HomeMy WebLinkAboutPK11-123 - Original - Healthpoint - CDBG Funded Healthcare for the Homeless Project - 01/01/2011 Records Marrtt-gemen'b
KENT _
WASH,.GTO. Document
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 City Clerk's Office.
Vendor Name: Health Point
Vendor Number: 33917
JD Edwards Number
Contract Number: Vkl l- 1 a-2-3
This is assigned by City Clerk's Office
Project Name: Healthcare for the Homeless
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 1/1/11 Termination Date: 12/31/11
Contract Renewal Notice (Days): 30
Number of days required notice for termination or renewal or amendment
Contract Manager: Dinah Wilson Department: Parks/Housing & Human Svs.
Detail: (i.e. address, location, parcel number, tax id, etc.):
This is a CDBG-funded contract. Nursing services are provided to homeless individuals
who reside in shelters located in Kent.
S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
CDBG AGREEMENT
BETWEEN THE CITY OF KENT
AND
HEALTH POINT
HEALTHCARE FOR THE HOMELESS PROJECT
This Agreement, entered into this 1st day of January, 2011, between the City of Kent, a
Washington municipal corporation (hereinafter the "City") and Health Point (hereinafter the
"Agency").
RECITALS
WHEREAS, the City is an entitlement City applicant for Community Development Block
Grant ("CDBG") funds (Catalogue of Federal Domestic Assistance-CFDA 14.218) under
the Housing and Community Development Act of 1974 (the "Act"), as amended, Pub.
L. No. 93-383, 88 Stat. 633 (1974), and anticipates receiving CDBG funds for the
purpose of carrying out eligible community development and housing activities under
the Act and under regulations promulgated by the Department of Housing and Urban
Development ("HUD"), at 24 CFR § 570, et seq.; and
WHEREAS, the City desires to contract with the Agency for the performance of certain
eligible activities described within this Agreement; and
WHEREAS, it is appropriate and mutually desirable that the Agency be designated by the
City to undertake the aforementioned eligible activities, so long as the requirements of
the Act, HUD regulations, and state and local laws are adhered to, as provided for
herein; and
WHEREAS, the purpose of this Agreement is to provide for cooperation between the City
and the Agency, as the parties to this Agreement, in the provision of such eligible
activities; and
WHEREAS, the parties are authorized and empowered to enter into this Agreement
pursuant to the Act, RCW 35.21.730 to .735, and/or by the Constitution and the
enabling laws of the State of Washington; NOW THEREFORE,
For and in consideration of the terms and conditions provided in this Agreement, the
parties mutually covenant and agree as follows:
INDEX TO AGREEMENT
PART I - GENERAL CONDITIONS ................. ... .............. . . ............... .. ........ . . .................. 1
1 Scope Of Agreement .. ............ ...... . ....... ...... ............. 1
2. Scope Of Project ................ ............ . .......... ..... ........ .. 1
3. Program Benefit - § 570.208(a) . . ............... ........ .. . ....... .. ................. ....... 1
4. Commencement And Termination Of Project(s)....... . .......... ........ .......... . . .. 2
5 Administration. . ....... ........... . .................... . . ............ ............. .. 3
6 Compensation And Method Of Payment .... .. . .............. . ............. ........... ........ 3
7. Eligible Costs ..................... .................. .................. .. . ...........I. .. . . ............. ..........4
8 Operating Budget..... ....................... . ............. ........... . .........I . .............. 4
9. Funding Alternatives And Future Support ............. ..................... .......... ......... . . 4
10 Amendments ........ . .................... . ............. . ........... .......... 5
11 Assignment And Subcontracting ............ .................. ........... ........... . ..... 5
12 Hold Harmless And Indemnification ............. . ............... . ... ............ . .......... . . . .......... 5
13 Project Close-Out....... ............ ................ . . ............. .......... . . ..........5
14 Insurance ................ ............. . .................. ........... .......... ....6
15. Conflict Of Interest. .................... ............. . ................. .......... ........... .6
16 Suspension And Termination Of Agreement . ...... . ........... ............ 7
17 Safeguarding Of Client Information . ....... ........... ........... .......... 7
PART II - FEDERAL, STATE, AND LOCAL PROGRAM REQUIREMENTS ................ . .......... . ........ . .7
1. Nondiscrimination ..... .. ......... ....... . ............... . ............ ....... 7
2 Section 504 And Americans With Disabilities Act ............... . .......... ......... ..... . 10
3. Procurement Standards ..... ...... ....... . . ............ ........ ... ... 10
4 Uniform Administrative Requirements And Cost Principles - § 570.502, 570 610.... .. .......... 10
5 Program Income - § 570 504 ..... .... ...... ........... .......... 11
6 Public Information ...... ............ . . .......... .......... . .......... .......... 11
7. Other Federal And State Requirements ............... ................. ........ . . ........ . .......... 11
8. Local Requirements ...... ........ ........ ................ . ........ .... ........... 12
Public service programs must comply with sections 9 and 10• .............. . ......... ..... .......... 12
9 Nonsubstitution For Local Funding ....... ........ . .. ......... ........ ........... ....... 12
10 Faith-Based Activities - §570 200(I) ......... ........... ...... .......... . .. 12
Acquisition or improvement of real property projects must comply with sections 11 through 18 ........ 13
itAccessibility ... ........... ............. ............ ........... ........ ..... ........ 13
12. Environmental Review ........... ........... .......... .......... ......... . .......... ........... 13
13 Labor Standards - § 570 603 . .... . ........ . ............... .... ........ 13
14. Volunteers - 24 CFR § 70 ....... ....... ........... .......... .. ..... ....... . ..15
15 Acquisition And Relocation ....... ..... ........... ........ . ........ . ....... ........ 15
16 Public Ownership ...... ........... ......... . .......... ...... .......... .. ........ 16
17 Reversion Of Assets - § 570 505 ..................... ...... ........... ...... ..... ...... 16
18. Property Management Standards . ........ ........ ........ ...... ....... ...... 16
19, Additional Local Requirements ....... ...... .... ....... ....... ...... 17
PART III - MONITORING & REPORTING REQUIREMENTS ... ..... ........ .... 17
1. Monitoring ........ ............. . ..... . .... . ...... .. .......... .... ..... ...... 17
2. Program Reporting........ . ............ ....... ........ ............I. ......... ..... ...... ........ 17
3 Fiscal Reporting Responsibilities . .......... ...... ...... ....... ........ . . ........ ........... 18
4. Audits ..... ... ........ .......... ...... ....... ....... ......... ....... ....... 18
PART IV - RECORDKEEPING REQUIREMENTS. ....... ...... .......... . ........ ....... . ......... .. 18
1. Program Records and Inspections . ........ ....... . .......... ....... ........ ... ..... 18
2 Program Benefit Records - § 570 506(b) . ...... ........... ........................ . . ...... ...... 19
3. Financial Records ..... ..... ..... ....... . . ..... ........ ..... ..... ........ 20
4. Records Of Program Operations, Management And Evaluation . ........ . ........ . ......... ........ 20
5 Property Records ........ . ...... ........ .... 21
6 Procurement Records - OMB Circular A-110 ... ....................I........................ 21
7. Nondiscrimination And Equal-Opportunity Records - § 570 506(g) . . ........ ........... .......... ... 21
8. Conflict Of Interest ... .... ...... ....... . . ......... . ......... ... ...... . ....... . 22
9. Verification Of Subcontractor's Eligibility - 24 CFR 5 ........ ...... ..... ......... ............ 22
10. Additional Requirements for Acquisition or Improvement of Real Property Projects ......... .......... . 22
PART I - GENERAL CONDITIONS
1. SCOPE OF AGREEMENT
The agreement between the parties shall consist of this Agreement and its
signature page; the recitals page; the general conditions and any special
conditions; the federal, state and local program requirements; the monitoring and
reporting requirements; the recordkeeping requirements; each and every project
exhibit, appendix, and attachment incorporated into the Agreement; all matters and
laws incorporated by reference herein; and any written amendments made
according to the general conditions. This Agreement supersedes any and all former
agreements applicable to projects attached as Exhibits to this Agreement.
2. SCOPE OF PROJECT
A. The Agency shall use the funds provided herein only to perform the activities
authorized by this Agreement and as set forth in the CDBG Project Scope of
Services, a draft of which is attached as Exhibit A and incorporated by this
reference. Because this Agreement is executed prior to funds being allocated to the
City through federal appropriations, the City will forward to Agency a final Exhibit A
that the City will create if federal appropriations are awarded to the City for
Agency's services, and that final Exhibit A, which may include adjustments in
allocations or scope imposed as a condition of the final federal appropriations, shall
relate back to and be incorporated into this Agreement. In the case of multiple
projects, each project shall correspond to a separate Exhibit. This Agreement may
be amended from time to time, in accordance with the general conditions, for the
purpose of adding new projects, amending the scope of work, or for any other
lawful purpose.
B. Agencies funded by the City to carry out neighborhood revitalization, community
economic development, or energy conservation projects shall meet the
qualifications of a Community Based Development Organization (CBDO) pursuant to
24 C.F.R. § 570.204(c). The 'carry out" requirement "means that the CBDO
undertakes the funded activities directly or through contract with an entity other
than the [City], or through the provision of financial assistance for activities in
which it retains a direct and controlling involvement and responsibilities." 24 C.F.R.
§ 570.204(a)(4).
3. PROGRAM BENEFIT - 24 C.F.R. § 570.208(a).
Activities undertaken by this Agreement must predominantly benefit low and
moderate income persons. At least seventy (70) percent of the persons served by
these activities must be low or moderate income persons as defined in Exhibit B,
which is attached and incorporated by this reference. The income guidelines
attached as Exhibit B at the time this Agreement is executed are in draft form
because federal income guidelines for 2011 had not been released and posted to
The Department of Housing and Urban Development's web site prior to the
execution of this Agreement. Therefore, the City will forward to Agency a final
Exhibit B, including any adjustments imposed by the federal government once it is
generated by the federal government at the time it finalizes its appropriations, and
that final Exhibit B shall relate back to and be incorporated into this Agreement.
