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AG 23-056 - THE GENESIS PROJECT
RETURN TO: Victoria Banks EXT: 2604 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM ORIGINATING DEPT./DIV. CD/CS . ORIGINATING STAFF PERSON: Patti Spaulding-Kiewin EXT: 2651 3. DATE REQ. BY: 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 m HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT(AG#): ❑ OTHER . PROJECT NAME: Drop -in Center Operations NAME OF CONTRACTOR: The Genesis Project ADDRESS: 2819S 2oath Street a.connere@comcast.net ❑ INTERLOCAL TELEPHONE 206-396-6544 FAX: SIGNATURENAME: Andy Conner TITLE EXHIBITS AND ATTACHMENTS: A SCOPE, WORK OR SERVICES ® COMPENSATION A INSURANCE REQUIREMENTS/CERTIFICATE IN ALL OTHER REFERENCED EXHIBITS 2 PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS TERM: COMMENCEMENT DATE: 01/01/2023 COMPLETION DATE: 12/31/2024 TOTAL COMPENSATION $ 12,000.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE -ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES If NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ®YES ONO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDE ❑ PURCHASING: PLEASE CHARGE TO: 001-7300-063-562-10-410 0. DOCUMENT/CONTRACT REVIEW INITIAL/ DATE REVIEWED ❑ PROJECT MANAGER SJB 12/14/2022 ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) X LAW KVA 12/21 /2022 1. COUNCILAPPROVAL(IFAPPLICABLE) COMMITTEE APPROVAL DATE: N/A 2. CONTRACT SIGNATURE ROUTING IN SENT TO VENDOR/CONTRACTOR DATE SENT: 1/26/23 INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: 11 /15/2022 DATE REC'D: 3110/23 ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ 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 'SakW DEPARTMENT VV i n Za 4• © SIGNATORY (MAYOR OR DIRECTOR) CITY CLERK ASSIGNED AG# A ;OMMENTS: kpproved Council budget 11/15/2022 CITY OF CITY HALL Federal Way 33325 Avenue South Federal Way, WA 98003-6325 (253)835-7000 www cityoffederalway com HUMAN SERVICES AGREEMENT FOR DROP -IN CENTER OPERATIONS This Human Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and The Genesis Project Seattle, a Washington nonprofit corporation ("Agency"). The City and Agency (together "Parties") are located and do business at the below addresses which shall be valid for any notice required under this Agreement: THE GENESIS PROJECT SEATTLE: CITY OF FEDERAL WAY: Andy Conner Patti Spaulding-Klewin 2819 S 208th St 33325 8th Ave. S. SeaTac, WA 98198 Federal Way, WA 98003-6325 206-396-6544 (telephone) (253) 835-2651 (telephone) a.conner(-,comcast.net Patti. Spaulding-Klewin@cityoffederalwa .com The Parties agree as follows: 1. TERM. The term of this Agreement shall be for a period commencing on January 1, 2023 and terminating on December 31, 2024 ("Term"). Funding for the second year of the Agreement is contingent upon satisfactory Agreement performance during the first year of the Agreement term and upon funding availability. This Agreement may 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 incorporated by this reference ("Services"), in a manner consistent with the accepted professional practices for other similar services within the Puget Sound region in effect at the time those services are performed to the City's satisfaction, within the time period prescribed by the City and pursuant to the direction of the Mayor or his or her designee. The Agency warrants that it has the requisite training, skill, and experience necessary to provide the Services and is appropriately accredited and licensed by all applicable agencies and governmental entities, including but not limited to obtaining a City of Federal Way business registration. Services shall begin immediately upon the effective date of this Agreement. Services shall be subject, at all times, 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 if the Agency fails to maintain required insurance, breaches confidentiality, or materially violates Section 12, and such may result in ineligibility for further City agreements. 4. COMPENSATION. 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 Exhibit B, attached hereto and incorporated by this reference. The City shall 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. 4.2 Method of Pn ment. On a quarterly basis, the Agency shall submit to the City an invoice for payment on a form provided by the City and all reports as required by this Agreement. Payment shall be made on a quarterly basis by the City only after the Services have been performed and within forty-five (45) days after the City's receipt and approval of a complete and correct invoice and reports. The City will use the quantity of Services actually delivered, as reported on the HUMAN SERVICES AGREEMENT - 1 - 10/2022 C[71f of CITY HALL A4Fe de ra y Feder l Avenue South Federal Way, WA 98003-6325 (253) 835-7000 wwwcitWffederahvay.. com 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 any time during the term of this Agreement. Exceptions may be made at the discretion of the City's Human Services Manager in cases where circumstances beyond the Agency's control impact its ability to meet its service unit goals and the Agency has shown reasonable efforts to overcome these circumstances to meet its goals. If the 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. 4.3 Final Invoice. The Agency shall submit its final invoice by the date indicated on Exhibit B. If the Agency's final invoice and reports are not submitted by the last date specified in Exhibit B, the City shall be relieved of all liability for payment to the Agency of the amounts set forth in said invoice or any subsequent invoice; provided, however, that the City may elect to pay any invoice that is not submitted in a timely manner. 4.4 Nan -Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this Agreement for any future fiscal period, the City will not be obligated to make payments for Services or amounts incurred after the end of the current fiscal period, and this Agreement will terminate upon the completion of all remaining Services for which funds are allocated. No penalty or expense shall accrue to the City in the event this provision applies. 5. INDEMNIFICATION. 5.1 Agency Indemnification. 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, 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 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 Waiver. 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. Agency'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. 