AG 23-235 - FEDERAL WAY COMMUNITY CAREGIVING NETWORKRETURN TO: Kim Bachrach EXT: 2654
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV: CD/Community Services
2. ORIGINATING STAFF PERSON: Kim Bachrach EXT: 2654 3. DATE REQ. BY:
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ® HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
A OTHER ARPA Human Services Grant
5. PROJECT NAME: Emergency Rent Assistance
6. NAME OF CONTRACTOR: Federal Way Community Caregiving Network
ADDRESS: PO Box 4717 Federal Way, WA 98063-4031 TELEPHONE (253) 839-1084
E-MAIL: FAX'
SIGNATURE NAME: Tony Robinson TITLE Executive Director
7. EXHIBITS AND ATTACHMENTS: 19 SCOPE, WORK OR SERVICES 0 COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE 19 ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: July 1, 2023 COMPLETION DATE: December 31, 2026
9. TOTAL COMPENSATION $ 175,000 (INCLUDE EXPENSES AND SALES TAX, IF ANY).
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: AYES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ 175,000
IS SALES TAX OWED ®YES IDNO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
m PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-410
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
N PROJECT MANAGER SJB 09/18/2023
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
It LAW JE 9122/23
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: 07/11/2023 COUNCILAPPROVALDATE: 07/18/2023
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 10/24/2023 DATE REC'D: 10/31/2023
❑ 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.)
ITIAL/ DATE SIGNED
WCAW DEPARTMENT tz�
P.�NATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK�90'(Fy){
❑ ASSIGNED AG# AG# R
COMMENTS:
2/20I7
CITY OF CITY HALL
"" Feder 8th Avenue South
Federal Way, WA 98003-6325
Feder 1111lay
(253) 835-7000
wwwchyv ederalway.com
HUMAN SERVICES AGREEMENT
FOR
EMERGENCY RENT ASSISTANCE
This Human Services Agreement ("Agreement") is made between the City of Federal Way, a Washington
municipal corporation ("City"), and Federal Way Community Caregiving Network 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:
FEDERAL WAY COMMUNITY CAREGIVING I CITY OF FEDERAL WAY:
NETWORK:
Tony Robinson
PO Box 4717
Federal Way, WA 98063-4031
(253) 839-1084 (telephone)
com
The Parties agree as follows:
Kim Bachrach
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2654 (telephone)
Kim.Bachrach@cityoffederalway.com
1. TERM. The term of this Agreement shall he for a period commencing on July 1, 2023, and terminating
on December 31, 2026 ("Term"). Funding for the second, third, and fourth years 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 and a Unique Business
Identifier (UBI). 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
ARPA HUMAN SERVICES AGREEMENT - 1 - 8/2023
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www ciryoffederalway com
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 not less than quarterly basis, the Agency shall submit to the City an
invoice for payment on a form provided by the City along with supporting documentation for costs claimed in the
invoice and all reports as required by this Agreement. Payment shall be made 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, supporting documentation, 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 Community 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 Budget. The Agency shall apply the funds received from the City under this Agreement in
accordance with the line item budget set forth in Exhibit B. The Agency shall request prior approval in writing
from the City to revise the line item budget when the cumulative amount of transfers from or to a line item is
expected to exceed ten percent (10%) of that line item. The Agency must provide supporting documents to fully
explain the nature and purpose of the revision with each request for prior approval. All budget revision requests
in excess of 10% of a line item amount shall be reviewed and approved or denied by the City in writing.
4.5 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 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
ARPA HUMAN SERVICES AGREEMENT - 2 - 8/2023
CITY OF CITY HALL
�.� Feder Fe d e ra I Wayth Avenue South
Federall Way, WA 98003-6325
(253) 835-7000
www cityoffederalway com
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.
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 ofLiability. 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
ARPA HUMAN SERVICES AGREEMENT - 3 - 8/2023
CITY OF CITY HALL
�� Federal
�� �� I �� 33325 Avenue South
Federall Way, WA 98003-6325
(253) 835-7000
www. dlyvllederafway com
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 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
ARPA HUMAN SERVICES AGREEMENT - 4 - 8/2023
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835- i 000
www. Gtyoffederal way. com
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. FQtTAL OPPORTt?NITY 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 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 Assigmnent 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.
