AG 20-166 - Brian Harris InsuranceCITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
I ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATEREQ.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
❑ CONTRACT ANT (AG#): ❑ INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECT NAME: CARES ACT GRANT —ROUND 1
NAME OF CONTRACTOR: BRIAN HARRIS INSURANCE AND FINANCIAL SERVICES INC
ADDRESS: 3400416TH AVE S, #102, FEDERAL WAY, WA, 98003 TELEPHONE: (206) 290-3007
E-MAIL: BRIAN@AGENTBH.COM
SIGNAT E: BRIAN HARRIS TITLE: SEE ATTACHED
EXHIBITS■ SCOPE,i• ■ COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE■ ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
COMMENCEMENT DATE:i AGREEMENT COMPLETION
TOTAL CO PESATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) Two THOUSAND AND NO/100 ($2,000.00)
(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: 0 RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND
ROVIDED
1. DOCUMENT/CONTRACT REVIEVIL
0 P=J ECT MANAGER
IRECTOR
■ i
■ LAW
0MCIrIN VAMON' `•
INITIAL / DATE APPROVED
r
SCHEDULED COMMITTEE DATE: COMMITTEE
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE C'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 MONTH PRIORTO 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 / DAI E SIG D
LAW EP T E
XFORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG# AG#`
;GETS:
CITY OF
F ederal Way
CITY HALL
33325 8th Avenue South
JjM2
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Brian Harris Insurance and Financial Services Inc, a Washington corporation
("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:
BRIANINSURANCE AND CITY OF FEDERAL WAY:
FINANCIAL SERVICES INC:
Ade Ariwoola
Brian Harris 33325 8th Ave. S.
34004 16TH AVE S, 4102 Federal Way, WA 98003-6325
FEDERAL WAY, WA 98003
(253) 835-2520 (telephone)
(206) 290-3007 (telephone) (253) 835-2509 (facsimile)
brian@agentbh.co ade.ariwoola@cityoffederalway.co
The Parties agree as follows:
1. TERM. This agreement contemplates1 of • to the Grantee under• • •
described herein. I
2.1 Warranties. The Grantee warrants the following, pre -requisites foreligibility:
a) Grantee operates a business physically located within the • boundaries of
of •:
• of t: business
agreementc) Grantee has paid all taxes and government fees due up to the date of execution of this
grant
d) Grantee is not the recipient of other state or federal flanding made available as a response
to the COVID-' pandernic
e) Grantee's business employees no more than the equivalentof i
• •yees (20,800 man-hours totalfor , • - per year).
f) Grantee's net revenues . • not exceed more than $1.5 millionper year
g) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue
Service
h) Due to i ' Grantee business••
jWas required by - or • : order to close
IncurredWas forced to lay off employees due to reduced patronage
over fIi in COVID-19 related expenses
Experienced10-50% lost
Experienced over 50% lost revenue
2.2 Use of Fund,sl- Grantee affirms that grant funds will be used for the following purposes:
CARES ACT BUSINESS GRANT AGREEMENT
c1l" OF CITY HALL
33325 Sth Avenue South
Ftgdeml My Federal Way, WA 98003-6325,
(263) 8354000
wwivoibphb�com
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. TERMINAIM. Should any of the conditions described in section 23, 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
not to exceed Two Thousand and NO/I 00 Dollars ($2,000,00).
4.2 Non��Avpropdjoatgiqonq��ofF �. If sufficient flinds 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 Omtdoh_ , 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,
in tiries damages liabilities taxes losses, fines, flees, enalties expenses, attorney's fees, costs, and/or
aw1 r I I Joni
all -
w
RCW, solely for the purp, opq nt �Iiiq ihja�__J i-ST1-11, urantee s inVe1rLuTicaTT=Vf7W =77 Pc -=17 ev",
by any limitation on the amount of damages, compensation or benefits payable to or by any third PartY 5if
workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties farthi
acknowledge that they have mutually negotiated this waiver.
CARES ACT BUSINESS GRANT AGREEMENT -2-
city 0� C1W HALL
33325 Sth Avenue South
.�deral Vft (253) _■; :ii
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BRIAN HARRIS INSURANCE AND FINANCIAL SERVICESINC:
Printed N e:rla"L
Title: Ae°
ATE: 2U
CARES ACT BUSINESS GRANT AGREEMENT -4-
7/24/2020
eServices
Services Business Lookup BRIAN HARRIS INSURANCE AND FINANCIAL SERVICES INC
License Information:
New search Back to results
Entity name: BRIAN HARRIS INSURANCE AND FINANCIAL SERVICES INC
Business name: BRIAN HARRIS INSURANCE AND FINANCIAL SERVICES INC
Entity type: Profit Corporation
UBI #: 603-337-856
Business ID: 001
Location ID: 0001
Location: Active
Location address: 34004 16TH AVE 3 STE 102
FEDERAL WAY WA 98003-8905
Mailing address: 34004 16TH AVE S
STE 102
FEDERAL WAY WA 98003
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 Active
Apr -30-20211 Apr -23-2020
Governing People May include governing people not registered with Secretary ot'State
Governing people Title
HARRIS, BRIAN
HARRIS, YOLANDA Secretary
Registered Trade Names
Registered trade names Status
First issued
BRIAN HARRIS INSURANCE AND FINANCIAL SERVICES Active
Oct -18-2013
INC
The Business Lookup information is updated nightly. Search date and time: 7/24/2020 3:40:46 PM
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