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The following requirements apply:
A. The Agency shall ascertain household income of persons applying for and receiving
assistance to assure compliance with the income limits defined in Exhibit B; and
shall maintain records pursuant to Part IV of this Agreement, Section 2(B); or
B. If the activity exclusively serves a clientele, which by federal regulation is
"presumed" to be low and moderate income, individual income verification is not
required. Persons eligible for this presumption are specified in Part IV of this
Agreement, Section 2(C). In this case, the Agency shall maintain appropriate data
to validate the presumption, as provided in Part IV, Section 2(C); or
C. If the activity is such that it is not feasible to identify and record beneficiaries, the
total population of the area from which the beneficiaries are drawn must be
predominantly low and moderate income. In this case, the Agency shall maintain
substantiation data as required by Part IV of this Agreement, Section 2(D).
D. The benefit to low and moderate income beneficiaries must be in the form of a free
or reduced cost service. If beneficiaries are charged for services, the charges to
low and moderate income beneficiaries, and to all other beneficiaries, shall be as
specified in the Exhibit(s), if applicable. Changes to the structure of charges during
the term of this Agreement (and, in the case of a facility project, for five years
thereafter) must preserve an identical discount for low and moderate income
beneficiaries, and the change must be approved by the City.
E. The low and moderate income limits in effect at the time of execution of this
Agreement are specified in Exhibit B. These limits are revised periodically by HUD.
It is the Agency's responsibility to use any revised limits when they take effect.
Revisions will be announced by and can be obtained from the City.
4. COMMENCEMENT AND TERMINATION OF PROJECT(S)
A. The City shall furnish the Agency with a written notice to proceed. No work on a
project shall occur without prior written approval from the City. Agency 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. Termination dates for individual projects
shall be specified in the appropriate Exhibits. Costs incurred prior to the date
written notice to proceed was given or after the termination date will not be
reimbursed. The termination date may be changed through an amendment of this
Agreement.
B. Although the term of this Agreement shall run from January 1, 2011 through
December 31, 2011, this Agreement, however, is contingent upon the availability of
funds to be allocated through federal appropriations. Therefore, should funds to
support Agency's services not be made available through anticipated federal
appropriations, this Agreement shall immediately terminate without risk or liability
to the City and without obligation to disburse funds or to reimburse Agency any
funds expended in anticipation of funding availability. All work shall be done at
Agency's own risk, and Agency shall be responsible for all losses associated with
services provided before the City issues its written notice to proceed. All acts
consistent with the authority of the Agreement and prior to the date of the
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Agreement's execution are hereby ratified and affirmed, and the terms of this
Agreement shall be deemed to have applied.
S. ADMINISTRATION
A. The Agency shall appoint a liaison person who shall be responsible for overall
administration of CDBG funded project(s) and coordination with the City's Parks,
Recreation, and Community Services Department. The person appointed shall be
designated in Exhibit C, which is attached and incorporated by this reference. The
Agency shall also designate one or more representatives who shall be authorized to
submit the Billing Voucher and Service Report, and Final Program Accomplishment
forms, which are attached as Exhibit D and E, respectively. The name of the liaison
person and representative shall be specified in the Exhibit.
B. The Agency shall provide ten (10) days written notice to the City of any changes in
program personnel or Board membership.
C. The agency shall provide the City with a current list of its Board of Directors,
general or limited partners, as applicable.
6. COMPENSATION AND METHOD OF PAYMENT
A. The City shall reimburse the Agency only for eligible costs allowed pursuant to this
Agreement, which are part of the activities specified in the Exhibit(s), and in an
amount not to exceed the amount specified in Exhibit A, plus any miscellaneous
surplus office equipment, as available, related to the provision of services under
this Agreement, and according to the procedures developed by the City of Kent.
Reimbursement shall be based on a Billing Voucher and Service Report, which shall
be submitted to the City by the Agency's authorized representative.
B. The City of Kent uses a variety of measures as indicators of satisfactory contract
performance. The Agency will be expected to meet 10011/o of the performance
measures as defined in Exhibit A. Exceptions may be made in cases where
circumstances beyond the Agency's control impact their ability to meet their units
of service and the Agency has shown reasonable effort to overcome those
circumstances. Exceptions are made at the discretion of the City's Human Services
Manager.
C. If the Agency does not meet performance goals, payment for services rendered
under the agreement will be reduced by the rate calculated for each service unit.
For example if an Agency contracted to provide 100 bed-nights a quarter for
$5,000.00 and only provide 75 bed-nights, payment would be $3,750.00 instead of
$5,000.00.
D. The Agency shall submit a Billing Voucher and Service Report on a quarterly basis.
Billing Vouchers and Service Reports are due by the 151h of the month following the
end of the quarter for costs eligible to be reimbursed by the City in accordance with
the budget incorporated as Exhibit A and in accordance with Section 7 below. If the
due date falls on a Saturday or Sunday, Billing Vouchers and Service Reports are
due on the prior Friday. If the due date falls on a City holiday, Billing Vouchers and
Service Reports are due the next working day following the holiday. The Final Billing
Voucher and Service Report is due in accordance with the schedule listed in Exhibit
A. If the Agency's line item budget includes personnel services costs, the Agency
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shall submit a CDBG Public Services Project Time Sheet (attached as Exhibit H if
applicable) with the Billing Voucher and Service Report. The City will make
payment to the Agency not more than forty-five (45) days after said Billing Voucher
and Service Report is received and approved by the City's Parks, Recreation, and
Community Services Department. The City will issue a statement of correction in
the event the Billing Voucher and Service Report is erroneous. Payment by the City
shall not constitute approval of the services for which payment is requested. The
City does not, by making such payment, waive any rights it may have pursuant to
this Agreement to require satisfactory performance of the services promised herein.
The City reserves the right to demand and recover reimbursements made for
ineligible costs.
7. ELIGIBLE COSTS
A. All costs incurred must be reasonable and of a nature which clearly relate to the
specific purposes and end product of the Agreement under which the services are
being performed. Care must be taken by all concerned in incurring costs to assure
that expenditures conform to these general standards and the following criteria for
eligibility of costs.
B. To be eligible for reimbursement, costs must:
(1)Be necessary and reasonable for proper and efficient execution of the
contractual requirements and in accordance with an approved budget.
(2)Be no more liberal than policies, procedures, and practices applied uniformly to
other activities of the Agency.
(3)Be accorded consistent treatment through application of account policy and
procedures approved and/or prescribed herein.
(4)Not be allowable under or included as costs of any other federal, state, local or
other agency-financed programs in either prior or current periods.
(5)Be net of all applicable credits such as purchase discounts, rebates or
allowances, sales of publication or materials, or other income or refunds.
(6)Be fully documented.
S. OPERATING BUDGET
The Agency shall apply the funds received from the City under this Agreement in
accordance with the Budget Summary found on Exhibit A. No line-item expense
therein shall cause expenditure in excess of ten (10) percent or more of the budget
line-item amount over the life of the Agreement without the prior written consent of
the City. Any request for a line-item expense which exceeds ten (10) percent of
the budgeted amount shall specifically state the reasons for the requested increase
and a justification for the corresponding decrease in other line-item(s).
9. FUNDING ALTERNATIVES, FUTURE SUPPORT, AND LIMITED RELEASE
A. The City makes no commitment to future support and assumes no obligation for
future support of the activities contracted for herein, except as may be expressly
set forth in this Agreement.
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B. Payment for the services provided herein is based on the expectation that future
revenues will be available to the City for such purposes. Should anticipated sources
of revenue not become available or become unavailable to the City for use in the
CDBG program, the City shall immediately notify the Agency in writing of such
unavailability and in that event, Agency fully releases City from any claims,
damages, or liability, related to lack of funding, the amount funded, or uncertainty
for that portion of the Agreement originally intended to be paid with such funds.
10. AMENDMENTS
Either party may request modifications in the scope of permissible activities, terms,
or conditions of this Agreement. Proposed modifications which are mutually agreed
upon shall be incorporated by a written amendment to this Agreement.
11. ASSIGNMENT AND SUBCONTRACTING
A. The Agency shall not assign any portion of this Agreement without the written
consent of the City, and it is further agreed that said consent must be sought by
the Agency not less than fifteen (15) days prior to the date of any proposed
assignment.
B. Any work or services assigned or subcontracted hereunder shall be subject to each
provision of this Agreement and proper bidding procedures to the extent herein.
The Agency agrees that it is as fully responsible to the City for the acts and
omissions of its subcontractors and their employees and agents, as it is for the acts
and omissions of its own employees and agents, as defined in paragraph Part I,
Section 12(B).
12. HOLD HARMLESS AND INDEMNIFICATION
A. The Agency agrees that it is financially responsible and liable to the City for any
audit exception or other financial loss to the City which occurs due to the Agency's
negligence or failure to comply with the terms of this Agreement.
B. The Agency further agrees to defend, indemnify, and hold the City, its elected and
appointed officials, agents, and employees, while acting within the scope of their
duties as such, harmless from and against all claims, demands, and causes of
action of any kind or character, including the cost of defense thereof, arising in
favor of any person(s), including Agency's employees or third parties on account of
personal injuries, death, or damage to property arising out of services performed or
omissions of services or in any way resulting from the acts or omissions of the
Agency and/or its agents, employees, volunteers, subcontractors, or
representatives under this Agreement.
13. PROJECT CLOSE-OUT
The Agency acknowledges and agrees that the amounts set forth in the Exhibit(s)
shall be used only to reimburse the Agency for eligible costs incurred by the Agency
during the period set forth in said Exhibit(s) and that upon expiration of such
period, or upon earlier termination pursuant to this Agreement, the Agency shall
have no interest in any said amount which is not required to reimburse the Agency
for eligible costs incurred before such expiration or earlier termination.
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14. INSURANCE
Agency shall maintain insurance in the types and amounts set forth in Exhibit F,
which is attached and incorporated by this reference.
15. CONFLICT OF INTEREST
A. Interest of Officers, Employees, or Agents - No officer, employee, or agent of the
City or Agency who exercises any functions or responsibilities in connection with the
planning and carrying out of the City CDBG program or the Agency's project, or any
other person who exercises any functions or responsibilities in connection with the
City's Parks, Recreation, and Community Services Department, shall have any
personal financial interest, direct or indirect, in the Agreement, and the City and
Agency shall take appropriate steps to assure compliance.
B. Interest of Subcontractor and Their Employees - The Agency agrees that it will
incorporate into every contract or subcontract, which is required to be in writing
and made pursuant to this Agreement, the following provisions:
The Contractor covenants that no person who presently
exercises any functions or responsibilities in connection with the
City CDBG program has any personal financial interest, direct or
indirect, in this Agreement. The Contractor further covenants
that he/she presently has no interest and shall not acquire any
interest, direct or indirect, which would conflict in any manner or
degree with the performance of his/her services hereunder. The
Contractor further covenants that in the performance of this
Agreement, no person having any conflict of interest shall be
employed. Any actual or potential conflict of interest on the
part of the Contractor or his/her employees must be disclosed to
the Agency and the City.
