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AG 15-100' RETURN TO: Sarah Bridgeford EXT: 2651 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT. /DIV: CD /CS 2. ORIGINATING STAFF PERSON: SARAH BRIDGEFORD EXT: 2651 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G, RFB, RFP, RFQ) ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE x CONTRACT AMENDMENT (AG #): 15 -100 ❑ OTHER ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT ❑ HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 5. PROJECT NAME: EMERGENCY SERVICES 6. NAME OF CONTRACTOR: ST. VINCENT DE PAUL ADDRESS: 3939 SW 311 ST STREET, FEDERAL WAY, WA 98023 TELEPHONE E -MAIL: FAX: SIGNATURE NAME: 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 8. TERM: COMMENCEMENT DATE: 01/01/2016 COMPLETION DATE: 12/31/2016 9. TOTAL COMPENSATION $ 46,400.25 (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 RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE BY (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED ❑ PURCHASING: PLEASE CHARGE TO: Opt— g360 - 083 ' (O2 — 10 —°40 b 10. DOCUMENT /CONTRACT REVIEW ROJECT MANAGER IRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW 1 11. COUNCIL APPROVAL (IF APPLICABLE) iii41 L DATE ' VIE ED INITIAL / DATE APPROVED Ws, (oI I (Ito COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: /%�e%j�lr DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ LAW DEPARTMENT CHIEF OF STAFF SIGNATORY (MAYOR OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: INITIAL / DATE SIGNED DATE SENT: // 29 -/ (p OW,910/ 6 CIiY OF Federal Way AMENDMENT NO. 2 TO HUMAN SERVICES AGREEMENT FOR EMERGENCY HUMAN SERVICES CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway corn This Amendment ( "Amendment No. 1 ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and St. Vincent de Paul of Seattle -King County, a nonprofit agency ( "Agency "). The City and Contractor (together "Parties "), for valuable consideration and by mutual consent of the Parties, agree to amend the original Agreement for Emergency Human Services ( "Agreement ") dated effective January 1, 2015 as follows: 1. AMENDED SERVICES. The Services, as described in Exhibit A and as referenced by Section 2 of the Agreement, shall be amended to include, in addition to the Services and terms required under the original Agreement and any prior amendments thereto, those additional services described in Exhibit A -2 attached hereto and incorporated by this reference ( "Additional Services "). 2. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or method of payment, as delineated in Exhibit B -2, attached hereto and incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate for the Term. Except as otherwise provided in an attached Exhibit, the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 3. 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, are 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. AMENDMENT [Signature page follows] - 1 - 1/2015 CITY ov Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.cityoffecleralway.com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY DATE: ST. VINCENT DE PAUL OF SEATTLE -KING COUNTY Bv: 914 Printed Name: Y it £ l k/ / .'. /Lf • p W • Title: lip DATE: l l //,/ 02,D STATE OF WASHINGTON ) COUNTY OF King ) ss. ,,f69/ ATTEST: lerk, Stephanie Court APPROVED AS TO FORM: Acting City Attorney, J. Ryan Call d_4„ et,,„,6 044 On this day personally appeared before me V r Oa M • R C Vt1 , to me known to be the ()h Ct 8 G�tAkof St. Vincent de Paul o Seattle-King County that executed the foregoing �e� w�l. �� .�I g X g g instru ent, 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 11 day of `��\ p, J0%N4 /,,# Notary's signature ∎� ?••V • • `r0�'� Notary's printed na o 9031 -kC 4o Nay. 04° NUVUa1I2cv ain AMENDMENT ,20110 1711 Notary Public in and or the State of Washington. My commission expires Q) — /'7 — Z d (!� - 2 - 1/2015 CITY OF Ate, Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.cilyoffederalway.com EXHIBIT A -2 ADDITIONAL SERVICES The Agency shall do or provide the following in addition to Services provided for in previous Exhibits: Project Summary The Agency shall provide emergency 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 additional 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: 4th Quarter OCT. — DEC. Total Additional number of unduplicated Federal Way persons assisted in 2016 72 72 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: C. Defmition of Services 1. Financial Aid: Number of households assisted to help avoid eviction and /or power shut -off, or provide homeless shelter in a motel. 2. Home Visit: Completion of a home visit conducted by two volunteers. AMENDMENT - 3 1/2015 4th Quarter OCT. — DEC. Total 2016 1. Additional Financial Aid /Households Served 21 21 2. Additional Home Visits 21 21 C. Defmition of Services 1. Financial Aid: Number of households assisted to help avoid eviction and /or power shut -off, or provide homeless shelter in a motel. 2. Home Visit: Completion of a home visit conducted by two volunteers. AMENDMENT - 3 1/2015 CITY or .t Federal Way D. Performance Measure(s) CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederaiway com Outcome(s) to be reported: 1. Individuals and /or families will have secure housing. Records A. Project Files The Agency shall maintain files for this project containing the following items: 1. Notice of Grant Award. 2. Motions, resolutions, or minutes documenting Board or 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. 9. 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. King County FY 2016 Income Limits Summary Median FY 2016 Income Income 1 2 3 4 5 6 7 8 King Limit Person Persons Persons Persons Persons Persons Persons Persons County Category Extremely Low (30 %) $19,000 $21,700 $24,400 $27,100 $29,300 $32,580 $36,730 $40,890 Income Limits Very Low $90,300 (50 %) $59,600 Income $31,650 $36,150 $40,650 $45,150 $48,800 $52,400 $56,000 0 Limits Low (80 %) $48,550 $55,450 $62,400 $69,300 $74,850 $80,400 $85,950 $91,500 Income Limits The Agency agrees to use updated Income Guidelines which will be provided by the City. AMENDMENT 4 1/2015 4_, Federal Way Reports and Reporting Schedule CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway. com The Agency shall collect and report client information to the City quarterly (on the dates outlined in Exhibit B) and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall also submit a quarterly Narrative Report describing the program's accomplishments and explaining any variance in quarterly service units that is more than twenty -five percent over or under the quarterly goal. 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. AMENDMENT 5 1/2015 Vecferal Way EXHIBIT B -2 ADDITIONAL COMPENSATION CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.cityoffederalway.com 1. Total Compensation: In return for the Additional Services, the City shall pay the Contractor an additional amount not to exceed Four Thousand One Hundred Eighty -Six and 25/100 Dollars ($4,186.25). The total amount of reimbursement pursuant to this Contract, including all amendments, shall not exceed Forty -Six Thousand Four Hundred and 25/100 Dollars ($46,400.25) (the sum of 2015 and 2016 awards as stated in the table below). 