HomeMy WebLinkAboutCAG2021-361 - Original - Puget Sound Training Center - CDBG Funded Employment and Training Services - 01/01/2021ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
Director or Designee Mayor
Date of Council Approval:
Grant? Yes No
Type:Review/Signatures/RoutingDate Received by City Attorney:
Comments:
Date Routed to the Mayor’s Office:
Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms.
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 20200218
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
N/A
N/A
8/16/2021
Original1386544
Parks, Recreation & Community ServicesDinah Wilson
12/31/2022
4
ASAP
4
1/1/2021
11/17/2020
4
Other
B00321.64150.6014
Contract
20000
Federal
4
4
4
Mh
i
CDBG AGREEMENT
BETWEEN THE CITY OF KENT
AND
PUGET SOUND OPPORTUNITIES INDUSTRIALIZATION CENTER,
D/B/A PUGET SOUND TRAINING CENTER
EMPLOYMENT AND TRAINING SERVICES
This Agreement, entered into this 1st day of August, 2021, between the City of Kent, a Washington
municipal corporation (hereinafter the "City") and Puget Sound Training Center (hereinafter the
"Agency").
RECITALS
WHEREAS, the City is an entitlement City applicant for Community Development Block Grant
(“CDBG”) funds (Catalogue of Federal Domestic Assistance-CFDA 14.218 and Federal Award
Identity Numbers-FAIN B-21-MC-53-0017 and B-22-MC-53-0017) under the Housing and
Community Development Act of 1974 (the “Act”), as amended, Pub. L. No. 93-383, 88 Stat. 633
(1974), and anticipates receiving CDBG funds for the purpose of carrying out eligible community
development and housing activities under the Act and under regulations promulgated by the
Department of Housing and Urban Development (“HUD”), at 24 CFR § 570, et seq.; and
WHEREAS, the City desires to contract with the Agency for the performance of certain eligible
activities described within this Agreement; and
WHEREAS, it is appropriate and mutually desirable that the Agency be designated by the City to
undertake the aforementioned eligible activities, so long as the requirements of the Act, HUD
regulations, and state and local laws are adhered to, as provided for herein; and
WHEREAS, the purpose of this Agreement is to provide for cooperation between the City a nd the
Agency, as the parties to this Agreement, in the provision of such eligible activities; and
WHEREAS, the parties are authorized and empowered to enter into this Agreement pursuant to the
Act, RCW 35.21.730 to .735, and/or by the Constitution and the enabling laws of the State of
Washington; NOW THEREFORE,
For and in consideration of the terms and conditions provided in th is Agreement, the parties mutually
covenant and agree as follows:
ii
INDEX TO AGREEMENT
PART I - GENERAL CONDITIONS .........................................................................................................................1
1. Scope Of Agreement ..................................................................................................................................1
2. Scope Of Project ..........................................................................................................................................1
3. Purpose and primary objective – 42 U.S.C. § 530(c), 24 C.F.R. § 570.200(a)(3). .....................1
4. Commencement And Termination Of Project(s) ..................................................................................2
5. Administration..............................................................................................................................................2
6. Compensation And Method Of Payment.................................................................................................3
7. Eligible Costs ................................................................................................................................................3
8. Operating Budget ........................................................................................................................................4
9. Funding Alternatives, Future Support, and Limited Release .............................................................4
10. Amendments ................................................................................................................................................4
11. Assignment And Subcontracting ..............................................................................................................4
12. Hold Harmless And Indemnification ........................................................................................................5
13. Project Close-Out ........................................................................................................................................5
14. Insurance ......................................................................................................................................................5
15. Conflict Of Interest .....................................................................................................................................5
16. Suspension And Termination Of Agreement .........................................................................................5
17. Safeguarding Of Client Information ........................................................................................................6
PART II - FEDERAL, STATE, AND LOCAL PROGRAM REQUIREMENTS .........................................................6
1. Nondiscrimination .......................................................................................................................................6
2. Section 504 And Americans With Disabilities Act ................................................................................9
3. Financial Management And Procurement Standards ...........................................................................9
4. Uniform Administrative Requirements And Cost Principles And Recordkeeping – 2 CFR Part
200, 24 CFR §§ 570.502, and 570.610. ................................................................................................9
5. Data Universal Numbering System
6. Lobbying…………………………………………………………………………………………………………………………………………………12
7. Program Income – 24 CFR § 570.504................................................................................................. 10
