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AG 23-058 - CHILDHAVENRETURN TO: Victoria Banks EXT: 2604 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM ORIGINATING DEPT./DIV: CD/CS ORIGINATING STAFF PERSON: Patti Spaulding-Klewin 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 ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE ❑ CONTRACT AMENDMENT (AG#)- ❑ OTHER PROJECT NAME: Continuum of Care A HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL NAME OF CONTRACTOR: Childhaven ADDRESS: 1035 SW 124th Street TELEPHONE 206-957-4802 E-MAIL: lonb@childhaven.org FAX: SIGNATURENAME: Jon BOtten TITLE EXHIBITS AND ATTACHMENTS: It SCOPE, WORK OR SERVICES It COMPENSATION A INSURANCE REQUIREMENTS/CERTIFICATE a ALL OTHER REFERENCED EXHIBITS IN PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS . TERM: COMMENCEMENT DATE: 01/01/2023 COMPLETION DATE: 12/31 /2024 TOTAL COMPENSATION $ 22,000.00 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ©. 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: 001-7300-083-562-10-410 0. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED ❑ PROJECT MANAGER SB 12/1/2022 ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) 0 LAW KVA 12/2/22 1. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: N/A 2. CONTRACT SIGNATURE ROUTING 0 SENT TO VENDOR/CONTRACTOR DATE SENT: 2/16/23 INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: 11 /15/2022 DATE REC'D: 3/13/23 ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.) W DEPARTMENT SIGNATORY (MAYOR OR DIRECTOR) k CITY CI-ERK ❑ ASSIGNED AG# ;OMMENTS: \pproved Council budget 11/15/2022 INITIAL / DATE SIGNED 3 III CITY OF CITY HALL Fe d e ra I Way33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway.com HUMAN SERVICES AGREEMENT FOR CONTINUUM OF CARE This Human Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Childhaven 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: CHILDHAVEN: Jon Botten 1035 SW 124th St Seattle, WA 98146-2746 206-957-4802 (telephone) The Parties agree as follows: CITY OF FEDERAL WAY: Patti Spaulding-Klewin 33325 8th Ave. S. Federal Way, WA 98003-6325 (253) 835-2651 (telephone) Patti. Spaulding-Klewin@cityoffederalway.com 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 mayimum 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 Payment. 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 HUMAN SERVICES AGREEMENT - 1 - 10/2022 CITY OF CITY HALL Federal Way Feder 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway com 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 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 Non -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 AgMa 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 A'S Federal ay Feder l Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www crryoffederalway 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 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 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 HUMAN SERVICES AGREEMENT - 3 - 10/2022 4 CITY OF Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway com 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 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 RCW, 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 IntgVretation 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 Assigignent 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 Fe d e ra ay 8th Avenue South Feder 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 A Feder Fe�eraf 111lay 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www.cllyof'ederal way. com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: Jim ell, Mayor DATE: .3 �l CHILDHAVE By: Printed Name: N Title: C v DATE: 0 �, 0 7 STATE OF WASHINGTON ) ss. COUNTY OF i V\ ATTEST: City Clerk )WR VED-AS TO FORM: 7 J Ryan Call, City Attoniey ,, On this day personally appeared before me �: 2 O to me known to be the C� Q of CE I U, ) kA Ly -r,-N that executed the foregoing instrument, and acknowledged the said instrument to be the free and 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. GIVEN my hand and official seal this 7 day of �-rGln , 20_2-3 Notary's