5.3 City Indemnification. 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, 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. HUMAN SERVICES AGREEMENT - 2 - 10/2022 CITY OF CITY HALL 33325 4 Feder Fe d e ra i Way8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway com 6. INSURANCE. The Agency agrees to carry insurance for liability which may arise from or in connection with the performance of the services or work by the Agency, their agents, representatives, employees or subcontractors for the duration of the Agreement and thereafter with respect to any event occurring prior to such expiration or termination as follows: 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 -completed operations, stop gap liability, personal injury, bodily injury, death, property damage, products 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 minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for bodily injury, including personal injury or death, and property damage. 6.2. No Limit of L &Llity. 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 respect the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Agency's insurance and shall not contribute with it. 6.3. Additional Insured, Verification. The City shall be named as additional insured on all commercial general liability insurance policies. Concurrent with the execution of this Agreement, Agency shall provide certificates of 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. 7. CONFIDENTIALITY. All information regarding the City obtained by Agency in performance of this Agreement shall be considered confidential subject to applicable laws. Breach of confidentiality by the Agency may be grounds for immediate termination. All records submitted by the City to the Agency will be safeguarded by the Agency. The Agency will fully cooperate with the City in identifying, assembling, and providing records in case of any public records disclosure request. 8. WORK PRODUCT. All originals and copies of work product, including plans, sketches, layouts, designs, design specifications, records, files, computer disks, magnetic media or material which may be produced or modified by Agency while performing the Services shall belong to the City upon delivery. The Agency shall make such data, documents, and files available to the City and shall deliver all needed or contracted for work product upon the City's request. At the expiration or termination of this Agreement all originals and copies of any such work product remaining in the possession of Agency shall be delivered to the City. 9. BOOKS AND RECORDS. The Agency agrees to maintain books, records, and documents which sufficiently and properly reflect all direct and indirect costs related to the performance of the Services and maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Agreement. These records shall be maintained for a period of six (6) years after the termination of this Agreement and may be subject, at all 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. 10. INDEPENDENT CONTRACTOR. The Parties intend that the Agency shall be an independent contractor and that the Agency has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. The City shall be neither liable nor obligated to pay Agency sick leave, vacation pay or HUMAN SERVICES AGREEMENT - 3 - 10/2022 CITY OF CITY HALL ,,4S Feder 8th Avenue South Federal Way, WA 98003-6325 Fe �e ra I �a� (253) 835-7000 www. ciryoffederalway com any other benefit of employment, nor to pay any social security or other tax which may arise as an incident of employment. Agency shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the Services and work and shall utilize all protection necessary for that purpose. All work shall be done at Agency's own risk, and Agency shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. The Agency shall pay all income and other taxes due except as specifically provided in Section 4. Industrial or any other insurance that is purchased for the benefit of the City, regardless of whether such may provide a secondary or incidental benefit to the Agency, shall not be deemed to convert this Agreement to an employment contract. 11. CONFLICT OF INTEREST. It is recognized that Agency may or will be performing services during the Term for other parties; however, such performance of other services shall not conflict with or interfere with Agency's ability to perform the Services. Agency agrees to resolve any such conflicts of interest in favor of the City. Agency confirms that Agency does not have a business interest or a close family relationship with any City officer or employee who was, is, or will be involved in the Agency's selection, negotiation, drafting, signing, administration, or evaluating the Agency's performance. 12. EQUAL OPPORTUNITY EMPLOYER. In all services, programs, activities, hiring, and employment made possible by or resulting from this Agreement or any subcontract, there shall be no discrimination by Agency or its subcontractors of any level, or any of those entities' employees, agents, sub -agencies, or representatives against any person because of sex, age (except minimum age and retirement provisions), race, color, religion, creed, national origin, marital status, or the presence of any disability, including sensory, mental or physical handicaps, unless based upon a bona fide occupational qualification in relationship to hiring and employment. This requirement shall apply to, but not be limited to, the following: employment, advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, including apprenticeship. Agency shall comply with and shall not violate any of the terms of Chapter 49.60 RC W, Title VI of the Civil Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973, 49 CFR Part 21, 21.5 and 26, or any other applicable federal, state, or local law or regulation regarding non-discrimination. 13. GENERAL PROVISIONS. 13.1 Interpretation and Modification. This Agreement, together with any attached Exhibits, 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. Should any language in any Exhibits to this Agreement conflict with any language in this Agreement, the terms of this Agreement shall prevail. The respective captions of the Sections of this Agreement are inserted for convenience of reference only and shall not be deemed to modify or otherwise affect any of the provisions of this Agreement. 