16. SUSPENSION AND TERMINATION OF AGREEMENT
A. Suspension for Failure to Perform - In the event of a failure to comply with any
terms or conditions of this Agreement or failure to provide in any manner the
activities or other performance as agreed to herein, the City reserves the right to
withhold all or any part of payment, suspend all or any part of the Agreement, or
prohibit the Agency from incurring additional obligations of funds until the City is
satisfied that corrective action has been taken or completed as more specifically
outlined in the Exhibit(s) to this Agreement. The option to withhold funds is, in
addition to and not in lieu of, the City's right to terminate the Agreement pursuant
to Paragraph (B) of this Section 16.
B. Termination of Agreement by City - This Agreement is subject to termination upon
thirty (30) days written notice by the City to the Agency in the event that:
(1)The Agency mismanages or makes improper or unlawful use of CDBG funds;
(2)The Agency fails to comply with any term or condition expressed herein or any
applicable federal, state, or local regulations or ordinances;
(3)CDBG funds no longer become available from the federal government or through
the City;
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(4)The Agency fails to carry out activities required by this Agreement; or
(5)The Agency fails to submit reports or submits incomplete or inaccurate reports
in any material respect.
C. Termination of Agreement by the Agency- This Agreement is subject to termination
upon thirty (30) days written notice by the Agency to the City in the event that:
(1)The City fails in its commitment under this Agreement to provide funding for
services rendered, as herein provided; or
(2)CDBG funds no longer become available from the federal government or through
the City.
D. Unless otherwise terminated pursuant to Paragraphs (B) and (C) of this Section 16,
this Agreement shall terminate on the termination date specified on the Exhibit(s)
and shall be subject to extension only by mutual agreement and amendment in
accordance with Part I, Section 10 of this Agreement.
E. Upon termination of this Agreement, any unexpended balance of Agreement funds
shall remain in the City CDBG fund.
F. In the event termination occurs under Paragraph (B) of this Section 16, the Agency
shall return to the City all funds that were expended in violation of the terms of this
Agreement including, but not limited to, any unexpended CDBG funds distributed to
the Agency under this Agreement, any accounts receivable, or any assets or
interests therein of any type and in any form acquired, leased, or rehabilitated with
CDBG monies.
17. SAFEGUARDING OF CLIENT INFORMATION
The use or disclosure by any party of any confidential information concerning a
recipient or client for any purpose not directly connected with the City's or the
Agency's responsibilities with respect to services provided under this Agreement is
prohibited, except upon written consent of the recipient or client, his/her attorney,
his/her responsible parent or guardian, or as otherwise provided by law.
PART II - FEDERAL, STATE, AND LOCAL PROGRAM REQUIREMENTS
1. NONDISCRIMINATION
A. General - The Agency shall comply with all federal, state, and local laws prohibiting
discrimination on the basis of age, sex, marital status, race, creed, religion, color,
national origin, or the presence of any sensory, mental, or physical handicap.
These requirements are specified in Chapter 49.60 RCW; Section 109 of the
Housing and Community Development Act of 1974, Pub. L. No. 93-383 as amended
and codified as 42 U.S.C. § 5309; Title VI of the Civil Rights Act of 1964, 42 U.S.C.
§§ 2000d, et seq.; Title VIII of the Civil Rights Act of 1968, 42 U.S.C. §§ 3601, et
seq.; Executive Order 11063; Executive Order 11246, as amended by Executive
Orders 11375, 11478, 12086 and 12107; Section 3 of the Housing and Urban
Development Act of 1968, 12 U.S.C.§ 1701(u), and implementing regulations at 24
CFR § 135; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, et seq.;
7
and the Age Discrimination Act of 1975, 42 U.S.C. § 6101, et seq. Specifically, the
Agency is prohibited from taking any discriminatory actions defined in the HUD
regulations at 24 C.F.R. § 570.602 and shall take such affirmative and corrective
actions as are required by the regulations at 24 C.F.R. § 570.602.
B. Specific Discriminatory Actions Prohibited:
(1)The Agency shall not, under any program or activity to which this Agreement
may apply, directly or through contractual or other arrangements, on the
grounds of age, sex, marital status, race, creed, religion, color, national origin,
or the presence of any sensory, mental, or physical handicap:
i. Deny any person facilities, services, financial aid, or other benefits provided
under the program or activity.
ii. Provide any person with facilities, services, financial aid, or other benefits
which are different, or are provided in a form different, from that provided to
others under the program or activity.
iii. Subject any person to segregated or separate treatment in any facility or in
any matter or process related to receipt of any service or benefit under the
program or activity.
iv. Restrict in any way access to or enjoyment of any advantage or privilege
enjoyed by others in connection with facilities, services, financial aid, or other
benefits under the program or activity.
v. Treat any person differently from others in determining whether the person
satisfies any admission, enrollment, eligibility, membership, or other
requirement or condition which individuals must meet in order to be provided
facilities, services, or other benefits provided under the program or activity.
vi. Deny any person any opportunity to participate in a program or activity as an
employee.
(2)The Agency shall not utilize criteria or methods of administration which have the
effect of subjecting individuals to unlawful discrimination on the basis of race,
color, national origin, sex, age, marital status, creed, religion, or presence of
any sensory, mental, or physical handicap, or which have the effect of defeating
or substantially impairing accomplishment of the objectives of the program or
activity by unlawfully discriminating against individuals of a particular race,
color, national origin, sex, age, marital status, creed, religion, or presence of
any sensory, mental, or physical handicap.
(3)The Agency, in determining the site or location of housing or facilities provided
in whole or in part with funds under this Agreement, may not make selections of
such site or location which have the effect of excluding individuals from, denying
them the benefits of, or subjecting them to unlawful discrimination on the
grounds of race, color, national origin, sex, age, marital status, creed, religion,
or presence of any sensory, mental, or physical handicap; or which have the
purpose or effect of defeating or substantially impairing the accomplishment of
the objectives of the Act or of HUD regulations.
C. Fair Housing — The Agency shall take necessary and appropriate actions to prevent
discrimination in federally-assisted housing and lending practices related to loans
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insured or guaranteed by the federal government (The Fair Housing Act VII, 42
U.S.C. § 3601, et seq.; Executive Order 11063, 24 CFR § 108).
D. Employment :
(1)In all solicitations under this Agreement, the Agency shall state that all qualified
applicants will be considered for employment. The words "equal opportunity
employer" in advertisements shall constitute compliance with this section.
(2)The Agency shall not unlawfully discriminate against any employee or applicant
for employment in connection with the Agreement because of age, sex, marital
status, race, creed, religion, color, national origin, or the presence of any
sensory, mental, or physical handicap, except when there is a bona fide
occupational limitation. Such action shall include, but not be limited to the
following: employment, upgrading, demotion or transfer, recruitment or
recruitment advertising, layoff or termination, rates of pay or other forms of
compensation, and selection for training (Chapter 49.46 RCW, Executive Order
11246, as amended).
(3)To the greatest extent feasible, the Agency shall provide training and
employment opportunities for lower income residents within the area served by
CDBG assisted projects (Section 3, Housing and Urban Development Act of
1968, 12 U.S.C. § 1701u, as amended).
E. Contractors and Suppliers:
(1)No contractor, subcontractor, union, or vendor engaged in any activity under
this Agreement shall engage in any unlawful discrimination as defined in any
federal, state, or local law.
(2)AII firms and organizations, as required under applicable HUD regulations, shall
be required to submit to the Agency certificates of compliance demonstrating
that it has, in fact, complied with the immediately foregoing provision; provided,
that certificates of compliance shall not be required from firms and organizations
with fewer than 25 employees, with yearly sales of less than $10,000, or on
contracts less than $10,000.
(3)To the greatest extent feasible, the Agency shall purchase supplies and services
for activities under this Agreement from vendors and contractors whose
businesses are located in the area served by CDBG-funded activities or owned in
substantial part by project area residents (Section 3, Housing and Urban
Development Act of 1968, 12 U.S.C. § 1701u, as amended).
(4)CDBG funds shall not be used directly or indirectly to employ, award contracts
to, or otherwise engage the services of, or fund any contractor or sub-recipient
during any period of debarment, suspension, or placement in ineligibility status
under the provisions of 24 CFR § 24.
F. Notice:
(1)The Agency shall include the provisions of the appropriate subsections A, B, C,
D, and E of this Part II, Section 1 in every contract or purchase order for goods
and services under this Agreement, and shall send to each labor union or
representative of workers with which it has a collective bargaining agreement or
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other contract or understanding, a notice advising the said labor union or
worker's representative of the commitments made in these subsections.
(2)In advertising for employees, goods, or services for the activities under this
Agreement, the Agency shall utilize minority publications in addition to
publications of general circulation.
2. SECTION SO4 AND AMERICANS WITH DISABILITIES ACT
If the Agency is a nonprofit corporation, the Agency warrants and represents that it
has completed a Disability Self-Evaluation Questionnaire for all programs and
services offered by the Agency (including any services not subject to this
Agreement) and has evaluated its services, programs, and employment practices
for compliance with Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794,
as amended ("504") and the Americans with Disabilities Act of 1990, 42 U.S.C. §§
12101, et seq., ("ADA"). The Agency warrants and represents that it has
completed a 504/ADA Disability Assurance of Compliance, which is attached as
Exhibit I and incorporated by this reference, and shall submit it to the City.
3. PROCUREMENT STANDARDS
In awarding contracts pursuant to this Agreement, the Agency shall comply with all
applicable requirements of local and state law for awarding contracts, including but
not limited to procedures for competitive bidding, contractor's bonds, and retained
percentages (Ch. 60.28 RCW, Ch. 39.12 RCW, and Ch. 39.04 RCW). In addition,
the Agency shall comply with the requirements of the U.S. Office of Management
and Budget ("OMB") Circular A-110, Attachment O, relating to "Procurement
Standards," and with Executive Order 11246 regarding nondiscrimination in bid
conditions for projects over $10,000. Where federal standards differ from local or
state standards, the stricter standards shall apply.
4. UNIFORM ADMINISTRATIVE REQUIREMENTS AND COST PRINCIPLES - 24 CFR §§ 570.502
and 570.610.
