AG 20-625 - Caren Osborn, LMFTCITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
OR1GfNXfING DEPVDW—ECONONt IC DEI,"'ELOPM ENT
ORIGINATING STAFF PERSON: TIM JOHNSON I--- EXT: — 2412 3. DATE REQ. BYASAP
TYPE OF DOCUMENT (CHECK ONE):
El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCE AGREEMENT
E1 GOODS AND SERVICE AGREEMENT Ei HUMAN SERVICES/ CDG
0 REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE El RESOLUTION
El CONTRACTA NT (AG#):_-- El INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
NAME OF CONTRACTOR: C OSBORN, LMFT
ADDRESS: 31919 1 STAVE S# 203, FEDERAL WAY WA 98003-5229 T ELEPHONE: (253) 221-6225
E-MAIL: CARENLEE3@YAHoo.com
SIGNATURENAME: CARENLEE OSBORN TITLE: SEE ATTACHED
EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES 0 COMPENSATION 0 INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS
. TERM: COMMENCEMENT DATE: SEE ATrACHEDAGREEMENT COMPLETION DATE:
TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND AND NO/100 1,0RN
MA AO6
,4Y
Y RA
(IF CALCULATED ON HOURLY LABOR CHARGE -ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOL'
REIMBURSABLE EXPENSE: El YES No IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED El YES X NO IF YES, PAID BY: El CONTRACTOR 0 CITY
RETAINAGE: RETArNAGE AMOUNT: RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
ROVIDED
El PURCHASING: PLEASE CHARGE TO: _001-1800-990-518-10-490 Project Code #267662-25060
Oa DOCU ITRACT ENTICONREVIEW INITIAL DATE REVIEWED INITIAL DATE APPROVED
2 0 J`F'CTMANAGER
1ZIR ECTOR N4sLa)
El RISK MANAGEMENT (IF APPLICABLE)
Ei LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
2. CONTRACT SIGNATURE ROUTING
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE C'D:
• ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
• CREATE ELECTRONIC REMINDERINOTIFICATION 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
Ed LAW DEPARTMENT /A
0
Z,SJOTTATORY (MAYOR OR DIRECTOR)
1:1 CITY CLERK to
El ASSIGNED AG# AG#
'OMMENTS:
I FFAIY;3�0
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Caren Osborn, LMFT, a sole proprietor -- The City . i.: ''(together
"Parties") . located `i s i ii, business at the belowaddresses which shallbe valid for any notice required under
this Agreement:
CAREN LEE • :i•,
1919 1 st Ave S # 203
FEDERAL , ,. 98003-5229
122
Ade Ariwoola
33325 8th Ave. S.
ederal Way, WA 980 03-6325
253) 835-2414 (telephone)
ii
TERM.1. one-time grant of i the Grantee under the conditions
tescribed
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
Federalof
grantb) 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
agreement;
) Grantee's business employs no more than the equivalent of ten (10) full-time employees
(20,800 -hours total for all employees per year);
e) Grantee's net revenues do not exceed more t $1.5 million per year;
f) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue
Service;
Due to CVI -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 CVI -19 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
) Personal Protection Equipment
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.
not to exceed One Thousand and NO/100 Dollars ($1,000.00).
4.2 Non-A-ppropriation 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 Orantoo lftdgftmi6�ation. 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.
1 -4
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resUILIng IrOM Me CORCUrECIR 11Ug11gt;11UC 01 UIC UFMILM, U11U LIX �,ALJ, LIM ULMILM S 11d:111-lity-LIereUTIOUT NOW I
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 indemnification.
5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Grante
waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 5
RCW, solely for the purposes of this indemnification. Grantee's indemnification shall not be 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. The Parties farthe
acknowledge that they have mutually negotiated this waiver. I
5.3 City Indemnificatibn. The City agrees to release, indemnify, defend and hold the Grantee, its
covy 60
F e
;�6d ral 1AW
CITY HALL
33325 8th Avenue South
Federal Way VVA 98003-6325
(253) 835-7000
wvvw, cityoffederalwaY com
officers, directors, shareholders, partners, employees, agents, representatives, and sub -contractors 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, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent
solely caused by the negligent acts, errors, or omissions of the City.
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.
6.1 IhtgMgg1gfipn_agd Modificafion. 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 fall 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
Ta rul i: M P i a T TMJ M, R,
effect. Failure or delay of the City to declare any breach or default immediately upon occurrence shall not waive
such breach or default. Failure of the City to declare one breach or default does not act as a waiver of the City's
right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in
accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference 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
does not have jurisdiction over such a suit, then suit may be filed in any other appropriate court in King County,
Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County,
Washington and waives any objection that such courts are an inconvenient forum. If either Party brings any
claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and
expenses incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other
recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the
Parties' rights to indemnification under Section 5 of this Agreement.
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
CM; OF
176deral Way
CITY HALL
33325 8th Avenue South
Federal Way WA 98003-6325
(253) 835-7000
v cityoffederatway corm
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 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 a
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.
MM
DATE:
By:
—GULV- Lan
Printed Name: I I
Title:
DATE: 2110
'aai'ashifigton State Departma-,.',' 0'r;e 't !Ue
Services Business Lookup CAREN OSBORN, LMFT
License Information: New search Back to results
Entity name: OSBORN, CAE N LEE
Business name: CAR EN OSBORN, LMET
Entity type: Sole Proprietor
UBI #- 602-540-148
Business ID: 002
Location ID: 0001
Location: Active
Location address: 31919 1 STAVE S
ST E 203
FEDERAL WAY WA 98003-5229
Mailing address: 319191ST AVE S
STE 203
FEDERAL WAY WA 98003-5229
Excise tax and reseller permit status: Click here
Endorsements
Endorsements held at this location License # Count Details Status Expiration date First issuance
Federal Way General Business 19 -100323 -00 -BL Active Nov -30-2020 Mar -14-2019
Governing People May include governing people not registeredwiffi Secretary of'State
Governing people Title
OSBORN, CAREN LEE
L-7rA-CT =-- Wir=,
Registered it names
CAREN OSBORN
I
I I-Ep InTorination IsTpualm'MUMT-6mm I . 111 1 . .' -
Working together to fund Washington's future