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AG 23-236 - BRIDGING A GAPRETURN TO: Kim Bachrach EXT: 2654 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATINGDEPT./DIV: CD/Community Services 2. ORIGINATING STAFF PERSON: Kim Bachrach EXT: 2654 3. DATE REQ. BY:12/19/2023 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 IN HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION * CONTRACT AMENDMENT (AG#): AG23-236 ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: ARPA Human Services Grant Amendment 1 6. NAME OF CONTRACTOR: Bridging A GAP ADDRESS: 33313 1st Way S Federal Way, WA 98003 TELEPHONE (206) 276-5745 E-MAIL: Vdanforth@cbdanforth.com FAX: SIGNATURE NAME: Valerie Danfprth TITLE Executive Director 7. EXHIBITS AND ATTACHMENTS: O 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: July 1, 2023 COMPLETION DATE: December31, 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: A YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ 175,000 IS SALES TAX OWED OYES ONO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED A PURCHASING: PLEASE CHARGE TO: 001-1600-990-518-10-410 10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED ® PROJECT MANAGER SJB 12/12/2023 ❑ DIRECTOR * RISK MANAGEMENT (IFAPPLICABLE) 9 LAW JE 01/16/24 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 3/21/2024 DATE REC'D: 3/27/2024 • ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDERINOTIFICATION 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.) INITIALI DATE SIGNED Vr`LAW DEPARTMENT GNATORY (MAYOR OR DIRECTOR) [TY CLERK Irr- CYASSIGNED AG# G COMMENTS: SJB (12/12/2023): The amendment is to change the services to accurately reflect the services proposed in the application, which were the basis for funding decisions. The applicant had then wanted reflect higher performance measures without realizing that this contract was specifically for new/added services rather than ongoing services like other City grants. 2/2017 cIrr OF CITY HALL Federal Way Feder l Avenue South Federal Way, WA 98003-6325 (253) 835-7000 vlmvdlyoffederalway. con AMENDMENT NO. 1 TO HUMAN SERVICES AGREEMENT FOR WEEKEND FEEDING PROGRAM This Amendment ("Amendment No. I") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Bridging a Gap Weekend Feeding Program, a Washington nonprofit corporation ("Contractor"). The City and Contractor (together "Parties"), for valuable consideration and by mutual consent of the Parties, agree to amend the original Agreement for Weekend Feeding Program("Agreement") dated effective November 9, 2023, as follows: 1. AMENDED SERVICES. The Services, as described in Exhibit A and as referenced by Section 2 of the Agreement, shall be amended as described in Exhibit A-1 attached hereto and incorporated by this reference ("Amended Services"). 2. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done by either Parry consistent with the authority of the Agreement, together with any prior amendments thereto, after the previous expiration date and prior to the effective date of this Amendment, are hereby ratified as having been performed under the Agreement, as modified by any prior amendments, as it existed prior to this Amendment. The provisions of Section 13 of the Agreement shall apply to and govern this Amendment. The Parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. [Signature page follows] AMENDMENT - 1 - 4/2023 CITY OF CITY HALL Federal Way Feder 8th Avenue South Federal Way, WA 9803-6325 (253)835-7000 www cityoffederal way. com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: By: _ (J2 J i rrell, ayor DATE: BRIDGING A GAP WEEKEND FEEDING PROGRAM: By: V(dy U0 } 1 p Printed Name: Title: Date: f a�lai STATE OF WASHINGTON ) ss. COUNTY OF n, ATTEST: g1an OVED AS TO FORM: t Call, City orney On this day personally appeared before me VoICn6 DeAn-Pby�to me known to be the Pie S id(5'?-�- of Bridging a Gap Weekend Feeding Program that executed the within and 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 or she was authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. r GIVEN undg, rW h�pd and official seal this S day of M6L4C/V7` , 2024. 