2. Method of Compensation: A. City of Federal Way Funds Amount 2015 City of Federal Way General Fund: $22,214.00 2016 City of Federal Way General Fund Additional Funds $4,186.25 2016 City of Federal Way General Fund: $20,000.00 Total City of Federal Way Funds: $46,400.25 B. Line Item Budget 2015 Funds 2016 Total Funds Personnel Services (detail below) $0 $0 Office or Operating Supplies $0 $0 Rent & Utilities $0 $0 Communications $0 $0 Travel and Training $0 $0 Direct Assistance (Utilities, Rent) $22,214.00 $24,186.25 Client Travel $0 $0 Administration (Overhead) $0 $0 Total City of Federal Way Funds: $22,214.00 $24,186.25 C. Personnel Detail Position Title Position Full Time Equivalent Annual Salary and Benefits HS Funds N/A N/A N/A N/A Total: $ $ Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly and are due on the following dates: 1st Quarter: April 15 or within 10 days of notice to proceed, whichever is later; 2nd Quarter: July 15; AMENDMENT 6 1/2015 A. Pecferal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cltyoffederalway com 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. Estimated Quarterly Payments: 2016 1st Qtr $5,000 2nd Qtr $5,000 3rd Qtr $5,000 4th Qtr $9,186.25 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 any specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. AMENDMENT 7 1/2015 ARD® CERTIFICATE OF LIABILITY INSURANCE k.....----- DATE(MM/DD/YYYY) 5/27/2016 THIS CERTIFICATE IS ISSUED AS A MATTER 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 BELOW. 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 conditions 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 Artex Risk Solutions, Inc. (CB) Two Pierce Place Itasca IL 60143 -3141 CONTACT Christian Brothers Services PHONE 800-807-0300 F X 630 378 2508 (a/c No Frtp (A/C. No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC S INSURER A :Pennsylvania Manufacturers Assoc In 12262 INSURED CHRIBRO -14 Brothers of the Christian Schools & Affiliates Loc #1134002 SOC SVDP COUNCIL OF SEATTLE /KING CNTY 1205 Windham Parkway Romeoville IL 60446 -1679 INSURER B :Old Republic Insurance Company 24147 INSURER C : 6/15/2017 INSURER D : $2,000,000 INSURER E : INSURER F : X COVERAGES CERTIFICATE NUMBER: 1989815935 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 BY PAID CLAIMS. 1NSR L R TYPE OF INSURANCE IN I NSD S WVD POCY NUMBER POLICY (MM/DD //YYYY) (MM DIC D/YYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY Y 821600 0578617 6/15/2016 6/15/2017 EACH OCCURRENCE $2,000,000 CLAIMS -MADE X OCCUR DAMAGE RENTED PREMISES ( (Ea occurrence) $ Included MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $Included GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES ECT PER: LOC GENERAL AGGREGATE $N /A PRODUCTS- COMP /OPAGG $Included $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS x SCHEDULED AUTOS NON -OWNED AUTOS Y MWTB 21543 6/15/2016 6/15/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER El. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Only the General Liability Coverage will apply on a Primary and Non - Contributory basis (per attached endorsement) if required by fully executed written contract. Certificate Holder is added as Additional Insured (per attached endorsement) for General Liability and Automobile coverages solely, strictly and specifically with regards to: Use of Various Parish Facilities by Society of Saint Vincent De Paul Council of Seattle /King County Conferences: Christ The King, Our Lady of Fatima, St Alphonsus, St Anne, St Benedict, St John The Evangelist, St Luke, Assumption, Blessed Sacrament, Our Lady of the Lake, St Bridget, St Catherine, St Mark, St Matthew, St Patrick, Blessed Rosalie Rendu, See Attached... CERTIFICATE HOLDER CANCELLATION Archdiocese of Seattle CIO Property Const Services 710 9th Avenue Seattle WA 98104 USA 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 ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACO AGENCY CUSTOMER ID: CHRIBRO -14 LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Artex Risk Solutions, Inc. (CB) NAMED INSURED Brothers of the Christian Schools & Affiliates Loc #1134002 SOC SVDP COUNCIL OF SEATTLE /KING CNTY 1205 Windham Parkway Romeoville IL 60446 -1679 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Immaculate Conception, Sacred Heart, St James, St Joseph, St Mary, St Therese, Holy Family, Holy Rosary, Our Lady of Guadalupe, Our Lady of Lourdes,St Edward, St George, St John Vianney, St Paul, St Peter, Mary Queen of Peace, Our Lady of Sorrows, Sacred Heart, St Anthony, St Joseph, St Louise, St Madeleine Sophie, St Monica, Blessed Teresa of Calcutta, Holy Family, Holy Innocents, St Brendan, St John Vianney, St Jude, Holy Spirit, St Benadette, St Francis of Assisi, St John The Baptist, St Philomena, St Teresa, and St Vincent De Paul, Mission and Activities in Individual Parish Locations. Coverage includes Sexual Misconduct and Review Board/Victim Outreach limited coverage $250,000, each claim and in the aggregate, in total and annually. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY Attaching to and forming part of Policy No. 821600 0578617 Named Insured: THE RELIGIOUS AND CHARITABLE RISK POOLING TRUST OF THE BROTHERS OF THE CHRISTIAN SCHOOLS AND AFFILIATES Effective date of this endorsement is June 15, 2016 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under SECTION II INSURING AGREEMENT C, GENERAL LIABILITY COVERAGE defined within the Coverage Agreement SECTION 1: Schedule Name of Additional Insured Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WHEN YOU HAVE AGREED IN A WRITTEN CONTRACT FOR THAT PERSON OR ORGANIZATION TO BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. Designated Location(s) Of Covered Operations If no entry appears above, information required to complete this endorsement will be shown in the Certificate of Coverage as applicable to this endorsement. Section II Insuring Agreement C - Name of Insured Amended A Who Is An Insured defined in the General Insurance Agreement is amended to include as an Additional Insured the person(s) or organization(s) shown in the Schedule above but only with respect to liability in the performance of the Named Insured's ongoing operations for the Additional Insured(s) at the Location(s) designated in the Schedule above for "bodily injury" or "property damage ", caused in whole or in part, by the Named Insured's acts or omissions which takes place after the execution of a written agreement with the Additional Insured(s). B For the coverage provided by this endorsement: the following paragraph is added to Section IV — General Conditions, Section II, Insuring Agreement C- General Liability. This insurance is primary insurance as respects to this coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and noncontributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured C. Who Is An Insured is also amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, with respect to liability for "bodily injury" or "property damage" caused, in whole or in part by the "Named Insured's work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". The most we will pay is the amount of insurance required by the written contract or the amount of applicable limits of insurance under this policy; whichever is less. This Insurance does not