All nonprofit Agencies shall comply with the policies, guidelines, and requirements
of OMB Circular Nos. A-133 "Audits of Institutions of Higher Education and Other
Non-Profit Institutions," A-122 "Cost Principles for Non-Profit Organizations," and
A-110 including: (1) Attachment A, "Cash Depositories," except for Paragraph 4
concerning deposit insurance; (2) Attachment B, "Bonding and Insurance"; (3)
Attachment C, "Retention and Custodial Requirements for Records"; (4) Attachment
F, "Standards for Financial Management Systems"; (5) Attachment H, "Monitoring
and Reporting Program Performance," Paragraph 2; (6) Attachment N, "Property
Management Standards, except for Paragraph 3 concerning the standards for real
property as it applies to federal agencies only and except that paragraphs 6 and 8
are modified so that the disposition of personal property is allowed only under the
guidance and approval of the City; and (7) Attachment O, "Procurement
Standards."
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S. PROGRAM INCOME — 24 CFR § 570.504.
A. All income directly generated from the use of CDBG funds, as defined in 24 CFR §
570.500(a), is Program Income and shall be recorded, reported, and treated as
funds subject to all the requirements of this Agreement.
B. Unless otherwise specifically provided by the special conditions herein, Program
Income received during the term of this Agreement may be retained and used by
the Agency to extend the service or other activity for which the CDBG funds are
provided, subject to the regulations of 24 CFR § 570.01, et seq., and all the same
terms and conditions of this Agreement. Any retained Program Income shall be
disbursed to pay for eligible expenses under this Agreement before additional funds
are requisitioned from the City.
C. Any Program Income not permitted to be retained for eligible activities as defined
above, shall be refunded to the City, together with any interest earned thereon, at
quarterly intervals.
D. Program Income on hand at the end of the term of this Agreement shall, unless
otherwise provided, be used for activities envisioned under this Agreement until it is
expended. Program Income generated from the use of CDBG funds under this
Agreement but received after the term of this Agreement shall, unless otherwise
provided, be governed by any succeeding CDBG funding agreement or, if there is
no succeeding agreement, shall be used for activities eligible under 24 CFR §
570.504(c) until it is expended.
E. Rules on Program Income are established in the CDBG regulations (24 CFR §
570.504); OMB Circular No. A-122, Cost Principles for Nonprofit Organizations; and
OMB Circular A-110, attachment D, Program Income. Separate instructions for
Program Income dealing with the proceeds from the sale of personal property are
set forth in Attachment N to OMB, Circular No. A-110, Property Management
Standards.
6. PUBLIC INFORMATION
A. In all news releases and other public notices related to projects funded under this
Agreement, the Agency shall include information identifying the source of funds as
the City of Kent CDBG program.
B. The Agency acknowledges that this Agreement and any other information provided
by it to the City and/or relevant to the project(s) described in the Exhibit(s), are
subject to the Washington State Public Disclosure Act, Chapter 42.17 RCW, except
to the extent specifically exempted from disclosure therein.
7. OTHER FEDERAL AND STATE REQUIREMENTS
The absence of mention in this Agreement of any other federal or state
requirements, which apply to the award and expenditure of federal funds made
available by this Agreement, is not intended to indicate that those federal or state
requirements are not applicable to Agency activities. The Agency shall comply with
all other federal and state requirements relating to the expenditure of federal funds,
including but not limited to the Hatch Act (5 U.S.C. § 15) regarding political
activities and the Architectural Barrier Act of 1968 (42 U.S.C. § 4151, et seq.).
11
S. LOCAL REQUIREMENTS
The activities performed under this Agreement are for the purposes of serving City
residents and the Agency shall, to the extent reasonably possible, not use said
funds to provide services outside the corporate boundary of the City, or for any
other purpose, except as specifically authorized by this Agreement.
Public service Programs must comply with sections 9 and 10:
9. NON-SUBSTITUTION FOR LOCAL FUNDING
The CDBG funding made available under this Agreement shall not be utilized by the
Agency to reduce substantially the amount of local financial support for community
development activities below the level of such support prior to the availability of
funds under this Agreement.
10. FAITH-BASED ACTIVITIES - 24 CFR § 570.200(j).
A. Organizations that are religious or faith-based are eligible, on the same basis as
any other organization, to participate in the CDBG program. Neither the Federal
government nor a State or local government receiving funds under CDBG programs
shall discriminate against an organization on the basis of the organization's
religious character or affiliation.
B. Organizations that are directly funded under the CDBG program may not engage in
inherently religious activities, such as worship, religious instruction, or proselytism,
as part of the programs or services funded under this part. If an organization
conducts such activities, the activities must be offered separately, in time or
location, from the programs or services funded under this part, and participation
must be voluntary for the beneficiaries of the HUD-funded programs or services.
C. A religious organization that participates in the CDBG program will retain its
independence from Federal, State, and local governments, and may continue to
carry out its mission, including the definition, practice, and expression of its
religious beliefs, provided that it does not use direct CDBG funds to support any
inherently religious activities, such as worship, religious instruction, or proselytism.
Among other things, faith-based organizations may use space in their facilities to
provide CDBG-funded services, without removing religious art, icons, scriptures, or
other religious symbols. In addition, a CDBG-funded religious organization retains
its authority over its internal governance, and it may retain religious terms in its
organization's name, select its board members on a religious basis, and include
religious references in its organization's mission statements and other governing
documents.
D. An organization that participates in the CDBG program shall not, in providing
program assistance, discriminate against a program beneficiary or prospective
program beneficiary on the basis of religion or religious belief.
E. CDBG funds may not be used for the acquisition, construction, or rehabilitation of
structures to the extent that those structures are used for inherently religious
activities. CDBG funds may be used for the acquisition, construction, or
rehabilitation of structures only to the extent that those structures are used for
conducting eligible activities under this part. Where a structure is used for both
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eligible and inherently religious activities, CDBG funds may not exceed the cost of
those portions of the acquisition, construction, or rehabilitation that are attributable
to eligible activities in accordance with the cost accounting requirements applicable
to CDBG funds in this part. Sanctuaries, chapels, or other rooms that a CDBG-
funded religious congregation uses as its principal place of worship, however, are
ineligible for CDBG-funded improvements. Disposition of real property after the
term of the grant, or any change in use of the property during the term of the
grant, is subject to government-wide regulations governing real property
disposition (see 24 CFR 84 and 85).
F. If the City voluntarily contributes its own funds to supplement the federally funded
activity, the City has the option to segregate the Federal funds or commingle them.
However, if the funds are commingled, this section applies to all of the commingled
funds.
Acquisition or improvement of real property projects must comply with sections
11 through 18:
11. ACCESSIBILITY
Any buildings or other facilities designed, constructed, or altered with federal funds
pursuant to this Agreement are subject to the requirements of the Architectural
Barriers Act of 1968 (42 U.S.C. § 4151, et seq.) and shall comply with the Uniform
Federal Accessibility Standards (Appendix A to 24 CFR § 40.1, et seq. for residential
structures, and Appendix A to 41 CFR § 101-19, et seq. for general type buildings).
When applicable, certain multifamily housing units designed and constructed for
first occupancy after March 13, 1991, with assistance provided under this
Agreement, must comply with the Fair Housing Accessibility Guidelines, 24 CFR §
100.1, et seq., as amended.
12. ENVIRONMENTAL REVIEW
A. National Environmental Policy Act - The City retains environmental review
responsibility for purposes of fulfilling requirements of the National Environmental
Policy Act as implemented by HUD Environmental Review Procedures (24 CFR §
58.1, et seq.). The City may require the Agency to furnish data, information, and
assistance for the City's review and assessment in determining whether an
Environmental Impact Statement must be prepared. The Agency shall be solely
responsible for the cost of compliance with all such federal laws and authorities
including the cost of preparing plans, studies, reports, and the publication of notices
that may be required.
B. Other Federal Environmental Laws -
(1)Historic Preservation - Activities affecting property listed in or found to be
eligible for inclusion in the National Register of Historic Places will be subject to
requirements set forth in HUD Environmental Review Procedures at 24 CFR §
58.1, et seq. The Agency shall meet the historic preservation requirements of
Pub. L. No. 89-665 (16 U.S.C. § 470(1)), and the Archaeological and Historic
Preservation Act of 1974, Pub. L. No. 93-291 (16 U.S.C. § 469a-1), and
Executive Order 11593, including the procedures prescribed by the Advisory
Council on Historic Preservation in the regulations at 36 CFR § 801, et seq.
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(2)Architectural Barriers - Any facility constructed pursuant to this Agreement shall
comply with design requirements of the Architectural Barriers Act of 1968 (42
U.S.C. §§ 4151, et seq.), and the Uniform Federal Accessibility Standards (US
Government Printing Office, 1985-494-187).
(3)National Flood Insurance - When applicable, the use of CDBG funds for
acquisition or construction purposes in identified special flood hazard areas shall
be subject to Agency mandatory purchase of flood insurance as required by
Section 102(a) of the Flood Disaster Protection Act of 1973 (Pub. L. No. 93-237,
42 U.S.C. § 2414 and 42 U.S.C. §§ 4001-4128).
(4)Lead-Based Paint - Whenever funds under this Agreement are used directly or
indirectly for construction, rehabilitation, or modernization of residential
structures, the Agency shall comply, at its sole expense, with the HUD Lead-
Based Paint regulations (24 CFR § 35) issued pursuant to the Lead-Based Paint
Poisoning Prevention Act, as amended (42 U.S.C. §§ 4801, et seq.) and the
Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. §§ 4851,
et seq.), with regard to lead-based paint, and with any and all applicable
federal, state, and local laws, regulations, or standards hereafter enacted or
issued with regard to lead-based paint. Without limiting the foregoing, the
Agency shall remove or cover, prior to the date for completion of the work
funded hereunder and in compliance with all applicable, laws, regulations, and in
conformity with guidelines issued by HUD, all lead-based paint with lead content
above the threshold established by HUD on surfaces affected by the work funded
under this Agreement. The Agency shall defend, indemnify, and hold harmless
the City from any liability, loss, damage, or expense, including costs and
attorneys' fees, relating in any way to lead-based paint at the property or the
abatement or disposal thereof. This provision shall survive expiration and
satisfaction of this Agreement, whether by payment, forgiveness, foreclosure, or
otherwise.
(5)Other - Clean Air Act as amended, 42 U.S.C. § 7401, et seq.; Water Pollution
Control Act, 33 U.S.C. §§ 1367, et seq., as amended; Environmental Protection
Agency regulations, 40 CFR §§ 1.1, et seq.