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
ARPA HUMAN SERVICES AGREEMENT - 5 - 8/2023
CITY OF CITY HALL
Federal Way Feder 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www c tyofTederafway com
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]
ARPA HUMAN SERVICES AGREEMENT - 6 - 8/2023
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoflederalway com
�N WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY: ATTEST:
cliaz�tiv� f4a6ftku
Jim Ferr May r St ie Courtney, CMC, it Clerk
APPROVED AS TO FORM:
DATE: I
FEDERAL WAY COMMUNITY CAREGIVING
NETWORK:
w
By:
Printed Name: � ���,e'l�
Title: �S�
DATE: l0 —o-Z .,2 O Z -7
STATE OF WASHINGTON )
COUNTY OF
@JRyCall, City Adomey
&I
On this day appeared before me �.!► y personally pp t-,brm CAI w Ton Cito me known to be the
of Federal Way Community Caregiving Network that executed the foregoing
ins rument, 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 they were 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 day of C)C-4-��� , 20Z�
-(Y I PAA'�''f, Notary's signature
�• '� +� �,� ter'% Notary's printed name
CP° '
• Notary Public in a d r the State of Washington.
i AR :
Bp�•�
r.� p . _ My commission expires t 'Z ( 2,c)
,LP�U B1-�G �n� 0
Exp-
J��i T�` ' ' • • ' ' \ ,tip
/,r'QF Iw4A5r�,�ti�
ARPA HUMAN SERVICES AGREEMENT - 7 - 8/2023
4 cIrr of
Ar!
Federal Way
EXHIBIT A
SERVICES
Proiect Services Summary
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(2531 835-7000
www � r�• c� �;,,de. r,lway. com
The Agency shall provide emergency rent assistance in the City of Federal Way. The Agency shall ensure that
services provided with funding under this Agreement are made available and delivered 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
ARPA funds:
1st
2nd
3rd
4tn
Quarter
Quarter
Quarter
Quarter
Total
JAN. —
APRIL —
JULY —
OCT. —
MARCH
JUNE
SEPT.
DEC.
No. of unduplicated Federal
Way persons assisted in 2023
N/A
N/A
144
144
288
No. of unduplicated Federal
Way persons assisted in 2024
144
144
144
144
576
No. of unduplicated Federal
W4y persons assisted in,2025
144
144
144
144
576
No. of unduplicated Federal
Way persons assisted in 2026
144
144
1441
144
1 576
B. Units of Service
The Agency agrees to provide, at minimum, the following units of service by quarter:
1st
2nd
3rd
4tn
Quarter
Quarter
Quarter
Quarter
Total
JAN. —
APRIL —
JULY —
OCT. —
MARCH
JUNE
SEPT.
DEC.
2023
1. Rent assistance
N/A
N/A
45
45
90
2024
1. Rent assistance
45
45
45
45
180
2025
ARPA HUMAN SERVICES AGREEMENT - 8 - 8/2023
CITY OF
Federal
CITY HALL
Way 33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www ciyoffederalway com
1. Rent assistance
45
45
45
45
180
2026
1. Rent assistance
45
45
45
45
180
1. Units of service are measured by number of households receiving rent assistance to prevent eviction.
C. Outcome Measure(s)
Outcome 1: Remain housed, at minimum, three months post assistance.
Outcome 1 Indicator: Monthly post survey of clients who receive assistance to determine
housing status.
Target: 60% of clients remain housed
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. Records documenting that costs reimbursed with funding provided under this Scope are allowable.
Such records include, but are not limited to:
■ for personnel costs, payroll for actual salary and fringe benefit costs.
■ for staff travel, documentation of mileage charges for private auto use must include: a)
destination and starting location, and b) purpose of trip; and
■ for copy machine use, postage, telephone use, and office supplies when these costs are shared
with other programs and no invoice is available, log sheets or annotated invoices.
9. Documentation of client address; residency verified via King County Parcel Viewer.
10. 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.
ARPA HUMAN SERVICES AGREEMENT - 9 - 8/2023
CITY OF
.t Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
wvvw cityoffederalway com
King County FY 2023 Income Limits Summary
(Effective June 15, 2023)
Median
FY 2023
Income
Income
1 Person
2 Persons
3 Persons
4 Persons
5 Persons
6 Persons
7 Persons
8 Persons
King
Limit
County
Category
Extremely
Low
-30%
$28,800
$32,900
$37,000
$41,100
$44,400
$47,700
$51,000
$54,300
Income
Limits
Very Low
$146,500
-50%
$47,950
$54,800
$61,650
$68,500
$74,000
$79,500
$84,950
$90,450
Income
Limits
Low
-80%
$70,650
$80,750
$90,850
$100,900
$109,000
$117,050
$125,150
$133,200
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 not less than quarterly. Required reports shall
be submitted together on a form and format to be provided by the City. Required reports are the reimbursement
request, service unit report with narrative, demographic data report, and outcomes reports.
