AG 20-810 - Stacy R Kanda DDS PS1 E R:ETUR_N TO: Tim Johnson EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1 1,
ORIGINATING DEPTJDIV. —ECONOMIC DEVELOPMENT
2. ORIGINATING STAFF PERSON: TIMJOHNSON EXT: 2412 3. DATEREQ,BY.- ASAP
4. TYPE OF DOCUMENT (CHECK ONE):
1:1 CONTRACTOR SELECTION DOCUMENT (E.G., REB, REP, RFQ)
0 PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
• GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CG
• REAL ESTATE DOCUMENT 11 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
* ORDINANCE El RESOLUTION
* CONTRACT AMENDMENT(AG#): El INTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
6. NAME OF CONTRACTOR: STACY RKANDA DDS PS
ADDRESS: 2335SW320THST#I,FEDEPALWAY WA98023 T ELEPHONE: (253) 661-2222
E-MAIL: STACYKANDA@COMCAST.NET
SIGNATURE NAME: STACY KANDA, DDS TITLE: SEEATTACHED
7. EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES El COMPENSATION D INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN 11 REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT COMPLETIONDATE:
JV TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) TWO THOUSAND AND NO/100 ($2,000.0
(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: $ i
IS SALES TAX OWED El YES X NO IF YES,$ -.-PAID BY: El CONTRACTOR El CITY
RETAINAGE: RETAfNAGE AMOUNT: ___[] RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
I
1:1 PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 Project Code #267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL DATE REVIEWED INITIAL / DATE -APPROVED
0 PROJECT MANAGER
CTOR
A, /6p - 0 7 — RO
El RISKMANAGE MENT (IF APPLICABLE)
El LAW
11. COUNCIL A.PPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
0 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 I DATE SIGNED
LAW EPARTNIENT
LAW
(MAYOR OR DIRECTOR)
0 CITY CLERK
11 ASSIGNED AG# AG#
COMMENTS:
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1/2020
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.M, N I YCUM MCA r
WITH
STACY R KANDA, DDS, PS
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Stacy R Kanda DDS PS, a professional service 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:
STA CY R KANDA, DDS, PS:
WU 91191M,
M!
UMSFAMMATO M* -
33325 8th Ave, S.
Federal Way, )NIA 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.
"I I I I M11 -Mal
2.1 Warranties: The Grantee wan -ants 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 ret 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)
et COVID-1 9, Grantee business (dn,,k A I _07a p
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-1 9 related expenses
Experienced 10-50% lost revenue
Experienced over 50% lost revenue
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CITY 0;' A L
"1"'325 Wh Avenk_*
Fe d e r a I kA I a Y
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
c) Insurance
d) Utilities
e) Marketing
0 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
Grantc�e 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/I 00 Dollars ($2,000.00).
4.2 Non-Apprgpriation 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 Qrffl�,I, 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.
W 41
E4 11 i ' 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 c�,vvenants of indemnification.
5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Grantee
v
waives any immunity that may begranted 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
CARES ACT BUSINESS GRANT AGREEMENT -2- 7/2020
CITY 01,
Fe d e ra I Wa, y
workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further
acknowledge that they have mutually negotiated this waiver.
5.3 r Inderntiffic- ion, e ity agrees to re ease, in emn
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-,
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,
caused by the negligent acts, errors, or omissions of the City.
5A Survival, The provisions of this Section shall survive the expiration or tennination of this
Agreement with respect to any event occurring prior to such expiration or termination.
6.1 IntqMretation and Mod'fication. 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 relinguishment of those covenants, alLeements or options, and the same shall be and remain in fall force and
ORIMPH."I HIM$ 0 RIC -011-
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a:ccor ance w t e aws o t e ate o as -ngton- s e una e to settle any dispute, M'Te�rence 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
CARES ACT BUSINESS GRANT AGREEMENT
CITY Of
Federal Way
C�'r FiX L
I Y 1
33325 81h Soulth
Y'ay, "i'l,k, 98003-§E332!`,,
3) 8355�1,',ICH3=Z),
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expenses incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any othm
recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit
Parties' rights to indemnification under Section 5 of this Agreement. I
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
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 acknowledgrnent 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 2
counterpart of this Agreement shall be the "date of mutual execution" hereof.
MWIM21:163:16 A
j ill" :well' avor
DATE:
By:
Printed Name;
Title:
. ...... .
DATE: — -----
CARES ACT BUSINESS GRANT AGREEMENT -4- 7/2020
9/29/2020 Washington State Department of Revenue
Denarf-len' e
Business Lookup
License Information: New search Back to results
Entity name: STACY R. KANDA, D.D.S., P.S.
Business name: STACY R KANDA DDS PS
Entity type: Professional Service Corporation
UB1 #: 600-393-009
Business ID: 001
Location ID: 0001
Location: Active
Location address: 2335 SW 320TH ST STE 1
FEDERAL WAY WA 98023-2569
Mailing address: 2335 SW 320TH ST STE I
FEDERAL WAY WA 98023-2569
Excise tax and reseller permit status: Click here
Secretary of State status; Click here
Endorsements
Endorsements held at this location License # Count Details
Status
Expiration date
First issuance dal
Dental X--Ray/CT/ Pan/Ceph 06992 6
Active
Mar -31-2021
Nov -07-2007
Federal Way General Business 00 -101982 -00 -BL
Active
Mar -31-2021
Feb -25-2000
X -Ray: 06992
Active
Mar -31-2021
Nov -07-2007
Dental/Podiatric/Veterinary
Governing People May Include go—Ing people nor rug htmod with S-M.,y of5ftm
Governing people Title
KANDA, STACY
Registered Trade Names
Registered trade names Status
First issued
STACY KANDA DDS, PS Active
Feb -10-2017
STACY R. KANDA, DDS, PS Active
Feb -05-2018
The Business Lookup information is updated nightly. Search date and time: 9/29/202011:24:55 AM
https://secure.dor.wa.gov/gteunauth/—,/#1 5
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