AG 20-503 - ARCO AMPM - PHSEXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPI/DIV: ECONOMIC DEVELOPMENT
. ORIGINATING STAFF PERSON: TIM JOHNSON - EXT: - 2412 3. DATE REQ. BY: ASAP
El PUBLIC WORKS CONTRACT 11 SMALL OR LIMITED PUBLIC WORKS CONTRACT
0 PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT 11 HUMAN SERVICES/ CDBG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE 0 RESOLUTION
El CONTRACT AMENDMENT (AG#):_ D INTERLOCAL
X OTHER CARES ACT rUND-S BUSINESS SUPPORT GRANTAGREA'MENT
PROJECT NAME: CARES ACT GRANT- ROUND 1,
NAME OF CONTRACTOR: ARCO AMPM
ADDRESS: 35505 PACIFIC HWY S, FEDERAL WAY, WA, 98003 TELEPHONE: (253) 344-9113
E-MAIL: BIKRAM_BIRK@YAHOO.COM
SIGNATURENAME: BIRKBIRK TITLE: SEEATFACHED
EXAIBITS AND ATTACHMENTS: 1:1 SCOPE, WORK OR SERVICES 0 COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICATE El Al
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
. TERM: COMMENCEMENT DATE:-ATTACHEDA( COMPLETION DATE -
TO I TAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/I 00 ($ 1,000.00)
(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 0 YES X NO IF YES, $ PAID BY: 11 CONTRACTOR 11 CITY
RETAINAGE: RETAINAGEAmOUNT: —Ei RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND PROVID
1:1 PURCHASING: PLEASE CHARGE TO: 001-1800-990-5 1 8-10-490 Pr I iect Code # 267662-25060
0. DOCUMENT/CONTRACT REVIEW INITIAL/ DATE REVIEWED, INIT'IALI DATE APPROVED
0 PROJECT MANAGER
1I CTO 4t) 6
El RISKMANAGEMENT (IFAPPLICABLE)
El LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: m COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
0 SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:—
El 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
D LAW DEPARTMENT SIGNED By L 7- 8-20
El SIGNATORY (MAYOR OR DIRECTOR)
EJ CITY CLERK
F-1 ASSIGNED AG# AG# 1,0
'OMMENTS:
1/2020
CITY Vf
F6d&al AAkky
FUNDSCARES ACT r
WITH
ARCO AMPM
CITY HALL
33325 8th Avenue South
0
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation i r a Washington, 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 • -
r � �
IiN •.11
r r 11011M
Ade s ff:J
Ave.33325
iFederal Way, WA 98003-6325
1 (telephone)
li
1. TERM. This agreement contemplates• of • to the Grantee• -conditions
described
Warranties.- Grantee warrants the following,are pre -requisites f• r
a) Grantee operates a business physically locatedwithin the political boundaries of
of Federal
r of -i business
c) Grantee has paid all taxes and government fees due up• the date oi of
grant agreement
d) Grantee is not the recipient of other state or federal funding made available as a response
to the COVID-
i pandemic
`
e) Grantee's business employeesno morethan theequivalent of ten
employees man-hours totalfor r f -. per .,
f) Grantee's net revenues do not exceed more than $1.5 million per year
• Grantee does notoperate i business as defined by Revenue
Service
h) Due to Df Grantee rapply):
Was required by state or local order to close
Was forced to lay off employees due to reduced patronage
Incurred over $1,000 in COVID-19 related expenses
1,Experienced 10-50% f
■Experienced over i% lost revenue
CARES ACT BUSINESS GRANT AGREEMENT 1
_AL CITY Of
F6d6rol My
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cayoffederalway coin
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes:
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 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.
5.1 Qatitee Indem-nificAfion. 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 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 is under
workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further
CITY �OF
Fbderal ANOY
CrTY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
mmotyoffederalwaycom
5.3 Cily 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 respectivg
nents- licensees or re%resentatives Wreement to the extem
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.
I - I CM M W Mei � , I I
6.1 ktgopgatiori grid Modj��. This Agreement contains all of the agreements of 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 aeai
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 Grantee
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
CITY O�F
A" ;%16- �
derol VV�
� &me
C1 A L33325 Sth Avenue South835-7000
Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with
the same effect a if all Partieshereto had signed the same document. All counterparts .ll 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.
IN WITNESS, the Parties execute this Agreement f. • effective the last date written below.
Wool 0 a a r
M
DATE:
By: t-conM
Printed Name: r✓`.
Title rn
DATE:Ay—?d
7/25/2020
eServices
Services Business Lookup ARCO AMPM
License Information:
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Entity name: TRIPLE B PAC HWY, INC.
Business name: ARCO AMPM
Entity type: Profit Corporation
UBI #: 603-570-659
Business ID: 001
Location ID: 0001
Location: Active
Location address: 35505 STATE HWY 99
FEDERAL WAY WA 98023
Mailing address: 35505 PACIFIC HWY 99
FEDERAL WAY WA 98003-7361
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
Cigarette Retailer
Active
Dec -31-2020
Apr -09-2018
Federal Way General Business 18 -103104 -00 -BL
Active
Dec -31-2020
Jul -24-2018
Grocery Store Beer/Wine 426287
Active
Dec -31-2020
Jul -19-2018
Liquid Fuel Meter - Low
50
Active
Dec -31-2020
Sep -10-2018
Lottery Retailer 280227
Active
Oct -08-2018
Tobacco Retailer - No Fee
Active
Dec -31-2020
Apr -09-2018
Underground Storage Tank
2 View Tanks
On Hold
Vapor Product Retailer
Active
Dec -31-2020
Apr -09-2018
Governing People May Include governing people not registered with
Secretary of State
Governing people
Title
BHANDAL, SARBJIT
BIRK, BIKRAM
SINGH, BIRKIRANDEEP
Registered Trade Names
Registered trade names
Status
First issued
ARCO AMPM
Active
Feb -13-2018
The Business Lookup information is updated nightly. Search date and time: 7/25/2020 5:23:40 PM
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