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HomeMy WebLinkAboutPK08-226 - Original - WA State Dept of Social & Health Services - Safe Havens Agreement # 08-64-31175 - 03/15/2008 Records Managem 'e'nt KENO Document W ABHINOTON 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: Vendor Number. X536455 7 Q JD Edwards Number Contract Number: I "2 2(P This is assigned by Mary Simmons Description: Axe400x ex-e Detail- 4 .4 Ar. Le U %'-� 1 Pro ect Nam Contract Effective Date: Termination Date: /eD Contract Renewal Notice (Days): Number of days required notice for terminati n or renewal or amendment Contract Manager: Department:292.121VIA z� .JL-.,M-%% Abstract: C:arn 3 y o� S-Public\RecordsManagement\Forms\ContractCover\ADCL7832 07/02 DSHS INTERLOCAL AGREEMENT 0864-3reemeMNumber 864-31175 SAFE HAVENS VISITATION CENTER This Agreement is by and between the State of Washington Department Program Contract Number 1501 of Social and Health Services DSHS and the Contractor identified Contractor actor Contract Number below, and is issued pursuant to the Interlocal Cooperation Act, chapter 39.34 RCW. CONTRACTOR NAME CONTRACTOR doing business as(DBA) City of Kent CONTRACTOR ADDRESS WASHINGTON UNIFORM DSHS INDEX NUMBER BUSINESS IDENTIFIER(UBI) 220 4th Ave South 173-000-002 22475 Kent,WA 98032-5895 CONTRACTOR CONTACT CONTRACTOR TELEPHONE CONTRACTOR FAX CONTRACTOR E-MAIL ADDRESS Kathenn Johnson 253 856-5073 Ext. 253 856-6070 kjohnson@ci.kent.wa.us DSHS ADMINISTRATION DSHS DIVISION DSHS CONTRACT CODE Chddrens Administration I Program and Practice Improvement 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 kelm300 dshs wa. ov IS THE CONTRACTOR A SUBRECIPIENT FOR PURPOSES OF THIS C5—N7 CFDA NUMBER(S) No AGREEMENT START DATE AGREEMENT END DATE MAXIMUM AGREEMENT AMOUNT 3/15/2008 1 6/30/2008 $50,000.00 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. CTNTRACTOR SIGNAT PRINTED NAME AND TITLE DATE S GNED DSHS GNATURE0 PRINT tcRl , EContracts Manager DATE SIGNED y 5 I Cc i U !, DSHS Children's[: ministration DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) 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. "Confidential Information"means information that is exempt from disclosure to the public or other unauthorized persons under RCW 42.56 or other federal or state laws. Confidential Information includes, but is not limited to, Personal Information. c. "Contract"or"Agreement"means the entire written agreement between DSHS and the Contractor, including any Exhibits, documents,or materials incorporated by reference. d. "Contracts Administrator"means the manager, or successor, of Central Contract Services or successor section or office. e. "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. f. "Debarment"means an action taken by a Federal agency or official to exclude a person or business entity from participating in transactions involving certain federal funds. g. "DSHS"or the"Department"means the state of Washington Department of Social and Health Services and its employees and authorized agents. h. "Encrypt"means to encipher or encode electronic data using software that generates a minimum key length of 128 bits. i. "Hardened Password" means a string of at least eight characters containing at least one alphabetic character, at least one number and at least one special character such as an asterisk, ampersand or exclamation point. j. "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. k. "Physically Secure" means that access is restricted through physical means to authorized individuals only. I. "Program Agreement"means an agreement between the Contractor and DSHS containing special terms and conditions, including a statement of work to be performed by the Contractor and payment to be made by DSHS. m "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://apps.leg.wa.gov/rcw/. n. "Regulation" means any federal, state, or local regulation, rule, or ordinance. DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 2 DSHS General Terms and Conditions o. "Secured Area" means an area to which only authorized representatives of the entity possessing the Confidential Information have access. Secured Areas may include buildings, rooms or locked storage containers(such as a filing cabinet)within a room, as long as access to the Confidential Information is not available to unauthorized personnel. p. "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. q. "Tracking"means a record keeping system that identifies when the sender begins delivery of Confidential Information to the authorized and intended recipient, and when the sender receives confirmation of delivery from the authorized and intended recipient of Confidential Information. r. "Transport"means the movement of Confidential Information from one entity to another, or within an entity, that(1) places the Confidential Information outside of a Secured Area or system (such as a local area network) and (2) is accomplished other than via a Trusted System. s. "Trusted Systems"include only the following methods of physical delivery: (1) hand-delivery by a person authorized to have access to the Confidential Information with written acknowledgement of receipt, and (2) United States Postal Service("USPS") delivery services that include Tracking,such as Certified Mail, Express Mail or Registered Mail. Any other method of physical delivery will not be deemed a Trusted System. t. "Unique User ID"means a string of characters that identifies a specific user and which, in conjunction with a password, passphrase or other mechanism, authenticates a user to an information system. u. "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://apps.leg.wa.gov/wac/. 