HomeMy WebLinkAboutPK07-165 - Original - WA Dept of Social & Health Services - Safe Havens Visitation Center - 01/15/2007 Records Management
0000�KENT Document
WA9HINGTOM
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./ Vs /V6r 6�r. / Vendor Number:
JD Edwards umber
Contract Number:
This Is assigned by Mary Simmons
Description
i
Detail:
U/sum 4!' rL''f.S
Project Name:
Contract Effective Date: Termination Date:
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Department: !'
Abstract: /
S Public\RecordsManagement\Forms\Contractcover\ADCL7832 07/02
DSHS
INTERLOCAL AGREEMENT 0764-1Agreement079Number
0764-11079
SAFE HAVENS VISITATION CENTER
This Agreement is by and between the State of Washington Department 150 am Contract Number
of Social and Health Services DSHS and the Contractor identified Contractor
ctor Contract Number
below, and is issued pursuant to the Interlocal Cooperation Act, chapter
39 34 RCW.
CONTRACTOR NAME CONTRACTOR doing business as(DBA)
C dy of Kent
CONTRACTOR ADDRESS WASHINGTON UNIFORM DSHS INDEX NUMBER
BUSINESS IDENTIFIER(UBI)
220 4th Ave South
22475
Kent,WA 98032-5895
CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAILADDRESS
Katherin Johnson 253 856-5073 Ext ) -
DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE
ALL All Divisions I 2000LC-64
DSHS CONTACT NAME AND TITLE DSHS CONTACT ADDRESS
Maureen Kelly PO Box45710
Program Manager
Olympia,WA 98504
DSHS CONTACT TELEPHONE DSHS CONTACT FAX DSHS CONTACT E-MAIL ADDRESS
360 902-7901 360 902-7903 1keIm3Q0adshswaqov
IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS CONTRACT? CFDA NUMBER(S)
No
AGREEMENT START DATE AGREEMENT END DATE MAXIMUM AGREEMENT AMOUNT
01/15/2007 1 50000
EXHIBITS. The following Exhibits are attached and are incorporated into this Agreement by reference:
❑ Exhibits(specify):
® No Exhibits
The terms and conditions of this Agreement are an integration and representation of the final,entire and exclusive
understanding between the parties superseding and merging all previous agreements,writings,and communications,oral
or otherwise regarding the subject matter of this Agreement, between the parties The parties signing below represent
they have read and understand this Agreement, and have the authority to execute this Agreement This Agreement shall
be binding on DSHS only upon signature by DSHS
CONT SIGNATURE PRINTED NAME AND TIT DATE SIGNED
Z OO "B O
D S G TUR INTE tUCI iTIb1h Contracts Niana DATE SIGNED
DSHS, Chili rec'S Atlm rl6stration l Q p
DSHS Central Contract Sel
6015LF Custom Interlocal Agreement(9-28-06) Page 1
DSHS General Terms and Conditions
1. Definitions The words and phrases listed below, as used in this Contract, shall each have the
following definitions
a "Central Contract Services" means the DSHS central headquarters contracting office, or successor
section or office
b. "Contract" means the entire written agreement between DSHS and the Contractor, Including any
Exhibits,documents, and materials incorporated by reference
c. "Contracts Administrator"means the manager, or successor, of Central Contract Services or
successor section or office
d. "Contractor"means the Individual or entity performing services pursuant to this Contract and
includes the Contractor's owners,members, officers, directors, partners, employees, and/or agents,
unless otherwise stated in this Contract For purposes of any permitted Subcontract, "Contractor"
Includes any Subcontractor and Its owners, members, officers, directors, partners, employees,
and/or agents The Contractor for this contract is City of Kent
e. "Debarment"means an action taken by a Federal official to exclude a person or business entity
from participating in transactions involving certain federal funds
f "DSHS"or the"Department"means the state of Washington Department of Social and Health
Services and its employees and authorized agents
g "Personal Information"means information identifiable to any person, including, but not limited to,
information that relates to a person's name, health,finances, education, business, use or receipt of
governmental services or other activities, addresses, telephone numbers, Social Security Numbers,
driver license numbers, other identifying numbers,and any financial identifiers
h. "RCW"means the Revised Code of Washington All references in this Contract to RCW chapters
or sections shall include any successor, amended, or replacement statute Pertinent RCW chapters
can be accessed at http Usic leg wa gov/.
i. "Regulation"means any federal, state, or local regulation, rule, or ordinance.