apply to any claims or suits seeking damages, including defense, arising out of, directly or indirectly, from any actual or alleged participation in any act of sexual misconduct, sexual harassment, sexual molestation, sexual abuse or any claim sexual in nature, physical or mental, of any person. Except as amended in this endorsement, this insurance is subject to all coverage terms. clauses and conditions in the policy to which this endorsement is attached and only applies to the extent permitted by law. THIS FORM APPLIES IN STATES WHICH USE: CA 00 01 (03 -10) AND CA 00 01 (03 -06) IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM SCHEDULE Name of Person(s) or Organization(s): All persons or organizations as required by contract or agreement With respect to LIABILITY COVERAGE, Who Is An Insured is changed with the addition of the following: Each person or organization shown in the Schedule for whom you are doing work is an "insured ". But only for "bodily injury" or "property damage" that results from the ownership, maintenance or use of a covered "auto" by: 1. You; 2. an "employee" of yours; or 3. anyone who drives a covered "auto" with your permission or with the permission of one of your "employees ". However, the insurance afforded to the person or organization shown in the Schedule shall not exceed the scope of coverage and /or limits of this policy. Not withstanding the foregoing sentence, in no event shall the insurance provided by this policy exceed the scope of coverage and /or limits required by the contract or agreement. PCA 001 03 06 MWTB 21543 Religious and Charitable Risk Pooling Trust 06/15/2016 - 06/15/2017 THIS FORM APPLIES IN STATES WHICH USE: CA 00 01 (10 -13) IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Name of Person(s) or Organization(s): All persons or organizations as required by contract or agreement With respect to COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured is changed with the addition of the following: Each person or organization shown in the Schedule for whom you are doing work is an "insured ". But only for "bodily injury" or "property damage" that results from the ownership, maintenance or use of a covered "auto" by: 1. You; 2. an "employee" of yours; or 3. anyone who drives a covered "auto" with your permission or with the permission of one of your "employees ". However, the insurance afforded to the person or organization shown in the Schedule shall not exceed the scope of coverage and /or limits of this policy. Not withstanding the foregoing sentence, in no event shall the insurance provided by this policy exceed the scope of coverage and /or limits required by the contract or agreement. PCA 001 10 13 MWTB 21543 Religious and Charitable Risk Pooling Trust 06/15/2016 - 06/15/2017 RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTIl *43lWV jb 1. ORIGINATING DEPT. /DIV: CD /CS 2. ORIGINATING STAFF PERSON: DEE DEE CATALANO 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 ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE X CONTRACT AMENDMENT (AG #):15 -100 ❑ OTHER 5. PROJECT NAME: EMERGENCY HUMAN SERVICES X HUMAN SERVICES/ CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 6. NAME OF CONTRACTOR: ST. VINCENT DE PAUL ADDRESS: _3939 SW 331ST STREET, FEDERAL WAY 98023 SIGNATURE NAME: TELEPHONE FAX: TITLE 7. EXHIBITS AND ATTACHMENTS: X SCOPE, WORK OR SERVICES X COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES X PRIOR CONTRACT /AMENDMENTS 8. TERM: COMMENCEMENT DATE: 01/01/2015 COMPLETION DATE: 121311201 to TOTAL COMPENSATION $_22,214 (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 10. DOCUMENT /CONTRACT REVIEW ❑ PROJECT MANAGER ❑ DIRECTOR JSK MANAGEMENT (IF APPLICABLE) AW 11. COUNCIL APPROVAL (IF APPLICABLE) 001 - 7300 - 083 - 562 -10 -410 IN"IAL DATE REVIEWED INITIAL / DATE APPROVED O 16 COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING r ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: 7 / DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS DEPARTMENT CHIEF OF STAFF • SIGNATORY (MAYOR OR DIRECTOR) • CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED 11/9 INITIAL/ DATE SIGNED i r� "0 /•► DATE SENT: WWZ5� aoA� A CITY OF CITY HALL 33325 �;, Fe d e ra I Way Feder 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www ct"ffedera&ay. com AMENDMENT NO. 1 TO HUMAN SERVICES AGREEMENT FOR EMERGENCY HUMAN SERVICES This Amendment ( "Amendment No. 1 ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and St. Vincent de Paul of Seattle -King County, a nonprofit agency ( "Agency "). The City and Contractor (together "Parties "), for valuable consideration and by mutual consent of the Parties, agree to amend the original Agreement for Emergency Human Services ( "Agreement ") dated effective January 1, 2015 as follows: 1. AMENDED SERVICES. The Services, as described in Exhibit A and as referenced by Section 2 of the Agreement, shall be amended to include, in addition to the Services and terms required under the original Agreement and any prior amendments thereto, those additional services described in Exhibit A -1 attached hereto and incorporated by this reference ( "Additional Services "). 2. AMENDED COMPENSATION. The amount of compensation, as referenced by Section 4 of the Agreement, shall be amended to change the total compensation the City shall pay the Contractor and the rate or method of payment, as delineated in Exhibit B -1, attached hereto and incorporated by this reference. The Contractor agrees that any hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate for the Term. Except as otherwise provided in an attached Exhibit, the Contractor shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of this Agreement. 3. 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, are 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] Olt 0 AMENDMENT - 1 - 1/2015 A., ` CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDERAL WAY ATTEST: By: AM Jim Ferrel y r Jerk, Stephanie C ney, CMC DATE: Oyk1c APPROVED AS TO FORM: A/ a, Q*� 'tc1 /City Attorney, Amy Jo Pearsall ST. VINCENT DE PAUL OF SEATTLE -KING COUNTY By: Printed Name: Ala D-elmce,,r, Title: DATE: Ol 010 STATE OF WASHINGTON ) ss. COUNTY OF YJ'nov On this day personally appeared before me N ).t )p 1 j (. to me known to be the Dir",f-, of St -2— A- C6 ,e S4 Ala ink f_ ?0.0 ( that executed the foregoing instrument, and acknowledged the said instrum*nt 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 day of , 20 j1�, `,592� ��t 1,y Notary's signature AA `AP � Notary's printed name ea o : Notary Public in and for the State of Washington. My commission expires ��13 t t � &> 8 0Z ( -V ,`; Shitlgt0�%��``� AMENDMENT - 2 - 1/2015 CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South Federal Way, WA 98003-6325 (253) 835 -7000 www ci"fiederaMoy. com EXHIBIT A -1 ADDITIONAL SERVICES The Agency shall do or provide the following in addition to Services provided for in previous Exhibits: Project Summary The Agency shall provide emergency 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 additional 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 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. — APRIL — JULY — OCT. — MARCH NNE SEPT. DEC. Additional number of unduplicated Federal Way 0 0 20 20 40 persons assisted in 2015 0 0 6 6 12 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: C. Definition of Services 1. Financial Aid: Number of households assisted to help avoid eviction and/or power shut -off, or provide homeless shelter in a motel. 