20 Notary's signature °`�. Notary's printed name K4mbn 1&y -C Notary Public in and for the State of Washington. F Zr- My commission expires Oq -U 1 a off,JOF W AS�`,�` • AMENDMENT - 2 - 4/2023 CITY OF CITY HALL Federal Way Feder l Avenue South Federal Way, IiUA 98003-6325 (253) 835-7000 www.ciryoffederahvoy com EXHIBIT A-1 SERVICES The Contractor shall do or provide the following Services in replacement of subsections A and B of the Performance Measures Section within Exhibit A of the original Agreement: 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 4th 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 0 94 94 No. of unduplicated Federal Way persons assisted in 2024 52 52 0 52 156 No. of unduplicated Federal Way persons assisted in 2025 52 52 0 52 156 No. of unduplicated Federal Way persons assisted in 2026 52 52 0 52 156 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. - APRIL - JULY - OCT. - MARCH JUNE SEPT. DEC. 2023 1. Weekend meals provided for N/A N/A 0 6,180 6,180 students in Federal Way Public Schools 2024 1. weekend meals provided for 6,180 6,180 0 6,180 18,540 students in Federal Way Public Schools 2025 AMENDMENT - 3 - 4/2023 CITY OF Federal CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. cityoffederalway.. com 1. Bags of weekend food for 6,180 6,180 0 6,180 18,540 students in Federal Way Public Schools 2026 1. Bags of weekend food for 6,180 6,180 0 6,180 18,540 students in Federal Way Public Schools 1. Units of service are measured by number of bags of food provided. AMENDMENT - 4 - 4/2023 RETURN 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 0 HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: ARPA Human Services Grant 6. NAME OF CONTRACTOR: Bridging A GAP ADDRESS: 33313 1st Way S Federal Way, WA 98003 TELEPHONE (206) 276-5745 E-MAIL: `V.4Wm04chdanlmth.ram FAX-. SIGNATURE NAME: Valerie TITLE Executive Director 7. EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES A COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE A ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8.. TERM: COMMENCEMENT DATE: July 1, 2023 COMPLETION DATE: December31, 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: EYES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ 175.000 IS SALES TAX OWED ®YES ONO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ® PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-410 10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED X PROJECT MANAGER SJB 09118/2023 ❑ DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ' © LAW JE 9/22/23 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: 07/11/2023 COUNCIL APPROVAL DATE: 07/18/2023 12. CONTRACT SIGNATURE ROUTING 0 SENT TO VENDOR/CONTRACTOR DATE SENT: 10/30/2023 DATE REC'D: 11/09/2023 ❑ 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 SIGNED PARTMENT r IGNATORY (MAYOR OR DIRECTOR) I I ❑ CITY CLERK ❑ ASSIGNED AG# AG# .,.. L COMMENTS: 2/2017 CITY OF CITY HALL Federal Way 33325Avenue South Federall Way, WA 98003-6325 (253) 835-7000 mm ckyoffederaMoy.. co HUMAN SERVICES AGREEMENT FOR WEEKEND FEEDING PROGRAM This Human Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Bridging a Gap Weekend Feeding Program 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: BRIDGING A GAP WEEKEND FEEDING PROGRAM: Valerie Danforth 33313 1st Way S Federal Way, WA 98003 (206) 276-5745 (telephone) V danforthA cbdanforth. con The Parties agree as follows: CITY OF FEDERAL WAY: Kim Bachrach 33325 8th Ave. S. Federal Way, WA 98003-6325 (253) 835-2654 (telephone) Kim.Bachrach a.cityaffederalway.com 1. TERM. The term of this Agreement shall be 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) and a Unique Entity Identifier (UEI). 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 Federal Way CITY OF CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www.rj"ffederalLvay.