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AG 13-084RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: 2. ORIGINATING STAFF PERSON: EXT: 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 ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE ONTRACT AMENDMENT (AG #):1. =094- ❑ OTHER ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES/ CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 5. PROJECT NAME: C L- L /V C rr (_T %� Q�u�U� C I ..+ --F-- 6. 8. 9. NAME OF CONTRACTOR: 'CN 1 L ADDRESS: TELEPHONE E -MAIL: FAX: SIGNATURE NAME: TITLE EXHIBITS AND ATTACHMENTS.;4COPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES RIOR CONTRACT/AMENDMENT'S TERM: COMMENCEMENT DATE: O (°S COMPLETION DATE: (�- f 3 Z,�o TOTAL COMPENSATION $ ODD (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY ❑ PURCHASING: PLEASE CHARGE TO: O- a -1 O -- w ' (Vi - -7-2& -00 -S k -tp -p 10. DOCUMENT /CONTRACT REVIEW INITIAL/ DATE REVIEWED ImTIAL / ATE APPROVED E4ROJECT MANAGER l © DIRECTOR If 7/ ❑ RISK MANAGEMENT (IF APPLICABLE) ❑LAW Q- 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING D SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPARTMENT ;;i-<GNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK • ASSIGNED AG# • SIGNED COPY RETURNED COMMENTS INETIAL / DATE SIGNED 12 I AG# DATE SENT: 11/9 CITY OF CITY HALL Federal ay 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www<cityoffederalway. com AMENDMENT NO. 1 TO HUMAN SERVICES AGREEMENT FOR CLINICAL PROGRAM FOR YOUTH This Amendment ( "Amendment No. 1 ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Kent Youth & Family Services, a non -profit organization ( "Agency "). The City and Agency (together "Parties"), for valuable consideration and by mutual consent of the parties, agree to amend the original Agreement for youth counseling and treatment services ( "Agreement ") dated effective January 1, 2013, as follows: 1. AMENDED SERVICES. The Services or Work, 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 ( "Additional 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 Party 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, is 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] ti 1 s?YP�1 4x7 71} A' � cM1 AMENDMENT - 1 - 1/2010 ` CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www. cityofiederaM,ay. com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY By: LJ?�' r W Pa 'ck Doherty, Directo Community & Economic Development Services DATE: KENT YOUTH & FAMILY SERVICES By: —""- Printed Name: f ' f ' ej 1jet ✓k ' t Title: �1CeGy�i ✓e Lr� ca DATE: STATE OF WASHINGTON ) COUNTY OF X11 ) ss. ATTEST: L&A Qx fnof'�A I - City Clerk, Carol McNeill y, C APPROVED AS TO FORM: 1; Z-' � � � � - ity Attorn , atricia A Richardson On this da� personally appeared before me I " I I e 1i AC L Ht I N l �Lg l; to me known to be the k�ireorr►y c 2-o2 of "45, vets]+ A ub FA H II_yy 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 he /she was 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 aot�) day of 20JS DOLORES R ASHMORE NOTARY PUBLIC STATE OF WASHINGTON COMMISSION EXPIRES FEBRUARY t 2016 Notary's signature Z24 K Notary's printed name 0-65 C Notary Public in and for the S ate f Washington. My commission expires �2 ©1 / AMENDMENT - 2 - 1/2010 CITY OF CITY HALL '** .,. Federal Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www. cityoffederahvay. com EXHIBIT A -1 ADDITIONAL SERVICES The Agency shall do or provide the following in addition to services in previous Exhibits: Project Summary The Agency shall provide youth counseling and treatment services in the City of Federal Way. The Agency shall ensure that services provided with funding under this Agreement are made available 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 Human Services funds: B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1St Quarter JAN. — MARCH 2 °d Quarter APRIL - JUNE 3rd Quarter JULY — SEPT. 4th Quarter OCT. — DEC. Total No. of unduplicated Federal JAN. - MARCH APRIL-JUNE JULY—SEPT. OCT.