AG 20-797 - Shannon Thompson CounselingRETURN TO: Tim Johnson
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT. IV: ECONOMIC DEVELOPMENT
1 ORIGINATING STAFF PERSON: TPA JOHNSON EXT: 2412 u 3. DATE REQ. BY: AS
4. TYPE OF DOCUMENT (CHECK ONE):
11 CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
11 PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCE AGREEMENT
* GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/ CG
* REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
* ORDINANCE ORESOLUTION
El CONTRACTA NT (AG#): OINTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
:)!12�,
5. PROJECT NAME: --1---CARES ACT GRANT =P10uND 2-
6. NAME OF CONTRACTOR: SHANNON THOMPSON COUNSELING
ADDRESS: 33442 IST WY S # 101, FEDERAL WAY WN 98003-6222 T ELEPHONE: (253) 320-3020
E-MAIL-. sHANNoN@STCOUNSELING.COM
SIGNATU'RENAME: SHANNON THOMPSON TITLE: SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: E3 SCOPE, WORK OR SERVICES 11 COMPENSATION El INSURANCE REQUHZEMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
I
9. TOTAL COMPENSATION$ (INCLUDE EXPENSES AND ONE THOUSAND AND NO/100
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: El YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED El YES X NO IF YES,$ PAR) BY: El CONTRACTOR El CITY
RETAINAGE: RETAINAGE AMOUNT: -13AETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAiNAGE BOND
PROVIDED
11 PURCHASING: PLEASE CHARGE TO: — 001-1800-990-518-10-490 Project Code #267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
0 P, OJ,ECT MANAGER
DIRECTO- -.2d
0 RISK MANAGEMENT (IF APPLICABLE)
El LAW
11. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: COMMITTEE APPRovAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPRovAL DATE:
12. CONTRACT SIGNATURE ROUTING
0 SENT TO CONT CT DATE SENT: DATE C'D:
El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
El CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE
(Include dept. supports if necessary and feel free to set notification more than a month in advance if council approval is needed.)
INITIAL DATE SIGNED
0 LA EpARTMFNT
F
=NATORY (MAYOR OR DIRECTOR)
El CITY CLERK
11 ASSIGNED AG# AG#
COMMENTS:
1/2020
This Grant Agreement ("Agreemenf') is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Shannon Thompson Counseling, a sole proprietor ("Grantee"). The City and Grantee
under this Agreement:
SHANNON THOMPSON Ade Ariwoola.
33440 1 st Way S # 104, Federal Way, WA 98003 33325 8th Ave. S.
Mailing address: 3 3 442 1 " WY S # 10 1 Federal Way, WA 98003-6325
Federal Way, WA 98003-6210 (253) 835-2414 (telephone)
(253) 320-3020 (telephone) (253) 835-2509 (facsimile)
1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions
1escribed 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 City
of Federal Way;
b) Grantee maintains a current City of Federal Way business license;
c) Grantee has paid all taxes and goveniment fees due up to the date of execution of this grant
agreement;
d) Grantee's business employees 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 mon 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 (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 $1,000 in COVID-19 related expenses
X Experienced 10-50% lost revenue
n Experienced over 50% lost revenue
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes:
a) Mortgage or Rent
b) Personal Protection Equipment
CARES ACT BUSINESS GRANT AGREEMENT -1-
7!2
I-7/2
upon request.
3. IEBAIINAIIgT� Should any of the conditions described in section 2. 1, above, not be met, the City may
recover all disbursed grant funds and terminate this agreement.
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses
It to exceed One Thousand and00 Dollars ($ 1,000.00).
I
5.1 Okqn��� The Grantee agrees to release indemnify, defend, and hold the City, its
elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless ftorn
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
of *�-Wmus caused bv *e CiJ%'s, sole -fe ' eTc,"houl&
J, 04', ON
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 h1dustriaLhW;:aA99LA9t_M!4hLeL It is 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 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, oniCtensation or i' i.yable to or b-kl 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.
CARES ACT BUSINESS GRANT AGREEMENT -2-
7/2020
CITY OF
As
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
MVW cityOffederalway coo
5.3 QftJg&OW&� The City agrees to release, indemnify, defend and hold the Grantee, its
officers, directors, shareholders, partners, employees, agents, representatives, and subcontractors 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 rer from, resulting from or connected with this A eement to the extent soleIN caused
-,resentatives,, arisin�?i
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.
2EE0WA3M`1-!1R=W
6.1 Inte
and Modili
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,
ori .1npAo *�rovkdon li.-��of 4old 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.
6.2 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
Tfjs igy-mr-Al-fay, lie dotmited i -t, fte Utited States
address set figrft above,
,11TIFTI&OU lUf WILCU L110 LCHUS *1 L1115 0 L 4pt LUAIC(L UIP VC CAUMS17c, UtL
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
t
Iwo -I- "11.6i
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
Eno*
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.
CARES ACT BUSINESS GRANT AGREEMENT -3-
7/2020
CITY OF Cl-rY'HALL
33325 8th Avenue South
Federal Way Federal Way, WA 98003-6325
oz`�— (253) 835-7000
www. cityvfh,,�dovaimny, com
co 1 0 ji F1
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 mululll execution" hereof.
I "Irmo•-
111:111vii� � " ToTys"
CITY OF FEDERAL WAY:
W14
Jim FZ 1. ayor / /-
q1
By:
Shannon Thompson
Title: Owner
DATE: 10-81nz
0— .. . ....... ....
CARES ACT BUSINESS GRANT AGREEMENT -4-
7/2020
Washington State Department of Revenue
Business Lookup
License Information:
Entity name:
THOMPSON, SHANNON K
Business name:
SHANNON THOMPSON COUNSELING
Entity type-
Sole Proprietcw
UBI #:
603-252-901
Businessl :
001
Location ID:
0001
Location:
Active
Location address:
33440 1 ST WAY S STE 104
FEDERAL WAY WA 98003-6222
Mailing address: 33442 1ST WAY 5 STE 101
FEDERAL WAY WA 98003-6210
Excise tax and reseller permit status: Click here
Endorsements
Endorsements held at this location License Count Details
Federal Way General &miness 13 -100438 -00 -BL
Governing People
Governing people Title
THOMPSON, SHANNON K
Registered Trade Names
Registered trade names
SHANNON THOMPSON COUNSELING
0
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Status Expiration date First issuance date
Active Nov -30-2020 Feb -05-2013
The Business Lookup information is updated nightly. Search date and time: 10/7/2020 3:34:53 PM
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