AG 20-308 - Jeselena TherapiesEXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
. ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: —TIM JOHNSON —..I.----- : . DATE RE . BY -.___As
011KNO1 140 1 CIAM" to) wl am an Its) I
El PUBLIC WORKS CONTRACT El SMALL OR LIN41TED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
0 GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE 0 RESOLUTION
* CONTRACTA NT (AG#):_ OINTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECT NAME: CARES ACT GRANT - ROUND 1
NAME OF CONTRACTOR: JESELENA THERAPIES PLLC
ADDRESS: 402 S 333RD ST, #130, FEDERAL WAY, WA, 98003 TELEPHONE: (321) 440-8074
E-MAIL: JESELENA.FROST@GMAIL.COM
SIGNATURE NAME: JESSICA FROST TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES 0 COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS 1:1 PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETIONDATIM
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 (SjQQQ,0
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: El YES X NO IF YES, mAxrmuM DOLLAR AMOUNT:
IS SALES TAX OWED El YES X NO IF YES, $ PAID BY: El CONTRACTOR 11 CITY
RETAINAGE: RETAINAGE AMOUNT: 0 RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
ROVIDED
El PURCHASING: PLEASECHARGETO: 001-1800-990-518-10-490 'r .—
ftqiect Code 9 267662-25060
PROJECT MANAGER
bfkECTOR
El RISKMANAGEMENT (IFAPPLICABLE)
11 LAW
INITIAL / DATE REVIEWED
�t"1-7/77
SCHEDULED COMMITTEE DATE:
SCHEDULED COUNCIL DATE:
Comma,= APPROVAL DATE:
COUNCIL APPROVAL DATE:
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE
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
0 LAW DIE ARTMENT
�TO
L,5413 ATORY (MAYOR OR DIRECTOR)
11 CITY CLERK J-6, Y%V*
El ASSIGNED AG# AG#-
ESIMMUM
1/2020
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Jeselena Therapies PLLC, a professional 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:
JESELENA THERAPIES PLLC:
Jessica Frost
402 S 333RD ST, #130
FEDERAL WAY, WA 98003
a
Irg-r-jr-gummaLWO _911golowsil
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2520 (telephone)
(253)
1• (facsimile)
1. TERM. This agreement contemplates a one-time grant • funds to the Grantee under the conditions
described 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 pandernic
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
Was forced to lay off employees due to reduced patronage
Incurred over $1,000 in COVID-19 related expenses
Experienced 10-50% lost revenue
Experienced over 50% lost revenue
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes:
CARES ACT BUSINESS GRANT AGREEMENT
CITY OF CITY HALL
33325 8th Avenue South
Federal Way Federal Way. WA 98003-6325
(253) 835-7000
WWW cityOffederalway coin
a) Mortgage or Rent
b) Personal Protection Equipment
c) Insurance
d) Utilities
e) Marketing
F) Payroll
Grantee agrees to retain receipts documenting use of grant funds and will provide them to the City or its
designee upon request.
3. TERMINATION. Should any of the conditions described in section 2.1, above, not be met, the City
may recover all disbursed grant funds and terminate this agreement.
to ine uVI 1175 �panaemic, the City stiall provide a grant to the Grantee in an amount
not to exceed One Thousand and NO/ 100 Dollars ($ 1,000.00).
4.2 Nbin�tAvmprf�n 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 Grantee 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
resultinP4 from the concurrent n #if jhu- C,nt- e-1,1MIL L 7
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 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 GR1NT AGREEMENT -2-
4
AFA
deml Voy
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
{2 a3) 835-7000
mm. cityOffe-deralway. coin
5.3 CjI416A���. 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 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.
I 01talmut""T gaw
6.1 14119Mfetatibil and Mbdifiogfibq. 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 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.
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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 HALL
33325 8th ,Avenue South
Federal Way, WA 8003-5325
(253) 835-7000
www ctyoffederahvgy cern
I 1-001111ol Maj *,e executel. in any numuer ot counterparts, eacti ot 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.
IN WITNESS, the Parties execute this Agreement
as ia:# effective
_a..the y date
below.
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Services Business Lookup JESELENA THERAPIES PLLC
License Information:
Entity name:
JESELENA THERAPIES PLLC
Business name:
JESELENA THERAPIES PLLC
Entity type:
Professional Limited Liability Company
UBI 9:
604-342-562
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
402 S 333RD ST
ST E 130
FEDERAL WAY WA 98003-6073
Mailing address:
402 S 333RD ST
STE 130
FEDERAL WAY WA 98003-6073
Excise tax and reseller permit status: Click here
Secretary of State status:
Click here
New search Back to results
Endorsements
Endorsements held at this location License # Count Details Status Expiration date First tssuanc(
Federal Way General Business Active Jan -31-2021 Jan -31-2020
Governing People May include governing people not registered with Secretary of State
Goveminq
� . people Title
FROST, JESSICA
Registered Trade Names
Registered trade names Status First issued
JESELENA THERAPIES PLLC Active Jan -29-2020
The Business Lookup information is updated nightly. Search date and time: 8/24/2020 1:58:28 PM
Working together to fund Washington's future
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