HomeMy WebLinkAboutPK11-084 - Original - South King County Council of Human Services - Capacity Building Project - 12/27/2010 KE N T Records M,4:rMgemen 4
Wa„,„Gro„ Document
CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission
to City Clerks Office. All portions are to be completed.
If you have questions, please contact City Clerk's Office.
Vendor Name: South King Council of Human Services
Vendor Number: 33386
JD Edwards Number
Contract Number:
This is assigned by City Clerk's Office
Project Name: Capacity Building Project
Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract
❑ Other:
Contract Effective Date: 01-01-11 Termination Date: 12-31-12
Contract Renewal Notice (Days): 30
Number of days required notice for termination or renewal or amendment
Contract Manager: Johnetta Rowsey Department: Parks, Human Services
Detail: (i.e. address, location, parcel number, tax id, etc.):
Human Services 1% General Fund CSA
S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08
KENT
WASH I..'.
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
South King Council of Human Services
Capacity Project
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation
(hereinafter the "City"), and South King Council of Human Services organized under the laws of
the State of Washington, located and doing business at 4800 South 188 to Street, Suite 232, Sea
Tac, WA 98188 (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
Consultant shall perform the following services for the City in accordance with the
following described plans and/or specifications:
Grant writing assistance, focus of program areas, community collaborations, and/or
regional meetings with particular groups to build capacity. The project will identify
appropriate resources and/or convene necessary meetings including outreach to the
Kent Food Bank, Lucy Lopez Community Center and New Connections Program.
Exhibit A, Scope and Schedule of Work; Exhibit B, Billing Voucher and Service
Report; Exhibit C, Kent Outcomes Report; Exhibit D, Demographic Report; Exhibit
E, Insurance Certificate; and Exhibit F, Debarment Certification.
Consultant further represents that the services furnished under this Agreement will be
performed in accordance with generally accepted professional practices within the Puget Sound
region in effect at the time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks
described in Section I above immediately upon the effective date of this Agreement. Upon the
effective date of this Agreement, Consultant shall complete the work described in Section I by
December 31, 2012. This Agreement, however, is contingent upon the availability of funds to be
allocated through the City's budget process. During the term of this Agreement, should the City
determine that funds to support Consultant's services are no longer available, the City shall
provide Consultant seven (7) days advance written notice of summary termination for the
services described in this Agreement.
III. COMPENSATION.
A. The City shall pay the Consultant, based on time and materials, an amount not to
exceed $15,000 ($7,500 per year) for the services described in this Agreement.
This is the maximum amount to be paid under this Agreement for the work
described in Section I above, and shall not be exceeded without the prior written
authorization of the City in the form of a negotiated and executed amendment to
this agreement. The Consultant agrees that the hourly or flat rate charged by it for
its services contracted for herein shall remain locked at the negotiated rate(s) for a
CONSULTANT SERVICES AGREEMENT - 1
(Over$10,000)
period of one (1) year from the effective date of this Agreement. The Consultant's
billing rates shall be as delineated in Exhibit A.
B. The Consultant shall submit quarter payment invoices to the City for work
performed, and a final bill upon completion of all services described in this
Agreement. The City shall provide payment within forty-five (45) days of receipt of
an invoice. If the City objects to all or any portion of an invoice, it shall notify the
Consultant and reserves the option to only pay that portion of the invoice not in
dispute. In that event, the parties will immediately make every effort to settle the
disputed portion.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent
Contractor-Employer Relationship will be created by this Agreement. By their execution of this
Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following
representations:
A. The Consultant has the ability to control and direct the performance and
details of its work, the City being interested only in the results obtained
under this Agreement.
B. The Consultant maintains and pays for its own place of business from which
Consultant's services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible
for a business deduction for federal income tax purposes that existed before
the City retained Consultant's services, or the Consultant is engaged in an
independently established trade, occupation, profession, or business of the
same nature as that involved under this Agreement.
D. The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal
Revenue Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account with
the state Department of Revenue and other state agencies as may be
required by Consultant's business, and has obtained a Unified Business
Identifier (UBI) number from the State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and
earnings of its business.
