AG 22-015 - JAG - DEPARTMENT OF COMMERCERETURN TO: EXT:
CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM
1. ORIGINATING DEPT./DIV: PD
2, ORIGINATING STAFF PERSON: Commander Raymond Bunk EXT: 6746 3. DATE REQ. BY: ASAP
4. TYPE OF DOCUMENT (CHECK ONE):
❑ CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ)
❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT
❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT
❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES / CDBG
❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS)
❑ ORDINANCE ❑ RESOLUTION
❑ CONTRACT AMENDMENT(AG#): ❑ INTERLOCAL
19 OTHER Grant
5. PROJECT NAME: Less Than Lethal Equipment Grant
6. NAME OF CONTRACTOR: JAG - Department of Commerce
ADDRESS: PO Box 42525, 1011 Plum Street SE. Olympia, WA 98504-2525 TELEPHONE 360-515-6205
E-MAIL: Abigail.Snyder@commerce.wa.gov FAX:
SIGNATURE NAME: TITLE
7. EXHIBITS AND ATTACHMENTS: A SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL
OTHER REFERENCED EXHIBITS ❑ PROOF OF AUTHORITY TO SIGN ❑ REQUIRED LICENSES A PRIOR CONTRACT/AMENDMENTS
8. TERM: COMMENCEMENT DATE: November 15, 2021 COMPLETION DATE: November 15, 2022
9. TOTAL COMPENSATION $11, 408 - Grant money to the City (INCLUDE EXPENSES AND SALES TAX, IF ANY)
(IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES)
REIMBURSABLE EXPENSE: ❑ YES [ENO IF YES, MAXIMUM DOLLAR AMOUNT: $
IS SALES TAX OWED 10YES ONO IF YES, $1,152.21 PAID BY: ❑ CONTRACTOR O CITY
RETAINAGE: RETAINAGE AMOUNT: ❑ RETAINAGE AGREEMENT (SEE CONTRACT) OR ❑ RETAINAGE BOND PROVIDED
❑ PURCHASING: PLEASE CHARGE TO: 001-2100-114-521-10-354 (Expenditure)
001-0000-114-333-16-738(Revenue)
10. DOCUMENT/CONTRACT REVIEW INITIAL / DATE REVIEWED INITIAL / DATE APPROVED
❑ PROJECT MANAGER
99 DIRECTOR Andy Hwang
❑ RISK MANAGEMENT (IF APPLICABLE)
❑ LAW JRC 12/13/2021
11. COUNCIL APPROVAL (IF APPLICABLE) COMMITTEE APPROVAL DATE: COUNCIL APPROVAL DATE: 01 / 18/22
12. CONTRACT SIGNATURE ROUTING
❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D:
❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS
❑ 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
❑ LAW DEPARTMENT
❑ SIGNATORY (MAYOR OR DIRECTOR)
❑ CITY CLERK
❑ ASSIGNED AG# AG#-- "- t
COMMENTS:
Commander Bunk will be able to sign documents as the "Authorized Representative," but some parts of the document will require signatures from other departments, such as Human Resources and
Finance.
2/2017
COUNCIL MEETING DATE: January 18, 2022 ITEM #: 5e
... .... ... -
CITY OF FEDERAL WAY
CITY COUNCIL
AGENDA BILL
SUBJECT: WASHINGTON STATE DEPARTMENT OF COMMERCE GRANT
POLICY QUESTION: Should the City of Federal Way/Federal Way Police Department accept a $11,408 grant
from the Washington State Department of Commerce to purchase Less than Lethal Equipment?
COMMITTEE: PRHS&PSC
MEETING DATE: January 11, 2022
CATEGORY:
® Consent ❑ Ordinance ❑ Public Hearing
❑ City Council Business ❑ Resolution ❑ Other
STAFF REPORT BY: RAY BUNK, COMMANDER DEPT: Police
Attachments:
1. Staff Report
2. Interagency Agreement
3. FWPD Technical Proposal
4. JAG Eligibility Forms
Options Considered:
1. Approve the proposed agreement and authorize execution.
2. Do not approve the proposed agreement and provide direction to staff.
MAYOR'S RECOMMENDATION: Option 1.
MAYOR APPROVAL: ry, DIRECTOR APPROVAL: �,- lw
C unittaa Coun InitiaE sie
fniSiallDaic lniliRllRare
COMMITTEE RECOMMENDATION: I move to forward the proposed grant agreement to the January 18, 2022
Council consent agenda for approval.
V
Committee Chair Committee Member Committee Member
PROPOSED COUNCIL MOTION: "I move to approve the proposed grant agreement and authorize the purchase
of said less than lethal equipment. "
iiiiim
(BELOW TO BE COMPLETED BY CITY CLERK'S OFFICE
UNC[L Acno
Vk APPROVED �1�5Z COUNCIL BILL#
❑ DENIED First reading
❑ TABLED/DEFERRED/NO ACTION Enactment reading
❑ MOVED TO SECOND READING (ordinances only) ORDINANCE #
REVISED — 12/2017 RESOLUTION #
CITY OF FEDERAL WAY
CITY COUNCIL COMMITTEE STAFF REPORT
DATE: January 11, 2022
TO: Parks, Recreation, Human Services and Public Safety Council Committee
VIA: Jim Ferrell, Mayor
FROM: Andy J. Hwang, Chief of Police
SUBJECT: Acceptance of Washington State Department of Commerce Less Than Lethal
Equipment Program Grant Money
Financial Impacts:
There will minimal impact to City funds/police department's operating budget in the form of sales
tax, not covered by the grant. There will be no overtime funding required, as all training will be
done during normal working hours.
Back -ground Information:
The Federal Way Police Department (FWPD) will receive grant funding from the Washington State
Department of Commerce Less Than Lethal Equipment Program. The grant money will be used to
purchase less than lethal weapons to be used by patrol officers and officers assigned to the Civil
Disturbance Unit. Ten (10) less than lethal weapons and related equipment will be purchased with
the $11,408 in grant money. This is a one-time grant opportunity.
The proposed purchases will involve the FN 303 Mk2 Less Lethal Launcher. According to the
website, "... the FN 303 Mk2's improved operating system doubles its service life and cuts armorer
maintenance in half. Built from lightweight, rugged polymer and driven by a compressed COz air
tank, the FN 3038 Mk2 upgrades FN's less lethal technology for today's officers, delivering
increased accuracy with new, adjustable flip up metal sights and a MIL -STD 1913 top rail for optical
or red dot sights. The fin -stabilized projectiles deliver optimum accuracy with maximum
effectiveness and safety. Officers can quickly change from inert, marking, impact or irritant
projectiles, with a clear view of the projectile type and remaining count in the magazine."
The FN 303 Mk2 Less Lethal Launcher will also comply with new laws for less lethal equipment, as
seen in Washington State House Bill 1054.
1
Co7Y.1 i.1..1erce
Interagency Agreement with
through
For
City of Federal Way
Less Than Lethal Equipment Program
Purchase of less than lethal equipment
Start date: November 15, 2021
TABLE OF CONTENTS
Special Terms and Conditions
1.
Authority .................................................
.................................... ....... 1
2.
Acknowledgement ofFederal Funding .
' -- _.......................... -..1
3.
Contract Management ......................... .....
..... .... .... ... ......... "........................ /
4.
Compensation .-..-------.--.. -�
........... .................... ,,_,,............. �
5.
Expenses ........................................ .-
S.
Indirect Costs ............... .......................................
-. -------._-1
7.
Billing Procedures and Payment ------
8.
Subcontractor Data Collection ................. .-.....
............ ............................ ... 2
&
Audit ....................................................
__ __................................ 2
10iOebarment-.....-------.-
...
-. .~.. ..---..... .. .-...%
111.
Insurance -..---.-,..-.-~. �
' -,. ....... ~. ...... - --.3
General Terms and Conditions
tDefinitions
...... .......... ......................................... ...... ...... ... ..... ............. .......... 4
2.
All Writings Contained Herein ............................ ......
---'.......... .......... .... .4
3.
Amendments ................ ................................... -..........
----........ ----�.4
4.
Assi-..-..------------' -''-�
'' -'- --'-*
5.
Confidentiality- mnd0afooumndingof|nhornnmtion-------.----..---.4
R.
Copyright ................ ^,...--.............. .... ....... .'.........
................ ....................... o
7.
Disputes ..................... ^'-'^^_^~~................. --
-' —'-------5
8.
Governing Law and Venue .................................. ......
'------'_--'__5
&
Indemnification ................. -......... ~............ .... ....
...... ........... .... 8
10.
Licensing, Accreditation and Registration ...........
--.-_........... '6
11.
---..~..-.-.-...~---
... -...... ................... ... n
12.
Records Maintenance .............................. ......... ..................
....... ..................... G
13.Savings
...................................................... .... ~.--
--o
14`
SaverabUity.......................................... .............. ..............
... ........... ...... --'.G
15.
Subcontracting .........................................................................
............. ... .]5
16.
Survival ........................................................................................
................... .... .7
17
Termination for Cause .....................................................................................
...... 7
18.
Termination for Convenience ................... --'--.~...�-_..-------.'T
19.
Termination Procedures .................. -............. --~''--~---
.............
20
Treatment ofAssets ........................................... ...............
.............................. .W
21.
VVmiver--...~-'---...----..----.. ........ n
Attachment A, Scope of Work
Attachment B, Budget
FACE SHEET
Contract Number: F19-31440-5(
Washington State Department of Commerce
Community Services and Housing Division
Office of Firearm Safety and Violence Prevention — Public Safety Unit
Less Than Lethal Equipment
1. Contractor 2. Contractor Doing Business As (optional)
City of Federal Way
33325 8w Ave S
Federal Way, WA 98003
3. Contractor Representative
4. COMMERCE Representative
Raymond Bunk
Abigail Snyder
P.O. Box 42526
Commander
Program Manager
1011 Plum Street SE y
253-835-6700
360-515-6205
Olympia, WA
Raymond.bunk@cityoffederalway.com
Abigail.Snyder@commerce.wa.gov
98504-2525
5. Contract Amount 6. Funding Source
7. Start Date
8. End Date
$11,408 Federal: ® State: ❑
Other: ❑ NIA: ❑ November 15, 2021 June 30, 2022
9. Federal Funds (as applicable) Federal Agency: CFDA Number: Indlrect.Rate (if applicable):
$11,408 Department
of Justice 16.738
Not Applicable
10. Tax ID #
11. SWV #
12. UBI #
13. DUNS #
91-1462560
0015957
601-223-538
612509901
14. Contract Purpose
To purchase less than lethal equipment.
15. Signing Statement
COMMERCE, defined as the Department of Commerce, and the Contractor, as defined above, acknowledge and accept
the terms of this Contract and Attachments and have executed this Contract on the date below and warrant they are
authorized to bind their respective agencies. The rights and obligations of both parties to this Contract are governed by
this Contract and the following documents hereby incorporated by reference: Attachment "A" — Scope of Work,
Attachment "B" — Bud- et
FOR CONTRACTOR FOR COMMERCE
Raymond Bunk, Commander Diane Klontz, Assistant Director
Date Date
j APPROVED AS TO FORM ONLY BY ASSISTANT
ATTORNEY GENERAL 07117/2019.
APPROVAL ON FILE.
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
1. AUTHORITY
F19-31440-507
COMMERCE and Contractor enter into this Contract pursuant to the authority granted by the Interlocal
Cooperation Act, Chapter 39.34 RCW.
2. ACKNOWLEDGMENT OF FEDERAL FUNDS
Federal Award Date: October 1, 2019
Federal Award Identification Number (FAIN): 2019-DJ-BX-0035
Total amount of the federal award: $3,303,848
Awarding official: Matt Dummermuth
The Contractor agrees that any publications (written, visual, or sound) but excluding press releases,
newsletters and issue analyses, issued by the Contractor describing programs or projects funded in
whole or in part with federal funds under this Contract, shall contain the following statements:
"This project was supported by Grant No. 2019-DJ-BX-0035 awarded by Department of
Justice. Points of view in this document are those of the author and do not necessarily
represent the official position or policies of the Department of Justice. Grant funds are
administered by the Office of Firearm Safety & Violence Prevention — Public Safety Unit,
Washington State Department of Commerce."
3. CONTRACT MANAGEMENT
The Representative for each of the parties shall be responsible for and shall be the contact person for
all communications and billings regarding the performance of this Contract.
The Representative for COMMERCE and their contact information are identified on the Face Sheet
of this Contract.
The Representative forthe Contractor and their contact information are identified on the Face Sheet
of this Contract.
4. COMPENSATION
COMMERCE shall pay an amount not to exceed $11,408 for the performance of all things necessary
for or incidental to the performance of work under this Contract as set forth in the Scope of Work.
5. EXPENSES
Contractor shall receive reimbursement for travel and other expenses as identified below or as
authorized in advance by COMMERCE as reimbursable. The maximum amount to be paid to the
Contractor for authorized expenses shall not exceed $11,408, which amount is included in the Contract
total above.
Such expenses may include alrfare (economy or coach class only), other transportation expenses, and
lodging and subsistence necessary during periods of required travel. Contractor shall receive
compensation for travel expenses at current state travel reimbursement rates.
6. INDIRECT COSTS
Contractor shall provide their indirect cost rate that has been negotiated between their entity and the
federal government. If no such rate exists a de minimis indirect cost rate of 1 D% of modified total direct
costs (MTDC) will be used.
7. BILLING PROCEDURES AND PAYMENT
COMMERCE will pay Contractor upon acceptance of services provided and receipt of properly
completed invoices, which shall be submitted to the Representative for COMMERCE at least quarterly,
but, not more often than monthly.
The invoice shall include the Contract Number F19-31440-507.
Intuageney Agreement Page I I
F19-31440-507
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
Payment shall be considered timely if made by COMMERCE within thirty (30) calendar days after
receipt of properly completed invoices,
COMMERCE may, in its sole discretion, terminate the Contract or withhold payments claimed by the
Contractor for services rendered if the Contractor fails to satisfactorily comply with any term or condition
of this Contract.