signature I � ti/ Notary's printed name U -e- Notary Public in and for the State of Washington. CHIGAKO BUTLER My commission expires A Notary Public State of Washington Commission # 21025521 My Comm. Expires Aug 13, 2025 HUMAN SERVICES AGREEMENT - 6 - 10/2022 CITY OF Federal Project Services Summamary CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. cityoffederalway. com EXHIBIT A SERVICES The Agency shall provide early learning, early support for infants and toddlers, out -patient behavioral health counseling, youth mentoring, substance use disorder (SUD) counseling, and home visit services to children, youth, and families. Some services are provided through community -based partnerships with Head Start and Early Childhood Education and Assistance Program (ECEAP). 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 tad 3rd 4th Quarter Quarter Q Quarter Q Quarter Total JAN. — APRIL — JULY — OCT. — MARCH NNE SEPT. DEC. No. of unduplicated Federal Way persons assisted in 2023 1 2 2 2 7 No. of unduplicated Federal Way persons assisted in 2024 1 2 2 2 7 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st tad 3rd 4th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — MARCH JUNE SEPT. DEC. 2023 1. Counseling 11 11 11 11 44 2024 1. Counseling 11 11 11 11 44 1. Counseling units of service are measured by the number of 60-minute sessions. 2. Early Learning units of service are measured by number of days attended by enrolled students. HUMAN SERVICES AGREEMENT -7- 10/2022 crrY of Federal C. Outcome Measure(s) CITY HALL ��� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www-ciWafederal way. com Outcome: Enrolled behavioral health clients make progress towards at least one goal on their individualized treatment plan. Indicator: Data collected through quarterly goal tracking on individualized treatment plans. Goal(s) are reviewed by client and clinician to assess progress and success in meeting goal(s). Target: 70% 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 CITY OF 40W N�' Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederahvay.. 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 Usnits Su.ntmary Median FY 2022 Income Income 1 2 3 4 5 6 7 8 King Limit Person Persons Persons Persons Persons Persons Persons Persons County 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 Reporting 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 A4SCITY OF ,Federal Pro ' ect Budget CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www atyoffederalway com EXHIBIT B COMPENSATION The Agency shall apply the following fiends to the project. The total amount of compensation pursuant to this Agreement shall not exceed Twenty -Two Thousand and 00/100 Dollars ($22,000.00). City of Federal Way Funds 2023 2024 City of Federal Way General Fund: $11,000.00 $11,000.00 Total City of Federal Way Funds: $11,000.00 $11,000.00 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 fonnat requested by the City. Payment requests shall include a copy of the Service Unit Report. Estimated Quarterly Payments: 2023 1 st Qtr $2,750.00 2nd Qtr $2,750.00 3rd Qtr $2,750.00 4th Qtr $2,750.00 2024 1st Qtr $2,750.00 2nd Qtr $2,750.00 3rd Qtr $2,750.00 4th Qtr $2,750.00 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 SIXTH AMENDED AND RESTATED BYLAWS Ford CHILDHAVEN 4.5 Vacancies A vacancy in any office created by the death, resignation, removal, disqualification, creation of a new office or any other cause may be filled by the Board for the unexpired portion of the term or for a new term established by the Board. 4.6 Chair, Vice Chair and Immediate Past Chair of the Board 4.6.1 Chair The Chair of the Board must be a Director. The Chair shall preside over meetings of the Board and shall perform such other duties as shall be assigned to him or her by the Board from time to time. 4.6.2 Vice Chair The Vice Chair of the Board must be a Director. The Vice Chair shall preside over meetings of the Board in the absence of the Chair and shall perform such other duties as shall be assigned to him or her by the Board from time to time. There may be more than one Vice Chair at the discretion of the Board. 