V. TERMINATION. Either party may terminate this Agreement, with or without
cause, upon providing the other party thirty (30) days written notice at its address set forth on
the signature block of this Agreement. After termination, the City may take possession of all
records and data within the Consultant's possession pertaining to this project, which may be
used by the City without restriction. If the City's use of Consultant's records or data is not
related to this project, it shall be without liability or legal exposure to the Consultant.
VI. DISCRIMINATION. In the hiring of employees for the performance of work under
this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on
behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age,
sexual orientation, national origin, or the presence of any sensory, mental, or physical disability,
CONSULTANT SERVICES AGREEMENT - 2
(Over$10,000)
discriminate against any person who is qualified and available to perform the work to which the
employment relates. Consultant shall execute the attached City of Kent Equal Employment
Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion
of the contract work, file the attached Compliance Statement.
VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its
officers, officials, employees, agents and volunteers harmless from any and all claims, injuries,
damages, losses or suits, including all legal costs and attorney fees, arising out of or in
connection with the Consultant's performance of this Agreement, except for that portion of the
injuries and damages caused by the City's negligence.
The City's inspection or acceptance of any of Consultant's work when completed shall not
be grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW
4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or
damages to property caused by or resulting from the concurrent negligence of the Consultant
and the City, its officers, officials, employees, agents and volunteers, the Consultant's liability
hereunder shall be only to the extent of the Consultant's negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE
INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF
IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF
THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY
NEGOTIATED THIS WAIVER.
In the event Consultant refuses tender of defense in any suit or any claim, if that tender
was made pursuant to this indemnification clause, and if that refusal is subsequently determined
by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the
Consultant's part, then Consultant shall pay all the City's costs for defense, including all
reasonable expert witness fees and reasonable attorneys' fees, plus the City's legal costs and
fees incurred because there was a wrongful refusal on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this
Agreement.
VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the
Agreement, insurance of the types and in the amounts described in Exhibit E attached and
incorporated by this reference.
IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide
reasonable accuracy of any information supplied by it to Consultant for the purpose of
completion of the work under this Agreement.
X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents,
drawings, designs, reports, or any other records developed or created under this Agreement
shall belong to and become the property of the City. All records submitted by the City to the
Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents,
and files available to the City upon the City's request. The City's use or reuse of any of the
documents, data and files created by Consultant for this project by anyone other than
Consultant on any other project shall be without liability or legal exposure to Consultant.
CONSULTANT SERVICES AGREEMENT - 3
(Over$10.000)
XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent
contractor with the authority to control and direct the performance and details of the work
authorized under this Agreement, the work must meet the approval of the City and shall be
sub3ect to the City's general right of inspection to secure satisfactory completion.
XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all
necessary precautions and shall be responsible for the safety of its employees, agents, and
subcontractors in the performance of the contract work and shall utilize all protection necessary
for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be
responsible for any loss of or damage to materials, tools, or other articles used or held for use in
connection with the work.
XIII. MISCELLANEOUS PROVISIONS.-
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City
requires its contractors and consultants to use recycled and recyclable products whenever
practicable. A price preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of
any of the covenants and agreements contained in this Agreement, or to exercise any option
conferred by this Agreement in one or more instances shall not be construed to be a waiver or
relinquishment of those covenants, agreements or options, and the same shall be and remain in
full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by
and construed in accordance with the laws of the State of Washington. If the parties are unable
to settle any dispute, difference or claim arising from the parties' performance of this
Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by
filing suit exclusively under the venue, rules and jurisdiction of the King County Superior Court,
King County, Washington, unless the parties agree in writing to an alternative dispute resolution
process. In any claim or lawsuit for damages arising from the parties' performance of this
Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or
bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award
provided by law; provided, however, nothing in this paragraph shall be construed to limit the
City's right to indemnification under Section VII of this Agreement.