2. Home Visit: Completion of a home visit conducted by two volunteers. AMENDMENT - 3 - 1/2015 1" Quarter 2nd 3rd 4th JAN. - Quarter Quarter Quarter Total MARCH APRIL — JULY — OCT. — JUNE SEPT. DEC. 2015 1. Additional Financial Aid/Households Served 0 0 6 6 12 2. Additional Home Visits 01 0 61 61 12 C. Definition of Services 1. Financial Aid: Number of households assisted to help avoid eviction and/or power shut -off, or provide homeless shelter in a motel. 2. Home Visit: Completion of a home visit conducted by two volunteers. AMENDMENT - 3 - 1/2015 QTY OF Federal Way D. Performance Measure(s) Outcome(s) to be reported: 1. Individuals and /or families will have secure housing. Records CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 mm Wyoffederalway com A. Project Files The Agency shall maintain files for this project containing the following items: 1. Notice of Grant Award. 2. Motions, resolutions, or minutes documenting Board or 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. 0 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. 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. King County FY 2015 income Limits Summary Median FY 2015 Income Income 1 2 3 4 5 6 7 8 King Limit Person Persons Persons Persons Persons Persons Persons Persons County Category Extremely Low (30 %) $18,850 $21,550 $24,250 $26,900 $29,100 $32,570 $36,730 $40,890 Income Limits Very Low $89,600 (50 %) $31,400 $35,850 $40,350 $44,800 $48,400 $52,000 $55,600 $59,150 Income Limits Low (80 %) $46,100 $52,650 $59,250 $65,800 $71,100 $76,350 $81,600 $86,900 Income Limits AMENDMENT -4- 1/2015 CITY OF CITY HALL '�... Fe d e ra I Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cayoffederalway com 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 (on the dates outlined in Exhibit B) and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall also submit a quarterly Narrative Report describing the program's accomplishments and explaining any variance in quarterly service units that is more than twenty -five percent over or under the quarterly goal. 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. AMENDMENT - 5 - 1/2015 ` CITY OF CITY HALL �.. 8th Avenue S Federal Way, WA 98003 003 -6325 Federal Way (253) 835 -7000 www cityoffederalway. com EXHIBIT B -1 ADDITIONAL COMPENSATION 1. Total Compensation: In return for the Additional Services, the City shall pay the Contractor an additional amount not to exceed Two Thousand Two Hundred Fourteen and 00 /100 Dollars ($2,214.00). The total amount payable to Contractor pursuant to the original Agreement, all previous Amendments, and this Amendment shall be an amount not to exceed Twenty -Two Thousand Two Hundred Fourteen Dollars and 00 /100 Dollars ($22,214.00). 2. Method of Compensation: A. City of Federal Way Funds 2015 Add'1 Funds 2015 Total Funds City of Federal Way General Fund: $2,214 $22,214 Total City of Federal Way Funds: $2,214 $22,214 B. Line Item Budget 2015 2016 Personnel Services detail below) $0 $0 Office or Operating Supplies $0 $0 Rent & Utilities $0 $0 Communications $0 $0 Travel and Training $0 $0 Direct Assistance Utilities, Rent) $2,214 $22,214 Client Travel $0 $0 Administration Overhead $0 $0 Total City of Federal Way Funds: $2,214 $22,214 C. Personnel Detail Position Title Position Full Time Equivalent Annual Salary and Benefits HS Funds N/A N/A N/A N/A Total: $ $ 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. AMENDMENT - 6 - 1/2015 ` Federal Way CITY OF CITY HALL 33325 Feder 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederahvay com 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. Estimated Quarterly Payments: 2015 1 st Qtr $5,000 2nd Qtr $5,000 3rd Qtr $6,107 4th Qtr $6,107 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 any specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. AMENDMENT - 7 - 1/2015 CITY OF CITY HALL Federal al Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7040 www. a "ffederaMWcom HUMAN SERVICES AGREEMENT FOR EMERGENCY HUMAN SERVICES This Human Services Agreement ( "Agreement") is made between the City of Federal Way, a Washington municipal corporation ( "City"), and St. Vincent de Paul of Seattle -King County, a nonprofit agency ( "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: ST. VINCENT DE PAUL OF SEATTLE -KING COUNTY Joseph Roni 3939 SW 331s' Street Federal Way, WA 98023 (253) 838 -8919 (telephone) com The Parties agree as follows: CITY OF FEDERAL WAY: Denise Catalano 33325 80' Ave. S. Federal Way, WA 98003 -6325 (253) 835 -2651 (telephone) (253) 835 -2609 (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, 2015 and terminating on December 31, 2016 ( "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 shall begin immediately upon the effective date of this Agreement. 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 shall 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 - 1/2015 CITY OF Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 mm.. cityoffederaMey.. can 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 $2,000,000 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 shall be primary insurance as respect the City. Any insurance, self - insurance, or insurance pool coverage maintained by the City shall 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 all commercial general liability policies attached hereto as Exhibit "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 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. CONFIDENTIALITY. All information regarding the City obtained by Agency in performance of this Agreement shall 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 remaining in the possession of Agency shall be delivered to the City. HUMAN SERVICES AGREEMENT - 3 - 1/2015 CITY OF 3 HALL 332 Federal Way 33325 l Avenue South Federal way, wa 983 -6325 (253) 835 -7000 www atyoll'ederatway 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 ofthe 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 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 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 ihc� , ty's right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in acpo:rdAnc'lwti e laws of the State of Washington. If the Parties are unable to settle any dispute, difference or claim arising from tiili`s Agremntlhe exclusive means of resolving that dispute, difference, or claim, shall be by filing suit under the venue, rulessact junsetiot ohe King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative ®res: f thli�King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any Qtheap r riatd court in King County, Washington. Each party consents to the personal jurisdiction of the state and federa our s` �ing C, purity, Washington and waives any objection that such courts are an inconvenient forum. If either Party brings, Any claira 'or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and expenses incurred in defending p't' bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided bylaw 0rovidQd '6wevcr, 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 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 - 1/2015 CITY OF Federal Project Summary CITY HALL Nay 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www catyoffedferatway corn EXHIBIT A SERVICES The Agency shall provide emergency 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 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN. - APRIL — JULY — OCT. — MARCH JUNE SEPT. DEC. No. of unduplicated Federal Way persons assisted in 2015 90 90 90 90 360 No. of unduplicated Federal 27 27 27 27 108 Way persons assisted in 2016 90 90 90 90 360 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: HUMAN SERVICES AGREEMENT - 7 - 1/2015 1st Quarter 2nd 3rd 4m JAN.