No payments in advance or in anticipation of services or supplies to be provided under this Agreement
shall be made by COMMERCE.
Invoices and End of Fiscal Year
Invoices are due on the 20th of the month following the provision of services.
Final invoices for a state fiscal year may be due sooner than the 20th and Commerce will provide
notification of the end of fiscal year due date,
The grantee must invoice for all expenses from the beginning of the Contract through June 30,
regardless of the Contract start and end date.
Du lication of Billed Costs
The Contractor shall not bill COMMERCE for services performed under this Agreement, and
COMMERCE shall not pay the Contractor, if the Contractor is entitled to payment or has been or will
be paid by any other source, including grants, for that service.
Disallowed Costs
The Contractor is responsible for any audit exceptions or disallowed costs incurred by its own
organization or that of its subcontractors.
8. SUBCONTRACTOR DATA COLLECTION
Contractor will submit reports, in a form and format to be provided by Commerce and at intervals as
agreed by the parties, regarding work under this Agreement performed by subcontractors and the
portion of funds expended for work performed by subcontractors, including but not necessarily limited
to minority -owned, woman -owned, and veteran -owned business subcontractors. "Subcontractors" shall
mean subcontractors of any tier.
9. AUDIT
If the Contractor is a subrecipient and expends $750,000 or more in federal awards from any and/or all
sources in any fiscal year, the Contractor shall procure and pay for a single audit or a program -specific
audit for that fiscal year. Upon completion of each audit, the Contractor shall:
A. Submit to COMMERCE the reporting package specified in OMB Super Circular 2 CFR 200.501,
reports required by the program -specific audit guide (if applicable), and a copy of any management
letters issued by the auditor.
B, Submit to COMMERCE follow-up and developed corrective action plans for all audit findings.
If the Contractor is a subrecipient and expends less than $750,000 in federal awards from any and/or
all sources in any fiscal year, the Contractor shall notify COMMERCE they did not meet the single audit
requirement.
The Contractor shall send all single audit documentation to auditreview0cammerce.wa qov.
10. DEBARMENT
A. Contractor, defined as the primary participant and it principals, certifies by signing these General
Terms and Conditions that to the best of its knowledge and belief that they:
i. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency.
ii. Have not within a three-year period preceding this Contract, been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
Interagency Agreement Paeo 12
F19-31440-507
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
connection with obtaining, attempting to obtain, or performing a public or private agreement
or transaction, violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, tax evasion, receiving stolen property, making false claims, or obstruction of
justice;
III. Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (Federal, State, or local) with commission of any of the offenses enumerated in
paragraph (1)(b) of federal Executive Order 12549; and
iv. Have not within a three-year period preceding the signing of this Contract had one or more
public transactions (Federal, State, or local) terminated for cause of default.
B. Where the Contractor is unable to certify to any of the statements in this Contract, the Contractor
shall attach an explanation to this Contract.
C. The Contractor agrees by signing this Contract that it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by COMMERCE.
D. The Contractor further agrees by signing this Contract that it will Include the clause titled
"Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier
Covered Transaction," as follows, without modification, in all lower tier covered transactions and in
all solicitations for lower tier covered transactions:
LOWER TIER COVERED TRANSACTIONS
i. The lower tier Contractor certifies, by signing this Contract that neither it nor its principals
is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or
agency.
ii. Where the lower tier Contractor is unable to certify to any of the statements i6 this Contract,
such Contractor shall attach an explanation to this Contract.
E. The terms covered transaction, debarred, suspended, ineligible, lower tier covered
transaction, person, primary covered transaction, principal, and voluntarily excluded, as
used in this section, have the meanings set out in the Definitions and Coverage sections of the
rules implementing Executive Order 12549. You may contact COMMERCE for assistance in
obtaining a copy of these regulations.
11. INSURANCE
Each party certifies that it is self -insured under the State's or local government self-insurance liability
program, and shall be responsible for losses for which it is found liable.
12. ORDER OF PRECEDENCE
In the event of an inconsistency in this Contract, the inconsistency shall be resolved by giving
precedence in the following order:
Applicable federal and state of Washington statutes and regulations
• Special Terms and Conditions
• General Terms and Conditions
• Attachment A — Scope of Work
• Attachment B — Budget
Interagency Agreement
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
1. DEFINITIONS
F19-31440-507
As used throughout this Contract, the following terms shall have the meaning set forth below:
A. "Authorized Representative" shall mean the Director of the Department of Commerce and/or the
designee authorized in writing to act on the Director's behalf.
B. "COMMERCE" shall mean the Department of Commerce.
C. "Contract" or "Agreement" means the entire written agreement between COMMERCE and the
Contractor, including any attachments, documents, or materials incorporated by reference. E-mail
or facsimile transmission of a signed copy of this Contract shall be the same as delivery of an
original.
D. "Contractor" shall mean the entity identified on the face sheet performing service(s) under this
Contract, and shall include all employees and agents of the Contractor.
E. "Personal Information" shall mean information identifiable to any person, including, but not limited
to, information that relates to a person's name, health, finances, education, business, use or receipt
of governmental services or other activities, addresses, telephone numbers, social security
numbers, driver license numbers, other identifying numbers, and any financial identifiers.
F. "State" shall mean the state of Washington.
G. "Subcontractor" shall mean one not in the employment of the Contractor, who is performing all or
part of those services under this Contract under a separate contract with the Contractor. The terms
"subcontractor" and "subcontractors" mean subcontractor(s) in any tier.
2. ALL WRITINGS CONTAINED HEREIN
This Contract contains all the terms and conditions agreed upon by the parties. No other
understandings, oral or otherwise, regarding the subject matter of this Contract shall be deemed to
exist or to bind any of the parties hereto,
3. AMENDMENTS
This Contract may be amended by mutual agreement of the parties, Such amendments shall not be
binding unless they are in writing and signed by personnel authorized to bind each of the parties.
4. ASSIGNMENT
Neither this Contract, work thereunder, nor any claim arising under this Contract, shall be transferred
or assigned by the Contractor without prior written consent of COMMERCE.
5. CONFIDENTIALITY AND SAFEGUARDING OF INFORMATION
A. "Confidential Information" as used in this section includes:
i. All material provided to the Contractor by COMMERCE that is designated as "confidential" by
COMMERCE;
ii. All material produced by the Contractor that is designated as "confidential" by COMMERCE;
and
iii. All personal information in the possession of the Contractor that may not be disclosed under
state or federal law.
B. The Contractor shall comply with all state and federal laws related to the use, sharing, transfer,
sale, or disclosure of Confidential Information, The Contractor shall use Confidential Information
solely for the purposes of this Contract and shall not use, share, transfer, sell or disclose any
Confidential Information to any third party except with the prior written consent of COMMERCE or
as may be required by law. The Contractor shall take all necessary steps to assure that Confidential
Information is safeguarded to prevent unauthorized use, sharing, transfer, sale or disclosure of
Confidential Information or violation of any state or federal laws related thereto. Upon request, the
Interagency Agreement Page 14
F19-31440-507
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
Contractor shall provide COMMERCE with its policies and procedures on confidentiality.
COMMERCE may require changes to such policies and procedures as they apply to this Contract
whenever COMMERCE reasonably determines that changes are necessary to prevent
unauthorized disclosures. The Contractor shall make the changes within the time period specified
by COMMERCE. Upon request, the Contractor shall immediately return to COMMERCE any
Confidential Information that COMMERCE reasonably determines has not been adequately
protected by the Contractor against unauthorized disclosure.
C. Unauthorized Use or Disclosure. The Contractor shall notify COMMERCE within five (5) working
days of any unauthorized use or disclosure of any confidential information, and shall take necessary
steps to mitigate the harmful effects of such use or disclosure.
6. COPYRIGHT
Unless otherwise provided, all Materials produced under this Contract shall be considered "works for
hire" as defined by the U.S. Copyright Act and shall be owned by COMMERCE. COMMERCE shall be
considered the author of such Materials. In the event the Materials are not considered "works for hire"
under the U.S. Copyright laws, the Contractor hereby irrevocably assigns all right, title, and interest in
all Materials, including all intellectual property rights, moral rights, and rights of publicity to COMMERCE
effective from the moment of creation of such Materials.
"Materials" means all items in any format and includes, but is not limited to, data, reports, documents,
pamphlets, advertisements, books, magazines, surveys, studies, computer programs, films, tapes,
and/or sound reproductions, "Ownership" includes the right to copyright, patent, register and the ability
to transfer these rights.
For Materials that are delivered under the Contract, but that incorporate pre-existing materials not
produced under the Contract, the Contractor hereby grants to COMMERCE a nonexclusive, royalty -
free, irrevocable license (with rights to sublicense to others) in such Materials to translate, reproduce,
distribute, prepare derivative works, publicly perform, and publicly display. The Contractor warrants and
represents that the Contractor has all rights and permissions, including intellectual property rights,
moral rights and rights of publicity, necessary to grant such a license to COMMERCE.
The Contractor shall exert all reasonable effort to advise COMMERCE, at the time of delivery of
Materials furnished under this Contract, of all known or potential invasions of privacy contained therein
and of any portion of such document which was not produced in the performance of this Contract. The
Contractor shall provide COMMERCE with prompt written notice of each notice or claim of infringement
received by the Contractor with respect to any Materials delivered under this Contract. COMMERCE
shall have the right to modify or remove any restrictive markings placed upon the Materials by the
Contractor.
7. DISPUTES
In the event that a dispute arises under this Agreement, it shall be determined by a Dispute Board in
the following manner: Each party to this Agreement shall appoint one member to the Dispute Board.
The members so appointed shall jointly appoint an additional member to the Dispute Board. The
Dispute Board shall review the facts, Agreement terms and applicable statutes and rules and make a
determination of the dispute. The Dispute Board shall thereafter decide the dispute with the majority
prevailing. The determination of the Dispute Board shall be final and b1ndfrng on the parties hereto. As
an alternative to this process, either of the parties may request intervention by the Governor, as
provided by RCW 43.17,330, in which event thE> Governor's process will control.
8. GOVERNING LAW AND VENUE
This Contract shall be construed and interpreted in accordance with the laws of the state of Washington,
and any applicable federal laws, and the venue of any action brought hereunder shall be in the Superior
Court for Thurston County.
Interagency Ag ernent Page 15
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
9. INDEMNIFICATION
F19-31440-507
Each party shall be solely responsible for the acts of its employees, officers, and agents.
10. LICENSING ACCREDITATION AND REGISTRATION
The Contractor shall comply with all applicable local, state, and federal licensing, accreditation and
registration requirements or standards necessary for the performance of this Contract.
11. RECAPTURE
In the event that the Contractor fails to perform this Contract in accordance with state laws, federal
laws, and/or the provisions of this Contract, COMMERCE reserves the right to recapture funds in an
amount to compensate COMMERCE for the noncompliance in addition to any other remedies available
at law or in equity.
Repayment by the Contractor of funds under this recapture provision shall occur within the time period
specified by COMMERCE. In the alternative, COMMERCE may recapture such funds from payments
due under this Contract.
12. RECORDS MAINTENANCE
The Contractor shall maintain books, records, documents, data and other evidence relating to this
contract and performance of the services described herein, including but not limited to accounting
procedures and practices that sufficiently and properly reflect all direct and indirect costs of any nature
expended In the performance of this Contract.
The Contractor shall retain such records for a period of six (6) years following the date of final payment.
At no additional cost, these records, including materials generated under the Contract, shall be subject
at all reasonable times to inspection, review or audit by COMMERCE, personnel duly authorized by
COMMERCE, the Office of the State Auditor, and federal and state officials so authorized by law,
regulation or agreement. ,
If any litigation, claim or audit is started before the expiration of the six (6) year period, the records shall
be retained until all litigation, claims, or audit findings involving the records have been resolved.
13. SAVINGS
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this Contract and prior to normal completion, COMMERCE may suspend or
terminate the Contract under the "Termination for Convenience" clause, without the ten calendar day
notice requirement. In lieu of termination, the Contract may be amended to reflect the new funding
limitations and conditions.
14, SEVERABILITY
The provisions of this Contract are intended to be severable. If any term or provision is illegal or invalid
for any reason whatsoever, such illegality or invalidity shall not affect the validity of the remainder of
the Contract.
15. SUBCONTRACTING
The Contractor may only subcontract work contemplated under this Contract if it obtains the priorwritten
approval of COMMERCE.
If COMMERCE approves subcontracting, the Contractor shall maintain written procedures related to
subcontracting, as well as copies of all subcontracts and records related to subcontracts. For cause,
COMMERCE in writing may: (a) require the Contractor to amend its subcontracting procedures as they
relate to this Contract; (b) prohibit the Contractor from subcontracting with a particular person or entity;
or (c) require the Contractor to rescind or amend a subcontract.
Every subcontract shall bind the Subcontractor to follow all applicable terms of this Contract. The
Contractor is responsible to COMMERCE if the Subcontractor fails to comply with any applicable term
[nteragency Agreement Page 16
F19-31440-507
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
or condition of this Contract. The Contractor shall appropriately monitor the activities of the
Subcontractor to assure fiscal conditions of this Contract. In no event shall the existence of a
subcontract operate to release or reduce the liability of the Contractor to COMMERCE for any breach
in the performance of the Contractor's duties.
Every subcontract shall include a term that COMMERCE and the State of Washington are not liable for
claims or damages arising from a Subcontractor's performance of the subcontract,
16. SURVIVAL
The terms, conditions, and warranties contained in this Contract that by their sense and context are
intended to survive the completion of the performance, cancellation or termination of this Contract shall
so survive.