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. Any act done by either Party prior to the effective date of the Agreement that is consistent with the authority of the Agreement and compliant with the terms of the Agreement, is hereby ratified as having been performed under the Agreement. 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. 13.2 Assigunent and Beneficiaries. Neither the Agency nor the City shall have the right to transfer or assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written consent of the other Party. If the non -assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action or interest in this Agreement based on any provision set forth herein. HUMAN SERVICES AGREEMENT - 4 - 10/2022 CITY OF CITY HALL Federal Way 33325Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway com 13.3 Compliance with Laws. The Agency shall comply with and perform the Services in accordance with all applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions, regulations, rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation of the City's Ethics Resolution No. 91-54, as amended, occurs as a result of the formation or performance of this Agreement, this Agreement may be rendered null and void, at the City's option. 13.4 Enforcement. Time is of the essence in this Agreement and each and all of its provisions in which performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the Agency's performance of this Agreement. 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 posted in the United States mail shall be deemed received three (3) days after the date of mailing. 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 Superior 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, 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 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 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. [Signature page follows] HUMAN SERVICES AGREEMENT - 5 - 10/2022 CITY OF CITY HALL Fe d e ra [ flay Feder l Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www.atyoffederalway com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. DATE: 3 1136-3 THE GENESIS PROJECT SEATTLE: By: Q Printed Name: ANb Title: i' ` ►�-7 �''' �, DATE: 2-2-�,' STATE OF WASHINGTON ) ss. COUNTY OF GI!� {- ATTEST: ourfney, CWC, City Clerk 7.PPROVY AS TO FORM: /j 1__� L_ — J, yan all, City Attorneil— On this day personally appeared before me ham'- to me known to be the of L 1 that executed the foregoing 4instTient, and acknowledged the said instrument to be the f e ancT voluntary act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that he/she was authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. f] GIVEN my hand and official seal this ��day of ROBERTSCAVOTTO Notary Public State of Washington Commission # 15687 My Comm. Expires Apr 17, 2024 Notary's signature Notary's printed name 2W2.� Notary P hi , in and for the Stat of ashingto . My commission expires HUMAN SERVICES AGREEMENT - 6 - 10/2022 4-6- - j r CITY OF Federal Proiect Services Summary CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. rityolfederal way com EXHIBIT A SERVICES The Agency shall provide drop -in services for survivors of sexual exploitation. The Agency shall ensure that services provided with funding under this Agreement are made available to Federal Way residents. 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 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — MARCH JUNE SEPT. DEC. No. of unduplicated Federal Way persons assisted in 2023 1 0 1 0 2 No. of unduplicated Federal Way persons assisted in 2024 1 0 1 0 2 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — MARCH JUNE SEPT. DEC. 2023 1. Case Management 1 0 1 0 2 2024 1. Case Management 1 1 0 1 1 01 2 Units of service are measured by individuals accessing drop -in center services. C. Outcome Measure(s) HUMAN SERVICES AGREEMENT - 7 - 10/2022 CITY OF Federal CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 wwwcityoffederalway com Outcome: Program participants achieve and/or further goals related to housing, legal issues, job skills training, and socio-economic relief Indicator: Client -centered action plan identifying goals, and progress as measured by data collected per client visit and tracked in Apricot, the Client Management Software Target: 85% 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. HUMAN SERVICES AGREEMENT - 8 - 10/2022 ,�SCITY of � Federal CITY HALL Way33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway. com 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 Countv Category Extremely Low (30%) $27,200 $31,050 $34,950 $38,800 $41,950 $45,050 $48,150 $51,250 Income Limits Very Low $134,600 (50%) $45,300 $51,800 $58,250 $64,700 $69,900 $75,100 $80,250 $85,450 Income Limits Low (80%) $66,750 $76,250 $85,800 $95,300 $102,950 $110,550 $118,200 $125,800 Income Limits The Agency agrees to use updated Income Guidelines which will be provided by the City. Reports and Renorting 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 data 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. Public Information In all news releases and other public notices related to projects funded under this Agreement, the Agency will include information identifying the source of funds as the City of Federal Way Human Services General Fund Program. HUMAN SERVICES AGREEMENT - 9 - 10/2022 CITY OF Federal Pryiect Budget CITY HALL Way33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cilyoffederalway com EXHIBIT B COMPENSATION The Agency shall apply the following funds to the project. The total amount of compensation pursuant to this Agreement shall not exceed Twelve Thousand and 00/100 Dollars ($12,000.00). City of Federal Way Funds 2023 2024 -City-of FederalWa General Fund: - - - -$6;000.00- -- $6;000-00- Total City of Federal Way Funds: $6,000.00 $6,000.00 . Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly and are due on the following dates: 1 st Quarter: April 15 or within 10 days of notice to proceed, whichever is later; 2nd Quarter: July 15; 3rd Quarter: October 15; and 4th Quarter: Final Reimbursement Request and Service Unit Report forms due January 8; Demographic Data Report and Annual Outcome Data Report 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. Estimated Quarterly Payments: 2023 1st Qtr $1,500.00 2nd Qtr $1,500.00 3rd Qtr $1,500.00 4th Qtr $1,500.00 2024 1st Qtr $1,500.00 2nd Qtr $1,500.00 3rd Qtr $1,500.00 4th Qtr $1,500.00 Quarterly payment requests shall not exceed the estimated payment without prior written approval from the City. Estimated quarterly payments are contingent upon meeting or exceeding the above performance measure(s) for the corresponding quarter. This requirement may be waived at the sole discretion of the City with satisfactory explanation of how the performance measure will be met by year-end on the Service Unit Report. HUMAN SERVICES AGREEMENT - 10 - 10/2022 THE GENESIS PROJECT, formerly known as Club Corridor AMENDED BYLAWS ARTICLE I CHANGE OF NAME OF CORPORATION The name of this corporation from now forward shall be The Genesis Project Seattle, a Washington non-profit corporation. The former name Club Corridor or any variation thereof will no longer be used to refer to this corporation. ARTICLE II AMENDED PURPOSE OF THE CORPORATION This corporation shall be organized and operated exclusively for charitable, religious, and educational purposes. Subject to the limitations stated in the Article of Incorporation, the purposes of this corporation shall be to engage in any lawful activities, none of which are for profit. And, for which corporations may be organized under the Revised Code of Washington Title 24.03 (or its corresponding future provisions) and Section 501(c)(3) of the Internal revenue Code of 1954 (or its corresponding future provisions). The goal of The Genesis Project is to provide support for treatment, education, shelter, training, and rehabilitation and restoration for female victims of sex -trafficking. This mission/vision is to include a 24/7 drop in center that offers educational/training/counseling/shelter/life skill training/and much more, as well as long term transitional housing. In the long term it is the purpose of The Genesis Project Seattle to duplicate GP projects and create a blueprint for planting other like minded Genesis Projects nationally and eventually internationally. The Genesis Project is a Christian Faith Based organization and will be run in such a way that upholds, abides, and reflects all aspects of the Bible and Christ's Teachings. This project will be continually seeking the wisdom and direction from God first and will be led in the same manner. This is the goal and purpose of the organization and should amend and change any previously stated goals and purposes of the organization in previously filed Articles and Bylaws. ARTICLE III GOVERNANCE OF THE GENESIS PROJECT An appointed Board of Directors shall govern this corporation, led and appointed by the founding President. Board members may also be elected as determined by the President. KCCPNW BYLAWS ARTICLE IV BOARD OF DIRECTORS Section 1. Duties: The Board of Directors shall manage all of the affairs of the corporation. Section 2. Number: The number of Directors may vary from four to fifteen and shall consist of at least four elected Directors at all times. Section 3. Nomination and Election of Board Members. a. Currently the founding President appoints the board members and Directors. b. A slate of candidates for the Board may be presented annually from a list of nominees submitted by the Board. C. The consent of each candidate must be obtained prior to nomination. d. Nominees may or may not be considered each year by presiding board determined by the Founding President. e. New Board members (directors or general) will have a 6 month probation period. During this time this member may have their board member status revoked and terminated by the sole discretion of the Founding President. Section 4. Term of Office. The term of office for Directors shall be determined by the Founding President. Currently directors shall hold a 4 year term of office. The Founding President is exempt from terms. A Director may be re-elected without limitation on the number of terms he or she may serve. Directors must be approved by the Founding President to run for additional terms Section 5. Vacancy and Removal. a. In the event an elected board member resigns or requests a leave of absence. during a term, the Board President may appoint a replacement for the balance of the term subject to ratification by the Board. If the result of a board member resigning or takes a leave of absence brings the number of board members below #4, the presiding President may immediately appoint a replacement at his/her discretion to fulfill a legal number of Board Members with or without ratification of the board. b. If a board member fails to attend scheduled necessary meetings and breaks contact and or disengages with the activities of the Genesis Project, they have in fact forfeited their board member privileges and powers and are now subject to termination by majority vote of remaining board members. C. One half of the Board may be elected (Set by Founding President). Even numbered positions should be elected in the even numbered years and odd numbered positions should be elected in odd numbered years. (Set by Founding President) KCCPNW BYLAWS d. Any board member may be removed and replaced by the Board whenever, in the judgment of 3/4 of the Board determined by vote, the best interests of the Board will be served (in line with Vision/Mission of GP) and/or the board member engages in conduct unbecoming of a member of the Board via a presidential initiated investigation. To include not living by the Biblical principles according to the Christian Faith. (see h — below) The Founding President cannot be discharged in this manner — see Article V, Section 1, letter F below. e. The Founding President shall establish the procedures and due process for removal in board policies and procedures. f. Board members shall always adhere to the mission and vision and goals of the Genesis Project Seattle, set forth in Article II (purpose of corporation) g. Board members who deviate from above listed (e) may be subject to a special hearing to investigate a vote of removal via the President. h. The President only, has the authority to initiate an investigation on board members who have deviated from the mission, vision and goals of GP or who have engaged in conduct unbecoming a GP board member. During the investigative time period the member or members under investigation have no voting authority or board privileges or powers until the investigation is completed and the member has been retained. i. In the event of a tie vote the Presidents vote will swing the decision in question in his/her favor. Section 6. Responsibilities of the Board The Board shall: a. Establish policies and procedures