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HomeMy WebLinkAboutPK13-070 - Original - Senior Services - Volunteer Transportation - 03/25/2013 Records MAr6gem - n't T -__- W.s„,„GroH - 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: Senior Services Vendor Number: 34124 JD Edwards Number Contract Number: kit-/3-17 70 This is assigned by City Clerk's Office Project Name: Volunteer Transportation Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 01-01-13 Termination Date: 12-31-14 Contract Renewal Notice (Days): 30 Number of days required notice for termination or renewal or amendment Contract Manager: Jason Johnson Department: Parks - Human Services Detail: (i.e. address, location, parcel number, tax id, etc.): Human Services General Fund Contract with Senior Services to coordinate and connect volunteers who will provide Seniors in Kent personalized, free transportation and escort services to medical appointments. 5 Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 .a KENT WASHINGTON CONSULTANT SERVICES AGREEMENT between the City of Kent and SENIOR SERVICES Volunteer Transportation THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Senior Services organized under the laws of the State of Washington, located and doing business at 2208 2nd Avenue Seattle, WA 98116 (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: Senior Services will coordinate and connect volunteers to seniors in Kent to provide personalized, free transportation and escort services to medical appointments. The following exhibits are attached and incorporated by this reference as if fully set forth herein; Exhibit A, Scope and Schedule of Work; Exhibit B, Insurance Certificate; and Exhibit C, Debarment Certification. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Upon the effective date of this Agreement, Consultant shall complete the work described in Section I by December 31, 2014. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $20,000 ($10,000 each year), plus applicable Washington State sales tax, for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. CONSULTANT SERVICES AGREEMENT - 1 (Over$10,000) B. The Consultant shall submit quarterly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant's services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant's services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant's business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant's possession pertaining to this project, which may be used by the City without restriction. If the City's use of Consultant's records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment CONSULTANT SERVICES AGREEMENT - 2 (Over$10,000) A Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability hereunder shall be only to the extent of the Consultant's negligence. IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and fees incurred because there was a wrongful refusal on the Consultant's part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City's request. The City's use or reuse of any of the documents, data and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work CONSULTANT SERVICES AGREEMENT - 3 (Over$10,000) authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or CONSULTANT SERVICES AGREEMENT - 4 (Over$10,000) other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. CONSULTANT: CITY OF KENT: By: BgNae (signature) (signature) Print Name:,.P1EW ���� �►� Pzette Cooke Its CAD I or (title) �S- DATE: 3Zc{ l DATE: �3 NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Denise Klein Katherin Johnson Senior Services City of Kent 2208 Second Avenue 220 Fourth Avenue South Seattle, WA 98116 Kent, WA 98032 demsek@semorservicesorg(email) (253) 856-5070 (telephone) 206-727-6255 (telephone) (253) 856-6070 (facsimile) facsimile APPROVED AS TO FO M: Itibl,' Kent Law Department CONSULTANT SERVICES AGREEMENT - 5 (Over $10,000) DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. Dated this day of 4�i -� , 20 r3. By: For: �`HC�lL�1�°QYJ Title: /mod Date: EEO COMPLIANCE DOCUMENTS - 1 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. Dated this day of 120 By: For: Title: Date: EEO COMPLIANCE DOCUMENTS - 3 �f . Exhibit A KENT W rSrvrvGiOry Scope and Schedule of Work PARKSCOMM ITY RECREATION S 2013-2014 Consultant Services Agreement COMMUNITY SERVICES 9 Agency: Senior Services 2013 Funding- $10 000 Program: Volunteer Transportation 2014 Funding: $10 000 This funding Senior Services will coordinate and connect volunteers will provide: to seniors in Kent to provide personalized, free Total: $20,000 transportation and escort services to medical appointments Annual Program Outputs: Program Outcomes: Unduplicated Kent Residents 105 Individuals and/or families will have improved Transportation (one-way tri s 500 access to transportation Pursuant to Item I. of the Consultant Services Agreement (CSA) executed on January 1, 2013, Consultant shall provide the approximate number of City of Kent clients with the following services each year of the CSA: Quarter Service Unit # of Units Cumulative Total 1st Unduplicated City of Kent clients served 27 27 Transportation (one-way trips) 125 125 2nd Unduplicated City of Kent clients served 26 53 Transportation (one-way tri s 125 250 3rd Unduplicated City of Kent clients served 26 79 Transport tion (one-way trips) 125 375 4th