17. TERMINATION FOR CAUSE
In the event COMMERCE determines the Contractor has failed to comply with the conditions of this
contract in a timely manner, COMMERCE has the right to suspend or terminate this Contract. Before
suspending or terminating the Contract, COMMERCE shall notify the Contractor in writing of the need
to take corrective action. If corrective action is not taken within 30 calendar days, the contract may be
terminated or suspended.
In the event of termination or suspension, the Contractor shall be liable for damages as authorized by
law including, but not limited to, any cost difference between the original Contract and the replacement
or cover contract and all administrative costs directly related to the replacement contract, e.g., cost of
the competitive bidding, mailing, advertising and staff time.
COMMERCE reserves the right to suspend all or part of the Contract, withhold further payments, or
prohibit the Contractor from incurring additional obligations of funds during investigation of the alleged
compliance breach and pending corrective action by the Contractor or a decision by COMMERCE to
terminate the Contract. A termination shall be deemed a "Termination for Convenience" if it is
determined that the Contractor: (1) was not in default; or (2) failure to perform was outside of his or her
control, fault or negligence.
The rights and remedies of COMMERCE provided in this Contract are not exclusive and are in addition
to any other rights and remedies provided by law.
18. TERMINATION FOR CONVENIENCE
Except as otherwise provided in this Contract, COMMERCE may, by ten (10) business days written
notice, beginning on the second day after the mailing, terminate this Contract, in whole or in part. If this
Contract is so terminated, COMMERCE shall be liable only for payment required under the terms of
this Contract for services rendered or goods delivered prior to the effective date of termination.
19. TERMINATION PROCEDURES
Upon termination of this Contract, COMMERCE, in addition to any other rights provided in this Contract,
may require the Contractor to deliver to COMMERCE any property specifically produced or acquired
for the performance of such part of this Contract as has been terminated. The provisions of the
"Treatment of Assets" clause shall apply in such property transfer.
COMMERCE shall pay to the Contractor the agreed upon price, if separately stated, for completed
work and services accepted by COMMERCE, and the amount agreed upon by the Contractor and
COMMERCE for (1) completed work and services for which no separate price is stated, (ii) partially
completed work and services, (iii) other property or services that are accepted by COMMERCE, and
(iv) the protection and preservation of property, unless the termination is for default, in which case the
Authorized Representative shall determine the extent of the liability of COMMERCE. Failure to agree
with such determination shall be a dispute within the meaning of the "Disputes" clause of this Contract.
COMMERCE may withhold from any amounts due the Contractor such sum as the Authorized
Representative determines to be necessary to protect COMMERCE against potential loss or liability.
The rights and remedies of COMMERCE provided in this section shall not be exclusive and are in
addition to any other rights and remedies provided by law or under this Contract.
Interagency Agreement Page 17
F 19-31440-607
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERALFUNDS
After receipt of a notice of termination, and except as otherwise directed by the Authorized
Representative, the Contractor shall:
A. Stop work under the Contract on the date, and to the extent specified, in the notice;
B. Place no further orders or subcontracts for materials, services, or facilities except as may be
necessary for completion of such portion of the work under the Contract that is not terminated;
C. Assign to COMMERCE, in the manner, at the times, and to the extent directed by the Authorized
Representative, all of the rights, title, and interest of the Contractor under the orders and
subcontracts so terminated, in which case COMMERCE has the right, at its discretion, to settle or
pay any or all claims arising out of the termination of such orders and subcontracts;
D. Settle all outstanding liabilities and all claims arising out of such termination of orders and
subcontracts, with the approval or ratification of the Authorized Representative to the extent the
Authorized Representative may require, which approval or ratification shall be final for all the
purposes of this clause;
E. Transfer title to COMMERCE and deliver in the manner, at the times, and to the extent directed by
the Authorized Representative any property which, if the Contract had been completed, would have
been required to be furnished to COMMERCE;
F. Complete performance of such part of the work as shall not have been terminated by the Authorized
Representative; and
G. Take such action as may be necessary, or as the Authorized Representative may direct, for the
protection and preservation of the property related to this Contract, which is In the possession of
the Contractor and in which the Authorized Representative has or may acquire an interest.
20. TREATMENT OF ASSETS
Title to all property furnished by COMMERCE shall remain in COMMERCE. Title to all property
furnished by the Contractor, for the cost of which the Contractor is entitled to be reimbursed as a direct
item of cost under this Contract, shall pass to and vest in COMMERCE upon delivery of such property
by the Contractor. Title to other property, the cost of which is reimbursable to the Contractor under this
Contract, shall pass to and vest in COMMERCE upon (i) issuance for use of such property in the
performance of this Contract, or (ii) commencement of use of such property in the performance of this
Contract, or (III) reimbursement of the cost thereof by COMMERCE in whole or in part, whichever first
occurs.
A. Any property of COMMERCE furnished to the Contractor shall, unless otherwise provided herein
or approved by COMMERCE, be used only for the performance of this Contract.
B. The Contractor shall be responsible for any loss or damage to property of COMMERCE that results
from the negligence of the Contractor or which results from the failure on the part of the Contractor
to maintain and administer that property in accordance with sound management practices.
C. If any COMMERCE property is lost, destroyed or damaged, the Contractor shall immediately notify
COMMERCE and shall take all reasonable steps to protect the property from further damage.
D. The Contractor shall surrender to COMMERCE all property of COMMERCE prior to settlement
upon completion, termination or cancellation of this Contract
All reference to the Contractor under this clause shall also include Contractor's employees, agents
or Subcontractors.
21. WAIVER
Waiver of any default or breach shall not be deemed to be a waiver of any subsequent default or breach.
Any waiver shall not be construed to be a modification of the terms of this Contract unless stated to be
such in writing and signed by Authorized Representative of COMMERCE.
Interagency A.greemcnt
F19-31440-507
Attachment A
Scope of Work
Contractor shall purchase the following:
30 FN Tactical W/ SCAR Buttstock,
• 10 FN 303 MK2 Less Lethal Launchers,
1 FN303 Fill Station Adapter,
• 1 FN303 Magazine Assembly,
• 1 FN303 10-Pack O-Rings w/ Lube,
1 PK FN303 O-ring Overhaul Kit,
• 1 FN303 Pava/OC Powder Less Lethal Projectiles,
• 1 FN303 Inert Powder Less Lethal Projectiles, and
• 1 FN303 Indelible Paint Less Lethal Projectiles
Items will be purchased shortly after the Contract is executed. All officers with access to these less -
than -lethal weapons shall receive training in the use of the equipment.
The Contractor will report on the activities identified above on a quarterly basis. Quarterly reports will be
due the 151h day of the month following the end of each calendar quarter of the award period.
Interagency Agreement Page 19
F19-31440-507
Attachment B
Budget
The budget for the award period of November 15, 2021 through June 30, 2022 is $11,408.
Equipment Total $11,408
Note: The Contractor may not obligate or expend any funds under this award until a completed Federal
Eligibility Package has been submitted to COMMERCE as identified in RFP 19-31440-1,
Interagency Agreement Page 110
FWPD Technical Proposal
3.2—Technical Proposal
(A) — Project Approach/Methodology
1—The City of Federal Way Police Department (FWPD) is a law enforcement agency that serves the
Federal Way community, with a population of over 100,000 residents, and has been impacted by RCW
10.116,040. Not only were we forced to turn in valuable less -than -lethal options, such as our shotgun
bean bag deployment, but there is also controversy regarding the use of less -than -lethal 40mm
launchers. Many officers are hesitant to use this item, have turned them in, and/or stopped using them.
2 —There is a need for other less -than -lethal options. The removal of the less -than -lethal shotguns and
40mm launchers has limited our abilities to use valuable lethal options. This includes not only our patrol
units, but also those assigned to the Valley Civil Disturbance Unit (VCDU). Without the ability to have
longer ranged less -lethal -weapons, de-escalation techniques would suffer and an increase in lethal use
of force incidents may occur.
3 — I will be in charge of the distribution and assignment of less -than -lethal weapons. I am currently
assigned as a Patrol Commander and oversee all patrol shifts. The plan is to purchase ten (10) less -than -
lethal weapons and distribute six (6) to FWPD patrol shifts (i.e. one per shift). These will be assigned to
the patrol supervisor (lieutenant) or their designee. The primary function of these less -than -lethal
weapons will be impact and impact with irritants. FWPD patrol officers respond to calls not only in our
jurisdiction, but we are regularly called to support other law enforcement agencies in King and Pierce
county, as well as calls involving the Washington State Patrol.
I am also the Commander of both the FWPD Civil Disturbance Unit and the overall Commander of the
Valley Civil Disturbance Unit (VCDU). VCDU consists of six (6) different agencies that deploy as a team to
protests, riots, etc. These agencies consist of Renton, Auburn, Port of Seattle, Tukwila, Kent, and
Federal Way, The VCDU responds to not only the listed jurisdictions, but we also deploy to several other
jurisdictions around King and Pierce counties, such as Seattle, Tacoma, and Bellevue. VCDU also has the
capabilities to assist other jurisdictions, to include those located in Thurston and Snohomish counties.
Four (4) less -than -lethal weapons will be assigned to the FWPD VCDU contingency for use by our trained
Special Ammunition Response Team (SART) to replace the 40mm and shotgun less -than -lethal weapons
currently being used; The primary function of these less -than -lethal weapons will be impact, impact
with irritants, and projectiles with "marking" capabilities. The removal of the ability to use CS gas has
also required the use to use other types of less -than -lethal weapons.
4 — We plan to purchase these items through Curtis Blue Line, located in Kent, Washington. This
company would be able to drop off the less -than -lethal weapons or we could arrange to obtain the
items by going to their location.
5 — We plan to purchase ten (10) FN 303 Mkt Less Lethal Launchers, with related projectiles and
maintenance equipment. This less -than -lethal weapon utilizes compressed air to launch projectiles
serving as an impact weapon, with some rounds containing an irritant, and another round used for
"marking" individuals. "Marking" and individual, particularly in a violent protest, allows officers to
identify those involved in criminal activities to be clearly identifiable for later arrest. This is particularly
helpful in violent protest situations where immediate arrest(s) may escalate the crowd and result in
increased amount of force used and increased use of force incidents.
This particular less -than -lethal weapon has reduced maintenance requirements and a longer service life.
Per the website's description, "Built from lightweight, rugged polymer and driven by a compressed
CO2 air tank, the FN 3030 Mkt upgrades FN's less lethal technology for today's officers, delivering
increased accuracy with new, adjustable flip up metal sights and a MIL -STD 1913 top rail for optical or
red dot sights. The fin -stabilized projectiles deliver optimum accuracy with maximum effectiveness and
safety. Officers can quickly change from inert, marking, impact or irritant projectiles, with a clear view of
the projectile type and remaining count in the magazine."
As stated prior, these less -than -lethal weapons will be distributed to both patrol officers and members
of the FWPD VCDU.
6 — For police officers at the City of Federal Way, training of less -than -lethal weapons occurs on an
annual basis. Instruction for patrol officers is provided by "in-house" trainers. This includes both
classroom and practical experience, with a related weapon qualification. For those officers who are on
the VCDU, there is also additional classroom and practical experience conducted on an annual basis.
Instructors for SART members of VCDU is provided by various firearms officers from the involved
agencies. In house less -than -lethal weapon training consists of a one (1) hour classroom presentation of
the current laws and approved practices, followed by a shooting qualification. Training and
recertification will continue on an annual basis. Patrol units will be trained and certified upon receipt of
the less -than -lethal weapons.
Less -than -lethal weapons issued to FWPD VCDU members will also consist of in-house training, as well
as advanced training related to protests and crowd control. VCDU SART training will first occur in the
spring on 2022 and then recertification and continued training on an annual'basis. Patrol and FWPD
VCDU units will receive additional training and recertification during departmental rifle qualifications,
which occurs in the summer months.
7 — N/A.
(B) — Work Plan = Upon procurement of the less -than -lethal weapons, officers who will deploy the less -
than -lethal weapons while on patrol will be identified and issued the weapons. After issuing the less -
than -lethal weapons, training will take place. In house less -than -lethal weapon training consists of a one
(1) hour classroom presentation of the current laws and approved practices, followed by a shooting
qualification. Less -than -lethal weapons issued to FWPD VCDU members will also consist of in-house
training, as well as, advanced training related to protests and crowd control. In-house training will
happen soon after procurement, with the advanced VCDU SART training occurring in the spring on 2022
and then recertification and continued training on an annual basis. Patrol units will receive additional
training and recertification during departmental rifle qualifications, which occurs in the summer months.
(C) — Project Schedule — Currently, our less -than -lethal weapons distributor has these items in stock,
meaning the less -than -lethal weapons would be purchased and obtained soon after the grant money
was received. There would likely be a delay, if the current stock was depleted and items needed to be
ordered.
The training for patrol units would happen soon after procurement. Initial training for VCDU SART
members would occur with the patrol units and additional training and certification to occur in the
spring of 2022. Using these timelines, these less -than -lethal weapons would be able to respond to
patrol incidents this year and VCDU SART members could respond to incidents in the spring of 2022.
(D) — Outcomes and Performance Measurement —The impact and outcomes of the use of less -than -
lethal weapons is the reduction of the chances of lethal force use. Less -than -lethal weapons assist in de-
escalation efforts of officer(s), in both the patrol and crowd control efforts.
Annually, the FWPD Administrative Unit conducts a review of all use of force incidents for the year prior.
During this use of force examination, possible trends are examined and analyzed, to include
departmental use of force, as well as the individual officers who were involved In incidents. This
valuable information is then used for later training and potential policy changes.
(E) — Risks —There are multiple risks involved with the use of less -than -lethal weapons. The first is the
misuse of these tools by the officers who are issued the weapons. This risk will be mitigated by initial
and reoccurring training to the officers who are issued the weapons. Additionally, all use of force
incidents involving FWPD officers are carefully and thoroughly reviewed by five (5) different induvial of
progressing rank to ensure the use of force is within current department policy and state and federal
laws.