I. "Subcontract"means any separate agreement or contract between the Contractor and an individual
or entity("Subcontractor")to perform all or a portion of the duties and obligations that the Contractor
is obligated to perform pursuant to this Contract
k. "Subrecipient"means a non-federal entity that expends federal awards received from a pass-
through entity to carry out a federal program, but does not include an individual that is a beneficiary
of such a program. A subrecrpient may also be a recipient of other federal awards directly from a
federal awarding agency
I. "WAC"means the Washington Administrative Code All references in this Contract to WAC
chapters or sections shall include any successor, amended, or replacement regulation Pertinent
WAC chapters or sections can be accessed at http //sic leg wa gov/
2. Amendment. This Agreement may only be modified by a written amendment signed by both parties
Only personnel authorized to bind each of the parties may sign an amendment
3. Assignment. The Contractor shall not assign this Agreement or Program Agreement to a third party
DSHS Central Contract Services
6015LF Custom Interiocal Agreement(9-28-06) page 2
DSHS General Terms and Conditions
without the prior written consent of DSHS
4. Billing Limitations.
a. DSHS shall pay the Contractor only for authorized services provided in accordance with this
Contract
b. DSHS shall not pay any claims for payment for services submitted more than twelve(12)months
after the calendar month in which the services were performed
c. The Contractor shall not bill and DSHS shall not pay for services performed under this Contract, If
the Contractor has charged or will charge the state of Washington or any other party for the same
services.
5. Compliance with Applicable Law. At all times during the term of this Contract, the Contractor shall
comply with all applicable federal, state, and local laws and regulations, Including but not limited to,
nondiscrimination laws and regulations
6. Confidentiality. The Contractor may use Personal Information and other information gained by reason
of this Agreement only for the purpose of this Agreement The Contractor shall not disclose,transfer,
or sell any such Information to any party, except as provided by law or, in the case of Personal
Information,without the prior written consent of the person to whom the Personal Information pertains
The Contractor shall maintain the confidentiality of all Personal Information and other information
gained by reason of this Agreement, and shall return or certify the destruction of such Information If
requested in writing by DSHS
7. Debarment Certification.The Contractor, by signature to this contract, certifies that the Contractor is
not presently debarred, suspended, proposed for debarment, declared Ineligible, or voluntarily excluded
by any Federal department or agency from participating in transactions The Contractor also agrees to
Include the above requirement in any and all subcontracts Into which it enters
8. Governing Law and Venue. This contract shall be construed and Interpreted in accordance with the
laws of the state of Washington and the venue of any action brought hereunder shall be in Superior
Court for Thurston County In the event that an action is removed to U S District Court, venue shall be
in the Western District of Washington.
