AG 23-271 - JAVIER CALVO, MARIA ISABEL LEON HERNANDEZ, AND CARLOS HERNANDEZ - PARCEL 092104-9170RETURN TO: PW ADMIN EXT: 2700 ID #: 4354
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PUBLIC WORKS / Deputy Director
2. ORIGINATING STAFF PERSON: Desiree Winkler EXT: 2711 3. DATE REQ. BY:
3. 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
El OTHER EXTENDED OCCUPANCY AGREEMENT AND RELEASE AND HOLD HARMLESS AGREEMENT - Template
4. PROJECT NAME: O&M Facility Property Acquisition
5. NAME OF CONTRACTOR: Javier CalVo, Maria Hernandez, and Carlos Hernandez
ADDRESS: TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAME: TITLE:
,6. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER
REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE # BL, EXP. 12/311— UBI # . EXP.
'7. TERM: COMMENCEMENT DATE:_ �l I f>r COMPLETION DATE:, &j IA'
:8. TOTAL COMPENSATION: $- P J A (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: i3 YES 13 NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED: ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: jj ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
inPURCHASING: PLEASE CHARGE TO: t� IA
'9. DOCUMENT / CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIVISION MANAGER-
S DEPUTY DIRECTOR DSW 12/723
8 DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
A LAW DEPT KVA 12/11/2023
10. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
11. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC• D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(INCLUDE DEPT. SUPPORT STAFF IF NECESSARY AND FEEL FREE TO SET NOTIFICATION MORE THAN A MONTH IN ADVANCE IF COUNCIL APPROVAL IS NEEDED.)
INITIAL / DATE SIGNED'
❑ FINANCE DEPARTMENT
❑ LAW DEPT
❑ SIGNATORY (MAYOR R DIRECTOR) '='t %, -ZL
❑ CITY CLERK %2
❑ ASSIGNED AG # AG# •
❑ SIGNED COPY RETURNED DATE SENT: L r)3
COMMENTS:
EXECUTE" " ORIGINALS
1 /2020
EXTENDED OCCUPANCY AGREEMENT AND
RELEASE AND HOLD HARMLESS AGREEMENT
As of December 8, per Recorded Warranty Deed, King County recorded document No.
20231208000341 the City of Federal Way (City/Owner) is the legal owner of the real property
located in King County, Washington, more particularly described (Property) as follows: King
County Assessor Number 092104-9170, the Property is physically located at 31014 28`h Ave
S, Federal Way, WA 98003, and is an improved parcel of real property purchased in
accordance with the City of Federal Way, Joint Operations & Maintenance Facility Project.
We, Javier Calvo, Maria Isabel Leon Hernandez, and Carlos Eduardo Leon Hernandez
(Occupants), understand that our participation and/or involvement in occupying and removing
personal property from the property/premises located at 31014 28th Ave S, Federal Way, WA
98003 carries with it the potential for certain risks, some of which may not be reasonably
foreseeable.
By signing this agreement, we agree to the following statements:
the City/Owner is willing to allow the Occupants, and their third parties and vendors the right
to utilize the City/Owner property located at 31014 28`h Ave S, Federal Way, WA 98003, for
a period of no more than seven (7) days, which will expire on December 20, 2023 at 5:00pm,
for purpose of temporary occupancy, to access the property, and efficiently remove personal
property to complete the move activities related to their Relocation Benefits Eligibility and
Entitlements. Temporary occupancy as lodging is not permitted.
The Occupants have inspected the City/Owner property and accept the same in an "as is"
condition and agrees that the City/Owner is not under any obligation to perform any work or
provide any material to improve the City Property for the Occupant's temporary use.
We recognize that there are certain inherent risks associated with the above -described activity
and we assume full responsibility for personal injury to ourselves and (if applicable) our family
members, and further release and discharge for injury, loss or damage arising out of our or our
family's use of or presence upon the facilities of, whether -caused by the fault of ourselves, our
family, or other third parties.
We further acknowledge that these risks could cause us, or others around us, harm, including,
but not limited to, bodily injury, damage to property, emotional distress, or death.