4.6.3 Immediate Past Chair The Immediate Past Chair of the Board shall be a Director pursuant to Section 3.4. The Immediate Past Chair shall assist in transition and advise the Chair of the Board as requested by the Chair. �> 4.7 CEO of the Corporation The CEO shall oversee all the business of the Corporation including its day to day operations, and may sign deeds, mortgages, bonds, contracts or other instruments, except when the signing and execution thereof have been expressly delegated by the Board or by these Bylaws to some other officer or agent of the corporation or are required by law to be otherwise signed or executed by some other officer or in some other manner. The CEO shall render such reports to the Board as from time to time may be requested by the Board and _shall arrange for the annual audit of the accounting records of the Corporation_by_a certified public accountant. The CEO shall also perform all duties incident to the office of CEO and such other duties as from time to time may be assigned to him or her by the Board. The CEO shall be a non -voting ex officio member of the Board. 4.8 Secretary of the Board The Secretary of the Board must be a Director. The Secretary of the Board shall or shall cause the following to occur: (a) keep the minutes of meetings of the Board and any minutes that may be maintained by committees of the Board; (b) see that all notices are duly Sixth Amended and Restated Bylaws Page 9 4833-2833-3501v.10059915-000003 ARTICLE 7. COMMUNITY LEADERSHIP BOARD 7.1 Composition There shall be a Community Leadership Board comprised of people who are supportive of the corporation's mission. The Community Leadership Board shall have no authority to act on behalf of the Board of Directors and shall not be entitled to vote on matters that come before the Board. The purpose of the Community Leadership Board is to provide support to the Board of Directors and organizational leadership by: Serving as an advocate and leader to help Childhaven increase financial support and community engagement. m Expanding outreach efforts and establishing and fostering relationships with key community partners. Offering guidance and expert advice on matters important to the agency upon the request of the Board of Directors or leadership. 7.2 Appointment, Resignation and Removal Community Leadership Board members will be nominated by the Governance Committee at the recommendation of the CEO, and appointed by a vote of the Board of Directors to serve for a term of three (3) years. There shall be no limit on the number of three (3)-year terms to which a member of the Community Leadership Board may be appointed. If a member of the Community Leadership Board misses three consecutive meetings of the Community Leadership Board, and the absences are unexcused by the Executive Committee, the member will be deemed to have resigned from the Community Leadership Board. The Board may remove any member of the Community Leadership Board from such position at any time, without cause, whenever it determines, in its sole discretion, that the best interests of the corporation would be served thereby. ARTICLE 8. AMENDMENTS These Bylaws may be altered, amended or repealed and new Bylaws may be adopted by the affirmative vote of at least two-thirds (2/3) of the total number of voting Directors serving on the Board at the time the matter comes before it, provided that at least five (5) days written notice is -given -of -intention to alter�-am-end or -repeal or to adopt -new Bylaws -at at any such meeting. The text of any such proposed alteration, amendment, or new Bylaws shall be provided with such notice. Any amendment to the Bylaws will be voted on only after examination of any possible conflicts with the Articles of Incorporation. The foregoing Bylaws were adopted by the Board on 02/23/2021 Secretary of the Board Sixth Amended and Restated Bylaws Page 12 4833-2833-3501v.1 0059915-000003 CITY Wayvmim'� CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www ciryoffederalway. 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 of: eA[1 #0WA.I (Contracting Agency), for the following: IM&, ►#AVV5 ~r ;M *?