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AG 20-368 - Marie's DelegationRETURN O. TIM JOHNSON EXT: 2412 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM ORIGINATING DEPT./DIV. I ECONOMIC DEVELOPMENT - ORIGINATING STAFF PERSON: JIM JOHNSON EXT: 2412 3. DATE Q. BY' ASAP TYPE OF DOCUMENT (CHECK ONE): El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT • PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCE AGREEMENT • GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CDBG El REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G BOND RELATED DOCUMENTS) * ORDINANCE El RESOLUTION * CONTRACTA T (AG#): OINTERLOCAL * OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT-,-------_,, PROJECT NAME:_ CARES ACT GRANT- ROUND 1___ NAME OF CONTRACTOR: NURSEDELEGATION m ADDRESS: 32615 IOTH PLS , FEDERAL WAY, WA, 98023 TELEPHONE: (253) 332-2525 E-MAIL: MIUNDOTORI@GMAIL.COM SIGNATURE NAME: SONG SONG TITLE: SEEATPACHED I All . TERM: COMMENCEMENT DATE: SFEATTACHEDAGR - COMPLETION DATE: TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO1100 ($1,000.00) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: 11 YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED D YES X NO IF YES,$ PAID BYD CONTRACTOR 0 CITY RETATNAGE: RETAINAGE AMOUNT: 0 RETAINAGE AGREEMENT (SEE CONTRACT) OR 17RETAINAGE BOND PROVIDE 0 PURCHASING: PLEASE CHARGE TO: __001-1800-990-51,E-10-490?r 0. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL/ DATE APPROVED 0 P OJECTMANAGER Erol'IRECTOR El RISKMANAG EMENT (IFAPPLICABLE) 0 LAW 1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: r Lolelcy V ALT -41 &3 144004 Rol N as 112020 �. . a �, •�M! !• � � .� i '- �i 111 a1 a �;- e �. . '' 1 � d - 1 1 • ill - 1 1 ' i': `� . 6'.. i'. ! • i +' - i i " ,: ., • .:...moi �, �. �: 1 i •' . i e 1 l is e - ' / "i i ii +i s- li ` i. '.. i b :1 +J 1 is i i'. i i �J - - r 11 i i : i . - • •_ - • 1. . 1 •'.,.1 1 i. i i .: '. i i i i * i - / ; _J :�" 11 ' i 1 i .,: 1 i - i i " i i ' . ' i. i i , / '... i i - i :',i • - . - i �. • . ., i t i it f 1 i 1 i"1 i i' i' i. i Mj, i `i �i i i'+'i 4� iJi ` , _ .. � _ i i i # i i i" i �.. ._ � - .. i i !! -- i _ t_ _ i i i i, i i • i i i ii " - - . '; !� _ _ i i � y * � .. i : i - -. :+- :i _ � _... i _ ... _ i ♦ * �i � i" ..: 1 �- : - ... _. f . - :. �:-` - i � - - fi i � i', i 1 i . * Y + _ s i i i i � a 1 � � ., i'' i'; / r 1i i i 1i i1 1 :1 i _ - . • ;_ i , :. r �. , 7/25/2020 eServices Services Business Lookup NURSE DELEGATION License Information: Entity name: SONG, HO BOUNG Business name: NURSE DELEGATION Entity type: Sole Proprietor UI #: 604-185-286 Business ID: 001 Location ID: 0001 Location: Active Location address: 32615 10TH PL SW FEDERAL WAY WA 98023-4923 Mailing address: 32615 10TH PL SW FEDERAL WAY WA 98023-4923 Excise tax and reseller permit status: Click here Endorsements Endorsements held at this location License # Count Details Federal Way Home Occupation Business Governing People May Include governing people not registered with Secretary of State Governing people Title SONG, HO BOUNG Registered Trade Names Registered trade names Status MARIE'S DELEGATION Active SONG'S DELEGATION Active Status Expiration date Active Feb -28-2021 The Business Lookup information is updated nightly. Search date and time: 7125/2020 2:42:22 PM EMUSEMLm- First issuance Feb -06-2020 hftps://secure.dor.wa.gov/gteunauth/­,/#556 111