8. Public Information .................................................................................................................................... 11
9. Other Federal And State Requirements .............................................................................................. 11
10. Local Requirements ................................................................................................................................. 11
Public service programs must comply with sections 10 and 11 : ........................................................... 11
11. Non-Substitution For Local Funding ..................................................................................................... 11
12. Faith-based activities – 24 CFR § 570.200(j). ................................................................................... 12
Acquisition or improvement of real property projects must comply with sections 12 through 19:12
13. Accessibility ............................................................................................................................................... 12
14. Environmental Review ............................................................................................................................ 13
15. Labor Standards – 24 CFR § 570.603 ................................................................................................. 14
16. Volunteers 24 CFR § 70 .......................................................................................................................... 14
17. Acquisition And Relocation ..................................................................................................................... 14
18. Public Ownership ...................................................................................................................................... 15
19. Reversion Of Assets – 24 CFR § 570.505........................................................................................... 15
20. Property Management Standards ......................................................................................................... 15
21. Additional Local Requirements .............................................................................................................. 16
PART III - MONITORING & REPORTING REQUIREMENTS ........................................................................... 16
1. Monitoring .................................................................................................................................................. 16
2. Program Reporting ................................................................................................................................... 16
3. Fiscal Reporting Responsibilities ........................................................................................................... 16
4. Audits .......................................................................................................................................................... 17
PART IV – RECORDKEEPING REQUIREMENTS ............................................................................................... 17
1. Program Records and Inspections ........................................................................................................ 17
2. Program Benefit Records – 24 CFR § 570.506(b). ........................................................................... 18
3. Financial Records ..................................................................................................................................... 18
4. Records Of Program Operations, Management And Evaluation ..................................................... 19
iii
5. Property Records ...................................................................................................................................... 19
6. Nondiscrimination And Equal-Opportunity Records – 24 CFR § 570.506(g). ............................. 19
7. Conflict Of Interest .................................................................................................................................. 20
8. Verification Of Subcontractor’s Eligibility – 24 CFR § 5. ................................................................. 20
9. Additional Requirements for Acquisition or Improvement of Real PROPERTY PROJECTS ........ 20
1
PART I - GENERAL CONDITIONS
1. SCOPE OF AGREEMENT
The agreement between the parties shall consist of th is Agreement and its signature page;
the recitals page; the general conditions and any special conditions; the federal, state and
local program requirements; the monitoring and reporting requirements; the recordkeeping
requirements; each and every project exhibit, appendix, and attachment incorporated into
the Agreement; all matters and laws incorporated by reference herein; and any written
amendments made according to the general conditions. This Agreement supersedes any and
all former agreements applicable to projects attached as Exhibits to this Agreement. It is the
intent of the parties that all applicable federal regulations and requirements are incorporated
herein, including, but not limited to, 24 CFR § 570, 2 CFR § 200, and 24 CFR § 570.
2. SCOPE OF PROJECT
A. The Agency shall use the funds provided herein only to perform the activities authorized by
this Agreement and as set forth in the CDBG Project Scope of Services, a draft of which is
attached as First Amendment to Exhibit A and incorporated by this reference. Because this
Agreement is executed prior to funds being allocated to the City through federal
appropriations, the City will forward to Agency a final First Amendment to Exhibit A that the
City will create if federal appropriations are awarded to the City for Agency’s services, and
that final First Amendment to Exhibit A, which may include adjustments in allocations or scope
imposed as a condition of the final federal appropriations, shall relate back to and be
incorporated into this Agreement. In the case of multiple projects, each project shall
correspond to a separate Exhibit. This Agreement may be amended from time to time, in
accordance with the general conditions, for the purp ose of adding new projects, amending
the scope of work, or for any other lawful purpose.