2. Amendment.This Contract 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 Contract or any Program Agreement to a third party 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 another agency of the state of Washington or any other party for the same services. S. 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. DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 3 DSHS General Terms and Conditions 6. Confidentiality. a. The Contractor shall not use, publish, transfer, sell or otherwise disclose any Confidential Information gained by reason of this Contract for any purpose that is not directly connected with Contractors performance of the services contemplated hereunder, except: (1) as provided by law; or, (2) in the case of Personal Information,with the prior written consent of the person to whom the Personal Information pertains. b. The Contractor shall protect and maintain all Confidential Information gained by reason of this Contract against unauthorized use, access, disclosure, modification or loss.This duty requires the Contractor to employ reasonable security measures,which include restricting access to the Confidential Information by: (1) Encrypting electronic Confidential Information during Transport; (2) Physically Securing and Tracking media containing Confidential Information during Transport; (3) Limiting access to staff that have an authorized business requirement to view the Confidential Information (4) Using access lists, Unique User ID and Hardened Password authentication to protect Confidential Information placed on computer systems; (5) Physically Securing any computers, documents or other media containing the Confidential Information; and (6) Encrypting all Confidential Information that is stored on portable devices including but not limited to laptop computers and flash memory devices. c. Upon request by DSHS or at the end of the Contract term, the Contractor shall return the Confidential Information or certify in writing that the Contractor employed a DSHS approved method to destroy the information. Contractor may obtain information regarding approved destruction methods from the DSHS contact identified on the cover page of this Contract. In the event of a theft, loss, unauthorized disclosure, or other potential or known compromise of Confidential Information, the Contractor shall notify DSHS within one(1)business day of the discovery of the event. Contractor must also take actions to mitigate the risk of loss and comply with any notification or other requirements imposed by law. 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(Debarred).The Contractor also agrees to include the above requirement in any and all Subcontracts into which it enters. The Contractor shall immediately notify DSHS if, during the term of this Contract, Contractor becomes Debarred. DSHS may immediately terminate this Contract by providing Contractor written notice if Contractor becomes Debarred during the term hereof. B. 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 DSHS Central Contract Ser%nces 6015LF Custom Interlocal Agreement(9-11-07) Page 4 DSHS General Terms and Conditions Court for Thurston County. In the event that an action is removed to U.S. District Court,venue shall be in the Wester 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 officer or employee. 10. Inspection.The Contractor shall, at no cost, provide DSHS and the Office of the State Auditor with reasonable access to Contractor's place of business, Contractor's records, and DSHS client records, wherever located.These inspection rights are intended to allow DSHS and the Office of the State Auditor to monitor, audit, and evaluate the Contractor's performance and compliance with applicable laws, regulations, and these Contract terms.These inspection rights shall survive for six(6)years following this Contract's termination or expiration. 11. Maintenance of Records.The Contractor shall maintain records relating to this Contract and the performance of the services described herein.The records include, but are not limited to, accounting procedures and 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. Without agreeing that litigation or claims are legally authorized, 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 Contract or any Program Agreement,the inconsistency or conflict shall be resolved by giving precedence to these General Terms and Conditions.Terms or conditions that are more restrictive, specific, or particular than those contained in the General Terms and Conditions shall not be construed as being inconsistent or in conflict. 