Annually, the FWPD Administrative Unit conducts a review of all use of force incidents for the year. prior,
During this use of force examination, possible trends are examined and analyzed, to include
departmental use of force, as well as the individual officers who were Involved in incidents. This
valuable information is then used for later training. These reviews be submitted to COMMERCE, upon
request.
Another risk would be the theft or misplacement of the less -than -lethal weapon itself. To mitigate this
risk, inventories will be conducted on a regular basis and"officers will be instructed to keep the items
locked up, either in a patrol vehicle or their personal work locker, when the weapon is not on their
person. In the event a theft or loss of a less -than -lethal weapon, the incident would be reported to the
COMMERCE.
The current political environment is also a potential risk. If future legislative or court decisions deem
these less -than -lethal weapons to be illegal, the items would need to be taken out of service and no
longer utilized. This risk will be mitigated,by constantly reviewing court decisions and new state and
federal laws.
(F) — Deliverables —These less -than -lethal weapons comply with RCW 10.116.040 as the projectiles are
ejected using compressed air, rather than being deployed with an explosive device or substance. All
officers with access to these less -than -lethal weapons shall receive training in the use of the equipment
before the equipment is used by that peace officer.
3.3 —Related Information
1- I have been unable to locate contracts with City of Federal Way or subcontractors during the past 24
months.
2 - I have only been able to identify on person who was an employee of the State of Washington in the
past 24 months. This person is identified as Officer Conall Murphy — Former WSP Trooper now an
officer assigned to patrol and in our Field Officer Training Program. He separated from WSP several
months ago.
3 — N/A.
Department of Commerce
Innovation is in our nature.
Justice Assistance Grant
FFY 2019-2021 Justice Assistance Grant
Eligibility Farms
Lisa Brown
Director
Eligibility Requirements:
Statement of Assurances..........................................................................................
Form 1
❑
Debarment, Suspension, Ineligibility and Voluntary Exclusion
Lower Tier Covered Transactions (Sub -Recipient) ................................................Form
2
❑
Certification Regarding Lobbying, Debarment, Suspension and
Other Responsibility Matters; and Drug -Free Workplace Requirements ..............
Form 3
❑
National Environmental Policy Act (NEPA)...........................................................Form
4
❑
Acknowledgement of Federal Funds.......................................................................Form
5
❑
Acknowledgement of Allowable and Unallowable Costs .......................................Form
6
❑
Compliance with Relevant Federal and State Laws ................................................Form
7
❑
CTFLITraining........................................................................................................
Form 8
❑
Civil Rights Training..........................................................................................Form
9
❑
Civil Rights Requirements..................................................... .................. ........Farm
10
❑
Equal Employment Opportunity Plan (EEOP) Certification...................................Form
11
❑
Office of Civil Rights Compliance Checklist ..........................................................Form
12
❑
Federal Funding Accountability and Transparency Act Certificate .......................Form
13
❑
Commercial Insurance, Risk Pool or Self Insurance ...............................................Form
14
❑
General Information Regarding Risk Assessment ...................................................Form
15
❑
Customer Satisfaetion and Improvement:
Customer Satisfaction and Improvement Form......................................................Form 16 ❑
SUBMISSION OF THIS PACKET
One electronic copy of these Certifications and Assurances must be completed and submitted to
be eligible to receive reimbursement with federal funds (any funds under this program).
DUE DATE
The package should be received by COMMERCE no later than November 15, 2021. Submission
after this date will cause delay in your being eligible to receive reimbursement under this
program.
SUBMIT' APPLICATION FORMS To:
Email:
abi jail . s n vderfii pcommc rc e. wa. uo v
Note [ : PDF is the preferred format
for electronic submission
If you have questions regarding the application or need technical assistance, please contact Abbie
Snyder at abigail.sn�
1
ELIGIBILITY
FORMS
STATE OF WASEINGTON
DEPARTMENT OF COMMERCE
The applicant:
JUSTICE ASSISTANCE GRANT
FORM 1
STATEMENT OF ASSURANCES
1. Has sufficient fiscal and management controls to implement and maintain the program in accordance
with this application and program requirements. The Applicant has sufficient monetary resources to
implement and maintain program operations in accordance with this contract
2. Will provide full cooperation of administrative and program staff, and will provide availability of all records
upon request and convenience of staff from the Department of Commerce; Office of the State Auditor;
or U.S. Department of Justice, who are charged with monitoring program compliance and the use of
funds provided.
3. Will comply with the requirements of the Justice Assistance Grant Program as published by the
Department of Commerce and relevant federal agencies, and as embodied in statute.
4. Will comply with Title V of the Anti -Drug Abuse Act of 1988 and regulations promulgated by the federal
government to maintain a drug -free workplace.
5. Will comply with Title II of the Americans with Disabilities Act of 1990.
6. Will not undertake any prohibited political activities with these funds including, but not limited to, voter
registration; partisan political activity; lobbying congress, the Legislature, or any federal or state agency
for project of jurisdictionally specific activity; or campaign for any ballot measure. Will comply with the
provisions of Title 28, Code of Federal Regulations; Part 61, Procedures for Implementing the National
Environmental Policy Act; and Part 63, Floodplain Management and Wetland Protection Procedures.
7. Guarantees that in performing any contract, purchase, or other agreement, the organization shall not
discriminate against any employee or applicant for employment because of race, color, religion, age,
sex, marital status, national origin, political affiliation, or the presence of any sensory, mental, or physical
disability. The organization agrees to take affirmative action to ensure that applicants are employed and
that employees are treated during the employment without discrimination because of their race, color,
religion, age, sex, political affiliation, handicap or national origin. Such action shall include, but not be
limited to, employment upgrading, demotion or transfer, recruitment and recruitment advertising, layoff
or termination, rates of pay or other forms of compensation, and training. This guarantee shall implement
federal, state, and any local equal opportunity and non-discrimination statutes. The applicant further will,
without delay, bring any finding of an equal opportunity or non-discrimination violation to the attention
of the Department of Commerce.
PLEASE NOTE: THE DEPARTMENT'S ACCEPTANCE OF THIS APPLICATION FOR FUNDING IS
SUBJECT TO SUBSEQUENT COMPLIANCE REVIEWS THAT MAY REQUIRE CORRECTIVE ACTION
BY THE APPLICANT. AUTHORIZED SIGNATURE BY THE APPLICANT GUARANTEES ASSURANCES
THAT ARE CONTAINED ON THE APPLICATION FACE SHEET.
9. A horized Signature for the Applicant:
IGNATURE
PRINTED NAME OF SIGNATURE
DATE
AC "t ,0e ott r(ej Man•wit
TfTLE
STATE OF WASHINGTON
DEPARTMENT OF COMMERCE
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATTON REGARDING
JUSTICE ASSISTANCE GRANT
FORM 2
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
LOWER TIER COVERED TRANSACTIONS
(SUB -RECIPIENT)
This certification is required by the regulations implementing Executive Order 12549, Debarment and
Suspension, 28 CFR Part 67, Section 67.510, Participants' responsibilities. The regulations were
published as Part VII of the May 26, 1988 Federal Register (pages 19160-19211).
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower tier participant certifies by submission of this proposal that neither it nor its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Whew the prospective tower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
A H� ,J � v �r �(-0
Name and Title of Authorized Representative
Si nature
Name of Organization
3^ 2Z • zrz,
Date
S w�4 fed y
Address of Organization
2
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this proposal, the prospective lower -tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance was placed when
this transaction was entered into. If it is later determined that the prospective lower -tier participant
knowingly rendered an erroneous certification, in addition to other remedies available to the Federal
Government, the department or agency with which this transaction originated may pursue available
remedies, including suspension and/or debarment.
3. The prospective lower -tier participant shall provide immediate written notice to the person to whom
this proposal is submitted if at any time the prospective lower -tier participant learns that its certification
was erroneous when submitted or has become erroneous by reason of changed circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower -tier covered
transaction," "participant," " person," "primary covered transaction, "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549:
5. The prospective lower -tier participant agrees by submitting this proposal that, should the proposed
covered transaction be entered into, it shall not knowingly enter into any lower -tier covered transaction
with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covered transaction, unless authorized by the department or agency with which
this transaction originated.
6. The prospective lower -tier participant further agrees by submitting this proposal that it will include the
clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -
Lower Tier Covered Transactions," without modification, in all lower -tier covered transactions and in
all solicitations for lower -tier covered transactions.
7: A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower -tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous. A participant may
decide the method and frequency by which it determines the eligibility of its principals. Each
participant may check the Non -procurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of records
in order to render in good faith the certification required by this clause. The knowledge and information
of a participant is not required to exceed that which is normally possessed by a prudent person in the
ordinary course of business dealings.
9. Except for transactions authorized under Paragraph 5 of these instructions, if a participant in a covered
transaction knowingly enters into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntary excluded from participation in this transaction, in addition to other
remedies available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment
5
STATE OF WASHIlVGTON JUSTICE ASSISTANCE GRANT
DEPARTMENT OF COMMERCE FORM 3
U.S. DEPARTMENT OF JUSTICE
OFFICE OF JUSTICE PROGRAMS
OFFICE OF THE COMPTROLLER
CERTIFICATIONS REGARDING LOBBYING; DEBARMENT,
SUSPENSION AND OTHER RESPONSIBILITY MATTERS
AND
DRUG -FREE WORKPLACE REQUIREMENTS
Applicants should refer to the regulations cited below to determine the certification to which they
are required to attest. Applicants should also review the instructions for certification included in
the regulations before completing this fonts. Signature of this form provides for compliance with
certification requirements under 28 CFR Part 69, "New Restrictions on Lobbying" and 28 CFR
Part 67, Government -wide Debarment and Suspension (Non -procurement) and Government -
wide Requirements for Drug -Free Workplace (Grants)." The certifications shall be treated as a
material representation of fact upon which reliance will be placed when the Department of
Justice determines to award the covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required by Section 1352, Title 31 of the U.S. Code, and implemented at 28 CFR Part 69, for
persons entering into a grant or cooperative agreement over $100,000, as defined at 28 CFR
Part 69, the applicant certifies that:
(a) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the making of any Federal
grant, the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal grant or cooperative agreement;
(b) If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member
of Congress in connection with this Federal grant or cooperative agreement, the
undersigned shall complete and submit Standard Form - LLL, "Disclosure of Lobbying
Activities," in accordance with its instructions;
(c) The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subgrants, contracts under
grants and cooperative agreements, and subcontracts) and that all sub -recipients shall
certify and disclose accordingly.
2. DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS
(DIRECT RECIPIENT)
As requited by Executive Order 12549, Debarment and Suspension, and implemented at 28
CFR Part 67, for prospective participants in primary covered transactions, as defined at 28 CFR
Part 67, Section 67.510
A. The applicant certifies that it and its principals:
C�
(a) Are not presently debarred, suspended, proposed for debarment, declared ineligible,
sentenced to a denial of Federal benefits by a State or Federal court, or voluntarily
excluded from covered transactions by any Federal department or agency;
(b) Have not within a three-year period preceding this application been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State, or
local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or
destruction of records, making false statements, or receiving stolen property;
(c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (Federal, State, or local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification; and (d) Have not within a three-year period
preceding this application had one or more public transactions (Federal, State, or local)
terminated for cause or default; and
B. Where the applicant is unable to certify to any of the statements in this certification, he or she
shall attach an explanation to this application.
3. DRUG -FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and implemented at 28 CFR Part
67, Subpart F, for grantees, as defined at 28 CFR Part 67 Sections 67.615 and 67.620
A. The applicant certifies that it will or will continue to provide a drug -free workplace by:
(a) Publishing a statement notifying employees that the unlawful manufacture, distribution,
dispensing, possession, or use of a controlled substance is prohibited in the grantee's
workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
(b) Establishing an on -going drug -free awareness program to inform employees about
(1) The dangers of drug abuse in the workplace;
(2) The grantee's policy of maintaining a drug -free workplace;
(3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4)' The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
(b) Making it a requirement that each employee to be engaged in the performance of the
grant be given a copy of the statement required by paragraph (a);
(c) Notifying the employee in the statement required by paragraph (a) that, as a condition of
employment under the grant, the employee will
(1) Abide by the terms of the statement; and
(2) Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in the workplace no later than five calendar days after such
conviction;
(d) Notifying the agency, in writing, within 10 calendar days after receiving notice under
subparagraph (d)(2) from an employee or otherwise receiving actual notice of such
conviction. Employers of convicted employees must provide notice, including position
title, to
Department of Justice
Office of Justice Programs
ATTN: Control Desk
810 Seventh Street, N.W.,
Washington, D.C. 20531
Notice shall include the identification number(s) of each affected grant;
(e) Taking one of the following actions, within 30 calendar days of receiving notice under
subparagraph (d)(2), with respect to any employee who is so convicted
(1) Taking appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
(2) Requiring such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a Federal, State, or local
health, law enforcement, or other appropriate agency;
(f) Making a good faith effort to continue to maintain a drug -free workplace through
implementation of paragraphs (a), (b), (c), (d), (e), and (f).
B. The grantee may insert in the space provided below the site(s) for the performance of work
done in connection with the specific grant:
Place of Performance (Street address, city, county, state, zip code)
Statewide —
Check X if there are workplaces on file that are not identified here.
Section 67, 630 of the regulations provides that a grantee that is a State may elect to make one
certification in each Federal fiscal year. A copy of which should be included with each
application for Department of Justice funding. States and State agencies may elect to use OJP
Form 4061 /7.
Check _ if the State has elected to complete OJP Form 406117.
As the duly authorized representative of the applicant, I hereby certify that the applicant will
comply with the above certifications.
1. R
E
andAddress:
2. Application Number and/or Project Name:
3. Grantee IRSNendor Numberl) ANSI 1A2.50�501
4. T pe/Print Name a d Title of Authorized Representative
5. Signature
9 6. Date 63
OJP FORM 4061/6 (3-91) REPLACES OJP FORMS 4061/2, 4061/3 AND 4061/4 WHICH ARE OBSOLETE.
