HomeMy WebLinkAboutGRA2019-029 - Original - St. Stephen Housing Association - CDBG Funded Transitional Housing Project - 01/01/2019 Agreement Routing Form
S�n KENT For Approvals, Signatures and Records Management Director initials
WASHINGTON
This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. .��,[`,,►
(Print on pink or cherry colored paper) Manager initials"
Originator: Dinah Wilson Department: Parks
Date Sent: 7.11.2019 Date Required: Soonest possible please
CDirectorAuthorized Date of
S. Sign: Council
11.20.2018
a Mayor Approval:
Q
Budget B00319.64150.6019 Grant? Yes El No
Account Federal
Number: Type:
Vendor Category: ra C
Name: St. Stephen Housing Association
Vendor 950857 Sub-Category ^ 'k �L/�
0 Number:
£ Name: Transitional Housing Project
0
= Project This is a CDBG funded project. Funding will provide housing to families and children
to Details:
41 E Basis for
Agreement $30,000 ($15,000 per RFP
IV Amount: Selection of
air year) Contractor:
Q Start Date: 1/1/2019 Termination Date: 12/31/2020
Notice required prior to Yes No Contract Number: 6 f,4,,2OJ 9 —0oZ17
disclosure?
Date Received by City Attorney: Comments:
3
0
h
d
3
a
Date Routed to the Mayor's Office:
N
d Date Routed to the City Clerk's Office:
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Date Sent to Originator.
Visit Documents.KentWA.gov to obtain copies of all agreements
adccW22373_6_19
CDBG AGREEMENT
BETWEEN THE CITY OF KENT
AND
ST. STEPHEN HOUSING ASSOCIATION
TRANSITIONAL HOUSING PR03ECT
This Agreement, entered into this 1st day of April, 2019, between the City of Kent, a Washington
municipal corporation (hereinafter the "City") and St. Stephen Housing Association (hereinafter the
"Agency").
RECITALS
WHEREAS, the City is an entitlement City applicant for Community Development Block Grant
('CDBG") funds (Catalogue of Federal Domestic Assistance-CFDA 14.218 and Federal Award
Identity Numbers-FAIN B-19-MC-53-0017 and B-20-MC-53-0017) under the Housing and
Community Development Act of 1974 (the "Act"), as amended, Pub. L. No. 93383, 88 Stat. 633
(1974), and anticipates receiving CDBG funds for the purpose of carrying out eligible
community development and housing activities under the Act and under regulations
promulgated by the Department of Housing and Urban Development ("HUD"), at 24 CFR § 570,
et seq.; and
WHEREAS, the City desires to contract with the Agency for the performance of certain eligible
activities described within this Agreement; and
WHEREAS, it is appropriate and mutually desirable that the Agency be designated by the City to
undertake the aforementioned eligible activities, so long as the requirements of the Act, HUD
regulations, and state and local laws are adhered to, as provided for herein; and
WHEREAS, the purpose of this Agreement is to provide for cooperation between the City and the
Agency, as the parties to this Agreement, in the provision of such eligible activities; and
WHEREAS, the parties are authorized and empowered to enter into this Agreement pursuant to the
Act, RCW 35.21.730 to .735, and/or by the Constitution and the enabling laws of the State of
Washington; NOW THEREFORE,
For and in consideration of the terms and conditions provided in this Agreement, the parties
mutually covenant and agree as follows:
1
INDEX TO AGREEMENT
PART I - GENERAL CONDITIONS 1
1
1. Scope Of Agreement 1
2. Scope Of Project 1
3. Purpose and primary objective - 42 U.S.C. § 530(c), 24 C.F.R. § 570.200(a)(3).
4. Commencement And Termination Of Project(s) 2
3
5, Administration 3
6. Compensation And Method Of Payment 4
7. Eligible Costs 5
8. Operating Budget 5
9. Funding Alternatives, Future Support, and Limited Release 5
10. Amendments
11. Assignment And Subcontracting 5
12. Hold Harmless And Indemnification 5
6
13. Project Close-Out
6
14. Insurance
6
15. Conflict Of Interest
16. Suspension And Termination Of Agreement 6
17. Safeguarding Of Client Information 7
PART II - FEDERAL, STATE, AND LOCAL PROGRAM REQUIREMENTS 8
1. Nondiscrimination 8
2. Section 504 And Americans With Disabilities Act 10
3. Financial Management And Procurement Standards 10
4. Uniform Administrative Requirements And Cost Principles And Recordkeeping - 2 CFR Part
200, 24 CFR §§ 570,502, and 570.610. 11
5. Data Universal Numbering System
6. Lobbying.....................................................................................................................................................................12
7. Program Income - 24 CFR § 570.504. 12
S. Public Information 13
9. Other Federal And State Requirements 13
10. Local Requirements 13
Public service programs must comply with sections 10 and 11: 14
11. Non-Substitution For Local Funding 14
12. Faith-based activities - 24 CFR § 570.200(j). 14
Acquisition or improvement of real property projects must comply with sections 12 through 19:15
13. Accessibility 15
14. Environmental Review 15
15. Labor Standards - 24 CFR § 570.603 17
16, Volunteers 24 CFR § 70 17
17. Acquisition And Relocation 17
18. Public Ownership 18
19. Reversion Of Assets - 24 CFR § 570.505. 18
20. Property Management Standards 18
21. Additional Local Requirements 19
PART III - MONITORING & REPORTING REQUIREMENTS 19
1. Monitoring 19
2. Program Reporting 19
3. Fiscal Reporting Responsibilities 20
4. Audits 20
PART IV - RECORDKEEPING REQUIREMENTS 20
1. Program Records and Inspections 20
2. Program Benefit Records - 24 CFR § 570.506(b). 21
3. Financial Records 22
2
4. Records Of Program Operations, Management And Evaluation 23
5. Property Records 23
6. Nondiscrimination And Equal-Opportunity Records - 24 CFR § 570.506(g). 23
7. Conflict Of Interest 24
S. Verification Of Subcontractor's Eligibility - 24 CFR § 5. 24
9. Additional Requirements for Acquisition or Improvement of Real PROPERTY PROJECTS 24
3
PART I - GENERAL CONDITIONS
1. SCOPE OF AGREEMENT
The agreement between the parties shall consist of this Agreement and its signature page;
the recitals page; the general conditions and any special conditions; the federal, state and
local program requirements; the monitoring and reporting requirements; the recordkeeping
requirements; each and every project exhibit, appendix, and attachment incorporated into
the Agreement; all matters and laws incorporated by reference herein; and any written
amendments made according to the general conditions. This Agreement supersedes any
and all former agreements applicable to projects attached as Exhibits to this Agreement. It
is the intent of the parties that all applicable federal regulations and requirements are
incorporated herein, including, but not limited to, 24 CFR § 570, 2 CFR § 200, and 24 CFR §
570.
2. SCOPE OF PROJECT
A. The Agency shall use the funds provided herein only to perform the activities authorized by
this Agreement and as set forth in the CDBG Project Scope of Services, a draft of which is
attached as Exhibit A and incorporated by this reference. Because this Agreement is
�e,� pr },. F. .d L. II } .d }n }hv C�}y }hr o, h f dAral apprvpriat;ons� the ('ity
executed u .vr w I U— veii:g a::s aye
will forward to Agency a final Exhibit A that the City will create if federal appropriations are
awarded to the City for Agency's services, and that final Exhibit A, which may include
adjustments in allocations or scope imposed as a condition of the final federal
appropriations, shall relate back to and be incorporated into this Agreement. In the case of
multiple projects, each project shall correspond to a separate Exhibit. This Agreement may
be amended from time to time, in accordance with the general conditions, for the purpose
of adding new projects, amending the scope of work, or for any other lawful purpose.
B. Agencies funded by the City to carry out neighborhood revitalization, community economic
development, or energy conservation projects shall meet the qualifications of a Community
Based Development Organization (CBDO) pursuant to 24 C.F.R. § 570.204(c). The "carry
out" requirement "means that the CBDO undertakes the funded activities directly or through
contract with an entity other than the City, or through the provision of financial assistance
for activities in which it retains a direct and controlling involvement and responsibilities." 24
C.F.R. § 570.204(a)(4).
3. PURPOSE AND PRIMARY OBJECTIVE - 42 U.S.C. § 530(c), 24 C.F.R. § 570.200(a)(3).
"The primary objective of this chapter and of the community development program of each
grantee under this chapter is the development of viable urban communities, by providing
decent housing and a suitable living environment and expanding economic opportunities,
principally for persons of low and moderate income. Consistent with this primary objective,
not less than 70 percent of the aggregate of the Federal assistance provided to States and
units of general local government [of CDBG expenditures] under section 5306 of this title
and, if applicable, the funds received as a result of a guarantee or a grant under section
5308 of this title, shall be used for the support of activities that benefit persons of low and
moderate income ..." 42 U.S.C. § 5301(c), 24 C.F.R. § 570.200(c).
Income limits for persons eligible to be served by these activities are outlined in Exhibit B,
which is attached and incorporated by this reference. The income guidelines attached as
Exhibit B at the time this Agreement is executed shall be in draft form if federal income
guidelines for the contract year have not been released and posted to The Department of
Housing and Urban Development's web site prior to the execution of this Agreement. If
federal income guidelines are in draft form, the City will forward to Agency a final Exhibit B,
including any adjustments imposed by the federal government once it is generated by the
4
federal government at the time it finalizes its appropriations, and that final Exhibit B shall
relate back to and be incorporated into this Agreement.
The following requirements apply:
A. The Agency shall ascertain household income of persons applying for and receiving
assistance to assure compliance with the income limits defined in Exhibit B; and shall
maintain records pursuant to Part IV of this Agreement, Section 2(B); or
B. If the activity exclusively serves a clientele, which by federal regulation is "presumed" to be
low and moderate income, individual income verification is not required. Persons eligible for
this presumption are specified in Part IV of this Agreement, Section 2(C). In this case, the
Agency shall maintain appropriate data to validate the presumption, as provided in Part IV,
Section 2(C); or
C. If the activity is such that it is not feasible to identify and record beneficiaries, the total
population of the area from which the beneficiaries are drawn must be predominantly low
and moderate income. In this case, the Agency shall maintain substantiation data as
required by Part IV of this Agreement, Section 2(D).
D. The benefit to low and moderate income beneficiaries must be in the form of a free or
reduced cost service. If beneficiaries are charged for services, the charges to low and
moderate income beneficiaries, and to all other beneficiaries, shall be as specified in the
Exhibit(s), if applicable. Changes to the structure of charges during the term of this
Agreement (and, in the case of a facility project, for five years thereafter) must preserve an
identical discount for low and moderate income beneficiaries, and the change must be
approved by the City.
E. The low and moderate income limits in effect at the time of execution of this Agreement are
specified in Exhibit B. These limits are revised periodically by HUD. It is the Agency's
responsibility to use any revised limits when they take effect. Revisions will be announced
by and can be obtained from the City.
4. COMMENCEMENT AND TERMINATION OF PROJECT(S)
A. The City shall furnish the Agency with a written notice to proceed. No work on a project
shall occur without prior written approval from the City. Agency shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and
subcontractors in the performance of the contract work and shall utilize all protection
necessary for that purpose. Termination dates for individual projects shall be specified in
the appropriate Exhibits. Costs incurred prior to the date written notice to proceed was
given or after the termination date will not be reimbursed. The termination date may be
changed through an amendment of this Agreement.
