AG 20-131 - Angels of AmericaEXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
. ORIGINATING DEPT/DIV.- ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TPA JOHNSON EXT: 2412 3. DATE Q. BY._ ASAP
TYPE OF DOCUMENT (CHECK ONE):
11 CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
0 PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
11 GOODS AND SERVICE AGREEMENT E] HUMAN SERVICES / CG
11 REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
0 ORDINANCE E] RESOLUTION
11 CON TRACTA MENDMENT(AG#): 0 INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
. PROJECT NAME: CARES ACT GRANT - ROUND I
NAME OF CONTRACTOR: ANGELS OF AMERICA ADULT FAMILY HOME, LLC
ADDRESS: 4041 SW 321ST ST, FEDERAL WAY, WA, 98023 TELEPHONE: (206) 351-0615
E-MAIL: ANGELSOFAMERIC AAFH@GMAIL.COM
SIGNATURENAME: NERIo BIDES TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: 11 SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE L3 A
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN 13 REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS i
. TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETIONIIF
ATE:
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) Two THOUSAND AND NO1100 ($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, $ PAID BY: El CONTRACTOR 0 CITY
RETAINAGE: RETAINAGE AMOUNT: 0 RETAINAGE AGREEMENT (SEE CONTRACT) OR [I RETAINAGE BOND
ROVIDED
a PURCHASING: PLEASE CHARGE TO:. 001-1800-990-518-10-490Project Code# 267662-25060
0. DOCUMENT/CONTRACT REVIEW
0 OJECT MANAGER
OR
El RISK MANAGEMENT (IF APPLICABLE)
0 LAW
INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
SCHEDULED COMMITTEE DATE: COMM1TTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
0 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
0 L EP TME
SIGNATORY
ORY (MAYOR OR DIRECTOR)
I `N A:
11 CITY CLERK
O(ASSIGNED AG AG
1/2020
CITY bF
F&deral My
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cjtyoffederahwv coni
CAx1V S ACT FJNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
ANGELS OF AMERICA ADULT FAMILY HOME, LLC
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Angels of America Adult Family Home, LLC, 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:
11111 1111111prip 111T.111121111! r111111;11j;1!11
7C1W=y-411 ilKIRLi6i Ll AL
HOME, LLC:
Nerio Bides
4041 SW 321 ST St
FEDERAL WAY, WA 98023
WM "11 111,1111 1,11,111MMIT"
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2520 (telephone)
(253) 835-2509 (facsimile)
ade.ariwoola@cityoffederalway.com
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
1 0 0 MU4 .91,1121
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):
E] Was required by state or local order to close
E] Was forced to lay off employees due to reduced patronage
Incurred 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 funds will be used for the following purposes:
CITY OF CITY HALL
All 33325 8th Avenue South
,sS�� Federal Way Federal Way, WA 98003-6325
(253) 835-7000
wmvotyoffe-deralwaycom
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.
4.1 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 Two Thousand and NO/100 Dollars ($2,000.00).
4.2 AN9�q:Aporopridtion qLFW6. 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.
5.1 Grft�q Iridbolgifiggfigg. 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 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
resulting from the concurrent negligence of the Grantee and the City, the Grantee's liability hereunder shall be
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 hisuraftce Act��. 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 SIS" HALL
4! 33325 8th Avenue South
ANN Federal Way WA 98003-6325
Federal Way (253) 835-7000
wim cityoffedera(way com
WA I W& IN
qu-IM114M
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.
I I - M"KIN
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6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
CARES ACT BUSINESS GRANT AGREEMENT -3 -
CITY OF
P e
;6d ral My
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www otyoffedeTalway cam
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 a
counterpart of this Agreement shall be the "date of mutual execution" hereof.
FN WITNESS, the Parties execute this Agreement below, effective the last date written below.
J 5
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9M
DATE:
By:
Printed Name:
I
Title: FW
DATE:.—
7/24/2020 eServices
Services Business Lookup ANGELS OF AMERICA ADULT FAMILY HOME, LLC
License Information: New search
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Entity name: ANGELS OF AMERICA ADULT FAMILY HOME, LLC
Business name: ANGELS OFA ERICA ADULT FAMILY HOME, LLC
Entity type: Limited Liability Company
UBI #: 603-524-916
Business ID: 001
Location ID: 0001
Location: Active
Location address: 4041 SW 321ST ST
FEDERAL WAY WA 98023-2413
Mailing address: 4041 SW 321ST ST
FEDERAL WAY WA 98023-2413
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 18 -100596 -00 -BL Active Aug -31-2021
Feb -26-2018
Governing People may include governing people not registered with Secretary of State
Governing people Title
BIDES, NERIO A
Registered Trade Names
Registered trade names Status
First issued
ANGELS OF AMERICA ADULT FAMILY HOME Active
Jul -16-2015
The Business Lookup information is updated nightly. Search date and time: 7/24/2020 3:21:50 PM
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