AG 17-066IRETURN 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 ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT
❑ REAL ESTATE DOCUMENT
❑ ORDINANCE
❑ CONTRACT AMENDMENT (AG #):
❑ OTHER
x HUMAN SERVICES / CDBG
❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ RESOLUTION
❑ INTERLOCAL
5. PROJECT NAME: SCHOOL OUTREACH COORDINATION
6. NAME OF CONTRACTOR: _COMMUNITIES IN SCHOOLS OF FEDERAL WAY
ADDRESS: .1 S kVtiek
?A P%
E -MAIL:
SIGNATURE N
�,....
as ,Vvovt, ;L► .:. p,� TELEPHONE 253 - SZ - '9•9q 0
o � A IE:: flA C$ � TITLE E Y � {i11e, p1RCC�o
7. EXHIBITS AND ATTACHMENTS: _xx SCOPE, WORK OR SERVICES X COMPENSATION X INSURANCE REQUIREMENTS /CERTIFICATE X ALL
OTHER REFERENCED EXHIBITS X PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
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8. TERM: COMMENCEMENT DATE: _01/01/2017
COMPLETION DATE: 12/31/2018
9. TOTAL COMPENSATION $_20,000.00 (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, $
RETAINAGE: RETAINAGE AMOUNT:
PAID BY: ❑ CONTRACTOR ❑ CITY
❑ RETAINAGE BY (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
❑ PURCHASING: PLEASE CHARGE TO: 001 - 7300 - 083 - 562 -10 -410
10. DOCUMENT /CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
❑ DIRECTOR /(
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW eC_ 3�ll4e
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
$ SENT TO VENDOR/CONTRACTOR DATE SENT: �(e 4,90
XI ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTI ICA E, LICENSES, EXHIBITS
INITIAL / DATE SI NED
COUNCIL APPROVAL DATE:
DATE REC'D: z/A,2/0261 �-
❑ LA EPARTMENT
GNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG#
❑ SIGNED COPY RETURNED
COMMENTS:
-ifiwzihri •
AG 1 'OWL
DATE SENT: 0i -l} - ti
Vecferal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www.cityoffederalway.com
HUMAN SERVICES AGREEMENT
FOR
SCHOOL OUTREACH COORDINATION
This Human Services Agreement ( "Agreement ") is made between the City of Federal Way, a Washington municipal
corporation ( "City "), and Communities in Schools of Federal Way, 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:
COMMUNITIES IN SCHOOLS OF FEDERAL
WAY:
Tracy Oster
1825 South 316th Street, #101
Federal Way, WA 98003
(253) 529 -7440 (telephone)
tracyo@cisfederalway.org
The Parties agree as follows:
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
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
QTY 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 OF
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
441i6. Federal Way
CITY HALL
33325 8th Avenue South
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 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
Vecleral 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 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. 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
Vecleral 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:
I
Jim Ferrell may•
DATE:
COMMUNITIES IN SCHOOLS OF FEDERAL
WAY:
By: g7
Printed Name:
Title:
(9g--ti„
DATE: �/ (i --
STATE OF WASHINGTON )
) ss.
COUNTY OF KING )
ATTEST:
ie Courtney, CM
APPROVED AS TO FORM:
Clerk
J. Ryan Call, City Attorney
On this day personally appeared before me / rek C � 0 , to me known to be the
of 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 / day of
Notary's signature
Notary's printed name
HUMAN SERVICES AGREEMENT
r, 1 2017
rule U n.s '
Christine Hune Munson
Notary Public in and for the State of Washington.
My commission expires
6 - 4/2015
CITY OF
Federal Way
EXHIBIT A
SERVICES
Project Summary
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway. com
The Agency shall provide a School Outreach Coordinator /CIS Site Coordinator at high -needs schools in Federal
Way Public Schools to coordinate service for students identified as "at -risk" by school personnel 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
2nd
Quarter
APRIL —
JUNE
4th
Quarter
OCT. —
DEC.
3rd
Quarter
JULY —
SEPT.
4th
Quarter
OCT. —
DEC.
Total
No. of unduplicated Federal
Way persons assisted in 2017
47
47
47
67
47
188
No. of unduplicated Federal
Way persons assisted in 2018
2018
47
47
47
47
188
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
Quarter
OCT. —
DEC.
Total
2017
1. Youth Services /Hours Worked
by Coordinators
67
67
67
67
268
2018
1. Youth Services/ Hours
Worked by Coordinators
67
67
67
67
268
HUMAN SERVICES AGREEMENT 1
HSA Exh 1/2017
CITY OF
�, Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway.. com
C. Definition of Services
1. Youth Services /Hours Worked by Coordinators: Youth Services are measured by hours worked by each
School Outreach Coordinator.
D. Performance Measure(s)
Outcome(s) to be reported:
1. Increased Academic Success: measured by Attendance, Behavior, and Coursework.
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
4_, Federal 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
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 - 3 - HSA Exh 1/2017
4.,arr or
Federal Way
EXHIBIT B
COMPENSATION
Project Budget
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www cityoffederalway.. com
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 Thousand and 00 /100
Dollars ($20,000.00).