—DEC. Total Way persons assisted in 2013 4 4 3 3 14 No. of unduplicated Federal Way persons assisted in 2014 4 4 3 3 14 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: AMENDMENT - 3 - 1/2010 1" Quarter 2 °d Quarter 3rd Quarter 4th Quarter JAN. - MARCH APRIL-JUNE JULY—SEPT. OCT.—DEC. Total 2013 1. Counseling 45 45 45 44 179 2. Case Management 20 20 20 20 80 3. Support Groups 65 65 65 65 260 2014 1. Counseling L 45 45 45 44 179 AMENDMENT - 3 - 1/2010 ` CITY OF ,.., Federal CITY HALL way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www. cityoffederaMoy. com 2. Case Management 20 20 20 20 80 3. Support Groups 65 1 65 1 65 1 65 1 260 C. Definition of Services 1. Counseling: This service unit is measured in number of hours of counseling services provided. Counseling services are all oriented to treatment and include individual, family and group services. 2. Case Management: Case management services are measured in hours. Case management services are signed to advocate for, engage or link persons in treatment or to support them is in through stages of treatment within or between separate entities. These are services that will assist clients in gaining access to needed medical, social, educational, and other services. 3. Support Groups: Support groups which are part of the clinical program, but not part of the treatment, will be measured in hours. Support groups are designed to assist or enhance treatment or services provided by the clinical program but are not considered part formalized treatment in the clinical program. To the fact that these groups are not considered treatment we do receive reimbursement in any manner. AMENDMENT - 4 - 1/2010 RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: CED/HS 2. ORIGINATING STAFF PERSON: DEE DEE CATAr_.ANo EXT: 2651 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 X HUMAN SERVICES / CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.c. sorm �Ln�n nocu�vTS> ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL ❑ OTHER _ S. PRO7ECT NAME: CLINICAL PROGRAMS FOR YOUTH 6. NAME OF CONTRACTOR: KElv�r Yov�rH & F,v�u.Y SERVicEs ADDRESS: E-MAIL: SIGNATURE NAME: TELEPHONE FAX: TITLE %. EXHIBTTS AND ATTACHMENTS: X SCOPE, WORK OR SERVICES X COMPENSATION X INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBTTS X PROOF OF AUTHORITY TO SIGN ❑ REQUIItED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENTDATE: O1/O1/2013 COMPLETION DATE: 12/31/2014 9. TOTAL COMPENSATION $24,000 �INCLUDE EXPENSES AND SALES TAX,1F' A1�t) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TTTLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑�S ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF' YES, PAID BY: ❑ CONTRACTOR O CITY ❑ PURCHASING: PLEASE CHARGE TO: 001-7300-083-562-10-410: $15,000 001-7300-089-562-10-410: $9,000 10. DOCUMENT/CONTRACT REVIEW I1�TIT / DATE REVIEWED Il�iITIAL / DATE APPROVED ❑ PROJECT MANAGER - Z . ❑ DIRECTOR �f 7 ❑ RISK MANAGEMENT (g' a�Pr.iC.4sl.,E) ❑ LAW � 3' I� ' I 3 11. COUNCIL APPROVAL �IF APPLICABLE� COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 3 l2- �� l3 DATE REC'D: ��`3 ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPARTMENT , ❑ SIGNATORY (NtAYOx DIRECTOR� ❑ CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: IIVITIAL / DATE SIGNED LI . 22 • t� A'J�( �- '25' � AG# DATE SENT: • i ` CITY OF ,'�...., Federal CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. ciryoffederahvay com HUMAN SERVICES AGREEMENT FOR CLINICAL PROGRAMS FOR YOUTH This Human Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Kent Youth & Family Services, a non-profit organization ("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: KENT YOUTH & FAMILY SERVICES Dennis Ballinger 232 S 2nd Avenue Kent, Washington 98032 253-859-0300 (telephone) The Parties agree as follows: CITY OF FEDERAL WAY: Denise Catalano 33325 8�' Ave. S. Federal Way, WA 98003-6325 (253) 835-2651 (telephone) (253) 835-2401 (facsimile) denise.catalanonu,cityoffederal� .com 1. TERM. The term of this Agreement sha11 be for a period of two (2) years commencing on January 1, 2013 and terminating on December 31, 2014 ("Term"). Funding for the second year 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, 