •n A 5.3 ODL��Ou. 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, -a "it causes of action- arbitrations, mediations, qroceedings,�ud ents. a,:. i l r abilities. lossM 9—m fines.-fees�qenalties exvenses. attomeN's fees_cpsts, and/or litigation ex venses to or bki n 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 pe rf-b=qAr-e-of.LV- g ej-eW- *3ieP5-4N. 911h9!Uf& MAI U1 W -Offl the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows: HUMAN SERVICES AGREEMENT -2- 12/2022 4 city OF P4deral Voy CITT HALL 33325 8th Avenue South Federal Wa�4_VVA=PJ1_P_P__-L• (253) 835-7000 www cityoffederalway corn 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-comDIeted olgerations sto. liability, advertising injury, and liability assumed under an insured contract with limits no less than $2,000,000 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 11ei 6.2. No limit of Liability. 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 res-,tect the Ci1g, Ang insurance - self-insur Agency's insurance and shall not contribute with it. RMINLIMIUC P01WICS. t,011UUrre11L WILH LIX eXeCUL1011 01 Lnis Agreement, Agency snaii provicie certificates or 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. log 8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design specifications performing the Services shall belong to the City upon delivery. The Agency shall make such data, documents, and files avail. •A;i to the y and shall deliver all needed or contrwltz_tifmw-t� is AUBMEIRWIM01 00 01011 - - '," I - a Jye�K 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. Now obtained under this Affeement. The Citv shall be neither liable nor obliga&ml--�.* n&e_ v% I, A 11 6 I 9xv 5 Lei a 11 F-4; 1 Ln,.Mq HUMAN SERVICES AGREEMENT -3- 12/2022 CITY 60 CITY HALL 33325 Sth Avenue South & Federal Way, WA 98003-6325 Fddeml IA� 100160�� (253) 835-7000 vvww. cityoffederalway- com .4 ITIn-STI- "10, TIMIUSS-al 11-01ILS-C-141-11 Forlient, of to MEMO any - 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 ofthe 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, ioverned bv. and interDreted in accordance with the law ally (CISPILM, J-111CI-011CC Or (;]Ullll dr. 1'reellieln, mr, uAk;mSITv lan-LIS 01 resolvilig LIM ulspuue, ulifererice, or claim, shall be by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, -rMdes 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 A costs and attorney's fees and e&qenses incurred in defending or brin ing, such claim or lawsuit includingAl-a3Weals 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 ii duli autbiriii w a --A ow 0-Ammoilik- �-- document. All such countergarts shall be construed together and shall ca-cstiltite oTe i-tstruT#ejt1,'-@ut 4, xtagErivt liereto it NENllso" - a ,Mlwil"1 1"UN• N•I=1WN1,11,1101111"111ONW - 11ffil1I101•1 and acknx &zi4gmL`xi-6-pf--g shall be the "date of mutual execution" hereof HUMAN SERVICES AGREEMENT -5- 12/2022 CITY Of OA� 56deral Yyoy Kli Iiiiii ftlkiWi ftil M V .. '' I 1 1 741113111171 11i'l � I � I RW I! 111c CITY HALL 33325 8th Avenue South 4�"_UW__i0"' *i_4444,ll (253) 835-7000 www cityoffederalway com q4hlinie Co uxtney, CMC,UClerk Iii, 11238M DATE: Ryan Call, City Attorney Title: DATE: 1 11 ) ss. COUNTY OF 911CI On till day personally appew d etbre me 1A I IC&L to me known to be the 2, no Re V �kr --that executed the foregoing instrument, and acknowledied the said instrument to be the free and voluntary act and deed of said comoration •r 1IRW i and that the seal affixed, if any, is the corporate seal of said corporation. d and o'M GIVEN my hanfficial seal