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AG 17-058
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 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCUMENT (E.G., ❑ PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ REAL ESTATE DOCUMENT ❑ ORDINANCE ❑ CONTRACT AMENDMENT (AG #): ❑ OTHER EXT: 2651 3. DATE REQ. BY: RFB, RFP, RFQ) ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ MAINTENANCE AGREEMENT x HUMAN SERVICES / CDBG ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ RESOLUTION ❑ INTERLOCAL 5. PROJECT NAME: DOMESTIC VIOLENCE COMMUNITY ADVOCACY PROGRAM 6. NAME OF CONTRACTOR: _CONSEJO COUNSELING AND REFERRAL SERVICE ADDRESS: V& fat . y� $ 1p, WA- ggy1A TELEPHONE - 4 t - 4f t E -MAIL: Mtvit � edvad �.o M., CMA €.0 j FAX: MIA - SIGNATURE NAME: M,A1(. o ` , /04_ a TITLE ai, 1: wt, fi1yeljeArnt, 7. EXHIBITS AND ATTACHMENTS: fa SCOPE, WORK OR SERVICES ® COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE X ALL OTHER REFERENCED EXHIBITS x PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS 8. TERM: COMMENCEMENT DATE: 01/01/2017 COMPLETION DATE: 12/31/2018 9. TOTAL COMPENSATION $ 24,000.00 (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: 001- 7300 - 083 - 562 -10 -410 10. DOCUMENT /CONTRACT REVIEW ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISK MANAGEMENT OF APPLICABLE) ❑ LAW 11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: INITIAL / DATE APPROVED COUNCIL APPROVAL DATE: 12. CONTRACT SIGNATURE ROUTING FT SENT TO VENDOR/CONTRACTOR DATE SENT: ,3/ /0Pl q" DATE REC'D: I�.ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIF CATE, LICENSES, EXHIBITS ❑ LAyW DEPARTMENT poSIGNATORY (Aiwa( OR DIRECTOR) ❑ CITY CLERK ❑ ASSIGNED AG# ❑ SIGNED COPY RETURNED COMMENTS: INITIAL / DATE S G D 3 1 if 7ft7 AG# lq -05V" DATE SENT: c*10-11 p/37' 0( 7- CITY oc Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com HUMAN SERVICES AGREEMENT FOR DOMESTIC VIOLENCE COMMUNITY ADVOCACY PROGRAM This Human Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal corporation ( "City "), and Consejo Counseling and Referral Service, a Washington nonprofit corporation ( "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: CONSEJO COUNSELING AND REFERRAL SERVICE: Mario Paredes 3808 South Angeline Street Seattle, WA 98118 (206) 461 -4880 (telephone) marioparedes@consejocounseling.org CITY OF FEDERAL WAY: Sarah Bridgeford 33325 8th Ave. S. Federal Way, WA 98003 -6325 (253) 835 -2651 (telephone) (253) 835 -2609 (facsimile) Sarah.Bridgeford@cityoffederalway.com The Parties agree as follows: 1. TERM. The term of this Agreement shall be for a period commencing on January 1, 2017 and terminating on December 31, 2018 ( "Term "). Funding for the second year of the Agreement is contingent upon satisfactory 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 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 the Agency of responsibility for performance of the Services in accordance with this Agreement, notwithstanding the City' s knowledge of defective or non - complying performance, its substantiality or the ease of its discovery. 3. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days' written notice at its address set forth above. The City may terminate this Agreement immediately if the Agency fails to maintain required insurance, breaches confidentiality, or materially violates Section 12, and such may result in ineligibility for further City agreements. 4. COMPENSATION. 4.1 Amount. In return for the Services, the City shall pay the Agency an amount not to exceed a maximum amount and according to a rate or method as delineated in Exhibit B, attached hereto and incorporated by this reference. The City shall reimburse the Agency only for the approved activities and in accordance with the procedures as specified in Exhibit B. The Agency shall be solely responsible for the payment of any taxes imposed by any lawful jurisdiction resulting from this Agreement. HUMAN SERVICES AGREEMENT 1 4/2015 CITY OF .�, Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -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 4/2015 CITY Federal Way CITY HALL 33325 8th Avenue South Federal Way. WA 98003 -6325 (253) 835 -7000 www cityoffederalway 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 subcontractors 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 the 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 shall 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 4/2015 444■._ Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway corn 9. BOOKS AND RECORDS. The Agency agrees to maintain books, records, and documents which sufficiently and properly reflect all direct and indirect costs related to the performance of the Services and maintain such accounting procedures and practices as may be deemed necessary by the City to assure proper accounting of all funds paid pursuant to this Agreement. These records shall be maintained for a period of six (6) years after the termination of this Agreement and may be subject, at all reasonable times, to inspection, review or audit by the City, its authorized representative, the State Auditor, or other governmental officials authorized by law to monitor this Agreement. 10. INDEPENDENT CONTRACTOR. The Parties intend that the Agency shall be an independent contractor 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, may be 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 - 4/2015 AN4.S■.- Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www.cityoffederalway.com assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. Subject to the foregoing, the rights and obligations of the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs and assigns. This Agreement is made and entered into for the sole protection and benefit of the Parties hereto. No other person or entity shall have any right of action or interest in this Agreement based on any provision set forth herein. 13.3 Compliance with Laws. The Agency shall comply with and perform the Services in accordance with all applicable federal, state, local, and city laws including, without limitation, all City codes, ordinances, resolutions, regulations, rules, standards and policies, as now existing or hereafter amended, adopted, or made effective. If a violation of the City's Ethics Resolution No. 91 -54, as amended, occurs as a result of the formation or performance of this Agreement, this Agreement may be rendered null and void, at the City's option. 13.4 Enforcement. Time is of the essence of this Agreement and each and all of its provisions in which performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the Agency' s performance of this Agreement. Any notices required to be given by the Parties shall be delivered at the addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the notice or maybe 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. If the King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are an inconvenient forum. If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney' s fees and expenses incurred in defending or bringing such claim or lawsuit, including 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 4/2015 CITY OF Federal Way CITY HALL 33325 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: DATE: 4/41 th 7 CONSEJO COUNSELING AND REFERRAL SER E: 1 By: ck" i . Tact/ it Printed Name: Rana c, r.(1ck 1 Title: ktt1c> 1)( JI�(IoZQ+i�- DATE: ATTEST: h.nie Courtney, CMC, Clerk APPROVED AS TO FORM: J. Ryan Call, City Attorney STATE OF WASHINGTON ) ) ss. COUNTY OF KING ) On this day personally appeared before me MQ -Q E . Pa pats , to me known to be the LXQu.c.v`� Dir -tCTDr of Qons..jo awns.