C. State Environmental Policy Act - Agencies which are branches of government under
RCW 43.21C.030 retain responsibility for fulfilling the requirements of the State
Environmental Policy Act, Chapter 43.21C RCW and the regulations and ordinances
adopted there under. If the Agency is not a branch of government under RCW
43.21C.030, the City may require the Agency to furnish data, information, and
assistance, as necessary, to enable the City to comply with the State Environmental
Policy Act.
D. Satisfaction of Environmental Requirements
(1) Limitations on Activities Pending Clearance - Per 24 CFR § 58 22(a). The
Agency shall not commit assistance under this Agreement until HUD has approved
the City's Request for Release of Funds (RROF) and the related certification from
the City. In addition, until the RROF has been approved by HUD, neither the City
nor the Agency may commit non-HUD funds on or undertake an activity or project
under a program listed in § 58.1(b) if the activity or project would have an adverse
environmental impact or limit the choice of reasonable alternatives. Provided;
however, that an option agreement, self-Help Homeownership Opportunity Program
14
funds, and relocation assistance may be excluded from the limitation above per 24
CFR § 58.22(d), (e) and (f) respectively.
(2) Notice to Proceed - Project execution under this Agreement, by either the City
or the Agency, shall not proceed until satisfaction of all applicable requirements of
the national and state environmental policy acts. A written notice to proceed will
not be issued by the City until all such requirements are complied with.
13. LABOR STANDARDS — 24 CFR § 570.603
A. The Agency shall require that project construction contractors and subcontractors
pay their laborers and mechanics at wage rates in accordance with the Davis-Bacon
Act, as amended (40 U.S.C. §§ 3141 and 3142), and that they comply with the
Copeland Act (18 U.S.C. § 874), and the Contract Work Hours and Safety
Standards Act (40 U.S.C. §§ 3701, et seq.); provided that this section shall not
apply to rehabilitation of residential property only if such property contains not less
than eight (8) units. In addition to complying with these federal labor standards,
the Agency shall further require that all project construction contractors comply
with all applicable state and local public works bidding and contracting regulations,
specifically including, without limitation, the prevailing wage provisions set forth in
Ch. 39.12 RCW and all regulations adopted by the State of Washington Department
of Labor and Industries.
B. The Agency shall require that project construction contractors and subcontractors
comply with Federal Labor Standards Provisions (HUD form 4010) and the Davis-
Bacon wage determinations (attached as Exhibits J and K, respectively if
applicable). For construction contracts, a copy of the Federal Labor Standards
Provisions (HUD form 4010) and the current Davis-Bacon wage determinations
must be included in all construction bid specs and/or contracts over $2,000.
14. - VOLUNTEERS 24 CFR § 70
If the Agency or the Contractor/Subcontractor uses volunteers to perform services
on a federally-assisted construction project, it shall ensure that work is performed
without promise, expectation or receipt of compensation for services rendered.
Volunteer files shall include: (1) the name and address of the agency sponsoring
the project; (2) a description of the project; and (3) the number of volunteers and
the hours donated to the project.
15. ACQUISITION AND RELOCATION
A. Any acquisition of real property for any activity assisted under this Agreement shall
comply with the Federal Uniform Relocation Assistance and Real Property
Acquisition Policies Act of 1970, 42 U.S.C. §§ 4601, et seq. (hereinafter the
"Uniform Act" and the government-wide regulations applicable to all federally-
assisted projects, effective April 2, 1989, at 49 CFR §§ 34.1, et seq.
B. Implementation of any project provided for in this Agreement will be undertaken so
as to minimize involuntary displacement of persons, businesses, nonprofit
organizations, or farms to the greatest extent feasible.
C. Any displacement of persons, businesses, nonprofit organizations, or farms
occurring as the result of acquisition of real property assisted under this Agreement
15
shall comply with the Uniform Act, and the regulations at 49 CFR §§ 24.1, et seq.,
required by federal CDBG regulations at 24 CFR § 570.606. The Agency shall
comply with the regulations pertaining to costs of relocation and written policies, as
specified by the City of Kent's Displacement Policy.
16. PUBLIC OWNERSHIP
For Agencies which are not municipal corporations organized under the laws of the
State of Washington, it may become necessary to grant the City a property interest
where the subject project calls for the acquisition, construction, reconstruction,
rehabilitation, or installation of publicly-owned facilities and improvements.
17. REVERSION OF ASSETS - 24 CFR § 570.505.
Any real property under the Agency's control that was acquired or improved in
whole or in part with CDBG funds in excess of $25,000 must be either:
A. Used to meet one of the national objectives set forth in 24 CFR § 570.208 of the
CDBG regulations until five (5) years after expiration of the Agreement, or such
longer period of time as determined by the City. For Acquisition or improvement of
real property projects, the Agency and the City shall execute a Community Facility
Covenant Agreement.
B. Disposed of in a manner that results in the City being reimbursed in the amount of
the current fair market value of the property, less any portion attributable to
expenditures of non-CDBG funds for acquisition of, and improvements to, the
property. Such reimbursement is not required after the period of time specified in
Paragraph (A) above.
18. PROPERTY MANAGEMENT STANDARDS
A. The Agency shall meet the following procedural requirements for all property
acquired in whole or in part with CDBG funds:
(1)Property records shall be maintained accurately and provide for a description of
the property; manufacturer's serial number or other identification number;
acquisition date and cost; source of the property; percentage of CDBG funds
used in the purchase of property; and location, use, and condition of the
property.
(2)A physical inventory of property taken and the results of that inventory are
reconciled with the property records at least once every two (2) years to verify
the existence, current utilization, and continued need for the property.
(3)A control system shall be in effect to ensure adequate safeguards to prevent
loss, damage, or theft of the property which shall be investigated and fully
documented.
B. The disposition of real property acquired in whole or in part with CDBG funds shall
be at no less than its current appraised fair market value (or for a lease, at the
current market value), except that such property may be disposed of for a lesser
value, including by donation, if the disposition at the lesser value is for a use which
qualifies under one of the criteria set forth in 24 CFR § 570.208 for meeting the
national objectives and is permissible under state and local law. Where the
16
disposition is for a lesser value, the recipient shall maintain documentation that the
use meets one of the national objectives pursuant to 24 CFR § 570.208.
19. ADDITIONAL LOCAL REQUIREMENTS
A. Mortgage or Leasehold Agreement - In acquisition, rehabilitation, and construction
projects, the City shall enter into a deed of trust or leasehold agreement with the
Agency to secure and protect the City's and the public's interest in the property.
B. Adequate Value - In acquisition projects, the City shall require evidence through a
property appraisal, title search, or other means to ensure that there is adequate
value so as to secure the City's financial interest.
C. City Ordinance, Codes, and Regulations - In acquisition and construction projects,
the Agency shall comply with all applicable City ordinances, codes, and regulations.
D. Additional Public Information - For all construction projects, the Agency shall erect
a sign to City specifications at the construction site, which identifies the source of
funds, except that this requirement may be waived for construction projects of
$5,000 or less.
PART III - MONITORING & REPORTING REQUIREMENTS
1. MONITORING
Agency understands and agrees that it will be monitored by the City and HUD from
time to time to assure compliance with all terms and conditions of this Agreement
and all applicable local, state, and federal laws, regulations, and promulgated
policies. Monitoring by the City under this Agreement shall include, but not be
limited to: (1) on-site inspections by City staff, (2) quarterly performance reviews,
and (3) an annual evaluation.
2. PROGRAM REPORTING
A. For public service programs - A Billing Voucher and Service Report shall be
submitted at least quarterly, even if no reimbursement is requested. The
report is due on the 15th of the month following the close of the quarter. If the due
date falls on a Saturday or Sunday, Billing Voucher and Service Reports are due on
the prior Friday. If the due date falls on a City holiday, Billing Voucher and Service
Reports are due the next working day following the holiday. The Final Billing
Voucher and Service Report, and Program Accomplishment forms, are due in
accordance with the schedule listed in Exhibit A. The reports shall detail
information on service units or steps/milestones accomplished during the
months/quarters as outlined in Exhibit A. The Final Program Accomplishment Form
is provided by the City and is attached as Exhibit E to this Agreement.
B. For acquisition or improvement of real property projects - Projects qualifying to
meet the national objective to serve low- and moderate-income persons (under Part
I, Section 3) shall submit a demographic report providing income, race, and head of
household information for the beneficiaries of the CDBG Project, which shall cover a
one year period extending back from the date of the report. If the facility is and
remains occupied during the project, this report is due thirty (30) days after the
date the project was closed. If the facility is first occupied or reoccupied after the
17
close of the project, the report is due one year from the date of the last project
closing.
3. FISCAL REPORTING RESPONSIBILITIES
The Agency shall provide fiscal statements or reports as may be required from time
to time by the City, which statements or reports, or both, must indicate the status
of all accounts and funds being used to perform under this Agreement. The Agency
shall maintain proper documentation and records of all expenditures incurred
pursuant to the terms of this Agreement in a manner as will facilitate auditing by
either HUD or the City.
4. AUDITS
A. If the Agency is a nonprofit corporation and expends a total of $500,000 or more in
federal financial assistance and has received federal financial assistance from the
City during its fiscal year, it shall have an independent audit conducted of its
financial statement and conditions, which shall comply with the requirements of
generally accepted auditing standards (GAAS); General Accounting Office (GAO's)
Standards for Audits of Governmental Organizations, Programs, Activities, and
Functions; and OMB Circular A-133, as amended, and as applicable.
The Agency shall provide a copy of the audit report no later than thirty (30) days
after the audit's completion or six (6) months subsequent to the end of the
Agency's fiscal year, whichever date is sooner. The Agency shall provide to the City
its response and corrective action plan for all findings and reportable conditions
contained in its audit. When reference is made in its audit to a "Management
Letter" or other correspondence made by the auditor, the Agency shall provide
copies of those communications and the Agency's response and corrective actions
plan.
B. The Catalog of Federal Domestic Assistance (CFDA) number for the CDBG program
is 14.218.
PART IV — RECORDKEEPING REQUIREMENTS
1. PROGRAM RECORDS AND INSPECTIONS
The Agency shall make, maintain, and preserve books and records, of whatever
form, detailing all CDBG-related expenditures and costs incurred by the Agency. All
such books and records shall be made available to representatives of the City or
HUD, or both, for formal inspection and, where necessary, copying. Intentional
noncompliance with this provision shall constitute a material breach of this
Agreement.
