AG 20-514 - V's Skin Care and LaserRETURNTO: TIMJOHNSON EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TIM JOHNSON" EXT: 2412 3. DATE REQ BY. ASAP
TYPE OF DOCUMENT (CHECK ONE):
E-1 CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
El PUBLIC WORKS CONTRACT F-1 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT o HUMAN SERVICES / CDBG
0 REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOC NTS)
El ORDINANCE El RESOLUTION
El CONTRACTA NT (AG#):_ El INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECT E: CARES ACT GRANT- ROUND I
NAME OF CONTRACTOR: V'S SKIN CARE AND LASER LLC
ADDRESS: 1626 S 310TH ST, #A, FEDERAL WAY, WA, 98003 TELEPHONE:
E-MAIL: AEMuRPHY292020@GMAIL.COM
SIGNATURE NAME: VERONIKA MARINO TITLE: SEE ATTACHED
TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETIONDATE:
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 ($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 El YES X NO IF YES, $ PAID BY: 0 CONTRACTOR El CITY
RETAINAGE: RETAINAGEAmoUNT: 11 RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
ROVIDED
0 PURCHASING: PLEASECHARGETO: 001-1800-990-518-jQt4q�L- Pwleet Code# 267662-25060
t. DOCUMENT/CONTRACT REVIEW
El PROJECT MANAGER
0 DIRECTOR
El RISKMANAGEMENT (IFAPPLICABLE)
El L1W
nffla��l ...
SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:-
0 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
11 CREATE ELECTRONIC REMINDERfNOTIFICATION 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'�LAX DEPARTMENT
GNAT(
NATORY (MAYOR OR DIRECTOR)
0 CITY CLERK
El ASSIGNED AG # AG_-ao
1/2020
T.1us Grant Agreement ("Agreement') is made between the City of Federal Way, a W4$1An&n municipal
corporation ("Cityand V's Skin Care and Laser, 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 itquired under this Agr�t.
V-�) I Mmlrm
Veronika Marino
1626 S 3 1 OTH
FEDERAL WAY, WA 98J
KN 4 1AA t I'll S;,FtM0PJUO
Ade Ariwoola.
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2520 (telephone)
(253) 835-2509 (facsimile)
vun,
1. TERA This agreement contemplates a one-time grant of funds to the Grantee under the conditions
tescri�,,V, it 4L.
2.1 )kg=6jjgg� 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
I f 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
tI= 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
Servim
h) Due to COVID-19, QrAnto hoiness (Obeck 60 41W #ppW-
Was *4*0 by state of Ideal Order to dose
Was forced to lay off employees due to reduced patronagci
Incurred over $ 1,000 in COVID- 19 related expenses
Experienced 10-501/o lost revenue
Experienced over 50% lost revenue
0TV OF CITY HALL
40 33325 Sth Avenue South
A� Fbdeml VVoy Federal Way, WA 98003-6325
4000�� (253) 835-7000
wwwa Wcom
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. URNEMAT1011N. 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. GRANT AMOUNT.
4.1 Am9knt. 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 One Thousand and NO/I 00 Dollars ($ 1,000.00).
4.2 NbriAgggggrdigatdion �of F�. If sufficient funds are not appropriated or allocated for pan
under this Agreement for any fiscal period, the City will not be obligated to make payments umde7r t1h,
agreement.
5-1 G0919LW���. The Grantee agrees to release indemnify, defend, and hold the City, its
elected officials, officers, employees, agents, represent4tives,- insurers, attorneys, and volunteers harmless from
any and all claims, demands, actions, suits', causes of action, arbitrations, mediations, proceodmgO, judgments,
awards uri es,.damayes, liabilities, taxes losses fines - - - - - - -
litigation expenses to or by any and all persons or entities, indkiding, without WititAtion, 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 Agr� 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
resulfiWf-rmnA"-"=rTmtne-&igenm=o-fA —
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 paograpb� The
Cit-r's insj , on or accaoa= of aWi of Grantee's work when c "nyt, eted s*dl not be
these covenants of indemnification.
5.2 hidgaidW h22�� AdLMtgim. It is specifically and expressly under -stood that the Grantee
waives any immunity that may be grotccl to it under the Washington State industrial insurance act� Title 51
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
ockoowl edge that they have mutually negotiated this waiver.
��# *,� M2 12�m �"�J
City OF CiTY HALL
33325 Sth Avenue South
4 &6, Fedeml Way, WA 98003-6325
Fbdefal V��y (253) 83&7000
�Vww COM
it
1. fl 011CAM-77"i- Y`i7 110,710 HTT-MaITT Ife &41111- UUUUMUML. ftil SUM counterparts SHU&I OU GODSIMICU
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 below, effective the last date written below.
lei I bwo) M a M 01 M IMI 1VM
DATE: q/P*liiii�
VS SKIN CARE AND LAS%E-R C:
By:
PrintedName: lleAom
Title: Ciaj
DATE:
CITY OF
Fedeml
Centered on Opportunity4
MEMM
Veronika Marino
V'S Skin Care and Laser
1626 S 310th ST STE A
MAYOR'S OFFICE
33325 8th Avenue South
Q-f2aw.
(253) 835-2400
wwwd4oom
dim Fbrreff, Mayor
Congratulationsl Your application for the City of Federal Way's Small Business Assistance Grant (2-V/19)
has been approved for $1000.00.
Enclosed is a grant contract for your review and signature. Upon signature please place in enclosed
addressed envelope and return with postage to the City for processing. Upon receipt, the City will
process a check to your business.
Should you have any questions, contact the City of Federal Way's Small Business Assistance Grant
hotline at 253-835-2414.
We are committed to helping businesses like yours! Should you have any questions on business issues
or on the economy, please contact our Director of Economic Development, Tim Johnson at 253-835-
2412.
We're all in this together. Congratulations again.
Best Wishes!
Jim Ferrell
Mayor
'Acense Information:
..ntity name: V'S SKIN CARE AND LASER LLC
Business
V'S SKIN CARE AND LASER LLC
name:
Entity ®
Limited Liability Company
UBI #:
604-347-882
Business ID:
001
Location ID:
0001
Location:
Active
Location address: 1626 S 310TH ST
UNIT A
FEDERAL WAY WA 98003-4911
Mailing address: 4102 W SPRING HOUSE
EAGLE ID 83616-7281
Excise tax and reseller permit status: Click hell
Secretary of State status:
Endorsements
Endorseinents held Licensie #
hftps://secure.dor.wa.gov/gteunauth/—/#1 5
Count Details
Status Expiratio First issu,
1/2
9/18/2020
Eridors ements held License#
Federal Way 19-100160-04:
General Business
Washington State Department of Revenue
Count Details Status
Expiratio First issu,
Oct -31-2 Jan -11-21
Governing People May include governing people not registered with Secretary of State
Governing people Title
The Business Lookup information is updated
qL
Contact us
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