this Al�! HUMAN SERVICES AGREEMENT - 6 - 12/2022 10,14:11:31 PLoject Services SuniffiRai CITY HALL 33325 8th Avenue South (25 835-7000 WW - cityoffederal "M The Agency shall provide fresh produce and dairy for holiday food boxes in the City of Federal Way. The Agency shall ensure that services provided with funding under this Agreement are made available to Feder Way residents. I 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 2 nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — MARCH JUNE SEPT. DEC. No. of unduplicated Federal Way persons assisted in 485 485 December 2022 B. Units of Service The Agency agrees to provide, at minimum, the following its of service by quarter: 1st 2 nd 3 rd 4 th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — CH JUNE SEPT. DEC. 2022 1. Food 485 485 Units of service are measured by number of unduplicated household visits. C. Outcome Measure(s) I Outcome: 485 households will receive approximately 6 pounds of food or an estimated 5 meals for the 2022 Christmas Holiday season Indicator: Number of households served Target: 100% HUMAN SERVICES AGREEMENT - 7 - 12/2022 CITY OF CITY HALL 33325 8th Avenue South 4! Federal Way, WA 98003-6325 AN Federal Way (253) 835-7000 www. cityoffederalway- com 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. 8. Documentation of client address; residency verified via King County Parcel Viewer. 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 2022 Income Limits Summary Median FY 2022 Income Income 1 2 3 4 5 6 7 8 King Limit Person Persons Persons Persons Persons Persons Persons Persons County Cate ory Extremely Low (30%) $27,200 $31,050 $34,950 $38,800 $41,950 $45,050 $48,150 $51,250 Income Limits Very Low $1349600 (50%) Income $45,300 $51,800 $58,250 $64,700 $69,900 $75,100 $80,250 $85,450 Limits Low (80%) $66,750 $76,250 $85,800 $959300 $102,950 $110,550 $118,200 $125,800 Income Limits Reports an a orting 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 dat.9- 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. CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www-cftyaffederalway com Public Information inciucte intormation identifying the source of tunds as the City ot Federal 'IT ay A-uman Services Cieneral Funif Progrun. HUMAN SERVICES AGREEMENT -9- 12/2022 CITY HALL 33325 Sth Avenue South Way Federal Way, WA 98003-6325 (253) 835-7000 www. cityoffederalway com 1 *14 so 1110 V 6 Is ProLect Budget # I I a I •14Nil 1kY1W R LAIN4 I U-IMOMMOAM 50 U-• 4 1 111�14 City of Federal Way Fudds City of Federal Way General Fund: Total City of Federal Way Funds: $5,000.00 B. Line Item Budget 2022_, "Tood $5,000.00 Other Total City of Federal Way Funds: Method of Pnt Annual Outcome Data Report are due January 15. The Agency shall submit payment requests in the format requested by the City. Payment requests shall include a copy of the Service Unit Report and any supporting documents for the billing period. Expenses must be incurred P i Le riorto submission of reimbursement req-uest-Prw-f-oL---Y4vjA& for the invoice to be approved. 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 milgoals and the A - encw has shown reasonable efforts to overcome these 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. HUMAN SERVICES AGREEMENT -10- 12/2022 MULTI-3 OP ID! LIABILITYCERTIFICATE OF INSURANCE 03/031141022 ISSUEDTHIS CERTIFICATE IS AS A MATTER OF •- it ONLY r CONFERS NO RIGHTS UPON -HOLDER. THIS CERTIFICATE DOES NOTOR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE•-DPOLICIES BELOW.OF - • DOES NOT• • - INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATEHOLDER. r nigia il.15N.1 I ll-1 Man I Iltzm k.,ill IWIM4111ii-I MAW Wil"1111il- r ._r•.. .. 