AG 20-590 - Morning Shine LLCRETURN TO: Tim Johnson
EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
I ORIGINATING DEPT./DIV' ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON:, TIM JOHNSON EXT: 2412 3. DATEREQ.BY, ASAP
TYPE OF DOCUMENT (CHECK ONE):
Ei CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT [I MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT Ei HUMAN SERVICES/ CDBG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
* ORDINANCE [I RESOLUTION
* CONTRACTA NT (AG#):_ El INTERLOCAL
* OTHER CARES ACT FUNDS B QS[NESS SUPPORT G.RANTAGREEMENT
PROJECT NAME: CART SACT ROUND
Mj�OZtjjNG 6AINE L—L&
NAME OF CONTRACTOR: ADULT HOMECARE
ADDRESS: 31428 28TH PL SW, FEDERAL WAY WA 98023-7837 T ELEPHONE: (206) 946-2226
E-MAIL: SARASNAKEW@GMAIL.COM
SIGNATURE NAME: SARA HAILEMARIAM TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES 0 COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICAFE 0 A
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS I
TERM: COMMENCEMENT DATE: SEE ATTACHED AGREEMENT ► DATE
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 ($1000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: I] YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED El YES X NO IF YES, $___ PAID BY: El CONTRACTOR El CITY
RETAINAGE: RETAINAGE AMOUNT: RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
ROVIDED
0 =P,JECT MANAGER
i I IR8CTOR
11 RISKMANAGEMENT (rEAPPLICABLE)
El LAW
11K#0109[a
" Kwa I Z I I " ' ! �1
INITIAL / DATE REVIEWED
C)
SCHEDULED COMMITTEE DATE:
SCHEDULED COUNCIL DATE:
INITIAL1 DATE APPROVED
COMMITTEE APPROVAL DATE:
COUNCIL APPROVAL DATE:
[_1 SENT TO VENDOR/CONTRACTOR DATE SENT: DATE RECD:
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 / DATE SIGNED
El LAW PARTMENT
Y LAW P.
(MAYOR OR DIRECTOR) e 2 -
CITY
0 ASSIGNED AG# eAa#
'OMMENTS:
1/2020
CITY OF UrY HALL
33325 8th Avenue South
4A� Fbdetal V%M Federal Way, WA 90003-6325
y (253) 835-7000
www. ciWoffederalway com
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
M 0
III 1111111111vill 11�� III I
and Urantep-
corporation Ultylly, —and ffioming Slime LLL;, a limitea I taI131111y Company k-kirantee- j. I ne—Uio
(together "Parties") are located and it business at the below addresses which shall be valid for any noti
required ur er this Agreement: i
SiM.A. HAILEMARL&M
31428 28th PI SW
FEDERAL WAY, WA 98023-7837
(206) 946-2226 (telephone)
sarasnakew(&�j wt ail. cow,
fty
Ade Ariwoola
33325 8th
WWA Ia.
1. TERM. This agreement contemplates a one-time grant of fiinds 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 Ci
of Federal
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
V- ant agreement;
d) Grantee's business employs no more than the equivalent of ten (10) full-time employe
(20,800 man-hours total for all employees per year);
e) Grantee's net revenues do not exceed more than 1 per year;
f) Grantee does not operate as a tax-exempt business as defined by the Interrial ev
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-1 9 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
b) Personal Protection Equipment
Fodeml AAby
MY
CITY HALL
33325 Sth Avenue South
(253) 835-7000
wwwcifyoffederoiwoy.corn
Grantee agrees to retain receipts documenting use of grant fimds and will provide them to the City or
designee upon request i
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
iot to exceed One Thousand and NO/I 00 Dollars ($ 1,000.00)
4.2 Non-Anropn a]
�ation of Funds. If sufficient funds are not appropriated or located for payment
under this Agreement for any fiscal period, the City will not be obligated to make payments under this
agreement.
�� 113 1) 3105 1a I al
5.1 Granted 16deMiti fication. 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,
.qwards,JnLun ee , v ties expenses, attowey's fees, costs- !v-idIg
�eg, damages, liabilities, taxes, losses, fines, f s enal
event of liability for damages arising out of bodily injury to persons or damages to property caused by or
p_qj ali iijj tAe co-Tzgr-(�o�t -re * 4.i6e of the Grantee and
I MMMI P M Mi
M MIN i W- NOW"Ll
ILLVL-WL%:-,�yAtN,�L7i�79gulmiKIW�--Lwtyv-m.agI "AMMY911-1
volunteers to the extent and on the same terms and conditions as the Grantee purgutnt� to tis papgraph. The
these covenants of indemnification.
5.2 industrial lwuram Acis 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
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.
oll 1 4 lg-r6l to) L'.M Oro t-740 J*J (11vi IM gr, 1 to I kg 11; Igo
J41 a I t� 1) v�ky-]W194m; 14 to W3 I I OJ2,41t) I I I V Vdmoffl��
i
ory OF CRY HALL
`r
F4deraf
n = _SouthFederal Way, WA 98003-6325
835-7000
e
one 1 counterpart, lan and acknowledgment pages fr1m such counterparts m.: be assembled
together to form a single insh-ument comprised of all pages of this Agreement and a complete set of all
signatureandacknowledgment pages.. Fri of all of the Parties executed
counterpart of this Agreement shall be the "date of mutual execution" hereof.
CrIY OF ERAL Y:
DATE: 0 411-,
MORNING SHINE LLC:
By:,
Printed e:
Title:
DATE:
2
. .,
Washington State Department of Revenue
Services Business Lookup ADULT HOME CARE
License Information:
Entity name:
MORNING SHINE LLC
Business name:
ADULT HOME CARE
Entity type:
Limited Liability Company
UBI #:
604-473-891
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
31428 28TH PIL SW
FEDERAL WAY WA 98023-7837
Mailing address:
31428 28TH PIL SW
FEDERAL WAY WA 98023-7837
Excise tax and reseller permit status: Click here
Secretary of State status:
Click here
Endorsements
Endorsements held at this location License # Count Details
Federal Way Home Occupation
Business
Governing People May include governing people not registered with Secretary ol'State
Governing people Title
HAIL EMARIA M, SARA
Registered Trade Names
Registered trade names Status
MORNING SHINE Active
New search Back to results
Status Expiration date
Active Oct -312020
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