AG 20-683 -Dodobara DDSCITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT.! IV: —ECONOMIC DEVELOP VIENT
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., RIB, RFP, RFQ)
El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
0 PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT [I HUMAN SERVICES / CDBG
0 REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
11 ORDINANCE o RESOLUTION
Ei CONTRACT AM:ENDMENT(AG#): Ei INTERLOCAL
X OTHER —CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
-MMSAiZA I>D S INC., PS
6. NAME OF CONTRACTOR: GARY Y DODO DDS INC PS
ADDRESS: 33515 LOTH PL S # 12, FEDERAL WAY WA 98003-5344 T ELEPHONE: (206) 920-5122
E-MAIL: SDODOBARA@GMAIL.COM
SIGNATURE NAME: STEVEN DODO BARA TITLE: SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES D COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE D ALL
OTHER REFERENCED EXHIBITS EI PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: SEEATTACHEDAGREEMENr COMPLETION DATE:
9. TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) TWO THOUSAND AND NO/100 ($2,000.00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLEE ENSE: 0 YES XNO IF YES, MAXIMUM DOLLAR AMOUNT:
IS SALES TAX OWED OYES X NO IF YES,$ PAID BY: El CONTRACTOR 11 CITY
a[MITAIllow
a PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 ode A2 7
10. DOCUMENT/CONTRACT REVIEW
�0 rP JECT MANAGER
lm,E C T 0 R
F-1 RISKMANAGE MENT (IF APPLICABLE)
0 LAW
INITIAL! DATE REVIEWED
J //o oB-26-
INITIAL / DATE APPROVED
SCHEDULED COMMITTEE DATE' COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
11 SENT TO VENDOR/CONTRACTOR. DATE SENT: DATE REC'D:
El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
0 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 SIG
11 LAW zPARTMENT /A
U,RAATORY (MAYOR OR DIRECTOR)
El CITY CLERK
El ASSIGNED AG# AG
COMMENTS:
1/2020
OTY OF CITY HALL
33325 8th Avenue South
Federal Way Federal Way, WA 98003-6325
(253) 835-7000
www.ciNoffederalway.com
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
DODOBARAS, DDS INC PS
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Dodobaras, DDS, Inc PS, a Washington corporation ("Grantee"). The City ani
Grantee (together "Parties") are located and do business at the below addresses which shall be valid for any
notice required under this Agreement:
STEVEN DODOBARA
33515 10th PI # 12
Federal Way, WA 98003-5344
0 1 -r A -
M4111#016010 I of
I
3"!
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2414 (telephone)
(253) 835-2509 (facsimile)
1. TERTM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
2® CONDITIONS OF GRANT.
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 it of Federal Way business license;
c)
Grantee has paid all taxes and government fees due up tote 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 (cheek a] I thg_Ap2jy):
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
CITY OF
41� P6deral My
CITY HALL
33325 Sth Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cj"ffederalway cam
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
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 suAicient 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 6rantee I lademin fl cation. 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.
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
resulting from the concurrent negligence of the Grantee and the City, the Grantee's liability hereunder shall be
onlp to the extent of Vie Grantee'&me,,-_
hs,�ence. Grantee shall ensure that each sub -Grantee shall ay-lec 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 Grante4
waives any immunity that may be granted 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
workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further
acknowledge that they have mutually negotiated this waiver.
X-31.3 IMU44 a 0,1910-IMMINP.R.'re
CITY Of CITY HALL
33325 9th Avenue South
OA� Federal Way Federal Way, WA 98003-6325
(253) 835-7000
www cityriffederalway coin
5.4 Survival. The provisions of this Section shall survive the expiration or termination of this
Agreement with respect to any event occurring prior to such expiration or termination.
6. GENER-AL PROVISIONS.
6.1 InterprigaticrEi i
_gind Moditi 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 anil
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.
6.3 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
C"V OF
41S� FW4ral My
CITY HALL
33325 6th Avenue South
Federal Way. WA 98003-6325
(253) 835-7000
wmv d1yoffederalway cors
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 acknowledgment pages ftorn 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.
CITY OF FEDERAL WAY:
''I z
9
DATE:
By:-.
Printed Name: STEVEN DODOBARA
a
State of Revenue
Services Business Lookup GARY Y DODOBARA DDS INC PS
License Information:
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Entity name: DODOBARAS, D.D.S., P.S.
Business name: GARY Y DODOBARA DDS INC PS
Entity type: Professional Service Corporation
UBI #: 600-032-096
Business ID: 001
Location ID: 0001
Location: Active
Location address: 33515 10TH CES BLDG 12
FEDERAL WAY WA 98003-5344
Mailing address: 33515 10TH PLACES BLDG 12
FEDERAL WAY WA 98003-5344
Excise tax and reseller permit status: (=jlf k �here
Secretary of State status: Click here
Endorsements
Endorsements held at this location License # Count Details,
Status
Expiration date
First issuance
Dental X-ray/CT/ Pan/Cep h 00765 4
Active
Nov -30-2020
Aug -11-2007
Federal Way General Business 00 -101400 -00 -BL
Active
Nov -30-2020
Jan -08-2000
X -Ray: Dental/Podiatric/Veterinary 00765
Active
Nov -30-2020
Aug -11-2007
Governing People May include governing people not registered with Secretary of State
Governing people Title
Working together to fund Washington's future