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HomeMy WebLinkAboutCAG2019-221 - Original - Living Well Kent Collaborative - Rental Housing Inspection Program (RHIP) Community Outreach - ENT Records Management Document w.sNr+aa« 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: Living Well Kent Collaborative 2010643 Vendor Number (JDE): Contract Number (City Clerk): G�'�S otU/� 'y1oZ Category: Contract Agreement Sub-Category (if applicable): None Project Name: RHIP Community Outreach Contract Execution Date: Upon Execution Termination Date: 8/1/2019 Contract Manager: Katie Whaley Department: ECD Contract Amount: $5250.40 Budgeted: ❑� Grant? Part of NEW Budget: Local: State: F Federal: Related to a New Position: ❑ Notice required prior to public disclosure? Basis for Selection of Contractor? Other Approval Authority: ❑✓ Director ❑ Mayor ❑ City Council Other Details: Contract drafted by Tanya Kosen KENT W-1-T- CONSULTANT SERVICES AGREEMENT between the City of Kent and LIVING WELL KENT COLLABORATIVE THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Living Well Kent Collaborative organized under the laws of the State of Washington, located and doing business at 10605 SE 240th St, #232, Kent, Washington 98031 (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: Statement of Work incorporated into this contract in the attached Exhibit A 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 upon execution of this contract. Consultant shall complete the work described in Section I by August 1, 2019. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed Five Thousand Two Hundred Fifty and 40/100 Dollars ($5,250.40), 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. B. The Consultant shall submit monthly 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. 1 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 INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. Consultant Services Agreement 2 Living Well Kent Collaborative 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. 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 Consultant Services Agreement 3 Living Well Kent Collaborative 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 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. 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. ]. City Business License Required. 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. The City of Kent Business License is incorporated as Exhibit C. K. Counterparts and Signatures by Fax or Email. 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. 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. (Remainder of page left blank intentionally) Consultant Services Agreement 4 Living Well Kent Collaborative 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 pF KENT: i- By' 752 ------�\� By: (signature) (signature) Print Name: `� Prin Name7: Kurt Hanson S� _ Its:_ Its: Director of Economic and Community title) Develo ment Date:_ Date: NOTICES TO BE SENT TO: NOTICES TO BE SENT TO: CONSULTANT: CITY OF KENT: Shamso Issak Katie Whaley Living Well Kent Collaborative City of Kent 10605 SE 2404h St, #232 220 Fourth Avenue South Kent, WA 98031 ( Kent, WA 98032 i 253-457-2964 (telephone) (253) 856-5550 (telephone) shamso@livingwellkent.ord kwhaley@kentwa.gov 1 APPROVED AS TO FORM: __ --- i Kent Law Department i ATTET:, Kent City Clerk Consultant Services Agreement 5 Livin-q Well Kent Collaborative 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. By: For: Title: 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. By: For: Title: Date: EEO Compliance Documents 3 EXHIBIT A Scope of Work Living Well Kent - Mission: Living Well Kent (LWK) is a community-driven collaborative focusing on creating a healthier, equitable and more sustainable community. Our goals include creating a community in which all residents thrive. In the past four years LWK has been successful in developing incubating a grass roots community-led movement to create awareness for action on healthy eating, staple thriving housing community in the city of Kent including Rental Housing Inspection Project (RHIP). LWK believes that well-informed community is a empowered and primed for systems change. Authentic and sustainable community engagement involves community participation in solution, development and implementation. LWK- Community Engagement Capacity LWK has the capacity and experience to educate, inform and mobilize all communities specifically non-English speaking communities, we utilize 45 Community Liaisons Team and 10 Community Leaders (CL) who speaks Somali, Spanish, Punjabi, Arabic, Swahili, French, Vietnamese, Chin, Burmese and Farsi. LWK plays a key role in the Kent community by serving as a convener, advocate and organizing group. Our role in the community has been integral in creating a multicultural dialogue and collaboration. LWK community leader's created outreach kits and related marketing materials in order to train community residents on how to engage with our neighbors, gather data and invite people to join speaking engagements. With LWK's effective