9. Independent Contractor. The parties intend that an independent contractor relationship will be
created by this contract The Contractor and his or her employees or agents performing under this
contract are not employees or agents of the Department The Contractor, his or her employees,or
agents performing under this contract will not hold himself/herself out as, nor claim to be, an officer or
employee of the Department by reason hereof, nor will the Contractor, his or her employees, or agent
make any claim of right, privilege or benefit that would accrue to such employee
10. Inspection. In addition to any rights of access or inspection that may be included in the Special Terms
and Conditions, or in any Program Agreement, the Contractor shall provide reasonable access to the
Contractor's place of business, Contractor records, and client records, to DSHS and to any authorized
agent of the state of Washington or the federal government in order to monitor, audit, and evaluate the
Contractor's performance and compliance with applicable laws, regulations, and these Contract terms
during the term of this Contract and for one (1) year following termination or expiration of this Contract
11. Maintenance of Records. The Contractor shall maintain records relating to this contract and the
performance of the services described herein, including but not limited to accounting procedures and
DSHS Central Contract Services
6015LF Custom Interlocal Agreement(9-26-06) page 3
DSHS General Terms and Conditions
practices,which sufficiently and properly reflect all direct and indirect costs of any nature expended in
the performance of this contract. All records and other material relevant to this contract shall be
retained for six(6) years after expiration or termination of this contract At no additional cost,these
records shall be subject at all reasonable times to Inspection, review or audit by the department,
personnel duly authorized by the department,the Office of the State Auditor, and any federal and state
officials so authorized by law, regulation or agreement
If any litigation,claim or audit is started before the expiration of the six (6)year period, the records shall
be retained until all litigation, claims or audit findings involving the records have been resolved
12. Order of Precedence. In the event of any inconsistency or conflict between the General Terms and
Conditions and the Special Terms and Conditions of this agreement or any Program Agreement,the
inconsistency or conflict shall be resolved by giving precedence to these General Terms and
Conditions
13. Severability. If any term or condition of this Contract is held invalid by any court, such invalidity shall
not affect the validity of the other terms or conditions of this Contract.
14. Survivability. The terms and conditions contained in this Agreement or any Program Agreement
which, by their sense and context, are intended to survive the expiration or termination of the particular
agreement shall survive. Surviving terms include, but are not limited to Billing Limitations,
Confidentiality, Disputes, Indemnification and Hold Harmless, Inspection, Maintenance of Records,
Notice of Overpayment, Ownership of Material,Termination for Default,Termination Procedure, and
Treatment of Property.
15. Termination Due to Change in Funding. If the funds DSHS relied upon to establish this Agreement
or Program Agreement are withdrawn, reduced or limited, or if additional or modified conditions are
placed on such funding, DSHS may immediately terminate this Agreement by providing written notice to
the Contractor. The termination shall be effective on the date specified in the termination notice
16. Waiver. Waiver of any breach or default on any occasion shall not be deemed to be a waiver of any
subsequent breach or default Any waiver shall not be construed to be a modification of the terms and
conditions of this Contract Only the DSHS Chief Administrative Officer or designee has the authority to
waive any term or condition of this Contract on behalf of DSHS.
Additional General Terms and Conditions— Interlocal Agreements:
17. Disputes Disputes shall be determined by a Dispute Board. Each party to this Agreement shall
appoint one member to the Dispute Board The members so appointed shall jointly appoint an
additional member to the Dispute Board The Dispute Board shall review the facts,Agreement terms,
and applicable statutes and rules and make a determination of the dispute As an alternative to this
process, either party may request intervention by the Governor, as provided by RCW 43.17 330, in
which event the Governor's process shall control Participation in either dispute process shall precede
any judicial or quasi-judicial action and shall be the final administrative remedy available to the parties
18. Hold Harmless
a The Contractor shall be responsible for and shall hold DSHS harmless from all claims, loss, liability,
damages, or fines arising out of or relating to the Contractor's,or any Subcontractor's, performance
or failure to perform this Agreement, or the acts or omissions of the Contractor or any
Subcontractor DSHS shall be responsible for and shall hold the Contractor harmless from all
DSHS Central Contract Services
6015LF Custom Interlocal Agreement(9-20-06) Page 4
DSHS General Terms and Conditions
claims, loss, liability, damages, or fines arising out of or relating to DSHS' performance or failure to
perform this Agreement
b. The Contractor waives its Immunity under Title 51 RCW to the extent it is required to Indemnify,
defend,and hold harmless the State and its agencies, officials, agents, or employees.