B. Although the term of this Agreement shall run from January 1, 2019 through December 31,
2020, this Agreement, however, is contingent upon the availability of funds to be allocated
through federal appropriations. Therefore, should funds to support Agency's services not be
made available through anticipated federal appropriations, this Agreement shall immediately
terminate without risk or liability to the City and without obligation to disburse funds or to
reimburse Agency any funds expended in anticipation of funding availability. All work shall
be done at Agency's own risk, and Agency shall be responsible for all losses associated with
services provided before the City issues its written notice to proceed. All acts consistent
with the authority of the Agreement and prior to the date of the Agreement's execution are
hereby ratified and affirmed, and the terms of this Agreement shall be deemed to have
applied.
S. ADMINISTRATION
5
A. The Agency shall appoint a liaison person who shall be responsible for overall administration
of CDBG funded project(s) and coordination with the City's Parks, Recreation, and
Community Services Department. The person appointed shall be designated in Exhibit C,
which is attached and incorporated by this reference. The Agency shall also designate one
or more representatives who shall be authorized to submit the Billing Voucher and Service
Report, and Final Service Report, which are attached as Exhibit D and D-1, respectively.
The name of the liaison person and representative shall be specified in the Exhibit.
B. The Agency shall provide ten (10) days written notice to the City of any changes in program
personnel or Board membership.
C. The agency shall provide the City with a current list of its Board of Directors, general or
limited partners, as applicable.
6. COMPENSATION AND METHOD OF PAYMENT
A. The City shall reimburse the Agency only for eligible costs allowed pursuant to this
Agreement, which are part of the activities specified in the Exhibit(s), and in an amount not
to exceed the amount specified in Exhibit A, plus any miscellaneous surplus office
equipment, as available, related to the provision of services under this Agreement, and
according to the procedures developed by the City of Kent. Reimbursement shall be based
on a Billing \/oucher and Service Report, which shall be submitted to the City by the
Agency's authorized representative.
B. the City of Kent uses a variety of measures as indicators of satisfactory contract
performance. The Agency will be expected to meet 100% of the performance measures as
defined in Exhibit A. Exceptions may be made in cases where circumstances beyond the
Agency's control impact their ability to meet their units of service and the Agency has
shown reasonable effort to overcome those circumstances. Exceptions are made at the
discretion of the City's Human Services Manager.
C. If the Agency does not meet performance goals, payment for services rendered under the
agreement will be reduced by the rate calculated for each service unit. For example if an
Agency contracted to provide 100 bed-nights a quarter for $5,000.00 and only provide 75
bed-nights, payment would be $3,750.00 instead of $5,000.00.
D. The Agency shall submit a Billing Voucher and Service Report on a quarterly basis. Billing
Vouchers and Service Reports are due in accordance with the schedule and budget
incorporated as Exhibit A and in accordance with Section 7 below. If the due date falls on a
Saturday or Sunday, Billing Vouchers and Service Reports are due on the prior Friday. If
the due date falls on a City holiday, Billing Vouchers and Service Reports are due the next
working day following the holiday. The Final Service Report is due in accordance with the
schedule listed in Exhibit A. If the Agency's line item budget includes personnel services
costs, the Agency shall submit a CDBG Public Services Project Time Sheet (attached as
Exhibit G if applicable) with the Billing Voucher and Service Report. The City will make
payment to the Agency not more than forty-five (45) days after said Billing Voucher and
Service Report is received and approved by the City's Parks, Recreation, and Community
Services Department. The City will issue a statement of correction in the event the Billing
Voucher and Service Report are erroneous. Payment by the City shall not constitute
approval of the services for which payment is requested. The City does not, by making
such payment, waive any rights it may have pursuant to this Agreement to require
satisfactory performance of the services promised herein. The City reserves the right to
demand and recover reimbursements made for ineligible costs.
7. ELIGIBLE COSTS
A. All costs incurred must be reasonable and of a nature which clearly relate to the specific
purposes and end product of the Agreement under which the services are being performed.
6
Care must be taken by all concerned in incurring costs to assure that expenditures conform
to these general standards and the following criteria for eligibility of costs.
B. To be eligible for reimbursement, costs must:
(1) Be necessary and reasonable for proper and efficient execution of the contractual
requirements and in accordance with an approved budget.
(2) Be no more liberal than policies, procedures, and practices applied uniformly to other
activities of the Agency.
(3) Be accorded consistent treatment through application of account policy and procedures
approved and/or prescribed herein.
(4) Not be allowable under or included as costs of any other federal, state, local or other
agency-financed programs in either prior or current periods.
(5) Be net of all applicable credits such as purchase discounts, rebates or allowances, sales
of publication or materials, or other income or refunds.
(6) Be fully documented.
S. OPERATING BUDGET
The Agency shall apply the funds received from the City under this Agreement in accordance
with the Budget Summary found in Exhibit A. No line-item expense therein shall cause
expenditure in excess of ten (10) percent or more of the budget line-item amount over the
life of the Agreement without the prior written consent of the City. Any request for a line-
item expense which exceeds ten (10) percent of the budgeted amount shall specifically
state the reasons for the requested increase and a justification for the corresponding
decrease in other line-item(s).
9. FUNDING ALTERNATIVES, FUTURE SUPPORT, AND LIMITED RELEASE
A. The City makes no commitment to future support and assumes no obligation for future
support of the activities contracted for herein, except as may be expressly set forth in this
Agreement.
B. Payment for the services provided herein is based on the expectation that future revenues
will be available to the City for such purposes. Should anticipated sources of revenue not
become available or become unavailable to the City for use in the CDBG program, the City
shall immediately notify the Agency in writing of such unavailability and in that event,
Agency fully releases City from any claims, damages, or liability, related to lack of funding,
the amount funded, or uncertainty for that portion of the Agreement originally intended to
be paid with such funds.
10. AMENDMENTS
Either party may request modifications in the scope of permissible activities, terms, or
conditions of this Agreement. Proposed modifications which are mutually agreed upon shall
be incorporated by a written amendment to this Agreement.
11. ASSIGNMENT AND SUBCONTRACTING
A. The Agency shall not assign any portion of this Agreement without the written consent of
the City, and it is further agreed that said consent must be sought by the Agency not less
than fifteen (15) days prior to the date of any proposed assignment.
B. Any work or services assigned or subcontracted hereunder shall be subject to each provision
of this Agreement and proper bidding procedures to the extent herein. The Agency agrees
that it is as fully responsible to the City for the acts and omissions of its subcontractors and
7
their employees and agents, as it is for the acts and omissions of its own employees and
agents, as defined in paragraph Part I, Section 12(B).
12. HOLD HARMLESS AND INDEMNIFICATION
A. The Agency agrees that it is financially responsible and liable to the City for any audit
exception or other financial loss to the City which occurs due to the Agency's negligence or
failure to comply with the terms of this Agreement.
B. The Agency further agrees to defend, indemnify, and hold the City, its elected and
appointed officials, agents, and employees, while acting within the scope of their duties as
such, harmless from and against all claims, demands, and causes of action of any kind or
character, including the cost of defense thereof, arising in favor of any person(s), including
Agency's employees or third parties on account of personal injuries, death, or damage to
property arising out of services performed or omissions of services or in any way resulting
from the acts or omissions of the Agency and/or its agents, employees, volunteers,
subcontractors, or representatives under this Agreement.
13. PROJECT CLOSE-OUT
The Agency acknowledges and agrees that the amounts set forth in the Exhibit(s) shall be
used only to reimburse the Agency for eligible costs incurred by the Agency during the
period set forth in said Exhibit(s) and that upon expiration of such period, or upon earlier
termination pursuant to this Agreement, the Agency shall have no interest in any said
amount which is not required to reimburse the Agency for eligible costs incurred before such
expiration or earlier termination.
14. INSURANCE
Agency shall maintain insurance in the types and amounts set forth in Exhibit E, which is
attached and incorporated by this reference.
15. CONFLICT OF INTEREST
A. Interest of Officers, Employees, or Agents - The Agency shall abide by and enforce the
conflict of interest requirement set forth in 24 CFR 570.611, 2 CFR 200.112, and 2 CFR
200.318. No employee, agent, consultant, officer, or elected official or appointed official of
the City, or of any designated public agencies, or of sub-recipients that are receiving CDBG
funds shall have any personal financial interest, direct or indirect, in the Agreement, and
the City and Agency shall take appropriate steps to assure compliance. 24 CFR 570.611
B. Interest of Subcontractor and Their Employees - The Agency agrees that it will incorporate
into every contract or subcontract, which is required to be in writing and made pursuant to
this Agreement, the following provisions:
The Contractor covenants that no person who presently exercises any
functions or responsibilities in connection with the City CDBG program
has any personal financial interest, direct or indirect, in this
Agreement. The Contractor further covenants that he/she presently
has no interest and shall not acquire any interest, direct or indirect,
which would conflict in any manner or degree with the performance of
his/her services hereunder. The Contractor further covenants that in
the performance of this Agreement, no person having any conflict of
interest shall be employed. Any actual or potential conflict of interest
on the part of the Contractor or his/her employees must be disclosed
to the Agency and the City.
16. SUSPENSION AND TERMINATION OF AGREEMENT
8
A. Suspension for Failure to Perform - In the event of a failure to comply with any terms or
conditions of this Agreement or failure to provide in any manner the activities or other
performance as agreed to herein, the City reserves the right to withhold all or any part of
payment, suspend all or any part of the Agreement, or prohibit the Agency from incurring
additional obligations of funds until the City is satisfied that corrective action has been taken
or completed as more specifically outlined in the Exhibit(s) to this Agreement. The option to
withhold funds is, in addition to and not in lieu of, the City's right to terminate the
Agreement pursuant to Paragraph (B) of this Section 16.
B. Termination of Agreement by City - This Agreement is subject to termination upon thirty
(30) days written notice by the City to the Agency in the event that:
(1) The Agency mismanages or makes improper or unlawful use of CDBG funds;
(2) The Agency fails to comply with any term or condition expressed herein or any
applicable federal, state, or local regulations or ordinances;
(3) CDBG funds no longer become available from the federal government or through the
City;
(4) The Agency fails to carry out activities required by this Agreement; or
(5) The Agency fails to submit reports or submits incomplete or inaccurate reports in any
material respect.
C. Termination of Agreement by the Agency- This Agreement is subject to termination upon
thirty (30) days written notice by the Agency to the City in the event that:
(1) The City fails in its commitment under this Agreement to provide funding for services
rendered, as herein provided; or
(2) CDBG funds no longer become available from the federal government or through the
City.
D. Unless otherwise terminated pursuant to Paragraphs (B) and (C) of this Section 16, this
Agreement shall terminate on the termination date specified on the Exhibit(s) and shall be
subject to extension only by mutual agreement and amendment in accordance with Part I,
Section 10 of this Agreement.
E. Upon termination of this Agreement, any unexpended balance of Agreement funds shall
remain in the City CDBG fund.
F. In the event termination occurs under Paragraph (B) of this Section 16, the Agency shall
return to the City all funds that were expended in violation of the terms of this Agreement
including, but not limited to, any unexpended CDBG funds distributed to the Agency under
this Agreement, any accounts receivable, or any assets or interests therein of any type and
in any form acquired, leased, or rehabilitated with CDBG monies.
17. SAFEGUARDING OF CLIENT INFORMATION
The use or disclosure by any party of any confidential information concerning a recipient or
client for any purpose not directly connected with the City's or the Agency's responsibilities
with respect to services provided under this Agreement is prohibited, except upon written
consent of the recipient or client, his/her attorney, his/her responsible parent or guardian,
or as otherwise provided by law.