#icn aetd "l ke.rrJ (-via-that executed the foregoing instrument, and acknowledged the said instrument to be eie 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 Zc+ ' day of Notary' Notary' Notary Public State of Washington LIDIA C ESCOTO My Appointment Expires May 6, 2019 HUMAN SERVICES AGREEMENT N10,icL , 20 i4 s signature . s printed name Lid1.;:a. C__ Es Notary Public in and for the State of Washington. My commission expires t41 6 4/2015 CITY OF Federal Way EXHIBIT A SERVICES CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway. com Project Summary The Agency shall provide advocacy, counseling, and support groups to survivors of domestic violence in the City of Federal Way. The Agency shall ensure that services provided with funding under this Agreement are made available to Federal Way residents. Performance Measures A. Number Served The Agency agrees to serve, at minimum, the following unduplicated number of Federal Way residents with Human Services funds: B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: 1st Quarter JAN. — MARCH 2nd Quarter APRIL — JUNE 211d Quarter APRIL — JUNE 4th ter Quarter OCT. — DEC. 3rd Quarter JULY — SEPT. 4th Quarter OCT. — DEC. Total No. of unduplicated Federal Way persons assisted in 2017 3 1. Advocacy 3 9 3 9 3 12 No. of unduplicated Federal Way persons assisted in 2018 13 3 13 3 3. Support Group 3 3 3 12 B. Units of Service The Agency agrees to provide, at minimum, the following units of service by quarter: HUMAN SERVICES AGREEMENT - 1 HSA Exh 1/2017 1St Quarter JAN. — MARCH 2nd Quarter APRIL — JUNE 3rd Quarter JULY — SEPT. 4th ter Quarter OCT. — DEC. Total 2017 1. Advocacy 9 9 9 9 36 2. Counseling 13 13 13 13 52 3. Support Group 3 3 3 3 12 2018 1. Advocacy 9 9 9 9 36 2. Counseling 13 13 13 13 52 3. Support Group 3 3 3 3 12 HUMAN SERVICES AGREEMENT - 1 HSA Exh 1/2017 4■‘, Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway.. com C. Definition of Services 1. Advocacy is measured by hours of service. 2. Counseling is measured by hours of counseling. 3. Support Groups is measured by hours received per client; each one (1) client that receives one (1) hour of service equates to one (1) service unit. D. Performance Measure(s) Outcome(s) to be reported: 1. Improved understanding of domestic violence. 2. Improved knowledge of community resources. 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 the Agency's Board or Council actions. 3. A copy of this Agreement with the Scope of Services. 4. Correspondence regarding budget revision requests. 5. Copies of all invoices and reports submitted to the City for this project. 6. Bills for payment with supporting documentation. 7. Copies of approved invoices and warrants. 8. Records documenting that costs reimbursed with funding provided under this Scope are allowable. Such records include, but are not limited to: • for personnel costs, payroll for actual salary and fringe benefit costs. • for staff travel, documentation of mileage charges for private auto use must include: a) destination and starting location, and b) purpose of trip; and • for copy machine use, postage, telephone use, and office supplies when these costs are shared with other programs and no invoice is available, log sheets or annotated invoices. HUMAN SERVICES AGREEMENT 2 HSA Exh 1/2017 444, Pecleral Way CITY HALL 33325 8th Avenue South 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. The Agency agrees to use updated Income Guidelines which will be provided by the City. King County FY 2016 Income Limits Summary Median Income King County FY 2016 Income Limit Category 1 Person 2 Persons 3 Persons 4 Persons 5 Persons 6 Persons 7 Persons 8 Persons $90,300 Extremely Low (30 %) Income Limits $19,000 $21,700 $24,400 $27,100 $29,300 $32,580 $36,730 $40,890 Very Low (50%) Income Limits $31,650 $36,150 $40,650 $45,150 $48,800 $52,400 $56,000 $59,600 Low (80 %) Income Limits $48,550 $55,450 $62,400 $69,300 $74,850 $80,400 $85,950 $91,500 Reports and Reporting Schedule The Agency shall collect and report client information to the City quarterly and annually on a Service Unit Report to be provided by the City in the format requested by the City. The Agency shall submit an Annual Demographic Data Report. The agency shall collect and retain the data requested on this form from the persons served through this contract. Data should be tracked in an ongoing mariner 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 - 3 - HSA Exh 1/2017 Vecleral Way EXHIBIT B COMPENSATION CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway.. com 