AG 20-872 - Chiropractic WellnessRETURN TO: Tim Johnson EXT: 2412
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
. ORIGINATING DEPT./DIV- ECONOMIC DEVELOPMENT
ORIGINATING STAFF PERSON: TlMM JOHNSON EXT: 2412 3. DATE Q. BY. ASAP
TYPE OF DOCUMENT (CHECK ONE):
[I CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFT, RFQ)
El PUBLIC WORKS CONTRACT El SMALL OR LIMITED PUBLIC WORKS CONTRACT
* PROFESSIONAL SERVICE AGREEMENT El MAINTENANCE AGREEMENT
* GOODS AND SERVICE AGREEMENT El HUMAN SERVICES / CBG
El REAL ESTATE DOCUMENT El SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
El ORDINANCE El RESOLUTION
* CONTRACTA NT (AG#):_ E-1 INTERLOCAL
* OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT
PROJECT E: CARES ACT GRANT ROUND 2
NAME OF CONTRACTOR: CHIROPRACTIC WELLNESS
ADDRESS: 32114 1 ST AVE S # 104, FEDERAL WAY, WA TELEPHONE: (253) 431-5343
E-MAIL: DOCTORCWRCLMCS@GMAIL.COM
SIGNATURE NAME: ALNOOR BHANJI TITLE: SEE ATTACHED
TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) TWO THOUSAND AND NO/100(L,2,000A)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: El YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $___
IS SALES TAX OWED' El YES X NO IF YES, $ — PAID BY: 0 CONTRACTOR C] CITY
RETAINAGE: RETAINAGE AMOUNT: 0.1 RETAINAGE AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND
ROVED
0 PURCHASING: PLEASE CHARGE TO: 001-1800-990-51S-10-4,99 Prpject Code #267662-25060
0. DOCUMENT/CONTRACT REVIEW INITIAL DATE REVIEWED INITIAL / DATE -APPROVED
O��PRECT MANAGER
IRE TO 'V /o - /2:7-2Z
El RISK MANAGEMENT (IF APPLICABLE) /
D LAW IL
SCHEDULED COMMITTEE DATE:
EDULED COUNCIL DATE:
COMMITTEE APPROVAL DATE:
CouNal, APPROVAL DATE:
El 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
11 LAW DEPARTMENT /A
4-66<NATORY (MAYOR OR DIRECTOR)
El CITY CLERK
El ASSIGNED AG# AG#
'OMMENTS:
2A4 -A
1/2020
AOL CITY OF
01TY HALL
33328 81h Avenwe SQU;h
4A�
Pederal Way, WA 98003-5325
(253) A354000
CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMEJ
WITH
CHIROPRACTIC WELLNESS
This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington Mutlicipal
corporation ("City"), and Chiropractic Wellness, a professional service corporation C'Grantee"). The City and
Grantee (together "Parties') are located and do busitim at the below addresses which shall be valid for any
notice required under this Agreement-
FODURIDIT-07.114"Ef
CITY OF FEDERAL WAYt
Ade Ariwoola
33325 8th Ave. S.
Federal Way, WA 98003-6325
(253) 835-2414 (telephone)
(253) $35-2509 (facsimile)
This agreement contemplates a one-time grant of funds to the Grantee under the conditions
described herein.
AL 0" Op CITY HALL
4W
33,325 Sth ManuaFOdeml OY 60" VVby, WA 96003�6325
0
www effyoffoderalway COM
2.2 Use of Funds,: Grantee affirms that grant funds will be used for the following purposes:
a) Mortgage or Rent
b) Personal Protection Equipment
c) Insurance
d) Utilities
e) Marketing
f) Payroll
Orantee agrees to retain receipts documenting use of grant funds and will provide them to the City or il
fesignee upon request- M
3. TERAiINATION. Should any of the conditions described in section 2,1 above, not be met, the City
may recover all disbursed grant fimds and terminate this agreement,
4, C_,IRANT A—THQUNT.
4.1 AMougt, In order to promote healthy economic activity in the City znd in response to i
gme w a m
'Fe i tjih .egwg -7. wxm
4.21N.of,Ftinds, If sufficient fiinds are not appropriated or allocated for payment
under this Agreement for any fiscal period, the City will not be obligated to make payments under this
agreement.
ilujrzw�Q.
7K," 5 IIISPMULi J1 11LIMLICU N W0171L Wnen zPe naff Jo a" Any 0 wIt'L CL s not Pe Von" Pow any o
these covenants of mdoncation.
