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HomeMy WebLinkAboutPK07-075 - Original - Jewish Family Services - Immigrant Refuge Employment Assistance - 01/01/2007 O Records Management KEN V WASHINGTON Document I CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed, if you have questions, please contact Mary Simmons, City Clerks Office. Vendor Name: PJVVI 1 1r1 Vendor Number: 6 v VYVu,I �A CZ (Cfj f V-- JD Edwards Number Contract Number: This is assigned by Mary Simmons Description: W/U L'tw p- Detail: Ave's FU nd 1 ,16 ron+ 2d! Project Name: I'll Contract Effective Date: V:' Termination Date: 1 Z—3 "09 Contract Renewal Notice (Days): I V t 1 r N ( 30 LJ04 S Number of days required notice for termination or renewal ro amendment Contract Manager: M�A ( I/�� .I�S� Department: I'�VrVtCWI S-P.rVi�tS Abstract: S Pubric\RecordsManagement\Forms\ContractCover\ADCL7632 07/02 KENT W/5HIN 0 T a N CONSULTANT SERVICES AGREEMENT between the City of Kent and Jewish Family Service and Multi-Ethnic Service Center THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Jewish Family Service and Multi-Ethnic Service Center organized under the laws of the State of Washington, located and doing business at 1209 Central Ave S., Suite 131, Kent, WA 98031 (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: Consultant shall provide job readiness training, joh placement, and retention services for low- income refugee or immigrant residents of Kent with limited English language skills. The following exhibits are attached and incorporated by this reference as if fully set forth herein. Exhibit A, Scope and Schedule of Work; Exhibit B,Billing Voucher and Service Report, Exhibit C, Kent First and Final Outcome Report; Exhibit D, Demographic Report; Exhibit E, Insurance Certificate; and Exhibit F, Debarment Certification. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices in effect at the time those services are performed. II. TIME OF COMPLETION. The term of this Agreement shall run from January 1, 2007, through December 31, 2008. However, due to the delay in execution of this Agreement, the parties agree that all actions consistent with the authority of this Agreement and prior to the date of the Agreement's execution are hereby ratified and affirmed, and the terms of this Agreement shall be deemed to have applied. The parties agree that Consultant shall complete the work described in Section I by December 31, 2008 This Agreement, however, is contingent upon the availability of funds to be allocated through the City's budget process. During the term of this Agreement should the City determine that funds to support Consultant's services are no longer available, the City shall provide Consultant seven(7) days advance written notice of summary termination. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $15,000 ($7,500 per year) for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed supplemental agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of CONSULTANT SERVICES AGREEMENT- 1 (Over$10,000) one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. The Consultant shall submit quarterly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement and that the Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER CONSULTANT SERVICES AGREEMENT-2 (Over$10,000) The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit E attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The city's use or reuse of any of the documents, data and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. CONSULTANT SERVICES AGREEMENT-3 (Over S 10,000) D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. IN WITNESS, the parties below execute this Agreement,which shall become effective on the last date entered below. CONSULTANT: iR By: kT�(signature) signature)Print Name: - vl- e Cooke Its ( r = 7(Title) (7itle) DATE: co -7 DATE: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Ken Weinberg, Executive Director Katherin Johnson, Human Services Manager Jewish Family Service & Multi-Ethnic Service Center City of Kent 1601 Wh Avenue 220 Fourth Avenue South Seattle, WA 98122 Kent, WA 98032 (206) 461-3240 (telephone) (253) 856-5070 (telephone) (206) 461-3696 (facsimile) (253) 856-5073 (facsimile) APPROVED AS TO FORM: CONSULTANT SERVICES AGREEMENT-4 (Over$10,000) nt aw Dena ent P Human Services\General Fund\General Fund 2007-2008 ContractVFS CSA 2007-2008\ CONSULTANT SERVICES AGREEMENT-5 (Over 510,000) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. Dated this _ l day of d V//wo ,200 By: For: �)Or U t C -P Title: Date: D 31 f D -7 EEO COMPLIANCE DOCUMENTS- 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year,must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS-2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date) , between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. Dated this day of 2200 ._ By: For: Title: Date: EEO COMPLIANCE DOCUMENTS -3 EXHIBIT A SCOPE AND SCHEDULE OF WORK 2007 CONSULTANT SERVICES AGREEMENT JEWISH FAMILY SERVICE AND MULTI-ETHNIC SERVICE CENTER Immigrant Refugee Employment