AG 20-868 - Rachael N Gathoni--Lj RETURN TO: Tim Johnson EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT. XV. —ECONOMIC DEVELOPMENT
2. ORIGINATING STAFF PERSON: TIM JOHNSON EXT: 2412 3. DATE Q. BY -ASAP
4. TYPE OF DOCUMENT (CHECK ONE):
El 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
• GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CBG
* REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
* ORDINANCE El RESOLUTION
* CONTRACT AMENDMENT (AG#).-__ DINTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AG E NT
5. PROJECT NAME: CARES ACT 6 ANT rRotj�ND2--
6. NAME OF CONTRACTOR: RACHAELNGATHONI
ADDRESS: 33025 18TK PL SE202, FEDERAL WAY, WA 98003 T ELEPHONE: 253-517-8372
E-MAIL: SOUTH KINGHEALTHCARE@OUTLOOK.COM
SIGNATURE NAME: RACHAEL N GATHONI TITLE: SEE ATTACHED
7. EXHIBITS AND ATTACHMENTS: 0 SCOPE, WORK OR SERVICES El COMPENSATION 11 INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN EI REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
9. TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAY, IF ANY) ONE THOUSAND AND No/100 ($JI�
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: 0 YES X NO IF YES, MAXIMUM DOLLAR AMOUNT:
IS SALES TAX OWED El YES X No rFyEs,w.$ PAID BY: El CONTRACTOR El CITY
RETAINAGE: RETAINAGE AMOUNT: --,-El RETAINAGE AGREEMENT (SEE CONTRACT) OR 0 RETAINAGE BOND
PROVIDED
0 PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 'q
jektq #267662-25060
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
0 PROJECT MANAGER
M-R(RE,CTOR
El RISK MANAGEMENT (IF APPLICABLE)
z z
0 LAW
11. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED CONMTTEE DATE: CONINUTTEE APPRovAL DATE:
SCHEDULED CouNcu, DATE: CouNcm APPRovAL DATE:
12. CONTRACT SIGNATURE ROUTING
El SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
11 ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
El 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 SIGNED
�
0 LA
,j DEPARTMENT /A
I G
GRATORY(MkYOR OR DIRECTOR)
0 CITY CLERK
11 ASSIGNED AG # AG#
COMMENTS:
This Great Agreemcnt (" . r rrrt ntt) is made b t Cur. rr the City " Federal ways in ton municipal
Porati (•� iVl and Rachael N G t rrri, sale Proprietor ("Gr t " t � e :r
"Parties") are located ted and d business, at the below addresses which shall be valid for * notice require
r ie dr r
this Agreement:d tinder
Rachael N Gathoni
33025 181h202
Federal Way, WA 98003
(233) 517-8372 (tllrrr)
sqL10*4qu
The Parties agree as follows:
1. • This agreement contemplates a orae -t• t f
described herein, t rat • .
ons
2. CONDIOF
2.1 lrtles: The Grantee warrants the following,
a Grantee operas • a business physically lcatedWithinnthe political boundarieseligibility:-requ,isites for grant ite
of Federdl Wof City
) Grantee maintains a ciwrent City of Federal Way business li ens '
) Grantee has paid all taxes and rrrrnent fees due U to the date of execution of this
agreement, grant
d) lr tee*s businem employs no morc flian the equivalent of t 1 - ® toys
20,800 man-hours, total for m e l ees yearces
Grantee's net revenues do not exceed more than $1 million per year;
J) Grantee does not operate is a tax-exempt buss ssdefined `
ser l e rzt
) Due t 19, Grantee business (check all that apply
requiredEl Was state or local order to dress
El Was furca to lay off employees; due to reduced patronage
Incurred over S 1,000 in Co [D- relined expense,.,,
Experienced 10® % lost mvenue
Experienced over % last revenue
2.2 s l t &, Grantee, affirms that _grant funds willor the following
a) tviortgage or Rant
b) PersOnal Protection Equipment
CARES ACT BUSINESS GRANT AGREEMENT
--
?1202
CITY OF
'V
Federal Way
c) Insurance
c) Insurance
d) Utilities
e) Marketing
f) Payroll
CITY HALL
33325 Sth Avenue South
Fpdel,ral Way, WA 98003-6325
(253) 835-7000
�w.ciy'yrciffeder,.Yiwaycoiri
Grantee agrees to retain receipts documenting use of grant funds and will provide the to the City or its designee
upon request.
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 NOII 00 Dollars
4.2 N . If sufficient funds are not appropriated or allocated for payment
Z11% fisy,,?] the Cil"ill n*t'_k,", ikli� tit) rtat-e u -t der V .
gateiL L
5.1 Grantw 1hdenmiftcation. 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
of Afpr A piv -t s czi i -, e d -Cj�j g -H
L=wj tV *JoTti itf the c12iT
M MTS n
ihe concurrent negligence ot the Urantee and the City, the Urantee's liability hereunder shall be 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 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, 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.