Throughout the term of this Agreement, the Agency shall establish and maintain
current the records described in this Section. These records shall conform to the
requirements and specifications of their individual source authorities, which are
cited herein. Be advised that the listing in this Section is intended only to assist the
Agency in identifying the required records and their respective authorities, and is
not all inclusive.
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A. Time for Retention of Records - Except where otherwise specifically provided, all
records as of the end of the term of this Agreement shall be kept in an accessible
file for four (4) years thereafter (24 CFR § 570.502(b)(3)(ix)). Exceptions to the
four (4) year retention period are as follows: (1) Records that are the subject of
litigation, claim, or audit findings shall be retained for ten (10) years after the date
all issues have been resolved and final action taken; and (2) Records for real
property and equipment shall be retained for three (3) years after its final
disposition, with the retention period starting from the date of the disposition,
replacement, or transfer at the direction of the City (24 CFR § 570.84(b)).
B. Contract and Amendments - A complete copy of this Agreement and all
amendments thereto and notices there under.
C. Records of City Approvals - Copies of all requests for amendments or revisions to
this Agreement and the City's subsequent approval or denial of such requests as
are required under this Agreement.
D. Subcontracts and Agreements - Complete copies of all contracts, subcontracts, and
agreements with third parties into which the Agency enters in the performance
under this Agreement; and all correspondence, reports, and other documentation
pertaining to such contracts, subcontracts, and agreements.
E. Records identifying the assisted activity - A complete description of each activity
assisted, in whole or in part, with CDBG funds under this Agreement, including:
(1)Location(s), organization, operating hours, qualifications for service or
participation, etc.;
(2)Fees or charges for services, fee waivers, or fee scales for CDBG-assisted
participants.
F. Additional Contract Req-uirements - The Agency shall submit to the City a copy of
the most recent independent financial audit and a current list of the Agency's board
of directors.
2. PROGRAM BENEFIT RECORDS - 24 CFR § 570.506(b).
As applicable, the following categories of records shall be maintained, for the
discrete activities which are assisted in whole or in part with funding under this
Agreement (or for all the Agency's activities if funding under this Agreement is not
specifically allocated to particular activities) for the purpose of documenting that a
majority of the beneficiaries are persons of low- or moderate-income.
A. Records specifying by dollar amount, family size, and household income limits used
to determine income level;
B. For service activities serving individual clients without regard to their residence
location within the City/County, records documenting: (a) manner in which each
client's income is determined in all cases; (b) determination that each individual
client's income is or is not within low- or moderate-income limits; (c) date
determination was made; and (d) tabulation of the individual determinations.
C. For a service or facility which exclusively serves a class of beneficiaries, the
members of which are presumed to be low- or moderate-income eligible absent
general evidence to the contrary (abused children, battered spouses, senior
19
citizens, adults meeting the Bureau of the Census' Current Population Reports
definition of'severely disabled," homeless persons, illiterate persons, persons living
with AIDS and migrant farm workers), records documenting: (1) that the facility
exclusively serves the eligible class; and (2) there is no generally available data
indicating specific population served is not predominantly low- or moderate-income.
D. For a service or facility which offers benefits uniformly without regard to income to
all persons residing within a delineated area, records establishing: (1) boundaries
of the service area; (2) the income characteristics of families and unrelated
individuals in the service area; and (3) if the percent of low- and moderate-income
persons in the service area is less than fifty-one (51) percent, data showing that
the area qualifies under the exception criteria set forth at 24 CFR §
570.208(a)(1)(ii).
3. FINANCIAL RECORDS
Agency shall maintain all accounting records that accurately record the source and
application of all funds; and recording funds received under this Agreement, all other
receipts, assets, authorizations and appropriations, obligations, disbursements and
unobligated balances (OMB Circular A-133 and A-110, Attachment F). The records
must:
A. Permit comparison of actual outlays with budgeted amounts;
B. Permit reporting of financial data on the accrual basis;
C. Be supported by source documentation;
D. Be independently audited usually annually, but not less frequently than every two
years.
4. RECORDS OF PROGRAM OPERATIONS, MANAGEMENT AND EVALUATION
Agency shall maintain all records of:
A. Operating policies and procedures;
B. Employee qualifications, training, and evaluation;
C. Principal operations data: work units completed; clients served, classified by client
and service characteristics; staff hours utilized; etc.
D. Self-evaluation of services, programs. and employment practices for compliance
with 504 and ADA requirements.
S. PROPERTY RECORDS
Agency shall maintain all records identifying any real and personal property acquired or
improved in whole or in part with funds under this Agreement (OMB Circular A-110) as
follows:
A. Itemized inventory of real property recording legal and common descriptions and
address, date of acquisition and/or improvements, cost of acquisition and/or
improvements, and CDBG-funded share of cost;
20
B. Itemized inventory of all non-expendable personal property recording full
identification, current location, date and cost of acquisition, and CDBG-funded share
of cost;
C. Complete records of any authorized disposition of real or non-expendable personal
property including how and to whom disposed, date, amount of disposition
proceeds, market value at time of disposition and how determined, intended use,
and any conditions governing use following disposition;
D. At the termination of this Agreement, a record of the total purchase cost of all
remaining unused expendable personal property.
6. PROCUREMENT RECORDS - OMB Circular A-110
Agency shall maintain all records of:
A. Agency's adopted code of conduct governing officers' and employees' actions in
contracting and purchasing;
B. Agency's standard operating procedures for authorizing and executing purchases
and contract procurements of various sizes and types.
C. Agency's individual purchases or contracts over $10,000 as required by the OMB
Circular A-110.
D. Agency's procurement procedures utilized and the bases for supplier
selection/contract award, for individual purchases or contracts over $10,000.
7. NONDISCRIMINATION AND EQUAL-OPPORTUNITY RECORDS - 24 CFR § 570.506(g).
Agency shall maintain:
A. A recordation and tabulation of the racial classification of all individual persons or
households receiving program benefits, and of whether these benefited persons are
single head of household.
B. A tabulation of all Agency employees classified by race, position, and salary in the
format of the U.S. Equal Employment Opportunity Commission Form EEO-4.,
C. Data identical to that required under A. and B. above for any subcontractor or
agent employed in the performance under this Agreement.
D. Documentation of all substantive actions taken to assure that no prohibited
discrimination occurs in the conduct of any of the Agency's operations.
E. Documentation of all actions taken to make minority residents aware of the
Agency's services and provide them with equal access to benefits.
F. Record of the racial classification and gender of the majority owners of each private
for-profit business with which the Agency contracts with any funds provided under
this Agreement.
8. CONFLICT OF INTEREST
A. Records documenting that all Agency board members, officers, employees and
consultants have been informed of the conflict of interest provisions of 24 CFR §
570.611 and have acknowledged understanding those provisions.
21
B. Complete records of all requests for exceptions submitted under 24 CFR §
570.611(d).
9. VERIFICATION OF SUBCONTRACTOR'S ELIGIBILITY - 24 CFR § 5.
The Agency shall maintain records documenting that the Agency, all subcontractors,
and consultants have been determined not to be currently debarred, suspended,
denied participation or declared ineligible to participate in federal government
funded programs. Verification of eligibility shall be accomplished by signing the
Certification Regarding Debarment and Suspension, which is attached and
incorporated as Exhibit G .
10. ADDITIONAL REQUIREMENTS FOR ACQUISITION OR IMPROVEMENT OF REAL PROPERTY
PROJECTS
A. For construction contracts over $100,000, records documenting compliance with
the bonding requirements of 24 CFR § 85.36 (h).
B. Flood Insurance, Flood Disaster Protection Act of 1973; and Federal Insurance
Administration Notice in Federal Register Vol. 24, No. 133, July 13, 1989.
(1)Record of determination whether the assisted project is located within a
designated flood plain or flood hazard area.
(2)If the project is within such area: (1) Evidence of current participation in the
National Flood Insurance Program; and (2) Evidence of flood insurance coverage
in force on all significant project structures.
C. Lead-Based Paint - Records required to document compliance with the Lead-Based
Paint Poisoning Prevention Act (42 U.S.C. §§ 4801, et seq.), as amended and the
Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U S.C. §§ 4851, et
seq.), and the implementing regulations 24 CFR § 35.
D. Labor Standards - Records required to document compliance with all requirements
of Davis-Bacon and Related Acts (40 U.S.C. §§ 3141 and 3142); Contract Work
Hours and Safety Standards Act (40 U.S.C. § 3701, et seq.); Copeland Act (18
U.S.C. § 874); US Secretary of Labor Regulations (29 CFR §§ 3, 5, 6, and 7).
E. Real Property Acquisition and Relocation - Records required to document
compliance with the Uniform Relocation Assistance and Real Property Acquisition
Policies Act of 1970, 42 U.S.C. §§ 4601, et seq., as amended; and the
implementing regulations 49 CFR § 24. The agency shall consult the City for
complete instruction prior to undertaking any action which may result in
displacement of persons as defined at 49 CFR § 24.2(g).
F. Miscellaneous Records - The Agency shall maintain such other records as may be
required by HUD or the City.
22
HEALTHPOINT: CITY OF KENT:
Sian in blue or black inkAa
Print Name: Thomas Trompeter Pri N e: Suzette Cooke
Title: Chief Exec ttivee Officer Ti I Ma or
DATE: !/v ' DATE: l t
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
HEALTHPOINT: CITY OF KENT:
Dinah Wilson, CDBG Coordinator
Faith Wimberley, HealthPoint City of Kent
Resource Development Manager 220 Fourth Avenue South
955 Powell Ave. SW, Suite A Kent, WA 98032
Renton, WA 98057-2908
Phone: 253.856.5076
Phone: 425-203.0419 Fax: 253.856.6070
Fax: 425.277.1566
APPROVED AS TO FORM:
Kent Law Department
23
EXHIBIT A
2011 CDBG PROJECT SCOPE OF SERVICES
HEALTHPOINT
Project No.: BG1102 Start Date: 1/1/11
Project Title: Healthcare for the Homeless End Date: 12/31/11
Project Manager: Faith Wimberley
Telephone: 425.203.0419 Fax: 425.277.1311 E-mail:
fwimberley@healthpointchc.org
CDBG Coordinator/City Contact: Dinah Wilson
Telephone: 253.856.5076 Fax: 253.856.6070 E-mail: drwilson@ci.kent.wa.us
HealthPoint (hereinafter referred to as "the Agency") shall utilize City of Kent
Community Development Block Grant funds to perform the activities specified
below. Such services shall be provided in a manner which fully complies with all
applicable federal, state and local laws, statutes, rules and regulations, as are now
in effect or may be hereafter amended.