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 A_geng 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 4 CITY OF CITY HALL Federal WayFeder 8th Avenue South Federal Way, WA 9803-6325 (253) 835-7000 www cilyoffederalway 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 parry 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 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 ARPA HUMAN SERVICES AGREEMENT - 3 - 8/2023 CITY OF CITY HALL Federal WayFeder 8th Avenue south Federal Way, WA 98003-6325 (253) 835-7000 www cityotfederalway 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) 835-7000 vA%v atyaflederalway.. corn 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 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 Assignment 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 Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. cityoffederahioy 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 'S CITY of As , � Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www ciryoffederanvay com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY: ATTEST: q&64�4� SWhJnie Courtney, CMC, t4y Clerk APPROVED AS TO FORM: DATE: 2 tt'� *JRn Call, CityFattorney BRIDGING A GAP WEEKEND FEEDING PROGRAM: By: - Printed Name: 4evie. Title: PfesiAeof DATE: STATE OF WASHINGTON ) ss. COUNTY OF iLt n On this day personally appeared before me \ a- '( - QK 0-k>r -0 to me known to be the Plus ickn 1 fi of Bridging a Gap Weekend Feeding Program 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 they were authorized to execute said instrument and that the seal affixed, if any, is the corporate seal of said corporation. GIVEN my hand iyAPflicial seal this �r day of eta �'Gt'Y^!-� 20� III,I , otary;s signature c,°a �5lotarys printed name ►�c Vic. Notary Public in and for the State of Washington. My commission expires ©el-51' . p Oftjj2zq... "; ASHtIS[', `� •�'IliITI10\ % ARPA HUMAN SERVICES AGREEMENT - 7 - 8/2023 cirr OF AN Federa Pro'ect Services Summa CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253)835-7000 www.c,i"ffaderal6vay.com EXHIBIT A SERVICES The Agency shall provide backpacks of food for weekends and extended school breaks to students in need 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 0 70 70 No. of unduplicated Federal Way persons assisted in 2024 71 70 0 70 211 No. of unduplicated Federal Way persons assisted in 2025 71 70 0 70 211 No. of unduplicated Federal W4y persons assisted in 2026 71 70 0 70 211 ARPA HUMAN SERVICES AGREEMENT - 8 - 8/2023 .ACITY OF �, Federal CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www 0yoffederahvay. con B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — MARCH JUNE SEPT. DEC. 2023 1. Bags of weekend food for N/A N/A 0 215368 21,368 students in Federal Way Public Schools 2024 1. Bags of weekend food for 21,387 21,386 0 21,368 64,104 students in Federal Way Public Schools 2025 1. Bags of weekend food for 21,387 21,386 1 0 21,368 64,104 students in Federal Way Public Schools 2026 1. Bags of weekend food for 21,387 21,386 0 21,368 64,104 students in Federal Way Public Schools 1. Units of service are measured by number of meals provided. C. Outcome Measure(s) Outcome 1: Report improved attendance. Outcome 1 Indicator: Federal Way School District attendance data Target: 60% of students who receive BAG backpacks 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. ARPA HUMAN SERVICES AGREEMENT - 9 - 8/2023 CITY of CITY HALL Federal Way Feder l Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www.cityoffederal,.v,ij�.com 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. King County FY 2023 Income Limits Summary (Effective June 15, 2023) Median FY 2023 Income Income Limit 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons King 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. ARPA HUMAN SERVICES AGREEMENT - 10 - 8/2023 Federal Way CITY OF CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www ciryot%derahvay. com 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 - 11 - 8/2023 ,4S CITY OF ,�� Federal Way EXHIBIT B COMPENSATION Project Budzet CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 wmv cityoffederalway. 