AG 20-853 - With Dignity Adult Family Home LLCRETURN TO: Tim Johnson EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT. IV: —ECONOMIC DEVELOPMENT
2. ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE REQ.BY: ASAP
4. TYPE OF DOCUMENT (CHECK ONE):
0 CONTRACTOR SELECTION DOCUMENT (E.G., RFB, REP, RFQ)
El PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
El GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
0 ORDINANCE El RESOLUTION
11 CONTRACTA NT (AG#): DINTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
S. PROJECT NAME: CARES ACJ' 6RANT--/,'�ROUND 2
I'll .........
6. NAF CONTRACTOR: WITH DIGNITY ADULT FAMILY HOME, LLC
ADDRESS: 2213 S 362' ST, FEDERAL WAY, WA 98003 T ELEPHONE: 253-486-8940
E-MAIL: AMARPREETLIDHAR@HOTMAIL.COM
SIGNATURE NAME: ARmARPREET SINGH TITLE: SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: El SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE D ALL
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN El REQUIRED LICENSES 0 PRIOR CONTRACT/AMENDMENTS
1115 11` i I I I wSmam
9. TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) ONE THOUSAND & NO/100 ($1, '0
i
(IF CALCULATED ON HOURLY LABOR CHARGE -ATTACH SCHEDULES OF EMPLOYEES TITLES AND I=V MATE �S)
REIMBURSABLE EXPENSE: El YES XNO IF YES, MAXIMUM DOLLAR AMOUNT:$
IS SALES TAX OWED EI YES X NO IF YES,$ PAID BY: 0 CONTRACTOR 11 CITY
RETAINAGE: RETAiNAGE AMOUNT: D RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
PROVIDED
0 PURCHASING: PLEASECHARGETO: 001-1800-99.0-518-10-490 —Project CO& #267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL DATE REVIEWED INITIAL1 DATE APPROVED
2fR"'ECT MANAGER
ECTOR q
El RISK MANAGEMENT (IF APPLICABLE)
0 LAW
11. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED CONIMITTEE DATE: COMIVIITTEE APPRovAL DATE:
SCHEDULED CouNcit, DATE: CouNciL APPRovAL DATE:
12. CONTRACT SIGNATURE ROUTING
El SENT TO VENDOR/CONTRACTOR. DATE SENT: DATE REC'D:----
El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXH113ITS
0 CREATE ELECTRONIC REMINDER/NOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE
(Include dept. supports if necessary and feet free to set notification more than a month in advance if council approval is needed.)
INITIAL DATE SIGNED
0 L?A��PARTMENT N/A
GNATONATO7
GRY (MAYOR OR DIRECTOR)
E] CITY CLERK
El ASSIGNED AG# AG
COMMENTS:
inon
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and With Dignity Adult Family Home, LLC, a limited liability company ("Grantee"). The
City and Grantee (together 'Tarties") are located and do business at the below addresses which shall be valid for
any notice required under this Agreement:
UFEj���
Armarpreet Singh
2213S362 nd St
Federal Way, WA 98003
(253) 486-8940 (telepho•ne)
. . . . . . . . . . .
CITY OF FEDERAL WAY.
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2414 (telephone)
(253) 835-2509 (facsimile)
1. TERM. This agreement contemplates a one-time grant of Rmds to the Grantee under the conditions
i'' b`# 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 government fees due up to the 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 (check all that apply):
D Was required by state or local order to close
E] Was forced to lay off eniployees due to reduced patronage
V Incurred over $1,000 in COVID-19 related expenses
E] Experienced 10-50% lost revenue
0 Experienced over 50% lost revenue
CARES ACT BUSINESS GRANT AGREEMENT
7/2020
kCITY Of
.�Tederal Way
CITY HALL
33325 8th Avenue SOLIth
Federal Way, WA 98003-6325
(2 53) 835-7000
www cityoffederalway- rom
2.2 Use of Funds: Grantee affirms that grant funds will be used for the following purposes:
a) Mortgage or Rent
b) Personal Protection Equipment
a)
aeon Rent
b) Personal Protection Equipment
c) Insurance
d) Utilities
e) Marketing
f) Payroll
Grantee agrees to retain receipts documenting use of grant funds and will provide them to the City or its designee
upon request.
JAMMU,
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses
Grantee has incurred due to the COVID- 19 pandemic, the City shall provide a grant to the Grantee in an amount
not to exceed One Thousand and NO/I 00 Dollars ($ 1,000.00).
4.2 NogjAppropriation of Funds. If sufficient fLmds are not appropriated or allocated for payment
1-
91 U D1 1911 KV -11,
5.1 Q- . 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
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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.
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LffL11n7LLj LYTHL to it MUT ME T1 wrITYgLIFTIMITME 17ITNI-R-1di JUNIJEWFIC0 UL;L, Ft
CARES ACT BUSINESS GRANT AGREEMENT -2-
7/2020
Cow Y Ot, CrrY HALL
4 33325 8th Avenue out
Federal Way Federal Way, WA 90003-6325
(253) 835-7000
wmv. c*ofAltf�,rahvAy- co,m
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.
5.3 Cit ndepig
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 6ingr from resulting from or o
cnnected with this Agreement to the extent solely caused by
gresentatives, aris'
R I 1,701112_1 1 J!_4M4 HrRfth-M I M IMIJ t iVM1
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 Intmet -retafioll -,,I 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,
i
iii' nul I and vo i d o r i I lkgal shal I in no w—a-k, affe ct o r i nvali d.te aiXA a ther i ga 41f &wjiexk&�4�
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.
M 9 T17 M- IT. I I a 2TX# M
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
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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
a•ee in writing to an alternative process. If the King Coun i' for Court does -olotiaye-•iction-over-suclu
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,
NXIM]
CfTy OF
Federal Way
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www. dtyoffederg Way. rom
Maemm c ion un=er 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 dulv authorized to exe eewg41_--7PijLjLjx_, eeg git Tfc7 L
M0 4 WIRIVITHIMM. MIM&WIRMlin I -
OM
't I V unterp
Fic-THS P1 It WIWI WILY ou necessary to proauce one sucil co no
=,,#,LTtTff I a"T7 r.
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 execution7 hereof.
CITY OF FEDERAL WAY:
Jim 11, ayor
DATE:Z-,
By: (r, I "W"k,
Printed Name: ArnirpreetSingh
Title: Owner
DATE: 101612020
. ... . .....
�1_ 0�Z I
Washington State Department of ReielIUE
Business Lookup
License Information:
Entity name: WITH DIGNITY ADULT FAMILY HOME, LLC
Business narne- WITH DIGNITY AFH
Entity type- Limited Liability Company
LJBI #.. 604-122-987
Business ID- 001
Location 11D.- 0001
Location: Active
Location address: 2213 S 362ND ST
FEDERAL WAY WA 98003-7238
Mailing address: 2213 S 362ND ST
FEDERAL WAY WA 98003-7238
Excise tax and reseller permit status: Click here
Secretary of State status: Click here
Endorsements
Endorsements heid at this location License # Count Details Status
Federal Way Gfneral Business Active
Governing People nor Wdudeg—&oy pnisk wt regatefed with Sweeas, of Rate
Governing people Title
KAUR VIRK RUPINDER
SINGH, AMARPREET
Registered Trade Names
Registered trade names Status
WITH DIGNITY AFH Active
The Business Lookup information is updated nightly. Search date and time: 10/6/2020 12:36:37 PIVI
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1.
NEWseas ch 113acktonesuks
Expiration date Ph st Issuance date
Jan -31-2021 Jan -07-2020
Ph st ksued
Sep -26-2017