•ay 6iwt Rx6 (Program Title). Authorizing Signature: (must be signed by person who signs the contract, generally, Executive Director) X Additional Authorized Signature: Additional Authorized Signature: (Printed Name) (Title) Xev+Jbf 46A6 (Printed Name) (Date) FIAMAI . RAd,+&Z. (Title) (Signature) (Date) C Po (Printed Name) (Title) "-3.3 g (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. f�CQ Cd DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 01/25/2023 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 endorsernent(s). PRODUCER The Partners Group Ltd 1111 Lake Washington Blvd N. Suite 400 Renton WA 98056 ttlAME_ T Teresa Hernandez PAHONN E[t : {8TT) 455-5640 FAX (425) 455-6727 AIC, NO); ADDRESS: themandexQtpgrp.cDm tNSURER(SI AFFORDING COVERAGE NAIC # INSURERA: Philadelphia Indemnity Ins Co 18058 INSURED Childhaven 1035 SW 124th St Seattle WA 98146 INSURER B : INSURER C : INSURER D : INSURER E: INSURERF: rnvGRer_Gc rFRTIFIrATF N"MRFR- 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPE OF INSURANCE ADDL 1NSD SUUR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 $15AQAGF EN 100,000 CLAIMS -MADE � OCCUR PREMISES Ea Occurrence) $ MED EXP (Any one erson) $ 51000 A Y PHPK2511065 01/20/2023 01/20/2024 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2.000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 X POLICY ❑ jF LOC CT OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANYAUTO BODILY INJURY (Per accident) $ AOWNED SCHEDULED PHPK2511065 01/20/2023 01/20/2024 AUTOS ONLY AUTOS HIRED NON -OWNED I PROPERTY DAMAGE Per aceldem $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAR OCCUR EACH OCCURRENCE S 10,000.000 A EXCESS LIAB CLAIMS -MADE PHUB848859 01/20/2023 01/20/2024 AGGREGATE S 10,000,000 DEC) I X RETENTION 5 10,000 s COMPENSATION RH PrRWORKERS STATUTE X ER AND EMPLOYERS' LIABILITY Y / N E L. EACH ACCIDENT 1,000,000 $ A ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA PH PK2511065 — WA Stop Gap 01/20/2023 01/20/2024 E L DISEASE - EA EMPLOYEE 1000000 $ , , OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L DISEASE -POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below Each Occur/Aggregate $1,000,000/$2M A Professional Liability Sexual Abuse/Phys/Abuse Molestation PHPK2511065 01I20I2023 01/20/2024 Each Occur/Aggregate $1,000,000/$11M DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Federal Way is included as Additional Insured on General Liability as their interest may appear as respects operations performed by or on behalf of the Named Insured per form PI-GLD-HS (10-11) attached GLAdditional Insured Primary and Non -Contributory provisions apply per form PI-GL-005 (07-12) attached. r�nTl C!r AVr unr nra rawrFl I BTIr)N 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. Attn: Patti Spaulding-Klewin AUTHORIZED REPRESENTATIVE 33325 8th Ave. S WA 98003-6325 Federal Way` © 1988-ZU15 ACORD CURPURAI IUN. All rlgnis reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD CITY OF Federal Way 33325 8th Avenue South, Federal Way, WA 98003 ❑New Vendor ❑ Update Form To add your business to our vendor file, or update information, please complete this form and mail to 33325 8' Ave South Federal Way, WA 98003 or fax #253-835-2509 or email accountspayableWityoffederalway.com Business In fbrn+atioa (as shown on your federal tax return) 1. Business Name: C k f l d k tl v e-n DBA 2. Contact Name: Me 9 f v 1 c) U I- (For office use only) VN#: 3. Business Address: 103 S' S 'w q t� City. State Zip Code 4. Remit To Address (if different): N/A- f .� City/State ''- Zip Code 5. Phone#: l2-0Q �zI -�4IT Fax#: �L O 30--3303 E-Mail: Me�!