PART II - FEDERAL, STATE, AND LOCAL PROGRAM REQUIREMENTS
1. NONDISCRIMINATION
9
A. General — The Agency shall comply with all federal, state, and local laws prohibiting
discrimination on the basis of age, sex, marital status, race, creed, religion, color, national
origin, or the presence of any sensory, mental, or physical handicap. These requirements
are specified in Chapter 49.60 RCW; Section 109 of the Housing and Community
Development Act of 1974, Pub. L. No. 93-383 as amended and codified as 42 U.S.C. §
5309; Title VI of the Civil Rights Act of 1964, 42 U.S.C. §§ 2000d, et seq.; Title VIII of the
Civil Rights Act of 1968, 42 U.S.C. §§ 3601, et seq.; Executive Order 11063; Executive
Order 11246, as amended by Executive Orders 11375, 11478, 12086 and 12107; Section 3
of the Housing and Urban Development Act of 1968, 12 U.S.C.§ 1701(u), and implementing
regulations at 24 CFR § 135; Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794,
et seq.; and the Age Discrimination Act of 1975, 42 U.S.C. § 6101, et seq. Specifically, the
Agency is prohibited from taking any discriminatory actions defined in the HUD regulations
at 24 C.F.R. § 570.602 and shall take such affirmative and corrective actions as are
required by the regulations at 24 C.F.R. § 570.602.
B. Specific Discriminatory Actions Prohibited:
(1)The Agency shall not, under any program or activity to which this Agreement may apply,
directly or through contractual or other arrangements, on the grounds of age, sex,
marital status, race, creed, religion, color, national origin, or the presence of any
sensory, mental, or physical handicap:
i. Deny any person facilities, services, financial aid, or other benefits provided under
the program or activity.
ii. Provide any person with facilities, services, financial aid, or other benefits which are
different, or are provided in a form different, from that provided to others under the
program or activity.
iii. Subject any person to segregated or separate treatment in any facility or in any
matter or process related to receipt of any service or benefit under the program or
activity.
iv. Restrict in any way access to or enjoyment of any advantage or privilege enjoyed by
others in connection with facilities, services, financial aid, or other benefits under the
program or activity.
v. Treat any person differently from others in determining whether the person satisfies
any admission, enrollment, eligibility, membership, or other requirement or condition
which individuals must meet in order to be provided facilities, services, or other
benefits provided under the program or activity.
vi. Deny any person any opportunity to participate in a program or activity as an
employee.
(2) The Agency shall not utilize criteria or methods of administration which Have the effect
of subjecting individuals to unlawful discrimination on the basis of race, color, national
origin, sex, age, marital status, creed, religion, or presence of any sensory, mental, or
physical handicap, or which have the effect of defeating or substantially impairing
accomplishment of the objectives of the program or activity by unlawfully discriminating
against individuals of a particular race, color, national origin, sex, age, marital status,
creed, religion, or presence of any sensory, mental, or physical handicap.
(3) The Agency, in determining the site or location of housing or facilities provided in whole
or in part with funds under this Agreement, may not make selections of such site or
location which have the effect of excluding individuals from, denying them the benefits
of, or subjecting them to unlawful discrimination on the grounds of race, color, national
origin, sex, age, marital status, creed, religion, or presence of any sensory, mental, or
10
physical handicap; or which have the purpose or effect of defeating or substantially
impairing the accomplishment of the objectives of the Act or of HUD regulations.
C. Fair Housing - The Agency shall take necessary and appropriate actions to prevent
discrimination in federally-assisted housing and lending practices related to loans insured or
guaranteed by the federal government (The Fair Housing Act (42 U.S.C. 3601-19) and
implementing regulations at 24 CFR part 100 et seq.; Executive Order 11063, as amended
by Executive Order 12259 (3 CFR, 1959-1963 Comp., p. 652 and 3 CFR, 1980 Comp., p.
307) (Equal Opportunity in Housing Programs) and implementing regulations at 24 CFR part
107. The Agency shall also administer programs related to housing and urban development
in a manner to affirmatively further fair housing. 24 CFR Parts 5, 91, 92, 570, 574, 576, and
903.
D. Employment
(1) In all solicitations under this Agreement, the Agency shall state that all qualified
applicants will be considered for employment. The words "equal opportunity employer"
in advertisements shall constitute compliance with this section.
(2) The Agency shall not unlawfully discriminate against any employee or applicant for
employment in connection with the Agreement because of age, sex, marital status, race,
creed, religion, color, national origin, or the presence of any sensory, mental, or physical
handicap, except when there is a bona fide occupational limitation. Such action shall
include, but not be limited to the following: employment, upgrading, demotion or
transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or
other forms of compensation, and selection for training (Chapter 49.46 RCW, Executive
Order 11246, as amended).
(3) To the greatest extent feasible, the Agency shall provide training and employment
opportunities for lower income residents within the area served by CDBG assisted
projects (Section 3, Housing and Urban Development Act of 1968, 12 U.S.C. § 1701u, as
amended).
E. Contractors and Suppliers:
(1) No contractor, subcontractor, union, or vendor engaged in any activity under this
Agreement shall engage in any unlawful discrimination as defined in any federal, state,
or local law.
(2) All firms and organizations, as required under applicable HUD regulations, shall be
required to submit to the Agency certificates of compliance demonstrating that it has, in
fact, complied with the immediately foregoing provision; provided, that certificates of
compliance shall not be required from firms and organizations with fewer than 25
employees, with yearly sales of less than $10,000, or on contracts less than $10,000.
(3) To the greatest extent feasible, the Agency shall purchase supplies and services for
activities under this Agreement from vendors and contractors whose businesses are
located in the area served by CDBG-funded activities or owned in substantial part by
project area residents (Section 3, Housing and Urban Development Act of 1968, 12
U.S.C. § 1701u, as amended).
(4) CDBG funds shall not be used directly or indirectly to employ, award contracts to, or
otherwise engage the services of, or fund any contractor or sub-recipient during any
period of debarment, suspension, or placement in ineligibility status under the provisions
of 2 CFR § 2424. The Agency shall certify that it and all sub-consultants and
subcontractors are not listed on the government-wide Excluded Parties List System in
the System for Award Management (SAM), in accordance with OMB guidelines at 2 CFR
180 that implement Executive Orders 12549 and 12689, "Debarment and Suspension,"
11
as set forth at 2 CFR 2424. Additional policies concerning debarment and suspension are
found at 2 CFR Part 180 and 2 CFR Part 2424.
F. Notice:
(1)The Agency shall include the provisions of the appropriate subsections A, B, C, D, and E
of this Part II, Section 1 in every contract or purchase order for goods and services
under this Agreement, and shall send to each labor union or representative of workers
with which it has a collective bargaining agreement or other contract or understanding, a
notice advising the said labor union or worker's representative of the commitments
made in these subsections.
(2) In advertising for employees, goods, or services for the activities under this Agreement,
the Agency shall utilize minority publications in addition to publications of general
circulation.
2. SECTION 504 AND AMERICANS WITH DISABILITIES ACT
If the Agency is a nonprofit corporation, the Agency warrants and represents that it has
completed a Disability Self-Evaluation Questionnaire for all programs and services offered
by the Agency (including any services not subject to this Agreement) and has evaluated its
services, programs, and employment practices for compliance with Section 504 of the
Rehabilitation Act of 1973, 29 U.-S.C. § 774, as amended ("504") and the Americans with.
Disabilities Act of 1990, 42 U.S.C. §§ 12101, et seq., ("ADA"). The Agency warrants and
represents that it has completed a 504/ADA Disability Assurance of Compliance, which is
attached as Exhibit H and incorporated by this reference, and shall submit it to the City.
3. FINANCIAL MANAGEMENT AND PROCUREMENT STANDARDS
The Agency shall comply with, and shall require any sub-contractor funded in whole or in
part with CDBG funds to comply with the following financial and program management and
procurement standards:
A. Agency shall adhere to the principles and standards governing federal grant distribution
set forth in the "Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards" (2 CFR Part 200).
B. Agency shall comply with all applicable requirements of local and state law for awarding
contracts, including but not limited to procedures for competitive bidding, contractor's
bonds, and retained percentages (Ch. 60.28 RCW, Ch. 39.12 RCW, and Ch. 39.04
RCW). In addition, the Agency shall comply with the requirements of 2 CFR § 200.318
(General procurement standards) through 200.326 (Contract provisions).Where federal
standards differ from local or state standards, the stricter standards shall apply.
C. Agency shall comply with 24 CFR Part 570 and 2 CFR Part 200 regarding the
management and disposition of cash and real, and personal property acquired with
CDBG funds.
D. Agency shall comply with 24 CFR 570.489, Program and Administrative Requirements.
E. Agency shall comply with 24 CFR 570.490,
4. UNIFORM ADMINISTRATIVE REQUIREMENTS AND COST PRINCIPLES AND RECORDKEEPING — 2 CFR Part
200, 24 CFR §§ 570.502, and 570.610.
A. Agency shall comply with 2 CFR Part 200, "Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards", except that:
(1)Section 200.305 "Payment" is modified for lump sum drawdown for financing of
property rehabilitation activities, in accordance with § 570.513.
12
(2) Section 200.306 'Cost sharing or matching" does not apply.
(3) Section 200.307 "Program income" does not apply. Program income is governed
by § 570.504.
(4)Section 200.308 "Revisions of budget and program plans" does not apply.
(5) Section 200.311 "Real property" does not apply, except as provided in §
570.200(j). Real property is governed by § 570.505.
(6) Section 200.313 "Equipment" applies, except that when the equipment is sold,
the proceeds shall be program income. Equipment not needed by the sub-recipient
for CDBG activities shall be transferred to the recipient for the CDBG program or
shall be retained after compensating the recipient.
Records to be maintained include:
Contract and Amendments - A complete copy of this Agreement
and all amendments thereto and notices there under.
ii Records of City Approvals - Copies of all requests for
amendments or revisions to this Agreement and the City's
subsequent approval or denial of such requests as are required
under this Agreement.
Subcontracts and Agreements - Complete copies of all
contracts, subcontracts, and agreements with third parties into
which the Agency enters in the performance under this
Agreement; and all correspondence, reports, and other
documentation pertaining to such contracts, subcontracts, and
agreements.
(iv) Records identifying the assisted activity - A complete description of each activity assisted,
in whole or in part, with CDBG funds under this Agreement, including:
(a) Location(s), organization, operating hours, qualifications for service or participation,
etc.;
(b) Fees or charges for services, fee waivers, or fee scales for CDBG-assisted participants.
B. Section 200.343 "Closeout" applies to closeout of sub-recipients.
C. Additional Contract Requirements - The Agency shall submit to the City a copy of the
most recent independent financial audit and a current list of the Agency's board of
directors.
S. DATA UNIVERSAL NUMBERING SYSTEM
Pursuant to 2 C.F.R. §25.100(a), the City is required to establish a Dun and Bradstreet (D &
B) Data Universal Numbering System (DUNS) as a universal identifier in order to receive
federal financial assistance. In addition, programs or sub-recipients receiving sub-awards
from the City shall establish a DUNS. 2 C.F.R. § 25.200(c)(1). The Agency shall provide its
DUNS to the City.
6. LOBBYING
In accordance with 2 CFR 200.450, the Agency shall not use CDBG funds for lobbying
purposes.
13
7. PROGRAM INCOME - 24 CFR § 570.504.
A. All income directly generated from the use of CDBG funds, as defined in 24 CFR §
570.500(a), is Program Income and shall be recorded, reported, and treated as funds
subject to all the requirements of this Agreement.