B. Agencies funded by the City to carry out neighborhood revitalization, community economic
development, or energy conservation projects shall meet the qualifications of a Community
Based Development Organization (CBDO) pursuant to 24 C.F.R. § 570.204(c). The “carry
out” requirement “means that the CBDO undertakes the funded activities directly or through
contract with an entity other than the City, or through the provision of financial assistance for
activities in which it retains a direct and controlling involvement and responsibilities.” 24
C.F.R. § 570.204(a)(4).
3. PURPOSE AND PRIMARY OBJECTIVE – 42 U.S.C. § 530(C), 24 C.F.R. § 570.200(a)(3).
“The primary objective of this chapter and of the community development program of each
grantee under this chapter is the development of viable urban communities, by providing
decent housing and a suitable living environment and expanding economic opportunities,
principally for persons of low and moderate income. Consistent with this primary objective,
not less than 70 percent of the aggregate of the Federal assistance provided to States and
units of general local government [of CDBG expenditures] under section 5306 of this title
and, if applicable, the funds received as a result of a guarantee or a grant under section
5308 of this title, shall be used for the support of activities that benefit persons of low and
moderate income …” 42 U.S.C. § 5301(c), 24 C.F.R. § 570.200(c).
Income limits for persons eligible to be served by these activities are outlined in Exhibit B,
which is attached and incorporated by this reference. The income guidelines attached as
Exhibit B at the time this Agreement is executed shall be in draft form if federal income
guidelines for the contract year have not been released and posted to The Department of
Housing and Urban Development’s web site pri or to the execution of this Agreement. If
federal income guidelines are in draft form , the City will forward to Agency a final Exhibit B,
including any adjustments imposed by the federal government once it is generated by the
2
federal government at the time it finalizes its appropriations, and that final Exhibit B shall
relate back to and be incorporated into this Agreement.
The following requirements apply:
A. The Agency shall ascertain household income of persons applying for and receiving assistance
to assure compliance with the income limits defined in Exhibit B; and shall maintain records
pursuant to Part IV of this Agreement, Section 2(B); or
B. If the activity exclusively serves a clientele, which by federal regulation is "presumed" to be
low and moderate income, individual income verification is not required. Persons eligible for
this presumption are specified in Part IV of this Agreement, Section 2(C). In this case, the
Agency shall maintain appropriate data to validate the presumption, as provided in Part IV,
Section 2(C); or
C. If the activity is such that it is not feasible to identify and record beneficiaries, the total
population of the area from which the beneficiaries are drawn must be predominantly low and
moderate income. In this case, the Agency shall maintain substantiation data as required by
Part IV of this Agreement, Section 2(D).
D. The benefit to low and moderate income beneficiaries must be in the form of a free or reduced
cost service. If beneficiaries are charged for services, the charges to low and moderate
income beneficiaries, and to all other beneficiaries, shall be as specified in the Exhibit(s), if
applicable. Changes to the structure of charges during the term of this Agreement (and, in
the case of a facility project, for five years thereafter) must preserve an identical discount for
low and moderate income beneficiaries, and the change must be approved by the City.
E. The low and moderate income limits in effect at the time of execution of this Agreement are
specified in Exhibit B. These limits are revised periodically by HUD. It is the Agency's
responsibility to use any revised limits when they take effect. Revisions will be announced by
and can be obtained from the City.
4. COMMENCEMENT AND TERMINATION OF PROJECT(S)
A. The City shall furnish the Agency with a written notice to proceed. No work on a project shall
occur without prior written approval from the City. Agency shall take all necessary
precautions and shall be responsible for the safety of its em ployees, agents, and
subcontractors in the performance of the contract work and shall utilize all protection
necessary for that purpose. Termination dates for individual projects shall be specified in the
appropriate Exhibits. Costs incurred prior to the date written notice to proceed was given or
after the termination date will not be reimbursed. The termination date may be changed
through an amendment of this Agreement.