— Quarter Quarter Quarter Total MARCH APRIL — JULY — OCT. — JUNE SEPT. DEC. 2015 1. Financial Aid/Households Served 27 27 27 27 108 2. Home Visits 27 27 27 27 108 2016 1. Financial Aid/Households Served 1 27 27 27 27 108 2. Home Visits 27 27 27 27 108 HUMAN SERVICES AGREEMENT - 7 - 1/2015 CITY OF ,, ;& Federal CITY HALL Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 wi4 w. criyoftederalway.com 9. 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. :King courltyf FY 20151ncome imits Summary Median FY 2015 Income Income 1 2 3 4 5 6 7 8 King Limit Person Persons Persons Persons Persons Persons Persons Persons County Category Extremely Low (30 %) $18,850 $21,550 $24,250 $26,900 $29,100 $32,570 $36,730 $40,890 Income Limits Very Low $89,600 (50 %) $31,400 $35,850 $40,350 $44,800 $48,400 $52,000 $55,600 $59,150 Income Limits Low (80%) $46,100 $52,650 $59,250 $65,800 $71,100 $76,350 $81,600 $86,900 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 (on the dates outlined in Exhibit B) and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall also submit a quarterly Narrative Report describing the program's accomplishments and explaining any variance in quarterly service units that is more than twenty -five percent over or under the quarterly goal. 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 - 1/2015 CITY OF Federal Estimated Quarterly Payments: 2015 1 st Qtr $5,000 2nd Qtr $5,000 3rd Qtr $5,000 4th Qtr $5,000 2016 1St Qtr $5,000 2nd Qtr $5,000 3rd Qtr $5,000 4' Qtr $5,000 CITY MALL Way 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www. cityoffederaiway 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 any specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. HUMAN SERVICES AGREEMENT - 11 - 1/2015 em+IDIfi The Princeton Excess and Surplus Lines Insurance Company 555 College Road East, Princeton, New Jersey 08543 -5241 Phone: (800) 305 -4954 POLICY NUMBER: N2- A3-EX- 0000008 -00 GENERAL LIABILITY NAMED INSURED: The Religious and Charitable Risk Pooling Trust Of the Brothers of the Christian Schools and Affiliates COVERAGE TERM: 6/15/2014 to 06/15/2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under SECTION li INSURING AGREEMENT C, GENERAL LIABILITY COVERAGE defined within the Coverage Agreement. SECTION 1: Schedule Name of Additional Insured Person(s) Or Organization(s): ANY PERSON OR ORGANIZATION WHEN YOU HAVE AGREED IN A WRITTEN CONTRACT FOR THAT PERSON OR ORGANIZATION TO BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Designated Location(s) Of Covered Operations: If no entry appears above,. information required to complete this endorsement will be shown in the Certificate of Coverage as applicable to this endorsement. Section 11 Insuring Agreement C —Name of Insured Amended A. Who Is An Insured defined in the General Insurance Agreement is amended to include as an Additional Insured the person(s) or organization(s) shown in the Schedule above, but only with respect to liability in the performance of the Named Insured's ongoing operations for the Additional Insured(s) at the Location(s) designated in the Schedule above for "bodily injury" or "property damage ", caused in whole or in part, by the Named Insured's acts or omissions which takes place after the execution of a written agreement with the Additional Insured(s). B. For the coverage provided by this endorsement: the following paragraph is added to Section IV — General Conditions, Section 11, Insuring Agreement C - General Liability. This insurance is primary insurance as respects to this coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and noncontributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. C. Who Is An Insured is also amended to include as an additional insured the person(s) or'organization(s) shown in . the Schedule, with respect to liability for "bodily injury" or "property damage° caused, in whole or in part, by the "Named Insured's worts" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". D. The insurance provided to the additional insured person or organization does not apply to: Bodily Injury, Property Damage or Personal or Advertising Injury arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; 2. Supervisory, inspection, architectural or engineering activities. Section IV All Other terms and conditions of the Insuring Agreement remain unchanged. t�-YT' r N r v J A� DF CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYrY) 6/3/2015 THIS CERTIFICATE IS ISSUED AS A MATTER 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 BELOW. 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 conditions 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 Artex Risk Solutions, Inc. (CB) Two Pierce Place Itasca IL 60143 -3141 CONTACT Christian Brothers Services PHONE 1- 800-807-0300 F"X 1- 630 - 378 -2508 -M E A ADDRIL E : INSURERS AFFORDING COVERAGE NAIC # Y INSURER A:Pennsylvania Manufacturers Assoc In 12262 /15/2015 INSURED CHRIBRO -14 INSURER B: Old Re ublic Insurance Company 24147 INSURER C: CLAIMS -MADE YX OCCUR Brothers of the Christian Schools & Affiliates Loc #1134002 SOC SVDP COUNCIL OF SEATTLE /KING CNTY 1205 Windham Parkway INSURER D : Romeoville IL 60446 -1679 INSURER E: $Included INSURER F : MED EXP (Any one person) $15,000 rnVFRArFC rFRTiFICATF NI IMRFR• 1439199103 RFVISION NIIMRFR- 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 BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 601501- 05- 78 -61 -7 /15/2015 /15/2016 EACH OCCURRENCE $1,000,000 CLAIMS -MADE YX OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $Included MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY PRO JECT F1 LOC - PRODUCTS - COMP /OPAGG $Included $ OTHER: B AUTOMOBILE LIABILITY MWT621543 /15/2015 /15/2016 Ea accident $1,000,000 BODILY INJURY (Per person) $ ANY AUTO AUT OWNED SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS x NON -OWNED AUTOS Ix PRO PE DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ ' WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE I PER OTH- STATUTE ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? H N /'�` (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Only the General Liability Coverage will apply on a Primary and Non - Contributory basis (per attached endorsement) if required by fully executed written contract. Certificate Holder is added as Additional Insured (per attached endorsement) for General Liability coverage solely, strictly and specifically with regards to: Human Services Contract agreement for Emergency Assistance Program from January 1, 2015 to December 31, 2016. UtK 111-IGA I t MULUtK I:ANGtLLA I