AG 20-801 - Shire Family Home ChildcareCITY OF FEDERAL .W DEPARTMEROUTINGr`
ORIGINATING DEPT./DIV: ECONOMIC DEVELOPMENT
2. ORIGINATING PERSON: 1 • i DATE REQ BY. ASAP
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES/ CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT (AG#): ❑ INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
5. PROJECT NAME: CARES ACT GRANT ROUND
6. NAME OF CONTRACTOR: SHIRE FAMILY HOME CHILDCARE
ADDRESS: 32301 2ND AVE SW, FEDERALWAY WA 98023-5604 T ELEPONE: (206) 488-7115
E-MAIL: LUCKY. GMAIL.COM
SIGNAT E: LUCKY ARRAB TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) TWO THOUSAND AND NO/loo ($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 DOLLAR AMOUNT: $
IS SALES TAX OWED ❑ YES X NO IF YES, $ PAID BY: ❑ CONTRACTOR ❑ CITY
RETAINAGE: RETAINAGE AMOUNT: _ ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND
PROVIDED
❑ PURCHASING: PLEASE CHARGE TO: 1 001-1800-990-518-10-490 Project Codi #267662-25060
10. DOCUMENT/CONTRACT REVIEWITI / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
.DfRECTO
❑ RISKMANAGEMENT (IF APPLICABLE)_
❑ LAW
11. C (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCILAPPROVAL DATE:
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATEC':
ATTACH: SIGNAT AUTHORITY, INS LICENSES, EXHIBITS
NCE CERTIFICATE, Lmm
El
❑ CREATE ELECTRONIC REMINDER/NOTIFICATION REMINDER/NOTIFICATIONFOR 1 MONTH PRIORTO 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
LAW EPARTMENT'
1` )XVTORY (MAYOR OR DIRECTOR) 1V
A
El CITY CLERK
❑ ASSIGNED AG# -Al,
m
COMMENTS:
1/2020
SHIRECARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
HOME ►
This t Agreement ("Agreemenf')is made between the Cityof Federala, a Washington municipal
corporation. ("City"), and Shire Family Home Childcare,le proprietor C' tee"). The City and Grantee
(together ",Parties") are located business addresses which shall be valid for any notice
required is Agreement:
SHIRE FAMILY HOME CHILDCARE: CITY OF FEDERAL WAY:
LUCKY ARRAB Ade 1
32301 2nd Ave SW 33325 8thAve. S.
FEDERAL WAY, WA 98023 Federal Way, WA 98003-6325
() 835-2414 le o )
-711 0 - (facsimile)
shire.c `ldcare ail. rn o a , o ederalway.corn
follows:The Parties agree as
This contemplates a-` f funds to the Grantee under the conditions
described i .
2. CONIDrr[ONS OrGRANT.
2.1 Warranties.is the following,pre-requisites for grant eligibility:
a) Grantee operates a businesssi a l cated within the political boundaries of the City
of Federal Way;
b) Grantee itis a current City of Federal Wayi license;
c) Grantee has paid all taxes and government fees due up to the date of execution of this
grant agreement-,
Grantee's s the equivalent of to (0) full-time loyees
(20,80 -hours total for all employees per year);
Grantee's net revenues do not exceed more than $1.5 million peryear;
Grantee o f operate as a tax-exempt business as defined by the InternalRevenue
Service;
} Due t - 19, Grantee business (gheek all that aDV I ):
Was required by state or local orderto close
forcedWas to lay off employeesa to reducedatro a e
Incurred over $ 1,000 in COVID-1related expenses
Experienced 10-50% lost revenue
Experienced ®l lost revenue
CARES ACT BUSINESS GRANT AGREEMENT - 1 - 7/2020
CITE" OF
Federal
Way
CITY HALL
33325 8th avenue South
Federal Way, WA 98003 6325
(2531 335-7000
SHIRECARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
HOME ►
This t Agreement ("Agreemenf')is made between the Cityof Federala, a Washington municipal
corporation. ("City"), and Shire Family Home Childcare,le proprietor C' tee"). The City and Grantee
(together ",Parties") are located business addresses which shall be valid for any notice
required is Agreement:
SHIRE FAMILY HOME CHILDCARE: CITY OF FEDERAL WAY:
LUCKY ARRAB Ade 1
32301 2nd Ave SW 33325 8thAve. S.
