AG 20-632 - Chong Aesthetic & Implant DentistryCITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
--------- . ..... -
ORIGINATING DEPTVDIV: ECONOMIC DEVELOPMENT ---
ORIGINATING STAFF PERSON: _11M JQ!INSON__ EXT: 2412 3. DATEREQ.BY. ASAP
TYPE OF DOCUMENT (CHECK ONE):
0 CONTRACTOR SELECTION DOCUMENT (E.G., RIB, RFP, RFQ)
El PUBLIC WORKS CONTRACT El SMALL OR LIN41TED PUBLIC WORKS CONTRACT
• PROFESSIONAL SERVICE AGREEMENT EJ MAINTENANCE AGREEMENT
• GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/ CG
C1 REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
* ORDINANCE El RESOLUTION
* CONTRACTA NT El INTERLOCAL
* OTHER CAPES t',(-TIii-NDS RIJSINE,SSSLJPPORI(.,,RjNI-AGREEN'IENI'
.
PROJECT NAME:._ CARES ACT GRANT -ROUND 2
NAME OF CONTRACTOR: COG AESTHETIC & IMPLANT DENTISTRY
ADDRESS: 33301 9TH AVE S # 125, FEDERAL WAY WA 98003-2600 TELEPHONE: (253)946-6361
E-MAIL: CHONGDDS@GMAIL.COM
SIGNATURE NAME: DANIEL CHONG TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES El COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICATE 11 ALL
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN [I REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
, TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT _COMPLETION DATE:
TOTAL COMPENSATION $ (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: El YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $_,__
IS SALES TAX OWED 0 YES X NO IF YES, $__ PAID BY: El CONTRACTOR El CITY
RETAINAGE: RETAINAGE AMOUNT: Ei RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETATNAGE BOND
ROVIDED
El PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 �P�roect Cod #267662-25060
k2§766Z-Z5060
0. ROCU NIENT/CONT R -QCT REVIEW INITIAL DATE REVIEWED INITIAL DATE APPROVED
is WPO'Jf-.CT MANAGER 1�1_1 1
EX, IRECTOR i o I
El SK MANAGEMENT (IF APPLICABLE}
El LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
El SENT TO VENDOR/CONTRACTOR DATE SENT:DATE R.EC'D:—
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 SIGN -ED
a 0 LA' DEPARTMENT N/A
NATORY (MAYOR OR DIRECTOR)
oe�kEl CITY CLERK
El ASSIGNED AG# AG# "'
'OMMENTS:
1/2020
CITY OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003--6325
(253) 835-7000
www rayoffeck raftey L om
ME" 14 010, 1 pley
WITH
CHONG AESTHETIC & IMPLANT DENTISTRY
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Chong Aesthetic & huplant Dentistry, 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:
itY_15WK44129NIC MN
33301 9th Ave S # 125
FEDERAL WAY, WA 98003 -IV 260NI I0
(253) 946-6361 (telephone)
chonvdds(&,Lymail.com
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2414 (telephone)
(253) 835-2509 (facsimile)
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
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'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 exceed 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 50% lost revenue
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes:
a) Mortgage or Rent
-1 -
VIK#K#1
CITY OF CITY HALL
33325 8th Avenue South
A4! Federal Way, WA 98003-6325
Federal Way (253) 835-7000
www cityoffederalway rom
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 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 Two Thousand and NO/100 Dollars ($2,000.00).
4.2 Non -Appropriation 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.
,IVA 1011 DI
5.1 Grantee Ifidtignificatiori. 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
kt�g and all i�iersons or entities, including, without limitation their resriecliyt_a�p �nts,
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
ar-&uAir-g r#coxfx*r-xKtm*,urrent negligence of the Grantee and the Cityth�_��Iiahilita 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 indemnification.
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, solek_,j f
or the iom%oses of this indemnification. Grantee's indemnification shall not be limited in amo—voxv
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.
CITY OF CITY HALL
33325 8th Avenue South
Federal Way Federal Way, WA 98003-6325
(253) 835-7000
mim atyoffedeialway com
MAIMMMIS MEA-FAIMN01,11 M.A. WMA -110
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
MS. I # �W�m I I mmm"Irl in
6.1 jhkWrctation MAMOMcatin. 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.
6.2 Enforcement. Any notices required to be given by the Parties shall be delivered at the addresses
set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the
notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice
so posted in the United States mail shall be deemed received three (3) days after the date of mailing. Any
remedies 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 conferred by this Agreement in one or more instances shall not be construed to be a waiver
or relinquishment of those covenants agreements or o-Dtions, and the same shall be and remain in full force and
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RITalvivaen or Teiaifu-f aill-T oT ine CLTTO-4-Da L UMN 1110L ZWL US W,TVUIVCr U1 UIC %-,ILY S
right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in
accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference
or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim, shall
be by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County,
Washington, unless the parties agree in writing to an alternative process. If the King County Superior Court
does not have �urisdietion over such a suit, then suit may be filed in any other a9mro ate co in Co
g )Eri urt Kiqg unty,
Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County,
Washington and waives any obiection that such courts are an inconvenient forum. If either Party brings any
claim or lawsuit arising from this Agreement, 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
re jej gi ij t2 ar"96 Aall )te-c4,Ttst-ffiedm6#) liinitmAie
114tometsi ms, 1mr-J, Mig"Immmusyll
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
Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with
CARES ACT BUSINESS GRANT AGREEMENT -3-
7/2020
CITY OF
FOderal VV�ay
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
4 G cityoffederalway coin
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 below, effective the last date written below.
10
DATE:
M
M
Title:
I
9/18/2020 Washington State Department of Revenue
< Business Lookup
License Information:
New search Back to results
Entity name: DANIEL H CHONG DDS PS
Business name: CHONG AESTHETIC & IMPLANT DENTISTRY
Entity type: Professional Service Corporation
UER #m 603-208-732
Business ID: 001
Location ID: 0001
Location. Active
Location address: 33301 9TH AVE S STE 125
FEDERAL WAY WA 98003-2600
Mailing address: 333019TH AVE S STE 125
FEDERAL WAY WA 98003-2600
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Endorsements
Endomernents held at this location License # Count Details
Status
Expiration date
First issuance dal
Dental X-Ray/CT/ Pan/Ceph 10731 3
Active
May -31-2021
Jun -02-2012
Federal Way General Business 13 -101231 -00 -BL
Active
May -31-2021
Mar -28-2013
X -Ray: 10731
Active
May -31-2021
Jun -02-2012
Dema l/Pod latrir j`Veteri na ry
Governing People May Include gove fqg pcaple norM d ofSWft
Governing peopie Title
CHONG, DANIEL
Registered r s
Registered trade names Status
Mrst issued
CHONG AESTHETIC & IMPLANT DENTISTRY Active
Aug -15-2012
The Business Lookup information is updated nightly. Search date and time: 9/18/202010:18:10 AM
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