AG 20-232 - FHL Tile1 RETURN TO: TIM J014NSON EXT� 2412
. ...... ... ...
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
. ORIGINATING DEPT/DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TIM JOHNSON
TYPE OF DOCUMENT (CHECK ONE):
El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP RFQ)
El PUBLIC WORKS CONTRACT D SMALL OR LIMITED PUBLIC WORKS CONTRACT
0 PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CDG
El REAL ESTATE OCNT0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
0 ORDINANCE 0 RESOLUTION
El CON-fRACTAMENDMINT(AG#):__ El INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECTNAME:— CARES ACT GRANT - ROUND I
NAME OF CONTRACTOR: FHL, TILE
ADDRESS: 1800 S 330TH ST, #AI06, FEDERAL WAY, WA, 98003 TELEPHONE: (253) 426-9366
E-MAIL: FHLTILE@GMAIL.COM
SIGNATURENAME: BRYSIUKBRYSIUK TITLE: >SEE ATTACHED
EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/I 00 ($1,00000)
(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 C1 YES X NO IF YES, $ — PAID BY. El CONTRACTOR 0 CITY
RETAINAGE: R-ETAINAGEAmoUNT: --Q RETAINAGE AGREEMENT (SEE CONTRACT) OR 0 RETAINAGE BOND PROVIDE
0. DOCUMENT/CONTRACT REVIEW
Ll PROJECT MANAGER
• DIRECTOR
• RISKMANAGE MENT (IF APPLICABLE}
11 LAW
SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
[] SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:—
[I 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
0 SIGNATORY (MAYOR OR DIRECTOR)
El CITY CLERK WT15ftm
El ASSIGNED AG# AG#
1/2020
Fyet 6eral My
CrTY HALL
33325 Sth Avenue South
Federal Way. WA 98003-6325
(253) 835-w-,000
wwwatyoffederalway-com
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
FHL TILE
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and FHL Tile, a sole proprietor ("Grantee"). The City and Grantee (together ",Parties") ar,,*
located and do business at the below addresses which shall be valid for any notice required under this
Agreement:
Igor Brysiuk
1800 S 330TH ST, #A106
FEDERAL WAY, WA 98003
fhltile@grnail.com
lei I Mae] a of of 113 AR
Ade Ariwoola
33325 8th
Federal Way, WA 98003-63217
(253) 835-2520 (telephon-
s
)
(253) 835-2509 (facsimile)
4c,skvile!t
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
,i&sc-w.bed Verei-c.
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 pandemic
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
Incurred over $1,000 in CI -19 related expenses
Experienced 10-50% lost revenue
Experienced over 50% lost revenue
1 1 0#0 MEOW- M-efroWiTS
ffiffl��Mfflill I q1 I I
CITY OF CITY HALL
33325 Sth Avenue South
Federal Way Federal Way WA 98003-6325
(253) 835-7000
mm. cityoffederakray 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. GRANT AMOUNT.
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/100 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.
WEENIM . M I 1104
5.1 Gtantot Indemnification. 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 deten-nine 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
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 Industrial Insurance 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 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.
CITY OF
F�dera I 1AW
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
mvw.cityoffederalwaycom
5.3 City Indemnification. 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 InteWretation �and Modification. This
• contains all of the agreements • 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 agreement signed by duly authorized
representatives of the Parties.
6.3 Execution. Each individual executing this Agreement on behalf of the City and Grante*
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
4 CITY Of
P6deral 7
CVTY HALL
33325 Sth Avenue South
Federal Way.. WA 980903-6325
(253) 335-7000
www cftyoffederalway corn
signaturethe 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
and acknowledgment pages. The i.,_ upon which the last of
Parties - executed
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 AY:
ly Jim Ferrell, Mayor
ATE: —gus 2-0 Z (1-3
By:
Printed e:
Title:lep-
ATE: Q.
7/25/2020 eServices
'VVash0n,.gton Depkartrnia.rlt of Reve'ru,""e
S e,� r,", 1 c P3 u s, i n ess L o o k u r) FHIL TILE
License Information:
Entity name:
BRYSIUK, IGOR
Business name:
FHL TILE
Entity type:
Sole Proprietor
UBI #:
604-299-677
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
1800 S 330TH ST
APT A106
FEDERAL WAY WA 98003-9401
Mailing address:
1800 S 330TH ST
APT A106
FEDERAL WAY WA 98003-9401
Excise tax and reseller permit status: Click here
Endorsements
Endorsements held at this
location License # Count Details
Federal Way Home Occupation
Business
Governing People may include governing people not registered with Secretary of State
Governing people
Title
BRYSIUK, IGOR
BRYSIUK, TETIANA
Registered Trade Names
New search Back to results
Status Expiration date
Active Feb -28-2021
Registered trade names Status First issued
FHL TILE Active Jul -02-2018
The Business Lookup information is updated nightly. Search date and time: 7/25/2020 12:40:38 PIM
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