B. Unless otherwise specifically provided by the special conditions herein, Program Income
received during the term of this Agreement may be retained and used by the Agency to
extend the service or other activity for which the CDBG funds are provided, subject to the
regulations of 24 CFR § 570.01, et seq., and all the same terms and conditions of this
Agreement. Any retained Program Income shall be disbursed to pay for eligible expenses
under this Agreement before additional funds are requisitioned from the City.
C. Any Program Income not permitted to be retained for eligible activities as defined above,
shall be refunded to the City, together with any interest earned thereon, at quarterly
intervals.
D. Program Income on hand at the end of the term of this Agreement shall, unless otherwise
provided, be used for activities envisioned under this Agreement until it is expended.
Program Income generated from the use of CDBG funds under this Agreement but received
after the term of this Agreement shall, unless otherwise provided, be governed by any
} if }hero no succeeding agreement shall he used
succeeding CDBG fundl�!g agreement or, i! t!!�r!c. e� !!_ ,:a�+.s,�..s�aa!!!y agreement,
for activities eligible under 24 CFR § 570.504(c) until it is expended.
E. Rules on Program Income are established in the CDBG regulations (24 CFR § 570,504); 2
CFR § 200.307Program Income. Proceeds from the sale of real property, equipment, or
supplies are not program income; such proceeds will be handled in accordance with the
requirements of Subpart D--Post Federal Award Requirements of 2 CFR § 200, Property
Standards §§ 200.311 Real property, 200.313 Equipment, and 200.314 Supplies, or as
specifically identified in Federal statutes, regulations, or the terms and conditions of the
Federal award. 2 CFR § 200.307(d).
8. PUBLIC INFORMATION
A. In all news releases and other public notices related to projects funded under this
Agreement, the Agency shall include information identifying the source of funds as the City
of Kent CDBG program.
B. The Agency acknowledges that this Agreement and any other information provided by it to
the City and/or relevant to the project(s) described in the Exhibit(s), are subject to the
Washington State Public Disclosure Act, Chapter 42.56 RCW, except to the extent
specifically exempted from disclosure therein.
9. OTHER FEDERAL AND STATE REQUIREMENTS
The absence of mention in this Agreement of any other federal or state requirements, which
apply to the award and expenditure of federal funds made available by this Agreement, is
not intended to indicate that those federal or state requirements are not applicable to
Agency activities. The Agency shall comply with all other federal and state requirements
relating to the expenditure of federal funds, including but not limited to the Hatch Act (5
U.S.C. § 15) regarding political activities and the Architectural Barrier Act of 1968 (42
U.S.C. § 4151, et seq.).
10. LOCAL REQUIREMENTS
The activities performed under this Agreement are for the purposes of serving City residents
and the Agency shall, to the extent reasonably possible, not use said funds to provide
services outside the corporate boundary of the City, or for any other purpose, except as
specifically authorized by this Agreement.
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Public service programs must comply with sections 11-12:
11. NON-SUBSTITUTION FOR LOCAL FUNDING
The CDBG funding made available under this Agreement shall not be utilized by the Agency
to reduce substantially the amount of local financial support for community development
activities below the level of such support prior to the availability of funds under this
Agreement.
12. FAITH-BASED ACTIVITIES — 24 CFR § 570.200(j).
A. Organizations that are religious or faith-based are eligible, on the same basis as any other
organization, to participate in the CDBG program. Neither the Federal government nor a
State or local government receiving funds under CDBG programs shall discriminate against
an organization on the basis of the organization's religious character or affiliation.
B. Organizations that are directly funded under the CDBG program may not engage in
inherently religious activities, such as worship, religious instruction, or proselytism, as part
of the programs or services funded under this part. If an organization conducts such
activities, the activities must be offered separately, in time or location, from the programs
or services funded under this part, and participation must be voluntary for the beneficiaries
of the HUD-funded programs or services.
C. A religious organization that participates in the CDBG program will retain its independence
from Federal, State, and local governments, and may continue to carry out its mission,
including the definition, practice, and expression of its religious beliefs, provided that it does
not use direct CDBG funds to support any inherently religious activities, such as worship,
religious instruction, or proselytism. Among other things, faith-based organizations may
use space in their facilities to provide CDBG-funded services, without removing religious art,
icons, scriptures, or other religious symbols. In addition, a CDBG-funded religious
organization retains its authority over its internal governance, and it may retain religious
terms in its organization's name, select its board members on a religious basis, and include
religious references in its organization's mission statements and other governing
documents.
D. An organization that participates in the CDBG program shall not, in providing program
assistance, discriminate against a program beneficiary or prospective program beneficiary
on the basis of religion or religious belief.
E. CDBG funds may not be used for the acquisition, construction, or rehabilitation of structures
to the extent that those structures are used for inherently religious activities. CDBG funds
may be used for the acquisition, construction, or rehabilitation of structures only to the
extent that those structures are used for conducting eligible activities under this part.
Where a structure is used for both eligible and inherently religious activities, CDBG funds
may not exceed the cost of those portions of the acquisition, construction, or rehabilitation
that are attributable to eligible activities in accordance with the cost accounting
requirements applicable to CDBG funds in this part. Sanctuaries, chapels, or other rooms
that a CDBG-funded religious congregation uses as its principal place of worship, however,
are ineligible for CDBG-funded improvements. Disposition of real property after the term of
the grant, or any change in use of the property during the term of the grant, is subject to
government-wide regulations governing real property disposition (see 24 CFR 84 and 85).
F. If the City voluntarily contributes its own funds to supplement the federally funded activity,
the City has the option to segregate the Federal funds or commingle them. However, if the
funds are commingled, this section applies to all of the commingled funds.
Acquisition or improvement of real property projects must comply with sections 13
through 20:
15
13. ACCESSIBILITY
Any buildings or other facilities designed, constructed, or altered with federal funds
pursuant to this Agreement are subject to the requirements of the Architectural Barriers Act
of 1968 (42 U.S.C. § 4151, et seq.) and shall comply with the Uniform Federal Accessibility
Standards (Appendix A to 24 CFR § 40.1, et seq. for residential structures, and Appendix A
to 41 CFR § 101-19, et seq. for general type buildings). When applicable, certain
multifamily housing units designed and constructed for first occupancy after March 13,
1991, with assistance provided under this Agreement, must comply with the Fair Housing
Accessibility Guidelines, 24 CFR § 100.1, et seq., as amended.
14. ENVIRONMENTAL REVIEW
A. National Environmental Policy Act - The City retains environmental review responsibility for
purposes of fulfilling requirements of the National Environmental Policy Act as implemented
by HUD Environmental Review Procedures (24 CFR § 58.1, et seq.). The City may require
the Agency to furnish data, information, and assistance for the City's review and
assessment in determining whether an Environmental Impact Statement must be prepared.
The Agency shall be solely responsible for the cost of compliance with all such federal laws
and authorities including the cost of preparing plans, studies, reports, and the publication of
notices that may be required.
B. Other Federal Environmental Laws -
(1) Historic Preservation - Activities affecting property listed in or found to be eligible for
inclusion in the National Register of Historic Places will be subject to requirements set
forth in HUD Environmental Review Procedures at 24 CFR § 58.1, et seq. The Agency
shall meet the historic preservation requirements of Pub. L. No. 89665 (16 U.S.C. §
470(i)), and the Archaeological and Historic Preservation Act of 1974, Pub. L. No. 93291
(16 U.S.C. § 469a-1), and Executive Order 11593, including the procedures prescribed
by the Advisory Council on Historic Preservation in the regulations at 36 CFR § 801, et
seq.
(2) Architectural Barriers - Any facility constructed pursuant to this Agreement shall comply
with design requirements of the Architectural Barriers Act of 1968 (42 U.S.C. §§ 4151,
et seq.), and the Uniform Federal Accessibility Standards (US Government Printing
Office, 1985494187).
(3) National Flood Insurance - When applicable, the use of CDBG funds for acquisition or
construction purposes in identified special flood hazard areas shall be subject to Agency
mandatory purchase of flood insurance as required by Section 102(a) of the Flood
Disaster Protection Act of 1973 (Pub. L. No. 93237, 42 U.S.C. § 2414 and 42 U.S.C. §§
4001-4128).
(d.) I-ad-Based Paint - Whenever funds Under this Agreement are used directly or indirectly
for construction, rehabilitation, or modernization of residential structures, the Agency
shall comply, at its sole expense, with the HUD Lead-Based Paint regulations (24 CFR §
35) issued pursuant to the Lead-Based Paint Poisoning Prevention Act, as amended (42
U.S.C. §§ 4801, et seq.) and the Residential Lead-Based Paint Hazard Reduction Act of
1992 (42 U.S.C. §§ 4851, et seq.), with regard to lead-based paint, and with any and all
applicable federal, state, and local laws, regulations, or standards hereafter enacted or
issued with regard to lead-based paint. Without limiting the foregoing, the Agency shall
remove or cover, prior to the date for completion of the work funded hereunder and in
compliance with all applicable, laws, regulations, and in conformity with guidelines
issued by HUD, all lead-based paint with lead content above the threshold established by
HUD on surfaces affected by the work funded under this Agreement. The Agency shall
defend, indemnify, and hold harmless the City from any liability, loss, damage, or
expense, including costs and attorneys' fees, relating in any way to lead-based paint at
16
the property or the abatement or disposal thereof. This provision shall survive expiration
and satisfaction of this Agreement, whether by payment, forgiveness, foreclosure, or
otherwise.
(5) Other - Clean Air Act as amended, 42 U.S.C. § 7401, et seq.; Water Pollution Control
Act, 33 U.S.C. §§ 1367, et seq., as amended; Environmental Protection Agency
regulations, 40 CFR §§ 1.1, et seq.
C. State Environmental Policy Act - Agencies which are branches of government under RCW
43.21C.030 retain responsibility for fulfilling the requirements of the State Environmental
Policy Act, Chapter 43.21C RCW and the regulations and ordinances adopted there under.
If the Agency is not a branch of government under RCW 43.21C.030, the City may require
the Agency to furnish data, information, and assistance, as necessary, to enable the City to
comply with the State Environmental Policy Act.
D. Satisfaction of Environmental Requirements
(1) Limitations on Activities Pending Clearance - Per 24 CFR § 58.22(a). The Agency shall
not commit assistance under this Agreement until HUD has approved the City's Request for
Release of Funds (RROF) and the related certification from the City. In addition, until the
RROF has been approved by HUD, neither the City nor the Agency may commit non-HUD
funds on or undertake an activity or project under a program listed in § 58.1(b) if the
activity or project would have an adverse environmental impact or limit the choice of
reasonable alternatives. Provided; however, that an option agreement, self-Help
Homeownership Opportunity Program funds, and relocation assistance may be excluded
from the limitation above per 24 CFR § 58.22(d), (e) and (f) respectively.
(2) Notice to Proceed - Project execution under this Agreement, by either the City or the
Agency, shall not proceed until satisfaction of all applicable requirements of the national and
state environmental policy acts. A written notice to proceed will not be issued by the City
until all such requirements are complied with.
15. LABOR STANDARDS - 24 CFR § 570.603
A. The Agency shall require that project construction contractors and subcontractors pay their
laborers and mechanics at wage rates in accordance with the Davis-Bacon Act, as amended
(40 U.S.C. §§ 3141 and 3142), and that they comply with the Copeland Act (18 U.S.C. §
874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 3701, et seg. ;
provided that this section shall not apply to rehabilitation of residential property only if such
property contains not less than eight (8) units. In addition to complying with these federal
labor standards, the Agency shall further require that all project construction contractors
comply with all applicable state and local public works bidding and contracting regulations,
specifically including, without limitation, the prevailing wage provisions set forth in Ch.
39.12 RCW and all regulations adopted by the State of Washington Department of Labor
and Industries.
