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AG 03-046RETURN TO: EXT: CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM 1. ORIGINATING DEPT./DIV: 2. ORIGINATING STAFF PERSON: EXT: 2_CQ.� 1 3. DATE REQ. BY: 4. TYPE OF DOCUMENT (CHECK ONE): ❑ CONTRACTOR SELECTION DOCLJMENT (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 DOCLTMENT ❑ SECURITY DOCLJMENT (E.c. sorm �r.n�n nocuMErr'['s) o ORDINANCE • ❑ RESOLUTION ❑ CONTRACT AMENDMEN'� (AG#): � .� — � ��p ❑ INTERLOCAL � OTHER 1' 5. PROJECTNAME: MD(ii.�-: �o�uT Fkww-�J S�/�� �°l°UCRrl�,usit-MdN s�V��✓'�'�S�l���s 6. NAME OF CONTRACTOR: Cjltil�(� N � MO Al�� W ���� �, ADDRESS: —� TELE ONE ?l.tr/�1) E-MAIL: FAX: SIGNATURE NAME: TITLE 7. EXHIBITS AND ATTACHMENTS: ❑ SCOPE, WORK OR SERVICES ❑ COMPENSATION ❑ INSURANCE REQUIREMENTS/CERTIFICATE ❑ ALL OTHER REFERENCED EXHIBTTS ❑ PROOF OF AUTHORTI'Y TO SIGN ❑ REQUIItED LICENSES ❑ PRIOR CONTRACT/AMENDMENTS S. TERM: COMMENCEMENT DATE: , ZO G 3 COMPLETION DATE: ���TZI ��L._ 9. TOTAL COMPENSATION $ /?S (n I��O C����" -'� �INCLUDE EXPENSES AND SALES TAX, IF ANY� (IF CALCULATED ON HOURLY LABOR CI�GE - ATTACH SCHEDULES OF EM YEES TTfLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: ��s ❑ tvo IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED ❑ YES ❑ NO IF YES, $ PAID BY: O CONTRACTOR O CITY ❑ PURCHASING: PLEASE CHARGE TO: 10. DOCUMENT/CONTRACT REVIEW I1�IIT / DATE REVIEWED IriITIAL / DATE APPROVED ❑ PROJECT MANAGER / Z /F / 2 � ❑ DIRECTOR ❑ RISK MANAGEMENT (� �rPr.iC�sLE) ❑ LAW 11. COUNCII. APPROVAL (IF APPLICABLE� COMMITTEE APPROVAL DATE: COUNCII. APPROVAL DATE: 12: CONTRACT SIGNATURE ROUTING ❑ SENT TO VENDOR/CONTRACTOR DATE SENT: DATE REC'D: ❑ ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS IIVITIAL / DATE SIGNED ❑ LAW DEPARTMENT ❑ SIGNATORY (MAYOR OR DutEC�roR) ❑ CITY CLERK ❑ ASSIGNED AG# AG# ❑ SIGNED COPY RETURNED DATE SENT: I r-I+ �" COMMENTS: 1/9 Final Calendar Year 2013 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. , , . ,,.� ... .T . a �fi '�c aY'��... �< �,. �tt ': , ,. . „ - �. ..., . . ..... .. .. .. .. .: , , - _:�' �.' Catholic Community Services for Emergency Assistance Federal Way - Lead City $ 13,500 Covington 8,500 Burien 10,500 Renton 10,609 SeaTac 12,000 TOTAL $ 55,109 Catholic Community Services for Volunteer Chore Services Federal Way - Lead City $ 9,000 Auburn 3,000 Covington 3,000 Renton 5,000 SeaTac 5,000 TOTAL $ 25,000 Child Care Resources for Information & Referral Covington - Lead City $ 3,585 Burien 5,000 Renton 5,000 SeaTac 5,000 Tukwila 5,000 TOTAL $ 23,585 Crisis Clinic for telephone referral line and 2- 1-1 2-1-1 $1,000: 24 hr line $1,000 Auburn - Lead City $ 2,000 2-1-1$8,500; 24 hr line None Burien 8,500 2-1-1$2,000; 24 hr line $2,400 Covington 4,400 2-1-1$2,600: 24 hr line $1,700 Des Moines 4,300 2-1-1$9,000: 24 hr line $3,000 Federal Way 12,000 2-1-1$15,000; 24 hr line $5,000 Renton 20,000 2-1-1$4,500; 24 hr line $2,500 SeaTac 7,000 2-1-1$1,500; 24 hr line $2,620 Tukwila 4,120 TOTAL $ 62,320 January 2, 2013 C:\Users\denisec\AppData\Local\Miaosoft\Windows\Temporary Intemet Files\Content.0utlook\KD6N3A0}i�HumServ Joint MOU Ex A 1 of 4 Final Calendar Year 2013 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. . � � �y� � , a - �, x ., n 2� '.�i y '�y .- . .. ,.,r e-., . .. . y, « . . . ^ , . ....„N . .:: 'e. v � ... � +:"-.^:. .. .. ... . ... . . � Ga ... .:. . Crisis Clinic for Teen Link Auburn - Lead City $ 1,000 Burien 1,000 Covington 2,671 Des Moines 500 Federal Way 3,000 Renton 5,000 SeaTac 2,500 Tukwila 1,500 TOTAL $ 17,171 Domestic Abuse Women's Network (DAWN) for Community Advocacy and Crisis Line Covington - Lead City $ 8,000 Burien 2,000 Des Moines 1,000 Federal Way 5,000 RenMn 5,780 SeaTac 5,000 Tukwila 4,000 TOTAL $ 30,780 Domestic Abuse Women's Network (DAWN) for Transitional Housing (Shelter) Burien - Lead City $ 8,000 Des Moines 5,000 Federal Way 20,000 SeaTac 8,000 Tukwila 7,000 TOTAL $ 48,000 Dynamic Partners for Children with Special Needs Tukwila - Lead City $ 6,750 Auburn 10,000 Burien 5,000 Covington 9,000 Federal Way 10,000 Renton 10,200 SeaTac 13,000 TOTAL $ 63,950 HealthPoint - DENTAL Renton - Lead City $ 5,000 Covington 3,181 Des Moines 2,600 Federal Way 15,900 SeaTac 14,000 Tukwila 4,550 DENTAL TOTAL $ 45,231 January 2, 2013 C:\Users\denisec\AppDaW\Local\Microsok\Windows\Temporary Internet Files\Content.0utlook\KD6N3AOH\Hum Serv Joint MOU Fac A 2 of 4 Final Calendar Year 2013 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. , , �� �. . . � ., � ,,, . �M �'_� :� " � ���� , � � .. , ���' �? �, .. �� r,�;�i .. � HealthPoint - MEDICAL Renton - Lead City $ 28,350 Burien 10,000 Covington 4,000 Des Moines 4,900 Federal Way 15,000 SeaTac 47,000 Tukwila 5,000 MEDICAL TOTAL $ 114,250 King County Sexual Assault Resource Center (KCSARC) for Comprehensive Sexual Assault Services Covington - Lead City $ 4,864 Auburn 22,500 Burien 7,500 Renton 32,000 Des Moines 4,100 Federal Way 25,000 SeaTac 8,100 Tukwila 8,305 TOTAL $ 112,369 Multi-Service Center for Emergency Shelter and Transitional Housing Burien - Lead City 4,000 Des Moines 4,000 Federal Way 38,000 Renton 6,631 SeaTac 7,000 Tukwila 4,000 TOTAL $ 63,631 Senior Services for Meals on Wheels Renton - Lead City $ 10,000 Auburn 7,000 Burien 5,000 Des Moines 3,750 Federal Way 10,000 SeaTac 11,000 Tukwila 7,079 TOTAL $ 53,829 Senior Services for Volunteer Transportation Services and Senior Shuttles Renton - Lead City $ 11,180 Auburn 5,000 Burien (Sr. Shuttle) 2,000 Des Moines (Sr. Shuttle) 500 Federal Way 10,000 SeaTac 4,000 Tukwila 2,048 TOTAL $ 34,728 January 2, 2013 C:\Usen\denisec\AppData\Local\Microsok\ Windows\Temporary Intemet Files\Contmt.0utlook\KD6N3AOH\Hum Serv Joint MOU Ex A 3 of 4 Final Calendar Year 2013 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Summary of Lead Cities: Auburn: Crisis Clinic - 2-1-1 & 24 hr line Crisis Clinic - Teen Link Burien: DAWN - Shelter Multi-Service Center -Emergency Housing Covington: Childcare Resources - Info & Referral DAWN - DV Advocacy/Crisis Line KSCARC Federal Way: CCS - Emergency Assistance CCS - Volunteer Chore Services Renton: HealthPoint - Dental HealthPoint- Medical Senior Services - Meals on Wheels Senior Services - Volunteer Transportation Tukwila: Dynamic Partners Jan,�ary 2 2013 C:\Users\denisec\AppData\LOCaI\Microsok\Windows\Temporary Intemet Files\Content.0utlook\KD6N3AOFI�HumServ Joint MOU Ex A 4 of 4 II RETURN TO: CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATION/DOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPT.IDIV: CD/HS 2. ORIGINATING STAFF PERSON: KELLI O'DONNELL EXT: 2653 3. DATEREQ. BY: 04/21/09 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) D CONTRACTOR SELECTION DOCUMENT (E. G, RFB, RFP, RFQ) D PUBLIC WORKS CONTRACT D SMALL PUBLIC WORKS CONTRACT D PROFESSIONAL SERVICE AGREEMENT D MAINTENANCE AGREEMENT D GOODS AND SERVICE AGREEMENT D HUMAN SERVICES / CDBG D REAL ESTATE DOCUMENT D SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) D ORDINANCE ~SOLUTION D CONTRACT AMENDMENT (AG#): C> '3- O'-\{o X OTHER ANNUALEXHIBITATO AG 03-046 2 09 5. PROJECT NAME: MOU RE: JOINT HUMAN SERVICES APPLICATIONS AMONG SEVERAL JURISDICTIONS 6. NAME OF CONTRACTOR: TuKWILA ADDRESS: SIGNATURE NAME: AUBURN, BURIEN, COVINGTON. DES MOINES, FEDERAL WAY. KENT, RENTON, SEATAC AND VARIOUS TELEPHONE TITLE 7. EXHIBITSANDATTACHMENTS:D SCOPE, WORK OR SERVICES D COMPENSATION D INSURANCE REQUIREMENTS/CERTIFICATE D ALL OTHER REFERENCED EXHIBITS D PROOF OF AUTHORITY TO SIGN D REQUIRED LICENSES D PRIOR CONTRACTI AMENDMENTS 8. TERM: COMMENCEMENT DATE: APRIL 3. 2003 COMPLETION DATE: PERPETUAL 9. TOTAL COMPENSATION $ 123.100 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: DYES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED D YES X NO IF YES, $ PAID BY: D CONTRACTOR 0 CITY D PURCHASING: PLEASE CHARGE TO: Various 10. CONTRACT REVIEW p-pROJECTMANAGER D DIRECTOR D SIGNATORY (CM, ACM, OR DIRECTOR) D RISK MANAGEMENT (IF APPLICABLE) DLAW INITIAL/DATERE~ 4/1 'i:(O'1~.zJ " INITIAL I DATE APPROVED 11. CONTRACT SIGNATURE ROUTING D SENT TO VENDOR/CONTRACTOR DATE SENT: ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS DATE REC'D: INITIAL/DATE SIGNED D LAW DEPARTMENT D SIGNATORY (CM, ACM, OR DIRECTOR) D CITY CLERK D ASSIGNEDAG# D SIGNED COpy RETURNED AG# DATE SENT: COMMENTS: Update City Clerk Agreement file to include annual update to Exhibit A outlining participating cities funding for joint projects. 4/9 FINAL - 1 Calendar Year 2009 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Catholic Community Services for Emergency Assistance Renton - Lead City' $ 10,609 Covington 8,500 Burien 10,500 SeaTac 8,000 TOTAL $ 37,609 Catholic Community Services for Volunteer Chore Services Renton - Lead City $ 5,000 Federal Way 5,000 SeaTac 4,000 TOTAL $ 14,000 Childcare Resources for Resource & Referral Covington - Lead City $ 3,360 Burien 5,000 Renton 10,289 SeaTac 4,000 Tukwila 5,000 TOTAL $ 27,649 Dynamic Family Services (previously Children's Therapy Center) for Early Intervention Tukwila - Lead City $ 5,750 Covington 8,000 SeaTac 3,500 TOTAL $ 17,250 Crisis Clinic for telephone referral line and 2- 1-1 2-1-1 $1,000: 24 hr line $1,000 Auburn - Lead City $ 2,000 2-1-1 $3,000; 24 hr line None Burien 3,000 2-1-1 $1,800; 24 hr line $2,000 Covington 3,800 2-1-1 $1,500: 24 hr line $1,500 Des Moines 3,000 2-1-1 $5,000; 24 hr line $3,000 Federal Way 8,000 2-1-1 $5,500; 24 hr line $5,000 Renton 10,500 2-1-1 $4,000; 24 hr line $2,000 SeaTac 6,000 2-1-1 $1,500; 24 hr line $1,500 Tukwila 3,000 TOTAL $ 39,300 C:\Documents and Settings\kellio\Local Settings\ Temporary Internet FiIes\Conlent.Outlook\FCGY86CG\Hum Serv Joint MOU Ex A.xIsx March 6, 2009 Page 1 of 3 FINAL -1 Calendar Year 2009 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Crisis Clinic for Teen Link HealthPoint (formerly Community Health Center) - DENTAL HealthPoint (formerly Community Health Center) - MEDICAL HealthPoint (formerly Community Health Center) - NATURAL MEDICINE Auburn - Lead City Burien Covington Des Moines Federal Way Renton SeaTac Tukwila TOTAL $ Renton - Lead City Covington Des Moines SeaTac Tukwila DENTAL TOTAL $ Renton - Lead City Covington Des Moines Federal Way SeaTac Tukwila MEDICAL TOTAL $ Renton - Lead City $ Covington Des Moines SeaTac Tukwila Natural Health TOTAL $ King County Sexual Assault Resource Center (KCSARC) for sexual