AG 16-146RETURN TO: b Dlv i c( C l e vvt o h S
EXT: 14-1,
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CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT/DIV: PARKS
2. ORIGINATING STAFF PERSON: b &v 1 el StAk �
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
❑ CONTRACT AMENDMENT (AG #):
X OTHER M.0 U
EXT: l5 3. DATE REQ. BY:
❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ MAINTENANCE AGREEMENT
❑ HUMAN SERVICES / CDBG
❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ RESOLUTION
❑ INTERLOCAL
5. PROJECT NAME: S.nni p v Mee.. t' fir+{ j Pr q r a yvl
4"p
6. NAME OF CONTRACTOR: IT yGV a ��e 1n S-7i it Giv 1nJ - --nite. V. p• C00'I �j P_ V1.1 G V' rj
ADDRESS: No Bp )c 4lea..3 1~ vk) a D 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
CFW LICENSE # BL, EXP. 12/31/ UBI # , EXP. 11 / /
1 1' 11 COMPLETION DATE: L Z! 31 J 1 e
A (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHAR E - 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, $
8. TERM: COMMENCEMENT DATE:
9. TOTAL COMPENSATION: $
❑ PURCHASING: PLEASE CHARGE To:
10. DOCUMENT / CONTRACT REVIEW
PROJECT MANAGER
SUPERVISOR
❑ IRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW DEPT
11. COUNCIL APPROVAL (IF APPLICABLE)
t
PAID BY: ❑ CONTRACTOR ❑ CITY
INITI L / 7 _ ttIiobi TE REVIEWED INITIAL / DATE APPROVED
COMMITTEE APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT T O VENDOR/CONTRACTOR D A T E SENT: 1 1 1 11' I I.
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ LAW DEPT
❑ SIGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG #
❑ SIGNED COPY RETURNED
❑ RETURN ONE ORIGINAL
COMMENTS:
COUNCIL APPROVAL DATE:
DATE REC'D: 12-1 18 I I I
11/9
Memorandum of Understanding
Senior Meal Program
City of Federal Way and Evergreen Club — The Korean Seniors
THIS MEMORANDUM OF UNDERSTANDING (MOU), dated effective theist day of January 2017, defines
the respective responsibilities of the City of Federal Way ( "City ") and Evergreen Club — The Korean Seniors, a
Washington corporation ( "Evergreen Club ") in connection with the senior meal program at the Federal Way
Community Center ( "FWCC ").
Background
A. The City and Evergreen Club desire to enter an agreement for use of space at the Federal Way
Community Center for a twice weekly meal program from January 1, 2017 through December 31, 2018.
B. The City of Seattle has provided funding for a congregate meal program to the Evergreen Club to serve
an unmet need in the community. The congregate meal program is donation -based and provides warm
nutritious meals to low income seniors.
C. The City of Federal Way will provide space at the Federal Way Community Center located at 876 S
333rd Street, Federal Way WA. 98003 for the purpose of offering an ethnic low income congregate meal
program provided by the Evergreen Club.
D. The Evergreen Club has permission to use the community rooms and kitchen or other space designated
by the Federal Way Community Center on Tuesdays and Thursdays from 8:OOam - 1:OOpm.
E. No party shall be responsible for events that are unforeseeable and beyond its reasonable control, such
as acts of God, weather delays or government restrictions.
F. This MOU may be terminated by either party with a minimum 30 day notice.
NOW, THEREFORE, the parties agree as follows:
City Responsibilities. The City agrees to:
• Provide dining areas and kitchen facilities on the days and times outlined above.
• Provide tables, chairs and appropriate kitchen equipment.
• Provide a minimum of ten days advance notice of any schedule changes or conflicts that may
result in canceled or reduced space.
• Limit the amount of changes or conflicts that may result in canceled or reduced space to no more
than two dates per month with the exception of holidays and FWCC annual closure week.
II. Evergreen Club Responsibilities. Evergreen Club agrees to:
• Acknowledge that this agreement is for temporary use of space at the FWCC and will develop an
alternative location for continuation of services in 2019. It is understood that a request may be
made at the end of this term to continue the senior meal program at the FWCC.
• Provide a congregate meal program at the FWCC on the days and times outlined above.
• Provide qualified cooks who hold current required permits and training.
• Purchase and provide all food at sole expense.
• Purchase and provide all paper and plastic products including, but not limited to plates, napkins
and utensils at sole expense.
• Clean the community rooms, kitchen and all equipment after each use.
• Solely manage inventory of food to insure safety and freshness.
• Take sole responsibility for any fines incurred due to violations of health codes.
• Provide and maintain a comprehensive general liability insurance policy with limits of Two
Million dollars ($2,000,000.00) per occurrence specifically naming the City of Federal Way as
additionally insured. This policy shall include personal injury, bodily injury or property claims of
the Evergreen Club services and its agents.
• Report any damage or malfunctioning equipment to designated FWCC staff upon discovery.
• Repair or replace any damaged equipment caused by misuse by the Evergreen Club at sole
expense.
• Use only assigned refrigerator storage space that has been designated by FWCC staff
• Assist in paying for quarterly kitchen cleanings, limited to no more than the amount of $500.00
per quarter.
• This MOU sets forth the intent of the parties herein.
[Signature page follows]
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY:
ATTEST:
John t'. n, Parks D -ctor C' C erk, Stephanie I ney, CMC
DATE: /LAS //4
EVERGREEN CLUB – THE KOREAN SENIORS:
Printed Name: C. (,( N.C, S-31►14 //Mif
Title: Q/e/(,( /—
DATE: �"2. p r' /b
STATE OF WASHINGTON )
t
COUNTY OF 1 )‘ r ) ss.
APPROVED AS TO FORM:
c�v e
City Attorney, 4S11 C
On this days personally appeared before me / V , U u i (9 5)49 me known to be the
1V1.`13';11,)/P/1 of � 0 Ail-ti ( that executed the foregoing
instrument, aid 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 `zY"day of 0 , 20 /
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=�,)\- ,,,\\‘‘\\11,„ / /// Notary's signature
- -`o� P Y `S '' %,�'O /�,� Notary's printed name 6 /141_ j C� tiR :�C.1i 2 �0 o 0 o,, Notary ublic in and r the State o Was ingto
S t,2 , p J0 O„' = r My commission expires & 4° 17th Yp/
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