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 Total City 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/Food $25,000.00 $50,000.00 $50,000.00 $50,000.00 $50,000.00 $50,000.00 Total City of Federal Way Funds: $25,000.00 $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 15th 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 $12,501.00. 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 Fundin 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 ARPA HUMAN SERVICES AGREEMENT - 12 - 8/2023 CITY OF �L Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 mvwWyoffederahvay com 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 - 13 - 8/2023 CITY OF .t Federal Way EXHIBIT C CERTIFICATE OF INSURANCE CITY HALL 33325 8th Avenue South Federal Way, V11A 98003-6325 (253) 835-7000 www cityoffederal�voy. com ARPA HUMAN SERVICES AGREEMENT - 14 - 8/2023 33 DATE (MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE 2/13/2023 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 coNracT Crystal Wells _ NAME: _ STANFORD INSURANCE INC PHONE 253-874-9200 l FAX _WQ..No,Extl PO Box 189 E-MAIL g�] nfoniinsurenCB.com AOj.3RE33: _ INSURERS AFFORDING COVERAGE NAIC * _ Gig Harbor WA 98335 INSURER A: Mount Vernon Fire Insurance Company INSURED INSURER B Bridging A Gap Weekend Feeding Program 515 S 312th Street INSURER C Federal Way WA 98003 INSURERO' INSURER E - INSURER F: r_nvwPAr_Fc r_>FRTIEIraTF NIIMRFR- 20230130145608472 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 REDUCEDPAIDPAID CLAIMS. AOOL SPO C TYPE OF INSURANCE i>'BR POLICY NUMBER I MMrpONYYY LIMITS A GEN'L . X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX1 OCCUR Y NPP2571932C - 07/02/2022 07/02/2023 EACH OCCURRENCE S 1,000,000 PREMISES Ma occurrence) S 100,000 $ 5,000 MED EXP JAny oneperson) PERSONAL BADVINJURY $ 1,000,000 $ 2,000,000 AGGREGATE LIMIT APPLIES PER: 77 POLICY j�7 J LOC OTHER: GENERAL AGGREGATE PRODUCTS -COMP/OP AGG $ Included $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY I ON D 81N IT �rccidan3S $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S P;KO RTY DAMAGE 5--91r.1 $ $ A X UMBRELLA LIAO EXCESS LIAR M OCCUR CLAIMS -MADE N XL1637019 02/10/2023 02/10/2024 I I EACH OCCURRENCE $ 1,000,000 AGGREGATE S 1,000,000 DED I RETENTION $ ` I $ 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY7ROPRIETOR/PARTNERIFJ*CUTIVE Y- Man6a�dE�HR EXCLUDED? 1f yye�s, des g tinder 0ESCR1 TIOTi Or OPERATIONS bolaw NIA - MUTE E-L EACH ACCIDENT S _ S S EL. DISEASE -EA EMPLOYE E.L. DISEASE - POLICY LIMIT I` i I III jI I f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be, attached if more space Is required) Federal Way Public Schools is named as additional insured. May 10, 2023 Fundraising event held at Federal Way High School 30611 16th Ave S Federal Way, WA 98003 CERTIFICATE HOLDER CANCELLATION Federal Way Public Schools 33330 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 25 (2016103) The ACORD name and logo are registered marks of ACORD ENDORSEMENT #1 This endorsement, issued by Mount Vernon Fire Insurance Company to BRIDGING A GAP WEEKEND FEEDING PROGRAM forms a part of Policy Number NPP2571932C effective on 1/25/2023 (MO. DAY YR.) at 12:01 A.M. Add/Remove/Amend Coverage In consideration of no change in premium" it is hereby agreed and understood that the policy is amended with the following changes: **A Minimum Premium was applied in the calculation of the Premium. LOCATIONS: Loc. # Address 1 Amend 33313 First Way South, Federal Way, WA, 96003 Covered Causes of Loss: Special Construction: Joisted Masonry Description: Social Service Special Deductible: None Special Deductible Type: COMMERCIAL GENERAL LIABILITY COVERAGE PART" Loc# Classification Code No. Premium Basis 1 Add Additional Insured - Designated Person 49950 1 Per Additional Insured Territory 002 Fire Code: 0756 Prot. Class: 2 Square Footage:500 Rate Premium Change Pr/Co* All Other Pr/Co* All Other Charged Included 100.000 Included $100 $43 It is hereby