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. Services sha11 begin ixnxnediately upon the effective date of this Agreement. Services shall be subject, at all tixnes, to inspection by and approval of the City, but the making (or failure or delay in making) such inspection or approval sha11 not relieve 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 ixnmediately 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 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. HUMAN SERVICES AGREEMENT - 1- 4/2011 ` CITY OF , �. Federal CITY HALL way 33325 8th Avenue Sowth Federai Way, WA 9$003-6325 (253) 835-7000 www cityoffederalway com 4.2 Method of Pavment. On a 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 on a quarterly basis 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 Human 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 circuxnstances 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 Eachibit "B". If the Agency's final invoice, supporting docuxnentation, 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; pmvided, however, that the City may elect to pay any invoice that is not submitted in a timely manner. 4.4 Bud�et. T'he Agency shall apply the funds received from the City under this Agreexnent in accordance with the line item budget set forth in Exhibit "B". The Agency shall request in writing prior approval from the City to revise the line item budget when the cumulative amount of transfers from a line item in any Project/Program Exhibit is expected to exceed ten percent (10%) of that line item. Supporting documents are necessary to fully explain the nature and purpose of the revision, and must accompany each request for prior approval. All budget revision requests in excess of 10% of a line item amount sha11 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 Agencv 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 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. HUMAN SERVICES AGREEMENT - 2- 4/2011 ` CITY OF ,� Federal CITY HALL W�� 33325 8th Avenue South Federai Way, WA 98003-6325 (253) 835-7000 rvtivw cityoffederalway. com 5.3 Citv Indemnification. The City agrees to release, indemnify, defend and hold the Agency, its officers, directors, shareholders, partners, employees, agents, representatives, and sub-contractors 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 ar 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 $1,000,000 for each occurrence and $1,000,000 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 owried, non-owned, hired and leased vehicles with a minimum combined single limits in the minimum amounts required to drive under Washington State law per accident for bodily injury, including personai injury or death, and property damage. 6.2. No Limit of Liabilitv. 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 sha11 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 a11 commercial general liability insurance policies. Concurrent with the execution of this Agreement, Agency shall provide certificates of insurance for a11 commercial general liability policies attached hereto as E�ibit "C" and incorporated by this reference. At 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 minimuxn 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 sha11 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 make such data, documents, and files available to the City and sha11 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. HUMAN SERVICES AGREEMENT - 3- 4/2011 ` CITY OF ,�.... Federal CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 ww�v crryoffederalway.com 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 AGENCY. The Parties intend that the Agency shall be an independent Agency 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 exnployment. 