assault services Covington - Lead City $ Auburn Burien Renton Des Moines Federal Way SeaTac Tukwila TOTAL $ C:\Documents and Settings\kelIio\LocaI Settings\ Temporary Internet FiIes\Content.Outlook\FCGY86CG\Hum Serv Joint MOU Ex A.xlsx $ 1,000 1,000 1,800 1,000 3,000 4,000 1,000 1,500 14,300 $ 13,300 3,000 1,000 11,054 4,000 32,354 $ 25,280 4,000 3,000 24,100 39,000 5,000 100,380 5,655 2,000 400 1,000 2,000 11,055 3,540 22,500 7,400 32,000 4,000 30,000 7,800 7,984 115,224 March 6, 2009 Page2of3 FINAL -1 Calendar Year 2009 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Multi-Service Center for Transitional Housing/Shelter Federal Way - Lead City $ Burien Des Moines Renton SeaTac Tukwila TOTAL $ Senior Services for Meals on Wheels Renton - Lead City $ Burien Des Moines Federal Way SeaTac Tukwila TOTAL $ Senior Services for Volunteer Transportation Services Renton - Lead City $ Burien (Sr. Shuttle) Des Moines (Sr. Shuttle) Federal Way SeaTac Tukwila TOTAL $ Summary of Lead Cities: Auburn: Crisis Clinic - 2-1-1 & 24 hr line Crisis Clinic - Teen Link Covington: Childcare Resources KSCARC Federal Way: Multi-Service Center -Transitional Housing Renton: CCS - Emergency Assistance CCs... Volunteer Chore Services HealthPoint - Dental HealthPoint- Medical HealthPoint - Natural Medicine Senior Services - Meals on Wheels Senior Services - Transportation Tukwila: Dynamic Family Services C:\ Documents and Settings\keIlio\LocaI Settings\ Temporary Internet Files\ContenI.OutIook\FCGY86CG\Hum Serv Joint MOU Ex A.xlsx 38,000 3,000 3,000 8,000 6,000 3,800 61,800 10,000 5,000 3,750 10,000 10,000 6,873 45,623 7,950 2,000 1,000 5,000 2,500 1,749 20,199 March 6, 2009 Page 3of3 II RETURN TO: CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPT.IDIV: CD/HS 2. ORIGINATING STAFF PERSON: KELLI O'DONNELL 3. DATEREQ.BY: 04/21/09 EXT: 2653 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) D CONTRACTOR SELECTION DOCUMENT (E. G, RFB, RFP, RFQ) D PUBLIC WORKS CONTRACT 0 SMALL PUBLIC WORKS CONTRACT D PROFESSIONAL SERVICE AGREEMENT D MAINTENANCE AGREEMENT D GOODS AND SERVICE AGREEMENT D HUMAN SERVICES / CDBG D REAL ESTATE DOCUMENT D SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) D ORDINANCE ~RESOLUTION D CONTRACT AMENDMENT (AG#): 03-0L.\-Lo ) X OTHER ANNUAL EXHIBITATO AG 03-046 2 08 5. PROJECT NAME: MOD RE: JOINT HUMAN SERVICES ApPLICATIONS AMONG SEVERAL JURISDICTIONS 6. NAME OF CONTRACTOR: TuKWILA ADDRESS: SIGNATURE NAME: AUBURN. BURIEN. COVINGTON, DES MOINES. FEDERAL WAY. KENT, RENTON. SEATAC. AND VARIOUS TELEPHONE TITLE 7. EXHIBITS AND ATTACHMENTS: D SCOPE, WORK OR SERVICES D COMPENSATION D INSURANCE REQUIREMENTS/CERTIFICATE D ALL OTHER REFERENCED EXHIBITS D PROOF OF AUTHORITY TO SIGN D REQUIRED LICENSES D PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: APRIL 3. 2003 COMPLETION DATE: PERPETUAL 9. TOTAL COMPENSATION $ 119.100 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: D YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED D YES X NO IF YES, $ PAID BY: 0 CONTRACTOR 0 CITY D PURCHASING: PLEASE CHARGE TO: Various 10. ~NTRACTREVIEW P PROJECT MANAGER D DIRECTOR D SIGNATORY (CM, ACM, OR DIRECTOR) D RISK MANAGEMENT (IF APPLICABLE) DLAW INITIAL/DATE~ITIAL/DATEAPPROVED ~n il<f/Dq 11. CONTRACT SIGNATURE ROUTING D SENT TO VENDOR/CONTRACTOR DATE SENT: ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS DATE REC'D: INITIAL/ DATE SIGNED D LAW DEPARTMENT D SIGNATORY (CM, ACM, OR DIRECTOR) D CITY CLERK D ASSIGNED AG# D SIGNED COPY RETURNED AG# DATE SENT: COMMENTS: Update City Clerk Agreement file to include annual update to Exhibit A outlining participating cities funding for joint projects. 4/9 FINAL Calendar Year 2008 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services a lication and fundin TO ram. Catholic Community Services for Emergency Assistance SeaTac 8,000 TOTAL $ 51,000 Catholic Community Services for Volunteer Chore Services Renton - Lead City $ 5,000 Auburn 1,500 Federal Way 4,000 SeaTac 3,000 TOTAL $ 13,500 Childcare Resources for Resource & Referral Covington - Lead City $ 2,340 Burien 4,000 Renton 7,800 SeaTac 2,000 Tukwila 5,000 TOTAL $ 21,140 Children's Home Society for Strenghthening Families Auburn -Lead City $ 10,000 Federal Way 5,000 Kent 10,000 TOTAL $ 25,000 Kent - Lead City Covington Des Moines Renton Tukwila $ 35,000 7,500 1,000 10,000 5,000 58,500 TOTAL $ C:\DOCUME-l\default\LOCAlS-l\Temp\XPgrpwise\Hum Serv Joint MOU Ex A January 9, 2008 Page 1 of 4 FINAL Calendar Year 2008 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services a lication and fundin ro ram. Community Health Centers for primary DENTAL services for low and moderate income persons. Community Health Centers for comprehensive MEDICAL services for low and moderate income persons. Community Health Center - Natural Medicine Crisis Clinic for telephone referral line and 2-1-1 2-1-1 $1,500; 24 hr line $2,000 2-1-1 None; 24 hr line $1,000 telephone serv $5,000 2-1-1 $5,500; 24 hr line $5,500 2-1-1 $2,550; 24 hr line $2,500 2-1-1 $4,000; 24 hr line $2,000 2-1-1 $1,500; 24 hr line $1,302 Crisis Clinic for Teen Link C:\IXJCUME-l\defauIt\LOCALS-l \ Temp\XPgrpwise\Hum Serv Joint MOU Ex A Kent - Lead City Covington Renton SeaTac Tukwila DENTAL TOTAL $ $ 20,000 2,160 19,000 5,000 2,500 48,660 $ Kent - Lead City Auburn Federal Way Renton SeaTac Tukwila MEDICAL TOTAL $ Renton - Lead City $ Covington Federal Way Natural Health TOTAL $ Auburn - Lead City Covington Des Moines Kent Federal Way Renton SeaTac Tukwila TOTAL $ Auburn - Lead City Covington Des Moines Federal Way Renton SeaTac Tukwila TOTAL $ 31,600 30,000 38,400 3,000 174,956 5,000 2,000 5,000 12,000 $ 5,000 3,500 1,000 5,000 11,000 5,050 6,000 2,802 39,352 $ $ 1,000 1,800 1,000 4,000 2,000 1,000 1,000 11,800 January 9, 2008 Page2of4 FINAL Calendar Year 2008 Exhibit A to Memorandum of Understanding (MOD) between the Cities for planning, funding, and implementation of a joint human services a lication and fundin ro am. King County Sexual Assault Resource Center (KCSARC) for sexual assault services Multi-Service Center for Transitional Housing/ Shelter Pregnancy Aid of South King County for Services for Pregnant Women and their children (Des Moines location) Senior Services for Meals on Wheels Senior Services for Volunteer Transportation Services C:\lXXUME-l\defauIt\LGCALS-l\ Temp\XPgrpwise\Hum Serv Joint MOU Ex A Renton - Lead City Auburn Burien Covington Des Moines Kent Federal Way SeaTac Tukwila TOTAL $ Kent - Lead City Des Moines Renton SeaTac Tukwila TOTAL $ $ 37,000 22,500 7,000 3,340 4,000 21,000 36,000 7,450 14,000 152,290 $ 40,000 2,500 5,000 5,200 3,800 56,500 Tukwila TOTAL $ Renton - Lead City Auburn 2,000 7,700 $ 10,000 7,000 Federal Way SeaTac Tukwila TOTAL $ Renton - Lead City Auburn Des Moines Federal Way SeaTac Tukwila TOTAL $ 9,500 10,000 5,600 44,600 $ 7,350 5,000 1,000 6,000 2,500 1,764 23,614 January 9, 2008 Page3of4 Washington Women's Employment and Education for the REACH Plus Program Kent - Lead City Renton SeaTac $ 35,000 10,000 2,000 47,000 TOTAL $ Summary of Lead Cities: Auburn: Children's Home Society Crisis Clinic - 2-1-1 & 24 hr line Crisis Clinic - teen link Covington: Childcare Resources Federal Way: Pre aney Aid Kent: Comm Health Or - Dental Comm Health Ctr - Medical Multi-Service Ctr - transitional housing Wash Womens Emplymt & Educ - REACH Renton: CCS - Emergency Assistance CCS- Volunteer Chore Services Comm Health Ctr - Natural Medicine KSCARC Senior Services - Meals on Wheels Senior Services - Transportation January 9, 2008 C:\DOCUME-l\defauIt\LOCALS-l\Temp\XPgrpwise\HumServ ]ointMOU ExA Page 4 of 4 TI RETURN TO: CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATION/DOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPTIDIV: CD/HS EXT: 2653_ 3. DATEREQ. BY: 04/21/09 2. ORIGINATING STAFF PERSON: KELLI O'DONNELL 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) D CONTRACTOR SELECTION DOCUMENT (E. G, RFB, RFp, RFQ) D PUBLIC WORKS CONTRACT D SMALL PUBLIC WORKS CONTRACT D PROFESSIONAL SERVICE AGREEMENT D MAlNTENANCEAGREEMENT D GOODS AND SERVICE AGREEMENT D HUMAN SERVICES 1 CDBG D REAL ESTATE DOCUMENT D SECURITYDOCUMENT(EG.BONDRELATEDDOCUMENTS) D ORDINANCE 0 RESOLUTION D CONTRACT AMENDMENT (AG#): 03-o~(I X OTHER ANNUAL EXHIBITATO AG 03-046 2007 5. PROJECT NAME: MOD RE: JOINT HUMAN SERVICES ApPLICATIONS AMONG SEVERAL JURISDICTIONS 6. NAME OF CONTRACTOR: TuKWILA ADDRESS: SIGNATURE NAME: AUBURN. BURIEN. COVINGTON. DES MOINES. FEDERAL WAY, KENT, RENTON. SEATAC. AND VARIOUS TELEPHONE TITLE 7. EXHIBITS AND ATTACHMENTS: D SCOPE, WORK OR SERVICES D COMPENSATION D INSURANCE REQUIREMENTS/cERTIFICATE D ALL OTHER REFERENCED EXHIBITS D PROOF OF AUTHORITY TO SIGN D REQUIRED LICENSES D PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: APRIL 3. 2003 COMPLETION DATE: PERPETUAL 9. TOTAL COMPENSATION $ 114.600 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: DYES XNO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED D YES X NO IF YES, $ PAID BY: D CONTRACTOR 0 CITY D PURCHASING: PLEASE CHARGE TO: Various 10. CONTRACT REVIEW flPROJECTMANAGER D DIRECTOR o SIGNATORY (CM, ACM, OR DIRECTOR) D RISK MANAGEMENT (IF APPLICABLE) DLAW INITIAL/DA1E~ ~ 4{,<t{~ / y INITIAL/ DATE APPROVED 11. CONTRACT SIGNATURE ROUTING D SENT TO VENDOR/CONTRACTOR DATE SENT: ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS DATEREC'D: INITIAL 1 DATE SIGNED D LAW DEPARTMENT D SIGNATORY (CM, ACM, OR DIRECTOR) D CITY CLERK D ASSIGNED AG# D SIGNED COPY RETURNED AG# DATE SENT: COMMENTS: Update City Clerk Agreement file to include annual update to Exhibit A outlining participating cities funding for joint projects. 