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 Twenty -Four Thousand and 00 /100 Dollars ($24,000.00). A. City of Federal Way Funds 2017 2018 City of Federal Way General Fund: $12,000.00 $12,000.00 Total City of Federal Way Funds: $12,000.00 $12,000.00 B. Line Item Budget 2017 2018 Personnel Services (detail below) $10,588.04 $11,013.34 Office or Operating Supplies $45,864.00 $8,026.20 Rent & Utilities 1.0 $73,1 95.00 Communications $128.94 $144.20 Travel and Training $1,283.02 $842.46 Other (specify): Client Travel Administration (Overhead) Total City of Federal Way Funds: $12,000.00 $12,000.00 C. Personnel Detail 2017 Position Title Position Full Time Equivalent Annual Salary and Benefits HS Funds DV Advocate 1.0 $45,864.00 $8,026.20 DV Supervisor 1.0 $73,1 95.00 $2,561.84 Total: 2.0 $119,059.00 $10,588.04 C. Personnel Detail 2018 Position Title Position Full Time Equivalent Annual Salary and Benefits HS Funds DV Advocate 1.0 $47,794.20 $9,499.44 DV Supervisor 1.0 $75,695.09 $1,513.90 Total: 2.0 $119,059.00 $11,013.34 HUMAN SERVICES AGREEMENT 4 HSA Exh 1/2017 4AL., Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cityoffederalway com 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. Estimated Quarterly Payments: 2017 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr 2018 1St Qtr 2nd Qtr 3rd Qtr 4th Qtr $3,000.00 $3,000.00 $3,000.00 $3,000.00 $3,000.00 $3,000.00 $3,000.00 $3,000.00 Expenses must be incurred prior to submission of quarterly reimbursement requests. Proof of expenditures must be attached to the reimbursement request for invoice to be approved. Quarterly reimbursement requests shall not exceed the estimated payment without prior written approval from the City. Estimated quarterly payments are contingent upon meeting or exceeding the above performance measure(s) for the corresponding quarter. This requirement may be waived at the sole discretion of the City with satisfactory explanation of how the performance measure will be met by year -end on the Service Unit Report. Conditions of Funding The Agency agrees that it will meet the specific funding conditions identified for the Agency and acknowledges that payment to the Agency will not be made unless the funding conditions are met. HUMAN SERVICES AGREEMENT 5 HSA Exh 1/2017 CONSE -1 OP ID: K1 ACORL7 kitar CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 03/29/2017 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 Brown & Brown of Washington 2106 Pacific Ave, Ste 501 Tacoma, WA 98402 Kim Wilson CONTACT Kim Wilson _ PHONE FAX (A/C, No, ExU: 253- 396 -5500 (ac, No): 253- 396 -4500 EMAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Philadelphia Indemnity Ins. Co 18058 INSURED Consejo Counseling & Referral Service 3808 S Angeline St Seattle, WA 98118 INSURER B : PHPK1502876 INSURER C : 06/01 /2017 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X PHPK1502876 06/01/2016 06/01 /2017 EACH OCCURRENCE $ 1,000,000 AMAGE-TO RENTED PREM SES Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 X WA Stop Gap GENERAL AGGREGATE $ 3,000,000 GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP/OP AGG $ 3,000,000 Emp Ben. $ 1,000,000 A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS AUTOS ED PHPK1502876 06/01/2016 06/01/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILYINJURY(Perperson) $ BODILY INJURY (Per accident) $ (Per accidentDAMAGE $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE PHUB542744 06/01/2016 06/01/2017 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 Prof /Liab $ Included DED X RETENTION$ 10,000 WORKERS COMPENSATION AND EMPLOYERS' UABIUTY Y ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A PER STATUTE ER H E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ A Professional Liab Claims Made PHPK1502876 RETRO 8/17/1992 06/01/2016 06/01/2017 Incident 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITYOI8 City of Federal Way 33325 8th Ave S. Federal Way, WA 98003 -6325 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE THEREOF, THDTHE POLICY PROVISIONSE WILL BE DELIVERED IN