13. Severability. If any term or condition of this Contract is held invalid by any court, the remainder of the Contract remains valid and in full force and effect. 14. Survivability.The terms and conditions contained in this Contract 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 Contract or Program Agreement are withdrawn, reduced or limited, or if additional or modified conditions are placed on such funding, DSHS may immediately terminate this Contract 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. DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 5 DSHS General Terms and Conditions 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 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; DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 6 DSHS General Terms and Conditions (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 VI 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 audit or a program-specific audit for that fiscal year. Upon completion of each audit, the Contractor shall: (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 fails 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 DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 7 DSHS General Terms and Conditions 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. DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 8 Special Terms and Conditions 1. Definitions Specific to Special Terms. The words and phrases listed below,as used in this Contract, 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. c. "Safe Havens Visitation Center" is a supervised visitation and safe exchange center for families impacted by domestic violence, sexual assault,child abuse, and stalking. 2. Intent of Service 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. 3. Purpose The purpose of this Agreement is to provide one-time funding to the City of Kent, as authorized by the budget proviso for FY08, 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. 4. 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 c. Through the Safe Havens Visitation Center,the Contractor shall provide such services to 8 families during the contract period,with approximately 48 hours of services for each family. Services shall include: (1) Intake of relevant family history and other information for services (approximately 1.5 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 .5-35 hours per week, per case). DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 9 Special Terms and Conditions 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 a final progress report regarding the above activities to the DSHS Contact listed on page 1 of this Agreement. The report shall be completed and submitted to DSHS using a form as prescribed by DSHS to be provided following execution of this Agreement. The report shall be submitted within two weeks of the termination of the contract. 5. Consideration 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 state on page 1 of this Agreement under "Maximum Agreement Amount". 6. Billing and Payment a. Invoice System. 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 is if"FOR SERVICES RENDERED IN PERFORMANCE UNDER DSHS AGREEMENT NO.0864-31175 FOR THE MONTH(S) OF , 2008". 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. DSHS 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. 7. 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. DSHS Central Contract Services 6015LF Custom Interlocal Agreement(9-11-07) Page 10 Special terms and Conditions 8. 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. 9. 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. 10. 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. 11. Administrative Records The Contractor shall retain all fiscal records that substantiate all costs charged to DSHS under this Agreement. 12. 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 services related records and materials, including financial records in support of billings, and records of staff time. 13. 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 Services 6015LF Custom Interlocal Agreement(9-11-07) Page 11 REQUEST FOR MAYOR'S, SIGNATURE • Please, Fill in All Applicable Boxes KENT' Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Ori inator: Katherin Johnson Phone (Originator): 5073 Date Sent: 03/07/08 ., Date Re uired: 03%13�08+ Return Signed Document to: Katherin CONTRACT TERMINATION DATE: 06/30/08 Johnson VENDOR NAME: DSHS WA ST DATE OF COUNCIL APPROVA . 03/04/08 Brief Explanation of Document: Interlocal agreement with DSHS WA ST for servi000 at Safe Havens Visitation and Exchange Center. Funding level for 2008 is $50, Sign and date all four (4)copies and return to Katherin Johnson, Human nS Services. A fully executed copy will be sent to the City Clerk upon receipt f rom All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: Approval of Law Dept.: RECEIVED Law Dept. Comments: MAR 1 1 2008 0- 1 KENT LAW DEPT. Date 'Forwarded to Mayor: � 0 Shaded Areas To Be Completed By Administration Staff SIP ik wn ' $ y Received;i � ���" � ;�:• `� •. Reconat gris,anci Comments: ; ',.,;'`'6,. Disposition Date' Returned:„ /� �zs