1) Project Summary
The Agency shall use CDBG funds to provide nursing services to homeless
individuals who reside in Kent-area transitional and domestic violence shelters. The
Agency shall use at least sixty percent (60%) of funds to cover the salary of a
registered nurse or other direct medical services staff who care for the homeless. A
portion of the remainder of funds may be used to cover the salary of the Client
Services Representative._
2) Project Budget
The Agency shall apply the following funds to the project in accordance with the
Line Item Budget Summary below:
A. City of Kent Funds
City of Kent Community Development $101785.00
Block Grant
Total City of Kent Funds: $10,785.00
B. Line Item Budget
Personnel Services $*91275.00
Office or Operating Supplies $
Communications $
Travel and Training $
Administrative Costs $ 1,510.00
Total City of Kent Funds: $10,785.00
2011 HealthPoint H for H CDBG Project Scope of Services- Page 1
3) Performance Measures
A. Number Served
The Agency agrees to serve, at minimum, the following unduplicated number of
persons with CDBG funds:
1st 2nd 3rd 4th
Quarter Quarter Quarter Quarter Total in
]AN. - APRIL- JULY - OCT. Year
MARCH TUNE SEPT. DEC. 2011
No. of unduplicated
persons assisted 4 4 4 3 15
B. Units of Service
The Agency agrees to provide, at minimum, the following units of servrce by
quarter:
1st 2" 3rd 4th
Quarter Quarter Quarter Total in
JAN. to April to QuarIULY to OCT.for Year
MARCH Jttne SEPT. 2011
DEC.
Nursing Visits T
9 9 9 8 35
C. Definition of Services
Nursing Visit: Face-to-face encounter between a homeless person seeking medical
services and a registered nurse providing treatment.
4) Records
A. Project Files
The Agency shall maintain files for this project containing the following items (all
Agency files must contain items 1 - 7, however items 8 - 12 are required
only if the costs are paid for by the CDBG budget. If clients are not
presumed eligible; e.g., homeless, #13 client income must be
documented):
1. Notice of Grant Award.
2. CDBG Agreement and all contract exhibits.
3. Motions, resolutions, or minutes documenting Board or Council actions.
4. A copy of this Scope and the City's Notice to Proceed on this project.
5. Correspondence regarding budget revision requests.
6. Copies of all invoices and reports submitted to the City for this project.
7. Bills for payment.
2011 Health Point H for H CDBG Project Scope of Services - Page 2
8. Copies of approved invoices and warrants.
9. Payroll time sheets for actual salary and fringe benefit costs. Time
sheets must be signed by a supervisor and annotated to document
percent of time charged against this project if less than full time.
10. Documentation of office costs (e.g., log sheets of copy machine use,
postage, telephone use, costs of office supplies, etc.) when these costs
are shared with other programs and no invoice is available. As an
alternative, annotated invoices may be used to document charges as
appropriate.
11. Documentation of mileage charges for private auto use must include: a)
odometer reading at beginning and end of trip, b) destination and
starting location, and c) purpose for trip.
12. Documentation of the solicitation process used to select vendors and
subcontractors with original purchase orders and subcontracts.
13. Documentation required by Part I, Section 21 E, if any funds provided
under this Scope are used to acquire equipment.
14. Documentation of client income. Unless clients are presumed eligible
based on CDBG regulations, the Agency shall screen all clients served
with funds provided under this Contract to ensure that at least 51% of
the total number of clients served do not have a gross annual family
income in excess of the limits specified in Exhibit B.
Adjusted gross income as defined by the Internal Revenue Service Form
1040 shall be used to determine persons' or households' income. The
following methods may be used to determine income eligibility:
a) IRS income tax return;
b) Client income certification on a form approved by the City; or
c) Documentation of qualification for participation in a "means-
tested" federal or state program at least as restrictive as CDBG
with regard to Income Guidelines.)
Income guidelines may be adjusted periodically by HUD. The Agency
agrees to use updated Income Guidelines, which will be provided by the
City.
B. Record Retention Period
All records required by this Scope shall be retained by the Agency for the period
of time specified in the Agreement - Part IV. The period of time shall commence
on January 1 of the year following the year in which the final invoice was paid.
2011 HealthPoint H for H CDBG Project Scope of Services- Page 3
5) Reports, Invoicing and Reporting Schedule
A. Reports
The Agency shall collect and report client information to the City quarterly on the
Service Units section of the Billing Voucher and Service Report to be provided
by the City. The Billing Voucher and Service Report shall be submitted
electronically via the City's web based reporting site at:
https://apps.ci.kent.wa.us/khforms/ .
B. Invoicing and Reporting Schedule
The Agency shall submit invoices electronically to the City in the form of a CDBG
Billing Voucher. Copies of supporting documents shall be attached to the
Billing Voucher or sent via the U.S. Postal Services and postmarked within
two days of the due dates listed below.
The Agency shall submit Billing Vouchers and Service Reports to the City in
accordance with the following schedule:
Billing Voucher and Service Report (Exhibit D)1 4/8, 7/8, 10/7, 12/9
CDBG Public Services Project Time Sheet 4/8, 7/8, 10/7, 1/10/12
(Exhibit H, if applicable)
Final Program Accomplishment Form (Exhibit E) 1/9/12
' All dates are 2011 unless otherwise noted.
2011 HealthPoint H for H CDBG Project Scope of Services- Page 4
EXHIBIT B
2011 HUD INCOME GUIDELINES
Effective 3/14/10
Median Family Income = $85,600
- -- 306l0 50% sot)
MEDIAN MEDIAN MEDIAN
FAMILY EXTREMELY VERY LOW
SIZE LOW LOW INCOME
INCOME INCOME
1 $18,000 $30,000 $45,100
2 $20,600 $34,250 $51,550
3 $23,150 $38,550 $58,000
4 $25,700 $42,800 $64,400
5 $27,800 $46,250 $69,600
6 " $29,850 $49,650 $74,750
7 $31,900 $53,100 $79,900
8 $33,950 $56,500 $85,050
EXHIBIT C
APPOINTMENT OF LIAISON &
AUTHORIZATION TO SUBMIT BILLING VOUCHERS & SERVICE
REPORTS
2011 CDBG AGREEMENT
Appointment of Liaison
The Agency appoints the following person as the liaison for the CDBG
Agreement between the City and the Agency; this person shall be responsible
for overall administration of the CDBG funded program:
Liaison: V V 1���JV''��iy1 (V( okf-Ct ►�C�t/Q��
(r�wmGl�
Authorization to Submit Billing Vouchers & Service Reports
The Agency authorizes the following individual(s) to electronically submit
Billing Vouchers & Service Reports for costs incurred and services provided
pursuant to the 2011 CDBG Agreement between the Agency and the City;
billing vouchers shall not be processed for payment unless they are
submitted by an authorized individual(s):
Authorized
Individual(s):
4� VU m lo-ems✓(-eel
(Type Name) (title)
Additional
Authorized
Individual:
(if applicable):
J'ox* - 9 1 1 L&I, I ill a///"'�
(Type Name) (title)
a I9-� j
(date)
Exhibit D CDBG
KENT Billing Voucher & Service Report
W A S H I N G T O N L 01 1
PARKS, RECREATION &
COMMUNITY SERVICES
To: Agency: HealthPoint
Dinah Wilson
Housing & Human Services
Parks, Recreation & Community Services
220 41h Ave. South, Kent, WA 98032 Program Contact: Faith Wimberley
Telephone: 425.203.0419
drwilson(fti.kent.wa.us E-mail: fwimberley@healthpointchc.org
Phone: 253 856-5076
Reporting Period Program Amount Requested
Healthcare for the Homeless $
BUDGET SUMMARY (COMPLETE LINE ITEM SUMMARY ON BACK)
FOR DEPARTMENT USE ONLY __= Total Contract Amount $ 10,785.00
Amount Requested $
Amount Remaining $
2011
KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
New City of Total Kent
Service Units Planned Total Kent Funded Funded
Service Unit Description Service Service
Each Quarter Served Units This Units To
Quarter Date
Total
Service Unit/Performance Measure 15i 2nd 3m 4ih served
in 2011
Unduplicated # of Kent clients
(persons) served 4 4 4 3 15
Nursing Visits g 1 g g 8 35
Page 1 of 2 (see over)
LINE ITEM BUDGET SUMMARY
COST CATEGORIES ORIGINAL TOTAL REVISED CUMULATIVE
BUDGET REQUESTED BUDGET TO DATE
1 Personnel Services
(Attach Time Sheets) $9,275.00
2 Administrative Costs $1,510.00
GRAND TOTAL
$10,785.00
Authorized Signature Date
FOR DEPARTMENT USE ONLY
AUTHORIZED FOR PAYMENT
gy; DATE:
Page 2 of 2
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EXHIBIT F
INSURANCE REQUIREMENTS FOR
2011 CDBG 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 11 85 or a substitute endorsement
providing equivalent coverage.
2. Automobile Liability insurance covering all owned, non-owned, hired
and leased vehicles. Coverage shall be written on Insurance Services
Office (ISO) form CA 00 01 or a substitute form providing equivalent
liability coverage. If necessary, the policy shall be endorsed to provide
contractual liability coverage.
3. Workers' Compensation coverage as required by the Industrial
Insurance laws of the State of Washington.
4. Excess Liability insurance covering both the Commercial General
Liability and Automobile policies.
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.
EXHIBIT F (Continued)
2. Automobile Liability insurance with a minimum combined single limit
for bodily injury and property damage of $1,000,000 per accident.
3. Excess Liability insurance shall be written with limits no less than
$1,000,000 per occurrence in excess of both the CGL and Auto Liability
policies cited above.
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 ANII.