4/9 .. ~ FINAL f' Calendar Year 2007 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Renton - Lead City $ 10,000 Covington 5,400 Burien 10,000 Des Moines 3,000 Federal Way 7,000 SeaTac 8,000 TOT AL $ 43,400 . Catholic Community Services for Volunteer Chore Services Renton - Lead City $ 5,000 Auburn 1,500 Federal Way 4,000 SeaTac 3,000 TOTAL $ 13,500 Covington - Lead City $ 2,340 Burien 4,000 Renton 7,800 SeaTac 2,000 Tukwila 5,000 TOT AL $ 21,140 Auburn -Lead City $ 10,000 Federal Way 5,000 Kent 10,000 TOT AL $ 25,000 Kent - Lead City $ 35,000 Covington 7,500 Des Moines 1,000 Renton 10,000 Tukwila 5,000 TOTAL $ 58,500 C:\Documcnts and Settings\De.f<luJt\ Local 5ettings\Temr\Hum Serv Joint r-.l0U Ex A.xls January 11, 2007 Page 1 of 4 I HNM Calendar Year 2007 Exhibit A to Memorandum of Understanding (MOD) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Community Health Centers for primary DENTAL services for low and moderate income persons. Kent - Lead City Covington Renton SeaTac Tukwila DENTAL TOTAL $ Community Health Centers for comprehensive MEDICAL services for low and moderate income persons. Kent - Lead City Auburn Covington Des Moines Federal Way Renton SeaTac Tukwila Crisis Clinic for telephone referral line and 2-1-1 2-1-1 $1,500; 24 hr line $2,000 2-1-1 None; 24 hr line $1,000 telephone serv $5,000 2-1-1 $5,500; 24 hr line $5,500 2-1-1 $2,550; 24 hr line $2,500 2-1-1 $4,000; 24 hr line $2,000 2-1-1 $1,500; 24 hr line $1,302 C\DOCUlllents and Settings\ Defdu1t\LocaJ Settings\Temp\ Hum Serv Joint t\10U Ex A.xls MEDICAL TOTAL $ Renton - Lead City $ Covington Federal Way Natural Health TOTAL $ Auburn - Lead City Covington Des Moines Kent Federal Way Renton SeaTac Tukwila TOTAL $ $ 20,000 2,160 19,000 5,000 2,500 48,660 $ 57,000 8,536 3,420 2,500 31,600 30,000 38,400 3,000 174,456 5,000 2,000 5,000 12,000 $ 5,000 3,500 1,000 5,000 11,000 5,050 6,000 2,802 39,352 January 11, 2007 Page 2 of 4 t FINAL Calendar Year 2007 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Crisis Clinic for Teen Link Auburn - Lead City $ 1,000 Covington $ 1,800 Des Moines 1,000 Federal Way 4,000 Renton 2,000 SeaTac 1,000 Tukwila 1,000 TOTAL $ 11,800 King County Sexual Assault Resource Center (KCSARC) for sexual assault services Renton - Lead City $ 37,000 Auburn 22,500 Burien 7,000 Covington 3,340 Des Moines 4,000 Kent 21,000 Federal Way 36,000 SeaTac 7,450 Tukwila 14,000 TOTAL $ 152,290 Multi-Service Center for Transitional Housing/ Shelter Kent - Lead City $ 40,000 Des Moines 2,500 Renton 5,000 SeaTac 5,200 Tukwila 3,800 TOTAL $ 56,500 Pregnancy Aid of Sou th King County for Services for Pregnant Women and their children (Des Moines location) Federal Way - Lead City $ 4,500 Des Moines 1,000 Tukwila 2,000 TOT AL $ 7,500 . C\Doruments and Settings\Defoull\Local Settings\ Temp\Hum Serv Joint MOU Ex A.xIs January 11, 2007 Page 3 of 4 ... . .. FINAL Calendar Year 2007 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Senior Services for Meals on Wheels Renton - Lead City $ 10,000 Auburn 7,000 Des Moines 2,000 Federal Way 9,500 SeaTac 10,000 Tukwila 5,600 TOTAL $ 44,100 Senior Services for Volunteer Transportation Services Renton - Lead City $ 7,350 Auburn 5,000 Des Moines 1,000 Federal Way 6,000 SeaTac 2,500 Tukwila 1,764 TOTAL $ 23,614 Washington Women's Employment and Education for the REACH Plus Program Kent - Lead City $ 35,000 Renton 10,000 SeaTac 2,000 TOTAL $ 47,000 Summary of Lead Cities: Auburn: Children's Home Society Crisis Clinic - 2-1-1 & 24 hr line Crisis Clinic - teen link Covington: Childcare Resources Federal Way: Pregnancy Aid Kent: Children's Therapy Center Comm Health Ctr - Dental Comm Health Ctr - Medical Multi-Service Ctr - transitional housing Wash Womens Emplymt & Educ - REACH Renton: CCS - Emergency Assistance CCS- Volunteer Chore Services Comm Health Ctr - Natural Medicine KSCARC Senior Services - Meals on Wheels Senior Services - Transportation New agency added in 2007 C\ Documents and Settings\ Default\ LocdISetlings\Temp\ Hum Serv Joint MOU Ex Axis January 11, 2007 Page 4 of 4 II RETURN TO: CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPTIDIV: CD/HS 2. ORIGINATING STAFF PERSON: KELLI O'DONNELL EXT: 2653 3. DATEREQ. BY: 04/21/09 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) D CONTRACTOR SELECTION DOCUMENT (E. G, RFB, RFP, RFQ) D PUBLIC WORKS CONTRACT D SMALL PUBLIC WORKS CONTRACT D PROFESSIONAL SERVICE AGREEMENT D MAINTENANCE AGREEMENT D GOODS AND SERVICE AGREEMENT D HUMAN SERVICES 1 CDBG D REAL ESTATE DOCUMENT D SECURITY DOCUMENT (EGBONDRELATEDDOCUMENTS) D ORDINANCE D RESOLUTION D CONTRACT AMENDMENT (AG#): 03- 04Lo ~ x OTHER ANNUAL EXHIBIT A TO AG 03-046 2006 5. PROJECT NAME: MOU RE: JOINT HUMAN SERVICES ApPLICATIONS AMONG SEVERAL JURISDICTIONS 6. NAME OF CONTRACTOR: TuKWILA ADDRESS: SIGNATURE NAME: AUBURN. BURIEN, COVINGTON. DES MOINES. FEDERAL WAY, KENT. RENTON. SEATAC. AND VARIOUS TELEPHONE TITLE 7. EXHIBITS AND ATTACHMENTS: D SCOPE, WORK OR SERVICES D COMPENSATION D INSURANCE REQUIREMENTS/CERTIFICATE D ALL OTHER REFERENCED EXHIBITS D PROOF OF AUTHORITY TO SIGN D REQUIRED LICENSES D PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: APRIL 3, 2003 COMPLETION DATE: PERPETUAL 9. TOTALCOMPENSATION$ 113,077 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: D YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED D YES X NO IF YES, $ PAID BY: D CONTRACTOR 0 CITY D PURCHASING: PLEASE CHARGE TO: Various 10. CONTRACT REVIEW Ji PROJECT MANAGER D DIRECTOR D SIGNATORY (CM, ACM, OR DIRECTOR) D RISK MANAGEMENT (IF APPLICABLE) DLAW INITIAL/DATERE~~~TIAL/DM'EAPPROVED ~ 4!t<f(O . 11. CONTRACTSIGNATUREROUTING D SENT TO VENDOR/CONTRACTOR DATE SENT: ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL/ DATE SIGNED DATE REC'D: D LAW DEPARTMENT D SIGNATORY (CM, ACM, OR DIRECTOR) D CITY CLERK D ASSIGNED AG# D SIGNED COPY RETURNED AG# DATE SENT: COMMENTS: Update City Clerk Agreement file to include annual update to Exhibit A outlining participating cities funding for joint projects. 4/9 - .. FINAL Calendar Year 2006 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Crisis Clinic for telephone referral line Crisis Clinic for Teen Link Pregnancy Aid of South King County for Services for Pregnant Women and their children (Des Moines location) Washington Women's Employment and Education for the REACH Plus Program YWCA for the Domestic Violence Services Program Hum Serv Joint MOU Ex A.xls Auburn - Lead City Burien Covington Des Moines Kent Federal Way Renton SeaTac Tukwila 4,500 5,000 2,500 5,000 TOT AL $ Auburn - Lead City Covington $ Des Moines Federal Way Renton SeaTac Tukwila 3,300 4,985 2,000 42,285 1,500 1,500 TOTAL $ Federal Way - Lead City $ SeaTac Tukwila TOTAL $ 1,000 1,500 1,000 9,500 4,000 3,600 2,000 9,600 Federal Way - Lead City Auburn Kent SeaTac TOTAL $ Federal Way - Lead City $ Auburn Kent Tukwila TOTAL $ 6,000 35,000 4,500 50,500 4,000 33,000 30,000 25,000 92,000 January 23, 2006 Page 1 of 3 - FINAL Calendar Year 2006 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Community Health Centers for primary DENTAL services for low and moderate income persons. Kent - Lead City $ 15,000 Covington 2,000 SeaTac 5,000 Tukwila 2,000 DENTAL TOTAL $ 24,000 Community Health Centers for comprehensive MEDICAL services for low and moderate income persons. Kent - Lead City $ 58,450 Auburn 32,000 Covington 3,200 Federal Way 31,827 Renton 24,000 SeaT ac 5,000 Tukwila 2,000 MEDICAL TOTAL $ 156,477 Multi-Service Center for Transitional Housing/ Shelter Kent - Lead City $ 40,000 Auburn 8,200 Des Moines Renton 2,000 SeaTac 5,200 Tukwila 3,000 TOT AL $ 61,000 King County Sexual Assault Resource Center (KCSARC) for sexual assault services Renton - Lead City $ 35,000 Auburn 26,500 Burien 7,500 Covington 3,605 Des Moines Kent 20,600 Federal Way 36,050 SeaTac 7,416 Tukwila 14,000 TOTAL $ 154,771 Hum Serv Joint MOU Ex A.xls January 23, 2006 Page 2 of 3 .. - ... FINAL Calendar Year 2006 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Catholic Community Services for Volunteer Chore Services Senior Services for Meals on Wheels Senior Services for Volunteer Transportation Services Hum Serv Joint MOU Ex A.xls Renton - Lead City $ 5,000 Auburn 5,000 Burien 8,000 Federal Way 4,000 Kent 5,000 SeaTac 3,000 TOTAL $ 30,000 Renton - Lead City $ 6,000 Auburn 7,000 Des Moines Federal Way 9,500 SeaTac 7,700 Tukwila 7,000 TOT AL $ 39,200 Renton - Lead City $ Auburn Des Moines Federal Way Kent SeaTac Tukwila TOTAL $ Changes from 2005 amts = 6,000 5,000 1,000 5,700 7,500 2,275 1,692 29,167 January 23, 2006 Page 3 DB TI RETURN TO: ~ CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATION/DOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPT.IDIV: CD/HS 2. ORIGINATING STAFF PERSON: KELLI O'DONNELL EXT: 2653 3. DATEREQ. BY: 4. TYPE OF DOCUMENT REQUESTED (CHECK ONE) D CONTRACTOR SELECTION DOCUMENT (E.G, RFB, RFP, RFQ) I L D PUBLIC WORKS CONTRACT 0 SMALL PUBLIC WORKS CONTRACT PilO.: ,f)~~ o PROFESSIONAL SERVICE AGREEMENT D MAINTENANCE AGREEMENT ~ D GOODS AND SERVICE AGREEMENT D HUMAN SERVICES 1 CDBG D REAL ESTATE DOCUMENT r'\AI/'l D SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) D ORDINANCE O<>.....(/\V D RESOLUTION X CONTRACT AMENDMENT (AG#): ADDING CITY OF COVINGTON TO MOU 2.a?s- D OTHER 5. PROJECT NAME: MOU RE: JOINT HUMAN SERVICES APPLICATIONS AMONG SEVERAL JURISDICTIONS 6. NAME OF CONTRACTOR: TuKWILA ADDRESS: SIGNATURE NAME: AUBURN. BURIEN. COVINGTON. DES MOINES, FEDERAL WAY. KENT. RENTON. SEATAC. AND VARIOUS TELEPHONE TITLE 7. EXHIBITSANDATTACHMENTS:D SCOPE, WORK OR SERVICES D COMPENSATION D INSURANCE REQUIREMENTS/CERTIFICATE D ALL OTHER REFERENCED EXHIBITS D PROOF OF AUTHORITY TO SIGN D REQUIRED LICENSES D PRIOR CONTRACT/AMENDMENTS 8. TERM: COMMENCEMENT DATE: APRIL 3,2003 COMPLETION DATE: PERPETUAL 9. TOTAL COMPENSATION $ 91.450 (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: DYES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED D YES X NO IF YES, $ PAID BY: D CONTRACTOR 0 CITY D PURCHASING: PLEASE CHARGE TO: Various 10. CONTRACT REVIEW P(PROJECT MANAGER D DIRECTOR D SIGNATORY (CM, ACM, OR DIRECTOR) D RISK MANAGEMENT (IF APPLICABLE) DLAW ~/DATE~ 4/ Jq{ otf INITIAL/DATEAPPROVED 11. CONTRACT SIGNATURE ROUTING D SENT TO VENDOR/CONTRACTOR DATE SENT: ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS INITIAL/DATE SIGNED DATEREC'D: D LAWDEPARTMENT D SIGNATORY (CM, ACM, OR DIRECTOR) D CITY CLERK D ASSIGNED AG# D SIGNED COPY RETURNED AG# DATE SENT: COMMENTS: Update City Clerk Agreement file to include the 2005 Addendum adding the City of Covington to the MOU. 4/9 Mayor Noel Gibb Deputy Mayor Joan McGilton CounciImembers Jack Block, Jr. Lucy Krakowiak Stephen Lamphear Sally Nelson Gordon Shaw City of Burien 415 Southwest 150th Street. Burien, Washington 98166-197.3 Phone: (206) 241-4647' Fax: (206)248-5539 www.d.burien.wa.us MEMORANDUM Date: March 15,2005 To: City of Auburn City of Des Moines City of Federal Way City of Kent City of Renton City of SeaTac City of Tukwila Cc: City of Covington From: Lori Fleming, City of Burien Subject: Addendum No. I to MOD between South King County cities for Joint Human Services Program Attached for your files is a copy of Addendum No.1 to the Memorandum of Understanding (MOU) amongst the various South King County cities for a Joint Human Services Funding Program. The purpose of Addendum No.1 is to add the City of Covington to the MOU, effective January 1,2005. If you have any questions, please contact me at (206) 248-5518 or Lorif@ci.burien. wa. us. R:\AD\LoriF\2005\Cvrmemo to cities on Addend I-Joint I-IS MOll.doc ()RIGINAL Addendum 1 to MEMORANDUM OF UNDERSTANDING BETWEEN THE CITIES OF AUBURN, BURIEN, DES MOINES, FEDERAL WAY, KENT, RENTON, SEATAC, AND TUKWILA FOR PLANNING, FUNDING, AND IMPLEMENTATION OF A JOINT HUMAN SERVICES APPLICATION AND FUNDING PROGRAM. The attached Memorandum of Understanding between the Cities for the planning, funding, and implementation of a joint human services application and funding program shall be modified to include the City of Covington, Washington. Provision 7. Notices on page 3 shall be changed to include the City of Covington, with the contact person being the Human Services Manager, currently Victoria Throm. All other terms and conditions of the above referenced contract shall remain the same. These changes shall become effective on January 1,2005. By: Title: ~ ~ ~ Date: Z - 2&.