B. The Agency shall require that project construction contractors and subcontractors comply
with Federal Labor Standards Provisions (HUD form 4010) and the Davis-Bacon wage
determinations (attached as Exhibits I and J, respectively if applicable). For construction
contracts, a copy of the Federal Labor Standards Provisions (HUD form 4010) and the
current Davis-Bacon wage determinations must be included in all construction bid specs
and/or contracts over $2,000.
16. VOLUNTEERS 24 CFR § 70
If the Agency or the Contractor/Subcontractor uses volunteers to perform services on a
federally-assisted construction project, it shall ensure that work is performed without
promise, expectation or receipt of compensation for services rendered. Volunteer files shall
17
include: (1) the name and address of the agency sponsoring the project; (2) a description
of the project; and (3) the number of volunteers and the hours donated to the project.
17. ACQUISITION AND RELOCATION
A. Any acquisition of real property for any activity assisted under this Agreement shall comply
with the Federal Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970, 42 U.S.C. §§ 4601, et seq. (hereinafter the "Uniform Act" and the government-wide
regulations applicable to all federally-assisted projects, effective April 2, 1989, at 49 CFR §§
34.1, et seq.
B. Implementation of any project provided for in this Agreement will be undertaken so as to
minimize involuntary displacement of persons, businesses, nonprofit organizations, or farms
to the greatest extent feasible.
C. Any displacement of persons, businesses, nonprofit organizations, or farms occurring as the
result of acquisition of real property assisted under this Agreement shall comply with the
Uniform Act, and the regulations at 49 CFR §§ 24.1, et seq., required by federal CDBG
regulations at 24 CFR § 570.606. The Agency shall comply with the regulations pertaining
to costs of relocation and written policies, as specified by the City of Kent's Displacement
Policy.
18. PUBLIC OWNERSHIP
For Agencies which are not municipal corporations organized under the laws of the State of
Washington, it may become necessary to grant the City a property interest where the
subject project calls for the acquisition, construction, reconstruction, rehabilitation, or
installation of publicly-owned facilities and improvements.
19. REVERSION OF ASSETS - 24 CFR § 570.505.
Any real property under the Agency's control that was acquired or improved in whole or in
part with CDBG funds in excess of $25,000 must be either:
A. Used to meet one of the national objectives set forth in 24 CFR § 570.208 of the CDBG
regulations until five (5) years after expiration of the Agreement, or such longer period of
time as determined by the City. For Acquisition or improvement of real property projects,
the Agency and the City shall execute a Community Facility Covenant Agreement.
B. Disposed of in a manner those results in the City being reimbursed in the amount of the
current fair market value of the property, less any portion attributable to expenditures of
non-CDBG funds for acquisition of, and improvements to, the property. Such
reimbursement is not required after the period of time specified in Paragraph (A) above.
20. PROPERTY MANAGEMENT STANDARDS
A. The Agency shall meet the following procedural requirements for all property acquired in
whole or in part with CDBG funds:
(1) Property records shall be maintained accurately and provide for a description of the
property; manufacturer's serial number or other identification number; acquisition date
and cost; source of the property; percentage of CDBG funds used in the purchase of
property; and location, use, and condition of the property.
(2) A physical inventory of property taken and the results of that inventory are reconciled
with the property records at least once every two (2) years to verify the existence,
current utilization, and continued need for the property.
(3) A control system shall be in effect to ensure adequate safeguards to prevent loss,
damage, or theft of the property which shall be investigated and fully documented.
18
B. The disposition of real property acquired in whole or in part with CDBG funds shall be at no
less than its current appraised fair market value (or for a lease, at the current market
value), except that such property may be disposed of for a lesser value, including by
donation, if the disposition at the lesser value is for a use which qualifies under one of the
criteria set forth in 24 CFR § 570.208 for meeting the national objectives and is permissible
under state and local law. Where the disposition is for a lesser value, the recipient shall
maintain documentation that the use meets one of the national objectives pursuant to 24
CFR § 570.208.
21. ADDITIONAL LOCAL REQUIREMENTS
A. Mortgage or Leasehold Agreement - In acquisition, rehabilitation, and construction projects,
the City shall enter into a deed of trust or leasehold agreement with the Agency to secure
and protect the City's and the public's interest in the property.
B. Adequate Value - In acquisition projects, the City shall require evidence through a property
appraisal, title search, or other means to ensure that there is adequate value so as to
secure the City's financial interest.
C. City Ordinance, Codes, and Regulations - In acquisition and construction projects, the
Agency shall comply with all applicable City ordinances, codes, and regulations.
D. Additional Public Information - For all construction projects, the Agency shall erect a sign to
City specifications at the construction site, which identifies the source of funds, except that
this requirement may be waived for construction projects of $5,000 or less.
PART III - MONITORING & REPORTING REQUIREMENTS
1. MONITORING
Agency understands and agrees that it will be monitored by the City and HUD from time to
time to assure compliance with all terms and conditions of this Agreement and all applicable
local, state, and federal laws, regulations, and promulgated policies. Monitoring by the City
under this Agreement shall include, but not be limited to: (1) on-site inspections by City
staff, (2) quarterly performance reviews, and (3) an annual evaluation.
2. PROGRAM REPORTING
A. For public service programs - A Billing Voucher and Service Report shall be submitted at
least quarterly, even if no reimbursement is requested. The report is due on in
accordance with the schedule listed in Exhibit A. If the due date falls on a Saturday or
Sunday, the Billing Voucher and Service Report are due on the prior Friday. If the due date
falls on a City holiday, the Billing Voucher and Service Report is due the next working day
following the holiday. The report shall detail information on service units or
steps/milestones accomplished during the months/quarters as outlined in Exhibit A. The
Final Service Report Form is provided by the City and is attached as Exhibit D-1 to this
Agreement; it is also due in accordance with the schedule listed in Exhibit A.
B. For acquisition or improvement of real property projects - Projects qualifying to meet the
national objective to serve low- and moderate-income persons (under Part I, Section 3)
shall submit a demographic report providing income, race, and head of household
information for the beneficiaries of the CDBG Project, which shall cover a one year period
extending back from the date of the report. If the facility is and remains occupied during
the project, this report is due thirty (30) days after the date the project was closed. If the
facility is first occupied or reoccupied after the close of the project, the report is due one
year from the date of the last project closing.
3. FISCAL REPORTING RESPONSIBILITIES
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The Agency shall provide fiscal statements or reports as may be required from time to time
by the City, which statements or reports, or both, must indicate the status of all accounts
and funds being used to perform under this Agreement. The Agency shall maintain proper
documentation and records of all expenditures incurred pursuant to the terms of this
Agreement in a manner as will facilitate auditing by either HUD or the City.
4. AUDITS
A. If the Agency is a nonprofit corporation and expends a total of $750,000 or more in federal
financial assistance and has received federal financial assistance from the City during its
fiscal year, it shall have an independent audit conducted of its financial statement and
conditions, which shall comply with the requirements of 2 CFR Part 200, Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards.
The Agency shall provide a copy of the audit report no later than thirty (30) days after the
audit's completion or six (6) months subsequent to the end of the Agency's fiscal year,
whichever date is sooner. The Agency shall provide to the City its response and corrective
action plan for all findings and reportable conditions contained in its audit. When reference
is made in its audit to a `Management Letter" or other correspondence made by the auditor,
the Agency shall provide copies of those communications and the Agency's response and
corrective actions plan.
B. The Catalog of Federal Domestic Assistance (CFDA) number for the CDBG program is
14.218.
PART IV — RECORDKEEPING REQUIREMENTS
1. PROGRAM RECORDS AND INSPECTIONS
The Agency shall make, maintain, and preserve books and records, of whatever form,
detailing all CDBG-related expenditures and costs incurred by the Agency. All such books
and records shall be made available to representatives of the City or HUD, or both, for
formal inspection and, where necessary, copying. Intentional noncompliance with this
provision shall constitute a material breach of this Agreement.
Throughout the term of this Agreement, the Agency shall establish and maintain current the
records described in this Section. These records shall conform to the requirements and
specifications of their individual source authorities, which are cited herein. Be advised that
the listing in this Section is intended only to assist the Agency in identifying the required
records and their respective authorities, and is not all inclusive.
A. Time for Retention of Records - Except where otherwise specifically provided, all records as
of the end of the term of this Agreement shall be kept in an accessible file for four (4) years
thereafter (24 CFR § 570.502(b)(3)(ix)). Exceptions to the four (4) year retention period are
as follows: (1) Records that are the subject of litigation, claim, or audit findings shall be
retained for ten (10) years after the date all issues have been resolved and final action taken;
and (2) Records for real property and equipment shall be retained for three (3) years after its
final disposition, with the retention period starting from the date of the disposition,
replacement, or transfer at the direction of the City (24 CFR § 570.84(b)).
B. Contract and Amendments - A complete copy of this Agreement and all amendments
thereto and notices there under.
C. Records of City Approvals - Copies of all requests for amendments or revisions to this
Agreement and the City's subsequent approval or denial of such requests as are required
under this Agreement.
D. Subcontracts and Agreements - Complete copies of all contracts, subcontracts, and
agreements with third parties into which the Agency enters in the performance under this
20
Agreement; and all correspondence, reports, and other documentation pertaining to such
contracts, subcontracts, and agreements.
E. Records identifying the assisted activity - A complete description of each activity assisted,
in whole or in part, with CDBG funds under this Agreement, including:
(1) Location(s), organization, operating hours, qualifications for service or participation,
etc.;
(2) Fees or charges for services, fee waivers, or fee scales for CDBG-assisted participants.
F. Additional Contract Requirements - The Agency shall submit to the City a copy of the most
recent independent financial audit and a current list of the Agency's board of directors.
2. PROGRAM BENEFIT RECORDS - 24 CFR § 570.506(b).
As applicable, the following categories of records shall be maintained, for the discrete
activities which are assisted in whole or in part with funding under this Agreement (or for all
the Agency's activities if funding under this Agreement is not specifically allocated to
particular activities) for the purpose of documenting that a majority of the beneficiaries are
persons of low- or moderate-income.
A. Records specifying by dollar amount, family size, and household income limits used to
determine income level;
B. For service activities serving individual clients without regard to their residence location
within the City/County, records documenting: (a) manner in which each client's income is
determined in all cases; (b) determination that each individual client's income is or is not
within low- or moderate-income limits; (c) date determination was made; and (d) tabulation
of the individual determinations.
C. For a service or facility which exclusively serves a class of beneficiaries, the members of
which are presumed to be low- or moderate-income eligible absent general evidence to the
contrary (abused children, battered spouses, senior citizens, adults meeting the Bureau of
the Census' Current Population Reports definition of "severely disabled," homeless persons,
illiterate persons, persons living with AIDS and migrant farm workers), records
documenting: (1) that the facility exclusively serves the eligible class; and (2) there is no
generally available data indicating specific population served is not predominantly low- or
moderate-income.
D. For a service or facility which offers benefits uniformly without regard to income to all
persons residing within a delineated area, records establishing: (1) boundaries of the
service area; (2) the income characteristics of families and unrelated individuals in the
service area; and (3) if the percent of low- and moderate-income persons in the service
area is less than fifty-one (51) percent, data showing that the area qualifies under the
exception criteria set forth at 24 CFR § 570.208(a)(1)(ii).
3. FINANCIAL RECORDS
Agency shall maintain a financial management system in accordance with 2 CFR § 200.302 and
24 CFR 570.506(h). Agency shall maintain all accounting records that accurately record the
source and application of all funds. The records must contain information pertaining to Federal
awards, authorizations, obligations, unobligated balances, assets, expenditures, income and
interest and be supported by source documentation.
