AG 20-127 - AMG Home Health CareCITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV'. —ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE REQ. BY, ASAP
El PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT D MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CDG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE D RESOLUTION
* CONTRACT AMENDMENT (AG#):_ El INTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECT NAME: —CARES ACT GRANT --ROUND I
NAME OF CONTRACTOR: AMG HOME HEALTH CARE AFH LLC
ADDRESS: 3921 S 337TH ST, FEDERAL WAY, WA, 98001 TELEPHONE: (253) 332-2597
E-MAIL: BILL.VADINO@CITYOFFEDERALWAY.COM
SIGNATURE NAME: AcORDA AcORDA TITLE: SEE ACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES D COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE 0 ALL
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS
. TERM: COMMENCEMENT DATE: —SEE ATTACHED AGREEMENT COMPLETIONDATE:
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 ($ 1,000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: El YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED DYES X NO IF YES, $ PAID: 0 CONTRACTOR El CITY
RETAINAGE: RETAINAGEAmoUNT: CIRETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAfNAGE BOND PROVIDE
n PURCHASING: PLEASECHARGETO: 001-1800-990-518-10-490 Project Code# 267662-25060
0. DOCUMENT/CONTRACT REVIEW
El PROJECT MANAGER
0 DIRECTOR
El RISKMANAGE MENT (IF APPLICABLE)
0 LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
2. CONTRACT SIGNATURE ROUTING
D SENT TO VENDORJCONT RACTO R DATE SENT: DATE C'D:
El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
El CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I 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
El LAW DEPARTMENT SIGNED By LAW 07-28-20
• SIGNATORY (MAYOR OR DIRECTOR)
• CITY CLERK
El ASSIGNED AG # AG�f
'OMMENTS:
1/2020
ciry OF
t My
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
wwvv CjtY0ffedeFa4wiY com
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
AMG HOME HEALTH CARE AFH LLC
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("Cityand AMG Home Health Care AFH LLC, a limited liability company ("Grantee"). The
City and Grantee (together "Parties") are located and do business at the below addresses which shall be valid for
any notice required under this Agreement:
-Gina Acorda
3921 S 337TH ST
FEDERAL WAY, WA 98001
(253) 332-2597 (telephone)
I
Ade Ariwii
33325 8th
Federal Way, WA 98003-631,1
(253) 835-2520 (telephone)
(253) 835-2509 (facsimile)
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
tescribed herein.
2. CONDITIONS OF GRANT
2.1 Warranties. The Grantee warrants the following, which are pre -requisites for grant eligibility:
a) Grantee operates a business physically located within the political boundaries of the City
of Federal Way;
b) Grantee maintains a current City of Federal Way business license
c) Grantee has paid all taxes and government fees due up to the date of execution of this
grant agreement
d) Grantee is not the recipient of other state or federal funding made available as a response
to the COVID- 19 pandernic
e) Grantee's business employees no more than the equivalent of ten (10) full-time
employees (20,800 man-hours total for all employees per year).
f) Grantee's net revenues do not exceed more than $1.5 million per year
g) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue
Service
h) Due to COVID- 19, Grantee business (check all that apply):
E] Was required by state or local order to close
Was forced to lay off employees due to reduced patronage
Incurred over $1,000 in COVID-19 related expenses
Experienced 10-50% lost revenue
Experienced over 50% lost revenue
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4SCItY OF CITY HALL
33325 8th Avenue South
AN Federal Way, VVA 98003-6325
Federal Way (253) 835-7000
WWW cityoffederalwqy com
a) Mortgage or Rent
b) Personal Protection Equipment
c) Insurance
d) Utilities
e) Marketing
F) Payroll
Grantee agrees to retain receipts documenting use of grant funds and will provide them to the City or its
designee upon request.
3. TERMINATION. Should any of the conditions described in section 2.1, above, not be met, the City
may recover all disbursed grant funds and terminate this agreement.
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses
Grantee has incurred due to the COVID- 19 pandemic, the City shall provide a grant to the Grantee in an amount
not to exceed One Thousand and NO/I 00 Dollars ($ 1,000.00).
4.2 Non -Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment
under this Agreement for any fiscal period, the City will not be obligated to make payments under this
agreement.
I
5.1 gt4�see Indetunifi6ation. The Grantee 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 Grantee and the City, the Grantee's liability hereunder shall be
only to the extent of the Grantee's negligence. Grantee shall ensure that each sub -Grantee 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 Grantee pursuant to this paragraph. The
City's inspection or acceptance of any of Grantee's work when completed shall not be grounds to avoid any of
these covenants of indemnification.
5.2 lhdu�Wdl lq�Drance Act Waiver. it is specifically and expressly understood that the Grantee
waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51
RCW, solely for the rcuuoses of i--K'W K I "PXRTift i-k_2u-J-WPJ
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.
CITY OF
wy
CITY HALL
33325 8th Avenue South
Federal Way, W.A 98003-6325
(253) 835-7000
wmv- cjtyoffederahvqy com
W _��Ofioh. The City agrees to release, indemnify, defend and hold the Grantee, its
officers, directors, shareholders, partners, employees, agents, representatives, and sub- contractors harmless
from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings,
judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs,
and/or litigation expenses to or by any and all persons or entities, including without limitation, their respective
agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent
solely caused by the negligent acts, errors, or omissions of the City.
5.4 Survival. The provisions of this Section shall survive the expiration or termination of this
Agreement with respect to any event occurring prior to such expiration or termination,
6.1 1 1 &r6retatiort and MOdification. This Agreement 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. 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. No provision of this Agreement, including this
provision, may be amended, waived, or modified except by written agreementsigned by duly authorized
representatives of the Parties.
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6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
CITY OF CrrY HALL
33325 "nth Avenue ° uth
Federal Way Federal Way, VVA 98003-6325
(253) 835-7000
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originalAgreement may be executed in any number of counterparts, each of which shall be deemed an
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.
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAIT:
Jim Ferrell, Mayor
ATE: —k�:�>!j -1, t, 2. ��)
Y
Printed Name:
r
Title:
ATE:
14 i. 1 ` • i i ! J
7/24/2020
eServices
'Washington State Departrnen,", of Revenue
Services Business Lookup ANIG HOME HEALTH CARE AFH U -C
License Information:
Entity name:
AMG HOME HEALTH CARE AFH LLC
Business name:
AMG HOME HEALTH CARE AFH LLC
Entity type:
Limited Liability Company
UBI #:
603-038-002
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
3921 S 337TH ST
FEDERAL WAY WA 98001-9570
Mailing address:
3921 S 337TH ST
FEDERAL WAY WA 98001-9570
Excise tax and reseller permit status: Click here
Secretary of State status:
Click here
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Endorsements
Endorsements held at this location License # Count Details Status Expiration date First issuancf
Federal Way General Business 12 -105494 -00 -BL Active May -31-2021 Dec -1 1 -2012
Governing People May include governing people not registered with Secretary of State
Governing people Title
ACORDA, GINA
https://secure.dor.wa.gov/gteunauth/—,/#69 1/1