{ - 0 5" MEMORANDUM OF UNDERSTANDING BETWEEN THE CITIES OF AUBURN, BURIEN, DES MOINES, FEDERAL WAY, KENT, RENTON, SEATAC, AND TUKWILA FOR PLANNING, FUNDING, AND IMPLEMENTATION OF A JOINT HUMAN SERVICES APPLICATION AND FUNDING PROGRAM. THIS MEMORANDUM OF UNDERSTANDING ("MOD") is entered into pursuant to Chapter 39.34 RCW by the Cities of Auburn, Burien, Des Moines, Federal Way, Kent, Renton, SeaTac, and Tukwila, Washington hereinafter referred to as "Cities", to provide for planning, funding, and implementation of a joint human services application and funding program. WHEREAS, the Cities engage in activities which support human service providers in King County; and WHEREAS, the parties wish to make the most efficient use of their resources by cooperating to provide funding to support human service providers in south King County; and WHEREAS, through the Interlocal Cooperation Act, the parties have the authority to engage in cooperative efforts which result in more efficient use of Government resources; and NOW THEREFORE, and in consideration of the terms, conditions and performances made herein, it is agreed as follows: 1. Purpose of MOD: The purpose of the MOD is the set up a cooperative arrangement between the Cities to consolidate the human services application and funding process. Four nonprofit human services agencies, commonly funded by many of the Cities, have been designated by the Cities for calendar year 2003. Nonprofit agencies may be added or deleted each year as determined by the Cities for the cooperative program. 2. Joint Participation. a) Lead City. A Lead City will be designated by the Cities for each Nonprofit Agency, as shown in Exhibit A, to act as the fiscal and administrative agent for the Cities for that Nonprofit Agency. A Lead City is usually established by the amount of funding and/or support to the particular Nonprofit Agency. The responsibilities of the Lead City are described in Section 4. b) Participating City. A Participating City is a city participating III the cooperative funding of a Nonprofit Agency, who is not a Lead City. Participating Cities for each Nonprofit Agency are identified in Exhibit A. A Participating City shall review quarterly reports from the Nonprofit Agency. Joint Human Services Application and Funding MOU Page 2 of7 If a Participating City becomes concerned with a Nonprofit Agency's services, it will promptly notify the Lead City. If a Participating City determines that a Nonprofit Agency is not performing satisfactorily for their city, the Participating City reserves the right to request the Lead City to withhold payments to the Nonprofit Agency for their share of funding. In the event that a claim or lawsuit is initiated by a Nonprofit Agency against any City for withholding payment, the City requesting the withholding of payment shall be responsible for settling or defending the claim or lawsuit. In addition, in the event of any settlement of or judgment on the claim or lawsuit, the City requesting that payment be withheld shall be fully responsible for the payment of such settlement of judgment and shall indemnify, defend, and hold harmless the other Cities for such settlement or lawsuit. c) Nonprofit Agency. For calendar year 2003, the Cities identified and agreed that they will coordinate to consolidate the human services application and funding process for the following four Nonprofit Agencies: Crisis Clinic, King County Sexual Assault Resource Center, Community Health Center, and the Part-Time Domestic Violence Planner through the King County Coalition Against Domestic Violence. Nonprofit Agencies may be added or deleted each year as determined by the Cities for the cooperative program. 3. Funding Arrangement. a) Allocation. Each Participating City shall provide to the Lead City no later than March 31 st of each year, the total annual funding allocation approved by their City Councils for the Nonprofit Agency, as described in Exhibit A. No administrative costs shall be imposed by the Lead City to the other Participating Cities. Exhibit A will be updated each year to show the Nonprofit Agencies, Lead Cities, Participating Cities, and funding amounts for that calendar year. {For City of Des Moines only, the last sentence of this paragraph was changed to read: "Exhibit A will be updated each year by approval of amendment to this agreement to show the Nonprofit Agencies, Lead Cities, Participating Cities, and funding amounts for that calendar year. "} b) Return of Unspent Funds. Any monies that the Nonprofit Agency(s) does not spend during the calendar year shall be proportionately returned to each Participating City. On or before March 31 st of the next calendar year the Lead City will provide the unspent funds to each Participating City. 4. Responsibilities of Lead City. A Lead City has been designated to act as the fiscal and administrative agent for the Cities for each Nonprofit Agency, as shown in Exhibit A. The responsibilities ofthe Lead City shall include the following: a) Send an invoice to each Participating City by January 30th of each year for their annual approved allocation to the Nonprofit Agency. R:\AD\Contracts\2oo2 Contracts\HmnServ-ArtsCuIt-CityMatch Contracts\Hwn Serv Joint Fund MOU.doc Final MOU - April 3, 2003 Joint Human Services Application and Funding MOD Page 3 of7 b) Contract with the Nonprofit Agency each year, for the total funding allocated by the Participating Cities, detailing performance measures to be performed by the Nonprofit Agency for each City. c) Receive, review, and process the quarterly invoices and reports from the Nonprofit Agency. Quarterly reports shall describe services provided specifically to each City. Disputes regarding billings will be resolved among the Participating Cities. d) Provide copies of quarterly reports to the Participating Cities, if the reports are not provided directly by the Nonprofit Agency. e) Provide the Nonprofit Agency with a funding application and technical assistance as required. f) Perform an annual monitoring visit of the Nonprofit Agency, to include the participation of another Participating City. g) Maintain accounts and records which properly reflect transactions related to this MOD. 5. Duration. This MOD shall become effective when it is approved by a majority of the Cities and shall remain in effect through December 31,2003, with automatic extensions annually, unless terminated as described in section 6. 6. Termination. Any party may terminate its participation in the MOD without cause by giving the other Cities a thirty day written notice. The terminating party shall remain fully responsible for meeting its funding responsibilities and other obligations established by this MOD through the end ofthe calendar year in which such notice is given. 7. Notices. Notices to the Cities shall be sent to the following persons: Kent ~. Renton SeaTac Tukwila 8. Indemnification. Each City agrees to indemnify the other Cities from any claims, damages, losses, and costs, including, but not limited to, attorney's fees and litigation costs, arising out of claims by third parties for property damage and bodily injury, including death, caused solely by the negligence or willful misconduct of such City, the City's employees, R:\AD\Contracts\2oo2 Contracts\HumServ-ArtsCult-CityMatch Contracts\Hwn Serv Joint FWld MOD.doc Final MOD - April 3, 2003 Joint Human Services Application and Funding MOD Page 4 of7 affiliated corporations, officers, and lower tier subcontractors in connection with this MOD. Each City hereby waives its immunity under Title 51 of the Revised Code of Washington for claims of any type brought by any City agent or employee against the other Cities. This waiver is specifically negotiated by the parties and a portion of the City's payment hereunder is expressly made the consideration for this waiver. 9. Insurance. Each City shall procure and maintain in full force throughout the duration of the Agreement comprehensive general liability insurance with a minimum coverage of $1,000,000.00 per occurrence/aggregate for personal injury and property damage. In the event that a City is a member of a pool of self-insured cities, the City shall provide proof of such membership in lieu of the insurance requirement above. Such self insurance shall provide coverage equal to or greater that required of non-self insurance pool member Cities. 10. Oversight Committee. This Agreement shall be managed by an Oversight Committee made up of one representative of each City. The representative of each City shall be that person designated in section 7 of this Agreement. The Oversight Committee shall meet at least annually to discuss the terms of the Agreement and manage the services provided pursuant to the Agreement. 11. Applicable Law; Venue; Attorney's Fees. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. In the event any suit, arbitration, or other proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and agree that venue shall be exclusively in King County, Washington. The prevailing party in any such action shall be entitled to its attorney's fees and costs of suit. 12. Counterparts. This document may be executed in any number of counterparts, each one which shall be considered an original. IN WITNESS WHEREOF, the undersigned have entered into this MOD as of this day of , 2003. R:\AD\Contrncts\2oo2 Contrncts\HwnServ-ArtsCult-CityMatcb Contrncts\Hum Serv Joint Fund MOD.doc Final MOD - April 3, 2003 IN WITNESS WHERE~ undersigned have entered into this MOD as of this z.\~ day of .. .. ~ ,,2003. :~OFA~~o.> Title:_ M~()Y Date: ~ 1 2DD3 Attest:~ ~ L_ Res. 3564 Exhibit A Joint Human Services Application and Funding MOU Page 5 of6 Joint Human Services Application and Funding MOU Page 5 of7 CITY J.F BURIE~ I .-A~'-- BY:.p~ ,r: vrQ'--IJ Title: tdv, ~ Date: I -/ ZI ~ 07 A~: City Attorney- Attest: CITY OF COVINGTON By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF DES MOINES By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF FEDERAL WAY By: Approved As To Form: Title: City Attorney Date: Attest: \\DcOI\records\AD\Contracts\2002 Contracts\HumServ-ArtsCult-CityMatch Contracts\Hum Serv Joint Fund MOU.doc Final MOU - December 19,2002 Joint Human Services Application and Funding MOU Page 5 of7 CITY OF BURIEN By: Title: Date: Attest: CITY OF COVINGTON By: Title: Date: Attest: ::TY q;q?J TItle: Cd, /IIAJ'fj 0/ Date: / 7 ~/I:J I Attest: CITY OF FEDERAL WAY By: Title: Date: Attest: Approved As To Form: City Attorney Approved As To Form: City Attorney To Form: C.~~ City Attorney Approved As To Form: City Attorney \\SENIOR_NT\DATA\WORD\SUE\human services\Hum Serv Joint Fund MOU2003.doc Final MOU - December 19,2002 I L___________ ~ 1" .., .... Joint Human Services Application and Funding MOU Page 6 of8 Approved As To Form: V1yMMA6d- ~~:~1l\Al1~ I Cl Attorney :~/~~~~ CITY OF KENT By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF RENTON By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF SEe.TAC By: Approved As To Form: Title: City Attorney Date: Attest: K:\CD Human Services\Regional\Joint HS MOU\MOU - Final.doc Final MOU - December 19,2002 Joint Human Services Application and Funding MOU Page 6 of7 Date: Attest: CITY OF RENTON By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF SEATAC By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF TUKWILA By: Approved As To Form: Title: City Attorney Date: Attest: C:\DOCUME-l\KJohnson\LOCAL8-l\Temp\Hum Serv Joint Fund MOU.doc Final MOU - December 19, 2002 Joint Human Services Application and Funding MOD Page 4 of5 Each City hereby waives its immunity under Title 51 of the Revised Code of ashington for ims of any type brought by any City agent or employee against t other Cities. This wa:. er is specifically negotiated by the parties and a portion of e City's payment hereunder I xpressly made the consideration for this waiver. 9. Insurance. ach City shall procure and maintain. full force throughout the duration of the Agree ent comprehensive general liabi . y insurance with a minimum coverage of $1,000,000. er occurrence/aggregate or personal injury and property damage. In the event that a ity is a member of pool of self-insured cities, the City shall provide proof of such mem ship in lieu the insurance requirement above. Such self insurance shall provide cover e eq to or greater that required of non-self insurance pool member Cities. 10. Oversight Committee. t shall be managed by an Oversight Committee made up of one re sentative of eac City. The representative of each City shall be that person desi ated in section 7 of is Agreement. The Oversight Committee shall meet at ast annually to discuss the te of the Agreement and manage the services provided suant to the Agreement. 11. A lica e Law. Venue. Attorne 's Fees. This Agreemen all be governed by and construe m accordance with the laws of the State of Washingto In the event any suit, arbit ion, or other proceeding is instituted to enforce any term of t . Agreement, the p . es specifically understand and agree that venue shall be exclusive . n King Cou y, Washington. The prevailing party in any such action shall be entitled 0 its att rney's fees and costs of suit. IN WIWESS WHEREOF uthe undersigned have entered into this MOD as of this .J~ day of .:i~ ,2.003. CITY O~F NTON By: _ ;/~ J se Tanner Title: Mayor ~~~~ City Attorney Date: ;1- .3-~OO.3 Attest: ~'". tJ~ City Clerk, Bonnie I. Walton H:\HUMAN _ SE\2003funding\JointFundingPilot\Hum Serv Joint Fund MOU.doc Final MOU - December 19,2002 Joint Human Services Application and Funding MOD Page 6 of7 CITY OF KENT By: Title: Date: Attest: CITY OF RENTON By: Title: Date: Attest: CITY OF SEAT AC BY:~~ . Bruce Ray m, City Manager TItle: Dale: ,3p/~ Attest: CITY OF TUKWILA By: Title: Date: Attest: Approved As To Form: City Attorney Approved As To Form: City Attorney ~ As To Form: - -1>- rvr~ ai.J City Attorney Approved As To Form: City Attorney Joint Human Services Application and Funding MOD Page 60f7 CITY OF KENT By: Title: Date: Attest: CITY OF RENTON By: Title: Date: Attest: CITY OF SEATAC By: Title: Date: Attest: CITY OF ~WILA By:QfJ S~t.l tV'HV, v-QQJ- Title: Cyyz ~ tJvLJ Date: / II I d :3 Attest: ~ ~ C:\WINDOWS\TEMP\Hum Serv Joint Fund MOU.doc Final MOU - December 17,2002 Approved As To Form: City Attorney Approved As To Form: City Attorney Approved As To Form: City Attorney Approved As To Form: FINAL Calendar Year 2005 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Catholic Community Services for Volunteer Chore Services Senior Services for Meals on Wheels Senior Services for Volunteer Transportation Services R:\CONTRACIS\Finance Admin contracts\Hum Serv JOinl MOU Ex A.xls Renton - Lead City $ 5,000 Auburn 5,000 Burien 8,000 Federal Way 4,000 Kent 5,000 SeaTac 3,000 TOTAL $ 30,000 Renton - Lead City $ 6,000 Auburn 7,000 Des Moines 1,500 Federal Way 9,500 SeaTac 7,700 Tukwila 7,000 TOTAL $ 38,700 Renton - Lead City $ Auburn Des Moines Federal Way Kent SeaTac Tukwila 6,000 5,000 400 5,700 7,500 2,275 1,692 28,567 TOTAL $ January 20, 2005 Page3of3 FINAL Calendar Year 2005 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Community Health Centers for primary DENTAL services for low and moderate income persons. Kent - Lead City $ 15,000 Covington 2,000 SeaTac 5,000 Tukwila 2,000 DENTAL TOTAL $ 24,000 Community Health Centers for comprehensive MEDICAL services for low and moderate income persons. Kent - Lead City $ 58,450 Auburn 32,000 Covington 3,200 Federal Way 31,827 Renton 24,000 SeaTac 5,000 Tukwila 2,000 MEDICAL TOTAL $ 156,477 Multi-Service Center for Transitional Housing/Shelter Kent - Lead City $ 40,000 Auburn 8,200 Des Moines 2,500 Renton 2,000 SeaTac 5,200 Tukwila 3,000 TOTAL $ 60,900 King County Sexual Assault Resource Center (KCSARC) for sexual assault services Renton - Lead City $ 35,000 Auburn 26,500 Burien 7,500 Covington 3,605 Des Moines 4,000 Kent 20,600 Federal Way 36,050 SeaTac 7,416 Tukwila 14,000 TOTAL $ 154,671 R:\CONTRACfS\Finance Admin contracts\Hum Serv Joint MOD Ex A.xIs January 20, 2005 Page 2 of3 FINAL Calendar Year 2005 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Crisis Clinic for telephone referral line Auburn - Lead City $ 1,500 Burien 4,500 Covington 5,000 Des Moines 2,500 Kent 5,000 Federal Way 11,000 Renton 3,300 SeaTac 4,985 Tukwila 2,000 TOTAL $ 39,785 Crisis Clinic for Teen Link Auburn - Lead City Covington $ 1,500 Des Moines 1,500 Federal Way 4,000 Renton 1,000 SeaTac 1,500 Tukwila 1,000 TOTAL $ 10,500 Pregnancy Aid of South King County for Services for Pregnant Women and their children (Des Moines location) Federal Way - Lead City $ 4,000 SeaTac 3,600 Tukwila 2,000 TOTAL $ 9,600 Washington Women's Employment and Education for the REACH Plus Program Federal Way - Lead City $ 10,000 Auburn 6,000 Kent 35,000 SeaTac 4,500 TOTAL $ 55,500 YWCA for the Domestic Violence Services Program Federal Way - Lead City $ 4,000 Auburn 33,000 Kent 30,000 Tukwila 25,000 TOTAL $ 92,000 R:\CONTRAcrs\Finance Admin contracIs\Hum Serv Joint MOD Ex A.xls January 20, 2005 Page lof3 Calendar Year 2004 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. King County Sexual Assault Resource Center (KCSARC) for sexual assault services Renton - Lead City $ Auburn Burien Des Moines Kent Federal Way SeaTac Tukwila Catholic Community Services for Volunteer Chore Services Senior Services for Meals on Wheels Senior Services for Volunteer Transportation Services R:\CONTRACIS\Finance Admin contracls\Hum Serv Joint MOU Ex Axis TOTAL $ Renton - Lead City $ Auburn Burien TOTAL $ Renton - Lead City $ Auburn Des Moines SeaTac Tukwila TOTAL $ Renton - Lead City $ Auburn Des Moines Kent SeaTac Tukwila TOTAL $ 35,000 26,500 7,500 4,000 20,000 35,000 7,200 14,000 149,200 5,000 5,000 10,000 20,000 6,000 7,000 2,000 7,700 7,000 29,700 6,000 5,000 2,000 5,000 2,178 1,575 21,753 3/15/2005 Page2of2 Calendar Year 2004 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Crisis Clinic for telephone referral line Crisis Clinic for Teen Link Community Health Centers for comprehensive medical services for low and moderate income persons. Part-Time Domestic Violence Planner through King Cty Coalition Against Domestic:;:Violence for planning activities in Multi-Service Center for Transitional Housing / Shelter R:\CONTRACfS\Finance Admin contracts\Hum Serv Joint MOU Ex Axis Auburn - Lead City $ Burien Des Moines Kent Federal Way Renton SeaTac Tukwila TOTAL $ Auburn - Lead City Des Moines Renton SeaTac Tukwila TOTAL $ Kent - Lead City $ Auburn Federal Way Renton SeaTac TOTAL $ Kent - Lead City $ Renton TOTAL $ Kent - Lead City $ Auburn Des Moines Renton SeaTac Tukwila TOTAL $ 1,500 4,500 2,500 5,000 10,000 3,300 2,780 2,000 31,580 1,500 1,000 1,000 1,000 4,500 69,350 32,000 31,827 24,000 10,600 167,777 15,000 5,000 20,000 38,250 8,200 2,500 2,000 5,000 3,000 58,950 3/15/2005 Page 1 of 2 Joint Human Services Application and Funding MOD Page 7 of7 EXHIBIT A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. CALENDAR YEAR 2003 Name of Nonprofit Agency Participating Cities & Tentative Fundinf!: Crisis Clinic for the telephone Auburn - Lead City - $1,500 referral line Burien - $4,500 Des Moines - $2,500 Kent - $5,000 Federal Way - $10,000 Renton - $3,300 SeaTac - $2,780 Tukwila - $2,000 TOTAL - $36,580 King County Sexual Assault Renton - Lead City - $35,000 Resource Center (KCSARC) Auburn - $26,500 for sexual assault services Burien - $7,500 Des Moines - $4,000 Kent - $20,000 Federal Way - $35,000 SeaTac - $7,200 Tukwila - $14,000 TOTAL - $152,700 Community Health Centers Kent - Lead City - $58,450 for comprehensive medical AubUrn - $27,550 services for low and moderate Federal Way - $31,827 Income persons. Renton - $24,000 SeaTac - $10,600 TOTAL - $155,627 Part-Time Domestic Violence Kent - Lead City - $15,000 Planner through King County Renton - $5,000 Coalition Against Domestic TOTAL - $20,000 Violence for planning activities in South King County. R:\AD\Contracts\2002 Contracts\HwnServ-ArtsCult-CityMatch Contracts\Hwn Serv Joint Fund MOU.doc Final MOU - April 3, 2003 D~~~I D 5"' I DATE OUT--.J TO: ~ _~ CITY OF FEDERAL WAY LAW DEPARTMENT__u- \ REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPT.IDIV: COMMUNITY DEVELOPMENT/HUMAN SERVICES DIVISION 2. 