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HomeMy WebLinkAboutCAG2021-234 - Original - World Relief Seattle - Art & Music Therapy Summer Academy - 05/17/20215/12/21 OK to sign, 5/13/2021, TW. CAG2021-234 05/18/2021 CONSULTANT SERVICES AGREEMENT - 1 (Over $20,000) CONSULTANT SERVICES AGREEMENT between the City of Kent and WORLD RELIEF CORPORATION OF NATIONAL ASSOCIATION OF EVANGELICALS DBA WORLD RELIEF SEATTLE THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and World Relief Corporation of National Association of Evangelicals dba World Relief Seattle organized under the laws of the State of Washington, located and doing business at 23835 Pacific Hwy S, Suite 100, Kent, WA 98032 (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. The Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: Supplement the Refugee Youth Summer Academy program with art and music therapy to provide more immediate mental health support to children attending the academy. Work with therapists who are trained in using creative cross-cultural modalities to help address stress, trauma and anxiety in children and include mental health interventions in "Next Generation" youth programming. The following exhibits are attached and incorporated by this reference as if fully set forth herein; Exhibit A, Scope and Schedule of Work, Exhibit B, Insurance Exhibit and Exhibit C, Debarment Certification. The 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. The Consultant shall complete the work described in Section I by December 31st, 2021. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $28,000 for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. Compensation is available within the budget amount stated of this Agreement. However, in special circumstances, and upon written agreement between the City and Consultant, funds unspent from 2021 may carry over to first quarter of 2022. This budget alteration or carryover will be documented through an amended Scope and Schedule of Work signed by the parties to be attached and incorporated into this Agreement through a revised Exhibit A without the need for a formal amendment to this Agreement. C. The Consultant shall submit bi-monthly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide CONSULTANT SERVICES AGREEMENT - 2 (Over $20,000) 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. D. Card Payment Program. The Consultant may elect to participate in automated credit card payments provided for by the City and its financial institution. This Program is provided as an alternative to payment by check and is available for the convenience of the Consultant. If the Consultant voluntarily participates in this Program, the Consultant will be solely responsible for any fees imposed by financial institutions or credit card companies. The Consultant shall not charge those fees back to the City. 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 the 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 the 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 the 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 the t, it shall be without liability or legal exposure to the Consultant. VI. FORCE MAJEURE. Neither party shall be liable to the other for breach due to delay or failure in performance resulting from acts of God, acts of war or of the public enemy, riots, pandemic, fire, flood, delayed due to a force majeure event shall not result in liability to the delayed party. Both parties represent to the other that at the time of signing this Agreement, they are able to perform as required and their performance will not be prevented, hindered, or delayed by the current COVID-19 pandemic, any existing state or national declarations of emergency, or any current social distancing restrictions or personal protective equipment requirements that may be required under federal, state, or local law in response to the current pandemic. CONSULTANT SERVICES AGREEMENT - 3 (Over $20,000) If any future performance is prevented or delayed by a force majeure event, the party whose performance is prevented or delayed shall promptly notify the other party of the existence and nature of the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be effective only to the extent and duration of the force majeure event causing the prevention or delay in performance and, provided, that the party prevented or delayed has not caused such event to occur and continues to use diligent, good faith efforts to avoid the effects of such event and to perform the obligation. Notwithstanding other provisions of this section, the Consultant shall not be entitled to, and the City shall not be liable for, the payment of any part of the contract price during a force majeure event, or any costs, losses, expenses, damages, or delay costs incurred by the Consultant due to a force majeure event. Performance that is more costly due to a force majeure event is not included within the scope of this Force Majeure provision. If a force majeure event occurs, the City may direct the Consultant to restart any work or performance that may have ceased, to change the work, or to take other action to secure the work or the project site during the force majeure event. The cost to restart, change, or secure the work or project site arising from a direction by the City under this clause will be dealt with as a change order, except to the extent that the loss or damage has been caused or exacerbated by the failure of the Consultant to fulfill its obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the Consultant. VII. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. The 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. VIII. INDEMNIFICATION. The 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 the Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless, and the 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 the 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 hav the there was a wrongful refusal The provisions of this section shall survive the expiration or termination of this Agreement. CONSULTANT SERVICES AGREEMENT - 4 (Over $20,000) IX. INSURANCE.The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference. X. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to the Consultant for the purpose of completion of the work under this Agreement. XI. 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. The Consultant shall make such data, documents, and files available to the City upon the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to Act. The the Consultant for this project by anyone other than the Consultant on any other project shall be without liability or legal exposure to the Consultant. XII. CITY'S RIGHT OF INSPECTION. Even though the Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XIII. WORK PERFORMED AT CONSULTANT'S RISK. The 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 the Consultant's own risk, and the 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. XIV. 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 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 VIII 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. CONSULTANT SERVICES AGREEMENT - 5 (Over $20,000) 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 the Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to the Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. / / / / / / / / / / / / / / CONSULTANT SERVICES AGREEMENT - (Over $20,000) K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. CONSULTANT: By: Print Name: _______________________ Its:_______________________________ DATE: CITY OF KENT: By: (signature) Print Name: Dana Ralph Its Mayor DATE: NOTICES TO BE SENT TO: CONSULTANT: Chitra Hanstad 23835 Pacific Hwy S., Suite 100 Kent, WA 98032 (253) 277-1121 (telephone) N/A (facsimile) NOTICES TO BE SENT TO: CITY OF KENT: Lori Guilfoyle City of Kent 220 Fourth Avenue South Kent, WA 98032 (253) (253) 856-5061 (telephone) (253) (253) 856-6070 (facsimile) APPROVED AS TO FORM: Kent Law Department ATTEST: Kent City Clerk 05/17/2021 EEO COMPLIANCE DOCUMENTS - 1 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 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 determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By:__________________________________________ For: _________________________________________ Title: ________________________________________ Date: ________________________________________ EEO COMPLIANCE DOCUMENTS - 2 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. 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 policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date), between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By:__________________________________________ For: _________________________________________ Title: ________________________________________ Date: ________________________________________ Exhibit A Scope and Schedule of Work 2021 Consultant Services Agreement Agency: World Relief Corporation of National Association of Evangelicals dba World Relief Seattle Program: Summer Academy Contact: Katie Stoppler KStoppler@wr.org Program Description: Supplement 5-week Refugee Youth Summer Academy program with art and music therapy to provide more immediate mental health support to children attending the academy. Work with a therapist who is trained in using creative cross-cultural modalities to help address stress, trauma and anxiety in children to include Mental Health interventions in all "Next Generation" youth programming Pursuant to Section I. of the Consultant Services Agreement (CSA) executed on April 24, 2021, Consultant shall provide the approximate number of City of Kent clients with the following services: Service Unit Descriptions and Deliverables Units for Kent Residents Contracted to Serve Service Unit 1: Art or Music Therapy Sessions Description: Sessions will be offered twice weekly during Summer Academy 8 Service Unit 2: Grantee learning Circle Description: Staff will participate in at least one learning circle hosted by the City of Kent Human Services Division. 1 Outcomes Resulting from Service Units Achievement Rate Target Outcome 1: Outcome 1: Increase health and well being Youth improve mental and emotional well-being and have skills and tools to overcome the impacts of mental and emotional stress. 