ACCORDANCE EXPIRATION AUTHORIZED REPRESENTATIVE IV ACORD 25 (2014/01) © 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTEPAD: HOLDER CODE CITYOI8 INSURED'S NAME Consejo Counseling CONSE -1 PAGE 2 OP ID: K1 Date 03/29/2017 Certificate Holder is Additional Insured as required by written contract Federal Way CITY HALL 33325 8th Avenue South Federal Way, WA 98003 -6325 (253) 835 -7000 www cilyoffederalway com City of Federal Way Human Services Contract for 2017 -2018 General Fund Authorized Signatures for Invoices I authorize the following individuals to sign invoices and quarterly reports on behalf of: Conseio Counseling and Referral Service (Contracting Agency), for the following: Domestic Violence Advocacy Program (Program Title). Authorizing Signature: (must be signed by person who signs the contract, generally, Executive Director) 01 TO. , (Printed Nam (Signature) CLiki,L73 6,*--c-CA■OL A)cf(LCA-c"r (Title) 3 LIs-t 13C3n-- (Date) Additional Authorized Signature: Additional Authorized Signature: i clR lt‘Dp cutio-\ (Printed Name) (Title) f\)\j'Al6U ZC?1(\1 Date (Signature) ( ) (Printed Name) (Title) (Signature) (Date) Note: It is the responsibility of the contractor to inform the City of Federal Way if they wish to add a name to or delete names from this list. CONSEJO COUNSELING AND REFERRAL SERVICE Client: 0EA68 Employee Roster Generated (03/29/2017 06:07:40 PM) Employee Code Employee Name Position Employee Status DOI. Status Department Desc 1807 ABREU, DAISY L 1796 ARELLANO, BRENDA KARINA 1787 AYALA, NANCY 1775 BARAJAS, SHAILA 1505 BARBOZA, MAYOLA 1749 BAUTISTA,KRYSTAL 1643 BEHRENS, RACHAEL ISAACS 1805 BERLEY, MARCUS P 1511 BOSCHMA, SHANA M. 1802 BURGOS, KAREN M 1517 CAPESTANY, CLAUDIA L. 1799 CELLA PUCHALVERT, LEONARDO 1602 CHAVEZ, HERBERT ALEXANDER 1797 CORDOVA, STEPHANIE 1521 CURIO, CARLA 1723 DEESE, LOURDES R 1523 DIAZ, LUIS MIGUEL 1777 DIAZ, LUZ E 1779 DIAZ, VERONICA I 1673 DRAPER, LETICIA 1630 EGOAVIL, XIMENA 1758 ELLEZ, BRIAN C 1525 ELMENDORF, YVONNE 1733 ENCALADA, CARLOS E 1526 ESCOTO, LIDIA C. 1792 FLORES, CYNTHIA M 1800 FLORES, LUZ E 1530 FLORES, RAQUEL G. 1803 GAINES, APPOLLONIA M 1747 GAVINO, CELESTINO B 1804 GENTRY, ASHLEA B 1699 GOMEZ - PULLIG, MARIA 1702 GRISSOM, NICOLE 1642 GUZMAN, NORMA 1731 JARAYSA, ILYAS I 1761 JERAISEH, DAVID E 1744 JUSCAMAITA, NANCY 1788 KMETZ, BRANDY LEIGH 1542 LAINEZ, MELANIE 1798 LOI, ANGELA LAI I 1783 LOPEZ CALVILLO, ELIZABETH 1545 LOPEZ MENDEZ, ELISA M. 1793 LOPEZ, MARTHA A 1753 MERINO, MAIAH ALICIA 1670 MONTELONGO, CYNTHIA 1557 MORENO, LUIS 1700 MUNOZ, RUTH E 1790 NIELSEN, BRIAN K 1559 NUANEZ -OLIVARES, CRUCITA 1763 NUNEZ, MARIA - ALEXANDRA 1789 OLMOS, ANNETTE H 1560 ORELLANA, LESBIA GUILLERMINA 1780 OSEGUEDA JUAREZ, FABIOLA 1561 OVIEDO, LAURA 1562 PAREDES, MARIO E. 1745 PARK, ISSA L. 1564 PARTIDA LOPEZ, ZORAIDA 1785 PEREZ BADILLO, JAIRO 1566 PEREZ M.D., ROMELIA 1765 PETRALIA, MARIA IRASEMA 1768 PICKETT, CRISTALJ 1801 PRIZONT, EVELYN S 1786 RAMIREZ, JESSICA G 1509 RAYMOND, ALEXANDRA 1692 ROBLES, ARTURO 1806 ROSAS, NANCY R 1668 RUIZ, SHEILA 1738 SANCHEZ, GABRIELA 1769 SANDOVAL ROBLES, SONIA P 1732 SANTIAGO, BEATRIZ 1 of 2 pages Mental Health Therapist CDPT Receptionist High Risk Youth Case Manager CUSTODIAN Mental Health Therapist Child Sexual Assault Therapist Mental Health Therapist Data Management Manager DV Advocate DV Advocate Mental Health Therapist Accounting Clerk High Risk Youth Case Manager CLINICAL SUPERVISOR CDPT Cook Mental Health Therapist Mental Health Therapist Trans Housing Coordinator Mental Health Therapist Mental Health Therapist SUD Supervisor Mental Health Therapist CONTROLLER CDPT Mental Health Therapist Mental Health Therapist Trans Housing Coordinator Accounting Supervisor Grants and Contracts Supervisor CDPT 11' Manager DV Supervisor Mental Health Therapist Mental Health Therapist Mental Health Therapist Mental Health Therapist Mental Health Therapist CLINICAL SUPERVISOR CDPT Lead Receptionist Access to Advocacy Hotline and Outreach Advocacy CLINICAL SUPERVISOR OPERATIONS FACIL177ES SUPERVIS Accounting Clerk MH CASE MANAGER Administrative