The Agency shall submit a Demographic Data Report not less than quarterly. The agency shall collect and
retain the data requested on the City provided form from the persons served through this contract. Data should
be tracked in an ongoing manner and submitted not less than quarterly 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 and detailed above in this Exhibit A. Changes to the outcome(s) presented in the application must be
approved by the City prior to implementation. The Agency shall report the results of its outcome measure(s) not
less than quarterly on the Outcome Data Report 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 ARPA Funds.
ARPA HUMAN SERVICES AGREEMENT - 10 - 8/2023
CITY OF
FederaI Way
EXHIBIT B
COMPENSATION
Project Bud,2et
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cayoffederalway. com
The Agency shall apply the following funds to the project in accordance with the Line Item Budget Summary,
detailed below. The total amount of compensation pursuant to this Agreement shall not exceed One Hundred
Seventy -Five Thousand and 00/100 Dollars ($175,000.00).
A. City of Federal Way Funds
2023
2024
2025
2026
City of Federal Way ARPA Fund:
$25,000.00
$50,000.00
$50,000.00
$50,000.00
TotalCity of Federal Way Funds:
$25 000.00
$50,000.00
$50,000.00
$50,000.00
B. Line Item Budget
2023
2024
2025
2026
Other (specify): Direct Aid to Clients
$24,615.00
$49,230.00
$49,230.00
$49,230.00
Insurance
$385.00
$770.00
$770.00
$770.00
Total City of Federal Way Funds:
$25,000.00
$50,000.00
$50 000.00
$50,000.00
Reimbursement Requests with supporting documentation for the billing period, Service Unit Report,
Demographics Data Report, and Outcomes Data Report shall be submitted no less frequently than quarterly and
are due on the 151h of the month after the reporting period ends, but not less than the following dates:
1 st Quarter: April 15;
2nd Quarter: July 15;
3rd Quarter: October 15; and
4th Quarter: Reimbursement Request, Service Unit Report, Demographic Data Report, and Outcomes
Data Report forms are due January 6.
The first quarter of reporting is the 3rd quarter of 2023. The first Reimbursement Requests, Service Unit Report
forms, Demographics Data Report shall be submitted on October 15, or within ten (10) days of notice to
proceed, whichever is later.
Services are to be delivered throughout each contract year. If the Agency anticipates expenditures will exceed
the estimated quarterly or monthly payments for the corresponding billing period, the Agency shall request prior
approval in writing from the City. Estimated Quarterly Payments are approximately $12,500.00. If the Agency
submits monthly reports, Estimated Monthly Payments are approximately $4,167.00.
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.
Conditions of Funding
ARPA HUMAN SERVICES AGREEMENT - 11 - 8/2023
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityotfederalway. com
The Agency agrees it will meet the specific funding conditions identified for the Agency and acknowledges
payment to the Agency will not be made unless the funding conditions are met. If the Agency's performance is
behind the agreed upon numbers stated above by June 2024, the City reserves the right to deny additional award
of funds beyond 2024 and re -distribute any remaining funding that otherwise would have been available to the
Agency to other agencies, programs, or projects as the City sees fit.
ARPA HUMAN SERVICES AGREEMENT - 12 - 8/2023
,w4SCITY OF
,Federal Way
EXHIBIT C
CERTIFICATE OF INSURANCE
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7400
www 0yoffederalway com
ARPA HUMAN SERVICES AGREEMENT - 13 - 8/2023
DATE (MM/DDNYYY)
AC�RD� CERTIFICATE OF LIABILITY INSURANCE
10/20/2023
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 CONTACT Crystal M. Wells
STANFORD INSURANCE INC PHONE 253-874-9200 FAX AfC No
PO Box 189 ao Rom. crystal@stanfordinsurance.com
INSURERS AFFORDING COVERAGE NAIC #
Gig Harbor WA 98335 INSURER A: Mount Vernon Fire Insurance Company
INSURED INSURER B
Federal Way Community Caregiving
P 0 BOX 4717 INSURER C :
Federal Way WA 98063 �INSURER D
URER E :
URER F :
r-nVFRAnFS rFRTIFIf.ATF NIIMRFR• 2023256558775568 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.