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 confums that Agency does not have a business interest or a close family relationship with any City 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. EOUAL OPPORTUNITY EMPLOYER In a11 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 regazding 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, sha11 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 sha11 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 pmvision 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 Assi�nment and Beneficiaries. Neither the Agency nor the City sha11 have the right to transfer or assign, in whole or in part, any or a11 of its obligations and rights hereunder without the prior written consent of the other Party. If the non- HUMAN SERVICES AGREEMENT - 4- 4/2011 � CITY OF '�,�,�.., Federal CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www ciryoffederalway. com 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 of 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 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 cuxnulative 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, Washi.ngton, 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 sha11 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 a11 pages of this Agreement and a complete set of all signature and acknowledgment pages. The date upon which the last of a11 of the Parties have executed a counterpart of this Agreement shall be the "date of mutual execution" hereof. [Signature page follows] ��.�.m �.�..... �. .:.n.. ,��-.- , ,, ° ?r49°r �,,�s �i��,S . �. . y t, ;'; :a r ,;:. . ,� ,' � l''`r ._ `t'F: e . °'' . • "3`� v;;� ;ci3.:�:tJ"; � �eft's'� i �'i�AtJ�^'"'!.1 i ia�..�+r«�;r�ycse�anTM.,•c+ratiR.��'� HUMAN SERVICES AGREEMENT - 5- 4/20l 1 ` CITY OF �, Federal CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www aryoffederalway. com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY P ck Doherty, Direct ' Community & Econo c Development Services ATTEST: City Clerk, arol McN lly, CMC APPROVED AS TO FORM: /� � -� DATE: � ' L 3 � � �Y f � City Attorn Patricia A Richardson KENT YOUTH & FAMILY SERVICES � _ By: �� C . � Printed Name: � s-� � � ��l r� Title: �-�Jfi vI � D� ra-� DATE: -` �� / � �J STATE OF WASHINGTON ) ) ss. COUNTY OF On this day rsonally appear/e� before me �� e q�� ��i,vis �,�./ , to me known to be the �xc-����rv� �i���o2 of ,KTN-,- �r�7-�� �,� � � M«y �'�Qv«�s that executed the foregoing instrument, and acknowledged the said �nstrument to be the free and volunta.ry act and deed of said corporation, for the uses and purposes therein mentioned, and on oath stated that he/she was 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 �lT N day of �-i A/Z1� 20/�. , � '�OLORES R ASHMORE 'JOTARY PUBIiC S fATE Of WASHIN�TbN GOMMISSiON EXPIRES FEBRUARY i. 2016 Notary s signature Notary's printed name a� E MOR E Notary Public in and for the State of Washington. My commission expires o2�o i�ao iG HUMAN SERVICES AGREEMENT - 6- 4/2011 ` CITY OF ,'�... Federal Project Summary CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www atyoffederahvay. com EXHIBIT �A" SERVICES The Agency shall provide youth counseling and treahnent services in the City of Federal Way. The Agency shall ensure that services provided with funding under this Agreement are made available 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 Human Services funds: 13� Quarter 2°d Quarter 3� Quarter 4te Quarter JAN. - MARCH APRIL - NNE NLY - SEPT. OCT. - DEC. TOtAl No. of unduplicated Federal Wa ersons assisted in 2013 4 4 3 3 14 No. of unduplicated Federal Wa ersons assisted in 2014 4 4 3 3 14 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1S` Quarter 2°d Quarter 3`d Quarter 4`h Quarter JAN. - MARCH APRILr JUNE NLY - SEPT. OCT. -DEC. TOt81 2013 l. Counseling 45 45 45 44 179 2. Case Management 60 60 60 60 240 3. Support Groups 30 30 30 30 120 2014 l. Counseling 45 45 45 44 179 2. Case Management 60 60 60 60 240 HUMAN SERVICES AGREEMENT - 7- 4/2011 ` �ITY OF , �... Federal GITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 wrvw. crryoftederalway. com 3. Support Groups 30 30 30 30 120 C. Defmition of Services 1. Counseling: This service unit is measured in number of hours of counseling services provided. Counseling services are all oriented to treatrnent and include individual, family and group services. 