1. :'i y `y , : MA .r 1 y •:.. - Y: * n 1 � Federal Way, WA 98093-0699 INSURER COM91RAGES CERTIFIC T E O N MB R>_ THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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. INSR TypE OF INSURANCE �ADDLI5UBRI POLICY NUMBER POLICY EFF i POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY . �acrl OCCURRENCE s 1,000,000 . CLAIMS -MADE I X; OCCUR X PHPK2385789 _ DAMAGE TO RENTED 03/01/2022 03/01/2023 pRFM1 ESLEa_ccsure_nce� S, ._ _ _ 1,000 OOO I_MED EXP I_PERSOgAnyoneperspn) 5 _— 5,000 . 1,000,000 & ADV INJURY _ S CEN i. a.GGREGA.TE LIMIT APPLIES PER .. :GENERAL AGGREGATE g--- 3,000,000 I PIS- -- POLICY - JEFF t. LOG PRODUCTS COMPIOP AGG.1.? 3,000,000 ... OTHFR A AUTOMOBILE LIABILITY COMBINED t)SINGLE LIMIT S 1,000,000 I ANY PHP 2386789 03/01/2022.03101/2023 1 F3GIDILYJN„1!„IRYtPerneisar2) X .OWNED I SCHEDULED .AUTOS ONLY ,.,. AUTOS { I :BODILY INJURY (P�r accadenk}i .S ) PROPERTY DAMAGE HIRED _X .. .. AUTOS ONLY ,. AUON-Q4) NLI,D:.; -�. S PERTY I: .. �_S------ -: A X UMBRELLA LIAB X .00CUR 1,000,000 . EXCESS LIAB I CLAIMS -MADE, ' �PHU 805264 03101/2022103/0112023 AGGREGATE s 1,000,000.' �... 1 0 r DED BETEN.TION sPER A WORKERS COMPENSATION 1 XH AND EMPLOYERS ° uasluTY YtN PHPK2385789 ANY PROPRIETOR/PARTNERIEXECUTIVE 03/01/2022' 03/0112023 L EACH ACClLlEN7 $ - 1,000,000 ^FI{;ERtUIEMBER EXCLUDED? L N t A WA STOP GAP E 1,000,000 ' _ _ arldatiawy in NH) -- - L DISEASE EA EMPLOYEE Sti,--- ....___v ._._.. If yes describe under 1,000,000 :.. ' DESCRIPTION OF OPERATIONS below LE-L DISEASE- POLICY UNIT S A !CRIME !PHPK2385789 0310112022 03/01/2023 LIMIT 100,000 EMPLOYEE DISHONEST DED i 5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) It is a reed the Cft of Federal Way and King County, its officers, Insured if by officials, ernplo�+ ees and agents are additional required General Llabill Written contract or agreement, subject to the additional Statililtyy CDB YES, Food insured provision endorsement Projects. Housing & Clothing Sank, Infant Feeding Program , CERTIFIC61g HQLPgJ3 CANCELLATIghl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Federal Way Attn: Sarah Bridgeford P ox 971 AUTHORIZED REPRESENTATIVE 33325 8th Avenue S F@&r@1 Way. WA 9 0 3-9718 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. 10113/22, 8:50 AM Corporations and Charities System ljr.ess%rpo�Myaand Charities Filing System 04-11M 1200 S 336TH ST, FEDERAL WAY, WA, 98003-6347, UNITED STATES 1200 S 336TH ST, FEDERAL WAY, WA, 98003-6347, UNITED STATES J 111IN91FROW wifflZiurk COMMUNITY ACTION NON-PROFIT 11 https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation Business Name: Business Type: Business Status: Principal Office Street Address: Principal Office Mailing Address: Expiration Date: Formation/ Registration Date: Period of Duration, Inactive Date: Nature of Business: H 10113)22, 8:50 AM 91-2161205 Corporations and Charities System Gross Revenue exceed $500,000, Has Members: Public Benefit Designation: Host Ficirne: Registered Agent Name: Mailing Address: Title Governors Type Entity Name First Name Last Name GOVERNOR INDIVIDUAL RETIE EWING GOVERNOR INDIVIDUAL CHRIS BERRY GOVERNOR INDIVIDUAL JOE ATKIN SON GOVERNOR INDIVIDUAL ROBIN CORAL https/IcGfs,gos,wa.govl#/BusinessSearchiBustnessInformatwon 2/3 ffmgmgg�� Corporations and Charities System =I in Filing History Name History Print Return to Business Search ---------- https://ccfs.sos.wa.gov/#/BusinessSearch/BusinessinforTnation 3/3