AG 15-053 RETURN TO: wl _S EXT:
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PROS/
2. ORIGINATING STAFF PERSON: DAVID CLEMONS EXT: 6922 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 ❑ HUMAN SERVICES/CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT(E.G.BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT(AG#): ❑ INTERLOCAL
X OTHER MOU
5. PROJECT NAME: MEAL PROGRAM Fo&SENIORS
6. NAME OF CONTRACTOR: EVERGREEN SENIOR CLUB
ADDRESS: TELEPHONE:
E-MAIL: FAX:
SIGNATURE NAME: CHUNG KWI YOUN TITLE:
7. EXHIBITS AND ATTACHMENTS: SCOPE,WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
CFW LICENSE# BL,EXP. 12/31/ UBI# ,EXP. / /
8. TERM: COMMENCEMENT DATE: j I/ I Cj COMPLETION DATE: (Z' a I // S
9. TOTAL COMPENSATION:$ /A (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:
NCB
10. DOCUMENT/CONTRACT REVIEW INITIAL/DATE REVIEWED INITIAL/DATE APPROVED
❑ PROJECT MANAGER
❑ SUPERVISOR Cfa /Z/3///L/
❑ DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE) ���
I/LAW DEPT /Y ' aifii Q
11. COUNCIL APPROVAL(IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY,INSURANCE CERTIFICATE,LICENSES,EXHIBITS
1 DIAL/DA E SIGNED
X LAW DEPT AWE I
❑ SIGNATORY(MAYOR OR DIRECTOR �. � _
CITY CLERK if V7 _. ./1
❑ ASSIGNED AG# A • ��
■ SIGNED COPY RETURNED DATE SENT: 0 'o Zvic
❑RETURN ONE ORIGINAL
COMMENTS:
" ) Gt.• i c' i , �N a c. (•
A la
fee 011 - -� _
11/9
Memorandum of Understanding
Evergreen Senior Club
City of Federal Way and Evergreen Senior Club
THIS MEMORANDUM OF UNDERSTANDING (MOU), dated effective January 1, 2015,
defines the respective responsibilities of the City of Federal Way ("City") and the Evergreen
Senior Club in connection with the senior meal program at the Federal Way Community Center.
Background
A. The City and Evergreen Senior Club desire to enter an agreement for use of space at the
Federal Way Community Center for a twice weekly meal program from January 1, 2015
through December 31, 2016.
B. The City of Seattle has provided funding for a congregate meal program to the Evergreen
Senior Club to serve an unmet need in the community. The congregate meal program is
donation based and provides warm nutritious meals to low income seniors.
C. The City will provide space at the Federal Way Community Center located at 876 S 333`d
Street, Federal Way WA. 98003 for the purpose of offering an ethnic low income
congregate meal program provided by the Evergreen Senior Club.
D. The Evergreen Senior Club has permission to use the community rooms and kitchen or
other space designated by the Federal Way Community Center on Tuesdays and
Thursdays. Time of use for the Evergreen Senior Club is from 8:00 a.m. until 1:00 p.m.
both days.
E. The City will provide a separate list of dates outlining the dates that are not available for
use by the Evergreen Senior Club or space may be reduced or the meal program moved to
another location in the building to accommodate for other uses of the Community Center.
F. No party shall be responsible for events that are unforeseeable and beyond its reasonable
control, such as acts of God, weather delays or government restrictions.
G. This MOU may be terminated by either party with 30 days' notice.
NOW, THEREFORE, the parties agree as follows:
I. City Responsibilities. The City agrees to provide the following:
• Dining areas and kitchen facilities on the days outlined above.
• Tables, chairs and appropriate kitchen equipment.
• List of dates that the Evergreen Senior Club will be moved to another location
in the building, which may affect the number of people that can be served and
a list of dates that the building is not available. Dates/times/locations subject
to change. Evergreen Senior Club will be notified two weeks in advance of
any schedule change for use of the building not included in the Memorandum of
Understanding in writing.
II. Evergreen Senior Club Responsibilities
• The undersigned hereby agrees to indemnify and hold the City, its elected officials,
officers, employees, agents and volunteers harmless from any and all claims,
demands, losses, action, and liabilities (including costs and all attorney fees) to or by
any and all persons or entities including, without limitations, their respective agents,
licensees and representatives, arising from, resulting from, or connected with the use
of the premises, or from any error or omission of the undersigned, its partners,
shareholders, officers, agents, employees, invitees, volunteers, or by the breach of the
MOU, unless such injury or damage is caused by the sole negligence of the City. The
undersigned hereby grants permission for the City to use any photographs, motion
pictures, recordings or any other record of this event for any legitimate purpose.
• Evergreen Senior Club acknowledges that this agreement is for temporary use of
space at the Federal Way Community Center on Tuesdays and Thursdays and will
develop an alternative location for continuation of services in 2017. It is understood
that a request may be made at the end of this term to continue the meal program at the
Federal Way Community Center.
• Provide a congregate meal program on Tuesdays and Thursdays at the Federal Way
Community Center on the days and times provided above.
• Qualified cooks who hold current required permits and training
• All food is to be purchased and provided by the Evergreen Senior Club at their sole
expense
• All paper and plastic products including, but not limited to plates, napkins and
utensils are to be purchased and provided by the Evergreen Senior Club at their sole
expense
• The Evergreen Senior Club is responsible for cleaning the community rooms, kitchen
and all equipment after each day of use.
• The Evergreen Senior Club is solely responsible for managing it's inventory of food
to insure safety and freshness
• The Evergreen Senior Club is solely responsible for any fines they incur due to
violations of health codes.
• The Evergreen Senior Club will provide and maintain a comprehensive general
liability insurance policy with limits of Two Million dollars ($2,000,000)per
occurrence specifically naming the City of Federal Way additionally insured. This
policy shall include personal injury, bodily injury or property claims of the Evergreen
Senior Club Services and its agents.
• The Evergreen Senior Club will report any damage or malfunctioning equipment to
designated Federal Way Community Center staff upon discovery.
• The Evergreen Senior Club will agree to repair or replace at their expense any
damaged equipment caused by misuse by the Evergreen Senior Club.
• The Evergreen Senior Club will only use the designated refrigerator storage space
that has been assigned to them.
• The Evergreen Senior Club will assist in paying for quarterly kitchen cleanings,
limited to no more than the amount of$300.00 per quarter.
• This MOU sets forth the intent of the parties herein.
[Signature page follows]
IN WITNESS WHERE OF, the City and Evergreen Senior Club. have executed this
Memorandum of Understanding as of the day and year first written above by their duly
authorized representatives.
CITY OF FEDERAL WAY: ATTEST:
IPTIP
Jo'i Hutton, ! -- ' ks C , C erk, Stephanie Co -y, CMC
DATE: /( ((3 APPROVED AS TO FORM:
Orr
.47/City Attorney, Amy Jo Pearsall
EVERGREEN SENIOR CLUB:
By:
Printed Name: Chung Kwi Youn
Title: President
DATE: _
STATE OF WASHINGTON )
) ss.
COUNTY OF
On this day personally appeared before me Chung Kwi Youn, to me known to be the President of
the Board of the Evergreen Senior Club 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 gi-td day of fed/4,lavy , 20 11.
Notary's Signature
�!
Notary's Print-
N. . .
• 'tic in and for the State of Washington.
Notary Public My commission expires (0/ ZQ/7
State of Washington
BRIAN THANDE KARIUKI
My Appointment Expires Oct 10,2017