Supervisor DV Advocate Mental Health Therapist CDPT Sexual Assault Therapist Receptionist Mental Health Therapist Executive Director CLINICAL SUPERVISOR HUMAN RESOURCE MANAGER Peer Specialist Medical Director Clinical Site Supervisor DV Advocate Mental Health Therapist CDPT Mental Health Therapist CDPT Health Records Admin Support Mental Health Therapist Mental Health Therapist Screener i3 paycom. Active Full -Time Active Full -Time Active Full -Time Active Full -Time Active Full -Time Active Part -Time Active Part-Time Active Full -Time Active Full -Time Active Full -Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Part-Time Active Full -Time Active Part-Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Full-Time Active Full-Time Active Full -Time Active Full-Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Full -Time Active Full-Time Active Full -Time Active Full -Time Active Full -Time Active Full -Time Active Full-Time Active Full -Time Active Full-Time Active Full-Time Active Full-Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Full -Time Active Full-Time Active Full -Time Active Full -Time Active Full -Time Active Part -Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Full-Time Active Full -Time Active Part-Time Active Full -Time Active Full-Time Active Part-Time Active Full -Time Active Full -Time Active Full -Time Active Temporary Active Full-Time Active Active Full-Time Active Full -Time 310 -MH- PC Tacoma 01 401 Substances Abuse - King Co 203 Finance & Admin - Faciliti 403 Youth Services 203 Finance & Admin - Faciliti 303 Mental Health - Kent 300 Mental Health - Management 304 Mental Health - Seattle 2 300 Mental Health - Management 503 Housing Program - Villa Es 601 Domestic Violence - Advoca 303 Mental Health - Kent 207 Finance & Admin - Data Man 403 Youth Services 300 Mental Health - Management 402 Substance Abuse - Pierce C 203 Finance & Admin - Faciliti 301 Mental Health - Seattle 1 301 Mental Health • Seattle 1 501 Housing Program - Mi Casa 304 Mental Health • Seattle 2 303 Mental Health - Kent 100 - Executive Director 301 Mental Health - Seattle 1 200 Finance & Admin - CFO 402 Substance Abuse - Pierce C 303 Mental Health - Kent 304 Mental Health - Seattle 2 503 Housing Program - Villa Es 201 Finance & Admin - Accounti 201 Finance & Admin - Accounti 401 Substances Abuse - King Co 200 Finance & Admin • CFO 600 Domestic Violence - Manage 304 Mental Health - Seattle 2 303 Mental Health - Kent 304 Mental Health - Seattle 2 304 Mental Health - Seattle 2 304 Mental Health - Seattle 2 300 Mental Health • Management 401 Substances Abuse - King Co 203 Finance & Admin - Faciliti 601 Domestic Violence - Advoca 300 Mental Health - Management 203 Finance & Admin - Faciliti 201 Finance & Admin - Accounti 301 Mental Health - Seattle 1 206 Finance & Admin - Grant De 601 Domestic Violence - Advoca 304 Mental Health • Seattle 2 402 Substance Abuse - Pierce C 301 Mental Health - Seattle 1 203 Finance & Admin - Faciliti 301 Mental Health - Seattle 1 100 - Executive Director 300 Mental Health - Management 100 - Executive Director 301 Mental Health - Seattle 1 300 Mental Health - Management 300 Mental Health - Management 601 Domestic Violence - Advoca 303 Mental Health - Kent 402 Substance Abuse - Pierce C 301 Mental Health - Seattle 1 401 Substances Abuse - King Co 200 Finance & Admin - CFO 300 Mental Health - Management 304 Mental Health - Seattle 2 303 Mental Health - Kent 300 Mental Health - Management 1 of 2 pages CONSEJO COUNSELING AND REFERRAL SERVICE Client: 0EA68 Employee Roster Generated (03/29/2017 06:07:40 PM) Employee Code P mplosee Name Position hmployee Status DOI. Status Department Des,. 