4. 5. 6. ORIGINATING STAFF PERSON: ANGELINAALLEN-MpYISI EXT: 26503. DATE REQ. BY: TYPE OF DOCUMENT REQUESTED (CHECK ONE) D PROFESSIONAL SERVICE AGREEMENT D MAINTENANCE/LABOR AGREEMENT D PUBLIC WORKS CONTRACT D SMALL PUBLIC WORKS CONTRACT (LESS THAN $200,000) D PURCHASE AGREEMENT) (MATERIALS, SUPPLIES, EQUIPMENn D REAL ESTATE DOCUMENT D SECURITY DOCUMENT (E.G. AGREEMENT & PERFIMAIN BOND; ASSIGNMENT OF FUNDS IN LIEU OF BOND) D CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) D CONTRACT AMENDMENT D CDBG D OTHER AG#:03-046 7ft. F, OJ' ~y PROJECT NAME: NEW EXHIBIT A FOR MOU WITH SOUTH KING COUNTY CITIES NAME OF CONTRACTOR: ADDRESS: SIGNATURE NAME: TELEPHONE TITLE 7. ATTACH ALL EXHIBITS AND CHECK BOXES D SCOPE OF SERVICES D ALL EXHIBITS REFERENCED IN DOCUMENT D INSURANCE CERTIFICATE D DOCUMENT AUTHORIZING SIGNATURE 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: 9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: DYES DNOIFYES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED DYES D NO IF YES, $ PAID BY: D CONTRACTOR D CITY 10. 11. CONTRACT REVIEW INITIALIDATE APPROVED D PROJECT MANAGER D DIRECTOR D RISK MANAGEMENT DLAW INITIALIDATE APPROVED CONTRACT SIGNATURE ROUTING INITIALIDATE APPROVED D LAW DEPARTMENT D CITY MANAGER D CITY CLERK D SIGN COPY BACK TO ORGINATING DEPT. D ASSIGNED AG# D PURCHASING: PLEASE CHARGE TO: INITIALIDATE APPROVED COMMENTS This is the amended Exhibit A that should be attached to the MOU contract (AG#03-046). Please let me know if you have questions. 10/09/02 e FINAL e Calendar Year 2005 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. N'ameofN'onprofit Agency & Program Participating.Cities FUlldillg Crisis Clinic for telephone referral line Auburn - Lead City $ 1,500 Burien 4,500 Covington 5,000 Des Moines 2,500 Kent 5,000 Federal Way 11,000 Renton 3,300 SeaTac 4,985 Tukwila 2,000 TOTAL $ 39,785 Crisis Clinic for Teen Link Auburn - Lead City Covington $ 1,500 Des Moines 1,500 Federal Way 4,000 Renton 1,000 SeaTac 1,500 Tukwila 1,000 TOTAL $ 10,500 Pregnancy Aid of South King County for Services for Pregnant Women and their children (Des Moines location) Federal Way.. Lead City $ 4,000 SeaTac 3,600 Tukwila 2,000 TOTAL $ 9,600 Washington Women's Employment and Education for the REACH Plus Program Federal Way - Lead City $ 10,000 Auburn 6,000 Kent 35,000 SeaTac 4,500 TOTAL $ 55,500 YWCA for the Domestic Violence Services Program Federal Way - Lead City $ 4,000 Auburn 33,000 Kent 30,000 Tukwila 25,000 TOTAL $ 92,000 Hum Serv Joint MOD Ex A.xls January 20, 2005 Page 1 of 3 e FINAL e Calendar Year 2005 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Name of Nollprofit Agency & Progra:m Participating Cities Funding Community Health Centers for primary DENTAL services for low and moderate income persons. Kent - Lead City $ 15,000 Covington 2,000 SeaTac 5,000 Tukwila 2,000 DENTAL TOTAL $ 24,000 Community Health Centers for comprehensive MEDICAL services for low and moderate income persons. Kent - Lead City $ 58,450 Auburn 32,000 Covington 3,200 Federal Way 31,827 Renton 24,000 SeaTac 5,000 Tukwila 2,000 MEDICAL TOTAL $ 156,477 Multi-Service Center for Transitional Housing/ Shelter Kent - Lead City $ 40,000 Auburn 8,200 Des Moines 2,500 Renton 2,000 SeaTac 5,200 Tukwila 3,000 TOTAL $ 60,900 King County Sexual Assault Resource Center (KCSARC) for sexual assault services Renton - Lead City $ 35,000 Auburn 26,500 Burien 7,500 Covington 3,605 Des Moines 4,000 Kent 20,600 Federal Way 36,050 SeaTac 7,416 Tukwila 14,000 TOTAL $ 154,671 Hum Serv Joint MOV Ex A.xls January 20, 2005 Page 2 oB e FINAL e Calendar Year 2005 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. Name of Nonprofit Agency~Program Participating Cities Funding Catholic Community Services for Volunteer Chore Services Renton - Lead City $ 5,000 Auburn 5,000 Burien 8,000 Federal Way 4,000 Kent 5,000 SeaTac 3,000 TOTAL $ 30,000 Senior Services for Meals on Wheels Renton - Lead City $ 6,000 Auburn 7,000 Des Moines 1,500 Federal Way 9,500 SeaTac 7,700 Tukwila 7,000 TOTAL $ 38,700 Senior Services for Volunteer Transportation Services Renton - Lead City $ 6,000 Auburn 5,000 Des Moines 1,000 Federal Way 5,700 Kent 7,500 SeaTac 2,275 Tukwila 1,692 TOTAL $ 29,167 Hum Serv Joint MOD Ex A.xls January 20, 2005 Page 3 of3 1. 2. 4. 5. 6. I?~o/l*/b3 I DATE OUT: I TO: CAr, 5- Gr~ , CITY OF FEDERAL WAY LAW DEPARTMENT REQUEST FOR CONTRACT PREPARATIONIDOCUMENT REVIEW/SIGNATURE ROUTING SLIP ORIGINATING DEPT.IDIV: C9 / (-IS ,. I/A/..7 /~ ~ /1 ~ tA.___ ORIGINATING STAFF PERSON: !t.er.-iYl.t7IS ( TYPE OF DOCUMENT REQUESTED (CHECK ONE) o PROFESSIONAL SERVICE AGREEMENT o MAINTENANCE/LABOR AGREEMENT o PUBLIC WORKS CONTRACT o SMALL PUBLIC WORKS CONTRACT EXT: L(03 9 3. DATE REQ. BY: (LESS THAN $200,000) o PURCHASE AGREEMENT) (MATERIALS, SUPPLIES, EQUIPMENT) o REAL ESTATE DOCUMENT PROJECT NAME: /Ill 0 U o SECURITY DOCUMENT (E.G. AGREEMENT & PERFIMAIN BOND; ASSIGNMENT OF FUNDS IN LIEU OF BOND) o CONTRACTOR SELECTION DOCUMENT (E.G., RFB, RFP, RFQ) ? 1'\ l II o CONTRACT AMENDMENT I ;)..1'~loJ AG#: 0..:).- \.Fno o CDBG ~j~,Y\~d ~ ilaOTHER( . EXhl h ,'-f A --For Abt3 .~). . &. -hveE.r\ S-o. ~~j Co. u -he < NAME OF CONTRACTOR: ADDRESS: SIGNATURE NAME: \ Kl """" Pt- \ TELEPHONE TITLE 7. ATTACH ALL EXHIBITS AND CHECK BOXES 0 SCOPE OF SERVICES 0 ALL EXHIBITS REFERENCED IN DOCUMENT o INSURANCE CERTIFICATE 0 DOCUMENT AUTHORIZING SIGNATURE 8. TERM: COMMENCEMENT DATE: COMPLETION DATE: 9. TOTAL COMPENSATION $ (INCLUDE EXPENSES AND SALES TAX, IF ANY) (IF CALCULATED ON HOURLY LABOR CHARGE - AIT ACH SCHEDULES OF EMPLOYEES TITLES AND HOLIDAY RATES) REIMBURSABLE EXPENSE: 0 YES 0 NO IF YES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED DYES DNOIFYES, $ PAID BY: o CONTRACTOR 0 CITY 10. 11. CONTRACT REVIEW INITIALIDA TE APPROVED o PROJECT MANAGER o DIRECTOR o RISK MANAGEMENT o LAW INlTIALIDA TE APPROVED CONTRACT SIGNATURE ROUTING INITIALIDATE APPROVED o LAW DEPARTMENT o CITY MANAGER o CITY CLERK o SIGN COpy BACK TO ORGINATING DEPT. o ASSIGNED AG# o PURCHASING: PLEASE CHARGE TO: INITIALIDA TE APPROVED COMMENTS 10/09/02 /' ..{! J ~~/(4~ 5}, Calendar Year 2004 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. T entabve Name of Nonprofit Agency & Program Participating Cities Funding Crisis Clinic for telephone referral line Auburn - Lead City $ 1,500 Burien 4,500 Des Moines 2,500 Kent 5,000 Federal Way 10,000 Renton 3,300 SeaTac 2,780 Tukwila 2,000 TOTAL $ 31,580 Crisis Clinic for Teen Link Aubum - Lead City Des Moines 1,500 Renton 1,000 SeaTac 1,000 Tukwila 1,000 TOTAL $ 4,500 Community Health Centers for comprehensive medical services for low and moderate income persons. Kent - Lead City $ 69,350 Auburn 32,000 Federal Way 31,827 Renton 24,000 SeaTac 10,600 TOT AL $ 167,777 Part-Time Domestic Violence Planner through King Cty Coalition Against Domestic Violence for planning activities in Kent - Lead City $ 15,000 Renton 5,000 TOTAL $ 20,000 Multi-Service Center for Transitional Housing/ Shelter Kent - Lead City $ 38,250 Auburn 8,200 Des Moines 2,500 Renton 2,000 SeaTac 5,000 Tukwila 3,000 TOTAL $ 58,950 Hum Serv Joint MOD Ex A for 2004 12/19/2003 Page 1 of 2 Calendar Year 2004 Exhibit A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. TentatIve Name of Nonprofit Agency & Program Participating Cities Funding King County Sexual Assault Resource Center (KCSARC) for sexual assault services Renton - Lead City $ 35,000 Auburn 26,500 Burien 7,500 Des Moines 4,000 Kent 20,000 Federal Way 35,000 SeaTac 7,200 Tukwila 14,000 TOTAL $ 149,200 Catholic Community Services for Volunteer Chore Services Renton - Lead City $ 5,000 Auburn 5,000 Burien 10,000 TOTAL $ 20,000 Senior Services for Meals on Wheels Renton - Lead City $ 6,000 Auburn 7,000 Des Moines 2,000 SeaTac 7,700 Tukwila 7,000 TOT AL $ 29,700 Senior Services for Volunteer Transportation Services Renton - Lead City $ 6,000 Auburn 5,000 Des Moines 2,000 Kent 5,000 SeaTac 2,178 Tukwila 1,575 TOT AL $ 21,753 Hum Serv Joint MOD Ex A for 2004 12/19/2003 Page 2 of 2 DATE IN: DATE OUT: TO: I -;J CITY OF FEDERAL WAY LAW DEPAR"'t W' REGUEST FOR CONTRACT PREPARATiON/DocUMENT REVIEW/SIGNATURE ROUTING SLIP 1. ORIGINATING DEPT.lDlv.: ~D / I-J. S ORIGINATING STAFF PERSON:j.. &-fa./4",hf) EXT~3.DATEREG.By:~;I~,1C)~ 2. 4. TYPE OF DOCUMENT REGUESTED [CHECK ONE]: D PROFESSIONAL SERVICE AGlREEMENT D MAINTENANCElLABOR AGlREEMENT D PUBLIC WORKS CONTRACT D SMALL PUBLIC WORKS CONTRACT (Less THAN 526,0003 D PURCHASE AGlREEMENT [MATERIALS. SUPPLIES. EcaUIPMENT1 D REAL ESTATE PURCHASE & SALES AGlREEMENT D SECURITY DOCUMENT [E.G., AGREEMENT & PERFIMAIN BONDi AsSIGNMENT OF FUNDS IN LIEU OF BOND] D CONTRACTOR SELECTION DOCUMENT [E.G.. RFB. RFP, RFGJ D CONTRACT AMENDMENT ~::::EN/l1 DIP D CDBG AG': 5. PRO.JECT NAME~~ ~; ::]OINT J..Ju/V1AN S~VIC6S /f(JPJ~1 G4=f1{)N.5 A-MbLY PnAg' '~' IMLtgtJ, Se/G1(/}LJuf<J.sD16r7o;./.s. NAME OF CONTRACTOR: ADDRESS: eMJN,:~JTUtJUJ&:k' 6. D INDIVIDUAL D PARTNERSHIP TAX ID'ISS', TYPE OF PERSDN OR ENTITY [CHECK ONE]: SIGNATURE NAME: D SOLE PROPRIETORSHIP D CDRPOt'-ATION V~\OU.-> TITLE: 7. SCOPE OF WORK: ATTACH EXHIBIT A . A COMPLETE AND DETAILED DESCRIPTION OF THE SERVICES OR SCOPE OF WDRK, INCLUDING COMPLETION DATE FOR EACH PHASE OF WORK AND LOCATION OF WORK. B. TERM: COMMENCEMENT DATE: '~/31 /QJ I I TDTAL CDMPENSATION $ 7 6 I Sl;;;,:7 [INCLUDE EXPENSES AND SALES TAX, IF ANY] [IF CALCULATED ON HOURLY LABOR CHARGE - ATTAcH BC~E ULES OF EMPLOYEES TITLES AND HOLIDAY RATESJ REIMBURSABLE EXPENSES: D VES 0 IF VES, MAXIMUM DOLLAR AMOUNT: $ IS SALES TAX OWED? D VES No IF VES, $ PAID BY: D CONTRACTOR COMPLETION DATE: 9. DCITY 10. SELECTION PROCESS USED [CHECK ONE]: D REGlUEST FDR BIDS D REGlUEST FOR PROPOSALS D REGlUEST FDR GUDTES D REGlUEST FOR GuALIFICATIDNS D ARCHITECT & ENGlINEER LIST D SMALL WDRKS ROSTER CONTRACT REVIEW ~ INITIALlDATE ApPROVED ~IRECTDR ~L\ \t~l; t~\~ J- LAW [ALL CONTRACTS] ^ \J :\J../,\.rt ~\j -0 vUi;P^ ~ ISK MANAGlEMENT (,V- ~~f ~ ~ ~ =~ _N.M.N~ L L\L- -"""'v - D=::':=N~~ I; ~ J/!'