AG 20-869 - AB Adult Family HomeEXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
•�JffK,�ENT ---a
. ORIGINATING STAFF PERSOM TIMJOHNSON EXT: 2412 3. DATE REQ. BY.—ASAP
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1, 1
MIL00,2955 kly.1to Lei 'Z410 91 NJ an I
El PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
• PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
• GOODS AND SERVICE AGREEMENT El HUMAN SERVICES/ CDBG
El REAL ESTATE DOCUMENT D SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
[I ORDINANCE El RESOLUTION
* CONTRACT AMENDMENT (AG#):_ El INTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
NAME OF CONTRACTOR: AB AI)LJLT FAMILY HOME
ADDRESS: 31416 27TH
AVE SW, FEDERAL WAY WA 98023-7814 TELEPHONE: (206) 747-89,13
E-MAIL: ABADULTFAMILYHOME@YAHOO.COM
SIGNATURE NAME: SHUPING DING TITLE: SEE ACHED
FXHIBITS AND ATTACHMENTS: 11 SCOPE, WORK OR SERVICES 0 COMPENSATION 11 INSURANCE REQUIREMENTS/CERTfFICATE 0 ALL
OTHER REFERENCED EXHIBITS 0 PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
(IF CALCULATED ON HOURLY LABOR CHARGE -ATTACH SCHEDD HOLIDA���
REIMBURSABLE EXPENSE: El YES X NO IF YES, MAXIMUM DOLLAR AMOUNT:
IS SALES TAX OWED DYES X NO IF YES, $_ PAID BY: D CONTRACTOR 0 CITY
RETAINAGE: RETAINAGE AMOUNT: El RETAINAGE AGREEMENT (SEE CONTRACT) OR E3RETArNAGE BOND PROVIDE
Ei PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 Project Code #267662-25060
0. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
2 0 PROJECT MANAGER t
—/DIRECTOR eo - t 5- -,2- c) :f _7 _;Z 0--. 2 -- 4
El 2
RISK MANAGEMENT (IF APPLICABLE)
0 LAW
1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: CoNsn'ITEE APPROVAL DATE:
SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE:
1
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
L . 'DEPARTMENT N/
NATORY (M "OR OR DIRECTOR)
[I CITY CLERK
0 ASSIGNED AG# AG#
'O S:
1/2020
CITY -Or ClTY,HAl_1_,
33325 Sth Avenue South
Federal Way Federal Way, WA 88003-5325
(253) S35-7000
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
AB ADULT FAMILY HOME
This Grant Agreement ("Agreernenf') is made between the City of Federal Way, a Washington municipa
corporation ("City"), and AB Adult Family Home, a sole proprietor ("Grantee"). The City and Grantet
(together "Parties") are located and do business at the below addresses which'shall be valid for any notict
required tinder this Agreement,
1-11 _. 11.11111-- --1------- 11-1- - ___________
AB ADULT FAMILY HOME:
EDWARD D. GACHOKA
31416 27'h Ave SW
FEDERAL WAY, WA 98023-7814
Erne
211- M
Ade Ariwoola
33325 8th Ave. S.
federal Way, WA 98003-6325
(253) 835-2414 (telephone)
(253) 835-2509 (facsimile)
1. TERM. This agreernimt contemplates a one-time grant of funds to the Grantee under the condition.,
described herein.
2. CONDITIONS
Of GRANT
11 ftrrantics. 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 Cit)
of Federal Way;
b)
Grantee maintai s 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 thii
grant agreement;
d)
Grantee's business employs no more than the -equivalent of ten (10) full-time employee;
(20,800 man-bouTs total for all employees per year),
e)
Grantee's net revenues do not exceed more than $1.5 million per year;
f)
Grantee docs not operate as a tax-exempt business as; defined by the Jrternal Revenue
Service" 7
Due to CAVI D-19, Grantee business (�hcckja I thn(a)Lfly).
❑ Was required by state or local order to close
Was forced to lay off ernployeas due to reduced patronage
Inc CTed over 51,000 in COVID-1 9 related expenses
Experienced 10-50% lost revenue
Experienced over 50% lost revenue
TOURISM GRANT AGREEMENT 312017
CITY HALL
33325 Sth Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www cityoffederalway coo
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
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.
3. TERMINATION. Should any of the conditions described in section 2.1 above, not be met, the City
rnay 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 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/100 Dollars ($1,000.00).
4.2 Non-Aimroi)riation 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.
113 11010 10 tol Myffrfm
5.1 -Grantee Indernnificatiot. 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
[!erformance of this Agreement, except for that portion of the claims caused by the City's sole negligence.
Should a court of comyvetent Jurisdiction determine that this Amur=rm.
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
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.
TOURISM GRANT AGREEMENT -2- 314
CITY OF
F6deral Way
CITY HALL
33325 Sth Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
mm o1yoffederalway com
5.3 City Indemnification. 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 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 and Modification. 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 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.
I to 'Maaffla�� E MM
COY OF CITY HALL
33326 Sth Avenue Sbuth
F�dertfl Wa Fed6ral Way. VVA 98003-6325
(253) 835-7000
www.;��O�w colt,
6. 6n, Eacb individua*l executing this Agreement on behalf of the, City and Grafitee
represents and wdryants that such individual is dul' authorized to execute and d6fiver this Agreement. This
y
Agreement may be execut6d in any numberi of counterparts,,each of which shall be deemed an original and with
the same effect as if all Parties hereto had sigried the sarne document. All such coUnterparts shall be construed
together and shall constitute one instrument, but in making proof hereof it shall only be necessary to produce
one such counterpart. The signatLme and acknowledgment pages from such counterparts may be as5embled
together to form a single instrument compr-ised of all pages of this Agreement and a complete set of all
sipaiure and acknowledgment
pages, The date upon whicli the last of all of the Parties have executed a
co�riterpart of this Agreement shall be the "date of mutual execution" hereof
CITYOF FEDERAL WAY:
Jim ell Mayor
tn
DAT -E -
By:
Printed I�arne:
-E—:
Title:
DATE:
TOURISM GRANT AGREEMENT -4- 312017
10/13/2020
< Business Lookup
License Information:
Entity name:
GACHOKA, EDWARD D
Business name:
AB ADULT FAMILY HOME
Entity type:
Sole Proprietor
U #: r
602-241-497
Business ID:
001
Location ID:
0002
Location:
Active
Washington State Department of Revenue
Location address: 31416 27TH AVE SW
FEDERAL WAY WA 98023-7814
Mailing address: 31416 27TH AVE SW
FEDERAL WAY WA 98023-7814
Uigjrk�
•r
Endorsements held at this location License # Count
Federal Way General Business 16 -100889 -00 -BL
Governing PeopleMyinct.dg.-mb,_qpeople not reg' t—dwith S—Wy®fftm
Governing people
GACHOKA, EDWARD D
KUNGA, ELIZABETH
Registered Trade Names
Registered trade names Status
AB ADULT FAMILY HOME Active
Details Status
Active
New search Back to results
Expiration date First lssuance dal
Oct -31-2020 Apr -18-2017
View Additional Locations
The Business Lookup information is updated nightly. Search date and time: l0/13/202010:15:06 AM
Con t.ct us
https://secure.dor.wa.goV/gteunauth/,/#24
First issued
Sep -08-2020
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