AG 20-316 - JSI Holding Corpa N a IN lRew toW1110NUf #101
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CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE Q. BY ASAP
OLKEN I tallaw [61t&I go 7_4111 I Mill
Ei PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
• PROFESSIONAL SERVICE AGREEMENT 11 MAP47ENANCE AGREEMENT
• GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/ CDBG
• REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G BOND RELATED DOCNTS)
El ORDINANCE 11 RESOLUTION
* CON TRACTAMENDMENT(AG #):_ DINTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT G H'ACs REEMENT
PROJECTNAME CARES ACT GRANT— RQVNDt,,,,__
NAME OF CONTRACTOR: T'�VTNLAKES CLEANERS
ADDRESS, 461&SW320TH ST, FEDERAL WAY, WA, 98023 TELEPHONE: (2s)!j32-9586
EAIAIU tHARL]Ef[ANFS@OCffMkg-.COM AAA/N -TWfj MS
TITLE-. SEEArTACHED
EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES 0 COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICATE 0 ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN OREQUIRED LICENSES C)PRIOR CONTRACT/AMFNDMENTS
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IFAM) ONE THOUSAND AND NO/100 ($1,000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: 0 YES XNO IF YES, MAXIMUM DOLLAR AMOUNT:
IS SALES TAX OWED DYES X NO IF YES, PAID BY. 11 CONTRACTOR 0 CITY
RETAINAGE: RFTAINAGE AMOUNT: El RETAINAGE AGREEMENT (SEE CONTRACT) OR DRETAINAGE BOND PROVIDII
0 PURCHASING: PLEASE CHARGE TO: _09J -1800z990-518-10 -490 Prosect Code# 267662-25060
!9
0. DOCUMENT/CONTRACT REVIEW INITIAL/ DATE REVIEWED 1NITIAL'DA- .u,APPRovED
O'FROJECT MANAGER
7kDIRECTOR j,
C''
RISKMANAGEMENT (IFAPPLICABLE) — ------------- — — ------- --
11 LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE-, COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: w COUNCIL APPROVAL DATE -
El SENT TO VENDOR/CCINTRACTOR DATE SENT: , DATE REC'D:..,;,,
F-1 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
0 CREATE ELECTRONIC REMINDERiNOTIFICATION 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
0 2LA 'DEPAKIVE�NT L 07 8
Qj. NYOPW�MAYOR' OR DIRECTOR)
0 CITY CLERK
El ASSIGNED AG# AG#
1/2020
city Of
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www,cityoffederalwaycom
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
JS1 HOLDING CORP DBA AM/PM TWIN LAKES CLEANERS
This Grant Agreement ("Agreemenf) is made between the City of Federal Way, a Washington municip]
corporation ("City"), and JSI Holding Corp dba AMfPM Twin Lakes Cleaners, a Washington corporati
("Grantee"). The City and Grantee (together "Partiee) are located and do business at the below address
which shall be valid for any notice required under this Agreement:
JSP HOLDING CORP DBA AM/PM TWIN
LAKES CLEANERS:
Jung Ilan
4616 SW 320TH ST
FEDERAL WAY, WA 98023
(253) 3329586 (telephone)
charliehail.com
The Parties agree as follows:
OF FEDERAL WAY:
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 8352520 (telephone)
(253) 8352509 (facsimile)
ade.ariwoola@cityoffederalway.com
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
2. CONDITIONS OF GRANT
-CARES ACT BUSINESS GRANT AGREEMENT - I -
CITY OF CITY HALL
33325 8th Avenue South
AIS, Federal Way Federal Way, WA 98003-6325
(253) 835-7000
www atyoffederalway com
2.2 Use of Funds: Grantee anns that grant funds will be used for the following purposes:
Grantee agrees to retain reccipts 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 insection 2. 1, above, not be met, the City
may recover all disc ad grant fun&, 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 lossil
ms jfaggl, due- tg4g.-W
2av4wffjj,, Ag ';b IL
4.2 Nl . If sufficient fiinds are riot appropriated or allocated for payment
under this Agreement for any fiscal period, the City will not be obligated to mike payments -under this
agreement.
5. INDEMNIFICATION.
5.2 Industrial In 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 dainages, compensation or benefits payable to or by any third petty under
CARES ACT BUSINESSGRANT AGREEMENT - 2 -
CITY OF CrrY HALL
33325 Sth Avenue South
Federal Way, WA 98003-6325
Federal Way (253) 835-7000
www a1yoffederahvey com
workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further
acknowledge that they have mutually negotiated this waiver.
5.3 The City agrees to release, indemnify, defend and hold the Grantee,
antee
�J
�7
officers, directors, shareholders, partners, employees, agents, representatives, and sub- contractors harmle
from any and all claims, demands, actioms, suits, causes of action, arbitrations, inediations, proceedin
judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, cos
and/or litigation expenses to or by any and all persons or entities, including without limitation, their respecti
a2ents, iicenseei f r fr -0 2, _ mi
SEE==
5.4 SUM
— �val. The provisions of this Section shall survive the expiration or termination of th
Agreement, with respect to any event, occurring prior to such expiration or termination, I
6. GENERAL PROVISIONS.
CARE S ACT BUSINESS GRANT AGREEMENT -3-
coly OF CITY HALL
33326 8th Avenue South
Federal Way Federal Way, WA 98003-6325
(253) 835-7000
.coo
CITY OF FEDERAL WAY:
JS1 HOLDING CORP DBA AMIPM TWIN
Printed Name-,
Title:
DATE:
CARES ACT BUSINESS GRANT AGREEMENT -4-
7/25/2020
Wa, �' 'n i n g t oo, 3t a 1, e D r,,,p a r is i � e I t () f R, --V te, n Ll
SeiMce's B,,,miness 1-ookuq�,, TWiN LAKES CLEANERS
License Information:
Entity name:
JSI HOLDING CORPORATION
Business name:
TWIN LAKES CLEANERS
Entity type:
Profit Corporation
UBI #:
602-879-992
Business ID:
001
Location ID:
0002
Location:
Active
Location address:
3440 SW 320TH ST
FEDERAL WAY WA 98023-2293
Mailing address:
4616 SW 320TH ST
FEDERAL WAY WA 98023-2400
Excise tax and reseller permit status: Click here
Secretary,of State status:
Click here
R -Mm
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Endorsements
Endorsements held at this location License # Count Details Status Expiration date First issuanCE
Federal Way General Business 01 -102846 -00 -BL Active Nov -30-2020 Jul -26-2001
Governing People May include governing people not registered with Secretary of State
Governing people Title
HAN, IN
HAN, JUNG
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