AG 20-859 - Janin's Piano LessonsRETURN TO: Tim Johns on EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
ORIGINATING DEPT./DIV- ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TIMJOHNSON -------,—EXT: 2412 3. DATE REQ. BY. ASAP
TYPE OF DOCUMENT (CHECK ONE):
El CONTRACTOR SELECTION DOCUMENT (E.G., RFB, REP, RFQ)
El PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
El PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCEAGREENIENT
1:1 GOODS AND SERVICE AGREEMENT 0 HUMAN SERVICES/ CDBG
0 REAL ESTATE DOCUMENT Ei SEC UFITYDOC UNMNT(E.G. BOND RELATED DOCUMENTS)
El ORDINANCE 0 RESOLUTION
El CONTRACT AMENDMENT(AG#):E-1 INTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECT E: CARES ACT GRANTk' ROUND"12
NAME OF CONTRACTOR: JANINAS PIANO LESSONS
ADDRESS: 4206SW338TH
ST, FEDERAL WAY, WA98023 T ELEPHON-E: (206) 816-2292
E-MAIL: BJBERANII@YAHOO.COM
SIGNATURENAME: BOZENABERAN TITLE: SEEATTACHED
EXHIBITS AND ATTACHMENTS: 11 SCOPE, WORK OR SERVICES 1:1 COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE El ALL
OTHER REFERENCED EXHIBITS El PROOF OF AUTHORITY TO SIGN 11 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IFANY) 1,000 qyj
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: E] YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $_
IS SALES TAX OWED El YES X NO IF YES, i PAID BY. 13 CONTRACTOR 13 CITY
RETAINAGE: RETAINAGE AMOUNT: Ei RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND PROVIDE
11 PURCHASING: PLEASE CHARGE TO: 00 1- 1800-990-518-10-490 Prqiect Code #267662-25060
0. DOCUMENT/CONTRACT REVIEW
=D P JECT MANAGER
ZIRECTOR
Li RISK MANAGEMENT (IF APPLICABLE'
11 LAW
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Ir 1 11 111 * a I
INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
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SCHEDULED COMMITTEE DATE: COMMITTEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
[r=
El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
0 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
OLN ARTMENT
I GNATORY (MAYOR OR DIRECTOR)
El CITY CLERK to tq %'zdk-
0 ASSIGNED AG # AG#:A,
'OMMENTS:
71.. J-1 Ae,
1/2020
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.
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses
Grantee has
`• • to the COVID- 19 pandemic, the City shall provide a grant to the Grantee in an amount
• to exceed One Thousand and i! ii Dollars ($1,000.00).
4.2 Non-Ap =iation 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 Qr . 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
[tierformance of this Agreement, except for that portion of the claims caused by the City's sole negligence.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the
event of liability for damages arising out of bodily injury to persons or damages to property caused by or
resulting from the concurrent negligence of the Grantee and the City, the Grantee'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
• any limitation • 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- 7/20:R
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10/7/2020
< Business Lookup
Washington State Department of Revenue
License Information:
Entity name: BERAN, BOZENA JANINA
Business name: JANINA'S PIANO LESSONS
Entity type: Sole Proprietor
UBI 601-SI0-374 SOP
Business ID: 001- IS
Location ID: 0001 LIP> 0!6
Location: Active
Location and Mailing address: 34409 27T E SW
F E
E 'AY WA 98023
Excise tax and reseller permit status: Click here
Endorsements
Endorsements held at this location License Count Details
Federal Way Home Occupation
Business
Governing People May Include gavaming people natragistwith S—qaerofStft
Governing peope Title
BE N, BOZENA JANINA
Registered Trade Names
Registered trade names Status
EUROLINE AUTO UPHOLSTERY Active
JANINA'S PIANO LESSONS Active
New search Back to results
Status Expiratlon date Rrit Nsuance dal
Active Sep -30-2021 Sep -17-2020
First issued
Dec -15-1993
Dec -01-1999
The Business Lookup information is updated nightly. Search date and time: 10/7/2020 9:24:46 AM
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