ILTR TYPE OF INSURANCE AMCS R POLICY NUMBER POLICY EFF MM POLICY y LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
Y
N
NPP2566521F
06/02/2023
06/02/2024
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL BADVINJURY
$ 1,000,000
MN'LAGGREGATE LIMIT APPLIES PER:
�{ POLICY❑ JERCOT 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
C{ OMBINED SENGLE LIMIT
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per aak5�st
$
A
X
UMBRELLALIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N XL1646179
10/18/2023
06/02/2024
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
OFFICEANYPROR/MEMB REXCLUDED ?ECUTIVE ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
PER OTH-
STATUTE ER
E.L-EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
City of Federal Way listed as Named Insured
CERTIFICATE HOLDER CANCELLATION
CITY OF FEDERAL WAY
33325 8TH AVE S
FEDERAL WAY WA 98003
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD
r
Federal Way Community Receipt #14801505
Caregiving Payment on 10/23/2023
dwdixi@comcast.net
Subtotal
Fee
Total
PAYMENT TYPE
NOTES
How do I reverse this payment?
How do I subscribe others to
notifications?
$424.00
$4.24
$428.24
ACH XXXXXXXX5804
Mount Vernon Fire Insurance Excess #XL1646179 10/18/2023
Stanford Insurance
3118 Judson Street #189 Gig Harbor, WA 98335 United States
253-874-9200
crystal@stanfordinsurance.com
Copyright 2023 All Rights Reserved I ePayPolicy
Washington State Department of Revenue
Pagel of 3
Washington State Department of Revenue Q
< Business Lookup
License information: New search Back to results
Entity name: FEDERAL WAY COMMUNITY CAREGIVING NETWORK
Business
FEDERAL WAY COMMUNITY CAREGIVING NETWORK
name:
Entity type:
Nonprofit Corporation
UBI #:
601-180-311
Business ID:
001
Location ID:
0001
Location:
Active
Location address: 32701 6TH AVE SW
FEDERAL WAY WA 98023-5624
Mailing address: 32701 6TH AVE SW
FEDERAL WAY WA 98023-5624
Excise tax and reseller permit Click here
status:
Secretary of State status: Click here
Endorsements
https://secure.dor.wa.gov/gteunauth/m/ 5/31/2023
Washington State Department of Revenue Page 2 of 3
Endorsements help License $ Count Details Status Expiratic First issu
Federal Way Active May-31- Mar-2S-;
Nonprofit
Business
Governing people Title
DOVEY, JENNIFER
JOHNSON, DOUGLAS
ROBINSON, NORMAN
Registered Trade Names
Registered trade names Status First issued
v
https:Hsecure.dor.wa.gov/gteunauth/,/ 5/31/2023
Washington State Department of Revenue
Page 3 of 3
Registered trade names Status
FWCCN Active
First issued
Feb-08-2023
The Business Lookup information is
updated nightly. Search date and time:
5/31/2023 2:49:24 PM
Contact us
How are we doing?