►nL 0AIIJ�nvtr+.0r 6. Will you provide suppplies or service to the City of federal Way? ❑ Supplies D"Services 7. City of Federal Way Staff/Department Contact Name: V d+h aU(dlnA- j�)Ew,n Business Type e Please Check a ra riale bos for edera! tax classification ofnersonlentity entered on line 1 ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Government Agency ❑ Trust/Estate e'Non-Profit (irexempt, Exempt payee code) 91—GYo2y30 Federal ID/EIN # (9 digits) ❑ Sole Proprietor Federal ID # (9 digits) or Social Security Number If you are not a corporation, is your Business subject to 1099 reporting? State of Washington U. B. I. # ❑ Yes dNo ❑ 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 ayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup witholding because: (a) I am exempt from; backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that Iam 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 -below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. The Internal Revenue Service does not require your consent to any provision of this document other than the certification required to avoid hackup withholdin Sign /*-� -Here Si uature of U.S. rson > ' Date > 03 -y f — - For information call: 253.835.2525 or Fax: 253.835.2509 or e-mail: accountsovableCo-,,cityoffederalway.coat Rev 1 2021 W=9 Request for Taxpayer Give Form to the Form (Rev. October2018) Identification Number and Certification requester. Do not Daparlment of IheTreasur`/ send to the IRS. Internal Revenue Service ► Go to www.irs.gov/FormW9 for instructions and the latest information. 1 Name (as shown on your income tax return). Name 1s reqwred on this line; do not leave this line blank. eya,b) x w 2 Business nanlehifsregtlyded entity name, if different from above `n �P 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the Y 4 Exemptions codes apply only to P� (- PPY Y following seven boxes. certain entities, not individuals; see ca Q o ElIndividual/sole proprietor or OQ C Corporation El Corporation ❑ Partnership ElTrust/estate instructions on page 3): single -member LI_C Exempt payee code (if any) ao ❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) ► o` y Note: Check the appropriate box in the line above for the tax classification of the single -member owner. Do nol check Exemption from FATCA reporting LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is freer for code (if any) a another LLC that Is net disregarded the owner U.S. federal tax purposes. Otherwise, a singfe-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner. o � ❑ Othei (see instructions) ► (!.' Sf(.'2CiJ1/lifS fl�LlillrnRR O;A541e 1.Mf [1 SJ n e CL 5 Address (number, street, and apt, or stale no.) See Instructions. Requester's name and address (oplional) 6 City, state, and ZIP code Sept—rr k W* 7 List account number(s) here (optional) Tax a er identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number backup withholding. For individuals, this is generally your social security number ( However, for a late). resident alien, sale proprietor, or disregarded entity, see the instructions for Part I, later. For other — m — entities, it Is your employer identification number (E1N). 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 I Employer identification number Number To Give the Requester for guidelines on whose number to enter. 7-T-7 MMISHU ©C EM Ceri;l'{ication 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 codes) 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 II, later. Sign Signature of Here I U.S. person General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9. Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following. • Form 1099-INT (interest earned or paid) Date * d3 . /. 3 • Form 1099-DIV (dividends, including those from stocks or mutual funds) • Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) • Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) • Form 1099-S (proceeds from real estate transactions) • Form 1099-K (merchant card and third party network transactions) • Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) • Form 1099-C (canceled debt) • Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. Il you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later. Cat. No. 10231X Form W-9 (Rev. 10-2018) g N V) N 7 C N N Q' r O C N E N a (D d m CD c �' ll c L >N `/ CN M N Q) ry, o LU z N 00 °0 � N 200 F- m 4-J Q) • • •O WW Q 2 U Q 2 V O 41 LO Q V A-! O Q c O z N 00 � 0 rn O 0 > +r Q `n N N M Q z m Q N 3 N O� Q w H III p O E O d J c •� C E = c _ a = 0 0 m 0 � vh m V J ++ W 'rn m ++ W D ' A m R w J R u J R w J 'CR C `O V N C M v N 7 N E L 0 a L i V C 10 x H � V Q � W co P7 N C m G7 N M R C) N � C) � � N {i V7 G � C N C) N � N C)O N O � i X W M Q a M 4A 41 i+ � �+ U .4- U a a i Y H 0 V 3 G d ti N_ O) l ti O G C a � O d a v M c �k of °1 M O N l/] u � e C 0 �+ o U O A' W y O r6 • — Q• Z {� O- •i Ln d W M � vi V > H W Lu a m Il M l7 a Q m 4- N u N N W L _ Z LU J p l7 W w 2 2 V V 8 Z Z U LL E-L M �I v A GJ a 0 aU a am c u a C) v, M N e M LU 2 Ln J J J p Z ON > o L J J � V Q m N Q p Z Q O Z O w D =O w J Z L J w H > O N � CLU a C w CQ C Q N Y R a w Q m N H 2 N w a N c 0 U 0 J fB C 0 Q N v v 0 a M N C m M N O N M N E C m w m s L tA s � I � I to '6 O a CL N � cam• 3 E 'A O > .