in accordance with the Bylaws and ensure compliance with these policies. b. Govern, implement and administer in accordance with the Bylaws. C. Attend fundraising activities — assist the ED in leading the events. d. Do all other things necessary and proper to carry out the purposes of the Board. e. Determine and approve the budget and establish fiscal policies and procedures. Section 7. Board Meetings and Votes a. The Board shall meet at least four times each year. b. Regular attendance at Board meetings shall be expected. More than two (2) consecutive unexcused absences shall be deemed grounds for removal from the Board, at the discretion of the residing Board President. C. At all meetings of the Board, a majority of the entire board shall be necessary to constitute a quorum for the transaction of business. The vote of the majority of the members present at the time of the vote, if a quorum is present, shall be the act of the Board, except as may be otherwise specifically provided by the Bylaws or Articles of Incorporation. d. If a quorum is not present at any meeting of the Board, the members present at such meetings may adjourn the meeting until a quorum is present. Notice of any KCCPNW BYLAWS such adjournment shall be given to absent members. e. A Board member is deemed present whether appearing in person, telephonically, or by other electronic means in which the board member can communicate with the other board members. f. Currently the board is 4 — quorum for this board is 3. g. In the event of a tie vote the Presidents vote will swing the decision in question in his/her favor h. While the Founding President resides on the board he shall have the equivalent to (2) two full board member votes. i. The Founding President's wife, and Co -Founder, regardless of her position, title or status, shall have an equal board vote in any matter presented before the board, in any board meeting where a vote is required or requested. j. Only the President can call for a board meeting, and will in fact set the time and place of said meeting(s). The President will also set the agenda, items brought up in the meeting that are not on the agenda but requiring or requesting a vote shall be postponed for the next scheduled board meeting, unless the President deems it not necessary to extend the agenda item for the next meeting. k. A majority vote of the GP Staff will serve as (1) equal board vote on any formal voting measure or issue when requested. Only the Founding President has the authority to request and allow this process to happen, and it is solely based on his discretion. Section 8. Qualifications and Requirements for Board Membership Board Membership is available on an open -and -equal basis regardless of race, color, creed, sex or national origin. Board members however must share, agree and accept the Christian Faith According to the Bible in its entirety. Board members must live in such a manner as to be above reproach concerning their walk in Christ. They shall also Tithe according to the Bible principal and be subject to any request from other board members to show this action is taking place. They must be Christians, as described within the Bible. Section 9. Annual Meeting. The Genesis Project shall hold an Annual Meeting set by the President who shall determine the month (not yet determined) Section 10. Compensation Members of the Board shall not receive any compensation for their services. Expense reimbursements may be allowed as outlined in Board Policies and Procedures, to include stipends for certain events and time requirements. KCCPNW BYLAWS ARTICLE V OFFICERS Section 1. The President: a. Preside at all meetings of the Board and Executive Committee. b. Set the time and place of Board and Executive Committee meetings. C. Set the Agenda for each Board Meeting. d. Present the annual report, during the annual meeting that has been prepared by the Executive Director. e. Only the President can initiate a formal investigation on another board member. f. The Founding President -has the unique authority_ to guide GP the way he feels God is leading it, and in the event of a divided board where there is any of the following; disharmony, discord, division, unethical behavior, and other forms of lawlessness, the Founding President can call for an emergency Board Meeting and override other board members and re-establish order and put GP back in line with God's vision as he sees fit and by his discretion. g. The Founding President is subject to comply with the Biblical Principles of the Christian Faith and must comply with the Vision/Mission of GP as God intended. Three seasoned Spirit Filled Christian Pastors (voted by majority board vote) shall monitor and hold the Founding President accountable for his actions and if at any time the Founding President deviates from God's Biblical principles and the Vision/Mission of GP for a substantial period of time the Three Pastors with a Majority vote of the Board can remove the Founding President of his Presidential duties and authority. If this occurs and there is evidence of true repentance the same process can re-establish the Founding President back into his Authority and duties. Section 2. The Vice President shall: a. Exercise the duties of the President (however, not the special "Founding" Presidential duties) in the event of the absence of the President. b. Assist the President in administrative matters as established in the Board policies and procedures. C. Be a member of the executive Committee. Section 3. The Secretary shall: a. Assist the President in administrative matters as established in Policies and Procedures. b. Keep and distribute written/recorded minutes of the meetings of the Board and Executive Committee. C. Be a member of the Executive Committee. Section 4: The Treasurer shall: KCCPNW BYLAWS a. Assist the President in administrative matters as established in Policies and Procedures. b. Oversee financial documents and activities in accordance to Bylaws, as well as monitor designated employees who have access to the corporation's funds. C. Oversee the maintenance of the Board financial accounts and records. d. Make a financial report to the Board at each regularly scheduled meeting and at the annual meeting of the Board and at other times as the President or board may require, with the assistance from the Executive Director. e. Be a member of the Executive Committee. ARTICLE VII ELECTION OF OFFICERS Section 