agreed that the following form(s) is(are) added to the Policy: CG2026 04/13 - Additional Insured -Designated Person or Organization and the following has(have) been amended: L-232s 04115 - Classification Limitation Endorsement All other terms and conditions of this Policy remain unchanged. This contract is registered and delivered as a surplus line coverage under the insurance code of the state of Washington, Title 48 RCW. It is not protected by any Washington state guaranty association law. Joel D. Cavaness — Risk Placement Services Inc. " Products/Completed Operations POLICY NUMBER: NPP2571932C COMMERCIAL GENERAL LIABILITY CG 20 26 0413 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) Or Organization(s): Effective Date: 01/25/2023 12:01 AM FEDERAL WAY PUBLIC SCHOOLS 33330 STH AVE S FEDERAL WAY, WA 98003 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III - Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 26 0413 © Insurance Services Office, Inc., 2012 Page 1 Of 1 This Endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM Classification Limitation Endorsement Coverage under this contract is strictly limited to the classification(s) and code(s) listed on the policy Declarations page. No coverage is provided for any classification(s) and code(s) not specifically listed on the Declarations page of this policy. All other terms and conditions of this policy remain unchanged. This endorsement is a part of your policy and takes effect on the effective date of your policy unless another effective date is shown. L-232s (04-15) Page 1 of 1 STANFORD INS INC PO BOX 189 GIG HARBOR, WA 98335 634365 212 AB 0 537 PPACA01 G 002 000021 Named insured BRIDGING A GAP WEEKEND FEEDING PROGRAM 33313 FIRST WAY SOUTH FEDERAL WAY, WA 98003 Irll�lll��l��ll�l�llll'I�I.II�11�1.11r1���llll�.��'�'��I�I�rl�lrl Commercial Auto Insurance Coverage Summary This is your revised Renewal Declarations Page RRMNEWYE' CONNSERC1,4L Policy number: 01206303-8 Underwritten by: United Financial Casualty Company October 5, 2023 Policy Period: Oct 8, 2023 - Apr 8, 2024 Page 1 of 2 agent.progress ive.com Online Service Make payments, check billing activity, print policy documents, or check the status of a claim. 1-253-874-9200 STANFORD INS INC Contact your agent for personalized service. 1-800-444-4487 For customer service if your agent is unavailable or to report a claim. Your coverage begins on October 8, 2023 at 12:01 a.m. This policy expires on April 8, 2024 at 12:01 a.m, This coverage summary replaces your prior one. Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto, unless the policy contract allows the stacking of limits. The policy contract is form 6912 (02/19). The contract is modified by forms 2852WA (02/19), 1652WA (02/19), 1198 (01/04), Z311 (02119), 4852WA (02/19), 4881 WA (02/19) and Z228 (01/11). The named insured organization type is a corporation, outline of coverage Description Limits Deductible Premium Li.... . ................ ........-......... .. ..... .................... Liability To Others $972 Bodily Injury and Property Damage Liability $1,000,000 combined single limit Underinsured Motorist Bodily Injury $1,000,000 combined singl e limit 99 Underinsured Motorist Property Damag........... .... - - ................_........-.. e $10,000 each accident $100 5 $300 hit & run lnry.... .. ........... Personauotection $10,00.0. . each person 50 .......... ......... Comprehensive 47 See Auto Coverage Schedule Limit of liability less deductible .,. Collision 90 See Auto Coverage Schedule Limit of liability less deductible .... I ... I ...... . ................ Rental Reimbursement 88 See Auto Coverage Schedule ......... ... ....... . Total 6 month policy premium $1,352 Rated drivers 1. DAVID DANFORTH 2. MATTHEW 1 MANGIO ......... . . 3. 10HN R TAYLOR 4. MICHAELT ROLPH Conti I VuO Foim 6489 V!r.(04/12) Policy number. 01206303-8 BRIDGING A GAP WEEKEND Page 2 of 2 Auto coverage schedule 1. 1994 Chevrolet P30 Stated Amount: *$10,000 (including Permanently Attached Equip) VIN: 1GBHP32K8R3312095 Garaging Zip Code: 98001 Radius: 200 Liability Liability UIM BI UIM PD. PIP Premium $972 $99 $6 $50 Camp Comp Collision Collision Physical Damage Wualble Premium Deductible Premium Premium $250 $47 $500 $90 Rernai Rental Other Coverages Lima Premium Premium $150 per day $88 Max $4500 `A vehicle's stated amount should indicate its current retail value, including any special or permanently attached equipment. In the event of a total loss, the maximum amount payable is the lesser of the Stated Amount or Actl:ol .ash Value. less deductible, Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy. Premium discounts Policy ................ ................. 01206303-8 Business Experience and Paid In Full Additional Insured information 1. Additional Insured Company officers f�CfGldf'd Form 6489 U1•'k (04/ i 2) CITY OF FEDERAL WAY 33325 8TH AVE S FEDERAL WAY, WA 98003 Auto Total $1,352 Policy number: 01206303-5 BRIDGING A GAP WEEKEND Pagel of 1 Provider Network Program If you're hurt in an accident that's covered by your Progressive policy, you may have access to a network of medical providers in your area who can treat you. These providers may offer reduced rates through the network that could allow you to get more treatment if necessary. Visit progressive.com/providernetworks anytime to find out what provider networks are available in your area. The claim representative handling your medical claim will also be able to provide this information if you're in an accident. You are under no obligation to use any network referenced above. You're free to see a medical service provider of your choice. Using a provider within the network doesn't necessarily mean that we'll cover the cost of their services, If you're in an accident, always check with the claim representative handling your medical claim to confirm what's covered. Form 7271(01/12) STANFORD INS INC p,R499REI1111F PO BOX 189 LoMMERCIAL GIG HARBOR, WA 98335 Policy number: 01206303-8 Underwritten by: United Financial Casualty Company BRIDGING A GAP WEEKEND Insured: FEEDING PROGRAM BRIDGING A GAP WEEKEND 33313 FIRST WAY SOUTH October 5, 2023 FEDERAL WAY, WA 98003 Policy Penod: Oct 8, 2023 - Apr 8, 2024 Mailing Address United Financial Casualty Company PO Box 94739 Additional insured endorsement Cleveland, OH44101 1-800-4444487 Name of Person•or Organization For customer service, 24 hours a day, CITY OF FEDERAL WAY 7 days a week 33325 8TH AVE S FEDERAL WAY, WA 98003 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability, We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. Limit of Liability Bodily Injury Not applicable. Property Damage Not applicable Combined Liability $1,000,000 each accident All other terms, limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number: 01206303-8 Issued to (Name of Insured): BRIDGING A GAP WEEKEND FEEDING PROGRAM Effective date of endorsement: 10/08/2023 Form 1198(01/04) Policy expiration date: 04/08/2024 Policy number 01206303-8 BRIDGING A GAP WEEKEND Pagel of 1 Rental Reimbursement Coverage Endorsement Except as specifically modified in this endorsement, all provisions of the Commercial Auto Policy apply. We agree with you that the insurance provided under your Commercial Auto Policy is modified as follows: Insuring Agreement Subject to the Limits of Liability, if you pay the premium for Rental Reimbursement Coverage, we will reimburse rental charges incurred when you rent an auto pursuant to a written rental agreement due to a loss to an insured auto that has Rental Reimbursement Coverage under this policy. This coverage applies only if you have purchased Collision Coverage and either Comprehensive Coverage or Fire and Theft With Combined Additional Coverage for that insured auto and the loss is covered under one of those coverages. If neither you nor we can locate a reasonable replacement auto, we will pay you the daily limit instead. Additional charges for fuel aie not covered. We will pay no more than the specified daily limit, including additional insurance, damage waivers, and/or