OFFICE OF JUSTICE PROGRAMS BJA NIJ OJJDP BJS OVC
STATE OF WASIIINGTON
DEPARTMENT OF COM31ERCE
JUSTICE ASSISTANCE GRANT
FORM 4
NATIONAL ENVIRONMENTAL POLICY ACT (NEPA)
The following information is required from each federal grant recipient. The Department of
Commerce will consolidate all responses and submit a consolidated response to the U.S.
Department of Justice as required.
Please check one of the blanks to the left of each item below to indicate whether or not the activity
described is being undertaken to support or facilitate the federally funded activity by the grant
recipient or any other party.
(Note —the source of funds utilized is irrelevant to your response.)
(Note —if the activity is being undertaken without regard to the presence or operation of a federally
funded activity, the item should not be checked.)
Yes
Activity N/A
❑ R] 1. New Construction
2. Minor renovation or remodeling of a property either:
❑ ® a. listed or eligible for listing on the National Register of Historical Places
❑ b. located within a 1 UU-year flood plain.
3. Renovation, lease, or any proposed use of a building or facility that will
either.:
❑ a. result in a change in its basic prior use (between industrial, office,
residential, etc.)
❑ b. significantly changes its size (total structure, not program's portion
thereof)
4. Implementation of a new program involving use of chemicals other than:
❑ a. chemicals purchased as an incidental component of the funded activity
❑ b. traditionally used (e.g., for office, household, recreational, educational
environments)
If any item above is checked, a clarification of the activity may be requested.
Response is made related to the following Byrne funded program/project:
Project: ��
Signature:` I L Date: Z
Typed Name: '11"" 0 A/ ` ^-) --k Title:
f
Representing: C 11 `� e �" e C 34-% { �"'2:!4
0
STATE OF WASHIINGTON
DEPARTMENT OF COMMERCE
JUSTICE ASSISTANCE GRANT
FORM 5
ACKNOWLEDGEMENT OF FEDERAL FUNDS
The recipient shall submit to the Department of Commerce, For re -submission to the Bureau of
Justice Assistance, one copy of all reports and proposed publications resulting from this grant
twenty (20) days prior to public release_ Any written, visual, or audio publications, with the
exception of press releases --whether published at the grantee's or government's expense —shall
contain the following statements:
"This project was supported by award number 201 S-DJ-BX-0187 by the Bureau
of Justice Assistance. The Bureau of Justice Assistance is a component of the
Office of Justice Programs, which also includes the National institute of Justice,
the Bureau of Justice Statistics, the Office of Juvenile Justice and Delinquency
Prevention, and the Office of Victims of Crime. Points of view or opinions in this
document do not represent the official position or the policies of the United States
Department of Justice."
l:'he undersigned agrees to the above requirements-
r ---
Signature 1
Name of applicant organization
Printed Name
10
STATE OF WASHINGTON
DEPARTMENT OF COMMERCE
JUSTICE ASSISTANCE GRANT
FORM 6
ACKNOWLEDGEMENT OF
ALLOWABLE AND UNALLOWABLE COSTS
ALLOWABLE COSTS
Allowable uses of federal grant funds include, but are not limited to, the following as they relate
to the coordination and implementation of activities performed under the goal(s), objectives, and
activities of the grant as described on Attachment A of the Grant, including:
• Operating costs, including:
o Approved personnel costs (salaries and benefits).
o Overtime
o Costs reflected in the project budget proposal (such as training fees, printing, supplies, or
contractual services).
• Procurement and installation of equipment (limitations may apply to high dollar items)
■ Space and utilities, to the extent utilized for the approved project.
• Travel, per diem, and lodging at the federally approved rates.
• Printing and duplication of written and visual materials.
UNALLOWABLE COSTS
Unallowable uses of federal grant funds include:
• Confidential funds, unless the applicant has completed/submitted a federal Confidential :Fund
Certificate to the Department of Commerce, and Commerce has approved the certificate.
• Body Armor/Vests, without specific prior approval (special conditions apply)
• Body Wom Cameras, without specific prior approval (special conditions apply)
• Food, beverages or other refreshments for meetings, conferences, or training (prohibition
does not apply to standard per diem when otherwise authorized)
• Vehicles, vessels, and aircraft/drones (all except `patrol' vehicles, those require pre -approval)
• Construction
• Land acquisition
■ Weapons and Ammunition
• Victim compensation (direct payment)
• Losses arising from uncollected accounts
• Contributions to a contingency reserve
• Contributions or donations
• Entertainment
• Fines and penalties (includes flight/hotel and other cancellation fees)
• Interest and other financial costs
• Consultant fees (above a reasonable and consistent rate for similar services, and/or above
$650 for an eight -hour day ---excluding travel and per diem)
The undersigned agrees to the above requirements.
Signature
Name of applicant organization
29'-0-1u11J 6,,,11k
Printed Name
11
STATE OF WASH NGTON JUSTICE ASSISTANCE. GRANT
DEPARTMENT OF COMMERCE FORM 7
COMPLIANCE WITH RELEVANT FEDERAL AND STATE LAW
All recipients of federal grant funds under this program must comply with all relevant federal and
state laws and regulations. Which laws and regulations are relevant may vary dependent upon the
specifics of the grant program(s) providing funding and the activities supported with such funding.
The laws and regulations generally relevant to this grant program include, but are not limited to
the following laws and regulations:
Financial Management System
Financial Management System, Title 2, Part 200 CFR, section 200,302 and .303
Cost Principles and Administrative Requirements, Title 2, Part 200 CFR, Appendices to Part 200
as appropriate
State budgeting, accounting, and reporting system, Chapter 43.88 RCW
Non -Supplanting, USDOJ OCFO's Financial Guide (as amended), Sec. 2.3 Standards for Financial
Management Systems
Audits
Title 2, Part 200 CFR (the Omni Circular), Subpart F-Audit Requirements
Laws Against Discrimination
Affirmative Action, RCW 41.06.020 (1)
Education Amendments of 1972 (20 U.S.C. §§ 1681,1683,1685-86)
Omnibus Crime Control and Safe Streets Act of 1968 (42 USC USC § 3789d)
Age Discrimination Act of 1975, Public Law 94-135, 42 U.S.C. 6101-07, 45 CFR Part 90
Nondiscrimination in Federally Assisted Programs
Civil Rights Act of 1964 (42 U.S.C. § 2000(d))
28 C.F.R. Part 42 (U.S. Department of Justice Regulations — Nondiscrimination, Equal
Employment Opportunity, Policies and Procedures)
Equal Employment Opportunity, Executive Order 11246, as amended by Executive Order 11375
and supplemented in U.S. Department of Labor Regulations, 41 CFR Chapter 60
Nondiscrimination and Equal Opportunity, 24 CFR 5.105(a)
Nondiscrimination in Benefits, Title VI of the Civil Rights Act of 1964, Public Law 88-352, 42
U.S.C. 2000d et seq, 24 CFR Part 1
Nondiscrimination in Employment, Title VII of the Civil Rights Act of 1964, Public Law 88-352
Nondiscrimination in Federally Assisted Construction Contracts, Executive Order 11246, 42
U.S.C. 2000e, as amended by Executive Order 11375, 41 CFR Chapter 60
Discrimination - Human Rights Commission, Chapter 49.60 RCW
Executive Order 13559 (Fundamental Principles and Policymakers Criteria for. Partnerships
with Faith -Based and Other Community Organizations);
28 C.F.F. Part 38 ((IJ.S. Department of Justice Regulations — Partnerships with Faith -Based
and Other Community Organizations)
Americans with Disabilities Act of 1990 (Title Il, and 42 U.S.C. §§ 12131-34)
Rehabilitation Act of 1973 (29 U.S.C. § 794)
Continued on Reverse
Handicapped Employees of Government Contractors, Rehabilitation Act of 1973, Section 503, 29
U.S.C. 793
12
Handicapped Recipients of Federal Financial Assistance, Rehabilitation Act of 1973, Section 504,
29 U.S.C.794
Minority Business Enterprises, Executive Order 11625, 15 U.S.C. 631
Minority Business Enterprise Development, Executive Order 12432, 48 FR 32551
Office of minority and Women's Business Enterprises, Chapter 39.19 RCW and Chapter 326-02
WAC
Notification of Findings of Discrimination or Non -Compliance
Policies Regarding Cooperation with Homeland Security, 8 U.S.C. Section 1373
Laws Regarding Ethics, Lobbying, Liability and Public Access
Federal Funding Accountability and Transparency Act of 2006 (FFATA)
Conflict of Interest, Ethics in Public Service Act, Chapter 42.52 RCW
Ethics in Public Service, Chapter 42.52 RCW
Lobbying and Disclosure, 42 USC 3537a and 3545 and 31 USC 1352. (Byrd Anti -Lobbying
Amendment). 31 U.S.C. 1352
Hatch Political Activity Act, 5 U.S.C. 1501-8
Anti -Kickback Act, 18 U.S.C. 874; 40 U.S.C. 276b, 276c; 41 U.S.C. 51-54
Disclosure -Campaign Finances -lobbying, Chapter 42.17A RCW
Omnibus Crime Control Act and Safe Streets Act of 1968 (42 U.S.C. § 3789d)
Victims of Crime Act (42 U.S.C. § 10604(e))
Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(b))
Executive Order 11246, as amended by EO 11375, 11478, 12086 and 12102
Housing and Urban Development Act of. 1968, Section 3,12 IJSC 1701 u (See 24 CFR 570.607(b))
Housing Assistance Payments Program, Section 8, Confidentiality/Safeguarding of Information,
Sub -Award Document Text, General Conditions Paragraph 10
Privacy Act of 1974, 5 U.S.C. 552a
Boards of Directors or Officers of Non -Profit Corporations — Liability - Limitations, RCW
4.24.264
Open Public Meetings Act, Chapter 42.30 RCW
Public Records Act, Chapter 42.56 RCW
Labor and Safety Standards
Convict Labor, 18 U.S.C. 751, 752, 4081, 4082
Drug -Free Workplace Act of 1988, Title V, and 41 USC 701 et seq.
Federal Fair Labor Standards Act, 29 U.S.C. 201 et seq.
Work Hours and Safety Act of 1962, 40 U.S.C. 327-330 and Department of Labor Regulations, 29
CFR Part 5
The undersigned acknowledges the above notice of relevant laws and regulations.
Signature
S� i)l z�,s,_,Uj U
Name of applicant organization
12 A -A w, u,- b )4 j,,,A
Printed Name
13
STATE OF WASHINGTON JUSTICE ASSISTANCE GRANT
DEPARTMENT OF COMMERCE FORM 8
CENTER FOR TASK FORCE LEADERSHIP AND INTEGRITY TRAINING
Every individual participating in a task force, overseeing or reimbursed with federal funds under this
program must complete the relevant CTFLI training as presented at https://www.centf.orgZCTFLI/.
Individuals responsible for program evaluation or assessment of compliance with either federal or
program rules and regulations for this program must complete each training module within 120 days of
assuming that position/duty or within one year of the beginning of the current contractual period,
whichever is later.
I certify that I have completed the training as specified above.
OR
[71 1 attest that I am within 120 days of assuming a position requiring the training specified above and
will notify COMMERCE when I have completed that training.
'I _8 `1 r- k
PrintedName
Gn V-w.A'-a 16
Titic
Dat
14
STATE OF WASHINGTON JUSTICE ASSISTANCE
GRANT
DEPARTMENT OF COIVEMERCE FORM 9
CIVIL RIGHTS TRAINING
An individual representing each entity receiving reimbursement under this program is required to
complete the Office of Justice Programs. 0Mice For C i. it Rights - Training for Granter loomed at:
litip:l/p ggt»/,botitiocr/ocr-tr :mitt -videos/video•oct-trainiii r.hiri, or training at least cquivalent to that
training, and return this completed certification prior to drawdown of grant funds.
Select one of the two training options:
1, Office for Civil Rights — Training for Grantees as specified below:
Module Lenath
f7Overview................................................................................................................................32:10
❑ Overview: Self Test ..................................... ............................................................................ 11:37
❑ Service to LEP Persons...........................................................................................................19:53
❑ Test: Service to LEP Persons..............................................................••....................................6:02
❑ State Administering Agencies ..... (Grantees with Sub -Recipients only)............................27:37
❑ Test: State Administering Agencies (Grantees with Sub -Recipients only) ............................. 6:48
❑ Faith -Based Organizations ........................... ......... .................................................................. 15:27
❑ Test: Faith -Based Organizations............................................................................................... 8:29
❑ American Indians...................................................................................................................10:40
❑ Test: American Indians ................................. .................................................................. ......... 6:01
❑ Standard Assurances .................... ............ ..... .......... ........ ..................... ... ....................... I ....... 12:41
❑ Test: Standard Assurances........................................................................................................4:38
OR
2. Other training at least equivalent to the Office for Civil Rights — Training for Grantees
Optional training videos are available from the Office for Violence Against Women and may be reviewed
at: https://se treli justice.gov/seareli?affiliate jtistice&op=Search&page=2&query=videos
As the individual with primary functional responsibility for equal opportunity and civil rights compliance
for the applicant jurisdiction or organization, I hereby certify that I have completed the on-line training
modules identified above, or have received equivalent professional `.HR' training equivalent to that
identified above, or a comprehensive update on such equivalent training, within the last two years. For
the State Administering Agencies module and the test for that module, I have consulted with the primary
grant manager for this award program as to whether there are or will be sub -recipients, and completed
those modules or equivalent training if applicable.