� L 3 a c L v 'o o -16 o u° `° 3 O w p ,A 2 ~ tA �+ a c Q O �C Ln Ln p 00 N p � � V s � i� 10/13/22, 8:40 AM Corporations and Charities System iri e,ssC rt�snand Charities Filing System BUSINESS INFORMATION Business Name: CHILDHAVEN UBI Number: 601 138 209 Business Type: WA NONPROFIT CORPORATION Business Status: ACTIVE Principal Office Street Address: 1035 SW 124TH ST, SEATTLE, WA, 98146-2746, UNITED STATES Principal Office Mailing Address: 1035 SW 124TH ST, SEATTLE, WA, 98146-2746, UNITED STATES Expiration Date: 04/30/2023 Jurisdiction: UNITED STATES, WASHINGTON Formation/ Registration Date: 04/15/1911 Period of Duration: PERPETUAL Inactive Date Nature of Business: PROVIDE RELATIONAL HEALTH SERVICES TO FAMILIES WITH CHILDREN RANGING IN AGE FROM INFANTS THROUGH LATE TEENS. Charitable Corporation: https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 1 /3 10/13122, 8:40 AM Corporations and Charities System 91-0402430 0 El FE 0 REGISTERED AGENT INFORMATION CHILDHAVEN 316 BROADWAY, SEATTLE, WA, 98122-5325, UNITED STATES GOVERNORS Title Governors Type GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL GOVERNOR INDIVIDUAL hftps:/Iccfs.sos.w.a.gov/#/BusinessSearch/Businessinformabon Entity Name FEIN Number: Gross Revenue exceed $500,000: Has Members: Public Benefit Designation: Host Home: Registered Agent Name: Street Address: Mailing Address: First Name Last Name ABIGAIL GRANT BAREQ PESHTAZ ANTHONY WASHINGTON SLAKE MARKS-DIAS CARL LOVSTE❑ 2/3 10/13/22, 8:40 AM Corporations and Charities System Title Governors Type Entity Name First Name Last Name GOVERNOR INDIVIDUAL CURT ANDERSON GOVERNOR INDIVIDUAL DAVID LAWRENCE GOVERNOR INDIVIDUAL DEREL FINCH GOVERNOR INDIVIDUAL GINI FINCH GOVERNOR INDIVIDUAL JC COTTRELL GOVERNOR INDIVIDUAL JOAN MATHESON GOVERNOR INDIVIDUAL KRISTIE GARRETT GOVERNOR INDIVIDUAL LAKEISHA GUNTER GOVERNOR INDIVIDUAL MIKE RODDEN GOVERNOR INDIVIDUAL MOLLY JOHNSON GOVERNOR INDIVIDUAL PAULETTE LEMON GOVERNOR INDIVIDUAL PAULO RESENDE GOVERNOR INDIVIDUAL ROD PIERSON GOVERNOR INDIVIDUAL SAM PARK Back Filing History Name History Print Return to Business Search hftps://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 3/3 CHILD HAVEN CHILDHAVEN BOARD OF TRUSTEES 316 Broadway, 2"d Floor / Seattle, WA 98122 MEETING MINUTES Tuesday, February 28, 2017, 8:00 a.m. -10:00 a.m. PRESENT: Nellie Allnutt, Jacque Brainard, Kristen Carden, Knox Duncan, Rich Grunder, Pamm Jardine, Carl Lovsted III, Blake Marks -Dias, Bareq Peshtaz, Heidi Happonen CONFERENCE CALL -IN: Jake Domer, David Byers, Rachel Esguerra, Ed Grabowy, Jon Jones, David Lawrence, Paulette Lemon, Marta Lowe, Don Rench, Lance Soliday, Beth Waldron -Nagy, Todd Yates ABSENT: Curt Anderson, Aline Flower, Roger Herringa, Clark Kokich, Matt Munson, Sam Park STAFF PRESENT: Jon Botten, Kelly Ciotti, Caitlen Daniels, Kelly Emery, Betsi Farrell, Leslie Jennings, Bethany Larsen, Kristi Nelson, Connie Ticeson, Melissa Williams GUEST: Carey Morris, Childhaven lobbyist (Conference Call -in) CALL TO ORDER The meeting was called to order by Chair Carl Lovsted III. Chair Lovsted welcomed the Board and Staff to the meeting. He made optimistic comments on the hiring of Jon Botten as Childhaven's new CEO which will provide outstanding leadership to the team. MEETING MINUTES A motion was made in support of the Meeting Minutes from February 22, 2017. The motion carried. STATE BUDGET UPDATE Carey Morris, lobbyist for Childhaven, reported on the State of Washington legislative session. The State budget has $4.2M budgeted for Childhaven through the Department of Early Learning (DEL). Morris