AG 20-626 - Ehrmantrout & Bush PLLCEXT: 2412
CITY OF FEDERAL
1 DEPARTMENT r
ORIGINATING i ECONOMIC DEVELOPMENT
ORIGINATING STAFFPERSON: 1 i DATEREQBY. .`
TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIN41TED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES 1 CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT ANT (AG#): — ❑ INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
E-MAIL:ADDRESS: 4
. r , r , r y`
SIGNATURE 4. ZACHARY i 4 i. DDS, i
r
EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES D COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICATE 11 ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
I TERM: COMMENCEMENT DATE: D AGREEMENT COMPLETIONDATE:
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: ❑ YES X NO IF YES, MAXIMUM DOLLARAMOUNT: $T
IS SALES TAX OWED ❑ YES X NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: _ ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND
ROVIDED
❑ PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 Proiect Cqde #267662-25060
DOCUMENT/DOCUMENT/CONTRACT REVIEWTI / DATE REVIEWED INITIAL 1 DATE APPROVED
❑ PP.J'ECT MANAGER. _.
Q,f)IRECTO a ' a
❑ RISK MANAGEMENT (IF APPLICABLE)"
1. COUNCIL APPROVAL(IF APPLICABLE) SCHEDULED COMMITTEE DATE: r COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
❑ ATTACH: SIGNATURE, AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION FOR 1 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
❑ LAS EP� TME
I ATOR (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG# G#
_...;
;Q E S:
74
1/2020
alrY OF CITY HALL
33325 8th Avenue Sculh
F6deml Mkoy Federal VVI WA 98003-6325
WMI (253) 8,3&7000
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CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
EHRMANTROUT & BUSH PLLC
III Pill I 1111 11171 111111�
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au zurrminTITILL "� ai-bri CIL%,, 4 PrV1Q551U114VUMM1_ orPWt4ff ff�`J" I Lyr J, -a
City and Grantee (together "Parties") are located and do business at the below addresses which shall be valid fc
any notice required under this Agreement:
15
& BUSH PLLC: CITY OF FEDERAL WAY. -
ZACHARY EHRMANTROUT, DDS, PS
1109 S 348 St� Federal Way, WA 98003-7079
Mailing address: 405 Cooper Point Rd NW #104,
OLYMPIA, WA 98502-4437
(360) 250-9402 (telephone)
Ade Ariwoola
33325 8th Ave. S.
.[sU!Uyk U1619RUMMU-614
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the condition
descriV,.1, hereft.
W` w
off a
�N I I MeM 4 Id
W` w
CITY Of CITY HALL
33325 8th Avenue South
Federal Way Federal Way. WA 98003-6325
(253) 835-7000
tvww. colyoffedetalmlay, coin
C} Insurance
d) Utilities
e) Marketing
f) Payroll
Grantee agrees to retain receipts documenting use of grant funds and will provide them 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.
'Aim
not to exceed Two Thousand and NO/ 100 Dollars ($2,000.00).
4.2 Noqn� * n of Funds. if sufficient funds are not appropriated or allocated for paym
mago mel
under this Agreement for any fiscal period, the City will not be obligated to make payments under th
zgreement.
9
5.1 Qfkntee� IgLeMnifidation. 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 med' r in
- i- i- - - - - - - - - RME!
RMIR I"
"
7111101111y nereunuer A
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 indemncation.
:jTj -Tom
Wn
#
_L1116 JULICliMnILIcution. OTA-Itut-s Incimnifluation snall not ve limited in any w
by any limitation on the amount of damages, compensation or benefits payable to or by any third party und
workers' compensation acts, disability benefit acts or any other benefits acts or programs. TheParties fitith
11
2cknowledge that they have mutually negotiated this waiver.
CARES ACT, BUSINESS GRANT AGREEMENT -21
city OF
�5;7� 176deral My
CITY MALL
33325 8th Avenue Scuth
(253) 835-7000
www o1yoffiederiAwlY com
together and shall constitute one instrument, but in making proof hereof it shall only be necessa ro""m
ry to p
s from such counterparts may -nbl
one such counterpart. The signature and acknowledgment page be assei
together to form a single instriiment comprised of all pages of this Agreement and a complete set of
11
mature and acknowledgment pages. The date upon which the last of all of t e Parties have executed
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.
off MAMOMMI
DATE:
EHRMANTROUT & BUSH PLLC-.,
By:
PrinAKN ime: `ty
Title:
DATE:
Services Business Lookup CASCADE ORTHODONTICS
License Information:
Expiration date
Entity name:
EHRMANTROUT AND BUSH, PLLC
Business name:
CASCADE ORTHODONTICS
Entity type:
Professional Limited Liability Company
LIBI #:
603-218-784
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
1109 S 348TH ST STE A
FEDERAL WAY WA 98003-7079
Mailing address:
405 COOPER POINT RD NW
# 104
OLYMPIA WA 98502-4437
Excise tax and reseller permit status: Click here
Secretary of State status:
Click here
Endorsements
Endorsements held at this location License # Count Details
Dental X-ray/CT/ Pan/Ceph 10934 1
Federal Way General Business 12 -104213 -00 -BL
X -Ray: Dental/Podiatric/Veterinary 10934
Governing People May include governing people not registered with Secretary of State
Governing people Title
ZACHARY P. EHRMANTROUT, D.D.S., P.S.
Registered Trade Names
Registered trade names Status
CASCADE ORTHODONTICS Active
FEDERAL WAY ORTHODONTICS Active
I I • # - . a • - - a
New search Back to results
Status
Expiration date
First issuance
Active
Jun -30-2021
Sep -18-2012
Active
Jun -30-2021
Sep -20-2012
Active
Jun -30-2021
Sep -18-2012
Working together to fund Washington's future
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