This certificate is valid for two years from the date of execution.
rN ItTi3H OFFICIAL WITH 1 rIONAL. RESPONSIBILITY TITLE OF OFFICIAL COMPLETING THE CERTIFICATION
RJR1SDiCT[QN/0RGANIZAJ0N REPRESENTED .DATE
15
STATE OF WASHINGTON
DEPARTMENT OF COMMERCE
JUSTICE ASSISTANCE GRANT
FORM 10
CIVIL RIGHTS REQUIREMENTS
1. C.[NIITEU ENc;[.ESH PROI'ICIEI,�['1'
To ensure compliance with the Omnibus Crime Control and Safe Streets Act of 1968 and
Title VI of the Civil Rights Act of 1964, grant recipients must take reasonable steps to ensure
that Persons with Limited English Proficiency have meaningful access to services and legal
protections. Meaningful access may entail providing language assistance services where
necessary, including oral and written translation. Assistance in understanding grant
recipient's obligations under the law may be found in the Department of Justice's Guidance
to Federal Financial Assistance Regarding Title VI Prohibition Against National Origin
Discrimination Affecting Limited English Proficiency Persons (LEP Guidance), which can be
found at 67 Fed. Reg. 41455 (June 18, 2002). Additional assistance regarding LEP
obligations and information may be found at www�le a.g_ov.
2. FEMitti, NON-DiscRIh11NA TION REQUIREMENTS
The applicant will comply with any applicable federal nondiscrimination requirements,
which may include:
* the Omnibus Crime Control Act and Safe Sheets Act of 1968, as amended (42 U.S.C. §
3789d);
* the Victims of Crime Act of 1984 as amended (42 U.S.C. § 10604.(e)) and 28 CFR §
94,114;
* the Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(b)) as
amended;
* Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000(d));
* the Rehabilitation Act of 1973 (29 U.S.C. § 794);
* the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 12131.34);
* the Education Amendments of 1972 (20 U.S.C. §§ 1681,1683,1685-86);
* the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07);
* 28 C.F.R. Part 42 (U.S. Department of Justice Regulations —Nondiscrimination, Equal
Employment Opportunity, Policies and Procedures);
* Executive Order 13559 (Fundamental Principles and Policymakers Criteria for
Partnerships with Faith -Based and Other Community Organizations);
* 28 C.F..R, Part 38 ((U.S. Department of Justice Regulations — Partnerships with Faith -
Based and Other Community Organizations);
* 28 CFR § 31.202, 403;
* Violence Against Women Act: (VAWA) of 1994, as amended (42 U.S.C. §
13925(b)(13)); and
Applicable Department of Justice regulations implementing the above -referenced statutes
The applicant shall further comply with Federal law prohibiting grant recipients from
retaliating against individuals taking action or participating in action to secure rights
protected by federal law.
3. NOT[ 11CAT ION of I+IND144GS OF DItiSCRIA1INATION ❑RNO1N-COMPLIANCE
16
In the event a state or federal court, or a state or federal administrative agency, makes a
finding of discrimination after a due process hearing on the grounds of race, color, religion,
national origin, age, disability, or sex, sexual orientation or gender identity against the
applicant or a program partner or participant receiving grant funds, the applicant will forward
a copy of the finding to the U.S. Department of Justice, Office of Justice Programs, Office of
Civil Rights (OCR), and the Department of Commerce (COMMERCE).
The applicant shall include a statement clearly stating whether or not the finding is related to
any grant activity supported with a grant in which U.S. Department of Justice Funds are
involved, and shall identify all open grants utilizing U.S. Department of Justice funding by
contract number and program title.
The applicant shall include a statement clearly stating whether or not the finding is related to
any grant activity supported with a grant in which U.S. Department of Justice Funds are
involved, and shall identify all open grants utilizing U.S. Department of Justice funding by
contract number and program title.
4. EQUAi, ENipi.o),,Nii~.!'!' OPPOR-rL:Nl-'1' PROGiIAM (ESOP)
The applicant will determine whether it is required to formulate an Equal Employment
Opportunity Program (EEOP), in accordance with 28 C.F.R. 42.301 et. seq. If the applicant is
not required to formulate an EEOP, it will submit a certificate form to the U.S. Department
of Justice, Office of Justice Programs, Office of Civil Rights (OCR), and Washington State
Department of Commerce (COMMERCE) indicating that it is not required to develop an
EEOP. If the applicant is required to develop an EEOP but not required to submit the EEOP
to the OCR, the applicant will submit a certification to the OCR and COMMERCE certifying
that it has an EEOP on file which meets the applicable requirements. If the applicant is
awarded a grant of $500,000 or more and has 50 or more employees, it will submit a copy of
its EEOP to the OCR and COMMERCE. Non-profit organizations, federally recognized
Indian Tribes, and medical and educational institutions are exempt from the EEOP
requirement, but are required to submit a certification form to the OCR toclaim the
exemption. A copy of the certification form will also be submitted to COMMERCE.
Information about civil rights obligations of grantees can be found at
litip:/Iw%vtv.oip.tisdoi.gov/ocr/
5. APPLICANT DUTY TO ENSURE, SuB-RcapIENTS COMPLIANCE
The applicant is required to ensure compliance with this requirement by any program partner
or participant receiving funding under this grant.
As the individual with primary functional responsibility for equal opportunity/civil rights
compliance for the applicant jurisdiction, I hereby certify that the applicant will comply with the
above Civil Rights requirements specified in this certification,
a CO "V
SwNxrvK9 OF INDIvEDUAL WITH FUNCTIONAL RESPONSIBILITY TITLE OF OFFICIAL COMPLETING THE CERTIFICATION
JURISDICTION/ORGANIZATION REPRESENTED DATE
17
STATE OF WASHINGTON JUSTICE ASSISTANCE GRANT
DEPARTMENT OF COMMERCE FORM II
EQUAL EMPLOYMENT OPPORTUNITY PLAN (EEOP) CERTIFICATION j�%
Recipient Name and Address LI ' �r��_ YV( I $-M.c-SS ,— ��
Grant Title: Justice Assistance Granan��ton State Grant Number:dw' 1'j4�-+�
Subaward No.: _
Award Amount: 2,a
Federal regulations require recipients of financial assistance from the Office of Justice Programs (OJP), its component agencies, and the Office of
Community Oriented Policing Services (COPS) to prepare, maintain on file, submit to OJP for review, and implement an Equal hmployment
Opportunity Plan (ESOP) in accordance with 28 CFR Sections 42.301-308. The regulations exempt some recipients from all ofthe EEOP
requirements. Other recipients, according to the regulations, must prepare, maintain on file, and implement an ESOP, but they do not need to submit
the EEOP to OJP for review. Recipients that claim a complete exemption from the EEOP requirement must complete Section B below. Recipients that
claim the limited exemption from the submission requirement must complete Section C below.
Recipients should complete Section A, B or Section C, asu inultirtlr_sections. If a recipient receives multiple federal grants, please complete a form
for each grant, Do Not Use Another Grant's Certificate when completing this application package.
5ectio A -Declaration rc pli nec with the EEOP Requirement
I �A e�' e[individuith rimary functional responsibility for equal opportunity/civil rights
compiiwice for the jurisdiction], certify that c s wid G - _
[recipient] has prepared an EEOP and if appropriate submiue in the OfTice of Civil Rights, US i partment of Justice a copy, pursuant to 28
CFR.
Vaness � HJe-4+ 03 f z2/Zo22
Print Name of Individual with ignature Date
Primary Functional Responsibility
Section B - Declaration of Claiming Complete Exemption from the EEOP Requirement. Please check all boxes that apply.
❑ Recipient has less than 50 employees ❑ Recipient is an Indian Tribe ❑ Recipient is a non-profit organisation
❑ I(ccilikv is an educationnl institution ❑ Recipient is a medical institution 1KRecipient's award is less than $25,000
i _Vko r°SS_&-;,- lindividt I wi primary tiro •tin lul responsibility for equal opportunity/civil rights
compliance for the jurisdiction], certify that l�I- �Q.r Gr _
[rccipi nt] is i� rcquir d r pare an EE(3P f+rr llle reastIn(s) checked above, pursuant CFR Sections 42.302. 1 further certify that
�t i _,& 'i [recipient jurisdiction] will comply with the applicable Federal civil rights laws
that prohibit disc minaiion in employment and in & delivery of services.
V&0�ar� Print Name of Individual Signature
Q Date
Section C: - Declaration Claiming ,Exemtrtian frisin tile F.E01, Sul+ntiss•ron flee nirement and Certifying that an EEOP Is on
File for Review.
If a recipient agency has 50 or more employees and is receiving a single award or subaward for $25,000 or more, but less than
$500,000, then the recipient agency does not have to submit an EEOP for review to the Department of Justice as long as it certifies
the following (42 CFR Section 42.305):
I [individual with primary functional responsibility for equal
oppartuttity/eivil rights compliance for the jurisdiction], certify that _ _ [recipient jurisdiction],
which has 50 or more employees and is receiving a single award or subaward for $25,000 or more, but less than $500,000, has formulated
an ESOP in accordance with 28 CFR Section 42.301, et. seq., subpart E, I further certify that the EEOP has been formulated and signed
into effect within the past two years by the proper authority and that it is available for review. The EEOP is on file in the office of
[organization], at [address], for review by the public and
employees or for review or audit by nMcials of the relevant state planning agency or the Office for Civil Rights, Office of Justice
Programs, U.S. Department of Justice, as required by relevant laws and regulations.
Print Name of Individual with Signature Date
Primary Functional Responsibility
18
Insert copy (image) of
Email a copy of the EEOP Utilization Report including signaturelapproval page(s) to
abigail.snyder@commerce.wa.gov
19
STATE OF WASHINGTON
DEPARTMENT OF COMMERCE
Office of Civil Rights Compliance Checklist
JUSTICE ASSISTANCE GRANT
FORM 12
A. Federally -Mandated Activities: Equal Opportunity Program
1. EEOP total exemption criteria: Yes No ` Yes No N/A
a.
Recipient agency (total agency/jurisdiction, not just applying
component) has less than 50 employee
X
b.
Recipient agency is an educational institution
X
C.
Recipient agency is an Indian Tribe
X
d.
Recipient agency is a medical institution
X
e.
Recipient agency is a non-profit organization
X
f.
Recipient agency's award is less than $25,000
X
g.
Recipient agency's award is less than $500,000
X
Totally Exempt? Is any complete exemption factor above (1a. thru 1f.) a
"Yes"? In comments enter "EEOP Total Exemption" or" EEOP Required"
X
EEOP Total Exemption
2-
If totally EEOP exempt recipient agency has certified it is so exempt and that it
will comply with applicable Federal civil rights laws that prohibit discrimination in
employment and in the delivery of services
X
lNot Totally Exempt:
371 If the award is for $500,000 or more, EEOP submission made to the USDOJ
Office of Civil Rights
4. Was the EEOP submitted to COMMERCE
5.
Approval and Expiration dates
Effective: Expiration:
6-
_
EEOP is available for review
If the award is for less than $500,000 EEOP Certification Form has been
submitted to COMMERCE
7-
8.
EEOP has been formulated and signed into effect within the past two (2) years
Generic Civil Rights Compliance (Non-EEOP):
9.
How does the agency notify program participants and beneficiaries
that it does not discriminate on the basis of race, color, national origin,
religion, sex, sexual orientation, gender identity, disability, and age in the
delivery of services (e.g. posters, inclusion in brochures or other program
materials, etc.)
Job Announcements
Web Site
Posters
Other (specify):
20
Office of Civil Rights Compliance Checklist
10
How does the agency notify employees and prospective employees
that it does not discriminate on the basis of race, color, national origin,
religion, sex, sexual orientation, gender identity and disability in
employment practices (e.g. posters, dissemination of relevant orders or
policies, inclusion in recruitment materials, etc.)
Written policies or procedures in place for notifying program beneficiaries
how to file complaints alleging discrimination by the agency with PG&R
and the USDOJ Office for Civil Rights — Explain
Yes
No NIA
Job Announcement l�
Orientation Training
Web Site
Refresher Training
Posters j
Employee Handbook
Other (specify):
11
12,
Grievance Procedures — Notification — Training - Point of Contact
Item 12a thru 12c apply only if both Items 1 a and 1f are 'No'
a. Adopted grievance procedures that incorporate due process standards
and provide for the prompt and equitable resolution of complaints
alleging a violation of the DOJ regulations implementing Section 504 of
the Rehabilitation Act of 1973, found at 28 CFR Part 42, Subpart G,
which prohibit discrimination on the basis of a disability in employment
practices and the delivery of services
Policy & Procedures
Web Site or Intranet
Employee Handbook
Collective Bargaining Agreement
Other
(specify):
b. Designated a person to coordinate compliance with the prohibitions
against disability discrimination contained in 28 CFR Part 42, Subpart G
Designee's
Title:
C.
Notified participants, beneficiaries, employees, applicants, and others
that the agency does not discriminate on the basis of disability - How
Does the agency conduct any training for its employees on the
requirements under federal civil rights laws - Explain
Job Announcement
Orientation Training
[ Web Site
Refresher Training
I Posters
Employee Handbook
Other (specify):
_
d.
Orientation Training Supervisors Training
Refresher Training (type):
Other (specify):
Limited English Proficiency
Steps has the agency taken to provide meaningful access to its
programs and activities to persons who have limited English proficiency
(LEP)
r Jurisdiction Law
W in general Enforcement
13.
Assessed LEP population & critical services
Hiring LEP language proficient speakers
Training personnel in LEP languages
Coordinating for LEP speakers in advance
LEP speakers called upon contact
Language Line used
Corresponding common phrase (crib) sheets
21
Ottice of UVII Klgnts uornpIlance
t neCKllsi
No I NIA E- Jurisdiction in general Law Enforcement i
14 Limited English Proficiency (LEP) -- Written policy on providing language
access to services (Not a requirement, a question)
Yes
Education Program or Activity operated by the agency, has the
taken the followin actions:Adopted
Ha
_agency
grievance procedures that incorporate due process standards
and provide for the prompt and equitable resolution of complaints
alleging a violation of the DOJ regulations implementing Title IX of the
Education Amendments of 1972, found at 28 CFR Part 54, which prohibit
discrimination on the basis of sex _
Designated a person to coordinate compliance with the prohibitions
b.