75% Funds Awarded: $28,000 Unduplicated Kent Clients Contracted to Serve 25 The above services shall be provided by December 31, 2021 Contract Administration - The Consultant shall notify the City, in writing, within ten (10) days of any changes in agency leadership or program personnel. - The Consultant shall provide the City with a current list of its board of directors, general or limited partners, as applicable. - In special circumstances and upon written agreement between the City and Consultant through a revised Scope and Schedule of Work, unspent funds the CSA can be carried over to 2022. The revised Scope and Schedule of Work shall be attached and incorporated into the CSA. - All records related to the CSA must be retained for three (3) years plus the current year. Reporting Requirements and Timeline All data and required forms shall be submitted electronically. Reimbursement Request Human Service Division will provide a form to be filled out electronically and serve as the invoicing mechanism for payment to your agency/program. It shall be submitted bi-monthly, no later than the 10th of the month following the end of the 2 months (i.e., July 10, Sept 10, Nov 10), unless otherwise specified. Service Unit Report - the goals stipulated in the Scope of Work. It shall be submitted bi-monthly, no later than the 10th of the month following the end of the 2 month period (i.e. July 10, Sept 10, Nov 10), along with the Reimbursement Request. Annual Outcome Data Report - Outcome data shall be submitted no later than the January 10, 2022. Data should Report Due Date Service Unit Report and Reimbursement Request 10th day following each Final Reimbursement Request January 10th, 2022 EXHIBIT B INSURANCE REQUIREMENTS FOR CONSULTANT SERVICES AGREEMENTS Insurance The Consultant shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Consultant, their agents, representatives, employees or subcontractors. A. Minimum Scope of Insurance Consultant shall obtain insurance of the types described below: 1. 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. If the Consultant elects to purchase Claims Made coverage, the Consultant is then obligated to purchase “tail” coverage for a minimum of 3 years beyond the expiration of such coverage last purchased. 1. 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. Professional Liability insurance appropriate to the Consultant’s profession. 4. Workers’ Compensation coverage as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Consultant shall maintain the following insurance limits: EXHIBIT B (Continued) 1.Commercial General Liability insurance shall be written with limits no less than $5,000,000 each occurrence, $5,000,000 general aggregate and a $5,000,000 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. 3.Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. If the Consultant elects to purchase Claims Made coverage, the Consultant is then obligated to purchase “tail” coverage for a minimum of 3 years beyond the expiration of such coverage last purchased. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions for Automobile Liability and Commercial General Liability insurance: 1.The Consultant’s insurance coverage shall be primary insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by the City shall be excess of the Consultant’s insurance and shall not contribute with it. 2.The Consultant’s insurance shall be endorsed to state that coverage shall not be cancelled by either party, except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. 3.The City of Kent shall be named as an additional insured on all policies (except Professional Liability) as respects work performed by or on behalf of the Consultant and a copy of the endorsement naming the City as additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Consultant’s Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claim is made or suit is brought, except with respects to the limits of the insurer’s liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. EXHIBIT B (Continued) E. Verification of Coverage Consultant shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Consultant before commencement of the work. F. Subcontractors Consultant shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverages for subcontractors shall be subject to all of the same insurance requirements as stated herein for the Consultant. ACORN® CERTIFICATE OF LIABILITY INSURANCE 10/1/2021 DATE (MM/DD/YYYY) 1 9/28/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies CONTACT NAME: 1801 K Street NW, Suite 200 DC DC 20006 (202)414-2400 PHONE FAX Ext : A/c No (AIWashington E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 1 INSURER A: Lloyd's of London 38253 INSURED World Relief Corporation Of National 1453384 Association of Evangelicals INSURER B : Great Northern Insurance Company 20303 INSURER C : National Fire and Marine Insurance Co 20079 INSURER D : Chubb Indemnity Insurance Company 12777 7 E. Baltimore Street Baltimore MD 21202 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 16906605 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP YY MM/DDIYY LIMITS A X COMMERCIAL GENERAL LIABILITY X I CLAIMS -MADE OCCUR Prof, Liability Y N B0572MR205283 10/1/2020 10/1/2021 EACH OCCURRENCE $ 5,000,000 A AGE To RETE PREMISES Ea oecur ence $ 1,000,000 X MED EXP (Any one person) $ XXXXXXX Retro Date- 10/0l/15 PERSONAL &ADV INJURY $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECOT- LOC OTHER: GENERAL AGGREGATE $ 5,000,000 PRODUCTS - COMP/OP AGG $ 5,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N 7359-06-53 10/1/2020 10/1/2021 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident) $ XXXXXXX PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 42-UMO-306147-04 10/1/2020 10/1/2021 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ 5,000,000 DED I X I RETENTION $ 25,000 $ XXXXXXX D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 7175-15-93 10/1/2020 10/1/2021 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The umbrella provides excess for the automobile liability and employers liability only City of Kent is included as additional insured as required by written contract CERTIFICATE HOLDER CANCELLATION 16906605 City Of Kent SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 220 Fourth Avenue South THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Kent, WA 98032 AUTHORIZED REPRFbZn i Ai IVE ACORD 25 (2016103) © 1988-2015 ACORD CORPORATION.'Al rights reserved. The ACORD name and logo are registered marks of ACORD ATTACHING TO AND FORMING PART OF POLICY NUMBER: B0572MR205283 IN THE NAME OF: World Relief Corporation of National Association of Evangelicals doing business as "World Relief'. ISSUED BY: Certain Underwriters at Lloyd's, London ENDORSEMENT NUMBER: Two Effective from Inception ADDITIONAL INSURED ENDORSEMENT In consideration of the premium charged for this Policy, it is hereby understood and agreed that the following entity: As may be declared is added as additional Insured under this Policy for Claims first made against them during the Period of Insurance, but only with respect to: 1) liability arising solely out of any negligent act, error or omission of the Insured in rendering or failing to render Security Professional Services or 2) liability for Bodily Injury or Property Damage caused directly by an Accident which is covered under Insuring Agreement I.F. of this Policy and then only to the extent the Insured Organisation would have been liable and coverage would have been afforded under the terms and conditions of this Policy had such Claim been made against the Insured Organisation. The above mentioned extension of coverage shall not apply to any Claim which includes allegations or facts indicating actual or alleged independent or direct liability on the part of any such entity detailed above. It is a condition precedent to liability under the above mentioned extension of coverage that such entities detailed above shall prove to Underwriters' satisfaction the extent of any Claim arising out of the Insured Organisation's conduct as described in paragraphs 1) and 2) above. Insurers waive any right of recovery they may have against the person or organization detailed above because of payments Insurers may make for injury or damage arising out of Insured Organisation's ongoing operations or work done under a contract with that person or organisation. This waiver applies only to the person or organization detailed above. ALL OTHER TERMS AND CONDITIONS OF THIS POLICY REMAIN UNCHANGED 59 B0572MR20 1 of 3 Exhibit C 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 governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and d) Have not within a three-year period preceding this application/ proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. 2.Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (A) 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon which reliance was placed when the department or agency determined to enter into this transaction. If it is later determined that the prospective primary participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default. 4. The prospective primary participant shall provide immediate written notice to the department or agency to whom this proposal is submitted if at any time the prospective primary participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 5. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the 2 of 3 meanings set out in the Definitions and Coverage sections of the rules implementing Executive Order 12549. You may contact the department or agency to which this proposal is being submitted for assistance in obtaining a copy of these regulations. 6. The prospective primary participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency entering into this transaction. 7. The prospective primary participant further agrees by submitting this proposal that it will include the clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction,” provided by the department or agency entering into this covered transaction, without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 8. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines this eligibility of its principals. Each participant may, but is not required to, check the Non-procurement List. 9. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 10. Except for transactions authorized under paragraph (6) of these instructions, if a participant in a covered transaction 11. Knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency may terminate this transaction for cause of default. Certification B: Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions 1.The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency. 2.Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (B) 1. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of fact upon which reliance was placed when this transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government/City of Kent, the department or agency with which this transaction originated may pursue available 3 of 3 remedies, including suspension and/or debarment. 