stressed the importance of activating Board and Staff to support DEL funding and Childhaven's programs. Bethany Larsen has been to Olympia multiple times advocating on Childhaven's behalf. Nellie Allnutt will send out an email communication to the full Board requesting they make contact and rally local legislators to assist with securing the additional $2.152M funding for Childhaven and the Yakima, WA counterpart. CHIEF EXECUTIVE OFFICER REPORT Jon Botten opened his presentation with thanks and appreciation for being selected as the new CEO of Childhaven. Botten shared his vision "To make Childhaven one of the most comprehensive and effective trauma prevention and early intervention treatment programs in the nation." Stating his personal commitment to the "Stella's" of the world —a true story and symbol of the thousands of children and families in our area who need Childhaven's services. Botten proposed an organizational challenge to bring bolder vision, new strategies, a cohesive culture, data -driven improvements, an entrepreneurial spirit, and a commitment to excellence. Consistent with the priorities of the strategic plan, he distributed a best practice Continuum of Care model that over time would offer a wider variety of evidence -based services to more kids and families — while also generating additional contract and fee for service revenue. An announcement was made that the Director of Communications position has been filled by Jon Lanthier with a start date of April 3, 2017. TREASURER'S REPORT Melissa Williams, Chief Financial Officer, presented the January 31, 2017 Treasurer's Report and Scorecard. Program enrollment is moving u to M out of M total enrollments with E current intakes in process. Program turnover has leveled at with positions still open. Operating income shows program service . With an increase in pendin intakes, the variance is expected to be reduced by an estimated . Contributions are currently E. Before depreciation, after 7 months of operations, financial report shows the has The board had approved a — DEVELOPMENT REPORT Kelly Ciotti, Chief Devel❑ meat Officer, presented the February 24, 2017, Development report. A contribution by donor in the amount of— was recently received. Ciotti Is working on full Board engagement and pledge commitments. Kudos go out to Chris Hafner, Grants and Foundation Manager, as well as art -time Grants Coordinator Anne Lacy who have exceeded their fundraising goal and brought in $. LUNCHEON EVENT UPDATE Leslie Jennings, Director of Events & Corporate Relations, announced that the Baty Family will be receiving the Mark Matthews Service to Children Award at the -Celebration Luncheon scheduled for March 7, 2017. She stated 57 table commitments are confirmed for the event which is down from 63 from the same time last year. Event sponsorship is currently at $_ which is down from $_ from last year Speakers include Nell Robinson and Jody Brown. Heidi Happonen has agreed to make "the ask". Jennings asked for more Board support to help fill tables for the event. Jennings who is expecting a child in April will be leaving Childhaven after the luncheon to focus on her new role as mother. PROGRAM REPORT / PARENT ADVISORY COMMITTEE UPDATE Larson and Kelly Emery, Program Operations Manager, announced that the Parent Advisory Committee (PAC) will be presenting at the board retreat. Staff view the PAC as crucial advisors and their interactions have all been overwhelmingly beneficial. Larson mentioned the PAC is thrilled to be asked to speak at the Board Retreat and will bring a powerful and meaningful message to the Board of Trustees. Discussion ensued to consider inviting a PAC member to join the Board of Trustees. OTHER BUSINESS - BOARD RETREAT AGENDA The Board was requested to block -out a 4-hour meeting period on Tuesday, March 28, 2017, from 8:00 a.m. — 12:00 p.m. for the Retreat. The Retreat agenda will feature Strategic Challenge Questions facing the organization and as noted above, an interactive presentation from the PAC. ADJOURMENT The meeting was adjourned at 9:25 a.m. Respectfully submitted, Connie Bacalzo Ticeson, Interim Executive Administrator.