Designee's
against sex discrimination contained in 28 CFR Part 54 -Who
I Title:
c.
Notified applicants for admission and employment, employees, students,
parents, and others that the agency does not discriminate on the basis of
sex in its educational programs or activities
16
Religious Activities, if subrecipient is a religious institution or a faith -based
'
or aniMtion:
a.
Provide notice actual & potential beneficiaries that the subrecipient does
not discriminate in the delivery of services based on religion
b-
Provide notice that if beneficiaries object to the `religious character' of the
subrecipient, the subrecipient will make a reasonable effort to find an
i
alternative service provider in close qegarphic proximity
Keep a record of requests for an alternative service provider and their
c.
efforts to find such, and their follow-up with the re uestor
+ 17
Finding/Rulings _
tea.
7 Has the contractor, or its subcontractors/formal participants, had any formal
f findings or rulings against it or its key officers regarding Equal Opportunity
(grounds of race, color, religion, national origin, or sex), within the last two
_
years? — Explain if Yes
b-
Was COMMERCE (or Task Force Lead agency) and USDOJ Office of Civil
_
Rights promptly notified of any finding? _
C.
I Corrective action, as negotiated or directed, been implemented?
18.
In accordance with the Federal Civil Rights Compliance Checklist, incorporated
in this section of the monitoring tool, does the agency appear to be in full
Comments:
compliance with federal law and regulation _
Office of Civil Rights Compliance Checklist
B. flrug4rr" i CP>I1Ca T Yea No NIA
19. Does the agency have a Drug -Free Workplace policy in place? �—
20 Who administers the Drug -Free Workplace Program? �Offce o- F:�
i Position Title
A\JL21ow0-cC_
21 Do the provisions include_
• Counseling 0 Rehabilitation_ . Employee Assistance If
22. Do violations result in:
• Termination . Penalties Rehabilitation c u ^� ='�Q r t S
23. Has any employee of the contractor, or its subcontractors/formal participants,
been convicted of a criminal drug offense on the job or premises, within the last ,
two years?
24. Was COMMERCE (or Task Force lead agency) notified promptly (within 5 days, I T
BJA within 10 days of the conviction)?
25. Was appropriate personnel action taken within 30 days-,
Conflict of Interest
26. Has any allegation or finding of Conflict of Interest been made against any
employee or official of the contractor, or its subcontractors/formal participants, in
relation to the grant within the last two years?
(Limit response to projects personnel, supervisors and policy chain) ;
27 Was COMMERCE (or Task Force lead agency) notified promptly j
(within 30 days; if actively investigated, after conclusion of the investigation)?
2$• Describe the allegation or finding x
Certification: The undersigned certify that the above is a true representation of
offthe Civil Rights
fand
r ,other issues covered by this checklist.
For (responding City, County, Tribal Jurisdiction, or Non -Governmental Entity): C,1 fiA Opt' i �(� t k`& I Y V 1 M11
Slg attlrB (of Human ondent) ate Sig nature (of grant activity coordinator (items 13,14,17 & 23-27))
Fl
Name/Title of Respondent Name/Title of Respondent
Note: Project coordinator/liaison (right signature block) should respond to questions with color accented line numbers (13, 14, 17 & 23-27)
as in some jurisdictions these events are resolved between department heads and the executive council, and are not consistently
reported to Human Resdurces/Personnel.
2y
3 _Lc- ZZ
Date
STATE OF WASE[INGTON
DEPARTMENT OF COMMERCE
JUSTICE ASSISTANCE GRANT
FORM 13
FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT
(FFATA)
Section 1
Agency/Jurisdiction legal Nance:
Section 2
Responses should be for the entire Jurisdiction/Organization, not just the department /division to utilize grant funds.
a) Total Federal Revenues for the prior fiscal year �S'3 Lq3Z q6
(ARRA, Non-ARRA, Directly & Indirectly received)
b) Is `a' above equal to or greater than $25,000,000? Yes f �o]
(ctrcien"
c) If `b' above is `No', skip to Section 3 a), enter check `Not Required'
and execute the certificate, otherwise continue, compensation reporting may
be required.
d) Total Revenue ( including Federal Revenue) for the prior fiscal year
e) Calculation: a d (Total :Federal Revenue divided by Total Revenue)
-f) Is `e' above equal to or greater than .8? Yes No
(Circle One)
g) If `>P above is `No', skip to Section 3, enter check `Not Required'
and execute the certificate, otherwise continue, compensation reporting may
be required.
h) Have you filed senior executive's compensation with either of the following?
1. Securities & Exchange Commission
(tinder see 13(a) or 15(d) of the Securities Exchange Act of 1954)
2. Internal Revenue Service
(Sec 6104 of the Internal Revenue Code of 1986) Yes No
(Circle One)
i) If `h' above is `Yes', skip to Section 3a), enter check `Not Required'
and execute the certificate, otherwise continue, compensation reporting
is required.
24
Section 3
Compensation Reporting Requirement:
a) Not required to report senior executive compensation.
(Sec 2b or 2f = `No', or 2h = `Yes') PD
b) Enter the name, title and total compensation of the five individuals receiving
the greatest total compensation for the reporting jurisdiction (or agency if the
Grantee is not a unit of state, local or tribal government).
Name Title Compensation
1.
2,
3.
4,
5.
Section 4
I, am the chief financial officer of the jurisdiction/organization or their designated representative,
and certify that the data presented on this form is an accurate reflection of the jurisdiction's/
organization's fiscal records.
- 7;;(�
Signature
Printed N ne
_ R/�$ZZ_
Date
25
STATE OF WASHINGTON JUSTICE ASSISTANCE GRANT
DEPARTMENT OF COMMERCE FORM 14
COMMERCIAL INSURANCE, RISK POOL OR SELF INSURANCE
Cities and Counties receiving grant funds directly from Commerce under this program must have:
Automobile Liability, In the event that performance pursuant to this Agreement involves the use of
vehicles, owned or operated by the Contractor or its Subcontractor, automobile liability insurance
shall be required. The minimum limit for automobile liability is $1,000,000 per occurrence, using a
Combined Single Limit for bodily injury and property damage.
Commercial General Liability Insurance Policy. Provide a Commercial General Liability Insurance
Policy, including contractual liability, written on an occurrence basis, in adequate quantity to protect
against legal liability arising out of Agreement activ€ty but no less than $1,000,000 per occurrence.
Additionally, the Contractor is responsible for ensuring that any Subcontractors provide adequate
insurance coverage for the activities arising out of subcontracts,
Employers Liability. Insurance providing wage replacement and medical benefits to employees
injured in the course of employment, filling the gaps between Worker's Compensation and
Commercial General Liability.
Fidelity Insurance. The Contractor shall maintain insurance coverage at least equal to the awarded
funds under this agreement to protect against fraudulent acts by individuals authorized to receive or
deposit funds into program accounts, or to prepare or issue financial documents, checks, or other
instruments of payment for program costs.
Professional Liability, Errors and Omissions Insurance, The Contractor shall maintain
Professional Liability or Errors and Omissions Insurance. The Contractor shall maintain minimum
limits of no less than $1,000,000 per occurrence to cover all activities by the Contractor and licensed
staff employed or under contract to the Contractor. The state of Washington, its agents, officers, and
employees need not be named as additional insureds under this policy.
Worker's Compensation. Coverage of employees which in the course of employment incurred
bodily injury (including death) by accident or disease that arises out of or in connection with the
performance of the grant agreement.
The agency executing the grant award for this program shall provide insurance coverage as set forth
above. The intent of the required insurance is to protect the state should there be any claims, suits,
actions, costs, damages or expenses arising from any loss, or negligent or intentional act or omission of
the Grantee or Subgrantee/subcontractor, or agents of either, while performing under the terms of this
Grant.
The insurance required shall be issued by an insurance company or risk pool authorized to do business
within the state of Washington. Except for professional Liability or Errors and Omissions Insurance, the
insurance shall name the state of Washington, its agents, officers, and employees as additional insureds
under the insurance policy. All policies shall be primary to any other valid and collectable insurance. The
Grantee shall instruct the insurers to give COMMERCE thirty (30) calendar days advance notice of any
insurance cancellation, non -renewal or modification.
The Grantee shall submit to COMMERCE, within 15 days of being requested, a certificate of insurance
which outlines the coverage and limits defined in this insurance section. Commerce will be named as an
additional insured on this certificate. During the term of the Grant, the Grantee shall submit renewal
certificates not less than thirty (30) calendar days prior to expiration of each policy required under this
section.
The Grantee shall provide insurance coverage that shall be maintained in full force and effect during the
term of this Grant
CJ `mow_ _
SIGNATURE OF INDIVIDUAL WITH FUNCTIONAL RESPONSIBILITY TLE C 1 IT3MCIAL CD. ijiNc THE CERTIFICATION
JURISI)iMON/OX0AINIZAITO PK sGN'rim T]ATi:
26
'rATE OF WASHINGTON JUSTICE ASSISTANCE GRANT
DEPARTMENT OF COMMERCE FORM 15
S
STATE OF WASHINGTON
OFFICE OF FIREARM SAFETY & VIOLENCE PR - ENTION
PUBLIC SAFETY UNIT
1011 Plum Street SE • PO Box 42525 • Olympla, Washing to 9iJ50A-2525
(360) 725-2895 • f-8
86-857
-9589
1
Jurisdiction/Organizati Tribe: Click or tap here to enter text
Recipient Program/I)epari ent: Click or tap hereto enter t t.
Person(s) completing the to\Click
here to enter xt.
Title: Click or tap hereto en
Phone/Email: Click or tap h.
Date submitted to Commerhere to s. iter text.
Assessment Questions
Please answer each question completely a
1
supporting details where requested.
Explain any organizational restructuri tha occurred within the last 12 months that affect
Commerce contracts or grants. Mak sure to 'cuss the following:
• Organizational changes ( visions, depa meats, units)
Programmatic changes ervices being pr ided, level of services, etc)
• Business systems (w ' h can include financi human resources, programmatic, etc)
Provide details of the restr cturing, the timeframe for wh\1aurring and the
status of the change.
Click or tap here to enk' text.
❑ Check box if n relevant organizational restructuring hthe last 12
months.
Has the org )ization expanded services or created new services within the Ia\4o?
❑ Yes No
If yes, ease describe and list the new or existing resources that support this
2 servi s.
' Click or tap here to enter text.
27
ATE OF WASHINGTON JUSTICE ASSISTANCE GRANT
YARTMENT OF COMMERCE ' "j'k FORM 15
a
� r
r
� � fll6p rl
STATE OF WASHINGTON
OFFICE OF FIREARM SAFETY & VIOLENCE PREVENTION
PUBLIC SAFETY UNIT
1011 Plum Street SE • PO Box 42525 • Olympia, Washington 98504-2525
(360) 725-2895 •1-866-857-9889
Jurisdiction/Organization/Tribe: Click or tap here to enter text.
Recipient Program/Department: Click or tap here to enter text.
Person(s) completing the form: Click or tap here to enter text.
Title: Click or tap here to enter text.
Phone/Email: Click or tap here to enter text.
Date submitted to Commerce: Click or tap here to enter text.
Assessment Questions
Please answer each question completely and provide supporting details where requested.
Explain any organizational restructuring that occurred within the last 12 months that affect
Commerce contracts or grants. Make sure to discuss the following:
Organizational changes (divisions, departments, units)
s Programmatic changes (services being provided, level of services, etc)
Business systems (which can include financial, human resources, programmatic, etc)
Provide details of the restructuring, the timeframe for which this has/is occurring and the
1 status of the change.
Click or tap here to enter text.
® Check box if no relevant organizational restructuring has occurred within the last 12
months.
Has the organization expanded services or created new services within the last 24 months?
❑ Yes ® No
If yes, please describe and list the new or existing resources that support this expansion in
services.
Click or tap here to enter text.
27
3
4
5
Describe turnover in key positions during the past 12 months in those areas of the
organization that administer or support OFSVP Public Safety Unit programs for the following
categories. Along with the description, include the number of positions/FTEs for each
category.
- Executive Management/Tribal Executive Management Staff
- Fiscal
- Council, Commissioners/Tribal Council
Describe your plan and timeframe for filling, training, or covering the duties of any vacant
positions.
Click or tap here to enter text.
® Check box if there has been no turnover in key positions during the past 12 months.
Does your organization/Tribe have any pending or recent past litigation or legal action?
®Yes ❑No
If yes, please describe the litigation or legal action.
1 have attached the annual report submitted to the Washington State Auditor's Office at the
end of this packet.
Has your organization/Tribe terminated or has Commerce terminated any contracts in the last
24 months because of performance or compliance issues?
❑ Yes ® No
If yes, please explain the circumstances.
Click or tap here to enter text.
Does your organization/Tribe have funders other than the OFSVP Public Safety Unit who
monitor (non -audit) contracts and grants?
® Yes ❑ No
If yes, please list them and include the frequency in which monitoring is conducted.
This is completed internally.
28
Have you had an audit in the last 24 months?
® Yes ❑ No
If no, explain why an audit was not needed or required.
Click or tap here to enter text.
7
If you have had an audit, explain the type of audit (e.g. financial, federal compliance, internal
control, etc).
All financial, federal compliance, and internal control audits are completed by the Washington
State Auditor's Office.
List any audit findings you have received from an external entity within the last 24 months.
Click or tap here to enter text.
If findings were included in the audit, please describe the corrective action plan and state if it
8
is either in progress (providing detail on the status for implementation) or has been
completed.
Click or tap here to enter text.
® Check box if there were no findings.
Have you, or do you intend to sub grant or sub contract any funds received from OFSVP Public
Safety Unit?
❑ Yes ® No
9
If yes, how do you monitor your sub grantees/sub contractors services and expenditures?
Click or tap here to enter text.