A. City of Federal Way Funds
2017
2018
City of Federal Way General Fund:
$10,000.00
$10,000.00
Total City of Federal Way Funds:
$10,000.00
$10,000.00
B. Line Item Budget
2017
2018
Personnel Services (detail below)
$10,000.00
$10,000.00
Office or Operating Supplies
$
$
Rent & Utilities
$
$
Communications
$
$
Travel and Training
$
$
Other (specify):
$
$
Client Travel
$
$
Administration (Overhead)
$
$
Total City of Federal Way Funds:
$10,000.00
$10,000.00
C. Personnel Detail
Position Title
Position Full
Time Equivalent
Annual Salary
and Benefits
HS Funds
School Outreach Coordinator
1.0
$39,800.00
$10,000.00
Total:
$39,800.00
$10,000.00
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 4 - HSA Exh 1/2017
V'ecleral Way
Estimated Quarterly Payments:
2017
1st Qtr
2nd Qtr
3rd Qtr
4th Qtr
2018
1St Qtr
2nd Qtr
3rd Qtr
4th Qtr
$2,500.00
$2,500.00
$2,500.00
$2,500.00
$2,500.00
$2,500.00
$2,500.00
$2,500.00
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003 -6325
(253) 835 -7000
www.cityoffederalway.com
Expenses must be incurred prior to submission of quarterly reimbursement requests. Proof of expenditures must
be attached to the reimbursement request for invoice to be approved.
Quarterly reimbursement requests shall not exceed the estimated payment without prior written approval from
the City. Estimated quarterly payments are contingent upon meeting or exceeding the above performance
measure(s) for the corresponding quarter. This requirement may be waived at the sole discretion of the City
with satisfactory explanation of how the performance measure will be met by year -end on the Service Unit
Report.
Conditions of Funding
The Agency agrees that it will meet the specific funding conditions identified for the Agency and acknowledges
that payment to the Agency will not be made unless the funding conditions are met.
HUMAN SERVICES AGREEMENT 5 HSA Exh 1/2017
It shall be the duty of the Secretary to see that all requirements of law and of
appropriate state and local authorities are duly observed in the conduct of the affairs
of the Corporation.
7.3.4. Treasurer. The Treasurer of the Board of Directors shall serve as Treasurer of the
Corporation and as Chair of the Finance /Audit Committee. He or she shall have
supervision over the receipt and custody of the Corporation's funds, and shall cause
to be kept correct and complete books and records of account, including full and
accurate accounts of receipts and disbursements in books belonging to the
Corporation, and in general shall perform such duties as are customary to the office
of Treasurer. In addition, the Treasurer shall perform such other duties as the Board
of Directors may from time to time assign to the Treasurer. The Treasurer may be
provided with a bond for the faithful discharge or his or her duties in such amount as
the Board of Directors may require.
7.3.5. Executive Director. The Executive Director shall hold office at the pleasure of
the Board, and shall be subject solely to the direction and control of the Board of
Directors. The Executive Director shall not be a member of the Board and shall not
have voting privileges.
The Executive Director shall be the official representative of the Board of Directors
in the management of the Corporation. He or she shall have authority and
responsibility for the administration of the Corporation in all its' activities subject
only to such policy as may be adopted and such orders as may be issued by the
Board of Directors or by any of its Committees to which power has been delegated
for such action. He or she shall act as the duly authorized representative of the
Board of Directors in all matters in which these Bylaws or the Board of Directors
have not designated some other person to act.
It shall be the duty of the Executive Director to plan, organize, maintain, and control
the operation of the Corporation within the policy limits established by the Board of
Directors. He or she shall analyze the Corporation's activities and advise the Board
respecting the same. He or she shall participate in all appropriate committees
thereof. He or she shall attend all meetings of the Board of Directors, and advise the
Board on matters of policy formation.
He or she shall represent the Corporation as its official representative in relation to
appropriate outside agencies.
The above duties of the Executive Director may be delegated by him or her to such
other qualified Corporation personnel as he or she may from time to time appoint.
In addition, the Executive Director shall perform such other duties as from time to
time may be assigned to him or her by the Board of Directors.
6IPage
Federal Way Education &
Communities In Schools Foundation
Board of Directors Meeting Minutes
DeVry University December 7th, 2006 11:30am- 1:OOpm
Present:
Aline Carnahan, Tim Hickel, Valea Lund, Nicole Miller, Tom Murphy, Karen
Vander Ark, Darcy Webb and Bob Wroblewski, Karen Czerniak and Tracy Oster
Absent:
Kristin Barsness, Natalie Ellington, Jack Stanford, Tom Pierson, Dini Duclos,
Reed Hackett
I. Call to Order
a. Meeting was called to order at 11:45AM
II. Welcome and Introductions
a. Aline Carnahan welcomed all in attendance to the meeting.
b. Aline announced that due to personal reasons, Valea Lund will not be able
to fulfill her responsibility of becoming the next chair of the Board. Karen
Vander Ark has agreed to be president - elect. Everyone thanked Karen
and was happy to have someone in place.
