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HomeMy WebLinkAboutCAG2019-094 - Original - Emergency Assistance �• .�''E'NT Recor s Management Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to the City Clerk's Office. All portions are to be completed. If you have questions, please contact the City Clerk's Office at 253-856-5725. Vendor Name: Catholic Community Services Vendor Number Contract Number (City Clerk): J Category: Contract Agreement Sub-Category (if applicable) Choose an_item Project Name: Emergency Assistance Contract Execution Date: 1/1/2019 Termination Date: 12/31/2020 Contract Manager: Christine Cain Department: Parks Contract Amount: $20,000 Budgeted: ® Grant? Part of NEW Budget: ❑ Local: ❑ State: ❑ Federal: ❑ Related to a New Position: ❑ Basis for Selection of Contractor? Bid: ❑ RFP: ® Small Works Roster: ❑ Quotes: ❑ Approval Authority: ❑ Director ® Mayor ❑ City Council Other Details The Consultant will provide emergency re,„n„,tal assastance,_utilty assists ce and case management. KENT CONSULTANT SERVICES AGREEMENT between the City of Kent and Catholic Community Services of King County THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Catholic Community Services of King County organized under the laws of the State of Washington, located and doing business at 100 23rd Ave S., Seattle, WA 98144 and (206) 328- 5908 (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: [Provide emergency rental assistance, utility assistance and case management. 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 Exhibit 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. Consultant shall complete the work described in Section I by 12/31/2020. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $20,000 ($10,000 per year), for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed 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. 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: CONSULTANT SERVICES AGREEMENT - 1 ($20,000 or Less) 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 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 duty to defend, indemnify, and hold the City harmless, and Consultant's liability accruing from that obligation 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 CONSULTANT SERVICES AGREEMENT - 2 ($20,000 or Less) 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 Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. The City's use or reuse of any of the documents, data, and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. tlt eYchlxle. GL,(rrrzfft. Pursuant to Chapter 2.80 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 C1i g>utis_Tiarri Governorlg.Gaw. 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 CONSULTANT SERVICES AGREEMENT - 3 ($20,000 or Less) 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; 1..1uAvl 1kk (1)',, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notre. 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. AS;(gaoVrrr„pit;. 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 Aylle'nrrVJ;dr�d;p„1. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Ca tupli-ante. ,Willa Lawns. 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. Public Records Act. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. J. C it„y„ Vialsit ac.,+,'a„ Lwiiuisrl„-l'tewtlr.11pe+rt. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. K. F'e't.4tCAfs�VlJrlrl _fanal 51gri,gtur ff _hy,„,¢ax orw l„=,fliail. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute CONSULTANT SERVICES AGREEMENT - 4 ($20,000 or Less) this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONSULTANT: CITY OF KENT: M! � _ _. ._ ..... -........ (.n✓rr rCur•e) (srr�revtorej Print Name Bill Hallerman, Pr' . Name: Juhr 1�4i_ag{rorrdola Cts: Its Fxari ilivr•a (1rt grFnr Pariec nirertnr . .w_ - .. .... .,.�.,. DATE: /�`r) r�' _ ... DATE NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Bill Hallerman Christine Cain Catholic Community Services of King County City of Kent 100 23rd Ave S. 220 Fourth Avenue South Seattle, WA 98144 Kent, WA 98032 (206) 328-5908 (telephone) 253-856-5063 (telephone) N/A (facsimile) 253-856-6070 (facsimile) .. ... ..— -- ...... ............ ......... ATTEST: Kent City Clerk CONSULTANT SERVICES AGREEMENT - 5 ($20,000 or Less) 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: I, 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, > r For: r*- C)TIA,�-00,4_n SrV eit i p f Title: ...........�lP r . l� Date: ....... if 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. 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. undersigned, a duly agent of Company, herebyacknowledge and declare that the before-m4�e(Jnt�i^o±n± ,t b� (Wa�s the prime contractor for the Agreement known as µtt r, ,*+xe_-,; _ 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. ^y For: �"�Ee4'�tEAP' L. �P�f.�e "� e)A �w"sL•rY � -. ,n.