FEDERAL WAY, WA 98023 Federal Way, WA 98003-6325
() 835-2414 le o )
-711 0 - (facsimile)
shire.c `ldcare ail. rn o a , o ederalway.corn
follows:The Parties agree as
This contemplates a-` f funds to the Grantee under the conditions
described i .
2. CONIDrr[ONS OrGRANT.
2.1 Warranties.is the following,pre-requisites for grant eligibility:
a) Grantee operates a businesssi a l cated within the political boundaries of the City
of Federal Way;
b) Grantee itis a current City of Federal Wayi license;
c) Grantee has paid all taxes and government fees due up to the date of execution of this
grant agreement-,
Grantee's s the equivalent of to (0) full-time loyees
(20,80 -hours total for all employees per year);
Grantee's net revenues do not exceed more than $1.5 million peryear;
Grantee o f operate as a tax-exempt business as defined by the InternalRevenue
Service;
} Due t - 19, Grantee business (gheek all that aDV I ):
Was required by state or local orderto close
forcedWas to lay off employeesa to reducedatro a e
Incurred over $ 1,000 in COVID-1related expenses
Experienced 10-50% lost revenue
Experienced ®l lost revenue
CARES ACT BUSINESS GRANT AGREEMENT - 1 - 7/2020
CITY OF CITY HALL
33325 8th Avenue South
Federal Way Federal Way, WA 98003-6325
(253, 83e-7000
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 them to the City or its
designee upon request.
3. TERMINATION. Should any of the conditions &scribed in section 2. 1, above, not be met, the City
may recover all 4ishiesed grant fimds and termiti4t6- this ogreOment.
4.1 Amount. In order to promote healthy economic activity in the City and in response . to the losses
Kzoltmil k5ftwA48
rrot to exceed Two Thousand and NO/100 Dollars ($2,000.00).
4.2 NNoqjpit-AApRrEgplioiAatfiioMtiSofflFgg�h. If sufficient funds are not appropriated or allocated for paymeni
under this Agreement for any fiscal period, the City will not be obligated to make payments under this
agreement.
111#11030
CARES ACT BUSINESS GRANT AGREEMENT - 2 - 7/2020
CITY OF
Federal Way
CITY HALL
325 3th Avenue South
ed r 9 Way, WA 98003-6325
( a3�) 835-7000
www � MmMe coal
6.3 Execution. Each individual executing this AgreeMent on ,- the City aW
Grantee
. execute and deliver
dtaned aj nal
CARES ACT BUSINESS GRANT AGREENIENT -4- 7/2020
9/29/2020
\,` --: 7,
< Business Lookup
Washington State Department of Revenue
License Information:
Entity name:
ARA, LUCKY
Business name:
SHIRE FAMILY HOME CHILDCARE
Entity type:
Sole Proprietor
I#:
604-354-765
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
32301 2ND AVE SW
FEDERAL WAY WA 98023-5604
Mailing address:
32301 2ND AVE SW
FEDERAL WAY WA 98023-5604
Erfdors-eue-rts
Endorsements held at this location Ucense # Count
Federal Way Home Occupation 18 -106046 -00 -BL
Business
Governing People
Governing people
ARRAB, LUCKY
Registered Trade Names
Registered trade names Status
SHIRE FAMILY HOME CHILDCARE Active
New search Back to results
Details Status Expiration date First issuance dal
Active Dec -31.2020 Jan -04-2019
om
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