B. Although the term of this Agreement shall run from January 1, 2021 through December 31,
2022, this Agreement, however, is contingent upon the availability of funds to be allocated
through federal appropriations. Therefore, should funds to support Agency’s services not be
made available through anticipated federal appropriations, this Agreement shall immediately
terminate without risk or liability to the City and without obligation to disburse funds or to
reimburse Agency any funds expended in anticipation of funding availability. All work shall
be done at Agency’s own risk, and Agency shall be responsible for all losses associated with
services provided before the City issues its written notice to proceed. All acts consistent with
the authority of the Agreement and prior to the date of the Agreement’s execution are hereby
ratified and affirmed, and the terms of this Agreement shall be deemed to have applied.
5. ADMINISTRATION
A. The Agency shall appoint a liaison person who shall be responsible for overall administration
of CDBG funded project(s) and coordination with the City's Parks, Recreation, and Community
Services Department. The person appointed shall be designated in Exhibit C, which is
3
attached and incorporated by this reference. The Agency shall also designate one or more
representatives who shall be authorized to submit the Billing Voucher and Service Report, and
Final Service Report, which are attached as First Amendment to Exhibit D and D-1,
respectively. The name of the liaison person and representative shall be specified in the
Exhibit.
B. The Agency shall provide ten (10) days written notice to the City of any changes in program
personnel or Board membership.
C. The agency shall provide the City with a current list of its Board of Directors, general or limited
partners, as applicable.
6. COMPENSATION AND METHOD OF PAYMENT
A. The City shall reimburse the Agency only for eligible costs allowed pursuant to this Agreement ,
which are part of the activities specified in the Exhibit(s), and in an amount not to exceed the
amount specified in First Amendment to Exhibit A, plus any miscellaneous surplus office
equipment, as available, related to the provision of services under this Agreement, and
according to the procedures developed by the City of Kent. Reimbursement shall be based
on a Billing Voucher and Service Report, which shall be submitted to the City by the Agency's
authorized representative.
B. The City of Kent uses a variety of measures as indicators of satisfactory contract performance.
The Agency will be expected to meet 100% of the performance measures as defined in Exhibit
A. Exceptions may be made in cases where circumstances beyond the Agency’s control impact
their ability to meet their units of service and the Agency has shown reasonable effort to
overcome those circumstances. Exceptions are made at the discretion of the City’s Human
Services Manager.
C. If the Agency does not meet performance goal s, payment for services rendered under the
agreement will be reduced by the rate calculated for each service unit. For example if an
Agency contracted to provide 100 bed-nights a quarter for $5,000.00 and only provide 75
bed-nights, payment would be $3,750.00 instead of $5,000.00.
D. The Agency shall submit a Billing Voucher and Service Report on a quarterly basis. Billing
Vouchers and Service Reports are due in accordance with the schedule and budget
incorporated as First Amendment to Exhibit A and in accordance with Section 7 below. If the
due date falls on a Saturday or Sunday, Billing Vouchers and Service Reports are due on the
prior Friday. If the due date falls on a City holiday, Billing Vouchers and Service Reports are
due the next working day following the holiday. The Final Service Report is due in accordance
with the schedule listed in First Amendment to Exhibit A. If the Agency’s line item budget
includes personnel services costs, the Agency shall submit a CDBG Public Services Project
Time Sheet (attached as Exhibit G if applicable) with the Billing Voucher and Service Report.
The City will make payment to the Agency not more than forty-five (45) days after said Billing
Voucher and Service Report is received and approved by the City's Parks , Recreation, and
Community Services Department. The City will issue a statement of correction in the event
the Billing Voucher and Service Report are erroneous. Payment by the City shall not constitute
approval of the services for which payment is requested. The City does not, by making such
payment, waive any rights it may have pursuant to this Agreement to requ ire satisfactory
performance of the services promised herein. The City reserves the right to demand and
recover reimbursements made for ineligible costs.
7. ELIGIBLE COSTS
A. All costs incurred must be reasonable and of a nature which clearly relate to th e specific
purposes and end product of the Agreement under which the services are being performed.
Care must be taken by all concerned in incurring costs to assure that expenditures conform
to these general standards and the following criteria for eligibility of costs.
4
B. To be eligible for reimbursement, costs must:
(1) Be necessary and reasonable for proper and efficient execution of the contractual
requirements and in accordance with an approved budget.
(2) Be no more liberal than policies, procedures, and practices applied uniformly to other
activities of the Agency.
