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AG 13-091RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: CED/HS 2. ORIGINATING STAFF PERSON: DEE DEE CATAraNO EXT: 2651_ 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCiJMENT (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 ❑ ORDINANCE ❑ CONTRACT AMENDMENT (AG#): � OTHER O SECURITY DOCUMENT (E.c. sorm �i.a,TEn nocvMErrrs> ❑ RESOLUTION ❑ INTERLOCAL 5. PRO7ECT NAME: CHILD & YOUTH MENTAL HEALTH 6. NAME OF CONTRACTOR: VALLEY CTTIES COUNSELING SL CONSULTATION ADDRESS: E-MAIL: SIGNATURE NAME: TELEPHONE FAX: TITLE 7. EXHIBITS AND ATTACHMENTS: X SCOPE, WORK OR SERVICES X COMPENSATION X INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBTTS X PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENTDATE: O1/O1/2013 COMPLETION DATE: 12/31/2014 9. TOTAL COMPENSATION $80,000 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLAYEES TTTLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ ❑ PURCHASING: PLEASE CHARGE TO: 001-7300-083-562-10-410: $70,000 001-7300-089-562-10-410: $10,000 10. DOCUMENT/CONTRACT REVIEW ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT (g' �rLiC,�sr.E) ❑ LAW 11. 'COiTNCILAPPROVAL (�,�rrLic.�r..E) PAID BY: � CONTRACTOR ❑ CTI'Y I1�TITIAL / DATE REVIEWED I1�TITIAL / DATE APPROVED ./ � 2.- P 3• t°�• 13 COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING y� �� ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: .� I DATE REC'D: ( ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, L CENSES, EXHIBITS ❑ LAW DEPARTME ❑ SIGNATORY AYOR R DIRECTOR� O CITY CLE O ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: IrTITIAL / DATE SIGNED .._ '��2 • i 3 �� '�' AG# — DATE SENT: 11/9 ,. � CITY OF GITY HALL .�.. Federa I Way 33325 8th Avenue South Federat Way, WA 98003-6325 (253) 835-7000 www cityoflederalway. com HUMAN SERVICES AGREEMENT FOR CHILD & YOUTH MENTAL HEALTH SERVICES This Huxnan Services Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Valley Cities Counseling & Consultation, 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: VALLEY CITIES COUNSELING & CONSULTATION: Kristen Royal 33301 - 1 st Way S. Federal Way, WA 98003 (253) 250-4063 (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.catalano@cityoffederalway.com 1. TERM. The term of this Agreement shall 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 ("Seivices"), 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 shall begin immediately upon the effective date of this Agreexnent. 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 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 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 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 W�� 33325 8th Avenue South Federai Way, WA 9$003-6325 (253) 835-7Q00 www. atyofiederalway. com r , 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 docuxnentation 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 xnay 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 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 fmal invoice by the date indicated on Exhibit "B". If the Agency's final invoice, supporting documentation, and reports are not submitted by the last date specified in Exhibit "B", the City sha11 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 Bud�et. The Agency shall apply the funds received from the City under this Agrcement 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 Proj ect/Program Exhibit is expected to exceed ten percent (10%) of that line item. Supporting documents are necessary to fully explain the nature and purpose ofthe 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 sha11 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, azbitrations, 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 a11 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 imxnunity 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 fixrther acknowledge that they have mutually negotiated this waiver. HUMAN SERVICES AGREEMENT - 2- 4/2011 � CITY OF , �, Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www ciryotfede�alway.com 5.3 City 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 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 $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 owned, 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 personal 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 sha11 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 all 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 fixrnish 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. CONFIDENTIALTTY. 