III. Introduction of New E.D.
a. Aline Carnahan introduced and everyone welcomed Tracy Oster as the
new Executive Director.
IV. Approval Of Meeting Minutes
a. November Board meeting minutes were reviewed, motion carried with no
discussion.
V. Financial Report
a. Tracy Oster reviewed financial report, budget vs. actual for month of
November 2006 and the fiscal year of 2006 -2007.
b. Discussion was held regarding the amount of money in the checking
account being too much and putting $20,000 into a CD. Motion was made
and carried to move $20,000 from the Checking Account at Columbia
Bank to a 6 -Month CD at Woodstone Credit Union.
VI. Marketing Committee
a. Literacy Breakfast: "Save the Date" postcards are ready and will be going
out this week to approximately 350 people. Angie Mentink is not available
as an emcee as hoped. All Board members were asked to think about
their contacts and come up with any ideas for an emcee.
i. Karen and Tom Vander Ark are starting a "Teacher of the Year"
and $500 award to be given out at the Literacy Breakfast. Forms
were distributed for everyone to review.
CITY OF
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:
Communities in Schools of Federal Way (Contracting Agency), for
the following: School Outreach Coordination (Program Title).
Authorizing
Signature:
(must be signed by
person who signs
the contract,
generally,
Executive Director)
-
(Printed Nat-0-
ar )
(Title)
‘%,11.7
C Wit---
(Date)
(Signature)
Additional
Authorized
Signature:
Additional
Authorized
Signature:
(Printed Name) (Title)
(Signature) (Date)
(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.
CommSFW
Non Profit Insurance Program
CERTIFICATE OF COVERAGE
Issue Date: 05/23/2016
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND, EXTEN D OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTI FICATE OF COVERAGE DOES NOT CONSTITUE 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 SUBROGRATION IS WAIVED, subject to the terms and conditions of
the policy, certain coyerage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
COMPANIES AFFORDING COVERAGE
Clear Risk Solutions
451 Diamond Drive
Ephrata, WA 98823
GENERAL LIABILITY
American Alternative Insurance Corporation
AUTOMOBILE LIABILITY
American Alternative Insurance Corporation
PROPERTY
American Alternative Insurance Corporation, et al.
MISCELLANEOUS PROFESSIONAL LIABILITY
INSURED
Communities in Schools of Federal Way
1825 S 316th, Ste. 101
Federal Way WA, 98003
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 SH OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1 -A2-RL -0000013 -08 06/01/2016 06/01/2018 PER OCCURRENCE
OCCURRENCE FORM PER MEMBER AGGREGATE
INCLUDES STOP GAP PRODUCT-CO MP /OP
PERSONAL & ADV. INJURY
(LIABILITY IS SUBJECTTO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE
$5,000,000
$10,000,000
$5,000,000
$5,000,000
$50,000,000
AUTOMOBILE LIABILITY
ANY AUTO N1 A2-RL -0000013 -08 06/01/2016 06/01/2018 COMBINED SINGLE LIMIT
(LIABILITY IS SUBJECTTO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE
$5,000,000
NONE
PROPERTY
N1 -A2-RL -0000013 -08 06/01/2016 06/01/2018 ALL RISK PER OCC EXCL EQ & FL
EARTHQUAKE PER OCC
FLOOD PER OCC
(PROPERTY IS SUBJECTTO A $50 000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE
$75,000,000
$1,000,000
EXCLUDED
NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
06/01/2016 06/01/2018 PER CLAIM
(LIABILITY IS SUBJECT TO A SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / SPECIAL ITEMS
Regarding Community Service Grant. The City of Federal Way is named Additional Insured regarding this grant only and is
subject to policy terms, conditions and exclusions.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLI CY PROVISIONS.
CERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVE
City 5 th Ave. Way
33325 8th Ave S
Federal Way, WA 98003
•
4
3115821
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED — DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program (NPIP)
Policy Number
N 1 -A2-RL -0000013 -08
Endorsement Effective
6/1/2016
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization (Additional Insured): As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator
City of Federal Way
33325 8th Ave. S
Federal Way, WA 98003
Regarding Community Service Grant. The City of Federal Way is named Additional Insured regarding this grant only and is
subject to policy terms, conditions and exclusions.
A. With respects to the General Liability Coverage Part only, the definition of Insured in the Liability Conditions, Definitions
and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above
Schedule. Such Person or Organization is an Insured only with respect to liability for Bodily Injury, Property Damage, or
Personal and Advertising Injury caused in whole or in part by your acts or omissions or the acts or omissions of those
acting on your behalf:
1. In performance of your ongoing operations; or
2. In connection with your premises owned or rented to you.
B. The Li mits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement; or
2. Declarations for this policy,
whichever is less. These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Includes copyrighted material of the Insurance Services Office, Inc., with its permission.
RL 2163 12/12 Page 1 of 1
3115822