(3) Be accorded consistent treatment through application of account policy and procedures
approved and/or prescribed herein.
(4) Not be allowable under or included as costs of any other fed eral, state, local or other
agency-financed programs in either prior or current periods.
(5) Be net of all applicable credits such as purchase discounts, rebates or allowances, sales of
publication or materials, or other income or refunds.
(6) Be fully documented.
8. OPERATING BUDGET
The Agency shall apply the funds received from the City under this Agreement in accordance
with the Budget Summary found in First Amendment to Exhibit A. No line-item expense
therein shall cause expenditure in excess of ten (10) percent or more of the budget line-item
amount over the life of the Agreement without the prior written consent of the City. Any
request for a line-item expense which exceeds ten (10) percent of the budgeted amount shall
specifically state the reasons for the requested increase and a justification for the
corresponding decrease in other line-item(s).
9. FUNDING ALTERNATIVES, FUTURE SUPPORT, AND LIMITED RELEASE
A. The City makes no commitment to future support and assumes no obligation for future
support of the activities contracted for herein, except as may be expressly set forth in this
Agreement.
B. Payment for the services provided herein is based on the expectation that future revenues
will be available to the City for such purposes. Should anticipated sources of revenue not
become available or become unavailable to the City for use in the CDBG program, the City
shall immediately notify the Agency in writing of such unavailability and in that event, Agency
fully releases City from any claims, damages, or liability, related to lack of funding, the
amount funded, or uncertainty for that portion of the Agreement originally intended to be
paid with such funds.
10. AMENDMENTS
Either party may request modifications in the scope of permissible activities, terms, or
conditions of this Agreement. Proposed modifications which are mutually agreed upon shall
be incorporated by a written amendment to this Agreement.
11. ASSIGNMENT AND SUBCONTRACTING
A. The Agency shall not assign any portion of this Agreement without the written consent of the
City, and it is further agreed that said consent must be sought by the Agency not less than
fifteen (15) days prior to the date of any proposed assignment.
B. Any work or services assigned or subcontracted hereunder shall be subject to each provision
of this Agreement and proper bidding procedures to the extent herein. The Agency agrees
that it is as fully responsible to the City for the acts and omissions of its subcontractors and
their employees and agents, as it is for the acts and omissions of its own employees and
agents, as defined in paragraph Part I, Section 12(B).
5
12. HOLD HARMLESS AND INDEMNIFICATION
A. The Agency agrees that it is financially responsible and liable to the City for any audit
exception or other financial loss to the City which occurs due to the Agency's negligence or
failure to comply with the terms of this Agreement.
B. The Agency further agrees to defend, indemnify, and hold the City, its elected and appointed
officials, agents, and employees, while acting within the scope of their duties as such,
harmless from and against all claims, demands, and causes of action of any kind or character,
including the cost of defense thereof, arising in favor of any person(s), including Agency's
employees or third parties on account of personal injuries, death , or damage to property
arising out of services performed or omissions of services or in any way resulting from the
acts or omissions of the Agency and/or its agents, employees, volunteers, subcontractors , or
representatives under this Agreement.
13. PROJECT CLOSE-OUT
The Agency acknowledges and agrees that the amounts set forth in the Exhibit(s) shall be
used only to reimburse the Agency for eligible costs incurred by the Agency during the period
set forth in said Exhibit(s) and that upon expiration of such period, or upon earlier termination
pursuant to this Agreement, the Agency shall have no interest in any said amount which is
not required to reimburse the Agency for eligible costs incurred before such expiration or
earlier termination.
14. INSURANCE
Agency shall maintain insurance in the types and amounts set forth in Exhibit E, which is
attached and incorporated by this reference.
15. CONFLICT OF INTEREST
A. Interest of Officers, Employees, or Agents – The Agency shall abide by and enforce the conflict
of interest requirement set forth in 24 CFR 570.611, 2 CFR 200.112, and 2 CFR 200.318. No
employee, agent, consultant, officer, or elected official or appointed official of the City, or of
any designated public agencies, or of sub-recipients that are receiving CDBG funds shall have
any personal financial interest, direct or indirect, in the Agreement, and the C ity and Agency
shall take appropriate steps to assure compliance. 24 CFR 570.611
B. Interest of Subcontractor and Their Employees - The Agency agrees that it will incorporate
into every contract or subcontract, which is required to be in writing and made pursuant to
this Agreement, the following provisions:
The Contractor covenants that no person who presently exercises any
functions or responsibilities in connection with the City CDBG program
has any personal financial interest, direct or indirect, in this Agreement.