�, Title: , . Date: « Exhibit A KENT Scope and Schedule of Work r , 2019-2020 Consultant Services Agreement g Y y Services of ilir�g County 2019 Funding $_10,000 ProThis-ram: The coonsultaA Assistance 2020 Funding 10,000 funding provide emergency rental $20,000 will provide: assistance, itility assistance and case management. Total: Annual Program Service Units: ram Outcomes: Unduplicated Kent Residents 17 Meeting Community Basi 11 cs Financial Aid 17 Ensuring that people facing hardship have access to resources to help meet Immediate or basic needs. Pursuant to Item I. of the Consultant Services Agreement (CSA) executed on ),a!,I,I,Igttry I, l;,(,):Yy,1, Consultant shall provide the approximate number of City of Kent clients with the following services each year of the CSA: Quarter Service Unit mm _ Q # of Units Cumulative Total Unduplicated City of Kent clients served 4 4 Financial Aid ,,,. ....... 2id Unduplicated City of Kent clients served 4 8 Financial Aid 4._.. .....,,,, 8 ... ... ..... ........ 3r° Urndu licated City of Kent clients served 4 12 Financial Aid 4 ]7-- 4ii' Unduplicated City of Kent clients served S 17 Financial Aid 5 1/,,.... The above services shall be provided by December 31, 2019 for year one of the two-year agreement and December 31, 2020 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 provide the City with a current list of its board of directors, general or limited partners, as applicable, - All records related to the CSA must be retained forthree (3) years plus the current year. Exhibit A (continued) Scope and Schedule of Work KENT 2019-2020 Consultant Services Agreement ViV1, , IIY EnVI-' d IJONrvI IINIIY SLHVIC LS Aaenev: Catholic Community Services of Kinq County Z019 Funding $10 000 Program: Emergency Assistance 2020 Funding $10,000 This funding The consultant will provide emergency rental $20,000 will provide: assistance, utility assistance and case management. Total Reporting Requirements and Timeline All data and required forms shall be submitted electronically. 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 he filled out electronically 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 8), 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 (by January 15). Annual Outcome Data Report - Outcome data shall be submitted 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"' day following each quarter Final Reimbursement Request (411' qtr) January 81h, 2020/January 81h, 2021 Demographic Data Report January 15°i, 2020/January 15`', 2021 Annual Outcome Data Report January 15'i', 2020/January 1511, 2021 Signature Please sign below to indicate acceptance of the Year 2019 and Year 2020 performance Measures listed above. Bill Hallerman, Executive Director, Catholic Community Date Scavice,s of King Coura Mer a r son, 1luman S r ices Manager Date - All records related to this CSA must be retained for three (3) years plus the current year, EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant 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 Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. Autcsrriobiio t liability insurance covering all owned, non-owned, hired and leased hi vecles. 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. C omrr7e;rmc_isil Gonermcil Liability insurance shall be written on ISO occurrence form CG 00 01. The City shall be named as an Additional Insured under the Consultant'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. Workers'.,,Cor.Pw.1A5, t&r_coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: I. Autonrtrlaiic l M1l.ity insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. COmmertu«�i (, nr,Ial ti,a)aai[,ty insurance shall he written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 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 Consultant'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 Consultant's insurance and shall not contribute with it. 2. The Consultant'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 Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insr,rl' II:1ce. The City reserves the right to receive a certified copy of all required insurance policies. The Consultant'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 A:VII, E. Verification of Coverage Consultant 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 Consultant before commencement of the work. F. Subcontractors Consultant 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 Consultant. KE,IVT Exhibit C City of Kent Certification Regarding Debarment and Suspension Catholic Community Services of King County Emergency Assistance Agency Name of Program Certification A: Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief that its principals; a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal debarment or agency; b) Have not within a three-year period preceding this proposal, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen property; c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and d) Have not within a three-year period preceding this application/ proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (A) 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2, The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency's determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to whom this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance In obtaining a copy of these regulations. S. 