2. Case Management: Case management services are measured in hours. Case management services are signed to advocate for, engage or link persons in treatment or to support them is in through stages of treatment within or between separate entities. These are services that will assist clients in gaining access to needed medical, social, educational, and other services. 3. Support Groups: Support groups which are part of the clinical program, but not part of the treatment, will be measured in hours. Support groups are designed to assist or enhance treahnent or services provided by the clinical program but are not considered part formalized treatment in the clinical program. To the fact that these groups are not considered treatment we do receive reimbursement in any manner. D. Outcome(s) Outcome(s) to be reported: 1. Individuals and/or families improve health (physicaUdental/mental). 2. Improved family relationships. Records A. Project Files The Agency shall maintain files for this project containing the following items: 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 docuxnentation. 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. HUMAN SERVICES AGREEMENT - 8- 4/2011 � CITY OF , '�... Federal � CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. aryoffederalway. com 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. L•..: '�ng'Gourrtty"FY 2013 tntdme Limits Summery E�'fiectiv'e.'��.1f202� Median Income 1 2 3 4 5 6 7 8 Income ��m�t Person Persons Persons Persons Persons Persons Persons Persons Category Extremely Low (30%) $18,200 $20,800 $23,400 $26,000 $28,100 $30,200 $32,250 $34,350 Income Limits Very Low $86,700 (SO%) Income $30,350 $34,700 $39,050 $43,350 $46,850 $50,300 $53,800 $57,250 Limits Low (80%) $45,100 $51,550 $58,000 564,400 $69,600 $74,750 $79,900 $85,050 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 quarterly and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall submit an Annual Demographic Data Report. The agency shall collect and retain the data requested on this form from the persons served through this contract. Data should be tracked in an ongoing manner and submitted annually no later than January 15 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. Changes to the outcome presented in the application must be approved by the City prior to implementation. The Agency shall report the results of its outcome measure(s) annually on the Annual Outcome Data Report to be submitted by January 15 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 Human Services General Fund Program. HUMAN SERVICES AGREEMENT - 9- 4/2011 CITY OF CITY HALL � ` 33325 8th Avenue South �.,_, Fe d e ra I Way Federal Way, WA 98003-6325 (253) 835-7000 www cityoffederalway. com EXHIBIT "B" COMPENSATION Project Budget The Agency shall apply the following funds to the project in accordance with the Line Item Budget Summary. The total amount of reimbursement pursuant to this Agreement shall not exceed $24,000. A. City of Federal Way Funds 2013 2014 Ci of Federal Wa General Fund: $12,000 $12,000 Total Ci of Federal Wa Funds: $12,000 $12,000 B. Line Item Bud et 2013 2014 Personnel Services (detail below $12,000 $12 000 Office or eratin Su lies $ $ Rent & Utilities $ $ Cominunications S $ Travel and Trainin $ $ Other s eci � $ S Client Travel $ $ Administration Overhead $ $ Total Ci of Federal Wa Funds: $12,000 $12,000 C. Personnel Detail Position Title Position Full Annual Salary HS Funds Time E uivalent and Benefits Co-occurrin Thera ist .28 $43,000 $12,000 Total: $43,000 $12,000 Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly and are due on the following dates: 1 st Quarter: April 15 or within 10 days of notice to proceed, whichever is later; 2nd Quarter: July 15; 3rd Quarter: October 15; and 4th Quarter: Final Reimbursement Request and Service Unit Report forms due Janua.ry 8; Demographic Data Report and Annual Outcome Data Report with supporting documentation due January 15. The Agency shall submit Reimbursement Requests in the format requested by the City. Reimbursement Requests Invoices shall include a copy of the Service Unit Report and any