D. Written Notice. All communications regarding this Agreement shall be sent to the
parties at the addresses listed on the signature page of the Agreement, unless notified to the
contrary. Any written notice hereunder shall become effective three (3) business days after the
date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to
the addressee at the address stated in this Agreement or such other address as may be
hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written
consent of the non-assigning party shall be void. If the non-assigning party gives its consent to
any assignment, the terms of this Agreement shall continue in full force and effect and no
further assignment shall be made without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this
Agreement shall be binding unless in writing and signed by a duly authorized representative of
the City and Consultant.
CONSULTANT SERVICES AGREEMENT - 4
(Over $10,000)
G. Entire Agreement. The written provisions and terms of this Agreement, together
with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or
other representative of the City, and such statements shall not be effective or be construed as
entering into or forming a part of or altering in any manner this Agreement. All of the above
documents are hereby made a part of this Agreement. However, should any language in any of
the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms
of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and
municipal laws, rules, and regulations that are now effective or in the future become applicable
to Consultant's business, equipment, and personnel engaged in operations covered by this
Agreement or accruing out of the performance of those operations.
I. Counterparts. This Agreement may be executed in any number of counterparts,
each of which shall constitute an original, and all of which will together constitute this one
Agreement.
IN WITNESS, the parties below execute this Agreement, which shall become
effective on the last date entered below.
CONSULTANT: CITY OF KENT:
By: � By:
��(srgnature) (signature)
Print Name: fllW i `L�f� S Print am ette Cooke
Its / 4 J, /La G� bN��E� Its Mayor
Pt, I`t'e) �
DATE: ( SIB S�>�i�d DATE: /- " /O
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
Mary Ellen Stone, Chair Katherin Johnson, Housing & Human Services
South King Council of Human Services Manager
4800 South 188th Street, Suite 232 City of Kent
Sea Tac, WA 98188 220 Fourth Avenue South
Kent, WA 98032
(206) 462-6644 (telephone)
(facsimile) (253) 856-5070 (telephone)
(253) 856-6070 (facsimile)
APPROVED AS TO--FORM:
nt Law DepkFtKent
CONSULTANT SERVICES AGREEMENT - 5
(Over$10,000)
DECLARATION
CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY
The City of Kent is committed to conform to Federal and State laws regarding equal opportunity.
As such all contractors, subcontractors and suppliers who perform work with relation to this
Agreement shall comply with the regulations of the City's equal employment opportunity
policies.
The following questions specifically identify the requirements the City deems necessary for any
contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative
response is required on all of the following questions for this Agreement to be valid and binding.
If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the
directives outlines, it will be considered a breach of contract and it will be at the City's sole
determination regarding suspension or termination for all or part of the Agreement;
The questions are as follows:
1. I have read the attached City of Kent administrative policy number 1.2.
2. During the time of this Agreement I will not discriminate in employment on the basis of
sex, race, color, national origin, age, or the presence of all sensory, mental or physical
disability.
3. During the time of this Agreement the prime contractor will provide a written statement to
all new employees and subcontractors indicating commitment as an equal opportunity
employer.
4. During the time of the Agreement I, the prime contractor, will actively consider hiring and
promotion of women and minorities.
5. Before acceptance of this Agreement, an adherence statement will be signed by me, the
Prime Contractor, that the Prime Contractor complied with the requirements as set forth
above.
By signing below, I agree to fulfill the five requirements referenced above.
Dated this day of ��� , 20-L).
For: [7
Title:
Date: L �S y
EEO COMPLIANCE DOCUMENTS - 1
CITY OF KENT
ADMINISTRATIVE POLICY
NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998
SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996
CONTRACTORS APPROVED BY Jim White, Mayor
POLICY:
Equal employment opportunity requirements for the City of Kent will conform to federal and
state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee
equal employment opportunity within their organization and, if holding Agreements with the City
amounting to $10,000 or more within any given year, must take the following affirmative steps:
1. Provide a written statement to all new employees and subcontractors indicating
commitment as an equal opportunity employer.