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 insured under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
EXHIBIT F (Continued)
All coverage for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
ACC>Rv CERTIFICA - OF LIABILITY INSURAIr ;E OP ID sR =DATEYYYY)
HEALT-2 /10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Sprague Israel Giles HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
1501 Fourth Avenue, Suite 2000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Seattle WA 98101-1637
Phone: 206-623-7035 Fax:206-682-4993 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA Ameucan Economy Insurance Co
INSURER B General Ins Co of America
HealthPoint INSURER C American States _nsurance Co
955 Powell Avenue SW, Suite A INSURER D
Renton WA 98057
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
LTR INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
DATE(MMIDD YYYY) DATE(MMIDDNYYY)I LIMITS
GENERAL LIABILITY EACH OCCURRENCE $2,000,000
A X X COMMERCIAL GENERAL LIABILITY 02BP466307-5 06/01/10 06/01/11 PREMISES(Eaoccurence) $2,000,000
CLAIMS MADE 1XI OCCUR MED EXP(Any one Person) $ 10,000
PERSONAL&ADV INJURY $ Included
GENERAL AGGREGATE $ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ Included _
J_CT
X POLICY PRO LOC STOP GAP Included
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $1,000,000
B X ANY AUTO 01CH941889-20 06/01/10 06/01/11 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
X HIRED AUTOS
BODILY INJURY $
X NCN-OWNED AUTOS (Peraccident)
X $10 0 Comp PROPERTY DAMAGE
X $100 Coll (Per accident) $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHERTHAN EA ACC $
r
AUTO ONLY AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
C X OCCUR CLAIMSNIADE O1SU382271-50 06/Ol/10 06/O1/11 AGGREGATE $ 1,000,000
DEDUCTIBLE $
X RETENTION $10,0 0 0 $
WORKERS COMPENSATION -
AND EMPLOYERS'LIABILITY YIN TORY LIMITS I_I ER
ANY PROPRIETORIPARTNER/EXECUTIVF--1 E L EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? u
(Mandatory in NH) E L DISEASE-EA EMPLOYEE $
If yes,describe under
SPECIAL PROVISIONS below E L DISEASE-POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
The City of Kent, Its elected and/or appointed officials, its employees and
agents & King County are named as additional insureds with respects
liability arising out of operations by or on behalf of the Named Insured for
General Liability per form BP7057 attached
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
City of Kent IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Parks Dept/Housing & Human Sry REPRESENTATIVES
Attn: Dinah R Wilson AUTHOR ZED REPRESENTA E
220 4th Avenue South
ent WA 98032
ACORD 25(2009101) @ 1988-20091ACORD CORPORATION All rights reserved.
The ACORD name and logo are registered marks of ACORD
M= BUSINESSOWNERS
BP 70 57 07 02
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - DESIGNATED
PERSON OR ORGANIZATION
This endorsement modries insurance pi ov{ded under the following
BUSINESSOWNERS COVERAGE FORM — Section 1: — Liatility
SCHEDULE-
City of Kent, its elected and/or appointed officials, its employees and
Nance of Person or Organization: agents& King County
WHO IS AN INSURED (Section C) is amended to include as an insured the person or organization sho:.n in
the Schedule as an insured but only with respect to liability arising out of your operations or premises owned
by or rented to you
Information required to complete the Schedule, IT nct eho%/n or this endorsement, will be shown in the
Declarations.
an, P�a Sas.:a :cp3 ar 6a�a^'w�s c 1 Ca�crcc_r
BP iC 57 C, C1
EXHIBIT G
City of Kent
Certification Regarding Debarment and Suspension
HealthPoint Healthcare for the Homeless/BG1102
Agency Name of Project/Project Number
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
I
1 of 4
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 which 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 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 Exclusion - 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
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.
2of4
Certification B: Certification Regarding Debarment, Suspension, Ineli-
gibility 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 whom this proposal is submitted if at any time the
prospective lower tier participant learns that its certification was erroneous
when submitted or has become erroneous by reason of changed
circumstances.
4. The terms covered transaction, debarred, suspended, ineligible,
lower tier covered transaction, participant, person, primary covered
transaction, principal, proposal, and voluntarily excluded, as used in
this clause, have the meanings set out in the Definitions and Coverage
sections of rules implementing Executive Order 12549. 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.
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 Exclusion - 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
3of4
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 Non-
procurement List.
8. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and Information of a
participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph (5) of these
Instructions, If a participant In a 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 trans-
action originated may pursue available remedies Including suspension and/or
debarment.
Primary Contractor/sub-Contractor Date
' UPrmt
I I IBelow) � _40
Aut /SJgnature �J/f Pri Title
Contra ctor/Sub-Conk (/c�
(Sign Below U ! n
.W
up
4 of 4
H Ir at t,T FI EXHIBIT H 2O11 EXEMPT PAYROLL REPORT
EMPLOYEE NAME:
41 ° N rt x SPAY PERIOD ENDING:
.16 '17, Aa: IV, '2ff`- '21 22 23 24 25 26 27 2a 129 39 W.
LEAVE CODE
LEAVE HOURS(FMLA ONLY)
"Hours by Site or Department
Department/Site
DepartmenUSrte
Department/Site
Department/Site
Department/Site
DepartmenUSrte
Department/Site
DepartmenUSrte CHCKC General Duties
Comments
I certify to the best of my knowledge that the foregoing is true and correct This timesheet is an
after the fact determination of actual effor texpended for the period indicated and I have full
knoweld a of 100%of these activities
THIS SECTION ONLY TO BE USED BY EMPLOYEE SIGNATURE
EMPLOYEES THAT FLOAT OR WORK AT
DIFFERENT SITES OR EMPLOYEES THAT
ARE REQUIRED TO TRACK THEIR HOURS
SPENT WITH DIFFERENT PROGRAMS OR
SITES(ie Grants). SUPERVISOR APPROVAL
LEAVE CODES.
ONLY EMPLOYEES THAT ARE EXEMPT,
50 FTE AND ABOVE,AND NOT A PTO-Illness or Vacation H-Holiday
CONTRACTED CONTACT HOUR
PROVIDER SHOULD USE THIS REPORT. CE-Continuing Education B-Bereavement
IF YOU ARE LESS THAN A 50 FTE
EMPLOYEE, USE THE REGULAR CHCKC J-Jury Duty W-Workers Comp.
TIMESHEET DENTAL PROVIDERS-
PLEASE NOTE APPROVED EXTRA U -Unpaid Leave F-Family Medical Leave of Absence
SHIFTS IN THE COMMENTS.
1-Inclement Weather/Snow/Power M-Military Leave
L-Leave of Absence-Other
E504/AD:ArD- ISABILITY ASSURANCE OF COMPLIANCE
ETE AND RETURN WITH SIGNED CONTRACT
Complying with Section 504 of the Rehabilitation Act of 1973, as amended, and the Americans With
Disabilities Act of 1990, two federal laws which prohibit discrimination against qualified people with
disabilities
I understand that federal and state laws prohibit discrimination in public accommodations and
employment based solely on disability In addition, I recognize that Section 504 requires recipients of
federal funds (either directly or through contracting with a governmental entity receiving federal
funds) to make their programs, services, and activities, when viewed in their entirety, accessible to
qualified and/or eligible people with disabilities I agree to comply with, and to require that all
subcontractors comply with, the Section 504/ADA requirements I understand that reasonable
accommodation is required in both program services and employment, except where to do so would
cause an undue hardship or burden
I agree to cooperate in any compliance review and to provide reasonable access to the premises of
all places of business and employment and to records, files, information, and employees therein to
the City of Kent for reviewing compliance with Section 504 and ADA requirements
I agree that any violation of the specific provisions and terms of the 504/ADA Disability Assurance of
Compliance and/or Corrective Action Plan required herein or Section 504 or the ADA, shall be
deemed a breach of a material provision of the Contract between the City of Kent and the Contractor.
Such a breach shall be grounds for cancellation, termination, or suspension, in whole or in part, of
Lhis Contract by the City of Kent
According to the responses to the questions in the 504/ADA Self-Evaluation YES NO
Questionnaire, (company name) 10 Ie q 11 poll?-
is in compliance with 504/ADA.
If the above response is NO, the following corrective actions will be taken:
Corrective Action Plan
The following Corrective Action Plan is submitted to comply with Section 504, and ADA requirements.
General Requirements
Actions To Be Taken s Completion'Date
i
L 'F 2 6w t 0-m 0 o - 7S
01 Ud , 14Orki
Program Access
Actions To Be Taken Completion Date
outZalzti( D o'yl Qe l l
sllzt)7
504/ADA Contract Forms 5-11-04 1
504/ADA DISABILITY ASSURANCE OF COMPLIANCE (continued)
Employment and Reasonable Accommodation
Actions To Be Taken Completion Date,---_
Physical Accessibility
Actions To Be Taken Completion Date
I Declare Under Penal of Perju der ws of the State of Washington that the
Foregoing is True an ct.
Signature of authorzed signator
Type or print name of authorizld signator Title Telephone
For Notary:
State of W f}Sk`I n4-6r% County of rn q
Signed and sworn before me on (date) �IO by (print authorized
F
signator name) MSS Tt`o n_p 1C
Notary signature `I l
YVflNNEL NIESTOVFR Notary (print name
cnv�a a
NOTARY PUBLIC —r-
STATC OF WASHINGTON
MALK koN expi4s My appointment expires: 1a 7
Gr:CEMBr.R 4'9, 2012
Contractor
Company Name r
S 1 awl f! ✓� S W 1A
Street Address City State Zip
5041ADA Contract Forms 5-11-04 2
REQUEST FOR MAYOR'S SIGNATURE
• Please Fill in All Applicable Boxes
KENT
WA5"IN .VN
Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT)
Originator: Dinah Wilson, Parks/Human Phone (Originator): 5076
Svs.
Date Sent: 3/8/11 Date Required: ASAP
Return Signed Document to: Dinah CONTRACT TERMINATION DATE: 12/31/11
VENDOR NAME: HUD DATE OF COUNCIL APPROVAL: 1112110
Brief Explanation of Documents: I have attached the 2011 CDBG Agreements. CDBG Funds are
awarded to non-profits to provide public service and capital projects that benefit Kent
residents. Examples include funds awarded to HealthPoint to provide nursing services to the
homeless who reside in shelters throughout the City of Kent and funds provided to Refugee
Women's Alliance to fund case management and emergency assistance to refugees and
immigrants.
All Contracts Must Be Routed Through The Law Department
p tf by the Law Department)
Received: l��
MAR 0 9 2011
Approval of Law Dept.:
Law Dept. Comments: KENT LAW DEPT. � E �I`JEl�
Date Forwarded to Mayor: CitY of Kent
(� (( Office Of the M°, fnr
Shaded Areas To Be Completed By Administration Staff
Received:
Recommendations and Comments: �}
Disposition: �` ���� ,� �� ��p✓�/U�� U �p
V
Date Returned: _
2011
CIT}•OF KEryT
E::2 CLE4K