supporting docuxnents for the billing period. HUMAN SERVICES AGREEMENT - 10 - 4/2011 CITY OF CITY HALL ` 33325 8th Avenue South ,,:� Fe d e ra I Way Federal Way, WA 9$003-6325 (253) 835-7000 w�awv. cityoffederalwsy. com Estimated Quarterly Payments: 2013 1 st Qtr 2nd Qtr 3rd Qtr 4th Qtr 2014 1 St Qtr 2nd Q�T, 3'� Qtr 4�' Qtr $3,000 $3,000 $3,000 $3,000 $3,000 $3,000 $3,000 $3,000 Expenses must be incurred prior to submission of quarterly reimbursement requests. Proof of expenditures must be attached to the reimbursement request for invoice to be approved. Quarterly reimbursement 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 The Agency agrees that it will meet the specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. The Agency is responsible for meeting the applicable portions of the funding conditions adopted as part of the 2013-14 Human Services General Fund Allocation Process including: No Conditions. HUMAN SERVICES AGREEMENT - 11 - 4/2011 RESOLUTION Michael Heinisch, as Executive Director, is full authorized to sign all contracts on behalf of Kent Youth and Family Services Board of Directors. Carla Dean 2009 Board President 4/09/09 COUNSELING PROGRAM PROGRAM MANAGER Dennis Ballinger, MA, CDP, MHP,CMHS, LMFT MENTAL HEALTH SUPERVISORS CJ Ellsworth, MA, LMFT, CMHS Michelle Mong, MA, LMFT, .75 Candis Molder, MA, LMHC MEDICAID COORDINATOR Wendy Naiman, MA, LMFTA SCHOOL BASED COUNSELORS Missa Braund-Allen, MA, CDPT Karen Craig, MA, LMHC, CDPT DeSean Gildyard, MA, CDPT Frewin Hermer, MA Suzette Kincaid, MA, CDPT Lorena King Paimer, MC, CMHC, LMNC, .80 Susy Lenhardt, MS Aisha Newchurch, MA, LMHCA COUNSELING INTERNS Jacoba Adams Caitlin Bauermeister Velma Cruz Bhakti Doroodian Rachel Garcia Christina Hanson Christina Hower Amanda Letts Satah Ortner Kristen Shomber Catie Wilkins KENT YOUTH AND FAMII.Y SERVICES VOLUNTEER BOARD OF DIRECTORS Israet Vela, President EXECUTIVE DIRECTOR Michael Heinisch ADMINISTRATION � ADMINISTRATION MANAGER Dee Ashmore ACCOUNTING COORDINATOR Tamara Sarroza, .40 AP SPECIALIST / ADMIN. ASSIST. Brian Hutchinson, .90 AR SPECIALIST Irfan Baig, .625 FRONT DESK NIGHT COVERAGE Tanya Shein ItECEPTIONIST Lisa Miranda ADMIN. ASSISTANT Michelle Newton, .75 SUBSTANCE ABUSE PROGRAM MANAGER Dennis Ballinger, MA, CDP, MHP,CMHS, LIV�'T SUBSTANCE ABUSE EVALUATOR Jayne Pelger, MS, CDP SUBSTANCE ABUSE COUNSELORS Christina Hanson, CDPT, .5 Christina Hower, CDPT, .5 Mike McCormick, CDP, .375 CO-OCCURRING COUNSELORS Karen Craig, MA, LMHCA, CDPT DeSean Gildyard, MA, CDPT SUBSTANCE ABUSE SYSTEMS & QUALITY ASSURANCE COORDINATOR Julie Marshall, BA, CDP, .6 SUBSTANCE ABUSE GAIN DATA MANAGER Karena Schlatter, CDPT, .2 GAIN INTAKES Caitlin Bauermeister, CDPT, .25 Rachel Garcia, CDPT, .25 HEADSTART PROGRAM CENTER DIRECTOR Mike Heinisch CENTER COORDINATOR Theresa LaRonde FAMILY SERVICES WORKERS Leslie Anderson, .78 Tricia Pierce, .78 Robin Robertson, .49 Dawn Sharp, .78 TEACHERS Lacey Pages, .63 Kathleen Meguro, .63 Joelle Smith, .63 Shelli Stinson-Pearce, .63 Diana Wendlandt, .63 Donna Werner, .63 Angela Fugere, .63 TEACHER ASSISTANTS Lai Io Loi, .49 Sabah Saed, .78 � Yelena Mamotyuk, .49 Paula Mengual, .49 Svetlana Nazarko, .49 Mariya Yarynych, .49 BUS MONITOR Amina Hassan, .3 ECEAP PROGRAM CENTER DIRECTOR Theresa LaRonde FAMILY SUPPORT WORKERS Antoinette Bunkasem - Holy Spirit, .78 Charlena Moultine - Panther Lake, .78 Brandi Pena - Family Center, .78 Diane Short - Kent Va11ey, .78 TEACHERS Ronda Boyd - Panther Lake, .78 Ann Frederickson - Kent Valley, .78 Ncel Fredrickson - Family Center, .78 Josie Morales - Holy Spirit, .78 TEACHER ASSISTANTS Anna Mamotyuk - Kent V alley, .67 Mariya Mamchits - Holy Spirit, .67 Angelica Trujillo - Panther Lake, .67 Donna Werner - Family Center, .10 Viktoriya Doma - Family Center, .78 PROGRAM ASSISTANTS Christal Lopez-Herrera - Kent Valley Marfelia Perez - Panther L,a1ce Haylee Fredrickson - Panther Lake KITCHEN AIDE Angie Bigford, Holy Spirit Kathy Nunn, Kent Valley, .3 JANITOR Angie Bigford, Holy Spirit Kathy Nunn, Kent Valley .10 All positions full-time unless noted. KENT YOUTH AND FAMII.Y SERVICES VOLUNTEER BOARD