AG 20-191 - Cornerstone Multicultural Medical ServicesRETURN TO: TIMJOHNSON EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: I TIM JOHNSON EXT::. 2412. -- 3. DATE Q. BY ASAP
El PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
0 GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/ CDBG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE El RESOLUTION
El CONTRACT AMENDMENT (AG#):_ DINTERLOCAL
X OTHER ___gARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
NAME OF CONTRACTOR: CORNERSTONE MULTICULTURAL MEDICAL SERVICES
ADDRESS: 32123 1 STAVES, #AI, FEDERAL WAY, WA, 98003 TELEPHONE: (360) 689-6268
E-MAIL: uscis693@GMAIL.COM
SIGNATURE NAME: BYEON BPEON TITLE: ,SEE ACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES E] PRIOR CONTRACT/AMENDMENTS
TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETIONDATE:
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO11 00 ($1;000:00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: 0 YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED 11 YES X NO IF YES, $_ PAID BY: 0 CONTRACTOR 0 CITY
RETAINAGE: RETAINAGEAmoUNT: µ ORETArNAGE AGREEMENT (SEE CONTRACT) OR EIRETAINAGE BOND PROVIDE
11 PURCHASING: PLEASE CHARGE TO� 001-1800-990-518-10-490 Project Code #267662-25060,.___
0. DOCUMENT/CONTRACT REVIEW
11 PROJECT MANAGER
El DIRECTOR
El SIS AGE (IF APPLICABLE)
0 LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE R -ECD: --,,-
0 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
11 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
11 LAW DEPARTMENT SIGNED BYLAW 07-28-20
El SIGNATORY (MAYOR OR DIRECTOR)
F-1 CITY CLERK
0 ASSIGNED AG# AG AH
KNITSFUTrd'"Ta
1/2020
a
CITY OF
ift
0s�Federal Way
�4
UTY HALL
33325 8th Avenue South
Federal Wa)k, WA 98003-6325
(253) 835-7000
wwwolyoffederalvmycom
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WITH
CORNERSTONE MULTICULTURAL MEDICAL SERVICES
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Cornerstone Multicultural Medical Services, a professional 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:
..... ... . .
CORNERSTONE MULTICULTURAL
MEDICAL SERVICES:
Jai Jun Byeon 33325 8th Ave. S.
32123 IST AVE S, #Al, FEDERAL WAY, WA Federal Way, WA 98003-6325
Mailing address:
16243 SE 326t' St, Auburn, WA 98092 (253) 835-2520 (telephone)
(253) 835-2509 (facsimile)
(360) 689-6268 (telephone) ade.ariwoola@cityoffederalway.com
uscis693a,izmail.com
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
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 Rinding 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):
Was required by state or local order to close
Was forced to lay off employees due to reduced patronage
--,Inc ed over $1,000 in COVID-19 related expenses
Experienced 10-50% lost revenue
Experienced over 50% lost revenue
2.2 Use of Funds: Grantee affirms that grant finids will be used for the following purposes:
CARES ACT BUSINESS GRANT AGREEMENT
C#TY OF CITY HALL
33325 8th Avenue South
Federal Way Federal Way, WA 98003-6325
(253) 835-7000
wvwv cityoffederalway coo
a) Mortgage or Rent
b) Personal Protection Equipment
c) Insurance
d) Utilities
e) Marketing
F) Payroll
Grantee agrees to retain receipts documenting use of grant fiinds and will provide them to the City or its
designee upon request.
3. TERMINAIM. Should any of the conditions described in section 2.1, above, not be met, the City
may recover all disbursed grant funds and terminate this agreement.
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses
Grantee has incurred due to the COVID- 19 pandemic, the City shall provide a grant to the Grantee in an amount
not to exceed One Thousand and NO/I 00 Dollars ($ 1,000.00).
4.2 NOntAmrolMon 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.
5. INDEMNIFICATION.
5.1 Grantee The Grantee agrees to release indemnify, defend, and hold the City, i
elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless fto
any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgment
awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses, attorney's fees, costs, and/
litigation expenses to or by any and all persons or entities, including, without limitation, their respective agent
licensees, or representatives, arising from, resulting from, or in connection with this Agreement or t
performance of this Agreement, except for that portion of the claims caused by the City's sole negligenc
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in t
event of liability for damages arising out of bodily injury to persons or damages to property caused by
resulting from the concurrent negligence of the Grantee and the City, the Grantee's liability hereunder shall b -
only to the extent of the Grantee's negligence. Grantee shall ensure that each sub -Grantee shall agree to defe
and indemnify the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, an
volunteers to the extent and on the same terms and conditions as the Grantee pursuant to this paragraph. T
City's inspection or acceptance of any of Grantee's work when completed shall not be grounds to avoid any
these covenants of indemnification.
5.2 Industrial Insurance Aq M�9�. 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 purposes of this indemnification. Grantee'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.
CARES ACT BUSINESS GRANT AGREEMENT -2-
CITY OF
4Federal Way
:�k�
MWAM WX MA,
(253) 835-7000
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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 2
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.
a
DATE: 2q2V-a -0
CARES ACT BUSINESS GRANT AGREEMENT -4-
7/25/2020 eServices
Services Business Lookup CORNERSTONE MULTICULTURAL MEDICAL SERVICES
License Information:
Status
Entity name:
CORNERSTONE MULTICULTURAL MEDICAL SERVICES, PLLC.
Business name:
CORNERSTONE MULTICULTURAL MEDICAL SERVICES
Entity type:
Professional Limited Liability Company
UBI #:
604-381-480
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
32123 1 STAVE S
ST E Al
FEDERAL WAY WA 98003-5720
Mailing address:
16243 BE 326TH ST
AUBURN WA 98092-5907
Excise tax and reseller permit status: Click here
Secretary of State status:
Click here
New search Back to results
Endorsements
Endorsements held at this location License # Count Details Status Expiration date First issuance
Federal Way General Business 19 -100853 -00 -BL Active Feb -28-2021 Feb -26-2019
Governing People May Include governing people not registered with Secretary of State
Governing people Title
BYEON, JAI JUN
Registered Trade Names
Registered trade names
Status
First issued
CORNERSTONE MEDICAL SIRVICES
Active
Apr -16-2019
CORNERSTONE MULTICULTURAL SERVICES
Active
Apr -16-2019
KEYSTONE MEDICAL SERVICES
Active
Dec -03-2019
https://secure.dor.wa.gov/gteunauth/—,/#36