What percent of your organization's annual budget is government funding (federal and state)?
10
❑ Under 10% ❑ 10 — 30% ® 30 — 50% ❑ More than 50%
Does 20% or more of the total funding for your organization come from OFSVP Public Safety
Unit? Please use a two or three year analysis to answer this question.
❑ Yes ® No
If your organization has experienced "funding swings" where one fiscal year you do receive
11
20% or more of your total funding from OFSVP Public Safety Unit and in another year you do
not, please explain why this has occurred.
Click or tap here to enter text.
Explain the management and the board/or council's role in the following:
12
■ Monitoring financial and programmatic compliance
29
Evaluating or assessing the performance of the executive director
■ Developing policy
• Reviewing programmatic results
Click or tap here to enter text.
City's Finance Director keeps the city in compliance.
1
How many years has your organization/Tribe administered federal or state funds?
13
• Federal funds: ❑ less than 2 years ❑ 2 — 5 years ® more than 6 years
14
• State funds: ❑ less than 2 years ❑ 2 — 5 years ® more than 6 years
List specific experience in government grant administration and government contract
administration for the following staff:
6 Executive Management: ❑ less than 2 years 112 — 5 years ❑ more than 6 years
6 Fiscal/Bookkeeping Staff: ❑ less than 2 years ❑ 2 — 5 years ❑ more than 6 years
Include the total number of years of experience for each of the categories above. 25+ years.
I certify that the information provided is true and correct
f
Sig ature Date
d-�.) D %J ^k C0 v.- �.
Print or type name and position
30
STATE OF WASHINGTON JUSTICE ASSISTANCE GRANT
DEPARTMENT OF COMMERCE FORM 16
CUSTOMER SATISFACTION AND EVIPROVEMENT
The following questions are intended to help us improve our application process. Please indicate
your agreement/disagreement with the following statements. Your responses will not impact the
evaluation of your application in any way.
1: Strongly Disagree
2: Disagree
3: Neither Agree Nor Disagree
4: Agree
5: Strongly Agree
1. The application instructions were clear.
1 2 3 4 5
2. The application questions were easily understood.
1 2 3 4 5
3. I was able to receive the assistance I needed from Commerce to complete the
application.
1 2 3 4 5
4. I had adequate time to prepare the application prior to the deadline.
1 2 3 4 5
5. Given program requirements, the application process was reasonable.
1 2 3 4 5
6. Which forms or portions thereof were particularly difficult to understand or
respond to, and do you have any recommendations for how they should be
presented?
31
CITY OF
AZ
Federal Way
Centered on Opportunity
VIA E-MAIL: Pavath.Phommachanh@sao.wa.gov
June 24, 2021
Washington State Auditor's Office
ATT: Pavath Phommachanh
P.O. Box 40021
Olympia, WA 98504
CITY HALL
33325 8th Avenue South
Federal Way, WA 98003-6325
(253) 835-7000
w ww. cityofederalway. com
Jlm Ferrell, Mayor
Re: Report on Contingencies and Litigation in Compliance with Auditing
Requirements
Dear Auditor:
Pursuant to RCW 43.09.260, this information is submitted to you in connection with the
audit of the City of Federal Way, for the year ending December 31, 2020.
Specific information with respect to pending lawsuits, claims and actions, the probable or
actual outcome of such claims and suits, and the nature and amount of any other direct or indirect
liabilities of the City of Federal Way are as follows:
I. LITIGATION
A. CASES FILED PRIOR TO OR IN 2020 AND RESOLVED IN 2020 or 2021
1. Branden Gonzalez vs. City of Federal Way, King County Superior Court, No. 20-2-
01880-5 KNT
The City was served on January 27, 2020. Plaintiff sustained injuries when he was struck by
a north -bound vehicle as he was crossing Pacific Hwy S at S Dash Point Rd. Plaintiff alleges
City staff were negligent in operating the Opticom system (an automatic system for controlling
traffic signals in response to approaching emergency vehicles) and the Ilse of Opticom created an
unreasonable risk to the plaintiff who was lawfully crossing the highway.
The City settled the lawsuit through negotiations.
Washington State Auditor
June 24, 2021
Page 2 of 5
2. NIichaeI Garrett vs. City of Federal Way, et al., Untied States District Court, Western
Division No. 2:19-cf-01916
The City received the lawsuit by U.S. Mail on December 3, 2019. The complaint alleges civil
rights claims under 42 U.S.0 § 1983 Fourth Amendment excessive force, battery, infliction of
emotional harm, and Respondent Superior for injuries sustained by Plaintiff when a police dog
("K-9") bit his leg during an arrest.
Plaintiff alleges that officers used excessive force by using the K-9 instead of a less lethal
force such as chemical spray, batons, etc. Plaintiff alleges he was complying with the officer's
orders at the time the K-9 apprchcnded him, even though he admits to yelling at the officers to
shoot him in the head while pointing at his heart and chest.
The City settled the lawsuit through negotiations.
3. Zakee Shakir vs. llichard Adams, United States District Court, Western Division No.
C18-1333-RSL-JPD
Plaintiff alleges that City of Federal Way officer Richard Adams intentionally used false
statements in order to have plaintiff incarcerated and charged with felony crimes.
A magistrate recommended the action be dismissed on summary judgment on April 12, 2019.
Plaintiff objected to the report and recommendation of the court. The Court confirmed its
dismissal on June 18, 2019. Plaintiff appealed the matter to the U.S. Court of Appeals, 9`h
Circuit. The 9th Circuit Court affirmed the dismissal in August. The Plaintiff pctitioncd the Court
for a rehearing which was denied on November 3, 2020.
B. CASES FILED IN 2021 THAT REMAIN PENDING
1. Aleksey Zorchenko vs. City of Federal Way, et. A., King County Superior Court No.
21-2-06919-0 SEA
The City was served on May 27, 2021. Plaintiff sustained injuries when he was pinned under
a vehicle driving by an alleged drunk driver. A Federal Way police officer was investing a rear -
collision that Mr. Zorchenko was involved in prior to the secondary collision where the alleged
drunk driver hit the police vehicle, that was parked behind the original collision, and then hit one
of the vehicles involved in the original collision and continued onto the shoulder pinning Mr.
Zorchenko under his vehicle. Plaintiff claims that the officer was negligent because she had not
parked her vehicle at the appropriate angle and allegedly did not have her safety lighting
activated.
The case is in the initial stage; however, the City believes it will prevail. Trial is scheduled
for May 23, 2022. Defense is being handled through WCIA.
C. CASES FILED PRIOR TO OR IN 2020 THAT REMAIN PENDING
Washington State Auditor
June 24, 2021
Page 3 of 5
1. NIelunv Mich (;Iiit"diun fr)r'.1.w. cl al. vs. Ci ty of I+edcraI Way, King County Superior
Court No. 19-2-08791-9 KNT
The City was served on April 4, 2019. Plaintiff alleges the City was negligent in the design,
placement, maintenance of a crosswalk and nearby foliage, that the sidewalk was not safe for
ordinary pedestrian travel including children who attend a nearby school, and infliction of
emotion distress.
Minor child, J.W., was hit by a driver while using a marked crosswalk with flashing warning
lights to cross a multi -lane road on his way to school on September 22, 2016.
The case is in the final states of discovery; however, the City believes it will prevail. Trial is
currently scheduled for October 25, 2021.
2. _Cara] Williams, vs. Citv of Federal Wes, of al., King County Superior Court No. 21-2-
01698-3 KNT
The City was served on November 4, 2019. Plaintiff alleges negligence under the Federal
Tort Claim Act for injuries sustained when she tripped and fell on a sidewalk outside Villa Capri
Apartments. Plaintiff stopped her vehicle by the curb to check her mailbox located in a row of
community mailboxes when she tripped on an exposed bolt protruding from the sidewalk.
The United States District Court, Western Division, granted defendant, United States Post
Office their motion to dismiss them as a party to the action on December 22, 2020. Plaintiff then
was required to refile the lawsuit in Superior Court.
Discovery is being conducted. Trial is currently scheduled for September 13, 2021.
3. Yolie FeIiz-Bordonada vs. Daniel Keiser, et al., King County Superior Court No. 18-2-
22470-5
The City was served this lawsuit on April 24, 2020. The other co-defendants include the
driver, land developer, and designer, all of which have been involved in the lawsuit prior to the
City being included.
Plaintiff alleges that City staff were negligent in approving the design and placement of a
business sign, stop sign, stop bar, and vegetation and maintaining the intersection and crosswalk
area of the driveway leading to businesses at 335" and Pacific Hwy S.
According to the complaint, Ms. Feliz-Bordonada was traveling by bicycle south on the east
sidewalk when the Defendant Keiser failed to stop, running over Ms. Feliz-Bordonada in a large
pick-up truck, while turning right onto north Pacific Hwy.
The case is in the end stages of discovery. A motion for summary judgement is scheduled
for August 6, 2021. Trial is currently scheduled for January 3, 2022.
Washington State Auditor
June 24, 2021
Page 4 of 5
4. Rental Housing Association of Washington vs. City of Federal Way, King County
Superior Court No. 19-2-32370=1 KNT
The City was served on December 16, 2019. Plaintiff alleges various violations of state and
federal law including a takings claim and due process claims related to the passage of Federal
Way Citizen's Initiative 19-001 related renter protections.
Initiative 19-001 was on the November 5, 2019, election ballot, which was passed by the
voters. The initiative provided for various rights and obligations by landlords and tenants to
protect their rights.
The case is in discovery. Trial is currently scheduled for November 29, 2021.
5. Graham Coniractin Ltd. vs. Ci of Federal Way. King County Superior Court No.
20-2-15834-8 KNT
On August 25, 2016, the City executed a $16,700,526.60 contract with Graham
Contracting, Ltd. ("Graham") to construct improvements to Pacific Highway South from S 340th
Street to S 359th Street in Federal Way. The project will add HOV lanes to Pacific Highway
South and includes new asphalt, concrete pavement, curb and gutters, sidewalks, median
construction, drainage improvements, structural retaining walls, utility undergrounding, traffic
signals and interconnect, illumination, landscaping, and other work. Graham began construction
on September 12, 2016 with 350 working days to complete the project and a substantial
completion date of February 2019.
Graham Contracting, Inc. has made claims against the City of Federal Way in King
County Superior Court, Cause No. 20-2-15834-8 KNT, under different legal theories seeking
recovery of additional costs it alleges to have incurred in completing its work with regard to the
remivation and expansion of the Pacilc Highway in Federal Way. Gi-altam seeks approximately
$12,000,000 from the City under various theories, including of City -caused delays, additional
work, defective drawings and specifications, cumulative impact, breach of the duty of good faith
and fair dealing, differing site conditions, and quantum merit/unjust enrichment. Graham also
seeks to recover from the City liquidated damages currently being withheld by the City due to
the significant delays caused by Graham in completing the project. The lawsuit is based upon
two claims made by Graham during the project, which the City reviewed and denied. Grah7nn
filed its complaint against the City in October, 2020, discovery cutoff is February 14, 2022, and
the case is currently scheduled for trial on April 4, 2022.
In response to the lawsuit, the City denied Graham's claims and asserted affirmative
defenses, including the defense that Graham waived its claims by failing to follow the
contractual notice and protest provisions of the contract. Since the lawsuit was initiated, the
parties have conducted discovery, mostly focused on production of documents. Given the length
of the project, there are over 1,000,000 documents that have been produced, and are continuing
to be produced. In addition, limited depositions have taken place. The City filed a motion for
sutnma}ry judgement, seeking dismissal of all or part of Graham's claims on the lack of notice
Washington State Auditor
June 24, 2021
Page 5 of 5
defense, which is set for oral argument on June 25, 2021. The City disputes and intends to
vigorously defend against any and all claims asserted by Graham.
II. CONCLUSION
This completes our summary of pending lawsuits, claims and actions pending against or
filed with the City of Federal Way from January 2020 through June 26, 2021. If you have any
questions about the foregoing, please call me at (253) 835-2572.
Sincerely.
J. Ryan Call
City Attorney
City of Federal Way
cc: Jim Ferrell, Mayor
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THIS IS TO CERTIFY
RAYMOND BUNK
HAS SUCCESSFULLY COMPLETED THE
CRIMINAL INTELLIGENCE SYSTEMS OPERATING POLICIES
(28 CFR PART 23) ONLINE TRAINING
ON
April 5, 2022
Training developed by the Institute for
Intergovernmental Research`on behalf of BJA
5SKFORCECENTER C FOR TATRAIN€NG
CENTER FOR TASK FORCE LEADERSHIP AND INTEGRITY
THIS IS TO CERTIFY THAT
Raymond Bunk
HAS SUCCESSFULLY COMPLETED THE
TASK FORCE COMMANDER LEADERSHIP
AND MANAGEMENT ONLINE TRAINING
ON
November 10, 2021
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Michael J. Costigatr. 4ving Director,
Bureau of Justice Assistance
CENTER FOR TASK FORCE TRAlNlMG
CENTER FOR TASK FORCE LEADERSHIP AND INTEGRITY
THIS IS TO CERTIFY THAT
Raymond Bunk
HAS SUCCESSFULLY COMPLETED THE
SAFEGUARDING PRIVACY, CIVIL RIGHTS, AND CIVIL
LIBERTIES
IN TASK FORCE OPERATIONS. ONLINE TRAINING
WINNI
November 11, 2021
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Michael J. C ostig Arsine Director,
Bureau of Justice Assistance
CenTFfCENTER FOR TASK FORGE TRAINING
CENTER FOR TASK FORCE LEADERSHIP AND INTEGRITY
THIS IS TO CERTIFY THAT
Raymond Bunk
HAS SUCCESSFULLY COMPLETED THE
EXECUTIVE LEADERSHIP
ONLINE TRAINING
ON
November 10, 2021
rj . P,X0,
Michael J. costigan ?trsi gig Director,
Bureau of Justice Assistance