This program provides job readiness training, job placement, and retention services to low income immigrants and refugees in the City of Kent with limited English language skills. This funding will provide: Outputs Unduplicated Kent Clients 14 Number of Pre-Employment Training Hours 175 Number of Job Placements 3 Membership and participation in the South King Council of Human Services Outcome Immigrant and refugee residents will have increased employability and financial self- sufficiency Budget Personnel $3,750 Nonpersonnel $3,750 Total $70500 Reporting Requirements and Timeline The agency will be reimbursed on a quarterly basis, upon submittal of appropriate documentation. Such documentation will include the following (as applicable). Billing Voucher & Service Report (Exhibit B), Outcome Based Evaluation Report (Exhibit C), and Client Demographic Data (Exhibit D) These items must be submitted on forms provided by the City by the 10th of following month for the previous quarter of service The reporting timeline is as follows Billing Voucher& Service Report(Exhibit B) 10T"day following each quarter Final Billing Voucher(4th Qtr Exhibit B) December 14, 2007 Outcome Based Evaluation Report(Exhibit C) July 31, 20071January 31, 2008 Client Demographic Data (Exhibit D) January 31, 2008 Contract Administration The Consultant will notify the City, in writing, within (10) days of any changes in program personnel or board membership The Consultant shall provide the City with a current list of its board of directors, general or limited partners, as applicable. All records related to this contract must be retained for three years plus the current year. EXHIBIT A SCOPE OF WORK (CONTINUED) 2007 JEWISH FAMILY SERVICE AND MULTI-ETHNIC SERVICE CENTER Immigrant Refugee Employment This program provides job readiness training, job placement, and retention services to low income immigrants and refugees in the City of Kent with limited English language skills. Pursuant to Item 1 of the Consultant Services Agreement executed on January 1, 2007, Jewish Family Service shall provide the approximate number of City of Kent clients with the following services: Quarter Service Unit Number of Cumulative Units Total 1St 1. Unduplicated City of Kent clients served 3 3 2. Pre-employment Training Hours 43 43 3 Number of Job Placements 0 0 2nd 1. Unduplicated City of Kent clients served 3 6 2. Pre-employment Training Hours 44 87 3. Number of Job Placements 1 1 3rd 1 Unduplicated City of Kent clients served 4 10 2. Pre-employment Training Hours 44 131 3. Number of Job Placements 1 2 4th 1. Unduplicated City of Kent clients served 4 14 2. Pre-employment Training Hours 44 175 3. Number of Job Placements 1 3 The above services shall be provided by December 31, 2007. 2007 Reimbursement: $7,500 Please sign to indicate acceptance of the Year 2007 Performance Measures listed above. K,ew� '4 Ken Weinbe g�J ish Family Service Executive Direc Date' a- a7-o7 Katherin Johnson, sin uma rvices Manager Date EXHIBIT A SCOPE AND SCHEDULE OF WORK 2008 CONSULTANT SERVICES AGREEMENT JEWISH FAMILY SERVICE AND MULTI-ETHNIC SERVICE CENTER Immigrant Refugee Employment This program provides job readiness training, job placement, and retention services to low income immigrants and refugees in the City of Kent with limited English language skills. This funding will provide: Outputs Unduplicated Kent Clients 14 Number of Pre-Employment Training Hours 175 Number of Job Placements 3 Membership and participation in the South King Council of Human Services Outcome Immigrant and refugee residents will have increased employability and financial self- sufficiency Budget Personnel $3,750 Nonpersonnel $3,750 Total $70500 Reporting Requirements and Timeline The agency will be reimbursed on a quarterly basis, upon submittal of appropriate documentation Such documentation will include the following (as applicable)- Billing Voucher & Service Report (Exhibit B), Outcome Based Evaluation Report (Exhibit C), and Client Demographic Data (Exhibit D) These items must be submitted on forms provided by the City by the 10th of following month for the previous quarter of service The reporting timeline is as follows Billing Voucher&Service Report (Exhibit B) 10T" day following each quarter Final Billing Voucher (41h Qtr Exhibit B) December 15, 2008 Outcome Based Evaluation Report(Exhibit C) July 31,2008/January 30, 2009 Client Demographic Data(Exhibit D) January 30, 2009 Contract Administration The Consultant will notify the City, in writing, within (10) days of any changes in program personnel or board membership. The Consultant shall provide the City with a current list of its board of directors, general or limited partners, as applicable. All records related to this contract must be retained for three years plus the current year. EXHIBIT A SCOPE OF WORK (CONTINUED) 2008 CONSULTANT SERVICES AGREEMENT— JEWISH FAMILY SERVICE AND MULTI-ETHNIC SERVICE CENTER Immigrant Refugee Employment Pursuant to Item 1 of the Consultant Services Agreement executed on January 1, 2007, Jewish Family Service shall provide the approximate number of City of Kent clients with the following services: Quarter Service Unit Number of Cumulative Units Total 1st 1. Unduplicated City of Kent clients served 3 3 2. Pre-employment Training Hours 43 43 3. Number of Job Placements 0 0 2nd 1. Unduplicated City of Kent clients served 3 6 2. Pre-employment Training Hours 44 87 3. Number of Job Placements 1 1 3`d 1. Unduplicated City of Kent clients served 4 10 2. Pre-employment Training Hours 44 131 3 Number of Job Placements 1 2 4th 1. Unduplicated City of Kent clients served 4 14 2 Pre-employment Training Hours 44 175 3. Number of Job Placements 1 3 The above services shall be provided by December 31, 2008. 