AG 20-420 - Pho HoangRETURN TO: EXT: (21
1 I
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE REQ. BY. ASAP
TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES/ CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
❑ OTHER
. PROJECT NAME: CARES ACT GRANT RESTAURANT AMENDMENT
NAME OF CONTRACTORYHO HOANG RESTAURANT, AN XUAN PHAM L_ Ld—
ADDRESS: 31871 GATEWAY CENTER BLVD S TELEPHONE: (253) 529-7288
E-MAIL: PHOHOANGFEDERALWAY@YAHOO.COM
SIGNATURE NAME: ANDY PHAM TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
TERM: COMMENCEMENT DATE:
COMPLETION DATE:
TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) FIVE THOUSAND AND NO/ 100 ($5,000)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES ❑ NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ .PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT:
❑ PURCHASING: PLEASE CHARGE TO:
0. DOCUMENT/CONTRACT REVIEW
0 P CT MANAGER
IRECTOR
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW
1. COUNCIL APPROVAL (IF APPLICABLE)
2. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR
T) RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDE
INITIAL / DATE REVIEWED
SCHEDULED COMMITTEE DATE:
SCHEDULED COUNCIL DATE:
DATE SENT:
INITIAL / DATE APPROVED
dq
! er
COMMITTEE APPROVAL DATE:
COUNCIL APPROVAL DATE:
DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 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
❑ LAW DEPARTMENT
ATORY (MAYOR OR DIRECTOR) I
CITY CLERK
❑ SSIGNED AG# AG# 20-420
;OMMENTS:
1/2020
CITY OF CITY HALL
Fe d e ra I Way 33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www. ciryoffederalway com
AMENDMENT NO. 1
TO
CARES ACT BUSINESS SUPPORT GRANT AGREEMENT
WITH
PHO HOANG RESTAURANT, AN XUAN PHAM LLC
This Amendment ("Amendment No. 1") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Pho Hoang Restaurant, An Xuan Pham LLC, a limited liability company ("Grantee").
The City and Grantee (together "Parties"), for valuable consideration and by mutual consent of the Parties, agree
to amend the original Agreement ("Agreement") dated effective November 17, 2020, as follows:
1. AMENDED COMPENSATION. The amount of the grant, as referenced by Section 4 of the Agreement,
shall be amended to change the total grant the City shall pay the Grantee as delineated in Exhibit A-1, attached
hereto and incorporated by this reference. Contractor shall be solely responsible for the payment of any taxes
imposed by any lawful jurisdiction as a result of payment of this Agreement. 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.
2. GENERAL PROVISIONS. All other terms and provisions of the Agreement, together with any prior
amendments thereto, not modified by this Amendment, shall remain in full force and effect. Any and all acts done
by either Party consistent with the authority of the Agreement, together with any prior amendments thereto, after
the previous expiration date and prior to the effective date of this Amendment, are hereby ratified as having been
performed under the Agreement, as modified by any prior amendments, as it existed prior to this Amendment.
[Signature page follows]
AMENDMENT - 1 - 3/2017
` CITY OF CITY HALL
Fe d e ra I Way Feder 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederalway.com
IN WITNESS, the Parties execute this Agreement below, effective the last date written below.
CITY OF FEDERAL WAY:
By: C)
Jim Fe Nftyor
DATE: 1
PHO HOANG RESTAURANT, AN XUAN PHAM LLC:
By:
Printed Name:
Title: n k) K e. ��
AMENDMENT - 2 - 3/2017
CITY OF: CITY HALL
Federal Way Feder 8th Avenue South
8003
Federal �Vay. N!A 98003-6325
(253) 835-7000
wivw c; tyoffederalway coir
EXHIBIT A-1
ADDITIONAL COMPENSATION
1. Total Compensation: In order to promote economic activity in the City and in response to losses incurred due
to the COVID-19 pandemic, the City shall provide an additional grant amount not to exceed Five Thousand -and
NO/100 Dollars ($5,000.00). The total amount payable to Grantee pursuant to the original Agreement and this
Amendment shall be an amount not to exceed Five Thousand and NO/100 Dollars ($5,000.00).