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. B. 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 Nan-procurement List. 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph (6) of these instructions, if a participant in a covered transaction 11. Knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default. Certification B; Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions 1, The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (B) 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclu- sion - Lower Tier Covered Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. S. 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 o (Print) Title Date �I t� i�r� Lor Signature of Executivo Director tiNle Datr (3, Adopted from HUD Farm-2992 09/04 EEO COMPLIANCE DOCUMENTS - 1 AC i CERTIFICATE OF LIABILITY INSURANCE oA1 '146/1 512 0 1 8 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 have ADDITIONAL INSURED provisions or 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 CONTACT Stephen Eml Arthur J, Gallagher Risk Management Services, Inc PHONE 425 454 3386 FAX 425 451-3716 777 108th Ave NE, #200 iA+a,Nre Exn; .. lac,Nat Bellevue WA 98004 ADDRESS! Stephen-Erm@ajg.com „I NSURERISI AFFORDING COVERAGE NAIL# INSURER A:Underwriters al Lloyd's London 15792 INSURED CORPOFT-01 INSURERS Old Republic Union Insurance Company 31143 Corporation of the Catholic Archbishop of Seattle - ' Catholic Community Services of Western Washington INSURERC State National Insurance Company Inc 12831 100 23rd Ave. S INSURER D: Seattle WA 98144 INSURERE: INSURER F,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, COVERAGES CERTIFICATE NUMBER:1515589576 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. INSR'. ...._AYoL SDBR' .._. POLICY EFF POLILVE%P,,. ... .._..... .,, ITS TYPEOFINSURANCE ,n en unrn POLICY NUMBER MMlDOIYYVY MM1DDfYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY BP102301B 7110018 m71112019 EACH OCCURRENCE $1000000 CLAIMS maoE X I accuR PRCIy{IPE$(paogunFlpre)„11$1 1 009000 MED EXP(Any oneperson) $Nil PERSONALIIADVINJURY 1 $1000000 GEN InAGGREGATE LIMIT APPL I ES PER GENERAL AGO RE GATE 11000000 X POLICY tEECA LOC PRODUCTS COMPIOP AGG 61000000 ECi OTHER A AUTOMOBILE LIABILITY BP1023018 ]I112018 7/1l2019 (Q-PMDINED SINGLE LIMIT $1,000000 m av,elenik_ X ANY AUTO BODILY INJ URY(Pe person) _ $ OWNED SCHEDULED BODILY INJURY Pi accident) $ AUTOS ONLY AUTOS X. HIRED X.. NON OWNEDPRUPERIY DAMAGE $ AUTOS ONLY AUTOS ONLY dI'mf ACGmOnit.. . 5 B UMBRELLA LIAD X OCCUR 821 BOO 0785428 7/11201e 7i V2019 EACH OCCURRENCE 'S5,000,000 ,X EXCESS LIAB CLAIMSMAE AGGREGATE 55000 DOB OFn RETENTION$... l $ C WORKERS COMPENSATION IX I PER OTH AND EMPLOYERS'LIABILITY NDE-0927I40-iB ]/11291a 71112019 11 YIN STATUTE I I FIR ANYPROPRIETORIPARTNER/EXECUTIVE EL EACHACCIDENT $1000000 OFFICER/MEMBEREXCLUOE04 �INIA. F (Mandatary in NH) EL DISEASE EA EMPLOYEE; $1�000000 Oyes describe under DESCRIPTION OF OPERATIONS below I EL DISEASE POLICYLIMIT $1000000 1 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLE$(AICO RD 101,Additianal Remarks Schedule,may be alla shed If more space Is required) Limits shown are inclusive of defense and insured retention, Coverage for Additional Insureds is restricted to the amount of insurance required by contract or permit, Coverage only extends for claims arising out of HOME and EA,for the term of the certificate. Includes$1,000,000 Counseling Errors&Omissions Coverage. Excludes Medical and Legal Liability. 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, Its Elected&Appointed Officials, and Its Employees&Agents AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD ENDORSEMENT attaching to and farming part of Policy No. BP1023018 NAMED ASSURED: Corporation of the Catholic Archbishop of Seattle Effective date of this endorsement: JUly 01 , 2018 Endorsement No. 14 GENERAL POLICY CONDITIONS ENDORSEMENT— INCLUDING PRIMARY NON-CONTRIBUTORY CERTIFICATES OF INSURANCE: It is hereby understood and agreed that holders of Certificates of Insurance issued against this Policy that are shown as Additional ASSUREDS are added to this Policy pursuant to the terms of this Policy as described in GENERAL POLICY DEFINITION 1. Where Certificates of Insurance are requested for Additional ASSUREDS who do not fall within GENERAL POLICY DEFINITION 1, prior agreement of Underwriters and subsequent endorsement