AG 20-408 - Palace SpaEXT: 2412
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ORIGINATING DEPT./DIV: ECONOMIC DE
EVVELOPMEN'1�
ORIGINATING STAFF PERSON: TIM JOHNSON .... ...... EXT: 2412 1 DATE REQBY: ASAP
TYPE OF DOCUMENT (CHECK ONE):
9 CONTRACTOR SELECTION DOCUMENT (E.G
0 PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
11 PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
E] GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/ CBG
El REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE El RESOLUTION
El CON TRACTA MENDMENT(AG#):_ 11 INTERLOCAL
X OTHER _-CARES ACT I"U N.DS BUS INESS SUPPORT GRANT AGREE\NTENIT
PROJECT NAME: CARES ACT GR NT — ROUND
NAME OF CONTRACTOR: PALACE SPA
ADDRESS: 1727 S 316TH ST, FEDERAL WAY, WA, 98003 TELEPHONE: (323) 702-6310
E-MAIL: KuAs600@YAHOO.COM
SIGNATURE NAME: Kim Kum TITLE: SEE ACHED
E:4-JIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES 0 COMPENSATION F-1 INSURANCE REQUIREMENTS/CERTIFICATE 0
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
COMMENCEMENT DATE: __5_EE ATTACHED _A, COMPLETION DATE:
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) Two THOUSAND AND NO/I 00 ($2,000.00)
(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 El YES X NO IF YES, $ u PAID BY. L1 CONTRACTOR 0 CITY
RETAINAGE: RETAINAGEAmoUNT: —0 RETAINAGE AGREEMENT (SEE CONTRACT) OR 11 RETAINAGE BOND PROVIDE
1:1 PURCHASING: PLEASECHARGETO: 001-1800-990-518-10-490 Pr
��ftdt�4e # 267662�25060
0. DOCUMENT/CONTRACT REVIEW INITIAL/ DATE REVIEWED INITIAL I D,,kTE_APPROVEQ
0 6'OJECT MANAGER
-,--,/DIRECTOR
0 RISKMANAGE MENT (IF APPLICABLE)
El LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: CouNcm APPROVAL DATE:
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:--
* ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
* CREATE ELECTRONIC REMINDERJNOTIFICATION 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-)
INLLIAL / DA "E SIGNEP
El LAW DEPARTMENT _SIGNED BYLAW 07-28-20,_
El SIGNATORY (MAYOR OR DIRECTOR)
0 CITY CLERK
:--- C
El ASSIGNED AG# A AGC_
#
'OMMENTS:
1/2020
CITY OF CITYLL
33325 Sth Avenue South
.:IS,, Federal Way, WA 98003�6325
(M) 8355-7DOO
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREENINT
WITH
PALACE SPA
This Grant " e t») is made between the City of Federal Way, a Washington municipal
corporation (" % and HSR Spa Inc, a Washingtoncorporation C' r tee' . The City and Grantee
"Parties") located "and do business at the below:addresses which shall be valid for any -notice required under
this t.
PALACE IOF]FEDERAL WAY:
Seung Hoe KimAdo Ariwoola
1727 S 31` ' St,'Federal Way, WA 98003 33325t . S.
Mailing address: Federal Way, WA 98003-6325
3 336" St , Federal Way, WA 98003
( 3) $35-2520 (telephone)
3) 3 10 (telephone) (253) 835-2509 (facsimile)
Idms6OO@yahoo.com ool city federal ay.
The Parties agree a& follows:
1. TERX This agreement contemplates a' one-time :. grant of funds to th6 Grantee under the. conditions
described i .
2. CONDITIONS OF �RANT
.1 ties. The Grantee warrants the following, which are re sits for grant eligibility:
) Grantee operates a business physically located within the `tie o es of the e City,
of Federal Way;
) Grantee maintains a current City of Federal Way businm license
c) Grantee has paidl taxes and governmeint fees due up to the date of execution of this
grant agreement
) Grantee is not the recipient o other state or federal funding madeavailable as a response
to the COVID-19oe . i
) Grantee"s businessGrantee"o care than the equivalent of ten full-time
employees ( s total for all employeesyear).
f) Gr
e ).