Unduplicated City of Kent clients served 26 105 Transportation (one-way trips) 125 500 ANNUAL South King Council of Human Services Participation Yes/No Yes/No The above services shall be provided by December 31, 2013 for year one of the two-year agreement and December 31, 2014 for year two of the agreement Contract Administration - The Consultant shall notify the City, in writing, within ten (10) days of any changes in program personnel or board membership. - The Consultant shall separately report the number of clients served who reside in the newly annexed Panther Lake area as detailed in the provided maps. - The Consultant shall provide the City with a current list of its board of directors, general or limited partners, as applicable. - The Consultant will hold active membership with the South King Council of Human Services http://skchs.org/ - All records related to this CSA must be retained for three (3) years plus the current year. a i /�0m" 4 Exhibit A (continued) K E N T Scope and Schedule of Work w-= -_ 2013-2014 Consultant Services Agreement PARKS RECREATION S COMMUNITY SERVICES , Agency: Senior Services 2013 Funding: $10,000 Program- Volunteer Transportation 2014 Funding: $10,000 This funding will Senior Services will coordinate and connect volunteers to provide: seniors in Kent to provide personalized, free transportation and escort services to medical appointments Reporting Requirements and Timeline All data and required forms shall be submitted through SharelApp: http://sharelApp culturegrants.org/index/login Service Unit Report - Data from this form will be used to track each program's progress toward meeting the goals stipulated in the Scope of Work. It shall be submitted quarterly, no later than the 15th of the month following the end of the quarter (i.e. April 15, July 15, Oct 15, Jan 15), along with the Reimbursement Request. Reimbursement Request - This form will be filled out on SharelApp and serve as the invoicing mechanism for payment to your agency/program. It shall be submitted quarterly, no later than the 15th of the month following the end of the quarter (i.e. April 15, July 15, Oct 15, Jan 15), unless otherwise specified. Demographic Data Report - The agency shall collect and retain the data requested on this form from the persons served through this contract. Data should be tracked in an ongoing manner and submitted annually in SharelApp (by January 15). Annual Outcome Data Report - Outcome data shall be submitted in SharelApp no later than the 15th following the end of the second quarter (i.e. July 15). Data should demonstrate the program's progress toward Outcomes specified in the Scope of Work. Report Due Date Service Unit Report and Reimbursement Request 15`h day following each quarter Final Reimbursement Request (4th Qtr) December 15th, 2013/December 15th, 2014 Demographic Data Report January 15th, 2013/January 15th, 2014 Annual Outcome Data Report January 15th, 2013/January 15th, 2014 Signature Please sign below to indicate acceptance of the Year 2013 and Year 2014 Performance Measures listed a bove. // t,, -1,1" 311 q 4 Denise Klein, Senior Services Executive Director Date Kathenn7ohnson, Hu an Services Manager Date i EXHIBIT B INSURANCE REQUIREMENTS FOR HUMAN SERVICES GENERAL FUND 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 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. 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 $2,000,000 each occurrence, $2,000,000 general aggregate and a $2,000,000 products-completed operations aggregate limit. 2. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $2,000,000 per accident. EXHIBIT B (Continued) C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1. The Contractor's insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Contractor's insurance and shall not contribute with it. 2. The Contractor's insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the contractor and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than 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 insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Contractor. 1 OP ID SR CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 03111/13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone:206-623-7035 N°AIMEAC7 Sprague Israel Giles Fax:206-682 4993 Pp ONN E# FAX 1501 Fourth Avenue,Suite 730 E-MAIL Seattle,WA 9 81 01-3225 ADDRESS John M.Pollcar cu°s�oMERIDu SENIO-2 INSURER(S)AFFORDING COVERAGE NAIC N INSURED Senior Services INSURER General Ins.Co.of America 24732 2208 2nd Avenue INSURER American States Insurance Co. 19704 Seattle,WA 98121 INSURER C INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER, REVISION NUMBER. THIS IS TO CERTIFY THAT 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS EXP INS rypE OF INSURANCE ADDL UB POLICY NUMBER MMIDDYPOLIC/YYYY MMIDDEFF YIYYVV LIMITS LTRAryn GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 -5-ARTGE-TZ5 RENTED A X COMMERCIAL GENERAL LIABILITY X 24CC27747540 01/01/13 01/01/14 PREMISES Ea occurrence $ 200,00 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ 20,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 3,000,00 17 POLICY F PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 B ANY AUTO 01CH727660-60 01/01113 01101/14 (Ea accident) BODILY INJURY(Per person) $ ALA OWNED AUTOS BODILY INJURY(Per accident) E