2. Actively consider for promotion and advancement available minorities and women.
Any contractor, subcontractor, consultant or supplier who willfully disregards the City's
nondiscrimination and equal opportunity requirements shall be considered in breach of contract
and subject to suspension or termination for all or part of the Agreement.
Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public
Works Departments to assume the following duties for their respective departments.
1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these
regulations are familiar with the regulations and the City's equal employment opportunity
policy.
2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines.
EEO COMPLIANCE DOCUMENTS - 2
CITY OF KENT
EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT
This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the
Agreement.
I, the undersigned, a duly represented agent of
Company, hereby acknowledge and declare that the before-mentioned company was the prime
contractor for the Agreement known as that was entered
into on the (date), between the firm I represent and the City of
Kent.
I declare that I complied fully with all of the requirements and obligations as outlined in the City
of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity
Policy that was part of the before-mentioned Agreement.
Dated this day of , 20
By:
For:
Title:
Date:
EEO COMPLIANCE DOCUMENTS - 3
f�. Exhibit A
KENT WASMiNG*ON Scope and Schedule of Work
PARKS, RECREATIONS COMMUNITY SERVICES 9 2011-2012 Consultant Services Agreement
Agency: South King Council of Human Services 2011 Funding: $7,500
Program: Capacity Project 2012 Funding: $7 500
This funding Grant writing assistance, focus of program areas, community
will provide: collaborations, and/or regional meetings with particular groups Total: " ' $15,000
to build capacity. The project will identify appropriate resources
and/or convene necessary meetings including outreach to the
Kent Food Bank, Lucy Lopez Community Center and New
Connections Program
Annual Program Outputs: Funding Priority Area:
Technical Assistance Hours 100 Increase access to services
Program Outcome:
Increase community capacity to serve
immigrant/refugee communities
Pursuant to Item I. of the Consultant Services Agreement (CSA) executed on January 1, 2011, South King Council of
Human Services shall provide the approximate number of City of Kent clients with the following services each year of
the CSA:
Quarter Service Unit Number of Cumulative
Units Total
1st Technical Assistance Hours 25 25
2nd Technical Assistance Hours 25 50
3rd Technical Assistance Hours 25 75
4tn Technical Assistance Hours 25 100
The above services shall be provided by December 31, 2011 for year one of the two-year agreement and December
31, 2012 for year two of the agreement.
Contract Administration
The Consultant shall notify the City, in writing, within ten (10) days of any changes in program personnel or board
membership.
The Consultant shall separately report the number of clients served who reside in the newly annexed Panther Lake
area as detailed in the provided maps.
The Consultant shall provide the City with a current list of Its board of directors, general or limited partners, as
applicable.
The Consultant will hold active membership with the South King Council of Human Services http://skchs oro/
All records related to this CSA must be retained for three (3) years plus the current year.
Exhibit A (continued)
`r KENT Scope and Schedule of Work
G•O. 2011-2012 Consultant Services Agreement
PARKS, RECREATION S
COMMUNITY SERVICES
Agency: South King Council of Human Services 2011 Funding:' $7,500
Program: Capacity Project 2012 Funding, 7 500
This funding will Grant writing assistance, focus of program areas,
provide: community collaborations, and/or regional meetings with Totaf: $15,000
particular groups to build capacity. The project will Identify
appropriate resources and/or convene necessary meetings
Including outreach to the Kent Food Bank, Lucy Lopez
Community Center and New Connections Program
Reporting Requirements and Timeline
The agency will be reimbursed on a quarterly basis, upon submittal of appropriate documentation. Such
documentation will Include the following (as applicable): Billing Voucher & Service Report (Exhibit B);
Outcome Based Evaluation Report (Exhibit C); and Client Demographic Data (Exhibit D). These items must
be submitted on forms provided by the City by the loth of the following month for the previous quarter of
service. The reporting timeline is as follows:
Report Due Date "
Billing Voucher & Service Report (Exhibit B) loth day following each quarter
Final Billing Voucher (41h Qtr Exhibit B) December 15th, 2011/December 15", 2012
Outcome Based Evaluation Report (Exhibit C) January 31st, 2012/January 315t, 2013
Client Demographic Data (Exhibit D) January 31', 2012/January 315t, 2013
Signature
Please sign below to indicate acceptance of the Year 2011 and Year 2012 Performance Measures listed
above.