1. The elected/appointed officers of the corporation are: a. President (Currently the Founding President) b. Vice President (Appointed by the Founding President) C. Secretary (Appointed by the Founding President) d. Treasurer (Appointed by the Founding President) Section 2. Nominations and Elections a. Officers may be elected from a slate of candidates developed from nominations from board Members at the time of the elections. b. The consent of each candidate should be obtained prior to nomination. C. Candidates must be voting members of the Board. d. Election of officers shall be by written ballot when there is more than one nominee for an office. If there is but one nominee, the election may be by voice vote, or if approved by founding President. e. Each nominee must first be approved by the Founding President before he/she can be considered for the board. f. In the event that the Founding President decides to step down from the Presidential Executive position, he will have sole discretion in appointing his successor as President. Section 3. Term of Office a. An officer's term shall be set by the Founding President. Current terms are 4 years for officers/directors as well as general board members. The founding President is exempt from term limits. b. There shall be no limitation on the number of terms served. C. The President (non Founding) shall be elected in even numbered years. The Vice KCCPNW BYLAWS President, Secretary and Treasurer shall be elected in odd numbered years. Section 4. Vacancy and Removal a. In the event an elected officer resigns or requests a leave of absence during a term, it shall be the responsibility of the President to appoint a replacement for the balance of the term, subject to ratification by the Board. See section 5, letter a) for additional terms. Also see Article IV section 5, letter a) for other terms b. Any officer except for the Founding President may be removed and replaced by the Board whenever in the judgment of the Board the best interests of the Board will be served and/or the board member has engaged in conduct unbecoming a member of the board, or deviates from the Mission/Vision and goals of the corporation. Adequate Evidence of this Section must be presented and proven. An independent arbitrator may be requested by the member in question to determine if the removal is within the by-law policy. This arbitrator process must be first approved by the Founding President, otherwise it shall not be allowed. C. The Board Policies and Procedures shall establish the procedure and due process for the removal from office. Section 5. Conduct unbecoming a member of the Board of Directors a. Conduct unbecoming a member of the board is defined as any conduct that: 1. Is incompatible with the best interests of the public or of members of the Board concerning the Vision/Goals/Objectives of GP. 2. Tends or threatens to harm the standing or reputation of the board in the local or National community. 3. Deviation from Mission/Vision/Goals and Purpose of the Genesis Project Seattle. (See Article II — Purpose of Corporation) 4. Deviation from the Biblical Principals of the Christian Faith 5. Practicing unethical and or immoral behavior of any kind to include gossip, lying, and purposely deviating from GP policies and protocols. b. Violation of conduct unbecoming a member of the board may result in disciplinary action, to include termination, against the offending member as outlined in the Board Policies and Procedures. KCCPNW BYLAWS ARTICLE VIII EXECUTIVE COMMITTEE Section 1. Composition of the Executive Committee a. The elected/appointed officers, as described in Article VI, shall constitute the Board Executive Committee. b. Committee Chairs will be invited to the executive committee. Section 2. Meetings a. The Executive Committee may meet as it deems necessary to carry on the business of the Board, determined by the President. b. Subject to the ratification by the Founding President, the Executive Committee shall have the power to make ongoing decisions between board meetings Section 3. Quorum and Action A quorum at a committee meeting exercising board functions shall be a majority of all committee members in office immediately before the meeting begins. If a quorum is present, action is taken by a majority vote of the Officers present. Attendance may be by telephonic or other electronic means in which the committee members may communicate with each other. Section 4. Limitations on the Powers of Committees No committee may approve dissolution, merger, or the sale, pledge, or transfer of all or substantially all of the corporation's assets. No committee may adopt, amend, or repeal the articles, bylaws, or any resolution by the Board of Directors. Section 5. Committee Chairperson Appointments The Executive Committee may assist the President in appointing Standing Committee Chairpersons upon request. ARTICLE IX COMMITTEES The President shall appoint standing Committee Chairpersons. Committees and Committee responsibilities shall be outlined in the Board Policies and Procedures. KCCPNW BYLAWS ARTICLE X FUND RAISING ACTIVITIES Section 1. Contributions All contributions to the Genesis Project shall be made to the Board's authorized accounts. Section 2. Notification a. The Board must authorize all fundraising activities. b. Any use of the Corporation's name as a participant in fundraising activity must have Board approval six weeks prior to the activity, or otherwise approved by board. C. All fundraising activities must comply with the fundraising policies and procedures outlined by the Board. ARTICLE XI FISCAL AND FINANCIAL POLICIES The Fiscal year of the Board shall be from January 1 through December 31. Section 1. Budget The Executive Committee and or Executive Director will prepare the annual budget for Board approval. Section 2. Expenditures Any presiding officer may authorize all expenditures in amounts not exceeding one thousand dollars ($1000.00) each. Signatures or verbal agreement of two members of the Executive Committee must authorize expenditures exceeding one thousand dollars ($1000.00), or by the Founding President. ARTICLE XII AMENDMENTS Section 1. Amending the Bylaws a. The Board shall have the power to alter, amend, repeal or adopt Bylaws. Written notice containing the text of any proposed bylaws changes shall be sent to the Board at least ten (10) days prior to such vote. b, The Articles or Bylaws may be altered, amended, or