OF DIRECTORS Israel Vela, President EXECUTIVE DIRECTOR Michael Heinisch FUND DEYELOPMENT AFTER SCHOOL PROGRAM FUNp DEVELOPER TEEN pAR�' NT pR�GRAM PROGRAM DEVELOPER Nathan Box TEEN PARENT PROGRAM MGR Robert White, .25 Laurie Peterson, MS SITE SUPERVISOR Kathy Jolly - .25 SITE ASSISTANTS Marcel Gildon, .20 Myrna Quinn - .20 Shamarke Ahmed, .3 Devan Bickman, 3 FRONT DESK MONITOR Johawna Whitlock, .375 Revised 4/08/13 SITE MANAGERS Erum Irfan, .75 Irfan Baig, .125 .AFTER SGHOOL PROGRAM AFf ER SCHOOL PROGRAMMANAGER Cyoon McBride PROGRAM COORDINATOR Gloria Vanzo EDUCATION COORDINATOR TUTORS Asma Ahmed, .25 PROGRAM DEVELOPER Robert White BIRCH CREEK TECHNOLOGY LAB SUPERVISOR Cyoon McBride LAB ASSISTANT Tanya Shein, 30 RECREATIONAL SITE LEADERS Dan Scheil — Birch Creek Janith Berry — .75 Cascade Julia Cain — .80 Valli Kee SITE ASSISTANTS Shamarke Ahmed, .45 Asha Jama, .75 Trihn Tran, .40 Samanha Young, .50 Ibrahim Abdizirak, .30 Devan Bickman, .45 Edmundo Serena-Sanchez, .40 Sirad Hssein, .475 CITY OF '�,,�....., Federal Way CITY HALL 33325 8th Avenue South Federal WaJr, WA 9$003-�325 (253) 835-7000 www. crryo/federalway com City of Federal Way Human Services Contract for 2013-2014 General Fund Authorized Signatures for Invoices I authorize the fottowing individuals to sign invoices and quarterly reports on behalf of: 1" �� � �� b v '�-� °t' G�,`v.�.�7 �c1'✓ � tR � (Contracting Agency), for the following: C._. ! t v�• L. � ��� r� � � (Program Title). �I�l�'�. J l�� �. �� ���� �� �� Authorizing fv �,f °�� �� � � ����'✓�`` � Signature: (must be signed by person who signs the contract, generally, Executive Director) �.�.�k�� a �ce Name) (Title) 1 � ' t � �"e � Y�l � �( i s (Signature) � Gv �' i ✓` r ��' �'� � '( y � (Date) ........................................................._.............................................................._....................................................................,.,.................................................................................................._....................._�......�...._....... Additional Authorized Signature: Addifional Authorized Signature: (Printed Name) (Title) .=u4 c- U=R-E�C'ro+2 �.�.��.�. � � - . � � � , . �,�. �. - (Printed Name) (Title) Note: It is the responsibility of the contractor to inform the City of Federal Way if they wish to add a name to or delete names from this list. KentYFS31 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED RERRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the poli�yCes) must be endorsed if SUBROGRATION IS WAIVED, subject to the terms and co�dNions of the policy, certain coverage may require an endorsement. A statement on this certifaate daes not confer rights to the certificate holder in lieu oi such endorsemeM(s). Canfield 451 Diamond Drive Ephrata, WA 98823 Kent Youth and Family Senrices 232 2nd Avenue South Kent, WA 98032 American Afternative Insurance Corporation AUTOMOBILE LIABILITY American Afternative Insurance Corporation PROPERTY American Afternadve Insurance Corporation MISCELLANEOUS PROFESSIONAL LIABILITY Princeton Excess and Swpius Lines Insurance Company THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERACiE PERIOD INDICATED, NOT WRHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF COMTRACT OR OTHER DOCUMENT WRH 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. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE Attn: Denise Catalano City of Federal Way 33325 8th Ave Federal Way, WA 98063-9718 2609768 �,t��. �'i �� POLICY NUMBER: N1-A2-RL-0000013-04 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION T his endorsement mod�es insurance provided under the following: SCHEDULE COMMERCIAL GENERALLIABILITY COVERAGE PART Section II — Who Is An Insured is amended to in- clude as an additional insured the person(s) or organa zation(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 omis- sions of those acting on your behalf: A. In the performance of your ongoing operations; or B. In connection with your premises owned by or rented to y�ou. CG 20 26 07 04 o ISO Properties, Inc:, 2004 Page 1 of 1 O 2609769