Mary Stone, Board Chair Date
Ka herin J nson, Fluman Services Manager Date
Exhibit B General Fund
KEN 2011 Billing Voucher
WASHINGTON and Service Report
PARKS RECREATION &
COMMUNITY SERVICES
Agency: South King Council of Human "
To: Services (SKCHS)
Johnetta Rowsey Program Contact: Nathan Phillips
Housing & Human Services to
Parks, Recreation & Community Services 4800 S 188 Street, Suite 232
220 4th Ave. South, Kent, WA 98032 Sea Tac, WA 98188
jrowsey@ci.kent.wa.us Telephone: (206) 462-6644
Phone: (253) 856-5075
E-mail: nathan@skchs.org
Reporting Period Program Amount Requested
Capacity Building Project $
BUDGET SUMMARY
FOR DEPARTMENT USE ONLY Total Contract Amount $
VENDOR NUMBER# PO# = _ _ _ __ Current Request $
AccOUNT`cODE Amount Remaining $
2011 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
New City of Total Kent Total Service
Service Unit Description Service Units Planned Kent Funded Funded Units to Date
p Each Quarter Service Units Service Units (ALL Funding
This Quarter To Date Sources)
Service Unit/Performance Measure 15 2n 3r 4 -`=
Technical Assistance Hours 25 25 25 25 -_
N
*Please attach a narrative explanation to this report in the event that the program is not meeting
performance measures.
Unduplicated Number of Residents in Panther Lake Annexed Area (quarter) (ytd)
Authorized Signature Date
FOR DEPARTMENT USE ONLY
AUTHORIZED FOR PAYMENT
BY: DATE:
Exhibit B General Fund
KENT 2012 Billing Voucher
WASHINGTON and Service Report
PARKS, RECREATION &
COMMUNITY SERVICES
Agency: South King Council of Human
To: Services (SKCHS)
Johnetta Rowsey Program Contact: Nathan Phillips
Housing & Human Services 4800 S 188th Street, Suite 232
Parks,Recreation & Community Services Sea Tac, WA 98188
2204 Ave. South, Kent, WA 98032
'jrowsey@ci.kent.wa.us
Phone: (253) 856-5075 Telephone: (206) 462-6644
E-mail: nathan@skchs.org
Reporting Period Program Amount Requested
Capacity Building Project $
BUDGET SUMMARY
FOR DEPARTMENT USE ONLY Total Contract Amount $
_VENDOR NUMBER# _ PO# Current Request $
aACCOUNT CODE Amount Remaining $
2012 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
New City of Total Kent Total Service
Service Unit Description Service Units Planned Kent Funded Funded Units to Date
Each Quarter Service Units Service Units (ALL Funding
This Quarter To Date Sources)
Service Unit/Performance Measure 1 st 2 nd 3 rd 4 th
Technical Assistance Hours 25 25 25 25
*Please attach a narrative explanation to this report in the event that the program is not meeting
performance measures.
Unduplicated Number of Residents in Panther Lake Annexed Area (quarter) (ytd)
Authorized Signature Date
FOR DEPARTMENT USE ONLY
AUTHORIZED FOR PAYMENT
BY-.T DATE:
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KENT Exhibit D Program
W`S"'""." Annual Demographic Report Date
PARKS, RECREATION S
COMMUNITY SERVICES Unduplicated Number of Clients Served*
Agency/Program Unduplicated New Individuals this Year
Client Residence**
Algona
Auburn
Black Diamond
Buren
Covington
Des Moines
Enumclaw
Federal Way
Kent
Maple Valle
Milton
Normandy Park
Pacific
Renton
SeaTac
Seattle
Tukwila
Unincorporated King Count
Unknown
TOTAL
Household Income Level
30% of Median or Below
50% of Median or Below
80% of Median or Below
Above 80%of Median
Unknown
TOTAL
Gender
Male
Female
Age TOTAL
0-4 years
5- 12 years
13- 17 years
18-34 years
35-54 years
55-74 years
75+years
Unknown
TOTAL
Ethnicit ..
