AG 20-871 - Alpha 4 Adult Family HomeRETURN 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 Q. BY- AsAp
4. TYPE OF DOCUMENT (CHECK ONE):
1:1 CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, R-FQ)
* PUBLIC WORKS CONTRACT 0 SMALL OR LIMITED PUBLIC WORKS CONTRACT
* PROFESSIONAL SERVICE AGREEMENT 0 MAINTENANCE AGREEMENT
* GOODS AND SERVICE AGREEMENT D HUMAN SERVICES/ CBG
* REAL ESTATE DOCUMENT 0 SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
* ORDINANCE 0 RESOLUTION
El CONTRACTA NT (AG#): DINTERLOCAL
X OTHER CARES ACT FUNDS BUSINESS SUPP011T GRANT AGREEMENT
5. GTN CARES ACT GIRANT - (0
:l D 2
N �
6. NAME OF CONTRACTOR: ALPHA 4 ADULT FAMILY HOME, LLC
ADDRESS: 31228 8T11 AVE- S, FEDERAL WAY, WA 98003
E-MAIL: JOSEPHKARANJAK@MSN.COM
SIGNATURENAME: FRANcISCAKARANiA
I I a 11 a 9 2*24242 1 1♦ 6
UAIMIMEMM
7. EXHIBITS AND ATTACHMENTS: 11 SCOPE, WORK OR SERVICES El COMPENSATION El INSURANCE REQUIREMENTS/CERTIFICATE 11 ALL
OTHER REFERENCED EXHIBITS EI PROOF OF AUTHORITY TO SIGN 0 REQUIRED LICENSES El PRIOR CONTRACT/AMENDMENTS
9. TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAY� IF ANY) ONE THOUSAND AND NO/l 00 ($ 1,000,00)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES Tfi!!§ ANbHOLID
REIMBURSABLE EXPENSE: El YES X NO IF YES, MAXE\4UM DOLLAR AMOUNT:
IS SALES TAX OWED DYES X NO IF YES, $— PAID BY: 11 CONTRACTOR 10 C
3
RETAINAGE: RETAINAGE AMOUNT: -EI RETAiNAGE AGREEMENT (SEE CONTRACT) OR 0 RETAiNAGE BOND]
PROVIDED
0 PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 _Rrout
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL TATE APPROVED
0 eC'Tt
JECT MANAGERA�Zr�- CJ
D RISKMANAGE MENT (TAPPLICABLE)
13 LAW
11. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED CONINUTTEE DATE: COnflTTEE APPRovAL DATE:
SCHEDULED CouNcu, DATE: CouNcIL APPRovAL DATE:
irmsillizi 111.1.XT-61 Wn"XIEN till
El SENT TO VENDOR/CONTRACTOR, DATE SENT: DATE REC'D:—
D ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXH113ITS
11 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
El LAW DEPARTMENT
E;,SfG NATORY (MAYOR OR DIRECTOR)
D CITY CLERK
1:1 ASSIGNED AG4
COMMENTS:
CITY OF
4N� Federal Way
4V
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
www. ci4,offiedprahvay com
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
WITH
ALPHA 4 ADULT FAMILY HOME, LLC
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal
corporation ("City"), and Alpha 4 Adult Family Home, a limited liability company ("Grantee"). The City and
Grantee (together "Parties") are located and do business at the below addresses which shall be valid for any
notice required under this Agreement:
FRANCISCA KARANJA
31228 8h Ave S, Federal Way, WA 98003-413*
FX# 5 r . �11 t
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 funds to the Grantee under the conditions
describe4, herein.
is 1 .0.0.0
L I 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 `checl all tlrat sal):
E] Was required by state or local order to close
E] Was forced to lay off employees due to reduced patronage
Incurred over $1,000 in COVID-19 related expenses
Experienced 10-50% lost revenue
E] 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 — I — 7/20:2,
Grantee agrees to retain receipts documenting use of grant funds and will provide the 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 fands and terminate this agreement.
4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses,
not to exceed One Thousand and N01100 Dollars ($1,000.00).
4.2 Non -A ri ficient funds are not appropriated or allocated for payment
— Mrop ation of Funds. If suf
under this Agreement for any fiscal period, the City will not be obligated to make payments under this
agreement.
I is womm-aLm. -
5.1 Grantee IndOmnificatioti. 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
performance of this Agreement, except for that portion of the claims caused by the City's sole negligence.
Should a court of competent jurisdiction deten-nine 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
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.
5.3 City Ind6intuffication. The City agrees to release, indemnify, defend and hold the Grantee, its
ifficers. directors, shareholders. partners. emplovees. a_%i�,n�tsre �resentatives. and subcontractors harmless from
CARES ACT BUSINESS GRANT AGREEMENT -2- 71M
CITY OF C ITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
Federal Way (253) 835-7000
mvw ciAuffederalway. corn
my and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgment%,
i.wards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs, and/Q&
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.
I
6.1 Interpretation and ModWofiqn. 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 fall 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.
'"IN 01,16, W"" olffilb"011
Ro-
CARES ACT BUSINESS GRANT AGREEMENT -3- 7/9M
CITY OF
Federal W, a y
CITY HALL
33325 Sth Avenue South
(253) 835-7000
www cityOffederafivay. com
6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee
represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This
A I ement mU, be executed in an-rA number of countaicarts', each of mmm�
the same effect as if all Parties hereto had signed the same 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 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
M
DATE:
CARES ACT BUSTNESS GRANT AGREEMENT -4- 7/2020
Washington State Department of Revenue
< Business Lookup
"i - I - it: * I .
Entity name.-
ALPHA 4 ADULT FAMILY HOME, LLC
Business name:
ALPHA 4 ADULT FAMILY HOME, LLC
Entity type:
Limited Liabflity Company
UBI #"
604-424-352
Business ID:
001
Location ID:
0001
Location:
Active
Location address,
31228 8TH AVE 5
FEDERAL WAY WA 98003-5301
Mailing address: 2622 S 296TH PL
FEDERAL WAY WA 98003-3787
Excise tax and reseller permit status: Click here
Secretary of State status; Click here
Endorsements
Endorsements held at this location License # Count Details Status
Federal Wdy Home Occupation Active
Business
Governing PeopleM..Wdg.—fipo. -t.91ourd Mth S—Mrr.fStft
Governing people Title
KARANJA, FRANCISCA W
KURIA, JOSEPH K
The Business Lookup information is updated nightly. Search date and time: 10/14/2020 10:33:55 AM
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Expiration date First issuance date
Dec -31-2020 Dec -12-2019