IUN City of Federal Way 33325 8th Ave South Federal Way WA 98003 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 yt rl� ee, ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY ENDORSEMENT NO. 43 Attaching to and forming part of Policy No. 601501- 05- 78 -61 -7 Named Insured: THE RELIGIOUS AND CHARITABLE RISK POOLING TRUST OF THE BROTHERS OF THE CHRISTIAN SCHOOLS AND AFFILIATES Effective date of this endorsement is June 15, 2015 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under SECTION 11 INSURING AGREEMENT C, GENERAL LIABILITY COVERAGE defined within the Coverage Agreement SECTION 1: Schedule Name of Additional Insured Persons) Or Organization(s): ANY PERSON OR ORGANIZATION WHEN YOU HALrE AGREED IN A WRITTEN CONTRACT FOR THAT PERSON OR ORGANIZATION TO BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY. Designated Locatton(s) Of Covered Operations If no entry appears above, information required to complete this endorsement will be shown in the Certificate of Coverage as applicable to this endorsement. Section If Insuring Agreement C -Name of Insured Amended A. Who Is An Insured defined in the General Insurance Agreement is amended to include as an Additional Insured the person(s) or organization(s) shown in the Schedule above, but only with respect to liability in the performance of the Named Insured's ongoing operations for the Additional Insured(s) at the Location(s) designated in the Schedule above for "bodily injury" or "property damage ", caused in whole or in part, by the Named Insured's acts or omissions which takes place after the execution of a written agreement with the Additional Insured's). B. For the coverage provided by this endorsement: the following paragraph is added to Section IV— General Conditions, Section II, Insuring Agreement C- General Liability. This insurance is primary insurance as respects to this coverage to the additional insured person or organization. where the written contract or written agreement requires that this insurance be primary and noncontributory, In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured, C. Who Is An Insured is also amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by the "Named Insured's work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard ". The most we will pay is the amount of insurance required by the written contract or the amount of applicable limits of insurance under this policy; whichever is less. Except as amended in this endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this endorsement is attached and only applies to the extent permitted by law. Administration -- St. Vincent De Paul Seattle /King County Council Staff DEPARTMENT NAME PHONE FAX CELL EMAIL (206) 767 -9975 (206) � %Executive Director Ned Delmore nedd @svdpseattie.org (/ ext 1105 767 -6439 (206) 767 -9975 (206) Deputy Director Steve Knipp stevek @svdpseattle.org ext 1123 767 -6439 Director of Finance (206) 767 -9975 (206) (Tax ID Number Eddie Roldan eddier @svdpseattle.org ext 1101 767 -6439 91- 0583891) Director of Marketing & Jim (206) 767 -9975 (206) 206-909 - Communications jimm @svdpseattle.org McFarland ext 1104 767 -6439 0839 (Brochures & Publicity Help) Donna (206) 767 -9975 206) 767 - Director of Development donnaw @svdpseattle.org Whitford ext 1132 6439 Human Resources/Volunteer Tammy (206) 767 -9975 (206) tammyh @svdpseattle.org Coordinator Haney ext. 1134 767 -6439 Marketing & Communications Danielle (206) 767 -9975 (206) 206-909 - danieliej @svdpseattle.org Specialist Johnston ext 1100 767 -6439 6296 o4st VIIVe��A � b de c N h O �9 E -KIN�O i 1, J eq � 11 4, Ar 11 0 �- PO � d Hereby Certify: 1) 1 am the President of the Board of Directors of the Society of St. Vincent de Paul Council of Seattle /King County - A Washington nonprofit corporation. 2) In executive session at its regular meeting on march 15, 2011, the Board of Directors of the Society voted to offer the position of Executive Director to Mr. Ned Delmore 3) Ned Delmore accepted the offer and began employment as Executive Director of the Society on April 4, 2011. 4) In accordance with the formal bylaws and Executive limitations the Executive Director has the authority to enter into contracts on behalf of the Society. Dated in Seattle on this day of , 201-5- 111 ► /l 111 .-- J�n Morford, Board President oUthe Society of St. Vincent de Paul Council of Seattle /King County St. Vincent de Paul of Seattle I King County 5950 4th Avenue South I Seattle, WA 981081 P: 206 -767 -99751 F: 2061767 -6439 www.svdpseattle.org CITY OF 4V � Federal WaA CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.dtyaflederaMWcom City of Federal Way Human Services Contract for 2015 -2016 General Fund -Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf of: 5n 1110 c e � r 12c ra w1 SoGt rT�r S'1. saw �LeKC Contracting Agency), for the following: 45-S i S-1 a 14 e-e, (Program Title). Authorizing Signature: (must be signed by person who signs the contract, generally, Executive Director) Additional Authorized Signature: Additional Authorized Signature: '(Printed Name) (Title) �Z'o (Signature) s 1, J-VSe & oko bt L V2 cc - S 1 jeA-" (Printed Name) (Title) tlV l 0 at , ' i�6N� l�JItO 7d1,C,�u j (Printed Name) (Title) ( Signa0bre) i 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. I I RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: CD/CS 2. ORIGINATING STAFF PERSON:_DEE DEE CATALANO 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.G.BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT(AG#): ❑ INTERLOCAL ❑ OTHER 5. PROJECT NAME: EMERGENCY HUMAN SERVICES 6. NAME OF CONTRACTOR: ST.VINCENT DE PAUL OF SEATTLE-KING COUNTY ADDRESS: 3939 SW 331ST STREET,FEDERAL WAY,WA 98023 TELEPHONE E-MAIL: FAX: SIGNATURE NAME: TITLE 7. EXHIBITS AND ATTACHMENTS:X SCOPE,WORK OR SERVICES X COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE X ALL OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: 01/01/2015 COMPLETION DATE:_12/31/2016 9. TOTAL COMPENSATION $40,000 (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: 001-7300-083-562-10-410 10. DOCUMENT/CONTRACT REVIEW Ar IA /DA' ' VIEWED INITIAL/DATE APPROVED PROJECT MANAGER wANIETE7 z0/� DIRECTOR ❑ RISK MANAGEMENT (IF APPLICABLE) ❑ LAW 11. COUNCIL APPROVAL(IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING ZZ ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: .-1: DATE REC'D: .• ❑ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFI ATE,LICENSES,EXHIBITS I►.t,IAL/DATE SIGNED C9'(AW DEPARTMENT OF STAFF // Z/2/2 IGNATORY(MAYOR OR DIRECTOR) ' �'�� CITY CLERK ,4j1 , r.1 ASSIGNED AG# AG#— 1 L?O SIGNED COPY RETURNED DATE SENT: O c j l 3 12-Q 1 COMMENTS: - C NodU 144 rI e-(P . G a kia iefim 11/9 ` CITY OF CITY HALL 4.4. „__ Federal Way 33325 8th Avenue South Federal Way,WA 98003 003 -6325 (253)835-7000 www cityoffederaiway com HUMAN SERVICES AGREEMENT FOR EMERGENCY HUMAN SERVICES This Human Services Agreement("Agreement")is made between the City of Federal Way,a Washington municipal corporation("City"),and St.Vincent de Paul of Seattle-King County,a nonprofit agency("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: ST.VINCENT DE PAUL OF SEATTLE-KING CITY OF FEDERAL WAY: COUNTY Denise Catalano Joseph Roni 33325 Stn Ave. S. 3939 SW 331St Street Federal Way, WA 98003-6325 Federal Way, WA 98023 (253) 835-2651 (telephone) (253) 835-2609 (facsimile) (253) 838-8919(telephone) Denise.catalano @cityoffederalway.com roniconsulting @msn.com The Parties agree as follows: 1. TERM. The term of this Agreement shall be for a period of two (2) years commencing on January 1, 2015 and terminating on December 31, 2016("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 maybe 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 shall begin immediately upon the effective date of this Agreement.