of this Policy is required GENERAL POLICY DEFINITION 1. ASSURED is stated as follows - 1. ASSURED means not only the NAMED ASSURED as stated on the Declaration Page, but also includes any past, present or future: agencies, subsidiaries, affiliates, institutions and societies owned by or operated by the NAMED ASSURED, officials, members of boards or commissions, trustees, directors, officers, partners, volunteers, student teachers, or employees of the NAMED ASSURED while acting within the scope of their duties as such, and any person, organization,trustee or estate to whom the NAMED ASSURED is obligated by virtue of a written contract or agreement to provide insurance such as is offered by this policy, but only in respect of operations by or on behalf of the NAMED ASSURED. GENERAL POLICY CONDITION 20. WAIVER OF SUBROGATION is stated as follows— 20. WAIVER OF SUBROGATION: This policy shall not be invalidated if the ASSURED, by written agreement, has waived or shall waive its right of recovery from any party for loss or damage covered hereunder; provided that any such waiver is made prior to the occurrence of said loss or damage. MORTGAGORS LOSS PAYEES & LENDER LOSS PAYEES: It is understood and agreed that GENERAL POLICY CONDITION 12.of this policy is deleted and replaced with the following: 12. MORTGAGORS, CREDITORS & LOSS PAYEES: Where required by written contract, the interest of any mortgagor, creditor or loss payee on property covered by this policy is included as if a separate endorsement were attached hereto to the extent of the amount of mortgage, loan or interest in property held by the ASSURED as of the date of loss subject to the limits of liability set forth in this policy. PRIMARY NON-CONTRIBUTORY: It is also agreed that, only where required by written contract between the NAMED ASSURED and the Certificate holder, this insurance shall be considered primary to any insurance held by the Certificate holder and theirs shall be excess. Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this Endorsement is attached. ENDORSEMENT attaching to and forming part of Policy No. B21023018 NAMED ASSURED: Corporation of the Catholic Archbishop of Seattle Effective date of this endorsement: JUIy 01, 2018 MUNICIPALITY PERMITS: Further, where required by written contract or evidenced in the insurance requirements of a permit issued by a municipality at the request of the NAMED ASSURED, that municipality shall be added to this policy as an Additional ASSURED but only as respects liabilities arising out of the subject matter of the written contract or issued permit and then only for liabilities arising from actions by or on behalf of the NAMED ASSURED. Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this Endorsement is attached. d CAT'1710LIC COMMUNITY SERVICES �NXM OI�MiYWiW01W4Jw 001iMG0WWl!pMA.WOIONOf 1. VONYWAW'W.9W9VVV!MNV.PW:fW IIMNWMYMW.'WBW.w.w1'MOmmmmmYluuWIUWJ!YWWY��' WM'WAV.MGM'VNVMAIIJIililibMII�M01pIW0�V:'W'.X'MN NNOINOM11tlIW WX'AJII w/:.w .ant Very Rev. Bradley R. Hagelin Dennis O'Leary (Vice-Chair) Joe Schick (Treasurer) (Chair) 322 N 175th St Archdiocese of Seattle Archdiocese of Seattle Shoreline WA 98133 710-9th Avenue 710- 9th Avenue Office: (206) 546-2451 Seattle, WA 98104 Seattle, WA 98104 E-mail frbrad@stlukecp.4rg Office: (206) 382-4834 Office: (206) 382-4588 Permanent E-mail: DennisOtcDseattlearch,are E-mail: Appointed Vicarfor Catholic Appointed July1988 Joe.Schick2seattlearch.org Charities April2017 Term Ends:October 2018 Permanent Appointed March 2018 Michael Reichert(Ex-Officio) Sharon Henderson Callahan Ned Delmore President, CCS/CHS 15100 6th Avenue SW, #521 3208 NE 90th 100—23rd Avenue S Burien, WA 98166 Seattle, WA 98115 Seattle, WA 98144 Office Phone: (206) 296-5336 Office Phone: (206) 767-9975 Office: (206) 328-5702 Email: scal@seattleu.edu x1105 E-mail: michaelr@ccsww.org Appointed September2015 Email: NedD@svdpseattle.2M Permanent Term Ends:September 2021 Appointed September2015 Appointed July 1988 Term Ends:September 2021 Edgardo G. lose Donna LaFrance Diane McWithey 13200A 35"Avenue N.E. 4101 S 19"Street, Apt 4136 1402 NE 151st Avenue Seattle, WA 98125 Tacoma, WA 98405 Vancouver, WA 98684-3614 Office: (206) 859-5105 x805 Office: (206) 639-6207 Office: (360) 952-8216 Email: elose@ckseattle,o , Email: E-mail: Appointed July2014 Donna.LaFrance@dshs,wa.gov execdir sharevancouver.or Term Ends:July 2020 Appointed March 2018 Appointed September 2006 Term Ends:March 2021 Term Ends:September 2021 Jose Ortiz Sr. Sharon Park, O.P. Sr. Charlotte Van Dyke, SP 11320 N. Skagit St. Adrian Dominican Sisters 4415 SW Oregon St., #203 Burlington, WA 98233 Assumption Convent Seattle, WA 98116 Lose@stcharles-burlington-wa.org 620033rd Avenue NE Appointed September2015 Appointed June 1018 Seattle, WA 98115-7307 Term Ends:September 2021 Term Ends:June 2021 Appointed September 2018 Term Ends:September 2021