repealed and new Articles or Bylaws may be adopted by an affirmative vote of two-thirds of the board members at a meeting of the Board called for that specific purpose. C. Any altered, amended, repealed and or new Articles or Bylaws must be approved KCCPNW BYLAWS first by the Founding President to be finalized as new Bylaws or Articles. If such changes are not approved by the Founding President then they are null and void without authority or purpose. ARTICLE XIH AUTHORITY The rules contained in the current edition of Roberts Rules of Order, Newly Revired, shall govern the Board in all cases to which they are applicable and in which they are not inconsistent with these Bylaws, or any special rules of order the Board may adopt, as well as needing to be approved by the founding President. ARTICLE XIV DISSOLUTION Section 1. Dissolution of the Genesis Project a. Upon dissolution of the Board, and after paying or adequately providing for the debts and obligations of the corporation, all remaining assets shall be distributed to any charitable foundation organized by, and benefiting, the fight against Sex Trafficking. These articles are adopted as the full and complete articles of the Genesis Project Seattle, formally known as Club Corridor, and should be adopted and given priority insofar as they amend or change the articles currently filed with the State of Washington and the IRS for this Nonprofit Corporation. Adopted this 25"' day of April, 2013. Andy Conner, Founder and Founding President Glorie Tiumalu, Vice President ]o rranova, Treasurer Matt Campbell, etary` KCCPNW BYLAWS CITY OF 401n" Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cltyoffederalway com City of Federal Way Human Services Contract for 2023-2024 General Fund Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf o£ _` X (Contracting Agency), for the following:-- t tl 'Cl a' (Program Title)._ Authorizing Signature: (must be signed by (Printed, person who signs the contract, generally, Executive Director) Additional Authorized Signature: Additional Authorized Signature: PLC r( 0 (Title) (Date) ��OGwvc C.mw\u k Name) /I (Title) r' f` l J 17c '-�, " (Date) R-yCSR + (Prirtte�j&ame) (Title) 021n,',j2oZ3 (Date) Note: It is the responsibility of the contractor to inform the City of Federal Way if they wish to add a name to or delete names from this list. CITY OF Federal Way 33325 8" Avenue South, Federal Way, WA 98003 ew Vendor ❑ Update Form To add your business to our vendor file, or update information, please complete this form and mail to 33325 8°i Ave South Federal Way, WA 98003 or fax #253-835-2509 or email accopntspayablc@cityciffederalway.com Business Information (as shown on your federal tax return) 1. Business Name: DBA 2. Contact Name: 3. Business Address: U6 M L U D ' ' ` lz `l U�: 4. Remit To Address (if different)- 5. Phone #: WU— r52— 'Z'�� Fax # 6. Will you provide suppplies or service to the City of Federal Way? 7. City of Federal Way Staff/Department Contact Name: (For office use only) VN#: 0'�j L�_ 0(1�Iq1� City State Zip Code City/State ' Zip Code E-Mail: 1 � ❑ Supplies ❑ Services Business Tyne (Please Check anpronrrate bos for federal tax classification ofnersonlentity entered on fin -eh ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Government Agency ❑ Trust/Estate Non -Profit (if exempt, Exempt payee code) Federal DYEIN # (9 digits) ❑ Sole Proprietor Federal ID # (9 digits) or Social Security Number If you are not a corporation, is your Business subi cot to 1099 reporting'? Yes ❑ No State of Washington U. B. f. # ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) > Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for US federal tax purposes. Otherwise, a single -member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. ❑ Other (see instructions)> Exemptions (codes apply only to certain entitles, not individuals; see instruction) Exempt payee code (if any) Exemption from FATCA reporting code (if any) Certification: Under penalties of perjury, I certify that: . The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup witholdin because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup witholding; and 3. I am a US citizen or other U.S. person (defined belay); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. The tnfurnnl Pevewtie Service does not rcqWre your consent to uy pmvision of this document other than the certification regutred to avoid backup wilhholdin Sign Here Signature of U.S. pqson > Date > Z v For information call: 253.835.2525 or Fax: 253.835.2509 or e-mail: accou]itspayablrC&cityofFederalway.com Rev 1 2021 Form W-9 (Rev. October 2018) Department of the Treasury Internal Revenue Service C6 rll m a C 0 ai c ao �v O i C H .Y c IL 0 w 0 d Q N tU Request for Taxpayer Identification Number and Certification ► Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your incgrne tax retum). Name Is uired SAS tQcS0 2 Business name/disregarded entity name, if different from abov on this line; do not leave this fine 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes. ❑ Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate single -member LLC ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do not check LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC tha jsS disregarded from the owner should check t _ appropriate box fort tax classification of its er. Other (see instructions) ► 1� " `�"r' �VM (X0&MZO�lM 5 Address (number, street, and apt or suite o.) See instructions. 6 City, state, and ZIP code_ 7 List account nulnber(s) here (optional) ■jj Taxpayer Identification Number (TIN) Give Form to the requester. Do not send to the IRS. 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) Requester's name and address (optional) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid I Social security number backup withholding. For individuals, this is generally your social security number (SSN). However, fora -Ell ~ resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later. or Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Employer identification number Number To Give the Requester for guidelines on whose number to enter. lico�0330q��O Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. 