Agency shall maintain evidence to support how the CDBG funds provided to such entities are
expended. Such documentation must include, to the extent applicable, invoices, schedules
containing comparisons of budgeted amounts and actual expenditures, construction progress
schedules signed by appropriate parties (e.g., general contractor and/or a project architect),
21
and/or other documentation appropriate to the nature of the activity. Agency records pertaining
to obligations, expenditures, and drawdowns must be able to relate financial transactions to
either a specific on in grant or to program income received during a specific program
year.
Financial records, supporting documents, statistical records, and all other records pertinent to a
Federal award shall be retained for a period of three years from the date of submission of the
final expenditure report or, for Federal awards that are renewed quarterly or annually, from the
date of the submission of the quarterly or annual financial report, respectively, as authorized by
the Federal awarding agency. The only exceptions are the following:
A. If any litigation, claim, or audit is started before the expiration of the three-year period, the
records shall be retained until all litigation, claims, or audit findings involving the records
have been resolved and final action taken.
B. Records for real property and equipment acquired with Federal funds shall be retained for
three years after final disposition.
C. When records are transferred to or maintained by the Federal awarding agency, the three-
vear retention requirement is not applicable to the recipient.
D. This section does not apply to records maintained by contractors or subcontractors.
2 CFR § 200.333.
4. RECORDS OF PROGRAM OPERATIONS, MANAGEMENT AND EVALUATION
Agency shall maintain all records of:
A. Operating policies and procedures;
B. Employee qualifications, training, and evaluation;
C. Principal operations data: work units completed; clients served, classified by client and
service characteristics; staff hours utilized; etc.
D. Self-evaluation of services, programs, and employment practices for compliance with 504
and ADA requirements.
S. PROPERTY RECORDS
Agency shall maintain all records identifying any real and personal property acquired or
improved in whole or in part with funds under this Agreement as follows:
A. Itemized inventory of real property recording legal and common descriptions and address,
date of acquisition and/or improvements, cost of acquisition and/or improvements, and
CDBG-funded share of cost;
B. Itemized inventory of all non-expendable personal property recording full identification,
current location, date and cost of acquisition, and CDBG-funded share of cost;
C. Complete records of any authorized disposition of real or non-expendable personal property
including how and to whom disposed, date, amount of disposition proceeds, market value at
time of disposition and how determined, intended use, and any conditions governing use
following disposition;
D. At the termination of this Agreement, a record of the total purchase cost of all remaining
unused expendable personal property.
22
E. Agency shall submit reports at least annually on the status of real property in which the
Federal government retains an interest, unless the Federal interest in the real property
extends 15 years or longer (2 CFR 200.329).
6. NONDISCRIMINATION AND EQUAL-OPPORTUNITY RECORDS — 24 CFR § 570.506(g).
Agency shall maintain:
A. A recordation and tabulation of the racial classification of all individual persons or
households receiving program benefits, and of whether these benefited persons are single
head of household.
B. A tabulation of all Agency employees classified by race, position, and salary in the format of
the U.S. Equal Employment Opportunity Commission Form EEO-4.
C. Data identical to that required under A. and B. above for any subcontractor or agent
employed in the performance under this Agreement.
D. Documentation of all substantive actions taken to assure that no prohibited discrimination
occurs in the conduct of any of the Agency's operations.
E. Documentation of all actions taken to make minority residents aware of the Agency's
services and provide them with equal access to benefits.
F. Record of the racial classification and gender of the majority owners of each private for-
profit business with which the Agency contracts with any funds provided under this
Agreement.
7. CONFLICT OF INTEREST
A. Records documenting that all Agency board members, officers, employees and consultants
have been informed of the conflict of interest provisions of 24 CFR § 570.611 and have
acknowledged understanding those provisions.
B. Complete records of all requests for exceptions submitted under 24 CFR § 570.611(d).
S. VERIFICATION OF SUBCONTRACTOR'S ELIGIBILITY — 24 CFR § 5.
The Agency shall maintain records documenting that the Agency, all subcontractors, and
consultants have been determined not to be currently debarred, suspended, denied
participation or declared ineligible to participate in federal government funded programs.
Verification of eligibility shall be accomplished by signing the Certification Regarding
Debarment and Suspension, which is attached and incorporated as Exhibit F .
9. ADDITIONAL REQUIREMENTS FOR ACQUISITION OR IMPROVEMENT OF REAL PROPERTY PROJECTS
A. For construction contracts over $100,000, records documenting compliance with the
bonding requirements of 24 CFR § 85.36 (h).
B. Flood Insurance, Flood Disaster Protection Act of 1973; and Federal Insurance
Administration Notice in Federal Register Vol. 24, No. 133, July 13, 1989.
(1) Record of determination whether the assisted project is located within a designated flood
plain or flood hazard area.
(2) If the project is within such area: (1) Evidence of current participation in the National
Flood Insurance Program; and (2) Evidence of flood insurance coverage in force on all
significant project structures.
C. Lead-Based Paint — Records required to document compliance with the Lead-Based Paint
Poisoning Prevention Act (42 U.S.C. §§ 4801, et seq.), as amended and the Residential
23
Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. §§ 4851, et seq.), and the
implementing regulations 24 CFR § 35.
D. Labor Standards - Records required to document compliance with all requirements of Davis-
Bacon and Related Acts (40 U.S.C. §§ 3141 and 3142); Contract Work Hours and Safety
Standards Act (40 U.S.C. § 3701, et seq.); Copeland Act (18 U.S.C. § 874); US Secretary of
Labor Regulations (29 CFR §§ 3, 5, 6, and 7).
E. Real Property Acquisition and Relocation - Records required to document compliance with
the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, 42
U.S.C. §§ 4601, et seq., as amended; and the implementing regulations 49 CFR § 24. The
agency shall consult the City for complete instruction prior to undertaking any action which
may result in displacement of persons as defined at 49 CFR § 24.2(g).
F. Miscellaneous Records - The Agency shall maintain such other records as may be required
by HUD or the City.
24
ST. STEPHEN HOUSING ASSOCIATION: CITY OF KENT:
Sign in blue or black ink only
L By:
By: (signature)
(signature) Print rame: Julie Parascondola, CPRE
Its: Director
Print Name: Ann Allen Parks, Recreation & Community
Its: Executive Director Services Department
(title)
/ DATE:
11 6
DATE: - 15-/9
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
Ann Allen, Executive Director CITY OF KENT:
St. Stephen Housing Association Dinah Wilson, CDBG Coordinator
13055 SE 192nd Street
Renton, WA 98058 City of Kent
220 Fourth Avenue South
Kent, WA 98032
Phone: 253.638.9798 Phone: 253.856.5076
25
/KENT EXHIBIT A
WAS H 14OTON 2019-2020 CDBG PROJECT SCOPE OF SERVICES
PARKS, RECREATION & St. Stephen Housing Association
COMMUNITY SERVICES
Project Title: Transitional Housing Start Date: 1/1/19
Project No.: BG1923-2023 End Date: 12/31/20
City of Kent Federal Award Identity Number (FAIN) B-19-MC-53-0017
B-20-MC-53-0017
Funding will provide temporary housing and support 2019 $15,000.00
services to families and children. Fundin :
2020 $15,000.00
Funding
Total City of $30,000.00
Kent Funds:
Project Manager: Ann Allen
Telephone: 253.638.9798 Fax: 866.861.6294 E-mail: aallen@ststephenhousing.org
CDBG Coordinator/City Contact: Dinah Wilson
Telephone: 253.856.5076 Fax: 253.856.6070 E-mail: drwilson@kentwa.gov
St. Stephen Housing Association (hereinafter referred to as "the Agency") shall
utilize City of Kent Community Development Block Grant funds to perform the activities
specified below. Such services shall be provided in a manner which fully complies with all
applicable federal, state and local laws, statutes, rules and regulations, as are now in effect
or may be hereafter amended.
1) Project Budget
The Agency shall apply the following funds to the project in accordance with the 2019
Line Item Budget Summary below:
Line Item Budget
Personnel Services $15,000.00
Other $0
Total City of Kent Funds: $15,000.00
2) Performance Measures
A. Number Served
The Agency agrees to serve, at minimum, the following number of persons each year of
the CDBG Agreement:
2019-2020 SSHA CDBG Revised Project Scope of Services: Agreement with City of Kent- Page 1
Reporting Periods 1st 2nd 3rd 4th
Quarter Quarter Quarter Quarter Total
JAN. - APRIL - ]ULY- OCT. - Per
MARCH
DUNE SEPT. DEC. Year
Persons assisted (# of
unduplicated individuals) 6 6 6 7 25
B. Units of Service
The Agency agrees to provide, at minimum, the following units of service by quarter:
Reporting Periods 1st 2nd 3rd 4th
Quarter Quarter Quarter Quarter Total
JAN. to April to JULY to Per
June OCT. to
MARCH SEPT. DEC. Year
Bed-nights (# of bed-nights
based on households 456 456 456 457 1825
served')
D. Definition of Services
Bed-nights: A bed-night equals one night of shelter in transitional housing per individual
served.
3) Records
A. Project Files
The Agency shall maintain files for this project containing the following items (all Agency
files must contain items 1 — 8, however items 9 — 17 are required only if the costs
are paid for by the CDBG budget:
1. Notice of Grant Award.
2. CDBG Agreement and all contract exhibits.
3. Motions, resolutions, or minutes documenting Board or Council actions.
4. A copy of this Scope and the City's Notice to Proceed on this project.
5. Correspondence regarding budget revision requests.
6. Copies of all invoices and reports submitted to the City for this project.
7. Bills confirming amount of rent or utilities for payment.
8. Documentation of client income. Unless clients are presumed eligible based on
CDBG regulations, the Agency shall screen all clients served with funds
provided under this Contract to ensure that at least 51% of the total number of
clients served do not have a gross annual family income in excess of the limits
specified in Exhibit B.
Adjusted gross income as defined by the Internal Revenue Service Form 1040
shall be used to determine persons' or households' income. The following
methods may be used to determine income eligibility:
This project will serve 25 individuals and five households.
2019-2020 SSHA CDBG Revised Project Scope of Services: Agreement with City of Kent- Page 2
a) IRS income tax return;
b) Client income certification on a form approved by the City; or
c) Documentation of qualification for participation in a "means-tested"
federal or state program at least as restrictive as CDBG with regard to
Income Guidelines.
Income guidelines may be adjusted periodically by HUD. The Agency agrees to
use updated Income Guidelines, which will be provided by the City.
9. Copy of agency check made out to vendor.
10. Client ID verification.
11. Verification of client address.
12. Copies of approved invoices and warrants.
13. Payroll time sheets for actual salary and fringe benefit costs. Time sheets must
be signed by a supervisor and annotated to document percent of time charged
against this project if less than full time.
14. Documentation of office costs (e.g., log sheets of copy machine use, postage,
telephone use, costs of office supplies, etc.) when these costs are shared with
other programs and no invoice is available. As an alternative, annotated
invoices may be used to document charges as appropriate.
15. Documentation of mileage charges for private auto use must include: a)
odometer reading at beginning and end of trip, b) destination and starting
location, and c) purpose for trip.
16. Documentation of the solicitation process used to select vendors and
subcontractors with original purchase orders and subcontracts.
17. Documentation required by Part IV, Paragraph 5, if any funds provided under
this Scope are used to acquire equipment.
B. Record Retention Period
All records required by this Scope shall be retained by the Agency for the period of time
specified in the Agreement - Part IV. The period of time shall commence on January 1 of
the year following the year in which the final invoice was paid.