19. Ownership of Material Material created by the Contractor and paid for by DSHS as a part of this
Contract shall be owned by DSHS and shall be"work made for hire'as defined by Title 17 USCA,
Section 101 This material Includes, but is not limited to books, computer programs, documents,films,
pamphlets, reports, sound reproductions, studies,surveys, tapes, and/or training materials Material
which the Contractor uses to perform the Contract but is not created for or paid for by DSHS is owned
by the Contractor and is not "work made for hire"; however, DSHS shall have a perpetual license to use
this material for DSHS Internal purposes at no charge to DSHS, provided that such license shall be
limited to the extent which the Contractor has a right to grant such a license
20. Subrecipients
a. General If the Contractor is a subrecipient of federal awards as defined by Office of Management
and Budget(OMB) Circular A-133 and this Agreement, the Contractor shall
(1) Maintain records that identify, in its accounts, all federal awards received and expended and the
federal programs under which they were received, by Catalog of Federal Domestic Assistance
(CFDA)title and number, award number and year, name of the federal agency, and name of the
pass-through entity,
(2) Maintain Internal controls that provide reasonable assurance that the Contractor is managing
federal awards in compliance with laws, regulations, and provisions of contracts or grant
agreements that could have a material effect on each of its federal programs,
(3) Prepare appropriate financial statements, Including a schedule of expenditures of federal
awards,
(4) Incorporate OMB Circular A-133 audit requirements into all agreements between the Contractor
and Its Subcontractors who are subrecipients,
(5) Comply with any future amendments to OMB Circular A-133 and any successor or replacement
Circular or regulation,
(6) Comply with the applicable requirements of OMB Circular A-87 and any future amendments to
OMB Circular A-87, and any successor or replacement Circular or regulation; and
(7) Comply with the Omnibus Crime Control and Safe streets Act of 1968,Title Vl of the Civil Rights
Act of 1964, Section 504 of the Rehabilitation Act of 1973,Title II of the Americans with
Disabilities Act of 1990,Title IX of the Education Amendments of 1972, The Age Discrimination
Act of 1975, and The Department of Justice Non-Discrimination Regulations, 28 C F R Part 42,
Subparts C D E and G, and 28 C F R Part 35 and 39 (Go to www oip usdoi gov/ocr/for
additional information and access to the aforementioned Federal laws and regulations.)
b. Single Audit Act Compliance If the Contractor is a subrecipient and expends$500,000 or more in
federal awards from any and/or all sources in any fiscal year,the Contractor shall procure and pay
for a single auditor a program-specific audit for that fiscal year Upon completion of each audit, the
Contractor shall-
DSHS Central Contract Services
6015LF Custom Interlocal Agreement(9-28-06) Page 5
DSHS General Terms and Conditions
(1) Submit to the DSHS contact person the data collection form and reporting package specified in
OMB Circular A-133, reports required by the program-specific audit guide (If applicable), and a
copy of any management letters Issued by the auditor,
(2) Follow-up and develop corrective action for all audit findings, in accordance with OMB Circular
A-133, prepare a "Summary Schedule of Prior Audit Findings "
c. Overpayments. If it is determined by DSHS,or during the course of a required audit,that the
Contractor has been paid unallowable costs under this or any Program Agreement, DSHS may
require the Contractor to reimburse DSHS in accordance with OMB Circular A-87
21. Termination.
a. Default If for any cause, either party falls to fulfill Its obligations under this Agreement in a timely
and proper manner, or if either party violates any of the terms and conditions contained In this
Agreement, then the aggrieved party will give the other party written notice of such failure or
violation The responsible party will be given 15 working days to correct the violation or failure If
the failure or violation is not corrected, this Agreement may be terminated Immediately by written
notice from the aggrieved party to the other party.
b Convenience. Either party may terminate this Interlocal Agreement for any other reason by
providing 30 calendar days'written notice to the other party
c. Payment for Performance If this Interlocal Agreement is terminated for any reason, DSHS shall
only pay for performance rendered or costs Incurred in accordance with the terms of this Agreement
and prior to the effective date of termination
22. Treatment of Client Property Unless otherwise provided, the Contractor shall ensure that any adult
client receiving services from the Contractor has unrestricted access to the client's personal property
The Contractor shall not interfere with any adult client's ownership, possession, or use of the client's
property The Contractor shall provide clients under age eighteen (18) with reasonable access to their
personal property that is appropriate to the client's age, development, and needs Upon termination of
the Contract, the Contractor shall Immediately release to the client and/or the client's guardian or
custodian all of the client's personal property.