community engagement approach in this project we will focus activities that focuses mobilizing community of rentals who reside North Kent East Hill (NKEH) neighborhood. RHIP - Project Goal The goal of RHIP is to develop communication feedback-Loop with NKEH neighborhood a multifamily rental housing units' tenant. The plan of action is increase awareness and sharing of information relating to RHIP with community members, property owners, property managers, landlords and tenants. RHIP - Scope of Work • LWK will work closely to implement these objectives with City of Kent Katie Whaley, Rental Housing Inspection Program Coordinator, Planning Services I Economic & Community Development • LWK will identified the following potential target communities who resides NKEH • LWK will work with RHIP coordinator to plan design and implement Community Leaders (CL) meeting and large Forum. • LWK will work with RHIP coordinator and CL to design communication plan including Outreach and translation. RHIP - Project Outcomes • LWK holds meeting (1) Convening with 10 community leaders (CL) • LWK holds meeting (2) Forum with 60 - 75 North of Kent East Hill (NKEH) neighborhood rental residents including non-English speaking immigrant and refugees • LWK provides meeting () space at NKEH area, • LWK provides food, childcare, interpretation for the target languages. • LWK co-develop outreach material for the target languages if needed. • LWK will use already existing communication channels through LWK's 45 community Liaisons Team member, LWK website www.livinawellkent.org and Facebook and Twitter https://www.facebook.com/search/top/?g=living%20well%20kent%20collaborative Exhibit A 1 RHIP BUDGET Expense Details Funding o Executive Director- Shamso Issak $32/hr o Project Manager- Riham Hashi $28/hr Personnel Hourly Rate o Housing Manager- Hoda Abdullahi $20/hr o Community Health Worker- Hamdi Hassan $17/hr Childcare for Childcare will be provided for the larger Forum $150.00 meeting 2 Meeting space For meeting 2 in NorthEast Kent $ 350 Supplies for We will spend $100 meeting (1) and $150 meeting (2) meeting (1 &2) Ex: Pens, name tag, writing note books, printing material, $ 250.00 cop in Translation and Interpretation 10 languages ($100 each*10 =$1000) $ 1000.00 Food Community Food for 16 people (16*$15 person = $224) $ 224.00 Leader meeting 1 Food for the Forum Food for 60 people (60*$15 person = $900) $900.00 meeting 2 Administration 10% of total project expense $436.40 Identify potential Housing Manager- Hoda Abdullahi $20/hr 13 target communities hours who reside in $260 North East Hill Plan, design, Project Manager- Riham Hashi $28/hr for implement meeting 5hours $140 1 Plan, design, Project Manager- Riham Hashi g $28/hr for implement meeting $364 2 13hours Design Executive Director- Shamso Issak $32/hr for communication Plan 10 hours $320 Social Media Posts Housing Manager- Hoda Abdullahi $20/hr for 5 $100 hours Contacting Community Community Health Worker- Hamdi Hassan $17/hr for 18 members that hours $306 reside in North East Ex: phone calls, e-mails, door to door Hill Bus Passes For 60 people ($15*30) $ 450 TOTAL BUDGET Total RHIP outreach, 1 community leader meeting and 1 large Forum $5250.40 Exhibit A 2 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. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. 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. Commercial General 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' Compensation coverage as required by the Industrial Insurance laws of the State of Washington. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability _insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate. 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 Insurance. 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. Exhibit B t 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 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. Exhibit B 2 l 0 DATE(MM/DDNYYY) A�o CERTIFICATE OF LIABILITY INSURANCE o3/2112019 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 endorsements. PRODUCER CONTACT Marcia Sylvestre StateFarm Doug Jones 47-6079 P110 253-850-3226 1uc N, 253-203-6029 124 4th Ave S Ste 210 E-MAIL marlia dou insuresme.com s ADDRESS: 9 Kent,WA 98032 INSURERS AFFORDING COVERAGE NAM;s INSURER A: State Farm Fire and Casualty Company 25143 INSURED INSURERS: LIVINGWELL KENT INSURER C ISSAK,SHAMSO D/B/A INSURER 10605 SE 240TH ST#232 INSURER E Kent,WA 98031 INSURER F: COVERAGES CERTIFICATE NUMBER: 98CKU3262 REVISION NUMBER:1 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, INICY EXP TR TYPE OF INSURANCE INSD WVD SUER POLICY NUMBER MMIODIYYYY MMI R DDrrYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE ®OCCUR PREMISES Ea occurrence $ MEO EXP(Any one person) S 5,000 Y 98-CK-U321-2 118/30/2018 08/30/2019 PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO LOC PRODUCTS-COMP/OP AGG S JECT OTHER: $ AUTOMOBILE LIABILITY Ea arB,ndeDISINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per.accident UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED ! RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER,VEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS oelow E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) King County,its officers,officials,agents and employees as additional insureds. 