AG 23-157 - CONNECTIONS CHURCH OF FEDERAL WAYRETURN TO: EXT:
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEP'T./DIV: CITY OF FEDERAL WAY - PARKS AND RECREATION
2. ORIGINATING STAFF PERSON: ASHRIYA GUPTAR EXT: 6950 3. DATE REQ. BY: 4/21/23
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ TNTERLOCAL
19 OTHER MOU
S. PROJECTNAME: CITY OF FEDERAL WAY AND CONNECTIONS CHURCH -SUMMER SOCCER CAMP
6. NAME OF CONTRACTOR: CONNECTIONS CHURCH OF FEDERAL WAY
ADDRESS: 30029 16th Ave S, Federal Way WA 98003 - TELEPHONE 263-545-1280
E-MAIL: rsg2wa@gmail.com FAX:
SIGNATURE NAME: Jonathan I ep TITLE owner
7. EXHIBITS AND ATTACHMENTS: It SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: 7/25/23 COMPLETION DATE: 7/28/23
9. TOTAL COMPENSATION $ (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 IDNO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAWAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
❑ PURCHASING: PLEASE CHARGE TO:
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
N PROJECT MANAGER KH 6/15/23
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
2 LAW JE 6/20/23
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.)
INITIAL / DATE SI NED
LAW DEPARTMENT
❑ SIGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK '� 1
❑ ASSIGNED AG# ,qG#� -1
COMMENTS:
2/2017
Memorandum of Understanding
City of Federal Way and Connections Church
THIS MEMORANDUM OF UNDERSTANDING (MOU), dated effective upon mutual execution by all
parties, defines the respective responsibilities of the City of Federal Way ("City") and Connections Church of
Federal Way (together "Parties").
Background
The City of Federal Way Recreation Department will partner with Connections Church of Federal Way
(CC) to provide one free soccer camp to children 6-12 years of age from July 25-28, 2023, from 9:00am-
11:00am each day at Steel Lake Park. The Federal Way Community Center will take all registrations.
Connections Church will operate the camp, providing coaches and instruction for participants. The Parties
anticipate registering a maximum of 80 participants.
The summer soccer camp will be a skills -based camp intended to work with youth of all different skill
levels. Games will mainly_ be --cooperative.
NOW, THEREFORE, the Parties agree as follows:
I. City Responsibilities. The City agrees to provide the following:
Conduct the registration process and obtain signed waiver forms from registered participants
• Provide a soccer ball for every registered participant;
• Provide space at Steel Lake Park for the soccer camp;
• Ensure appropriate bathrooms and standard goals are available for staff and participants — bathrooms
will be in close proximity to the field provided for use and within sight of employees;
• Advise participants/parents that they are responsible for snacks, water, proper attire, etc.; and
• Provide rosters to Connections Church containing parent contact information for each child for
check -in and check-out purposes
H. Connections Church of Federal Way (CC) Responsibilities. CC agrees to the following:
• Provide cones, goals, and other necessary equipment to run soccer drills and games;
■ Provide coaches and instruction for participants of the soccer camp;
• Provide appropriate staffing for camp with a minimum of 1-12 ratio of staff to participants;
• Conduct background checks on all volunteers and employees working at the camp;
• Take steps to arrange for the safety of participants and ensure all volunteers and employees receive
appropriate training for the supervision and care of minors;
■ Facilitate check in and check out process of participants during camp using City provided rosters;
and
• Support and ensure the sole focus of the camp and all instructors remains on soccer and the
development of teamwork, individual skills, and other secular activities and topics throughout the
camp due to the partnership with the City in putting on this recreational opportunity.
[Signature page follows]
IN WITNESS, the Parties execute this MOU below, effective the last date written below.
CITY OF FEDERAL WAY: ATTEST:
I Hutton, ks 're or C lerk. Stephanie C u ey, CMC
DATE: 2'e2z APPROVED AS TO FORM:
3. yan Call, Cit Attorney
Connections Church:
Signature: _ —.-- -
Printed Name:l1
Title:
DATE:! .fig a-3
6/20/23, 10:07 AM Corporations and Charities System
,i,n'Ss�fWft�Q nd Charities Filing System
BUSINESS INFORMATION
CONNECTIONS CHURCH OF FEDERAL WAY
604 899 905
WA NONPROFIT CORPORATION
ACTIVE
3002916TH AVE S, FEDERAL WAY, WA, 98003, UNITED STATES.
PO BOX 23986, FEDERAL WAY, WA, 98093-0986, UNITED STATES
03/31/2024
UNITED STATES, WASHINGTON
03/30/2022
PERPETUAL
RELIGIOUS NONPROFIT CHURCH
R
https://ccfs.sos.wa.gov/#/BusinessSearch/Businesslnformation
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
6/20/23, 10:07 AM
Corporations and Charities System
88-1520248
R
IVI
REGISTERED AGENT INFORMATION
SUNG YONG LEE
Nonprofit EIN:
Most Recent Gross Revenue is less than $500,000:
3002916TH AVE S, FEDERAL WAY, WA, 98003, UNITED STATES
PO BOX 23986, FEDERAL WAY, WA, 98093-0986, UNITED STATES
GOVERNORS
Title
GOVERNOR
GOVERNOR
Back
Governors Type
INDIVIDUAL
INDIVIDUAL
Entity Name
Has Members:
Public Benefit Designation:
Host Home:
Registered Agent Name:
Street Address:
Mailing Address;
First Name Last Name
DAVI D GASS
SUNG YONG LEE
Filing History Name History Print Return to Business Search
httpsl/ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 2/2
6/20/23, 10:06 AM Washington State Department of Revenue
Washington State Department of Revenue
< Business Lookup
License Information: New search Back to results
Entity name: CONNECTIONS CHURCH OF FEDERAL WAY
Business
name:
Entity type: Nonprofit Corporation
UBI #: 604-899-905
Business ID:
Location ID:
Location: None
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Governing People May include governing people not registered with Secretary of State
Governing people Title
GASS, DAVID
LEE, SUNG YONG
The Business Lookup information is updated
nightly. Search date and time: 6/20/2023 10:06:28
https://secure.dor.wa.gov/gteunauth/_/#3 1 /2
R e CERTIFICATE OF LIABILITY INSURANCE
06n 3/2023
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 WtIlIC210 hO1d0F man ADDITIONAL INSURED. the p c ell) must have ADDITIONAL IN3URED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the farms and conditions of the policy, certain policies may regain an endorsement. A statement on
this certificate does not confer rights to the certificate holder In lieu of such endorsement(s).
PRODUCER NAM. CAA $e19Ci CuMCm?T 5ervxm
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THIS IS I THE POOCIES OF INSLRANCE LOW HAVE N ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REOUIREMENT, 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.
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DESCRIPTION OF OPERAT ONS below
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DESCRDTION OF OPERATIONS I LOCATIONS I VENICLES (ACORD 101, AddOW" Reawft SeaedMY. m" be aatadrd a mue WAw is FagW1
Sm-cer Camp
ADDITIONAL INSURED = Qy of Federal Way
r'FRTIFIC.ATE HOLDER
City of Federal Way
33325 8Th Ave S
Federal Way. WA 98003
253-545-1280
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED ICEPRES,EIITATIVE D
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ACORD 25 (2016f03) The ACORD name and logo are registered marks of ACORD