A'
Asian/Pacific Islander
Black/African American
Hispanic/Latino(a)
Native Amencan/Alaskan Native
White/Caucasian
Other
Unknown
TOTAL
Femate'Headed Household
Disabling Condition
Limited English Speaking
*Unduplicated means count each client only once per calendar year
**List of all clients served in client residence category and Kent clients only in rest of the categories
EXHIBIT E
INSURANCE REQUIREMENTS FOR
SERVICE CONTRACTS
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on
ISO occurrence form CG 00 01 and shall cover liability
arising from premises, operations, independent contractors,
products-completed operations, personal injury and
advertising injury, and liability assumed under an insured
contract. The City shall be named as an insured under the
Contractor's Commercial General Liability insurance policy
with respect to the work performed for the City using ISO
additional insured endorsement CG 20 10 11 85 or a
substitute endorsement providing equivalent coverage.
2. Automobile Liability insurance covering all owned, non-
owned, hired and leased vehicles. Coverage shall be written
on Insurance Services Office (ISO) form CA 00 01 or a
substitute form providing equivalent liability coverage. If
necessary, the policy shall be endorsed to provide
contractual liability coverage.
3. Workers' Compensation coverage as required by the
Industrial Insurance laws of the State of Washington.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with
limits no less than $2,000,000 each occurrence, $2,000,000
general aggregate and a $2,000,000 products-completed
operations aggregate limit.
2. Automobile Liability insurance with a minimum combined
single limit for bodily injury and property damage of
$2,000,000 per accident.
EXHIBIT E (Continued)
C. Other Insurance Provisions
The insurance policies are to contain, or be endorsed to contain, the following
provisions for Automobile Liability and Commercial General Liability
insurance:
1. The Contractor's insurance coverage shall be primary insurance as respect
the City. Any Insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and
shall not contribute with it.
2. The Contractor's insurance shall be endorsed to state that coverage shall
not be cancelled by either party, except after thirty (30) days prior
written notice by certified mail, return receipt requested, has been given
to the City.
3. The City of Kent shall be named as an additional insured on all policies
(except Professional Liability) as respects work performed by or on behalf
of the contractor and a copy of the endorsement naming the City as
additional insured shall be attached to the Certificate of Insurance. The
City reserves the right to receive a certified copy of all required insurance
policies. The Contractor's Commercial General Liability insurance shall
also contain a clause stating that coverage shall apply separately to each
insured against whom claim is made or suit is brought, except with
respects to the limits of the insurer's liability.
D. Acceptability of Insurers
Insurance is to be placed with insurers with a current A.M. Best rating of not
less than ANII.
E. Verification of Coverage
Contractor shall furnish the City with original certificates and a copy of the
amendatory endorsements, including but not necessarily limited to the
additional insured endorsement, evidencing the insurance requirements of
the Contractor before commencement of the work.
F. Subcontractors
Contractor shall include all subcontractors as insureds under its policies or
shall furnish separate certificates and endorsements for each subcontractor.
All coverages for subcontractors shall be subject to all of the same insurance
requirements as stated herein for the Contractor.
Client#:55. )TKIN5
DATE(MWDONYYY)
ACORDn CERTIFICATE OF LIABILITY INSURANCE 05/03/2010
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Bell-Anderson Ins.-Kent C/L ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