4) Reports, Invoicing and Reporting Schedule
A. Reports
The Agency shall collect and report client information to the City quarterly on the Service
Units section of Exhibit D (Billing Voucher and Service Report) to be provided by the City.
Exhibits D and D-1 (including backup documents) shall be submitted electronically to
drwilson(Okentwa.gov in accordance with the schedule outlined in Paragraph 3.B. below.
Copies of supporting documents shall be emailed as well, or sent via the U.S.
Postal Services and postmarked within two days of the due dates listed below.Z
'- if the due date falls on a Saturday or Sunday, Billing Vouchers and Service Reports are due on the prior Friday. If
the due date falls on a City holiday, Billing Vouchers and Service Reports are due the next working day following
the holiday.
2019-2020 SSHA CDBG Revised Project Scope of Services: Agreement with City of Kent- Page 3
B. Reporting Schedule
The Agency shall submit Billing Vouchers and Service Reports to the City in accordance with
the following schedule:
3rd Quarter Billing Voucher & Service 151h day following each quarter
Re ort Exhibit D
4th Quarter Billing Voucher & Service December 10, 2019
Report
CDBG Public Services Project Time 15th day following each quarter
Sheet
Exhibit G if applicable)
Final Service Report (Exhibit D-1) January 10, 2020
2019-2020 SSHA CDBG Revised Project Scope of Services: Agreement with City of Kent- Page 4
EXHIBIT B
INCOME GUIDELINES
Effective 4/24/19
Median Family Income = $108,600
*Median 50% 800/0
MEDIAN MEDIAN
FAMILY EXTREMELY VERY LOW
SIZE LOW LOW INCOME
INCOME INCOME
1 $23,250 $38,750 $61,800
2 $26,600 $44,300 $70,600
3 $29,900 $49,850 $79,450
4 $33,280 $55,350 $88,250
5 $35,900 $59,800 $95,350
6 $38,550 $64,250 $102,400
7 $41,200 $68,650 $109,450
8 $43,850 $73,100 $116,500
*The FY 2014 Consolidated Appropriations Act changed the definition
of extremely low-income to be the greater of 30/50ths (60%) of the
Section 8 very low-income limit or the poverty guideline as established
by the Department of Health and Human Services (HHS), provided
that this amount is not greater than the Section 8 50% very low-
income limit. Consequently, the extremely low-income limits may
equal the very low (50%) income limits.
Income Limit areas are based on FY 2019 Fair Market Rent (FMR)
areas.
EXHIBIT C
APPOINTMENT OF LIAISON &
AUTHORIZATION TO SIGN BILLING VOUCHERS & SERVICE REPORTS
2019-2020 CDBG AGREEMENT
The Agency appoints the following person as the liaison for the CDBG
Agreement between the City and the Agency; this person shall be responsible
for overall administration of the CDBG funded program:
Ann 41/e-7 �k ee-a/7 ✓G��r��
Liaison: (title)
Authorization to Sign Billing Vouchers & Service Reports
The Agency authorizes the following individual(s) to sign Billing Vouchers &
Service Reports for costs incurred and services provided pursuant to the
CDBG Agreement between the Agency and the City; billing vouchers shall
not be processed for payment unless they are signed by an authorized
individual(s):
Authorized
Individual(s):
A-nrr � /lei (title)
-i,5-�9
(Type Name) (title)
(Signature)
Additional Authorized IIndividual (if applicable):
(Type Name) (title)
(Signature)-�
(Date)
� Exhibit D CDBG
KENO W A 5 H I N GTO N Billing Voucher & Service Report
PARKS, RECREATION & 2019
COMMUNITY SERVICES
Agency: St. Stephen Housing Association
To: Dinah Wilson, City of Kent 3547 S. 239th St.
Housing & Human Services Kent, WA 98032 (Mailing: 13055 SE 192nd
Parks, Recreation & Community Services Street, Renton, WA 98058)
220 4th Ave. South, Kent, WA 98032
drwilson@kentwa.gov Program Contact: Ann Allen
Phone: (253) 856-5076 Telephone: 253.638.9798
E-mail: aallen@ststephenhousing.org
Reporting Period Program Amount Requested
Transitional Housing Project $
SEC. 1 : BUDGET SUMMARY
For Department Use Only Total Contract Amount $ 30,000.00
2019 Contract Amount $ 15,000.00
Amount Requested This Qtr. $
Amount Requested YTD $
Amount Remaining (subtract
amount requested YTD from 2019
contract amount
SEC.2: 2019 LINE ITEM BUDGET SUMMARY
ORIGINAL TOTAL REVISED CUMULATIVE
COST CATEGORIES BUDGET REQUESTED BUDGET TO DATE
1 Personnel
Attach Time Sheets $15,000.00
2 Other $0
GRAND TOTAL
$15,000.00
Page 1 of 5
SEC. 3: PERSONNEL FUNDED IN WHOLE OR IN PART BY CDBG GRANT
SEC. 4: PERFORMANCE MEASURES - 2019 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
Service Unit Description Contracted to Serve Total Clients Actually Year to Date
Contracted Served Total
Total
Service Unit/Performance
Measure 1 Sc 2nd 3rd 4cn Contracted 1st 2nd 3rd 4th
to Serve
Unduplicated # of Kent clients
individuals served 6 6 6 7 25
Bed-Nights (# of bed-nights
based on households served') 456 456 456 457 1825
Sec. 5: NARRATIVE
Provide a narrative explanation if you are behind in either progress toward meeting performance
measures or projected expenditure rate.
' This project will serve 25 individuals and five households.
Page 2 of 5
Sec. 6: DEMOGRAPHIC INFORMATION
Number of Households or Persons Assisted (please specify "H" or "P"):
Race Unduplicated Unduplicated Undup. Unduplicated
Quarter Quarter(Hispanic) Year to Year to Date
(All) Date (Hispanic)
All
1 2 3 4 1 2 3 4
White
Black/African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native AND White
Asian AND White
Black/African American AND White
American Indian /Alaska Native AND
Black/African American
Other Multi-Racial
GRAND TOTAL CLIENTS
Income Level Unduplicated Quarter Unduplicated Year
to Date
1 2 3 4
Extremely Low Income 0-30% of MFI
Low Income 31-50% of MFI
Moderate Income 51-80% of MFI
Above Moderate Income 81% + of MFI
GRAND TOTAL CLIENTS
Homeless* Complete only for individuals & families who Unduplicated Quarter Unduplicated Year
have been assisted with transitional and permanent housin to Date
1 2 3 4
Individuals
Families
Total Homeless
Page 3 of 5
By signing this report, I certify to the best of my knowledge and belief that the report is true, complete,
and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives
set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or
fraudulent information, or the omission of any material fact, may subject me to criminal, civil
or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title
18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).
Agency Authorized Signature Date
Payment Authorization this section to be completed by City of Kent only)
Contractual Obligations Met?
YES NO Circle one
Enter notes if Agency underperformed:
Authorized Date:
By:
Page 4 of 5
Instructions
Refer to: Accomplishments by Performance Measures in your CDBG Contract.
Sec. 1: BUDGET SUMMARY
Enter the amount requested this quarter, Year to Date(YTD)and the budget balance.
SEC.2: LINE ITEM BUDGET SUMMARY
Enter the amount requested by budget line item quarterly and YTD.
SEC. 3: PERSONNEL FUNDED IN WHOLE OR IN PART BY CDBG GRANT
Enter the names and titles of personnel being charged to the CDBG grant. Remember all hours charged to CDBG must be tracked and
a timesheet certifying the hours worked were to directly support the CDBG funded program must be signed by the employee and
supervisor and submitted to the City with the request for reimbursement.
SEC.4: PERFORMANCE MEASURES
Unduplicated Count of Households/Persons Assisted
Projections: Circle either persons or households according to the method of counting clients specified in your CDBG Contract Scope.
Insert the projected number of clients to be served as specified in your CDBG Contract Scope.
Achievements: Insert the unduplicated number of clients served during the reporting period. Unduplicated number means that a
person or a household served by your agency may be counted only once during the calendar year. You may report only those persons
or households for which you maintain written records. This record must be established at the time the person or household is first
served by your agency.
Year to Date: Insert the total unduplicated number of clients served to date.
Service Units
Insert the service unit measures specified in your CDBG Contract Scope. Insert the projected number of service units for the reporting
period. Insert the actual number of service units provided during the Reporting Period. The actual number of service units provided may
be duplicated counts. Duplicated means that a client served by your agency may receive service one or more times during the calendar
year in one or more of the service unit categories.
SEC. 5: NARRATIVE EXPLANATION
You must provide a narrative explanation if your agency is behind in meeting either performance measures specified in your CDBG
Contract Scope or your expenditure rate. Your expenditure rate should equal approximately one quarter of your HHS contract amount
per quarter.
SEC. 6: DEMOGRAPHIC INFORMATION
Race: You are required to collect racial and ethnic information for the clients served. There are 10 race categories to select from. Each
client should select one of these categories. Clients identifying themselves as
Hispanic also need to select from the race categories.
Example: A client selects Hispanic as his ethnicity and white as his race. The grand total in the first column will not match the grand
total in the second column. You may only have a few clients who identify as Hispanic.
Female Head of Household: Insert the unduplicated number of single female head of households with dependents served during the
reporting period.
Income Only for Non-presumed Benefit Projects which require income screening: Insert the unduplicated clients served who are
Low Income(51 —80%), Very Low-Income(31-50%)and Extremely Low-Income(0-30%). You do not have to complete if your
CDBG project directs services toward the following clients: abused children, elderly persons, DV victims, homeless persons, those
meeting the federal definition of severely disabled persons, illiterate adults, persons living with aids, or migrant farm workers.
Homeless: For programs providing transitional and permanent housing insert the unduplicated clients served.
Page 5 of 5
• Exhibit D-1 CDBG
KENT Service Report-St. Stephen Housing Association
WA5N IN*TON
PARKS, RECREATION & 2019
COMMUNITY SERVICES
To: Dinah Wilson, CDBG Coordinator From: Ann Allen, Executive Director
Housing & Human Services St. Stephen Housing Association
Parks, Recreation & Community Services 3547 S. 239th St.
220 411 Ave. South, Kent, WA 98032 Kent, WA 98032 (Mailing: 13055 SE 192nd Street,
Renton, WA 98058)
E-mail: drwilsonCabkentwa.gov E-mail: aallen@ststephenhousing.org Telephone:
Phone: 253.856.5076 Phone: 253.638.9798
Reporting Period Program
Final Q4 Transitional Housing Project
SEC. 1: PERFORMANCE MEASURES - 2019 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
Service Unit Description Contracted to Clients Actually Year to
Serve Served Date Total
Service Unit/Performance 1st 2nd 3rd 4th 1st 2nd 3rd 4th
Measure
Unduplicated # of Kent clients
(persons) served 6 6 6 7
Bed-Nights (# of bed-nights based
on households served') 456 456 456 457
Sec. 2: NARRATIVE
Provide a narrative explanation if you did not meet performance measures for the contract year
This project will serve 25 individuals and five households.