1579 SAURI, MARCO A. 1756 TAITAGUE, TERESITA M 1778 VALENCIA, ESTEBAN J 1782 VALENTIN, BRENDA L 1677 VALLE,SAMANTHA 1577 VILLAGOMEZ, MIRELLA A. 1591 VISPO-CUBA, TERESA 1735 WILCOX, MANDI E 1773 WILSON, CASSANDRA M 1794 WOJCIK, KATYA H 1791 ZAMORA, EFRAIN 2 of 2 pages SUD Supervisor CDPT Academic Engagement Specialist DV Advocate Chemical Dependency Professional Chemical Dependency Professional Deputy Director CDPT Mental Health Therapist Mental Health Therapist Case Manager r] paycom• Active Active Active Active Active Active Active Active Active Active Active Full-Time Full -Time Full -Time Full-Time Full -Time Full -Time Full -Time Full -Time Full -Time Full -Time Full -Time 100- Executive Director 402 Substance Abuse - Pierce C 403 Youth Services 601 Domestic Violence - Advoca 401 Substances Abuse - King Co 402 Substance Abuse - Pierce C 100- Executive Director 402 Substance Abuse - Pierce C 304 Mental Health - Seattle 2 305 - Mental Health - SoPark 301 Mental Health - Seattle 1 2 of 2 pages 3/9/2017 Corporations: Registration Detail - WA Secretary of State A Business Licensing Service and MyDOR will be offline Thursday, March 9th from 9:00 PM to 1:00 AM. Annual report filings will not be available during that time. We apologize for any inconvenience. CONSEJO COUNSELING AND REFERRALsoma UBI Number 600287044 Category REG Profit/Nonprofit Nonprofit Active /Inactive Active State Of Incorporation WA WA Filing Date 01/06/1978 Expiration Date 02/28/2018 Inactive Date Duration Perpetual Charity This corporation is also a charity. View Info . lhtto; /laN W sos.wa ow/charities/search detaiLasox' charity Id =11141 Registered Agent Information Agent Name CONSEJO COUNSELING AND REFERRAL SERVICE Address 38085 ANGELINE ST City SEATTLE State WA ZIP 981181712 Special Address Information Address City State Zip GoyeetigPastes( asdefitedY1RC WZi95.105(1z )(htgtr /app.legwagov/RCW /s pdefaultaspx:',itE=2395.105)) Title Name Governor STRALEV JD, NICK Governor Distrad, MD, Jane Governor Guerra, Marcelo Address https://www.sos.wa.gov/corps/search_detail.aspx?ubi=600287044 1/1 CONSEJO Counseling and Referral Service EXECUTIVE DIRECTOR JOB DESCRIPTION The Executive Director serves as the Chief Executive Officer for Consejo Counseling and Referral Services and all subsidiaries. The Executive Director (ED) has overall responsibility for overseeing and directing all operations. The ED is responsible for maintaining financial viability," ensuring organizational integration, good quality of care and overall management of the organization. The ED is the authorized person on behalf to sign all contracts, purchases and sales, financial transactions, open and close bank accounts, engage in lease agreements and purchase or sale of Consejo Properties. • CONSEJO's administrator is responsible for the day -to -day operation of the CONSEJO's licensed behavioral health treatment services, including: (a) All administrative matters; (b) Individual care services; and (c) Meeting all applicable rules, policies, and ethical standards. • (2) CONSEJO's administrator must: (a) Delegate to a staff person the duty and responsibility to act in the adm nistrator's behalf when the administrator is not on duty or on call. (b) Ensure administrative, personnel, and clinical policies and procedures are adhered to and kept current to be in compliance with the rules in this chapter, as applicable. (c) Employ sufficient qualified personnel to provide adequate treatment services and facility security. (d) Ensure all persons providing clinical services are credentialed for their scope of practice as required by the department of health. (e) Identify at least one person to be responsible for clinical supervision duties. (f) Ensure that there is an up -to -date personnel file for each employee, trainee, student, volunteer, and for each contracted staff person who provides or supervises an individual's care. (g) Ensure that personnel records document that Washington state patrol background checks consistent with RCW 43.43.830 through 43.43.834 have been completed or each employee in contact with individuals receiving services. (3) The administrator must ensure the agency develops and maintains a written internal quality management plan process that: (a) Addresses the clinical supervision and training of clinical staff; (b) Monitors compliance with the rules in this chapter, and other state and federal rules and laws that govern agency licensing and certification requirements; and (c) Continuously improves the quality of care in all of the following: (i) Cultural competency; (ii) Use of evidence based and promising practices; and (iii) In response to: (A) Critical incidents; (B) Complaints and (C ) Grievances CoL r t,$ n+; and Meferrsai V ? C4 • (3) The Executive Director must ensure the agency develops and maintains a written internal quality management plan process that: (a) Addresses the clinical supervision and training of clinical staff; (b) Monitors compliance with the rules in this chapter, and other state and federal rules and laws that govern agency licensing and certification requirements; and (c) Continuously improves the quality of care in all of the following: (1) Cultural competency; (ii) Use of evidence based and promising practices; and (iii) in response to: (A) Critical incidents; (B) Complaints; and (C) Grievances • Responsible for all aspects of agency operations, including satellite sites. • Defines, determines and oversees program objective within established policies and contractual requirements. Q Establishes and maintains an organizational structure to implement policies, procedures and program contractual requirements. • Evaluates on -going services and makes recommendations in the areas which need program development and /or corrective actions. • Responsible for maintaining agency expenditures within approved budget. • Reviews agency budget with Director of Finance and Human Resources Manager which conforms to resources, contractual agreements and funding source requirements. In conjunction with the Board, develops and coordinates a plan of action for securing financial support for agency programs and activities through fund raising, grant writing and contract development. t) Develops yearly sources, goals and objectives for federal, state and local governments; as well as for non- profit and private foundation grants with the Board of Directors. • Researches and develops new sources of funding, and develops enhancements with established funding sources. Ensures personnel practice relating to working conditions, salary schedules and job descriptions are administered per agency policy, union contract and law. Delegates as required the assignment of job duties, evaluation of work performance, hiring and termination of employees. • Provides supervision and consultation to management staff • Acts on behalf of the agency regarding employee grievance procedures. insures the maintenance of adequate case records in compliance with federal, state and local laws. Submits required wrttten reports in compliance with government regulations and as required by funding sources. • Prepares monthly agenda and other supports for Board meetings and is present at these meetings to report and advice on agency activities and finances. e Supports agency's public image, goals and objectives. • Maintains liaison with other community -based agencies, city, county, state and regional agencies. • Provides education and information in the community as needed. • Serve on committees, task forces and special assignments as needed • Serve as the primary spokesperson for the agency. Communicate Consejo's mission to community leaders, supporters, staff, legislators and other constituents. Provides Leadership and facilitate effective communication among Consejo staff. • Deveiolp leadership and promote skill development within the organization O Engage relevant local, state and federally funding sources and secure necessary funding from blended sources to ensure the sustainabitity of Consejo's services. Develop annual budget of agency in partnership with the accountinglfinance department. Fulfill other duties as may be assigned to meet agency operational needs Requirements • MA in management, social service or related field. • At 5+ years of relevant management experience. Bilingual in English and Spanish O Bicultural experience, knowledge and awareness of HispaniclLatino issues. • Demonstrated grant writing and fund raising experience • Lifting requirements up to 10 lbs. EX.I .itri D; w+.ttiK