AG 20-741 - Leslie DonaldEXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
*RIGfNATING DEPT./DIV. ECONOMIC DEVELOPMENT
2. ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 1 3. DATE REQ. BY.__AsAp
4. TYPE OF DOCUMENT (CHECK ONE):
0 CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT 11 MAINTENANCE AGREEMENT
• GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES / CG
• REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
• ORDINANCE 11 RESOLUTION
• CONTRACTA T (AG):_ DINTERLOCAL
• OTHER CARES ACT FUNDS BUSINESS S JPPORT GRANT AGREEMENT
5. PROJECT NAME: CARES ACT GRANT —ROUND 2
6. NAME OF CONTRACTOR: LESLIEDONALD
ADDRESS: 1067 SW 325TE CT, FEDERAL WAY WA 98023-4913 TELEPHONE: (253) 285-6014
E-MAIL: L.RENEE36@YAHOO.COM
SIGNATURENAME: LESLIE DONALD TITLE: SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS t'' OF AUTHORITY TO SIGN 0 REQUIRED LICENSES D PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETION DATE.
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 ($1,000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE E] YES X NO IF YES, MAXIMUM DOLLAR AMOUNT:
IS SALES TAX OWED DYES X NO IF YES,$ PAID BY: 0 CONTRACTOR 0 CITY
RETAINAGE: RETAINAGE AMOUNT: 0 RETAINAGE AGREEMENT (SEE CONTRACT) OR 0 RETAINAGE BOND
PROVIDED
0 PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 1!rp
. j�qt ( god q 4267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITLAL / DATE APPROVED
nV_1,�IOJECT MANAGER
- D RECTOR _2 4> AO
• RISK MANAGEMENT (IF APPLICABLE)
• LAW
11. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMVIITTEE DATE: ComA=F APPRovAL DATE:
SCHEDULED CouNcu, DATE: CouNcit, APPRovAL DATE:
• SENT TO VENDOR/CONTRACTOR. DATE SENT: DATE C'D:
• ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
11 CREATE ELECTRONIC REMINDERJNOTIFICI ON FOR 1 MONTH PRIOR TO EXPIRATION DATE
(Include dept. supports if necessary and feel free to set notification more than a month in advance if council approval is needed.)
INITIAL / DATE SIGNED
❑ 1A DEPARTMENT /A
G>N ATORY (MAY01Z OR DIRECTOR)
11 CITY CLERK 4 10
11 ASSIGNED AG # A
COMMENTS:
1/2020
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this Agreement:
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Mailing address: 1067 SW 325r" CT,
Federal Way, WA 98023-4913
(253) 285-6014 (telephone)
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AdeArniwoola
'h
33325 8th Ave. S.
r -63
(253) 835-2414 (telephone)
(253) 835-2509 (facsimile)
1. TEM This agreement contemplates a one-time grant of funds to the Grantee under the conditiDi
tescribed herein.
L I 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's business employs no more than the equivalent of ten (10) full-time employees
(20,800 man-hours total for all employees per year);
e) Grantee's net revenues do not excmd more than $1.5 million per year;
f) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue
Service;
g) Due to COVID- 19, Grantee business (check all'that apply):
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 5 0% lost revenue
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
CARES ACT BUSINESS GRANT AGREEMENT - I -
7/2020
CITY OF
Federal Way
c) Insurance
d) Utilities
e) Marketing
f) Payroll
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederalway com
Grantee agrees to retain receipts documenting use of grant funds and will provide the 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 One Thousand and NO/ 100 Dollars ($ 1,000.00).
4.2 Non -Appropriation of Funds. If sufficient ftmds are not appropriated or allocated for payment
under this Agreement for anv fiscal Deriod. the Citv will not be obligated to make t)avinents under this agreement.
5.1 Grantee I Indemm'f[cation. 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 clairns, 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
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
indeninifkaion.
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 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.
FOYMMIM �01 �111_
CITY OF
Federal Way
CITY HALL
33325 Std Avenue South
Federal Way, WA 98003--6325
(253) 835-7000
www d1yofA,-derahvqy. com
5.3 Ci indernnifigg6on. The City agrees to release, indemnify, defend and hold the Grantee, its
officers, directors, shareholders, partners, employees, agents, representatives, and subcontractors harmless from
any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments,
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.
6.1 hitgMIgation and, ModifigWiqn. 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,
in no way affect or invalidate any-other�-trovision hereof and such other
(i,rovisions 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
Partie;-
• .
oie or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice
provided for under the terms of this Agreement are not intended to be exclusive, but shall be cumulative with all
other remedies available to the City at law, in equity or by statute. The failure of the City to insist upon strict
performance of any of the covenants and agreements contained in this Agreement, or to exercise any option
r. 111M -of
A 1 1 1� LLot L uis lant
Mat sucii coLLuts aare I L I ir AFL Vrl Igs ull:T clail
each Party shall pay all its legal costs and attorney's fees and expenses incurred in defending or bringing such
claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided,
however, nothing in this paragraph shall be construed to limit the Parties' rights to indemnification under Section
5 of this Agreement.
OTY OF CITY HALL
33325 Sth Avenue South
Federal Way, WA 98003-8325
Federal Way (253) 835-7000
www,dwff9dsraMwcom
The signature and acknowledgment pages from such counterparts may be assembled together to form a sin
instrument comprised of all pages of this Agreement and a complete set of all signature and acknowled•
pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement shall
the "date of mutual execution" hereof
DATE:
Im"41:81.4
Printed Name:
DATE:
CARES ACT BUSINESS GRANT AGREEMENT 4 -
7/2120
Washington State Department of Revenue
< Business Lookup
License Information:
Entity name-
DONALD, LESLIE
Business name.
LESLIE DONALD
Entity type:
Sole Proprietor
UBI #-
604-653-324
Business ID:
001
Location ID:
0001
Location:
Active
METIMirt I I �-- M
Excise tax and reseller permit status:
Endorsements
Endorsements held at this location License #
Federal Way Home Occupation
Business
Governing People r4o icuw. g.—bw p -pi. -r regkwm Wob S-rfty fswu
Governing people
DONALD, LESLIE
Registered Trade Names
Registered trade names
DYMOND DISHES
LESLIE DONALD
I
iEm
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Expiration date First issuance date
Aug -31-2021 Sep -03-2020
First issued
Aug -25-2020
Aug -25-2020