AG 17-131I RETURN TO:
Oa V I d S C111441/11" EXT: a S
CITY OF FEDERA L WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: T G,rk-S
ORIGINATING STAFF PERSON: JX.tw / 4 S't,h
EXT: c 42.S 3. DATE REQ. BY:
TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG #): ❑ INTERLOCAL
j .r OTHER M (� u
Sem (6r MeA,(
NAME OF CONTRACTOR: vt �nJ�- Cwh 44.n d MOM t4"Wr-vl atf Sc l4. I c r..•."t A40u.t_m t/''
ADDRESS: (lox 4(o 23 � %d.-re-A LAnvif .NR 'POfo 3 TELEPHONE
E -MAIL: FAX:
SIGNATURE NAME: TITLE
PROJECT NAME:
EXHIBITS AND ATTACHMENTS:g SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS /CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT /AMENDMENTS
TERM: COMMENCEMENT DATE: (AMC n St7� 1 k, ql if cr ku COMPLETION DATE: I' 3//Y(
TOTAL COMPENSATION $
(IF CALCULATED ON HOURLY LABORIGE - 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
N/A
(INCLUDE EXPENSES AND SALES TAX, IF ANY)
RETAINAGE: RETAINAGE AMOUNT:
❑ PURCHASING: PLEASE CHARGE TO:
0. DOCUMENT /CONTRACT REVIEW
ftr PROJECT MANAGER
DIRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW
I. COUNCIL APPROVAL (IF APPLICABLE)
❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDE
INITIAL / DATE EV EWED
DS 812-4- 111
kiz Y 1 '1
t 2 41 A.7 201
INITIAL / DATE APPROVED
COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE:
2. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIOR TO EXPIRATION DATE
(Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.)
INITIAL / DATE SIGNED
FLAW DEPARTMENT Z A07 2.-4917
)21-SIGNATORY (MAYOR OR DIRECTOR)
.0-CITY CLERK f 'L
(ASSIGNED AG# AG# 13-03
❑ SIGNED COPY RETURNED DATE SENT: O.?15-17—
;OMMENTS:
Memorandum of Understanding
Senior Meal Program
City of Federal Way and Evergreen Club - The Korean Seniors and Multicultural
Self - Sufficiency Movement
THIS MEMORANDUM OF UNDERSTANDING (MOU), dated effective when signed by all parties, defines
the respective responsibilities of the City of Federal Way, a Washington Municipal corporation ( "City ") and
Evergreen Club — The Korean Seniors, a Washington corporation ( "Evergreen Club ") and Multicultural Self -
Sufficiency Movement a Washington corporation, in connection with the senior meal program at the Federal
Way Community Center ( "FWCC "). The Evergreen Club and Multicultural Self Sufficiency Movement are
collaborative partners referred to here together as "The Senior Meal Providers."
Background
A. The City and The Senior Meal Providers desire to enter an agreement for use of space at the Federal
Way Community Center for a twice weekly meal program until December 31, 2021.
B. The City of Seattle has provided funding for a congregate meal program to The Senior Meal Providers to
serve an unmet need in the community. The congregate meal program is donation -based and provides
warm nutritious meals to low income seniors.
C. The City of Federal Way will provide space at the Federal Way Community Center located at 876 S
333`d Street, Federal Way WA. 98003 for the purpose of offering an ethnic low income congregate meal
program provided by the Senior Meal Providers.
D. The Senior Meal Providers have permission to use the community rooms and kitchen or other space
designated by the Federal Way Community Center on Tuesdays and Thursdays from 8:OOam - 1:OOpm.
E. No party shall be responsible for events that are unforeseeable and beyond its reasonable control, such
as acts of God, weather delays or government restrictions.
F. This MOU may be terminated by either party with a minimum 30 day notice.
NOW, THEREFORE, the parties agree as follows:
City Responsibilities. The City agrees to:
• Provide dining areas and kitchen facilities on the days and times outlined above.
• Provide tables, chairs and appropriate kitchen equipment.