1 am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later. Her Signature of To- r U3 1 -Lu `� Here U.S. person ► � � Date ► jJ [� LJ (� General Instructions • Form 1099-DIV (dividends, including those from stocks or mutual funds) Section references are to the Internal Revenue Code unless otherwise a Form 1099-MISC (various types of income, prizes, awards, or gross noted. proceeds) Future developments. For the latest information about developments . Form 1099-B (stock or mutual fund sales and certain other related to Form W-9 and its instructions, such as legislation enacted transactions by brokers) after they were published, go to www.irs.gov/FormW9. • Form 1099-S (proceeds from real estate transactions) Purpose of Form • Form 1099-K (merchant card and third party network transactions) An individual or entity (Form W-9 requester) who is required to file an • Form 1098 (home mortgage interest), 1098-E (student loan interest), information return with the IRS must obtain your correct taxpayer 1098-T (tuition) identification number (TIN) which may be your social security number • Form 1099-C (canceled debt) (SSN), individual taxpayer identification number (ITIN), adoption e Form 1099-A (acquisition or abandonment of secured property) taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other Use Form W-9 only if you are a U.S. person (including a resident amount reportable on an information return. Examples of information alien), to provide your correct TIN. returns include, but are not limited to, the following. If you do not return Form W-9 to the requester with a TIN, you might • Form 1099-INT (interest earned or paid) be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) /�C•��0P CC) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 3/9/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER UUNIAUI NAME: Greg Lewis G. Lewis Insurance Agency LLC g y PHo 425 572-0671 RIC, E Ext :FAX ) {AfX, NO f 607 SW GRADY WAY #230 ADDRESS: greg@glewisinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Western World RENTON WA98057 INSURED INSURER B : Scottsdale Insurance Company INSURER C GENESIS PROJECT INSURER D 2819 S 208TH ST INSURER E : INSURER F : SEATAC WA 98198-5901 rnVFPAAFA r.I=R71FIr-ATF NIJMRFR: REVISION NUMBER: 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. LTR TYPE OF INSURANCE IINSD WVD POLICY NUMBER (MM/DD/YYYY) fMM/DDIYYYY) LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR NPP8932433 01/20/2023 01/20/2024 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL $ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY En acddont) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ — [Par accidanl) $ $ B UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE XBS0173520 02/27/2023 01/21/2024 EACH OCCURRENCE $ 2,000,000 )C AGGREGATE $ 2,000,000 DED RETENTION $ $ NORKERS COMPENSATION 4ND EMPLOYERS' LIABILITY YIN %NY PROPRIETOR/PARTNER/EXECUTIVE ❑ DFFICERIMEMBER EXCLUDED? Mandatory in NH) If yes, describe under [DESCRIPTION OF OPERATIONS below NIA F- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) LICKIIFEUA1C r1ULJrK Lm IY I., LLLM I I MY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Federal Way ACCORDANCE WITH THE POLICY PROVISIONS. 33325 8th Ave S AUTHORIZED REPRESENTATIVE ClREC,f LEWIS Federal Way WA 98003 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD g a 0 0 V m m t V L m aj w 0 e r C a d d m U) c 0 v t � > W J L!') i � H Op lG O C Q) W In W a ui w W d ui w 0 0 Q u +r I co O l/I °N° 00 Q �j V Q V)i l� X m a lD O Q z Q .. 0W z z W tr-- O L Q z m N O N O > Q 0 � can Q o o n c m El o = v E _ +• W s '� m a Z W m 'c � m 0 Ira u J 0 u J m 0 u V M = 'Co N IV N N § � . uj m ? k % 2 L b q k V / 2 Al IA 2 q N q L V) q N q L V) o D VA _ IA c a « k 0 7 _ L- & \ \ t •/ k (D 2 -C C -he cu - v q \ $ a : � $ $ § 0 2 ƒ . < k � a � ul B § § k ul p E O W § C to ■ 2 E § LU R F )k L £ m § '§ � ƒ 2 V)U k 0- '� ■ o CL k D ƒ z - 'cn � - E c M - 2 R b U U O O U q - § CN \ k k t k W g / g M M O O O O O O O O O N N N N N N N N N N N N N N N N N N N N N N N N N N N H Q Q L Q Q Q Q Q Q : N O N N N N N O N li Ln Ln Ln Ln Ln Ln In Ln Ul Ln c O m u O J m c O Q N i '+ Vl Q Q Q Q Q Q Q Q Q Q J Q Ur w J Od ~ w Z Ln _O F- E N D w W Q -% pC O O W_ W_ LU LU GJ 0 d d a a p p O et O O *W O = _ M d d z w J LL LL OC Ln Ln LUw �+ Ln Ln Ln O O z Z OU LU LU Ln Ln LU Ln LU QLU LU H M C7V pl Z Z Z Ln LD w w w LU LU LU CL v 9 l7 l7 (D l7 Z Z H H H co N N N E 4- C m N m t v rd a� �n +r t O1 N a..1 Q 7 c O 4- m E 0 C i d n• 'a i O a� a n• v 7 � � o ro N O Q Y V d s u Q LO 7t 00 N N g v N 10/14/22, 1:31 PM Corporations and Charities System iroesSCrct�snand Charities Filing System BUSINESS INFORMATION THE GENESIS PROJECT SEATTLE 602 723 464 WA NONPROFIT CORPORATION ACTIVE 2819 S 208TH ST, SEATAC, WA, 98198-5901, UNITED STATES PO BOX 6449, KENT, WA, 98064-6449, UNITED STATES 04/30/2023 UNITED STATES, WASHINGTON 04/19/2007 PERPETUAL CHARITABLE https://ccfs.sos.wa.g ovt#/BusinessSearch/Business I nformation Business Name: UBI Number: Business Type: Business Status: Principal Office Street Address: Principal Office Mailing Address: Expiration Date: Jurisdiction Formation/ Registration Date - Period of Duration: Inactive Date: Nature of Business: Charitable Corporation: 1/2 10/14/22, 1:31 PM Corporations and Charities System 26-0330950 C� 17 REGISTERED AGENT INFORMATION ANDY CONNER 12028 SE 223RD DR, KENT, WA, 98031-9603, UNITED STATES PO BOX 6449, KENT, WA, 98064-6449, UNITED STATES GOVERNORS Title GOVERNOR Back FEIN Number: Gross Revenue exceed $500,000: Has Members: Public Benefit Designation; Host Home: Registered Agent Name: Street Address: Mailing Address: Governors Type Entity Name First Name Last Name INDIVIDUAL ANDY CONNER Filing History Name History Print Return to Business Search https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 2/2 STA o� q b 7 STATE OF WASHINGTON BUSINESS LICENSING SERVICE Thank you for filing online Our processing time generally takes up to 10 business days. Some endorsements may take more time for state or city approval. You will receive your business license with approved endorsements in the mail. An updated business license will be mailed to you when additional endorsements are approved. Confirmation Number: 0-029-738-153 Filing Date and Time: 11/09/2022 12:25:43 PM Payment Method: ACH Debit/E-Check Business Entity Information Entity Type: Nonprofit Corporation Name of Entity: THE GENESIS PROJECT SEATTLE AccountlD: 602723464-001-0002 Firm Name: THE GENESIS PROJECT Endorsement(s) Applied For Begin Federal Way Nonprofit Business 11/09/2022 Fee Type Begin BLS Processing Fee 11/09/2022 End Count Fee 11 /30/2023 1 $0.00 $0.00 End Count Fee 1 $0.00 $0.00 Grand Total: $0.00 txL0004