Page 1 of 3
Sec. 3: DEMOGRAPHIC INFORMATION
Number of Households or Persons Assisted (please specify "H" or "P"):
Race Unduplicated Unduplicated Undup. Unduplicated
Quarter Quarter Year to Year to Date
(All) (Hispanic) Date (Hispanic)
(All
1 2 3 4 1 2 3 4
White
Black/African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native AND
White
Asian AND White
Black/African American AND White
American Indian /Alaska Native AND
Black/African American
Other Multi-Racial
GRAND TOTAL CLIENTS
Income Level Unduplicated Quarter Unduplicated
Year to Date
1 2 3 4
Extremely Low Income 0-30% of MFI
Low Income 31-50% of MFI
Moderate Income 51-80% of MFI
Above Moderate Income 81% + of MFI
GRAND TOTAL CLIENTS
Page 2 of 3
Homeless * Complete only for individuals & families Unduplicated Quarter Unduplicated
who have been assisted with transitional and Year to Date
permanent housin
1 2 3 4
Individuals
Families
Total Homeless
Final Service Report Review this section to be completed by City of Kent only)
Contractual Obligations Met?
YES NO (Circle one)
Agency Paid in Full?
YES NO (Circle one)
Enter explanation if Agency underperformed and paid in full:
Reviewed Date:
By:
Page 3 of 3
EXHIBIT E
ST. STEPHEN HOUSING ASSOCIATION
INSURANCE REQUIREMENTS FOR
2019-2020 CDBG AGREEMENT
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 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. 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.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with limits no
less than $1,000,000 each occurrence, $2,000,000 general aggregate
and a $1,000,000 products-completed operations aggregate limit.
2. Automobile Liability insurance with a minimum combined single limit
for bodily injury and property damage of $1,000,000 per accident.
EXHIBIT E (Continued-page 2 of 2)
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.
StSHA3Revised
Non Profit Insurance Program
CERTIFICATE OF COVERAGE Issue Date: 04/25/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND,EXTEN D OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE DOES NOT CONSTITUE A CONTRACT
BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTAT IVE OR PRODUCER,AND THE CERT IFICATE HOLDER.
------------------------------------------------------------------------------------------------
IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed If SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain coverage may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER COMPANIES AFFORDING COVERAGE
GENERAL LIABILITY
Clear Risk Solutions American Alternative Insurance Corporation, et al.
451 Diamond Drive
Ephrata, WA 98823 AUTOMOBILE LIABILITY
American Alternative Insurance Corporation,et al.
INSURED
PROPERTY
St. Stephen Housing Association American Alternative Insurance Corporation, et al.
13055 S.E. 192nd Street MISCELLANEOUS PROFESSIONAL LIABILITY
Renton, WA 98058 Princeton Excess and Surplus Lines Insurance Company
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1-A2-RL-0000013-09 11/08/2018 06/01/2020 PER OCCURRENCE $1,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $2,000,000
INCLUDES STOP GAP PRODUCT-CO MP/OP $1,000,000
PERSONAL&ADV.INJURY $1,000,000
(LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
AUTOMOBILE LIABILITY
ANY AUTO N1-A2-RL-000001 3-09 11/08/2018 06/01/2020 COMBINED SINGLE LIMIT $1,000,000
(LIABILITY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
PROPERTY
N1-A2-RL-000001 3-09 11/08/2018 06/01/2020 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC EXCLUDED
FLOOD PER OCC EXCLUDED
(PROPERTY IS SUBJECT TO A$50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3-RL-0000060-09 11/08/2018 06/01/2020 PER CLAIM $1,000,000
(LIABILITY IS SUBJECT TO A $50,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Regarding 2019-2020 CDBG Agreement. City of Kent is named as Additional Insured regarding this agreement only and is
subject to policy terms, conditions, and exclusions. Additional Insured endorsement attached.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLI CY PROVISIONS.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE
Attn: Dinah R Wilson
City of Kent
220 Fourth Ave South fiL_
Kent, WA 98032
3526156
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED- DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program (NPIP)
Policy Number Endorsement Effective
N 1-A2-RL-0000013-09 6/1/2018
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization(Additional Insured): As Per Schedule on file with Clear Risk Solutions, Underwriting Administrator
Attn: Dinah R Wilson
City of Kent
220 Fourth Ave South
Kent,WA 98032
Regarding 2019-2020 CDBG Agreement.City of Kent is named as Additional Insured regarding this agreement only and is
subject to policy terms,conditions,and exclusions. Additional Insured endorsement attached.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions, Definitions
and Exclusions section of this policy is amended to include as an Insured the Person or Organization shown in the above
Schedule. Such Person or Organization is an Insured only with respect to liability for Bodily Injury,Property Damage,or
Personal and Advertising Injury caused in whole or in part by your acts or omissions or the acts or omissions of those
acting on your behalf:
1. In performance of your ongoing operations;or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement;or
2. Declarations for this policy,
whichever is less.These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Includes copyrighted material of the Insurance Services Office, Inc.,with its permission.
RL 2163 12/12 Page 1 of 1
3526157
EXHIBIT F
City of Kent
2019-2020 Certification Regarding Debarment and Suspension
St. Stephen Housing Association Transitional Housing/ BG1923-2023
Agency Name of Project/Project Number
Certification A: Certification Regarding Debarment, Suspension, and
Other Responsibility Matters - Primary Covered Transactions'-
1. The prospective primary participant certifies to the best of its knowledge
and belief that its principals;
a. Are not presently debarred, suspended, proposed for debarment, declared
ineligible, or voluntarily excluded from covered transactions by any Federal
debarment or agency;
b. Have not within a three-year period preceding this proposal, been
convicted of or had a civil judgment rendered against them for commission of
fraud or a criminal offense in connection with obtaining, attempting to obtain,
or performing a public (Federal, State, or local) transaction or contract under
a public transaction; violation of Federal or State antitrust statutes or
commission of embezzlement, theft, forgery, bribery, falsification, or
destruction of records, making false statements, or receiving stolen property;
c. Are not presently indicted for or otherwise criminally or civilly charged by a
governmental entity (Federal, State, or local) with commission of any of the
offenses enumerated in paragraph (1)(b) of this certification; and
d. Have not within a three-year period preceding this application/ proposal
had one or more public transactions (Federal, State, or local) terminated for
cause or default.
2. Where the prospective primary participant is unable to certify to any of the
statements in this certification, such prospective participant shall attach an
explanation to this proposal.
' The Agency shall notify the City if it is disbarred after this certification is signed. The City is responsible
for checking the excluded parties list in SAM on an annual basis.
1 of 4
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 which this proposal is submitted if at any
time the prospective primary participant learns that its certification was
erroneous when submitted or has become erroneous by reason of changed
circumstances.
5. The terms covered transaction, debarred, suspended, ineligible,
lower tier covered transaction, participant, person, primary covered
transaction, principal, proposal, and voluntarily excluded, as used in
this clause, have the meanings set out in the Definitions and Coverage
sections of the rules implementing Executive Order 12549. You may contact
the department or agency to which this proposal is being submitted for
assistance in obtaining a copy of these regulations.
6. The prospective primary participant agrees by submitting this proposal
that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covered transaction, unless authorized by the department
or agency entering into this transaction.
7. The prospective primary participant further agrees by submitting this
proposal that it will include the clause titled 'Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier
Covered Transaction," provided by the department or agency entering into
this covered transaction, without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a certification of a
prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A participant
may decide the method and frequency by which it determines this eligibility
of its principals. Each participant may, but is not required to, check the Non-
2 of 4
procurement List.
9. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and information of a
participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
10. Except for transactions authorized under paragraph (6) of these
instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency may terminate this
transaction for cause of default.
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 (S)
1. By signing and submitting this proposal, the prospective lower tier
participant is providing the certification set out below.
2. The certification in this clause is a material representation of fact upon
which reliance was placed when this transaction was entered into. If it is later
determined that the prospective lower tier participant knowingly rendered an
erroneous certification, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency with which this
transaction originated may pursue available remedies, including suspension
and/or debarment.
3. The prospective lower tier participant shall provide immediate written
notice to the person to whom this proposal is submitted if at any time the
prospective lower tier participant learns that its certification was erroneous
when submitted or has become erroneous by reason of changed
circumstances.
4. The terms covered transaction, debarred, suspended, ineligible,
lower tier covered transaction, participant, person, primary covered
transaction, principal, proposal, and voluntarily excluded, as used in
this clause, have the meanings set out in the Definitions and Coverage
sections of rules implementing Executive Order 12549. You may contact the
person to which this proposal is submitted for assistance in obtaining a copy
3 of 4
of these regulations.
5. The prospective lower tier participant agrees by submitting this proposal
that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covered transaction, unless authorized by the department
or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this
proposal that it will include this clause titled 'Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier
Covered Transaction," without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a
prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A participant
may decide the method and frequency by which it determines the eligibility
of its principals. Each participant may, but is not required to, check the Non-
procurement List.
8. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and information of a
participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph (5) of these
instructions, if a participant in a lower covered transaction knowingly enters
into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency with which this
transaction originated may pursue available remedies including suspension
and/or debarment.
Primary Contractor/Sub-Contractor Date
(Print Below)
A n h A/lW► 41-/4f-/9
Authorized Signature of Primary Title
Contractor/Sub-Contractor
(Si Below)
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EXHIBIT H
504/ADA DISABILITY ASSURANCE OF COMPLIANCE
COMPLETE AND RETURN WITH SIGNED CONTRACT
Complying with Section 504 of the Rehabilitation Act of 1973, as amended, and the Americans With Disabilities
Act of 1990, two federal laws which prohibit discrimination against qualified people with disabilities.
I understand that federal and state laws prohibit discrimination in public accommodations and employment
based solely on disability. In addition, I recognize that Section 504 requires recipients of federal funds (either
directly or through contracting with a governmental entity receiving federal funds) to make their programs,
services, and activities, when viewed in their entirety, accessible to qualified and/or eligible people with
disabilities. I agree to comply with, and to require that all subcontractors comply with, the Section 504/ADA
requirements. I understand that reasonable accommodation is required in both program services and
employment, except where to do so would cause an undue hardship or burden.
I agree to cooperate in any compliance review and to provide reasonable access to the premises of all places
of business and employment and to records, files, information, and employees therein to the City of Kent for
reviewing compliance with Section 504 and ADA requirements.
I agree that any violation of the specific provisions and terms of the 504/ADA Disability Assurance of
Compliance and/or Corrective Action Plan required herein or Section 504 or the ADA, shall be deemed a
breach of a material provision of the Contract between the City of Kent and the Contractor. Such a breach shall
be grounds for cancellation, termination, or suspension, in whole or in part, of this Contract by the Kent.
According to the responses to the questions in the 504/ADA Self-Evaluation �YEJS ' NO
Questionnaire, (company name) sf• Stl�;011f-*7 �s.soG Un-
is in compliance with 504/ADA.
If the above response is NO, the following corrective actions will be taken:
Corrective Action Plan
The following Corrective Action Plan is submitted to comply with Section 504 and ADA requirements.
General Requirements
Actions To Be Taken Completion Date
Program Access
Actions To Be Taken Completion Date
504/ADA Contract Form 9/17
Page 1
504/ADA DISABILITY ASSURANCE OF COMPLIANCE (continued)
Employment and Reasonable Accommodation
Actions To Be Taken Completion Date
Physical Accessibility
Actions To Be Taken Completion Date
1 Declare Under Penalty of Perjury under the Laws of the State of Washington that the
Foregoing i True and rrect.
Signature of authorized signator
Aerr 4 I/el , 263- 9799
Type or print name of authorized signator Title Telephone
For Notary: t
State of V✓1�.5�i��4 f f.�'! , County of �-
Signed and swom before me on (date) • o61 ��� 010/g by (print authorized
signatory name) t7 Allol
- - - - - - - -
DAWN M SMITH Notary signature:
Notary Public Notary (print name):
State of Washington
My Appointment Expires My appointment expires: 1ln� { �2
Jun 3,2021
Contractor:
Company N e
Street Address
City State Zip
504/ADA Contract Form 9/17
Page 2