AMENDMENT - 3 - 3/2017
RETURN TO: TIM JOHNSON 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):
❑ CONTRACTOR SELECTION DOCUMENT (E.C�, RFB, RFP, RFQ)
EXT: 2412 3_ DATE REQ. BY: ASAP
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES/ CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACTAMENDMENT(AG#): ❑ INTERLOCAL
X OTHER CARES ACT FUNDS BUS [NESS SUPPORT GRANT AGREEMENT
PROJECT NAME:
NAME OF CONTRACTOR:! PHO HOAN PAD HOMQ 6 RiesTAUIZAMT
ADDRESS: 31871 GATEWAY ENTER BLVD S, FEDERAL WAY, WA, 98003 TELEPHONE: (253) 529-7288
E-MAIL: PROHOANGFEDERAY@YAHOO.COM
SIGNATURE NAME: PHAM PHAM TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS
TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETION DATE:
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: ❑ YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED
❑ YES X NO IF YES, $
PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDE
❑ PURCHASING: PLEASE CHARGE TO:. 001-1800-990-518-10-490 Project Code # 267662-25060
0. DOCUMENT/CONTRACT REVIEW
❑ PROJECT MANAGER
❑ DIRECTOR
❑ RISKMANAGEMENT (IFAPPLICABLE)
❑ LAW
INITIAL/DATE REVIEWED INITIAL/ DATE APPROVED
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 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
❑ LAW DEPARTMENT IGS D BY L w 07-28-20
IATORY (MAYOR OR DIRECTOR) a
❑ CITY CLERK
❑ ASSIGNED AG# AG# 2i -L12.4
;OMMENTS:
1/2020
. J-0
city OF M, HALL
�.�. Feder 3COOth ue South
Federal `clay Vi`A 99003-6325
Federal Way 253 ; 35-
,.,..v )If, Lie(
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
PHO HOANG RESTAURANT. AN XUAN PHAM
This Grant Agreement (``Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Pho Hoang Restaurant, An Xuan Pham 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:
� PN/1An�^T(_AFCT1i'p.��TT �N�TT��T
PHAM:
An Pham
31871 GATEWAY CENTER BLVD S
FEDERAL WAY, WA 98003
('53) 52n n00 1uluFl
lV LlG),
phohoangfederalway@yahoo.com
The Parties agree as follows:
rr•ry n17VVnV D .. T X... v.
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2520 (telephone)
(251) ;35-2_G3
ade.ariwooIa@cityoffederalway.com
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
descn oed 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 pandemic
e) Grantee's business employees no more than the equivalent of ten (10) full-time
emplovees (20.800 man-hours total for all emnlovees ver vear).
t) Grantee's net revenues do not exceed more than S 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
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11 ll.rullVU VY�rI y'l I,V VV 111 VV � 1L-171LLLLL{..0 VA�1l.1lJl.J
❑ Experienced 10-50% lost revenue
Experienced over 50% lost revenue
CARES ACT BUSINESS GRANT AGRFFMF.NT
CITY OF CIT'rHALL_
33,325 8*h Aven,.e Sc�.V,,
.�
Federal Way Federal Aa} 98GC3-5325
1253;83=-7000
acknowledge that they have mutually negotiated this waiver.
4�.3 City Indemnificatil�n The City a�*rees to release- indemnify. defend and held the Grqntc-e ;N
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. GENERAL PROVISIONS.
6.1 Into rotation and '.10odific:ation. This Agreement contains all of the agreements of the Parties
rr!Zh ant i7natt,i L.V w\.1 VU VL 111\.11L1V11L.L1 111 1.1113 a11L1 1LV PLLUl 3LaL1-:L11G11LJ UL a61GGl1LC11LJ,
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.