3. The prospective lower tier participant shall provide immediate written notice to the person to which this proposal is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction, participant, person, primary covered transaction, principal, proposal, and voluntarily excluded, as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of these regulations. 5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this trans- action originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled “Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction,” without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency by which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. 9. Except for transactions authorized under paragraph (5) of these instructions, if a participant in a lower covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government/City of Kent, the department or agency with which this transaction originated may pursue available remedies including suspension and/or debarment. Executive Director (Print) Signature of Executive Director Date (3/ Adopted from HUD Form-2992 09/04 Signature: %4&Y-- Mori ja H nson (May 6, 202109:32 PDT) Email: mhanson@kentwa.gov Signature: 10L9- Email: rlashley@kentwa.gov Signature: �rcCce P�uR��rr�uJo Julie Parascondola (May 11, 202114:36 PDT) Email: jparascondola@kentwa.gov World Relief Seattle - Summer Academy Final Audit Report 2021-05-11 Created: 2021-05-06 By: KateLynn Jennings (kjennings@kentwa.gov) Status: Signed Transaction ID: CBJCHBCAABAAD1jG9k6xEe3OoR4C-w3WojOFcwlgKzuO "World Relief Seattle - Summer Academy" History Document created by KateLynn Jennings (kjennings@kentwa.gov) 2021-05-06 - 2:51:04 PM GMT- IP address: 146.129.252.126 Document emailed to Merina Hanson (mhanson@kentwa.gov) for signature 2021-05-06 - 2:53:30 PM GMT Email viewed by Merina Hanson (mhanson@kentwa.gov) 2021-05-06 - 4:32:17 PM GMT- IP address: 174.204.69.248 Document e-signed by Merina Hanson (mhanson@kentwa.gov) Signature Date: 2021-05-06 - 4:32:57 PM GMT - Time Source: server- IP address: 174.204.69.248 Document emailed to chitra hanstad (chanstad@wr.org) for signature 2021-05-06 - 4:33:01 PM GMT Email viewed by chitra hanstad (chanstad@wr.org) 2021-05-06 - 4:40:41 PM GMT- IP address: 104.47.56.126 `E? Document e-signed by chitra hanstad (chanstad@wr.org) Signature Date: 2021-05-06 - 4:45:52 PM GMT - Time Source: server- IP address: 73.97.254.6 Document emailed to Ronald Lashley (rlashley@kentwa.gov) for signature 2021-05-06 - 4:45:55 PM GMT Email viewed by Ronald Lashley (rlashley@kentwa.gov) 2021-05-11 - 8:47:38 PM GMT- IP address: 146.129.252.126 E� Document e-signed by Ronald Lashley (rlashley@kentwa.gov) Signature Date: 2021-05-11 - 8:50:01 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Julie Parascondola (jarascondola@kentwa.gov) for signature 2021-05-11 - 8:50:05 PM GMT Adobe Sign Email viewed by Julie Parascondola (jparascondola@kentwa.gov) 2021-05-11 - 9:35:35 PM GMT- IP address: 146.129.252.126 da Document e-signed by Julie Parascondola (jparascondola@kentwa.gov) Signature Date: 2021-05-11 - 9:36:50 PM GMT - Time Source: server- IP address: 146.129.252.126 Q Agreement completed. 2021-05-11 - 9:36:50 PM GMT a Adobe Sign 1 Finn, Kelly From:Guilfoyle, Lori Sent:Thursday, May 13, 2021 10:06 AM To:White, Tammy; Jennings, KateLynn Cc:Reyes-Selden, Tania; Finn, Kelly Subject:FW: youth MH contract Attachments:Exhibit B Consultant Svcs 5M GL 5M PL Claims Made.pdf Follow Up Flag:Follow up Flag Status:Flagged Hi – Please see below – Chitra agrees with the new Exhibit. From: Chitra Hanstad <CHanstad@wr.org> Sent: Thursday, May 13, 2021 9:55 AM To: Guilfoyle, Lori <LGuilfoyle@kentwa.gov> Cc: Katie Stoppler <KStoppler@wr.org>; Luke Williams <LWilliams@wr.org> Subject: Re: youth MH contract EXTERNAL EMAIL Oh ok! Then it's fine! Yes make the change. Chitra Hanstad, Exec Director World Relief Seattle c 206-612-7730 From: Guilfoyle, Lori <LGuilfoyle@kentwa.gov> Sent: Thursday, May 13, 2021, 9:52 AM To: Chitra Hanstad Cc: Katie Stoppler; Luke Williams Subject: RE: youth MH contract Hi Chitra – just to clarify – we updated the Exhibit to match your insurance, your coverage was more than adequate! Thanks! From: Chitra Hanstad <CHanstad@wr.org> Sent: Thursday, May 13, 2021 9:50 AM To: Guilfoyle, Lori <LGuilfoyle@kentwa.gov> Cc: Katie Stoppler <KStoppler@wr.org>; Luke Williams <LWilliams@wr.org> Subject: Re: youth MH contract 2 EXTERNAL EMAIL Hi Lori I'm just adding our finance manager to make sure we can comply with the change. Thanks! Chitra Chitra Hanstad, Exec Director World Relief Seattle c 206-612-7730 From: Guilfoyle, Lori <LGuilfoyle@kentwa.gov> Sent: Thursday, May 13, 2021 9:17:19 AM To: Chitra Hanstad <CHanstad@wr.org> Cc: Katie Stoppler <KStoppler@wr.org> Subject: youth MH contract Hi Chitra and Katie – your insurance coverage is slightly different than the exhibit in the Youth Mental Health contract, so I have been asked to include a new Exhibit B. The Exhibit attached more closely reflects your coverage limits and also updates the conditions regarding the fact that your coverage is “Claims Made.” The Ex. B and your coverage now conform. Can you confirm that this Exhibit B is acceptable to you and approve to have it added to the contract? Thank you! Lori