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 shall 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 - 1/2015 CITY OF CITY HALL 1.... 33325 8th Avenue South Federal Way Federal Way,WA 98003 003 -6325 (253) 835-7000 www cityoffederalway com 4.2 Method of Payment.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 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 final 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 shall 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 Budget.The Agency shall apply the funds received from the City under this Agreement 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 shall 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 Agency 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 - 1/2015 CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South Federal Way,WA 98003-6325 (253)835-7000 www atyoffederalway 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$2,000,000 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 Liability.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 shall 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 all commercial general liability policies attached hereto as Exhibit"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 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. CONFIDENTIALITY.All information regarding the City obtained by Agency in performance of this Agreement shall 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 remaining in the possession of Agency shall be delivered to the City. HUMAN SERVICES AGREEMENT - 3 - 1/2015 4%6 CITY OF CITY HALL I � 33325 8th Avenue South ,,..�.,, e d e a ay Federal Way,WA 98003-6325 (253)835-7000 www cityoffederalway 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 maybe 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 employment.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 confirms 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. EQUAL OPPORTUNITY EMPLOYER.In all 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 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 of this Agreement shall 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 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,maybe amended,waived,or modified except by written agreement signed by duly authorized representatives of the Parties. 13.2 Assignment 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 - 1/2015 CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue South 003 Federal Way,WA 98003-6325 ^...� (253)835-7000 www atyoffederalway corn 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 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 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,Washington, unless the parties agree in writing to an alternative process.fthe;,King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any pthet appro riate court in King County, Washington. Each party consents to the personal jurisdiction of the state and federal courts itf 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 p 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 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 - 1/2015 • CITY OF CITY HALL ,,� . Federal ra I Way 33325 8th Avenue Federal Way,WA 98003 8003 -6325 (253)835-7000 www crtyoffederalway corn IN WITNESS, the Parties execute this Agreement below, effective the last date written below. CITY OF FEDE L WAY ATTEST: Jim Ferret ayor ! lerk, Stephanie Courtn, CMC APPROVED AS TO FORM: DATE: 6741/-5—7 //_ 47(City Attorney,Amy Jo Pearsall ST. VINCENT DE PAUL OF SEATTLE-KING COUNTY By: �� r� � � � r Printed Name: ///'() C � n `„01111,14. Title: �c ,'ce /� .� y Le/ DATE: Y/�„?� 3° + 7:.;N Public • ; STATE OF WASHINGTON ) Oa AS •,. c 'j O f •-........VOA % ss. Was it COUNTY OF kT%Ai ) -h is jl\��i , r On this day personally appeared before me -AAL.j .11.S , to me known to be the L A,,t_ 'L&lx. of 3V 0,,„ ( 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 aa_day of } 6 , 20A5 , Notary's signature � �" (J` tx- , 1, v Notary's printed name '�-jti ir`ir-v__\ Notary Public in and for the State of Washington. My commission expires D j 3 cpo g HUMAN SERVICES AGREEMENT - 6 - 1/2015 Aiihk, CITY OF CITY HALL Fe d e ra I Way 33325 8th Avenue South Federal Way,Avenue 98003-6325 (253)835-7000 www crtyoffederalway corn EXHIBIT A SERVICES Project Summary The Agency shall provide emergency 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: 1st 2nd 3rd 4th Quarter Quarter Quarter Quarter Total JAN.— APRIL— JULY— OCT.— MARCH JUNE SEPT. DEC. No. of unduplicated Federal Way persons assisted in 2015 90 90 90 90 360 No. of unduplicated Federal Way persons assisted in 2016 90 90 90 90 360 B. Units of Service The Agency agrees to provide, at minimum,the following units of service by quarter: 1st Quarter 2nd 3rd 4th JAN.— Quarter Quarter Quarter Total MARCH APRIL— JULY— OCT.— JUNE SEPT. DEC. 2015 1. Financial Aid/Households Served 27 27 27 27 108 2. Home Visits 27 27 27 27 108 2016 1. Financial Aid/Households Served 27 27 27 27 108 2. Home Visits 27 27 27 27 108 HUMAN SERVICES AGREEMENT - 7 - 1/2015 CITY OF CITY HALL .,.�. Fe d e ra I Way 33325 8th Avenue South Federal Way,WA 98003 03 -6325 (253)835-7000 www cityoffederalway com C.Definition of Services 1. Financial Aid: Number of households assisted to help avoid eviction and/or power shut-off, or provide homeless shelter in a motel. 2. Home Visit: Completion of a home visit conducted by two volunteers. D. Performance Measure(s) Outcome(s)to be reported: 1. Individuals and/or families will have secure housing. Records A. Project Files The Agency shall maintain files for this project containing the following items: 1. Notice of Grant Award. 2. Motions,resolutions, or minutes documenting Board or 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 - 1/2015 44kii. CITY OF CITY HALL 33325 8th Avenue South Federal Way Federal Way,WA 98003-6325 (253)835-7000 www cityoffederalway com 9. 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. King County FY 2015 Income Limits Summary Median FY 2015 Income Income 1 2 3 4 5 6 7 8 King Limit Person Persons Persons Persons Persons Persons Persons Persons County Category • Extremely Low (30%) $18,850 $21,550 $24,250 $26,900 $29,100 $32,570 $36,730 $40,890 Income Limits Very Low $89,600 (50%) Income $31,400 $35,850 $40,350 $44,800 $48,400 $52,000 $55,600 $59,150 Limits Low (80%) $46,100 $52,650 $59,250 $65,800 $71,100 $76,350 $81,600 $86,900 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(on the dates outlined in Exhibit B) and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall also submit a quarterly Narrative Report describing the program's accomplishments and explaining any variance in quarterly service units that is more than twenty-five percent over or under the quarterly goal. 