CARES ACT BUSINESS GRANT AGREEMENT -2-
7/2020
CITY OF
r -ederal Way
CITY'HALL
33325 Sth Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
w.vwa1yn&dbrahva,Vcam
53 Cily_L qd
The City agrets to, release, indemnify, defend and hold the Grantee, its
officers, directors, shareholders, partners, ernployces, agents, representatives, and subcori ftuctors harmless from
any and all claims, demands, actions, suit,-;, eases of action, arbitrations, mediations-, proceedings, judgments,
awards, injuries, darnages, liabilities, Josses, fines, 1-1:,es, penalties exirenses, attorney's fees, costs, rid or litigation
expenses to or by any and all persons or entities,iricluding, 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 ori issions of the City.
5..urvi—val, The provisions of this Section shall survive the, expiration or termination of this
Agreement %,itll respect to any event Occuning prior to such expiration or termination,
6. 91-
LNE, RAL P.ROV
ISIONS.
&IWlk!1119t rti rir r tl l rrl tali r, This Agreement contains all of the agreements of the Parties with
respIr-cl to any matter covered or incntioned 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 mid void, or illegal shall in no way affect or invalidate any other provision hereof` and sueb other
provisions shall re, main in full force and effect. No provision of this Agreement, including this provision, may be
arnended, waived, or modified except 'by written agaecinent signed by duly authorized representatives of the
panie&
6*2 Enfo—mement. Any notices required to btu given by the Parties It be delivered at the add,,-�
set forth at the beginning, of this Agreement, Any notices may be delivered personally to the addressee of the
notice or inay be deposited in the Unitcd States mail,
Postage prepaid, to the address sot> forth above. Any notice
so posted in flie United States inail, 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
or relinquishment of a -r
conferred by this Agreement in one or more instances shall not be c0 nstrued to be a w . ive
those covenants, agreements or options, and the slime shall be and remain in full force and 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 Cityto declare one breach or default does riot act as a waiver of the City's right to declare another
breach or defaulL This Agreement shall be made in, governed by, and interpreted in accordance with the laws, of
the State of W&shington. If the Parties are unable to settle any dispute, difference or claim arising from this
Agreement, the exclitsfive means of resolving that, dispute� diBerence, or claim, shall be bY filing soil ander the
venue, rules and jurisdiction of the King County Superior Court, Kh19Cottnty� Washington, unless the parties
agree in writing to an altemative process, if the King County Superior Court doe , s 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 nnniiq
"Y t)-tLl-igzsdt,'Ycla'mGrlawSUltsin gtromthiSA;
each Party shall pay all its legal costs and attomey"s fees said expenses incurred in defending or brig;
Claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law;
however, nothing in this pwagraph shall he construed to limit the Parties' rights to inderanification unrh
5 of this Agreement.
CARES ACT BUSINESS GRANT AGREEMENT
NNW
TY OF I
TY HALL
Federal Way 33325 8th Avenue South
Federal`Nay W 32
(253) 8,35-7000
www ci
6.3 RK-ecution. Each individual executing this Agreement on bqUf of the City and Gmthe Mromts
rwarrants that such individualduly authorized to execute and deliver
be ;r! in any numbersr i !:eachof M r
f .
r r;�' • . - r i i' ri
r- is i r r► �r
PartiesLN WITNESS, the
..e........
Printed Name:
Title: 0040
P.w
.mw.
10/13/2020 Washington State Department of Revenue
V1/-ishmq-:.r)n State Department of Reven,j�,
< Business Lookup
Entity name-
GATHONI, RACHAEL NYAVVIRA
Business name:
RACHAEL N GATHONI
Entity type:
Sole Proprietor
UB1 4:
604-307-737
Business ID:
001
Location ID:
0001
Location:
Active
Location address:
3302518TH PL S
Excise tax and re Iter permit status:
Endorsements
Endorsements lMd at this i,scafion License #
Federal Way Home Occupation
Business
APT E202
FEDERAL WAY WA 98003-9408
33025 18TH PL S
APT E202
FEDERAL WAY WA 98003-9408
Count Details
Governing PeopleMay &,dud. goveming;mple ear nebumd with S—Warl ®i`Sww
Governing people Title
GATHONI, RACHAEL NYAMRA
Registered Trade Names
Registered trade names Status
SOUTH I(ING HEALTHCARE SERVICES LLC Active
New search Back to results
Status Expirationdate First issuance daV
Pending Oct -31-2021
First issued
Jul -25-2019
View Additional Locations
The Business Lookup information is updated nightly. Search date and time: 10/13/2020 2:23.48 PM
f'-0-4 —
https://secure.dor.wa.gov/gteunauth/—,/#5 1/2
Pamela Jones
From: Scott Sproul
Sent: Tuesday, October 13, 2020 1:35 PM
To: Pamela Jones
Subject: RE: I got another one for you
She applied yesterday
And approved
From: Pamela ]ones
Sent: Tuesday, October 13, 2020 12:31 PM
To: Scott Sproul
Subject: I
of another one for you
Hi Scott,
Is Rachael N Gathoni good to go? Shea lied fora Home Occupation Business — 3302518th PI S #E202. This is an office
for her. She is in healthcare and travels.
Executive Assistant to the May
City
I
of Federal Way
33325 8h Avenue South
0
Federal Way, WA 9803
Phone: (253) 835-2402
Fax: (253) 835-2409
R