X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ X $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WCSTATL X OTH- T RY T ER AND EMPLOYERS'LIABILITY A ANY PROPR IETORIPARTNER'EXECUTIVEYIN ❑ NIA 24CC27747540 01101113 01/01/14 EL EACH ACCIDENfT E 1,000,00 OFFICERIMEM(Mandatory ER NH) WA WA STOP GAP EL DISEASE-EA EMPLOYEE $ 1,000,00 (Nandatory in NH) If yes,tlescnbe under E L Of POLICY LIMIT $ 3,000,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate holder is additional insured with respects liability arising out of operations by or on behalf of the named insured for General Liability, subject to a written contract being in force per CG7635 attached. Re: Transportation Department CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Kent Attn: Jason Johnson AUTHORIZED REPRESENTATIVE Human Services Coordinator 220 Fourth Avenue South �avty�—�� Kent WA 98032 V ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD REPRINTED FROM THE FORMS LIBRARY'" Ins-uI`Cance COMMERCIAL GENERAL LIABILITY e CG 76 35 02 07 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LIABILITY PLUS ENDORSEMENT This endorsement modifies insurance provided under the following COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: City of Kent ADDITIONAL INSURED — BY WRITTEN lease or occupy, subject to the following CONTRACT, AGREEMENT OR PERMIT, OR additional provisions SCHEDULE (a) This insurance does not apply to any "occurrence"which takes place The following paragraph is added to WHO IS AN after you cease to be a tenant In INSURED (Section ll) any premises leased to or rented to 4. Any person or organization shown in the Sched- you; ule or for whom you are required by written con- (b) This insurance does not apply to tract, agreement or permit to provide insurance any structural alterations, new con- is an insured, subject to the following additional struction or demolition operations provisions' performed by or on behalf of the a. The contract, agreement or permit must be person or organization added as an In effect during the policy period shown in insured, the Declarations, and must have been exe- (2) Your ongoing operations for that in- cuted prior to the 'bodily injury", "property sured, whether the work is performed damage", or "personal and advertising by you or for you, injury". (3) The maintenance, operation or use by b. The person or organization added as an in- you of equipment leased to you by such sured by this endorsement is an insured only person or organization, subject to the to the extent you are held liable due to following additional provisions, (1) The ownership, maintenance or use of (a) This insurance does not apply to that part of premises you own, rent, any "occurrence" which takes place after the equipment lease expires, Includes Copyrighted Material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services, 2001 Safes and the Safes logo are registered trademarks of Sai Corporation GG 76 35 02 07 Page t of 4 EP t ^'REPRWTED FROM THE FORMS LIBRARY--^(b) This insurance does not apply to This exclusion applies even if the claims "bodily injury" or "property dam- against any insured allege negligence or age" arising out of the sole negli- other wrongdoing in the supervision, hiring, gence of such person or employment, training or monitoring of others organization, by that insured, if the "occurrence" which caused the "bodily injury" or "property (4) Permits issued by any state or political damage" Involved the ownership, mainte- subdivision with respect to operations nance, use or entrustment to others of any performed by you or on your behalf, aircraft, "auto" or watercraft that is owned subject to the following additional pro- or operated by or rented or loaned to any en- vision sured This insurance does not apply to "bodily This exclusion does not apply to* injury", "property damage", or (1) A watercraft while ashore on premises "personal and advertising injury" arising you own or rent, out of operations performed for the state or municipality (2) A watercraft you do not own that is. c. The insurance with respect to any architect, (a) Less than 52 feet long, and engineer, or surveyor added as an insured (b) Not being used to carry persons or by this endorsement does not apply to property for a charge; "bodily injury", "property damage", or "per- sonal and advertising injury" arising out of (3) Parking an "auto" on, or on the ways the rendering of or the failure to render any next to, premises you own or rent, pro- professional services by or for you, includ- vided the "auto" is not owned by or ing, rented or loaned to you or the insured, (1) The preparing, approving, or failing to (4) Liability assumed under any "insured prepare or approve maps, drawings, contract" for the ownership, mainte- opinions, reports, surveys, change or- nance or use of aircraft or watercraft, or ders, designs or specifications, and (5) "Bodily injury" or "property damage" (2) Supervisory, inspection or engineering arising out of, services (a) the operation of machinery or equipment that is attached to, or d. This insurance does not apply to 'bodily PP Y y part of, a land vehicle that would injury" or 'property damage" included within qualify under the definition of the "products-completed operations haz- "mobile equipment" if it were not ard" subject to a compulsory or financial responsibility law or other motor ve- A person's or organization's status as an insured un- hicle insurance law in the state der this endorsement ends when your operations for where it is licensed or principally that insured are completed garaged, or (b) the operation No coverage will be provided if, in the absence of this any - ery or equipment t fistedd the in Paragraph endorsement, no liability would be imposed by law on f(2) or f.