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 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 remauung in the possession of Agency shall be delivered to the City. HUMAN SERVICES AGREEMENT - 3- 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 www. cityoffederahvay. com 9. BOOKS AND RECORDS. T'he 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 a11 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 sha11 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 sha11 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 sha11 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 dces 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 all services, programs, activities, hiring, and employment made possible by or resulting from this Agreexnent 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 peison 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 locallaw 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 ofthis Agreement shall prevail. The respective captions ofthe Sections of this Agreement are inserted for convenience of reference only and sha11 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 Assi�nment 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- HUMAN SERVICES AGREEMENT - 4- 4/2011 � CITY OF ,:�., F+ederal Way CITY HALL 33325 8th Avenue South Federa{ Way, WA 98003-6325 (253) 835-7000 www cityoffedera(way. 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 ofthe 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 Comnliance 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 Agreexnent and each and a11 of its provisions in which performance is a factor. Adherence to compl�tion 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 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 exeroise 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 imxnediately 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. T'his Agreement sha11 be made in, govemed 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 a11 appeals, in addition to any other recovery or awazd provided by law; provided, however, however nothing in this paragraph sha11 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] { HUMAN SERVICES AGREEMENT - 5- 4/2011 � CITY OF CITY HALL '�..- Fe d e ra I Way 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www atyoffederalwey. com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY Skip Pries , Mayor DATE: '�-�'' �� • I � VAl : Prin Title: � �� DATE: � STATE OF WASHINGTON ) ) ss. COUNTY OF �N� ) TATION ATTEST: � City Clerk, Carol McNeil y, CMC APPROVED AS TO FORM: ,,P Qh�G�C!/ � City Attorn , atricia A Richardson On this day personally appeared before me ',``l�� ��� � �A'4% �� to me known to be the � L—`v of �,� ! I�� L° �Tl s� (��u,vs sc ,� � CiiNd u crM�7a� 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 oZ `°� day of /�Q�L , 20 ��. KANDISS A TORZA NOTARY PUBLIC STATE OF WASHINGTON COMMISSION EXPIRES JUNE 20, 2018 Notary's signature ` �� Notary's printed name ,v��.sf �4. 02�� � N tary Public in and for the State of Washington. My commission expires G/���o/G HUMAN SERVICES AGREEMENT - 6- 4/2011 ` CITY OF �;, Federal Way EXHIBIT KA" SERVICES Project Summary CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7�00 www. atyoffederalway. com The Agency shall provide mental health counseling services for youth 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: 18` Quarter 2°d Quarter 3`� Quarter 4�' Quarter JAN. — MARCH APRIL - NNE NLY — SEPT. OCT. — DEG TOt81 No. of unduplicated Federal Wa ersons assisted in 2013 28 28 29 29 114 No. of unduplicated Federal Wa ersons assisted in 2014 28 28 29 29 114 B. Units of Service The Agency agrees to provide, at minimuxn, the following units of service by quarter: lst Quarter 2°d Quarter 3�d Quarter 4�h Quarter JAN. - MARCH APRILr NNE NLY — SEPT. OCT. —DEC. TOtAl 2013 1. Counseling/Service Hours 111 111 111 111 444 2. 