Loading...
AG 10-038RETURN TO: � ►�� EXT: � � � a CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING SLIP 1. ORIGINATING DEPT./DN: /�! � I� L W p r✓f � � �� 2. ORIGINATING STAFF PERSON: � a�/ Gro S"S EXT: oZ I 3. DATE REQ. BY: p? �p o� O D 4. TYPE OF DOCUMENT (CHECK ONE): � CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ SMALL PUBLIC WORKS CONTRACT � PROFESSIONALSERVICEAGREEMENT � GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOrm �LATED nocuMENTS) ❑ RESOLUTION ❑ CONTRACTAMENDMENT(AG#): ❑ INTERLOCAL �(,' OTI�R Sttife wie�t o� Aav�ee w�,e►ti�" 5. PROJECT NAME: A wti �✓� �<a v► 1'� e� CY�D SI ���� e+^ e►�'�" d� �t� Y'� e w�, ��7� 6. NAME OF CONT CTOR: Y J'L.. �� �� V O�S ADDRESS: .O. l7 C7q, / ' �`I TELEPHONE E-MAIL: FAX: cTrTNATURE NAME: TITLE �Pt�G : Ivl�:k.�. C�'�a-� 7. EXHIBITS AND ATTACHM NTS: ❑ 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: COMPLETION DATE: �.Ql'�L2-�U�C�q /P1��T ttl.rt�! 9. TOTAL COMPENSATION $ � IQ- � (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY OR CHARGE -ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ��s ❑ No 1F �s MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: 0 CONTRACTOR ❑ CITY � PURCHASING: PLEASE CHARGE TO: �'lQ- DOCUMENT/CONTRACT REVIEW �. PROJECT MANAGER a S � DIRECTOR � ��R 0 RISK MANAGEMENT (� arrLtcasLE) ' � s LAW �� , 11. COUNCILAPPROVAL (IF APPLICASLE) %Y;�r``.�? 9 COUNCIL �PPROVAL DATE: I � � �(OO � 12. CONTRACT SIGNATURE ROUTING �. SENT TO VENDOR/CONTRACTOR DATE SENT: �„/` oZ- � � DATE REC'D: j�' ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS �/ i � �' SIG ( nD ^��- °�� � g 5� CITY CLERK � L 1� ST) 6�f ASSIGNED AG# I�' SIGNED COPY RETURNED COMMENTS: `2 CDN INITIAL / DATE SIGNED AG# 1U - DATE SENT: 3 •9 � � c�� /.�i // l�//o/d o0 11/9 ��,�L,�., C� (� Ir l C� l •�---- — v INITIAL / DATE REVIEWED INITIAL / DATE APPROVED R � y/ddla � d/y/o �i►�wr_ z!�/a� i', :- 1: t: Together, �re can s€rve a Cife Statement of Agreement For Use of Facility This Agreement is made and entered into between the governing board of City of Federal Way (school district, church, other organization) of Ki.na County, state of Washington, and the American Red Cross serving King and Kitsap Counties, chapter of The American National Red Cross (Red Cross), collectively "the Parties." Recitals Pursuant to the terms of federal statutes, the Red Cross provides emergency services on behalf of individuals and families who are victims of disaster. Cary Roe (Official) is authorized to permit the Red Cross to use Federal Way Commun�_tX Center (school disirict, church, other organization)'s buildings, grounds and/or equipment required in the conduct of Red Cross disaster services activities, and wishes to cooperate with the Red Cross for such purposes. The Parties hereto mutually desire to reach an understanding that will result in xnalcing the afaresaid facilities of Ci.ty of FederaJ_ Way (school district, church, other organization) available to the Red Cross for the aforesaid use. Now, therefore, it is mutually agreed between the Parties as follows: 1. The City of Federal. Way (school district, church, other organization) agrees that, after meeting its responsibilities to its pupiUparishioners/members/clients, it will pernrit, to the extent of its ability and upon request by the Red Cross, the use of its physical faciliiies by the Red Cross for disasters victims. 2. The Red Cross agrees that it shall use reasonable care in the conduct of its activities in such facilities. 3. The Red Cross and Ci.ty of Federal Way (school district, church, other organization) agree to provide to each other, and update yearly, the point of contact information with each other by providing written notice, hand delivered or mailed to the parties at their respective addresses set forth below, or at such other address of which either party shall notify the other in accardance with the provisions hereof. To: American Red Cross To: �; t� �f FPr�ara 1 w:�� Serving King and Kitsap Counties Emergency Management Disaster Services—Logistics ! MSS - PO Box 3097 PO Box 9718 5eattle, WA 98114-3097 Federal. Way, WA 98063 (Location: 1900 2S� Ave S) �,�; Ray Gross 4. At the time of a disaster, for each use of the facility, the parties agree to execute a Facility Agreement form. The parties, acting through their duly authorized officers, have executed this Contract as of the Effective Date. American Red Cross City of Federal Way Se ing King an Kitsap Counties Organization Cha ter f the A eric National Red Cross ... � �-�' Signature of e porrsibde Authority/President/Governing Board Signature of Red Cross Disaster perations Authority Brian J. Wilson Kevin Kopp PrintName 8 8�I • City Manager/Police Chief Title Title d���ae�n (as3) 835-a4o I �- � P� /o Effective Date Phone Number e This Statement ofAgreement is valid until terminated in writing by either party