P.O. Box 887 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
724 West Smith St.
Kent,WA 98035-0887 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Hartford Casualty Insurance Com
- South King Council of Human Services INSURER
4800 S 188th St Suite 232 INSURER C
Sea Tac,WA 98188 INSURER D
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
INSftkDO'L YPE OFINSURANCE POLICY NUMBER POLICYEFFECTIVE POLICY EXPIRATION LIMITS
LTR NSR T DATE MMIOD DATE MMIDD
A GENERALUABILTTY 52SBAVU0919 05/09/2010 05/09/2011 EACH OCCURRENCE S1 000 000
X COMMERCIAL GENERAL LIABILITY DAMAGES(RENTED
PREMISES s300 000 CLAIMS MADE F OCCUR MED EXP(Any one person) S10,000
PERSONAL&ADV INJURY $1 000 000
GENERAL AGGREGATE s2 000 000
GEN'L AGGREGATE LIMITAPPLIES PER PRODUCTS-COMPIOP AGG s2,000,000
POLICY JET FI LOC
A AUTOMOBILE LIABILITY 52SBAVU0919 05/09/2010 05/09/2011 COMBINED SINGLE LIMIT
ANY AUTO (Ea acedenf) $1,000,000
ALL OWNED AUTOS BODILY INJURY
SCHEDULEDAUTOS (Per person) $
X HIREDAUTOS BODILY INJURY
(Per accident) $
X NON-OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY y AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EAACC $
AUTO ONLY AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
S
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 52SBAVU0919 05/09/2010 05/09/2011 VJC SLIMIT OTH-
EMPLOYERS'LIABILITY
A ANY PROPRIETOR/PARTNER/EXECUrIVE WA STOP GAP E L E ACH ACCIDENT $1,000,000
iMendatory in NH)EXCLUDED? hi E L DISEASE-EA EMPLOYEE $1,000,000
Kyes,describe under
SPECIAL PROVISIONS below EL DISEASE-POLICY LIMIT $1,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The certificate holder is additional insured for general liability, but
only if required by written contract or written agreement per the
attached endorsement#SS0008 04/05 and IH1200 11185 _
CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment
SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Kent DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL d9 DAYS WRITTEN
220 4th Ave S NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Kent,WA 98032 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
.46
ACORD 25(2009101) 1 of 2 #S262977/M262976 o 1988-2009 ACORD CORPORATION. All rights reserved.
T4.n An',10111 nama and Innn ara ron1cforad mnrke of ACORD CJL
KENT Exhibit F
PARKS RECREATION S
COMMUNITY SERVICES City of Kent
Certification Regarding Debarment and Suspension
Agency Name of Program(s)
Certification A: Certification Regarding Debarment, Suspension, and Other Responsibility
Matters - Primary Covered Transactions
1. The prospective primary participant certifies to the best of its knowledge and belief that its principals,
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any Federal debarment or agency,
b) Have not within a three-year period preceding this proposal, been convicted of or had a civil judgment
rendered against them for commission of fraud or a criminal offense in connection with obtaining,
attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a
public transaction, violation of Federal or State antitrust statutes or commission of embezzlement,
theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving
stolen property,
c) Are not presently indicted for or otherwise criminally or civilly charged by a govemmental entity
(Federal State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this
certification, and
d) Have not within a three-year period preceding this application/ proposal had one or more public
transactions (Federal, State, or local) terminated for cause or default
2. Where the prospective primary participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal
Instructions for Certification (A)
1 By signing and submitting this proposal, the prospective primary participant is providing the
certification set out below
2 The inability of a person to provide the certification required below will not necessarily result in
denial of participation in this covered transaction The prospective participant shall submit an
explanation of why it cannot provide the certification set out below The certification or explanation
will be considered in connection with the department or agency's determination whether to enter
into this transaction However, failure of the prospective primary participant to furnish a certification
or an explanation shall disqualify such person from participation in this transaction
3 The certification in this clause is a material representation of fact upon which reliance was placed
when the department or agency determined to enter into this transaction If it is later determined
that the prospective primary participant knowingly rendered an erroneous certification, in addition
to other remedies available to the Federal Government/City of Kent, the department or agency
may terminate this transaction for cause of default
4 The prospective primary participant shall provide immediate written notice to the department or
agency to whom this proposal is submitted if at any time the prospective primary participant learns
that its certification was erroneous when submitted or has become erroneous by reason of
changed circumstances
5 The terms covered transaction, debarred, suspended, ineligible, lower tier covered
transaction, participant, person, primary covered transaction, principal, proposal, and
voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and
Coverage sections of the rules implementing Executive Order 12549 You may contact the
department or agency to which this proposal is being submitted for assistance in obtaining a copy
of these regulations
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
1 of 3
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 Exclu-
sion - Lower Tier Covered Transaction," provided by the department or agency entering into this
covered transaction, without modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions
8 A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous A participant may
decide the method and frequency by which it determines this eligibility of its principals Each
participant may, but is not required to, check the Non-procurement List
9 Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause The knowledge and
information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings
10 Except for transactions authorized under paragraph (6) of these instructions, if a participant in a
covered transaction
11 Knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies
available to the Federal Government/City of Kent, the department or agency may terminate this
transaction for cause of default
Certification B: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary
Exclusion - Lower Tier Covered Transactions
1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its
principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or agency
2. Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal
Instructions for Certification (B)
1 By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below
2 The certification in this clause is a material representation of fact upon which reliance was placed
when this transaction was entered into If it is later determined that the prospective lower tier
participant knowingly rendered an erroneous certification, in addition to other remedies available to
the Federal Government/City of Kent, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment
3 The prospective lower tier participant shall provide immediate written notice to the person to which
this proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances
4 The terms covered transaction, debarred, suspended, ineligible, lower tier covered
transaction, participant, person, primary covered transaction, principal, proposal, and
voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549 You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of these regulations
5 The prospective lower tier participant agrees by submitting this proposal that, should the proposed
covered transaction be entered into, it shall not knowingly enter into any lower tier covered
transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded
from participation in this covered transaction, unless authorized by the department or agency with
which this transaction originated
2of3
6 The prospective lower tier participant further agrees by submitting this proposal that it will Include
this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclu-
sion - Lower Tier Covered Transaction," without modification, in all lower tier covered transactions
and in all solicitations for lower tier covered transactions
7 A participant in a covered transaction may rely upon a certification of a prospective participant in a
lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded
from the covered transaction, unless it knows that the certification is erroneous A participant may
decide the method and frequency by which it determines the eligibility of its principals Each
participant may, but is not required to, check the Nonprocurement List
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
Prima Contractor/Sub-Contractor r Date
ry (P int) Title
Signature o nma Con dor/Sub-Contractor Title Date
(3,
Adopted from HUD Form-2992
09/04
3of3
\ REQUEST FOR MAYOR'S SIGNATURE
y KtNT Please FIII in All Applicable Boxes
WA S....T..
Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) 6 047
Orl Inator: Merina Hanson Phone (Originator): x5077
Date Sent: December 21"' 2010 Date Required: January 2"d, 2011
Return Sicined Document to: M. Hanson CONTRACT TERMINATION DATE: 12-31-2012
VENDOR NAME: various DATE OF COUNCIL APPROVAL: 12-14-2010*
Brief Explanation of Document:
Human Services General Fund contracts with agencies for services to low-income Kent
residents. The attached CSA's are two year contract for 2011-2012, with the second
year of funding contingent upon availability of funds and successful agency
performance. -rW\s bw � -
f{
*Passed as part of the 2011 City of Kent budget a
;a IrM ine[udeS ' Cif"fr,-fl)r Cci,rae r A+KvVlC[AlJer,C k i ldrf1s 11 Sec IsLi
n Awti , 0T11Lq(lC_fXrv11kJ SVCS/ Wv" "osi✓1g) JfS ) rt rll-{vod 1'CnK, r-`fFS
K05 We) Mulh _ ►'occUI'- evx3i PICC, S6011 �InyCoonulof"S, Wo()(WAIwwEE
All Contracts Must Be Routed Through The Law Department
(This area to be completed by the Law Department)
Received:
Approval of Law Dept.:
i
Law Dept. Comments:
Date Forwarded to Mayor:
Shaded Areas To Be Completed By Administration Staff
Received: �1f� (�
Recommendations and Comments: D `(�� E Q " `y
Disposition: /212-11io �' '`� DEC 2 8 2010
CITY OF RENT
Date Returned: CITY CLERK