5.2 h! ij9tL1q99A9e- Act )YAJ It is specifically and expressly understood that the Grantee
waives any irnmunity that may be granted to it under the Washington State industrial insurance act, Title 51
RCW, sole1v for the Mi ses of this indemnification- Groa i pai V�-tTuWWW:,,F-S1q1
lk ail -Ari-Ayfff-UMI'Urd, - -
tp� ' 11 1 Okuuxvs P4jztujLu LO OT Dy any itinu pany under
Tj
workers' compensation acts, disability benefit acts or any other benefits acts or program& The Parties fin-ther
acknowledge that they have mutually negotiated this waiver,
CARES ACT BUSMSS GRANT AGREEMENT -2- 7/2020
CrrY HALL
3332$ 8th AVehue Sou
44�� iQera,l, VVOY Federef Way, WA �MOth :1-6-326
�25S) $35-7000
5.3 The City agrees to release, indemnify, defend and hold the Grantee, its
officers- directors- shareholders. .-artners, employ
any and all claims, demands, acelons, 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 r^ .# or entities, including without hinitatioll, their respective agents,
16 nsff �q i hi, "i-Ii.6
gsll F-.1gaulkAg I its I (jg31g-!W 04wik 1 9 4
Thz- provisions of this Section shall survive the expiration or termination of
Agreement with respect to any event occurring prior to such expiration or termination.
6,1 This AgTeement Contains all of the agreements of the Parties
with respect to any matter covered or mentioned in this Agreement and no pTior statements or agreements,
whether oral or written, shall be effective, for any purpose. Any provision of this AgTcernent 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 pro'6sioR of this Agreement, including this
provision, may be amended, waived, or modified except by written agreement signed by duly authorized
represeritatives of the Parties.
6,2 Any notices required to be given by the Parties shall be delivered at the addresses
set forth at the beginning of this Agreement, Any notices may be delivered personally to the addressee of the
notice or may be deposited in the United States mail, postage prepaid, to the address set fortb above. Any notice
so posted in the United States mail shall be deemed received ftee (3) days after the date of mailing. Any
remedies provided for under the terrns of this Agreement are not intended to be exclusive, but sball be
cumulative with all other remedies available to the City at law, in equity or bystatate. 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 conferred b this A cement in one or more instances shall
q 111
............ I Pip "I ru may IF n ea in any 011er 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 courts are an inconvenient foram. If either T)arty brings any
claim or lawsuit arising from this Agreezuent, each Party shall M 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, however, nothing in this paragraph shall be construed to limit the
Parties' rights to indemnification under Section 5 of this Agreement.
CARES ACT 13USINESS GRANT AGREEMENT -3- 7/2020
41s� K�6rai way
Cilrf"?SALL
33Z25 13th Avenue So t
Fedora Wi I WA
lumg= "WWOOMME j
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
Agreement may be executed in ank-A number of counterparts. each of which JLJ-Iftjj
I _4t_l
the same effect as if all Parties hereto had signed the s=e document. -All s-uch counterparts shall be construed
together and shall constitute one instbut in making proof hereof it shall only be necessary to produce
one such countarput, 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
gignature and acknowledgment pages, Tbt date upon which the last of all of the Parties have executed a
counterpart of this, Agreement shall be the "date of mutual execution" hereof,
11 Ilk *Twyn=-Vtm�� I 1 11 1 1 1,
0 -0
CHIROPRACTIC WELLNESS:
By: A
Printed Name:
Title.� P/L-,5, r rd
DATE: I cy,-
CARES ACT BUSWESS GRANT AGREEMENT .4- 7/2020
10/7/2020 Washington State Department of Revenue
< Business Lookup
License Information: New search Back to results
Entity name: CHIROPRACTIC WELLNESS & REHABILITATION CLINICS PS
Business name: CHIROPRACTIC WELLNESS
Entity type: Professional Service Corporation
U #: 602-041-073
Business ID: 001
Location ID: 0001
Location: Active
Location address:
32114 IST AVE SOUTH, SUIT 104
BLDG 104
FEDERAL WAY WA 98003
Mailing address:
321141ST AVE S
STE 104
FEDERAL WAY WA 98003-5760
Excise tax and reseller permit status:
Click here
Secretary of State status:
Click here
Endorsements
Endorsements held at this location License # Count Details Status
Expiration date First issuance dal
Federal Way General Business
Active
Sep -30-2021 Sep -22-2020
Governing People May include governing
people not registered with Secretary ofStft
Governing people
Title
BHANJI, ALNOOR
Regisiered Trade Names
Registered trade names
Status
First issued
CHIROPRACTIC WELLNESS
Active
Jun -01-2000
CHIROPRACTIC WELLNESS CENTERS
Active
Dec -18-2000
CHIROPRACTIC WELLNESS CLINICS
Active
Dec -18-2000
SOUND DIETETICS
Active
May -25-2010
URGENT CARE MEDICAL
Active
May -25-2010
WELLNESS CHIROPRACTIC CENTERS
Active
Dec -18-2000
https://secure.dor.wa.gov/gteunauth/—,/#9 1/2