2014 1. Counseling/Service Hours 111 111 111 111 444 2. HUMAN SERVICES AGREEMENT - 7- 4/2011 ` CITY OF ,�. Federal Way C. Definition of Services CITI HA�L 33325 8th Avenue South Federal Way, Wp 98003-6325 (253) 535-7000 www. dtyoffederalway. com 1. Counseling/Service Hours: The service unit is a mental health service hour, defined as an hour of program service delivery to children and youth by the program's Mental Health Professional. D. Outcome(s) Outcome(s) to be reported: 1. Individuals andlor families improve health (physical/dental/mental). Records A. Project Files The Agency shall maintain files for this project containing the following items: 1. Notice of Crrant Award. 2. Motions, resolutions, or minutes documenting Board or Council actions. 3. A copy of this Agreement with the Scope of Services. 4. Correspondence regarding budget revision requests. 5. Copies of all invoices and reports submitted to the City for this project. 6. Bills for payment with supporting documentation. 7. Copies of approved invoices and warrants. 8. Records documenting that costs reimbursed with funding provided under this Scope are allowable. Such records include, but are not limited to: � for personnel costs, payroll for actual salary and fringe benefit costs. ■ for staff travel, documentation of mileage charges for private auto use must include: a) destination and starting location, and b) purpose of trip; and ■ for copy machine use, postage, telephone use, and office supplies when these costs are shared with other programs and no invoice is available, log sheets or annotated invoices. HUMAN SERVICES AGREEMENT - 8- 4/2011 � CITY OF �•..., Federal � CITY HALL W�� 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 �vww. atyoffederalway. 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. `;` Tf�'ii��r�uimlr �r �Qi� tnCorrfi� E�mits sum �ry Ef%c�cive i `. -�I�o31� � � : k Median �ncome 1 2 3 4 5 6 7 8 Income �imit 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 586.700 (50%) Income $30,350 $�4,700 $39,050 $43,350 $46,850 $50,300 $53,800 $57,250 Limits Low (80%) $45,100 $51,550 $58,000 $64,400 $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 � Federal CITY HAL� W�� 33325 8th Avenue South Federal Way, WA 9$003-6325 (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 Sumrnary. The total amount of reimbursement pursuant to this Agreement shall not exceed $80,000. A. City of Federal Way Funds 2013 2014 Ci of Federal Wa General Fund: $40,000 $40,000 Total Ci of Federal Wa Funds: $40,000 $40,000 C. Personnel Detail Position Title PosiHon Full Annual Salary HS Funds Tune E uivalent and Benefits CFS Clinician 20hrs/wk .50 $54,385 $27,193 Supervision & Support .07 $68,294 $4,780 3hrs/wk Total: $122 679 $31,973 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 January 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 documents for the billing period. HUMAN SERVICES AGREEMENT - 10 - 4/2011 ` CITY OF �. Federal Way Estimated Quarterly Payments: 2013 1 st Qtr 2nd Qtr 3rd Qtr 4th Qtr 2014 1 S` Qtr 2nd Q�T, 3'� Qtr 4�' Qtr $10,000 $10,000 $10,000 $10,000 $10,000 $10,000 $10,000 $10,000 CITY HALL 33325 8th Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www. ciryoifederalway com 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 DRAFT MOTION March 17, 2011 Recommended Action: THE BOARD OF DIRECTORS APPROVES TRANSFER OF CEO AUTHORITY FROM INTERIM CEO, STACEY DEVENNEY, TO KEN TAYLOR, CEO, EFFECTIVE MARCH l, 2011. THIS ACTION ALSO AMENDS THE REGISTERED AGENT FROM FAITH RICHIE TO KEN TAYLOR AS NOTED IN ARTICLE X OF THE ARTICLES OF INCORPORATION AND AUTHORIZES THE CHIEF EXECUTIVE OFFICER, KEN TAYLOR, SIGNATURE AUTHORITY TO SIGN CONTRACTS WITH ALL FUNDERS AND ALL OT'HER LEGAL DOCUMEN'TS ON BEHALF OF VALLEY CITIES COUNSELING & CONSULTATION. ,(S✓� � �. / C Brian Wilson, Board Date � e VALLEY CITIES COUNSELING & CONSULTATION BOARD OF DIRECTORS BOARD MEETING MINUTES r m i. � i s w r• c s i� r i a� r� i w r a> i�� r+i , e r i m i e� a i s a i� r E s i r. �+ i, r� r a a i F r i o i.� i r r ir a r i, s r r r� i r� i s'� s i a r r n i� i�� a n. r.,� r� i. � i. p a r, c r i, r✓ r n i a r r a r i, r r i� n a r i a i c� i� r i� i r i� i d i. � i.� s i. e,� i v i r a i E a� c, � r s r i. e s i a��.n i, m r r s i, v' i. e n� r a.� i e r i. .