401 5th Avenue,Suite 1300 Seattle.WA 98104 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN King County Public Health-Seattle&King County ACCORDANCE WITH THE POLICY PROVISIONS. Contract,Procurement&Real Estate Services(CPRES) 401 5th Avenue,Suite 1300 AUTHORIZED REPRESENTATIVE Seattle,WA 98104 �/�/1 V ` ©1988-2015 AltORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1DO1486 132949.12 03-16-2016 Policy No. 98 CKU32 6 2 age 47of 1 9 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP-4786 ADDITIONAL INSURED —OWNERS, LESSEES, OR CONTRACTORS (Scheduled) This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 96 CKU326 2 Named Insured: LIVING WELL KENT COLLABORATIVE 10605 SE 240TH ST STE 232 KENT WA 98031-4903 Name And Address Of Additional Insured Person Or Organization: CITY OF KENT 400 WEST GOWE KENT WA 98032 1. SECTION II — WHO IS AN INSURED of b. Products-Completed Operations SECTION II — LIABILITY is amended to in- "Your work" performed for that additional clude, as an additional insured, any person insured and included in the "products- or organization shown in the Schedule, but completed operations hazard". only with respect to liability for "bodily in- 2. Any insurance provided to the additional in- jury", "property damage", or "personal and sured shall only apply with respect to a claim advertising injury" caused, in whole or in made or a "suit" brought for damages for part, by: which you are provided coverage. a. Ongoing Operations 3. Primary Insurance. The insurance afforded the additional insured shall be primary insur- (1) Your acts or omissions; or ance. Any insurance carried by the additional insured shall be noncontributory with respect (2) The acts or omissions of those acting to coverage provided by you. on your behalf; There will be no refund of premium in the event in the performance of your ongoing opera- this endorsement is cancelled. tions for that additional insured; or All other policy provisions apply. CMP-4786 1006104 137713.1 10-23-2013 ©,Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office,Inc.,with its permission. Policy No. 98 CKU326 2 CMP-4787 Page 1 of 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY CMP-4787 WAIVER OF TRANSFER OF RIGHTS OR RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE Policy Number: 98 CKU326 2 Named Insured: LIVING WELL KENT COLLABORATIVE 10605 SE 240TH ST STE 232 KENT WA 98031-4903 Name And Address Of Person Or Organization: CITY OF KENT 400 WEST GOWE KENT WA 98032 The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of: a. Your ongoing operations; or b. "Your work" done under contract with that person or organization and included in the "products- completed operations hazard". This waiver applies only to the person or organization shown in the Schedule. All other policy provisions apply. CMP-4787 1006225 137715.1 11-19-2013 O,Copyright,State Farm Mutual Automobile Insurance Company,2008 Includes copyrighted material of Insurance Services Office,Inc,with its permission. Whaley, Katie From: ethan@livingwellkent.org Sent: Thursday, April 11, 2019 4:53 PM To: Whaley, Katie Cc: 'Shamso Issak' Subject: RE: Living Well Kent Contract Attachments: Living well Endorsement pages.pdf EXTERNAL EMAIL Hi Katie, So this should be everything. Attached is the insurance endorsement and below is the auto insurance piece: The employees of Living Well Kent: Shamso Issak, Ethan Anderson, Nigiste Abdi, Akarim Abdi, Safia Abdullahi, Abdul Wahed Ahamdi, Hawraa Al Helli, Morgan Hartline, Riham Hashi, and Hamdi Hassan that are coming to the city of Kent have current personal auto liability. Thanks Kati, Hopefully we have everything now. Ethan Anderson Living Well Kent Administration/Development Assistant ethan[a@livingweilkent.org http://Iivingwellkent.org1 LivingWell I-,ff.e m,nA=L t H' r ?hie,'Gil`;of Kenf From: Whaley, Katie <KWhaley@kentwa.gov> Sent:Thursday, April 11, 2019 8:31 AM To: 'ethan@livingwellkent.org' <ethan@livingwellkent.org>; 'Shamso Issak' <Shamso.lssak@hotmail.com> Subject: RE: Living Well Kent Contract Hi Ethan, No I do not need to be added to the insurance policy. i EXHIBIT C City of Kent Business License Exhibit C 1 City of Kent Business License LIVING WELL KENT ATTN: SATWINDER KAUR 10605 SE 240TH ST#232 KENT,WA 98031 Please tear at perforation BUSINESS LICENSE Per RCW$2. local sates and use tax Must be coded LICENSE MUST BE PAID ANNUALLY BY No. 1715 for all qualified JANUARY 1st TO AVOID PENALTY sales within the city of Issuance of License Does Not Imply Licensee's Kent. Compliance with State and Local Laws THIS LICENSE MUST BE POSTED IN A CONSPICUOUS 2019 PLACE.NOT TRANSFERABLE OR ASSIGNABLE NAME AND ADDRESS OF BUSINESS BLNP-2170471 t J 01- r�Q— LIVING WELL KENT %,I,A Ok 10605 SE 240 ST #232 The City of Kent Tax Registration KENT, WA98030 Endorsement A!2204THAV SO KENT,WASHINGTON 99032