equipment. The maximum we will pay is the daily amount shown on the declarations page up to the number of days shown on the declarations page. If Rental Reimbursement Coverage applies, no other coverage under this policy for rental expenses will apply. Rental charges will be reimbursed beginning: 1. When the insured auto cannot be used for its intended purpose due to a loss; or 2 If the insured auto can be operated for its intended purpose, when you deliver the insured auto to an auto repair shop for repairs due to the loss; and ending the earliest of: 1 When the insured auto has been returned to you; 2. When the insured auto has been repaired; 3. When the insured auto has been replaced; 4. 72 hours after we make an offer to settle the loss if the insured auto is deemed by us to be a total loss; or 5. When you incur 30 days worth of rental charges. You must provide us written proof of your rental charges to be reimbursed. Additional Coverage When Rental Reimbursement Coverage applies, we will consider the rented auto to be an insured auto for coverage under Part II - Damage To Your Auto. The rented auto will have the same coverages that you have purchased for the insured auto that the rented auto replaces, and the same deductible will apply. Definition "Reasonable replacement auto" means an auto of the same type as the insured auto that is out of service, or an auto of a different type that can be used in a manner comparable to the insured auto that will permit you to continue your business operations. This may include the rental of a larger or heavier duty auto if it will allow you to continue to operate your business, if the rental is within the daily rate stated on the declarations page. Limits of Liability The limit shown on the declarations page is the most we will pay under this endorsement for a loss to any one insured auto. ALL OTHER TERMS, LIMITS, AND PROVISIONS OF THE POLICY REMAIN UNCHANGED. Foam Z3 1 1 (02i 19) Washington State Department of Revenue < Business Lookup License Information: New search Back to results Entity name: BRIDGING A GAP WEEKEND FEEDING PROGRAM Business BRIDGING A GAP WEEKEND FEEDING PROGRAM name: Entity type: Nonprofit Corporation UBI #: 604-088-164 Business ID: 001 Location ID: 0002 Location: Active Location address: 33313 1 ST WAY S FEDERAL WAY WA 98003-6247 Mailing address: 33313 1 ST WAY S FEDERAL WAY WA 98003-6247 Excise tax and reseller permit status: Click here Secretary of State status: Click here Endorsements Endorsements held a License # Count Details Status Expiratior First issua Federal Way Active Mar-31-2( Mar-09-21 Endorsements held a License # Count Details Status Expiratior First issua General Business Governing People May include governing people not registered with Secretary of State Governing people DANFORTH, VALERIE HILLER, JULIE HULSE, JOYCE OLDHAM, LUKE Title View Additional Locations The Business Lookup information is updated nightly. Search date and time: 5/31/2023 4:49:06 PM Contact us How are we doing? Take our survey! Don't see what you expected? Check if your browser is supported ;pssCffjW�rtAy nd Charities Filing System J, 177 I,LL�1,.©1� � BRIDGING A GAP WEEKEND FEEDING PROGRAM 604 088164 WA NONPROFIT CORPORATION ACTIVE 333131 ST WAY S, FEDERAL WAY, WA, 98003-6247, UNITED STATES 03/31/2024 UNITED STATES, WASHINGTON 03/12/2017 PERPETUAL 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: FOOD & NUTRITIONAL SUPPORT FOR FEDERAL WAY SCHOOL DISTRCT STUDENTS Charitable Corporation: Nonprofit EIN: 81-5461393 Most Recent Gross Revenue is less than $500,000: U Has Members: El Public Benefit Designation: [-01 Host Home: ❑� Registered Agent Name: VALERIE DANFORTH Street Address: 333131 ST WAY S, FEDERAL WAY, WA, 98003-6247, UNITED STATES Mailing Address: 333131 ST WAY S, FEDERAL WAY, WA, 98003-6247, UNITED STATES GOVERNORS Title Governors Type Entity Name First Name Last Name GOVERNOR INDIVIDUAL JOYCE HULSE GOVERNOR INDIVIDUAL VALERIE DANFORTH GOVERNOR INDIVIDUAL LUKE OLDHAM GOVERNOR INDIVIDUAL JULIE HILLER Back