• Provide a minimum of ten days advance notice of any schedule changes or conflicts that may
result in canceled or reduced space.
• Limit the amount of changes or conflicts that may result in canceled or reduced space to no more
than two dates per month with the exception of holidays and FWCC annual closure week.
II. The Senior Meal Providers. The Senior Meal Providers agree to:
• Acknowledge that this agreement is for temporary use of space at the FWCC and will develop an
alternative location for continuation of services in 2021. It is understood that a request may be
made at the end of this term to continue the senior meal program at the FWCC.
• Provide a congregate meal program at the FWCC on the days and times outlined above.
• Provide qualified cooks who hold current required permits and training.
• Purchase and provide all food at sole expense.
• Purchase and provide all paper and plastic products including, but not limited to plates, napkins
and utensils at sole expense.
• Clean the community rooms, kitchen and all equipment after each use.
• Solely manage inventory of food to insure safety and freshness.
• Take sole responsibility for any fines incurred due to violations of health codes.
• Provide and maintain a comprehensive general liability insurance policy with limits of Two
Million dollars ($2,000,000.00) per occurrence specifically naming the City of Federal Way as
additionally insured. This policy shall include personal injury, bodily injury or property claims of
the The Senior Meal Providers services and its agents.
• Report any damage or malfunctioning equipment to designated FWCC staff upon discovery.
• Repair or replace any damaged equipment caused by misuse by the The Senior Meal Providers at
their sole expense.
• The Senior Meal Providers will exhibit behavior consistent with the FWCC's guidelines and
policies
• Use only assigned refrigerator storage space that has been designated by FWCC staff
• Assist in paying for quarterly kitchen cleanings, limited to no more than the amount of $500.00
per quarter.
• This MOU sets forth the intent of the parties herein.
[Signature page follows]
IN WITNESS WHERE OF, the City, Evergreen Club — Korean Seniors, and Multicultural Self - Sufficiency
Movement have executed this Memorandum of Understanding by their duly authorized representatives.
ATTEST:
CITY OF FEDERAL WAY
Jo utton, Parks Dir
CI y of Federal W
33325 8th Ave S'
Federal Way, WA 98003
DATE: GO S //
(Ni�
tephanie Co ey, CMC
City Attorney, J. Ryan Call
MULTICULTURAL SELF - SUFFICIENCY MOVEMENT:
B y: C
qk/1,'N
Printed Name: M ( Go MO
=1-\,2-c__+-2(
Title:
DATE:
STATE OF WASHINGTON )
ss.
COUNTY OF Y/t N V )
On this day person lly appeared before rile O\ W I/\C' )tj O , to me known to be the
Q G tAi Ve 01 V Z CAW of k1 i,4 CAA r k\ C-7t Mb' ,,vtyv e hat executed the foregoing
instrument, and acknowledged the said instrument to be the free and 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 n\ and official seal this day of ALA 1A , 20j ....e.e.
_ .
..
...
MAR
Notary's signature,
Notary's printed
Notary
My com
i• in : d for the St to Washington.
sion expires O3/ ff
2v (1
EVERGREEN CLUB — THE KOREAN SENIORS:
By:
Printed Name:
Title:
DATE: �� r/
7
IV ‘i
STATE OF WASHINGTON )
ss.
COUNTY OF
On this ay personally appeared before me O. v , to me known to be the
c f P C, this,
e lAk of e,a re (if) ; k. 9 Y (L9 C,i4that executed the foregoing
instrument, and acknowledged the said in tr ment 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 mx,hand and official seal this day of
�• MARSh, '��,
�(Z, -` s Er - IV, Notary's signature A VA,k . t "LL
2 € fik 4a:; Notary's printed n. � e; � , 1 ,.
„ i _ - • - s o Notary P • in . d '. or the State of Washington.
pus% %Nc_ = My comm .n ex.' s 04 �l %o�Cj
114 71. 1OF,�N P.
tIII111%M \ \•
, 2011.