(3) of the definition of you. Coverage shall be limited to the extent of your "mobile equipment" negligence or fault according to the applicable princi- ples of comparative fault (6) An aircraft you do not own provided it is not operated by any insured NON-OWNED WATERCRAFT AND NON-OWNED AIRCRAFT LIABILITY TENANTS'PROPERTY DAMAGE LIABILITY Exclusion g. of COVERAGE A (Section 1) is replaced When a Damage To Premises Rented To You Limit is by the following shown in the Declarations, Exclusion 1, of Coverage A, Section I is replaced by the following g. "Bodily injury" or "property damage" arising out of the ownership, maintenance, use or j. Damage To Property entrustment to others of any aircraft, "auto" "Property damage" to, or watercraft owned or operated by or rented or loaned to any insured Use includes oper- (1) Property you own, rent, or occupy, including ation and 'loading or unloading". any costs or expenses incurred by you, or Page 2 of 4 ^'REPRNTEO FROM THE FORMS L13RARY any other person, organization or entity, for WHO IS AN INSURED — MANAGERS repair, replacement, enhancement, restora- tion or maintenance of such property for any The following is added to Paragraph 2.a, of WHO IS reason, including prevention of injury to a AN INSURED (Section If)* person or damage to another's property; (2) Premises you sell, give away or abandon, if Paragraph (1) does not apply to executive officers, or the "property damage" arises out of any part to managers at the supervisory level or above of those premises, SUPPLEMENTARY PAYMENTS — COVERAGES A (3) Property loaned to you, AND B — BAIL BONDS — TIME OFF FROM (4) Personal property In the care, custody or WORK control of the insured, Paragraph 1.b. of SUPPLEMENTARY PAYMENTS — (5) That particular part of real property on which COVERAGES A AND B is replaced by the following- you or any contractors or subcontractors working directly or indirectly on your behalf b. Up to $3,000 for cost of bad bonds required are performing operations, if the "property because of accidents or traffic law violations damage" arises out of those operations, or arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies (6) That particular part of any property that must We do not have to furnish these bonds be restored, repaired or replaced because "your work" was incorrectly performed an it. Paragraph 1 d. of SUPPLEMENTARY PAYMENTS — Paragraphs (1), (3) and (4) of this exclusion do COVERAGES A AND B is replaced by the following not apply to "property damage" (other than d. All reasonable expenses incurred by the in- damage by fire) to premises, including the con- sured at our request to assist us in the in- tents of such premises, rented to you A separate vesiigation or defense of the claim or "suit", limit of insurance applies to Damage To Prem- including actual loss of earnings up to $500 ises Rented To You as described in Section III a day because of time off from work. — Limits Of Insurance. Paragraph (2) of this exclusion does not apply if EMPLOYEES AS INSUREDS — HEALTH CARE the premises are "your work" and were never SERVICES occupied, rented or held for rental by you. Provision 2 a(1)(d) of WHO IS AN INSURED (Section Paragraphs (3), (4), (5) and (6) of this exclusion II) is deleted, unless excluded by separate endorse- do not apply to liability assumed under a side- ment. track agreement. Paragraph (6) of this exclusion does not apply to EXTENDED COVERAGE FOR NEWLY ACQUIRED "property damage" included in the "products- ORGANIZATIONS completed operations hazard" Provision 3.a. of WHO IS AN INSURED (Section II) is Paragraph 6. of LIMITS OF INSURANCE (Section III) replaced by the following: is replaced by the following, a. Coverage under this provision is afforded 6. Subject to 5. above, the Damage To Premises only until the end of the policy period Rented To You Limit is the most we will pay un- EXTENDED "PROPERTY DAMAGE" der Coverage A for damages because of "property damage" to any one premises, while Exclusion a of COVERAGE A (Section 1) is replaced rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by by the following you with permission of the owner a. "Bodily injury" or "property damage" expected or intended from the standpoint of the insured. The Damage To Premises Rented To You limit is the This exclusion does not apply to "bodily injury" higher of the Each Occurrence Limit shown in the or "property damage" resulting from the use of Declarations or the amount shown in the Declarations reasonable force to protect persons or property. as Damage To Premises Rented To You Limit CG 76 35 02 07 Page 3 of 4 EP I "'-REPRINTEO FROM THE FORMS LI6RARY"•' EXTENDED DEFINITION OF BODILY INJURY Interrupted only by a street, roadway, waterway, or right-of-way of a railroad Paragraph 3. of DEFINITIONS (Section V) is replaced by the following INCREASED MEDICAL EXPENSE LIMIT 3. °Bodily injury" means bodily injury, sickness