.V CONTRACT B'G_~AE ROU~'NG ~~ i1(i INOTOAUDATE APPRQVEC ~ O._~~ ", f' Is s~ ~ . ,1 <C. '\- '(JL.. yj 1 ~:::.:-- /l;~~:I(d<' .%: J'/i.~fp';'J D SIGlN CDPY BACK TO ORIGlINATI ~ / M5f/llrik. 'f-:1.5.-f)"3- ~:=N:7:~E:"'-:=' l-i3(j)-M3 -:<-,~(Q-4-J D /. &-w1a'e (~.{[tv- ~ /I .5.. p/.q,..S;A. r ",f/z;c;u.1. .'(1 vo/u..i~ 3D ffs- 11. 11. '* WHITE - ORIGINAL STAYS WITH CONTRACT CANARY - CLERK TO STAFF PINK - .LAW DEPT. GlDLOENRDD - ORIGINATING STAFF L04S12 [REV 11/98] flGr#o 3"-O'f~ MEMORANDUM OF UNDERSTANDING BETWEEN THE CITIES OF AUBURN, BURIEN, DES MOINES, FEDERAL WAY, KENT, RENTON, SEATAC, AND TUKWILA FOR PLANNING, FUNDING, AND IMPLEMENTATION OF A JOINT HUMAN SERVICES APPLICATION AND FUNDING PROGRAM. THIS MEMORANDUM OF UNDERSTANDING ("MOU") is entered into pursuant to Chapter 39.34 RCW by the Cities of Auburn, Burien, Des Moines, Federal Way, Kent, Renton, SeaTac, and Tukwila, Washington hereinafter referred to as "Cities", to provide for planning, funding, and implementation of a joint human services application and funding program. WHEREAS, the Cities engage in activities which support human service providers in King County; and WHEREAS, the parties wish to make the most efficient use of their resources by cooperating to provide funding to support human service providers in south King County; and WHEREAS, through the lnterlocal Cooperation Act, the parties have the authority to engage in cooperative efforts which result in more efficient use of Government resources; and NOW THEREFORE, and in consideration of the terms, conditions and performances made herein, it is agreed as follows: 1. Purpose of MOU: The purpose of the MOU is the set up a cooperative arrangement between the Cities to consolidate the human services application and funding process. Four nonprofit human services agencies, commonly funded by many of the Cities, have been designated by the Cities for calendar year 2003. Nonprofit agencies may be added or deleted each year as determined by the Cities for the cooperative program. 2. Joint Participation. a) Lead City. A Lead City will be designated by the Cities for each Nonprofit Agency, as shown in Exhibit A, to act as the fiscal and administrative agent for the Cities for that Nonprofit Agency. A Lead City is usually established by the amount of funding and/or support to the particular Nonprofit Agency. The responsibilities of the Lead City are described in Section 4. b) Participating City. A Participating City is a city participating in the cooperative funding of a Nonprofit Agency, who is not a Lead City. Participating Cities for each Nonprofit Agency are identified in Exhibit A. A Participating City shall review quarterly reports from the Nonprofit Agency. Joint Human Services Application and Funding MOD Page 2 of7 If a Participating City becomes concerned with a Nonprofit Agency's services, it will promptly notify the Lead City. If a Participating City determines that a Nonprofit Agency is not performing satisfactorily for their city, the Participating City reserves the right to request the Lead City to withhold payments to the Nonprofit Agency for their share of funding. In the event that a claim or lawsuit is initiated by a Nonprofit Agency against any City for withholding payment, the City requesting the withholding of payment shall be responsible for settling or defending the claim or lawsuit. In addition, in the event of any settlement of or judgment on the claim or lawsuit, the City requesting that payment be withheld shall be fully responsible for the payment of such settlement of judgment and shall indemnify, defend, and hold harmless the other Cities for such settlement or lawsuit. c) Nonprofit Agency. For calendar year 2003, the Cities identified and agreed that they will coordinate to consolidate the human services application and funding process for the following four Nonprofit Agencies: Crisis Clinic, King County Sexual Assault Resource Center, Community Health Center, and the Part-Time Domestic Violence Planner through the King County Coalition Against Domestic Violence. Nonprofit Agencies may be added or deleted each year as determined by the Cities for the cooperative program. 3. Funding Arrangement. a) Allocation. Each Participating City shall provide to the Lead City no later than March 31 st of each year, the total annual funding allocation approved by their City Councils for the Nonprofit Agency, as described in Exhibit A. No administrative costs shall be imposed by the Lead City to the other Participating Cities. Exhibit A will be updated each year to show the Nonprofit Agencies, Lead Cities, Participating Cities, and funding amounts for that calendar year. {For City of Des Moines only, the last sentence of this paragraph was changed to read: "Exhibit A will be updated each year by approval of amendment to this agreement to show the Nonprofit Agencies, Lead Cities, Participating Cities, and funding amounts for that calendar year. ''} b) Return ofUnsvent Funds. Any monies that the Nonprofit Agency(s) does not spend during the calendar year shall be proportionately returned to each Participating City. On or before March 31 st of the next calendar year the Lead City will provide the unspent funds to each Participating City. 4. Responsibilities of Lead City. A Lead City has been designated to act as the fiscal and administrative agent for the Cities for each Nonprofit Agency, as shown in Exhibit A. The responsibilities of the Lead City shall include the following: a) Send an invoice to each Participating City by January 30th of each year for their annual approved allocation to the Nonprofit Agency. R:IAD\Contracts\2002 Contracts\HmnServ-ArtsCuIt-CityMatch Contracts\Hwn Serv Joint Fund MOU.doc Final MOU - April 3, 2003 Joint Human Services Application and Funding MOU Page 3 of7 b) Contract with the Nonprofit Agency each year, for the total funding allocated by the Participating Cities, detailing performance measures to be performed by the Nonprofit Agency for each City. c) Receive, review, and process the quarterly invoices and reports from the Nonprofit Agency. Quarterly reports shall describe services provided specifically to each City. Disputes regarding billings will be resolved among the Participating Cities. d) Provide copies of quarterly reports to the Participating Cities, if the reports are not provided directly by the Nonprofit Agency. e) Provide the Nonprofit Agency with a funding application and technical assistance as required. f) Perform an annual monitoring visit of the Nonprofit Agency, to include the participation of another Participating City. g) Maintain accounts and records which properly reflect transactions related to this MOD. 5. Duration. This MOD shall become effective when it is approved by a majority of the Cities and shall remain in effect through December 31, 2003, with automatic extensions annually, unless terminated as described in section 6. 6. Termination. Any party may terminate its participation in the MOD without cause by giving the other Cities a thirty day written notice. The terminating party shall remain fully responsible for meeting its funding responsibilities and other obligations established by this MOU through the end ofthe calendar year in which such notice is given. 7. Notices. Notices to the Cities shall be sent to the following persons: Ci Auburn Burien Des Moines Federal Way Renton SeaTac Tukwila Contact Planner, currently Shirley Aird Management Analyst, currentl Lori Fleming Senior Services Mana er, currently Sue Padden Human Services Manager, currently Lydia Assefa- Dawson Human Services Manager, currently Katherin Johnson Contract S ecialist, currently Dianne Utecht Senior Project Coordinator, currentl Soraya Low Human Services Mana er, currentl Evel Bo kan Kent 8. Indemnification. Each City agrees to indemnify the other Cities from any claims, damages, losses, and costs, including, but not limited to, attorney's fees and litigation costs, arising out of claims by third parties for property damage and bodily injury, including death, caused solely by the negligence or willful misconduct of such City, the City's employees, R:\AD\Contracts\2oo2 Contracts\HurnServ-ArtsCult-CityMatch Contracts\Hmn Serv Joint Fund MOU.doc Final MOU - April 3, 2003 Joint Human Services Application and Funding MOD Page 4 of7 affiliated corporations, officers, and lower tier subcontractors in connection with this MOD. Each City hereby waives its immunity under Title 51 of the Revised Code of Washington for claims of any type brought by any City agent or employee against the other Cities. This waiver is specifically negotiated by the parties and a portion of the City's payment hereunder is expressly made the consideration for this waiver. 9. Insurance. Each City shall procure and maintain in full force throughout the duration of the Agreement comprehensive general liability insurance with a minimum coverage of $1,000,000.00 per occurrence/aggregate for personal injury and property damage. In the event that a City is a member of a pool of self-insured cities, the City shall provide proof of such membership in lieu of the insurance requirement above. Such self insurance shall provide coverage equal to or greater that required of non-self insurance pool member Cities. 10. Oversight Committee. This Agreement shall be managed by an Oversight Committee made up of one representative of each City. The representative of each City shall be that person designated in section 7 of this Agreement. The Oversight Committee shall meet at least annually to discuss the terms of the Agreement and manage the services provided pursuant to the Agreement. 11. Applicable Law: Venue: Attorney's Fees. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. In the event any suit, arbitration, or other proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and agree that venue shall be exclusively in King County, Washington. The prevailing party in any such action shall be entitled to its attorney's fees and costs of suit. 12. Counterparts. This document may be executed in any number of counterparts, each one which shall be considered an original. IN WITNESS WHEREOF, the undersigned have entered into this MOD as of this day of ,2003. R:\AD\Contracts\2oo2 ContractslHwnServ-ArtsCult-CityMatch ContractslHum Serv Joint Fund MOU.doc Final MOU - April 3, 2003 IN WI!NBSS WHEREQF, the undersigned have entered into this MOD as of this 2-\s.;t- dayof ~~~ . ,2003. CITY OF A,~ .~ By: -~.1 Tit1e:_'fY\~ov Date: .~ 1 2ll1l3 At1est:~ ~ Res. 3564 Exhibit A Joint Human Services Application and Funding MOD Page 5 of6 Joint Human Services Application and Funding MOU Page 5 of7 CITY IF BURIE~ / -'"^" ~~ By: ,l)~r: C/O r--7J Title: &..1,1 ;/?~ Date: I -/21 - 07 Appro;>~ASr<IYrm: ~<>~ ~/ / - '-- City Attorney Attest: CITY OF COVINGTON By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF DES MOINES By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF FEDERAL WAY By: Approved As To Form: Title: City Attorney Date: Attest: \\DcOl\records\AD\Contracts\2002 Contracts\HumServ-ArtsCult-CityMatch Contracts\Hum Serv Joint Fund MOU<doc Final MOU - December 19, 2002 Joint Human Services Application and Funding MOU Page 5 of 7 CITY OF BURIEN By: Title: Date: Attest: CITY OF COVINGTON By: Title: Date: Attest: By: Title: ~(Il $Af'lj ()/ Date: II ;;:t/l):] I Attest: CITY OF FEDERAL WAY By: Title: Date: Attest: Approved As To Form: City Attorney Approved As To Form: City Attorney To Form: C.~~ City Attorney Approved As To Form: City Attorney \\SENIOR_NT\DA T A \ WORDlSUE\human services\Hum Serv Joint Fund MOU2003.doc Final MOU - December 19,2002 ~ ; ..' Joint Human Services Application and Funding MOU Page 6 of8 vTj )4/WAGU-- D~lm Attest: - I - - ~~i ~~~~ Approved As To Form: ((UU~ ~_~~Uv\lk~ CI Attorney CITY OF KENT By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF RENTON By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF SEATAC By: Approved As To Form: Title: City Attorney Date: Attest: K:\CD Human Services\Regional\Joint HS MOU\MOU - Final.doc Final MOU - December 19, 2002 Joint Human Services Application and Funding MOU Page 6 of7 By: Titl Date: Attest: CITY OF RENTON By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF SEATAC By: Approved As To Form: Title: City Attorney Date: Attest: CITY OF TUKWILA By: Approved As To Form: Title: City Attorney Date: Attest: C:\DOCUME-I\KJohnson\LOCALS-I\Temp\Hum Serv Joint Fund MOU.doc Final MOU - December 19, 2002 Joint Human Services Application and Funding MOU Page 4 of5 Each City hereby waives its immunity under Title 51 of the Revised Code of ashington for ims of any type brought by any City agent or employee against t other Cities. This wa" er is specifically negotiated by the parties and a portion of e City's payment hereunder 1 xpressly made the consideration for this waiver. 9. Insurance. ach City shall procure and maintain' full force throughout the duration of the Agree ent comprehensive general liabi . y insurance with a minimum coverage of $1,000,000. er occurrence/aggregate or personal injury and property damage. In the event that a ity is a member of pool of self-insured cities, the City shall provide proof of such mem ship in lieu the insurance requirement above. Such self insurance shall provide cover e eq to or greater that required of non-self insurance pool member Cities. 10. Oversight Committee. T s Agree nt shall be managed by an Oversight Committee made up of one re sentative of eac City. The representative of each City shall be that person desi ated in section 7 of is Agreement. The Oversight Committee shall meet at ast annually to discuss the te of the Agreement and manage the services provided rsuant to the Agreement. 11. A lica e Law' Venue' Attorne 's Fees. This Agreemen all be governed by and construe III accordance with the laws of the State of Washingto In the event any suit, arbit ion, or other proceeding is instituted to enforce any term of t . Agreement, the pa . es specifically understand and agree that venue shall be exclusive in King Cou y, Washington. The prevailing party in any such action shall be entitled 0 its atte5mey's fees and costs of suit. IN Wr~:~ESS WHEREOF{)he undersigned have entered into this MOD as of this .J~ day of 4~ ,2003. NTON ;;/~ ~~3vu~ City Attorney By: J Title: Mavor Date: ~- .J.Pl..003 Attest: ~\". LJ~ City Clerk, Bonnie I. Walton H:\HUMAN_SE\2003funding\JointFundingPilot\Hum Serv Joint Fund MOU.doc Final MOU . December 19, 2002 Joint Human Services Application and Funding MOD Page 60f7 CITY OF KENT By: Title: Date: Attest: CITY OF RENTON By: Title: Date: Attest: CITY OF SEAT AC By: ~ ~1! Bruce Ray m, City Manager Title: Date: -3p/0 Attest: CITY OF TUKWILA By: Title: Date: Attest: Approved As To Form: City Attorney Approved As To Form: City Attorney CJ[i T;;;~Oil.J City Attorney Approved As To Form: City Attorney Joint Human Services Application and Funding MOU Page 6 of7 CITY OF KENT By: Title: Date: Attest: CITY OF RENTON By: Title: Date: Attest: CITY OF SEAT AC By: Title: Date: Attest: CITY OF TSKWILA By:QfJ S~,..;) ,V)\V)WlQ.J- Title 4/1 d, tl--u Date: III., I d :3 #; ;;..L'.' , ~ -;-t-- Attest: t'.~. " . , .,~ . ~ (!.i!.[{4<---' C;\WINDOWS\TEMP\Hum Serv Joint Fund MOU.doc Final MOU, December 17,2002 Approved As To Form: City Attorney Approved As To Form: City Attorney Approved As To Form: City Attorney Approved As To Form: Joint Human Services Application and Funding MOD Page 7 of7 EXHIBIT A to Memorandum of Understanding (MOU) between the Cities for planning, funding, and implementation of a joint human services application and funding program. CALENDAR YEAR 2003 Name of Nonprofit Agency Participating Cities & Tentative Fundint! Crisis Clinic for the telephone Auburn - Lead City - $1,500 referral line Burien - $4,500 Des Moines - $2,500 Kent - $5,000 Federal Way - $10,000 Renton - $3,300 SeaTac - $2,780 Tukwila - $2,000 TOTAL - $36,580 King County Sexual Assault Renton - Lead City - $35,000 Resource Center (KCSARC) Auburn - $26,500 for sexual assault services Burien - $7,500 Des Moines - $4,000 Kent - $20,000 Federal Way - $35,000 SeaTac - $7,200 Tukwila - $14,000 TOTAL - $152,700 Community Health Centers Kent - Lead City - $58,450 for comprehensive medical Auburn - $27,550 services for low and moderate Federal Way - $31,827 Income persons. Renton - $24,000 SeaTac - $10,600 TOTAL - $155,627 Part- Time Domestic Violence Kent - Lead City - $15,000 Planner through King County Renton - $5,000 Coalition Against Domestic TOTAL - $20,000 Violence for planning activities in South King County. R:IAD\Contracts\2002 Contracts\HwnServ-ArtsCult-CityMatch Contracts\Hum Serv Joint Fund MOU.doc Final MOD - April 3, 2003 CITY OF RENTON 1055 S. GRADY RENTON, WA 98055 (425) 430-6897 CITY OF FEDERAL WAY PATRICK BRIGGS PO BOX 9718 FEDERAL WAY, W A 98063 MAKE CHECKS PAYABLE TO THE CITY OF RENTON PLEASE DETACH AND RETURN WITH YOUR REMITTANCE CITY OF RENTON Miscellaneous Interlocal Agreement for King County Sexual Assault Resource Center (KCSARC) 1] 1"'- - /1,1 '"Xl t?) ++ "'=I- C" /~ -~~O W<ZL -fiLO ~clp.?eJea .eJnIEU6!S .IUSH d JOt. ,. "1! r 1_'." ~ ' " # Je ..) J01l-,.~;_J\j pZZjJOlunB 841 S'tj 'eO!OMI! S!Ln uo pelB~S SB p6A!eOeJ ueaq eAB4 SeO!Al8:J )O/Pl.B aSlPUB40JaW a41llnn aE,.;aIMOU>foB ^qeJal~ I COI-73CD-OZ3r-Sh lX-to --4/0 A-G.tf 03 ~o~(p ACCOUNT NO. 1337 Please Remit to: CITY OF RENTON 1055 S. GRADY WAY RENTON, W A 98055 f'( ooF INVOICE 02355 AMOUNT PAID 0211112003 1337 35,000.00 3/18/2003 Total Amount Due: PAYABLE UPON RECEIPT 35,000.00 35,000.00 35,000.00 ACORQM CERTIFICATE OF LIABILITY INSURANCE 112~i1M_2D002 PRODUCER THIS CERTIFICATE IS ISSUED ~S A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WILLIAM F. DAVIS INSURANCE AGENCY, INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P .0. BOX 45 2 ~ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. RENTON, WA. 98057 Ab 0 J--4f0, INSURERS AFFORDING COVERAGE .1~~u~;Dl~.2--68]~-.-.--- .--.-----+I~SUA~~A:.WEST~RN...WORLD_ INSURANCE COMPANY --== KING COUNTY SEXUAL AS SAUL T RESOURCE CENTER ; INSURERB UNIGARD INSURANCE COMPANY 1--......-...-----..--.---... P .0. BOX 300 INSURER C: 1---.-.- .. -..-.--....------..--- RENTON, \~A. 98057 INSURERD.._ __._____~_____ . INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i~i:T--. TYPE OF;~SURANC-;-.'. ! _..__n ---- [".POLICY EFFECTIVE I POLICY EXPIRATiONr--."- -.-- ..- POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 ~ ! ; - A ffi'~'^' "'"'\"''';'^''''w I NPP720373/1 11-23-2002 11-23-2003, FIRE DAMAG!,_.~Any one fire) $ 50,000 : CLAIMS MAlJE l."-..J OCCUR , iviED EXP (Any aile person) ,$ 1,000 r-.- i $ 1 ,000,000 '-X WA S TOP--GAE.--.-- I PERSONAL & ADV INJURY ~.;;;;"''''''' """ '"''''' ,,;;. GENERAL AGGREGATE $2,000,000 . .u_ $ INCLUDED-- PRODUCTS. COMP/OP AGG POLICY h j~gT n' LOC ...-.--- ! AUTOMOBILE LIABILITY ! COMBINED SINGLE LIMIT ~. (Ea accident) $1,000,000 : ANY AUTO I ~ --.........- . I ALL OWNED AUTOS i BODILY INJURY '--j $ i -l SCHEDULED AUTOS : (Per person) r----........--- -.-- B '~ HIRED AUTOS PX808932 11-23-2002 11-23-20031 BODILY INJURY i tx-: NON.OWNED AUTOS (Per accident) i$ .--.-- ~m. ...----.- PROPERTY DAMAGE $ : (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ---,.,~ -"--'_.'--"-'-"'- .- ANY AUTO OTHER THAN EA ACC $ -.-.- ______I I AUTO ONLY: AGG $ , EXCESS LIABILITY i EACH OCC'!fl~5_f\ICE $ CJ OCCUR D CLAIMS MADE .-........ ! AGGREGATE 1$ -.---.---- ~_.__._.__.- ~_~ DEDUCTIBLE 1$ ... - I -- _.-.- i$ "-~_.'.-'- RETENTION $ $ WORKERS COMPENSATION AND I. we STATU- ! IOTH- TORY LIMITS i EA EMPLOYERS' LIABILITY ----~ E.L. EACH ACCIDENT $ --...-.-- : I ---.-...-..........-.-......- I nEC~C'OISEASE . EA EMPLOYEE $ ...-...-.... , i E.L. DISEASE. POLICY LIMIT $ ! OTHER i i ; LIABILIITY A iPROFESSIONAL NPP720373/1 11-23-2002 11-23-2003 $1,000,000 EA. INCIDENT DESCRIPTION OF OPERATIONSlLOCATlONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICA TE E10LDER IS AN ADD IT I ONAL INSURED AS RESPECTS: CONTRACT ISSUED FOR OPERA lIONS AS SEXUAL ASSAULT AND EDUCA lION SERVICE. CERTIFICATE HOLDER 'x' ADDITIONAL INSURED; INSURER LETTER: CANCEllATION CITY OF FEDERAL WAY P.O. BOX 9718 FEDERAL WAY, WA. 98063-9718 ATTN: LYDIA ASSEFA-DAWSON SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3CL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR ACORD 25-5 (7/97)