APPROVED AS TO FORM BY THE OFFICE OF THE ATTORNEY GENERAL
DSHS Central Contract Services
6015LF Custom Interlocal Agreement(9-26-06) Page 6
Special Terms and Conditions
1. Definitions Specific to Special Terms. The words and phrases listed below, as used in this Interlocal
Agreement,shall each have the following definitions
a. "Agreement" means this Interlocal Agreement, including all documents attached or incorporated by
reference.
b. "CA" means Children's Administration and its employees and authorized agents.
2. Purpose
The purpose of this Agreement is to provide one-time funding to the City of Kent, as authorized by
budget proviso for FY07 under ESSB 6386, for supervised visitation and safe exchange services to be
provided by the Safe Havens Visitation Center in Kent to families impacted by domestic violence,
sexual assault,child abuse, and stalking.
3. Statement of Work
The City of Kent as Contractor shall provide services under this Agreement as follows:
a. The Contractor shall ensure that funds payable under this Agreement will be used to provide
supervised visitation and safe exchange services for families impacted by domestic violence, sexual
assault,child abuse, and stalking Funds shall not be used by the City of Kent for policy
development and outreach
b. The Contractor shall provide such services to families through the Safe Havens Visitation Center in
Kent The Safe Havens Visitation Center is a supervised visitation and safe exchange center for
families impacted by domestic violence, sexual assault,child abuse, and stalking The mission of
the Safe Havens Visitation Center is to provide a culturally sensitive,safe and accessible
supervised visitation and exchange program to families affected by intimate partner violence and
abuse All policies and procedures of the Safe Havens Visitation Center have been designed to
increase safety for the victim and child and decrease opportunities for continued abuse
c. Through the Safe Havens Visitation Center,the Contractor shall provide such services to 8 families,
with approximately 48 hours of service for each family
Services shall include:
(1) Intake of relevant family history and other information for services(approximately 15 hours per
family),
(2) Child Orientations (approximately 5 hours per family);
(3) Supervised visits and/or exchanges (visits are generally 1 hour per week with an additional .75
hours pre/post wait/debrief time and exchanges use .5 hours per occurrence),
(4) Regular case consults and related documentation (average of approximately 5 - 75 hours per
week, per case).
All services listed above shall be performed by a trained supervised visitation monitor and/or the
visitation center program supervisor employed by the City of Kent
d. Reports The Contractor shall provide progress reports regarding the above activities to the DSHS
Contact listed on page 1 of this Agreement The reports shall be completed and submitted to
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6015LF Custom Interlocal Agreement(9-26-06) Page 7
Special Terms and Conditions
DSHS using a form as prescribed by DSHS to be provided following execution of this Agreement.
The reports shall be submitted in accordance with the following schedule-
Quarter Reporting Period Due Date
1 01/01/07—03/31/07 04/15/07
2 04/01/07—06/30/07 07/15/07
4. Consideration
Maximum Agreement Amount. The maximum amount of total compensation payable to the Contractor
for satisfactory performance of the work under this Agreement is the amount of$50,000 as stated on
page 1 of this Agreement under"Maximum Agreement Amount,"and Is based on the following
Fundin The operative budget proviso for FY07 contained in ESSB 6386. PL provided one-time
funding for the Safe Havens Visitation Center in Kent to provide supervised visitation and safe
exchange services as follows under ESSB 6386, section 202
Subsection(15) $50,000 of the general fund—state appropriation for fiscal year 2007 Is provided solely for the
supervised visitation and safe exchange center In Kent The department shall not retain any portion for
administrative purposes
5. Billing and Payment
a. The Contractor shall submit at least quarterly, and not more often than monthly, invoices for
services performed as described In this Agreement on State of Washington Invoice Voucher forms
(Form A-19), prepared in the manner prescribed by DSHS
b. The voucher shall clearly indicate that it is "FOR SERVICES RENDERED IN PERFORMANCE
UNDER DSHS AGREEMENT NO.0764-11079 FOR THE MONTH(S) OF _, 2007"
c The A-19 invoice vouchers shall be submitted to
Maureen Kelly, Program Manager
Children's Administration
PO Box 45710
Olympia,WA 98504-5710
d. The Contractor shall contact the above Program Manager at (360) 902-7901 concerning billing
questions.