or The Medical Expense Limit is amended to $10,000 disease sustained by a person, including mental anguish or death resulting from any of these at KNOWLEDGE OF OCCURRENCE any time. The following is added to Paragraph 2. Duties In The TRANSFER OF RIGHTS OF RECOVERY Event Of Occurrence, Offense, Claim Or Suit of COMMERCIAL GENERAL LIABILITY CONDITIONS The following is added to Paragraph S. Transfer Of (Section IV) Rights Of Recovery Against Others To Us of COM- MERCIAL GENERAL LIABILITY CONDITIONS (Sec- Knowledge of an "occurrence", claim or "suit" by tion IV)* your agent, servant or employee shall not in itself constitute knowledge of the named insured unless an We waive any rights of recovery we may have against officer of the named insured has receiveo such notice any person or organization because of payments we from the agent, servant or employee make for injury or damage arising out of your ongoing operations or "your work" done under a contract with UNINTENTIONAL FAILURE TO DISCLOSE ALL that person or organization and included in the HAZARDS "products-completed operations hazard" This waiver applies only to a person or organization for whom you The following is added to Paragraph 6. Representa- are required by written contract, agreement or permit tions of COMMERCIAL GENERAL LIABILITY CONDI- to waive these rights of recovery TIONS (Section IV). AGGREGATE LIMITS OF INSURANCE — PER If you unintentionally fail to disclose any hazards ex- LOCATION isting at the inception date of your policy, we will not deny coverage under this Coverage Form because of For all sums which the insured becomes legally obli- such failure However, this provision does not affect gated to pay as damages caused by "occurrences" our right to collect additional premium or exercise our under COVERAGE A (Section 1), and for all medical right of cancellation or non-renewal expenses caused by accidents under COVERAGE C (Section 1), which can be attributed only to operations LIBERALIZATION CLAUSE at a single `location": The following paragraph is added to COMMERCIAL Paragraphs 2.a. and 2.b. of Limits of Insurance (Sec- GENERAL LIABILITY CONDITIONS (Section IV). tion Ill) apply separately to each of your "locations" owned by or rented to you 10. If a revision to this Coverage Part, which would provide more coverage with no additional pre- "Location" means premises involving the same or mium, becomes effective during the policy period connecting lots, or premises whose connection is in the state shown in the Declarations, your pol- icy will automatically provide this additional cov- erage on the effective date of the revision Page 4 of 4 KENT Exhibit C PARKS RECREATION S COMMUNITY SERVICES City of Kent C rtification Regarding Debarment and Suspension Agency Name of Program(s) Certification A: Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief that its principals; a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal debarment or agency; b) Have not within a three-year period preceding this proposal, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and d) Have not within a three-year period preceding this application/ proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (A) 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to whom this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the 1 of 3 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 11. Knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default. Certification B: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions 1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (B) 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency with which this transaction originated may pursue available 2of3 remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this trans- action 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 transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph (5) of these instructions, if a participant in a lower covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency with which this transaction originated may pursue available remedies including suspension and/or debarment. Executive Director (Print) Title Dat i s� l�(� I CAD 13 Signature of Executive Director Title D t a 31g1 (3 Adopted from HUD Form-2992 09/04 3of3 A REQUEST FOR MAYOR'S SIGNATURE a T Please Fill in All Applicable Boxes Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) Originator: Jason Johnson Phone (Originator): 856-5061 Date Sent: 03-15-13 -date*Re uired: 03-22-13 Return Signed Document to: J. Johnson CONTRACT TERMINATION DATE: 12-31-14 VENDOR NAME: DATE OF COUNCIL APPROVAL: Senior Services 12-11-12 as part of City Budget) Brief Explanation of Document: Human Services General Fund Contract with Senior Services to coordinate and connect volunteers who will provide Seniors in Kent personalized free transportation and escort services to medical appointments. iF> „U `�� 13 �� +� .RECEIVED t MAR 2 2 Z013 City of Kent Office of the Mayor All Contracts Must Be Routed Through The Law Department (This area to be completed by the Law Department) Received: E F t j fi` Approval of Law Dept.: " ` 2013 Law Dept. Comments. x Ems! f LAW' DEP Date Forwarded to Mayor. Shaded Areas To Be Completed By Administration Staff Received: Recommendations and Comments: 'P� Or!OF RK Disposition: -����L�J/%� L`� ✓ � � 2 6161 Date Returned: