AG 20-695 - Hart Insurance AgencyRETURN TO: Tim Johnson EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV: —ECONOMIC DEVELOPMENT,
2. ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE REQ BY
ASAP
4. TYPE OF DOCUMENT (CHECK ONE):
El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
0 PUBLIC WORKS CONTRACT E] SMALL OR LE\4ITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCE AGREEMENT
11 GOODS AND SERVICE AGREEMENT E] HUMAN SERVICES/ CBG
0 REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
11 ORDINANCE El RESOLUTION
El CONTRACTA NT (AG#): El INTERLOCAL
X OTHER- CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
5. PROJECT NAME: —CARES ACT GRANT- ROUND 2
6. NAME OF CONTRACTOR: H,ARTCNS URANCE49ENTEfCA6en,,,--'�
ADDRESS: 31811 PACIFIC HWY S # B294, FEDERAL WAY WA 98003-6386 T ELEPHONE: (206) 714-8178
E-MAIL: DPAPKF@HARTINS.COM
SIGNATURE NAME: SUSAN HENDRICKS TITLE: SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: Ll SCOPE, WORK OR SERVICES D COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE C1 ALL
OTHER REFERENCED EXHIBITS 11 PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES 11 PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETION DATE:
9. 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 El YES X NO IF YES, $ PAID BY: El CONTRACTOR 0 CITY
RETAINAGE: RETAINAGE AmoUNT: El RETAINAGE AGREEMENT (SEE CONTRACT) OR 0 RETAINAGE BOND
PROVIDED
El PURCHASING: PLEASE CHARGE TO: 001 1800-990-518-10-490 Project Code #267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
C1 PROJECT MANAGER
r9_.DkECTCR ca 0
El RISK MANAGEMENT (IF APPLICABLE)
El LAW
I I. 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:—,,.
11 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 LAW DEP T E k N/A
ATORY (MAYOR OR DIRECTOR)
0 CITY CLERK
4
El ASSIGNED AG# AG#
COMMENTS:
1614, —11 114
-- - ------ -
1/2020
,.;&CITY O
Federal Way
CITY HALL
33325 Sth Aveme South
Federal Way, WA 98003-6325
(253)835-7000
e,ty,aMode ,ukva co m
CARES r SUPPORT GRANT■
WITH
HART INSURANCE
This Grant Agreement + f' between the City of #' Washington #+,
corporation ("City"), and Hart Insurance Agency Inc., a Washington corporation ("Grantee"). The City and
required under this Agreement:
SUSAN HENDRICKS
1 S 336th St # F, Federal Way, WA #rii
Mailing address: # w Pacific#
Federal 98003
(206) 714-8178 (telephone)
dDankeaffiartins.com
Ade ^Ariwoola
Federal33325 8th Ave. S.
98003-632i
' r
r #
c i+
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described
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 Ci
of Federal Way;
# Grantee maintains a current City of Federal Way business
c) Grantee has paid . taxes and government fees due up to the date of execution
agreement;
} tee's business employs no more than the equivalent of to (1) full-time employees
( man-hours total for all employees per year;
Grantee's net revenues do not exceed more than $1.5 millionper ;
Grantee does not operate as a tax-exempt usinesS as definedy the Internal Revenue
Service;
} Due to COVID-19, Grantee business (check all thatapply).-
E] Was
required by state or local order to close
forcedWas lay off employees reduced
x Incurred over $1,000 in COVID-19 related expenses
x Experienced 10-50% lost revenue
Experienced over 5% lost revenue
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following es;
a} Mortgager Rent
b} Personal Protectioni e t
& CITY OF
Federal Way
c) Insurance
d) Utilities
e) Marketinj�
f) Payroll
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 83517000
WMVb0"0#bd(,'rJ,'W,3y,C0M
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 a+reement.
not to exceed Two Thousand and NO/ 100 Dollars ($2,000.00).
4.2 If sufficient funds are not appropriated or allocated for paymeni
lWer this__&�_
-.0 glogiggilula,
5.1 Q r . 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
IRT, iI;,,& a1,P,*-tiA,n of the clail
NO" MITI
Lff
L Wo "runec-fl,14- LHC CTq-,7f1C kilailloo S lidulinj 11CIC
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.
waives any immunity that may be granted to it under the'llashington State industrial ins uxance act, I itle -) I &UTT,
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 GRANT AGREEMENT -2-
7/2020
.;JCITY OF
h� Federal Way
UTY HALL
33325 8th Avenue South
Fede rM Way. WA 98003-6325
(253) 835-7000
www0yoffederalwpy.com
5.3 City 1ri&rhw'fkAqn. The City agrees to release, indemnify, defend and hold the Grantee, its
any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments,
lvx,pomos Lill OF llj-Urij, wrlls- all
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. i of this Section shall survive the expiration or terinination of this
Agreement with respect to any event occurring prior to such expiration or termination.
1 21 -han ff M a1h1mgh, a
6.1 IlAnligri2matiol cation. 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,
inoierative,, nuil and void, or illeial shall in no iwa affect or invalidate ani other Arovision hereof and such other
amended, waived, or modified except by written agreement signed by duly authorized representatives of the
I P -a-6 S.
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
g ig be de,,gsited in the United States mail-, ostaie ire-oaid, to the address set forth above. Any notice
NU PUSLIOUin LUMITIMM", R"I"I 'tCClllC4- FMCIVOL MUCC �J) UlJS UILCI L11C LILLC 4,
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 Doon
*1,11f ibbut of
those covenants, agreements or options, and the same shall be and remain in full force and effect. Failure or delay
A WOO
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each Party shall pay all its legal is 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.
CARES ACT BUSINESS GRANT AGREEMENT -3-
7/2020
CITY OF OTY HALL
33325 8th Avenue South
Federal Way Federal Way, WA 98003-6325
(253) 835-7000
wwwcityvttPdPrnhvay com
6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee represents
md 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 the same effect
9-s ij Wj -doc
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
jv,ages. 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.
Jim Ferye ",ayof
DATE: -e
'Jlvu� "Cly- Nl��
in.
Title: Vice -President
DATE: -October 2, 2020
CARES ACT BUSINESS GRANT AGREEMENT -4-
7/2020
Services Business Lookup HART INSURANCE CENTER
License Information:
Status
Entity name:
HART INSURANCE AGENCY, INC.
Business name:
HART INSURANCE CENTER
Entity type:
Profit Corporation
UBI #:
600-081-665
Business ID:
001
Location ID:
0004
Location:
Active
Location address:
1230 S 336TH ST ST E F
FEDERAL WAY WA 98003-6386
Mailing address:
31811 PAC HWY S #13294
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
Federal Way General Business 00 -101340 -00 -BL
Governing People May include governing people not registered with Secretary of State
Governing people Title
HENDRICKS, SUSAN
PARKE, DANIEL P
Registered Trade Names
Status Expiration date
Active Jul -31-2021
Registered trade names
Status
First issued
ACTION AUTO INSURANCE AGENCY
Active
Jan -25-1991
ACTION AUTO INSURANCE CENTER
Active
Sep -02-1998
HART INSURANCE CENTER
Active
Sep -02-1998
THE INSURANCE CENTER
Active
Sep -02-1998
of. - 9 1 M Trommm M-11