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 - 1/2015 CITY OF CITY HALL 1116, ...- Federal Way Fe 8th Avenue South 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$40,000. A. City of Federal Way Funds 2015 2016 City of Federal Way General Fund: $20,000 $20,000 Total City of Federal Way Funds: $20,000 $20,000 B.Line Item Budget 2015 2016 Personnel Services(detail below) $ $ Office or Operating Supplies $ $ Rent&Utilities $ $ Communications $ $ Travel and Training $ $ Direct Assistance(Utilities, Rent) $20,000 $20,000 Client Travel $ $ Administration(Overhead) $ $ Total City of Federal Way Funds: $20,000 $20,000 C.Personnel Detail Position Full Annual Salary Position Title Time Equivalent and Benefits HS Funds N/A N/A N/A N/A Total: $ $ Reimbursement Requests and Service Unit Report forms shall be submitted no less frequently than quarterly and are due on the following dates: 1st 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- 1/2015 CITY OF CITY HALL 33325 Federal Way Feder 8th Avenue 50 Federal Way,WA 98003-6325 3-6325 (253)835-7000 www cityoffederalway corn Estimated Quarterly Payments: 2015 1st Qtr $5,000 2nd Qtr $5,000 3rd Qtr $5,000 4th Qtr $5,000 2016 1st Qtr $5,000 2nd Qtr $5,000 3rd Qtr $5,000 4"'Qtr $5,000 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 any specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. HUMAN SERVICES AGREEMENT - 11 - 1/2015 • Princeton The Princeton Exams and Surds Lines Insurance Company 555 College Road East, Princeton, New Jersey 08543-5241 Phone: (800)305-4954 POLICY NUMBER: N2-A3-EX-0000008-00 GENERAL LIABILITY NAMED INSURED: The Religious and Charitable Risk Pooling Trust Of the Brothers of the Christian Schools and Affiliates COVERAGE TERM: 6/15/2014 to 06/15/2015 THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under SECTION H INSURING AGREEMENT C, GENERAL LIABILITY COVERAGE defined within the Coverage Agreement. SECTION I: Schedule Name of Additional Insured Persons) Designated Location(s)Of Covered Or Organization(s): Operations: - ANY PERSON OR ORGANIZATION WHEN YOU HAVE AGREED IN A WRITTEN CONTRACT FOR THAT PERSON OR ORGANIZATION TO BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY If no entry appears above, information required to complete this endorsement will be shown in the Certificate of Coverage as applicable to this endorsement. Section II Insuring Agreement C—Name of Insured Amended A. Who Is An Insured defined in the General Insurance Agreement is amended to include as an Additional Insured the person(s)or organization(s)shown in the Schedule above,but only with respect to liability in the performance of the Named Insured's ongoing operations for the Additional Insured(s) at the Location(s) designated in the Schedule above for"bodily injury"or"property damage", caused in whole or in part, by the Named Insured's acts or omissions which takes place after the execution of a written agreement with the Additional Insured(s). B. For the coverage provided by this endorsement:the following paragraph is added to Section IV—General Conditions, Section II, Insuring Agreement C-General Liability. This insurance is primary insurance as respects to this coverage to the additional insured person or organization, where the written contract or written agreement requires that this insurance be primary and noncontributory. In that event, we will not seek contribution from any other insurance policy available to the additional insured on which the additional insured person or organization is a Named Insured. C. Who Is An Insured is also amended to include as an additional insured the person(s) or.organization(s) shown in the Schedule, with respect to liability for "bodily injury' or "property damage" caused, in whole or in part, by the "Named Insured's work"at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the"products-completed operations hazard". D. The insurance provided to the additional insured person or organization does not apply to: Bodily Injury, Property Damage or Personal or Advertising Injury arising out of the rendering or failure to render any professional architectural, engineering or surveying services including: 1. The preparing, approving or failing to prepare or approve maps, shop drawings, opinions, reports, surveys,field orders, change orders or drawings and specifications; 2. Supervisory, inspection, architectural or engineering activities. Section IV • All Other terms and conditions of the Insuring Agreement remain unchanged. Administration -- St. Vincent De Paul Seattle/King County Council Staff DEPARTMENT NAME PHONE FAX CELL EMAIL (206)767-9975 (206) VExecutive Director Ned Delmore nedd @svdpseattle.org ext 1105 767-6439 (206)767-9975 (206) Deputy Director Steve Knipp stevek @svdpseattle.org ext 1123 767-6439 Director of Finance (206)767-9975 (206) (Tax ID Number Eddie Roldan eddier @svdpseattle.org ext 1101 767-6439 91-0583891) Director of Marketing& Jim (206)767-9975 (206) 206-909- Communications jimm @svdpseattle.org McFarland ext 1104 767-6439 0839 (Brochures&Publicity Help) Donna (206)767-9975 206)767- Director of Development donnaw @svdpseattle.org Whitford ext 1132 6439 Human ResourcesNolunteer Tammy (206)767-9975 (206) tammyh @svdpseattle.org Coordinator Haney ext. 1134 767-6439 Marketing&Communications Danielle (206)767-9975 (206) 206-909- 9 (2 ) ( ) daniellej @svdpseattle.org Specialist Johnston ext 1100 767-6439 6296 I , cs.S1 VINO. 87 lb n b C 9TTLE-KING We'll Be There. J✓1-7 I-i 4 iv o c-0 V Hereby Certify: 1) I am the President of the Board of Directors of the Society of St. Vincent de Paul Council of Seattle/King County-A Washington nonprofit corporation. 2) In executive session at its regular meeting on march 15, 2011,the Board of Directors of the Society voted to offer the position of Executive Director to Mr. Ned Delmore 3) Ned Delmore accepted the offer and began employment as Executive Director of the Society on April 4, 2011. 4) In accordance with the formal bylaws and Executive limitations the Executive Director has the authority to enter into contracts on behalf of the Society. Dated in Seattle on this S day of sf/a,y , 20 1S- 94 l J n Morford, Board President o the Society of St. Vincent de Paul Council of Seattle/King County St.Vincent de Paul of Seattle I King County 5950 4th Avenue South I Seattle,WA 98108 I P: 206-767-9975 I F:206 1 767-6439 www.svdpseattle.org CITY OF CITY HALL 33325 8th Avenue South �.„ Federal VVay Federal Way,WA 98003-6325 (253) 835-7000 www cityoffederaiway.com City of Federal Way Human Services Contract for 2015-2016 General Fund Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf of: 5f (f f"i c e n fi pc raw, Soct e si 74e-re-.;(6 Ca, tic u- Contracting Agency), for the following: El'it w j r/ri cej Ass (Program Title). Authorizing Signature: ✓e `9 �-l�a0r� 1C e G u. �(must be signed by 41/e-- (1) Tinted ame) (Title) person who signs the contract, generally, Executive Director) (Signature) (Da ) Additional Authorized Signature: J©S('fl4) ROO i VI nre.Si de-14_-f- (Printed Name) (Title) /,, ,J fovt4: —ft- or (;':gnat re) (Date) Additional Authorized ` • // Signature:9 V 4./Nl o Ee-€A/Gt, ?,s.tdag,A/f (Print Name) (Title)/g/A /4 5 (Signature) (Da e) 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.