0.2 tntorcement. Any notices required to be given by the Farttes shall be delivered at the addresses
set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the
notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice
so posted in the United States mail shall be deemed received three (3) days after the date of mailing. Any
remedies provided for under the terms of this Agreement are not intended to be exclusive, but shall be
cumulative with all other remedies available to the City at law, in equity or by statute. The failure of the City to
insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to
exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver
or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and
effect. Failure or delay of the City to declare any breach or default immediately upon occurrence shall not waive
such breach or default. Failure of the City to declare one breach or default does not act as a waiver of the City's
right to declare another breach or default. This Agreement shall be made in. governed by, and interpreted in
accordance with the laws of the State of Washington. if the Parties are unable to settle any dispute, difference or
claim arisiniz from this Aereement. the exclusive means of resolving that diSDUte. difference. or claim. shall be
by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County,
Washington, unless the parties agree in writing to an alternative process. If the King County Superior Court
does not have jurisdiction over such a suit, then suit may be tiled in any other appropriate court in King County,
Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County,
Washington and waives any objection that such courts are an inconvenient forum. If either Party brings any
claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and
PYnPn QPQ inrltrrPd In (l PfPnrl7nV nr 6rincnnn cnrh nigh,, nr 1�n•cr7ih innhiriinn oll nn"lc n �d,44;r
recovery or award provided by law-, provided, however, however nothing in this paragraph shall be construed to
limit the Parties' rights to indemnification under Section 5 of this Agreement.
6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee
CARFS .ACT BUSINESS GRANT AGREF.MFNT - ; -
CITY OF CITY HALL
�� 8th Avenue South
Federal Way Feder
Federal 'J1lay SVA 98003-6325
12531835-7000
sww U1, 0r,:0VI ,rwav LU.',:
2.2 Use .of Funds: Grantee affirms that grant funds will be used for the following purposes:
a) Mortgage or Rent
UJ Ft:UjUtidl FrU1CLAW11 Gqulpinein
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 (S 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.
5. INDEMNIFICATION.
5.1 Grantee 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
anv and all elnim, demand,; nrtinnc cuitc rancea of irtion arh1tratinnc mPrtiatinn¢ nrnrPPr11nvc Mdo nPntc
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
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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.-, industriai insurance tact waiver. it is speciricaiiy and expressiy unaerstood tnat the Orantee
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
e"r n I' C 7\ *r' C• C' !"` n A A ^r A/ n r" 1 1 T T X r 'T
LI 11\LJ \\.l UVJL.�LJU V1\lil�A AV1\LLIV LLIIL ,,,,
urr of
400.,Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
�tiIvw otyoffedera'wav colli
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
Ag=reement may be executed in any number of counterparts, each ofwhich shall be deemed an original and with
the -qame effect as if all Parties hereto had signed the same cin..umernr A11 cu(,h coljntem�r+c , qII h� r•I I
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 WAY:
Jim Fe . 1i `
DA I E: i
PHO HjANG REST
�
By: --I.
Printed Name:
Title: j
DATE:
NT, ANXL'A PHAM:
t r:i t _\ ,I
Inti/)
CARES ACT BUSINESS GRANT AGREEMENT -4-
7/25/2020
Washington State Department of Revenue
Services Business Lookup PHO HOANG
License Information:
Entity name:
PHO HOANG, LLC
Business name:
PHO HOANG
Entity type:
Limited Liability Company
UBI #:
602-997-249
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
31871 GATEWAY CENTER BLVD
FEDERAL WAY WA 98003
Mailing address:
1215 S MAIN ST
SEATTLE WA 98144-2030
Excise tax and reseller permit status: Click here
Secretary of State status:
Click here
eServices
New search Back to results
Endorsements
Endorsements held at this location License # Count Details Status Expiration date
Federal Way General Business 10 -101295 -00 -BL Active Mar -31-2020
Restaurant Beer Only 80051 Active Mar -31-2021
('governing People May include governing people not registered with Secretary of State
Governing people Title
HUYNH, MAI
PHAM, AN
Registered Trade Names
Registered trade names
PHO HOANG
Status
Active
The Business Lookup information is updated nightly. Search date and time: 7/25/2020 3:52:22 PM
Working together to fund Washington's future
First issuance
Jun -04-2010
Dec -27-2010
First issued
Mar -05-2010
https://secure.dor.wa.gov/gteunauth/_/#176 1 /1