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https://secure.dor.wa.gov/gteunauth/,—/ 5/31/2023
Corporations and Charities System Pagel of 2
;r,es5WjWfj�tAy &-pnd Charities Filing System
BUSINESS 1N'FORMATIOU
Business Name:
FEDERAL WAY COMMUNITY CAREGIVING NETWORK
UBI Number:
601 180 311
Business Type:
WA NONPROFIT CORPORATION
Business Status:
ACTIVE
Principal Office Street Address:
32701 6TH AVE SW, FEDERAL WAY, WA, 98023-5624, UNITED STATES
Principal Office Mailing Address:
PO BOX 4717, FEDERAL WAY, WA, 98063-4717, UNITED STATES
Expiration Date:
05/31/2024
Jurisdiction:
UNITED STATES, WASHINGTON
Formation/ Registration Date:
05/15/1989
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
CHARITABLE, SUPPORT OF PEOPLE NEEDING RENT AND FOOD ASSISTANCE
Charitable Corporation:
it
Nonprofit EIN:
94-3105476
Most Recent Gross Revenue is less than $500,000:
it
Has Members:
EI
Public Benefit Designation:
https:Hccfs.sos.wa.gov/ 5/31/2023
Corporations and Charities System
Page 2 of 2
n
WISTENDAINWWOMMMS
DOUGLAS W JOHNSON
32701 6TH AVE SW, FEDERAL WAY, WA, 98023-5624, UNITED STATES
GOVERNOIRS
Title
Governors Type
GOVERNOR
INDIVIDUAL
GOVERNOR
INDIVIDUAL
GOVERNOR
INDIVIDUAL
Back
Entity Name
Host Home:
Registered Agent Name:
Street Address:
Mailing Address:
First Name
Last Name
JENNIFER
DOVEY
DOUGLAS
JOHNSON
NORMAN
ROBINSON
Filing HistoryName History Print Return to Business Search
https://ccfs.sos.wa.gov/ 5/31/2023
Last updated by Howard Sloh on Aug 13, 2023 at 06:22 PM FEDERAL WAY COMMUNITY CAREGIVING NETWORK
III SAM*SOW
FEDERAL WAY COMMUNITY CAREGIVING NETWORK
Unique Entity ID
X777FKH561T5
Registration Status
Active Registration
Physical Address
32701 6TH AVE SW
Federal Way, Washington 98023-5624
United States
Buslntsss.information
Doing Business as
(blank)
Congressional District
Washington 09
Registration Dates
Activation Date
Aug 25, 2023
Entity Dates
Entity Start Date
Jan 1, 1990
Immediate Owner
CAGE
(blank)
Highest Level Owner
CAGE
(blank)
CAGE/NCAGE
(blank)
Expiration Date
Aug 22, 2024
Mailing Address
32701 6TH AVE SW
Federal Way, Washington 98023-5624
United States
Division Name
(blank)
State / Country of Incorporation
Washington / United States
Submission Date
Aug 23, 2023
Fiscal Year End Close Date
Dec 31
Legal Business Name
(blank)
Legal Business Name
(blank)
Purpose of Registration
Federal Assistance Awards Only
Division Number
(blank)
URL
(blank)
Initial Registration Date
Aug 23, 2023
Executive Compensation
Registrants in the System for Award Management (SAM) respond to the Executive Compensation questions in accordance with Section 6202 of
P.L. 110-252, amending the Federal Funding Accountability and Transparency Act (P.L. 109-282). This information is not displayed in SAM. It is
sent to USAspending.gov for display in association with an eligible award. Maintaining an active registration in SAM demonstrates the registrant
responded to the questions.
Proceedings Questions
Registrants in the System for Award Management (SAM.gov) respond to proceedings questions in accordance with FAR 52.209-7, FAR 52.209-9,
or 2. C.F.R. 200 Appendix XII. Their responses are displayed in the responsibility/qualification section of SAM.gov. Maintaining an active
registration in SAM.gov demonstrates the registrant responded to the proceedings questions.
ExcLu.sign Summary , -
Active Exclusions Records?
No
SAM Search Authorirat3u — — — — —
I authorize my entity's non -sensitive information to be displayed in SAM public search results:
Yes
Entlty Types
Business Types
Entity Structure Entity Type Organization Factors
Corporate Entity (Tax Exempt) Business or Organization (blank)
Profit Structure
Non -Profit Organization
Nov 09, 2023 09:04:21 PM GMT
htips:llsam.gov/entify/X777FKH561 T5/coreDala?s1atus=nu11
Page 1 oj2
Last updated by Howard Stolz on Aug 23, 2023 at 06:22 PM
Socio-Economic Types
FEDERAL WAY COMMUNITY CAREGII/ING NETWORK
Check the registrant's Reps & Certs, if present, under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA -certified HUBZone small
business concern. Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the
SBA supplemental pages during registration.
Financial Information
Accepts Credit Card Payments Debt Subject To Offset
No No
EFT Indicator CAGE Code
0000 (blank)
Points of Con
Electronic Business
32701 6TH AVE SW
Doug Johnson, Treasurer Federal Way, Washington 98023
United States
Government Business
- 31219 4TH AVE. SW
Tony Robinson, Board President Federal Way, Washington 98023
United States
Service Cfassifications�
NAICS Codes
Primary NAICS Codes NAICS Title
a ponse
This entity does not appear in the disaster response registry.
Nov 09, 2023 09:04:21 PM GMT
https: Usan4govlentity/X777FKH561 T5/coreDaia?sta1us=null Page 2 oj2