e. DSHS may withhold payment to the Contractor if reports required under this Agreement are not
submitted within 10 working days of the due date,or are incomplete.
f DS HS may, at its sole discretion,withhold payment claimed by the Contractor for services rendered
If Contractor fails to satisfactorily comply with any term or condition of the Agreement
g. Claims for payment must be received by DSHS no later than sixty(60) days from the date services
were rendered
h. DSHS shall make payment within thirty(30) days of receipt of a properly completed invoice for
services
DSHS Central Contract Servnces
6015LF Custom Interlocal Agreement(9-28-06) Page 8
r
Special Terms and Conditions
6. Payment Only for Authorized Services
DSHS shall pay the Contractor only for authorized services provided in accordance with this
Agreement If this Agreement Is terminated for any reason, DSHS shall pay only for services
authorized and provided through the date of termination
7. Funding Stipulations
a. Duplicate Billing The Contractor must not bill other funding sources for services rendered under
this Agreement which would result in duplicate billing to different funding sources for the same
service. Furthermore, the Contractor shall ensure that no subcontractor bills any other funding
sources for services rendered under this Agreement, which would result In duplicate billing to
different funding sources for the same service
b. No Federal Match The Contractor shall not use funds payable under this Agreement as match
toward federal funds without the prior written permission of DSHS
c. Supplanting The Contractor shall use these funds to supplement, not supplant the amount of
federal,state and local funds otherwise expended for services provided under this Agreement.
8. Recovery of Fees for Noncompliance
In the event the Contractor bills for services provided and is paid fees for services that DSHS later finds
were either(a) not delivered or (b) not delivered in accordance with applicable standards or the
requirements of this Agreement, DSHS shall have the right to recover the fees for those services from
the Contractor, and the Contractor shall fully cooperate during the recovery process
9. Prohibition of Use of Funds for Lobbying Activities
The Contractor, shall not use funds payable under the Agreement for lobbying activities of any nature
The Contractor certifies that no state or federal funds payable under this Agreement shall be paid to
any person or organization to influence, or attempt to Influence, either directly or Indirectly, an officer or
employee of any state or federal agency, or an officer or member of any state or federal legislative body
or committee, regarding the award, amendment, modification, extension, or renewal of a state or
federal contract or grant
Any act by the Contractor in violation of this prohibition shall be grounds for termination of this
Agreement,at the sole discretion of DSHS, and shall subject Contractor to such monetary and other
penalties as may be provided by law
10. Administrative Records
The Contractor shall retain all fiscal records that substantiate all costs charged to DSHS under this
Agreement
11. Auditing and Monitoring
DSHS may schedule monitoring visits with the Contractor to evaluate performance of services. The
Contractor shall provide at no further cost to DSHS reasonable access to all service-related records
and materials, Including financial records in support of billings, and records of staff time
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Special Terms and Conditions
12. Insurance. For purposes of this Agreement.
Each Party to this Agreement certifies that It Is self-insured under the state of Washington self-
Insurance liability program, as provided by RCW 4 92 130, and shall pay for losses for which It Is found
liable.
DSHS Central Contract Sermces
6015LF Custom Interlocal Agreement(9-28-06) Page 10
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