r to ' netrevenues do not exceed more 1million year
Grantee does not operate as t business as definedt v e
Service
h) Due to -1 , Grantee business (check all that apply),
Was required by state or local order o close
Was o to lay off employeesue to reduced patronage
Incurred over S 1,000 mi COVID-1. related expenses
Experienced 10-50% lost revenue
Experiencedover % lost revenue
2.2 Use of Funds. Grantee affirms t grant funds will be used for the following z os
BUSINESSCARES ACT -1T
�l,
J t� CITY OFjvt�� PwOoj i ft�
Seung Hee Kim
1727 S 316th ST
MAYOR.&OFFIC
8th Avenue
N6 33325
f!i
Www
• s
Jim
a
Erl([Osed� is z grant contract for voUr review an&5i n I I . signature blease �place in enclosed
Velopo and �ret6rn with postage to the city for processing. Upon receipt, the City, will
P*ess acheck i} your business.
Should you have any questions, contact the City
hotline 253-83,5-2414.,
committedFhelgingbusinesses Hk Vbrsl
i 'i■ #
WGstj941 i t i
WIM711"Conomy, please contactour ►r ot Economit !* - aD-Johnson
24A n
12.
wereaWin'thistogether.
00
CITY OF CITY HALL
'w" 33325 8th Avenue SCUth
Federal Way Federal Way, WA 9s M325
(253) $35-7060
Agreement may be executed,in any number of counterparts, each of which shall be deemed an original d with
the same effect as if ° 1 Parties hereto had signedsame document. All such counterparts shall be construed
together"shall constitute one instrument, but in making proof hereof it shall only be necessary to produce
one such counterpart. e signature and acknowledgrnent pages from such o to s 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" last of all of the Parties have executed
counterpart of this Agreement shad be the" to of mutual e do °' hereof
IN WITNESS, e Parties execute this Agreement below, effective the last date written below.
CY17Y OF FEDERAL WAY:
e ell, may6r
DATE: 4��//2�/
PALACE Spy. ..
By:
Printed e, :5- i yq 1 ee
Title: 0 W
DATE: N,s
CARR
IS A .T, TRINFIRR CIR ANT Ar. R A ti A
7/25/2020 eServices
Washington State Department of Revenue
Services Business Lookup PALACE SPA
License Information:
New search
Back to results
Entity name: HSR SPA INC.
Business name: PALACE SPA
Entity type: Profit Corporation
UBI #: 604-565-150
Business ID: 001
Location ID: 0001
Location: Active
Location address: 1727 S 316TH ST
FEDERAL WAY WA 98003-5499
Mailing address: 930 S 336TH ST
STE D
FEDERAL WAY WA 98003-6384
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Endorsements
Endorsements held at this location License # Count
Details Status Expiration date
First issuance
Federal Way General Business
Active Jan -31-2021
Mar -20-2020
Governing People May include governing people not registered with Secretary of State
Governing people
Title
KIM, SE UNG HEE
President, Secretary, Treasurer, Chairman of the Board
Registered Trade Names
Registered trade names Status
First issued
PALACE SPA Active
Jan -03-2020
https://secure.dor.wa.gov/gteunauth/,/#1 30 1/1
8/13/2020 Corporations and Charities System
Business Name:
HSR SPA INC.
U Number:
604 565150
Business Type:
WA PROFIT CORPORATION
Business Status:
ACTIVE
Principal Office Street Address:
1727 S 316TH ST, FEDERAL WAY, WA, 98003-5499, UNITED STATES
Principal Office Mailing Address:
930 S 336TH ST STE D, FEDERAL WAY, WA, 98003-6384, UNITED STATES
Expiration Date:
01/31/2021
Jurisdiction:
UNITED STATES, WASHINGTON
Formation/ Registration Date:
01/02/2020
Period of Duration:
PERPETUAL
Inactive Date:
Nature of Business:
RETAIL
el 6-19 A V . Me] A a
Registered Agent Name:
JAESOON PARK CPA PLLC
Street Address:
930 S 336TH ST STE D, FEDERAL WAY, WA, 98003-6384, UNITED STATES
Mailing Address:
930 S 336TH ST STE D, FEDERAL WAY, WA, 98003-6384, UNITED STATES
X*00=101161
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Governors Typi
VDIVIDUAL
Entity Name is Name
ONIJK62*61-44
Ism
https://ccfs.sos.wa.gov/#/BusinessSearch/Businessinformation 1/1