° s i v i. � i[� i�' i� r. c Y i� s i� i� i• s� r a i o i o i�� r s i� i� r m i e+i n DATE: PLACE: MEMBERS PRESENT: EXCUSED MEMBERS: STAFF PRESENT: � Q March 17, 2011 2704 I Street NE; Auburn, WA 98002 Walt Bishop, Chuck Booth, Jeannie Johnson, Sharon Lavigne, Kelly Togeson, Iwen Wang, ChaMes Woode Barbara Bell, Deb Casey, Barb Mucrynski, Steve Williams, Brian Wilson Ken Taylor, Stacey Devenney, Shekh Ali, Pam Taylor, Kandiss Torza CALL TO ORDER AND ANNOUNCEMENTS: Board �ce Chair, Walt Bishop, called the meeting to order at 5:15 p.m. STAFF RECOGNITION: None III. APPROVAL OF THE AGENDA MOTION; Chuck.moved that; — �FtE-C-flidSEM-T-746ENDAfAR-Mar-�f��-'�-2�'! . Sharon seconded and motion carried:. FEBRUARY MINUTES The February Minutes were approved as written. IV. STAFF COMMUNCIATION TO THE BOARD CEI � V. COMMITTEE REPORTS FINANCE COYMITTEE INTERNAL AFFAIRS COMMITTEE EXTERNAL AFFAIRS: - VI. EXECUTIVE COMMITTEE Walt reported in Brian's absence. The committee discussed; • CMHC server issues and relocation as reported in the CEO report. • Privilege for new MD and Re-Privileging for ARNP The committee reviewed and approved the privileges for new MD, Anna Holen, and re-privileging for ARNP, Debi Kabisch. This process is in accordance with the JCAHO requirement that the Board be made aware of the approval. The Board Chair will continue to sign the approvals. • Walt presented a draft motion to the Board transferring CEO authority to Ken Taylor. VII. ADJOURNMENT The meeting was adjourned at 5:40 p.m. The next Board meeting will be held on April 21, 2011 at 5:00 p.m. � C17'� oF CITY HALL �, Federal Way 33325 8th Avenue South Federal Way, WA 980�3-6325 (253)$35-7000 www. atyoffederah.vay. com City of Federal Way Human Services Contract for 2013-2014 General Fund Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf of: ��t�f,� L"i�7E:1 (.�,vs�[�ti6 f �,rrJu�7�T7aJ (Contracting Agency), for the following: Authorizing Signature: (must be signed by person who signs the contract, generally, Executive Director) �vr��s /It6�t�f.4��w/c r �n� �°. (Printed Name) � (Signature) ;( (Program Title). �,�-`� (Title) y�� \ 3 (Da%) ............................................................................................._..........................._.....,..............................,.,.,.,.,.................................,.................._.........................._.�........................................___......�.........._._.._.._......._... Additional Authorized Signature: Addifional Authorized Signature: (Signature) /� D'L Nf J /, (Printed Name) ,i�/r-�� (Date) (Title � �.�.n r� c� � QS�/ �/ �22�/3 (Signature) (Date) � 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. Client#: 709605 VALLECIT DATE (MMIDD/YYY� ACORD� CERTIFICATE OF LIABILITY INSURANCE si,sr�o,z � THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 'CERTIFICATE DOES NOT AFFIRMATNELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES e3ELOW. 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 be endorsed. If SUBROGATION IS WAIVED, subject to the terms and wnditions 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 NAME: Kibble & Prentice, a USI Co CL PHONE 206 441 �300 � N, : 610-362-8530 NC No Ext : 601 Union Street, Suite 1000 e-�uu� aoor�ss: Seattle, WA 98101 �uc� ixoia� ecFnann� Cpy�p� wvc # iNSUr�a n : INBURED INSU�R B : Valley Cities Counseling 8 Consultation 325 W Gowe St iNSU� c: Kent, WA 98032 INSURER D: Insuranc 18058 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS. NSR ������ L BR POLICY EPF POLICY E7� LTR I R NND POLICY NUMBER V�$ A�+�^� �uT�' PHPK879954 0/2012 06/30/201 EACH OCCURRENCE s 1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES �o .�c�urrence S i��O X CLAIMS-AAADE � OCCUR MED EXP (Arry one persai) S S OOO X 1/28/8T Retro PERSONAL 8 ADV INJURY s 1 000 000 X WA Stop Gep GENERALAGGREGATE E3sO� O� CaEN1 AGOREGATE LIMIT APPLIES PER: PRODUCTS - CAMP/OP ACiG a 3�000�000 � X Pa.�cr �OT �oc WA Sto Ga aS1mJs1m/s1m ; A��i� �� PHPK879954 6/3012012 06/30/201 Ea eaJ�dEentSINGLE LIMR ����� X ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED BODILY INJURY (Per a�q S A�� NO �N-OWNED PROPERTY DAMAGE a X HIRED AUTOS X AUTOS Per acddsnt S A X ��LL"` � occuR PHUB385742 0/2012 06/30/201 EACH OCCURRENCE s5 000 000 �� �� X cw�nns-nnnoe per unde�lying AGGREGATE s5 000 000 oeo X aEreririav s10 000 $ WORI�RS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LUBILITY ANY PROPRIETOWPARTNERIEXECUTIVE Y� N E.L. EACH ACCIDENT $ OFFlCERIMEMBER EXCLU�ED7 � N I A (Ma�Watory in NH) E.L DISEASE - EA EMPLOYEE E Ifyes, desai6e under . DE5CRIPTION OF OPERATIONS below E.L. DISEASE - Pa.ICY LIMIT a A Prof Liab PHPK879954 /30/2012 06/30/201 ;1,000,000 per claim Claims Made 1/28/87 Retro 53,000,000 aggregate DESCRIPTION OF OPERATIOWS I LOCATIONS 1 VEHICLES (Attaeh ACORD 101, Additlonal Remerks Sehedule, fl morc spaee is requlred) RE: Mental Health Counseling Certificate Holder is additional insured on the general liability as respects their interest with the named insured. Evidence of Insurance for Professional Liability City of Federal Way Mental Health Counseling 33325 8th Ave S PO BOX 9718 Federel Way, WA 98063-0000 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 ��' � ,r,�'� � 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S7361710/M7355914 �ZP Client#: 709605 VALLECIT ACORD,� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6N 5/2012 THIS CERTIFICATE IS ISSUED AS A MA7TER 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 i3ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S�, AUTHORRED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the �rms and conditions of the policy, certaln policies may require an endorsement. A statement on this certif� doe.s not cor�fer rights to the certificate holder in lieu of such endorsemerrtlsl. r��ucea Kibbie 8� Prentice, a USI Co CL 601 Union Street, Suite 1000 Seattle, WA 98101 �sur�u Valley Cities Counseling & Consultation 325 W Gowe St Kerrt, WA 98032 MISURER E : 206 441-6300 COVERAGE 610-362-8530 COVERAGES CERTIFICATE NUMBER: 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 �CUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. � TYPE OF INSURANCE �� POLICY NUMBER POLICY �F PW.ICY E1� � A°�°�^�- ��-m' PHPK879954 0/2012 06/30/201 EACH OCCURRENCE 51 000 000 X COMMERCIALGENERALLIABILITY ��� �� $�QQQQQ _ — — CLAIMS-MADE � OCCUR _ . _- - -- — _ MED EXP - - - ._. . (Arry one person) $ 5 �a) X 1/28/87 Retro PERSONAL 8 ADV INJURY S i�� X WA Stop Gap aeN�a�c�onre a3,000 000 OEN'L AG�REGATE UMR APPLIES PER: PRODUCTS - COMP/OP AGG S� OOO OOO � X Pa.�cr �Ea �oc WA sslm/S1m1s1m ," ^uro�os�� uaaiuTr PHPK879954 6/30/2012 06/30/201 �Me �tSINGLE LJMIT ����� X ANY AUTO BODILY INJURY (Par pereon) S ALL OWNW SCHEDULED BODILY INJURY (Pera�ident) $ AUTOS AUTOS X HIRED AUfOS X AUTOS E� . �� �t�MAGE a s A► X�^ � occuR PHUB 42 0/2012 06/30/Z07 eacH occuw�r� s5 000 000 ��� � X cwnnsnnnoe per underlying acc�c3arE 000 000 DED X RETENTION$�O OOO $ NfORKH2S CONWEN8JITION WC 5TATU- OTH- AND HAPWYERS' LJABILI7'Y ANY PROPRIETORIPARTNEWEXECUTIVE Y� N E.L EACH A�IDENT $ OFFlCEWMEMBER EXCLUDED7 � N I A (��Y �� �) E.L aSEABE - EA EMPLOYEE S Ifyes� �eaibe under DESCRIPTION OF OPERATIONS below E.L DISEASE - POUCY LIMIT $ A Prof Liab PHPK8799S4 /2012 06/30/Z01 31,000,000 per daim Claims Made 1/28/87 Retro �,000,000 aggregabe D�PTIOI�I OF OPERATiONS / LOCA7101� / VEHICLES (Attaeh ACAt� 107, Additlonal RanqAcs Sehedule, N morc spece is roqWred) Certificate Holder is additional insured per attached CG 2026 endorsement on the generai liability as respects their i�erest with the named insured. Evidence of Insurance for Professional Liability City of Federal Way Human Services Division 33326 8th Ave S PO BOX 9718 Federal Way, WA 98063-0000 SHOULD ANY OF THE ABOVE OESCRIBED POLIC�S BE CANCELI.ED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELtVERED Ml ACCORDANCE WITH TNE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE .�l�r�- .r.�._. � 7988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #57361708/M7355914 AXVZP � This page has been left blank intentionally: POLICY NUMBER PHPK879954 COMMERCIAL GENERAL LIABILITY CG 20 26 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATtON This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Additional Insured Person(s) or Organization(s): City of Federal Way Human Services Division 33326 8th Ave S PO BOX 9718 —�deFal�llEa�IAFA-98863-8A00 — _-- - . Information required to complete this Schedule, if not shown above, will be shown in th� Dedarations. WHO IS AN INSURED (Section II) is amended to include as an insured the person(s) or organization(s) shown in the Schedule, but only with r 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 ads or omissions of those acting on your beha�: A. in the perFormance of your ongoing operations; or B. In connecfion withh your premises owned by or rented to you. CG 20 26 07 04 Copyright Insurance Senrices Office, Inc., 2004 Page 1 of 1