2008 Reimbursement: $7,500 Please sign to indicate acceptance of the Year 2008 Performance Measures listed above. Ken Weinb g,Jewish Famil rvice Executive D Date 3 - a7-o7 Katherin Johnso , Ho g H an a ,ces Manager Date Exhibit B General Fund NS �KKNT 2007 Billing Voucher WASH NGTON and Service Report PARKS, RECREATION S COMMUNITY SERVICES To: Agency: Jewish Family Service Merina Hanson Housing & Human Services Parks,Recreation & Community Services program Contact: Jeanette Lozovsky 2204 Ave. South, Kent, WA 98032 Telephone: 425.643.2221 mhanson@ci.kent via us E-mail: jlozovsky@jfsseattle.org Phone: 253 856-5077 Reporting Period Program Amount Requested Immigrant Refugee Employment Is BUDGET SUMMARY FOR DEPARTMENT USE ONLY---- Total Contract Amount $ 7,600.00 ,VENDOR NUMBER#79920- -; �' Current Request $ ACCOUNT CODE 1000-6370-64150-4650! �„ Amount Remaining $ 2007 KENT FUNDED SERVICE UNITS Note: Unduplicated client counts must be reported both quarterly and year-to-date New City of Total Kent Total Service Service Unit Description Service Units Planned Kent Funded Funded Units to Date Each Quarter Service Units Service Units (ALL Funding This Quarter To Date Sources th Service Unit/Performance Measure l't 2" 3` 4 Unduplicated # of Kent clients served 3 3 4 4 # of pre-employment training hours 43 44 44 44 # of job placements 0 1 1 1 *Please attach a narrative explanation to this report in the event that the program is not meeting performance measures. Authorized Signature Date FOR DEPARTMENT USE ONLY AUTHORIZED FOR PAYMENT BY: DATE: ~ O o 0 N N a ^ O W w > 3 W 7S 4 O U— m F O w _ > LL v U w a� y Z c LV d ~ m Y a E Qco L E o E c=i ++ a W d Q t L O C 0 0 C OQ 0 N�Q)/ y+ LL c C 0 x � x E o c LL Z o_ 1 LL V Q a _m E i p a> W ° - v F o 73 D C >1 wW N z p O 0 W w aNi d U N 0 cr u, � d c w ui �' L O it � cz -0 a O V 0 _N vi i s ¢ Z aEi aEi N Q a 0 c�i d +. E rn Q (� (� cc o 0 O N N _ o r w+ W CO) T- w M C E O U m ❑ V � � m o co LL ; cCL n � a) w Z LV .o t ,L m c y a E o co E w v +. Q a► r Cd m o v Cy Y C O O C 0- O N c O Q a) y E E o ii Z C U O c +m �.+ � Y a t o L N U G t Y W `o (D E V a 0 b w Z o> c ro C O N c •z u CL vi N t W u CD a .Q U ai t w x N z E E Gco y U o w U � O rn � co cn (n � co OkC * R W n e W O2 � � � ¢ O ) Cl) 7 Q) cu \ Fa ) Z @ ¥ K \ WM QQ \ C CL § /Ike § \ E cca § _ k � L \ k / \ ( k \ % CL \ ° E § & U ± $ 7 \ / 4 % x cc j E ) kj} k 2§ a} G G ©22 § / 3k a \ �z [ ( dia § 2 0 2 / }/ / E E 2 2 # » § / % \ \ O O 7 e a hoc 0gCm WC ■ -0 M E O $ � 0Q O 2 Q e Z 7 2 > � \ ° § bi 9 I % Z - L 2 E 2 k _ E f CL \ ( z / a w 2 / k ) � ® k \ 0 / � } 0 a) (D r E o U Z 0 U- ) k 0 / x o : o { E 2 a ` : f k c R >1 ° ,z[ \ [ k § �i § ( ) ■ 2 m § /_ }) § / k E cc / \_ � 0 » \ \ § 2 2 § E , C 2 / 0 D cc $ a)2 m n Agency KENT Exhibit D Program WASMIN6TON PARKS, RECREATIONS 2007 Demographic Report Date COMMUNITY SERVICES Unduplicated Number of Clients Served* Agency/Program Unduplicated New Individuals this Year Client Residence'," _ - - Algona Auburn Black Diamond Burien Covington Des Moines Enumclaw Federal Way Kent Maple Valle Milton Normandy Park Pacific Renton SeaTac Seattle Tukwila Unincorporated King Count Unknown TOTAL Household Income Level 30%of Median or Below 50% of Median or Below 80% of Median or Below Above 80%of Median Unknown TOTAL Gender Male Female Age TOTAL 0-4 years 5- 12 years 13- 17 years 18-34 years 35-54 years 55-74 vears 75+ ears Unknown TOTAL Ethnicity Asian/Pacific Islander Black/African American His anic/Latino a Native American/Alaskan Native White/Caucasian Other Unknown TOTAL Female Headed Household Disabling Condition Limited English Speaking "Unduplicated means count each client only once per calendar year "List of all clients served in client residence category and Kent clients only in rest of the categories. ATTACHMENT E INSURANCE REQUIREMENTS FOR HUMAN SERVICES AGREEMENTS Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: 1. Commercial General Liability insurance shall be written on ISO occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors,products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. There shall be no endorsement or modification of the Commercial General Liability insurance for liability arising from explosion, collapse or underground property damage. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 1185 or a substitute endorsement providing equivalent coverage. 2. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 3. Professional Liability insurance appropriate to the Consultant's profession. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: 1. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $1,000,000 general aggregate and a $1,000,000 products-completed operations aggregate limit. 2. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. EXHIBIT E (Continued ) C. Other Insurance Provisions The insurance policies are to contain,or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty(30) days prior written notice by certified mail, return receipt requested,has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A M Best rating of not less than AN IL II. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. POLICY NUMBER PHPK2' 'i 304 COMMERCIAL GENERAL Jewish Fi rv1!/ Services LIABILITY CG 20 26 07 04 THIS I"I dC C PSEM£NT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies it is r ance provided under the following: COMMERCIAL GENERAL I I E I1_ITY COVERAGE PART SCHEDULE Name Of Additional lin sr redi Person(s) or Organization(s) .0.; ._•. City of Kent, Human Se l ce s n.• .mow • Information required to co it >lete this Schedule, if not shown above, will be shown in the Declarations Section 1I—Who Is An Insnr c is amended to include as an additional insured tl a persons)or orgenization(s)shown in the Schedule, but only with rear e, ; a liability for"bodily injury", "property damage"or"personal and advertising injury"caused, in whole or in part, by your ad s 1 r omissions or the acts or omissions of those actin!i on your behalf: A In the performance of yni it irigoing operations, or B In connection with your p re n ses owned by or rented to you CG 20 26 07 04 © ISO Properties,Inc., 2004 ©ISO Properties, Inc. 02006 SilverPiume Reference s ems, Inc.All Rights Reserved. KEN.. w. Exhibit F PARKS RECREATION 6 COMMUNITY SERVICES City of Kent Certification Regarding Debarment and Suspension Agency Name of Program(s) Certification A: Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief that its principals, a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal debarment or agency, b) Have not within a three-year period preceding this proposal, 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/ proposal had one or more public transactions (Federal, State, or local)terminated for cause or default 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (A) 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction The prospective participant shall submit an explanation of why it cannot provide the certification set out below The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction 3 The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default 4 The prospective primary participant shall provide immediate written notice to the department or agency to whom this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances 5 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 the rules implementing Executive Order 12549 You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of these regulations 6. The prospective primary 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 1 of 3 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 entering into this transaction 7. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclu- sion - Lower Tier Covered Transaction," provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions 8. 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 this eligibility of its principals Each participant may, but is not required to, check the Non-procurement List 9. 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 10. Except for transactions authorized under paragraph (6) of these instructions, if a participant in a covered transaction 11 knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default Certification B: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered Transactions 1. The prospective lower tier participant certifies, by submission of this proposal, 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 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal Instructions for Certification (B) 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/City of Kent, 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 which 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 You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations 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 2of3 6 The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclu- sion - Lower Tier Covered Transaction," 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, but is not required to, check the Nonprocurement 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 lower covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency with which this transaction originated may pursue available remedies including suspension and/or debarment Pnmary ontractor/Sub•Contractor(Print) Title Date o 33 ) 1 . e�)-7 Signature o Prima ry Co ub-Contract r Title Date (3, Adopted from HUD Form-2992 09104 3 of 3