We agree to indemnify, fully permitted by law, defend and hold the City/Owner, Tierra Right
of Way Services, Ltd., Contract Land Staff, LLC, Keystone Consultants, LLC, EPIC Land
Solutions, Inc., Paragon Partners Consultants, Inc., and all officials, agents and employees of
the City of Federal Way, a Municipal Corporation (City/Owner); from and against all claims
arising out of or resulting from the performance of the above referenced activity. Claims as
used in this document mean any financial loss, claim, suit, action damage or expense, including
but not limited to attorneys' fees, attributable for bodily injury, sickness, disease or death, or
injury to or destruction of tangible property including loss of use resulting therefrom.
Occupant's obligation to indemnify, defend, and hold harmless includes any claim by the
Occupant, its agents, employees, representatives, the public or any subcontractor or its
employees. Solely for the purposes of this provision, the Occupant waives its immunity under
Title 51 (Industrial Insurance) of the Revised Code of Washington and acknowledges that
waiver mutually negotiated.
We agree to pay for all damages to the property located at 31014 281h Ave S, Federal Way,
WA 98003 caused by any negligent, reckless, or willful actions by us, Javier Calvo, Maria
Isabel Leon Hernandez, and Carlos Eduardo Leon Hernandez, vendors, friends or our
family members.
We agree and acknowledge that we are under no pressure or duress to sign this Agreement and
that we have been given a reasonable opportunity to review it before signing. We further agree
and acknowledge that we are free to have our own legal counsel review this Agreement if we
so desire.
This Agreement and each of its terms are the product of an arm's length negotiation between
the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement,
or any of its provisions, the Parties, and each of them, explicitly reject the application of any
legal or equitable rule of interpretation which would lead to a construction either "for" or
"against" a particular party based upon their status as the drafter of a specific term, language,
or provision giving rise to such ambiguity.
The invalidity or unenforceability of any provision of this Agreement, whether standing alone
or as applied to a particular occurrence or circumstance, shall not affect the validity or
enforceability of any other provision of this Agreement or of any other applications of such
provision, as the "case may be, and such invalid or unenforceable provision shall be deemed not
to be a part of this Agreement.
The parties will attempt to resolve any dispute arising out of or relating to this Agreement
through friendly negotiations amongst the parties. If the matter is not resolved by negotiation,
the parties will resolve the dispute using the below Alternative Dispute Resolution (ADR)
procedure.
Any controversies or disputes arising out of or relating to this Agreement will be submitted to
mediation in accordance with any statutory rules of mediation. If mediation does not
successfully resolve the dispute, then the parties may proceed to seek an alternative form of
resolution in accordance with any other rights and remedies afforded to them by law.
Javier Calvo and Maria Isabel Leon Hernandez will coordinate removal of all personal property
and disconnection of all utilities with Tierra Right of Way Services, Ltd., Relocation Agent.
Upon completion of the final move -out, Javier Calvo and Maria Isabel Leon Hernandez will
schedule a final walk-thru of the home in order to receive the final payment for self -move
relocation benefits.
A final documented walk-through move -out inspection approval will nullify this Agreement.
WE HAVE READ THIS DOCUMENT AND UNDERSTAND IT. WE FURTHER
UNDERSTAND THAT BY SIGNING THIS RELEASE, WE VOLUNTARILY
SURRENDER CERTAIN LEGAL RIGHTS.
Signature: �_ ] 3A V
Lute: -{- Q 3
Javier Calvo
Signature: 2L4�Date: - 7 - 3
T
Isabel Leon Hernandez
Signature: Date: 7 2-- Y4- 902-3
Carlos Eduardo Leon Hernandez
STATE OF WASHINGTON)
)ss
COUNTY OF KING)
On this 14, day of December, 2023 personally appeared before me Javier Calvo, Maria
Isabel Leon Hernandez, and Carlos Eduardo Leon Hernandez to me known to be the
individuals described in and who executed the within and foregoing instrument
and acknowledged that they signed the same as their free and voluntary act and deed, for the
uses and purposes therein mentioned.
GIVEN under my hand and official seal this /Y day of 'Q- , 2023.
M
Notary Public in and for the State of
Washington. J
Residing at: .r�- _ ' A
My CommissioExpires: 0 -c� '� D a 5'
Tax Parcel No. 092104-9170
Received by:
Ci of F ral Way
tr
f/l/ Date: L - k 2 k \ 2M>
EJ W sh, P.E.
Dir for of Public Works