The Contractor further covenants that he/she presently has no interest
and shall not acquire any interest, direct or indirect, which would conflict
in any manner or degree with the performance of his/her services
hereunder. The Contractor further covenants that in the performance
of this Agreement, no person having any conflict of interest shall be
employed. Any actual or potential conflict of interest on the part of the
Contractor or his/her employees must be disclosed to the Agency and
the City.
16. SUSPENSION AND TERMINATION OF AGREEMENT
A. Suspension for Failure to Perform - In the event of a failure to comply with any terms or
conditions of this Agreement or failure to provide in any manner the activities or other
6
performance as agreed to herein, the City reserves the right to withhold all or any part of
payment, suspend all or any part of the Agreement, or prohibit the Agency from incurring
additional obligations of funds until the City is satisfied that corrective action has been taken
or completed as more specifically outlined in the Exhibit(s) to this Agreement. The option to
withhold funds is, in addition to and not in lieu of, the City's right to terminate the Agreement
pursuant to Paragraph (B) of this Section 16.
B. Termination of Agreement by City - This Agreement is subject to termination upon thirty (30)
days written notice by the City to the Agency in the event that:
(1) The Agency mismanages or makes improper or unlawful use of CDBG funds;
(2) The Agency fails to comply with any term or condition expressed herein or any applicable
federal, state, or local regulations or ordinances;
(3) CDBG funds no longer become available from the federal government or through the City;
(4) The Agency fails to carry out activities required by this Agreement; or
(5) The Agency fails to submit reports or submits incomplete or inaccurate reports in any
material respect.
C. Termination of Agreement by the Agency- This Agreement is subject to termination upon
thirty (30) days written notice by the Agency to the City in the event that:
(1) The City fails in its commitment under this Agreement to provide funding for services
rendered, as herein provided; or
(2) CDBG funds no longer become available from the federal government or through the City.
D. Unless otherwise terminated pursuant to Paragraphs (B) and (C) of this Section 16, this
Agreement shall terminate on the termination date specified on the Exhibit(s) and shall be
subject to extension only by mutual agreement and amendment in accor dance with Part I,
Section 10 of this Agreement.
E. Upon termination of this Agreement, any unexpended balance of Agreement funds shall
remain in the City CDBG fund.
F. In the event termination occurs under Paragraph (B) of this Section 16, the Agency shall
return to the City all funds that were expended in violation of the terms of this Agreement
including, but not limited to, any unexpended CDBG funds distributed to the Agency under
this Agreement, any accounts receivable, or any assets or interests ther ein of any type and
in any form acquired, leased, or rehabilitated with CDBG monies.
17. SAFEGUARDING OF CLIENT INFORMATION
The use or disclosure by any party of any confidential information concerning a recipient or
client for any purpose not directly con nected with the City's or the Agency's responsibilities
with respect to services provided under this Agreement is prohibited, except upon written
consent of the recipient or client, his/her attorney, his/her responsible parent or guardian, or
as otherwise provided by law.
PART II - FEDERAL, STATE, AND LOCAL PROGRAM REQUIREMENTS
1. NONDISCRIMINATION
A. General – The Agency shall comply with all federal, state, and local laws prohibiting
discrimination on the basis of age, sex, marital status, race, creed, religion, color, national
origin, or the presence of any sensory, mental , or physical handicap. These requirements are
7
specified in Chapter 49.60 RCW; Section 109 of the Housing and Community Development
Act of 1974, Pub. L. No. 93-383 as amended and codified as 42 U.S.C. § 5309; Title VI of the
Civil Rights Act of 1964, 42 U.S.C. §§ 2000d, et seq.; Title VIII of the Civil Rights Act of 1968,
42 U.S.C. §§ 3601, et seq.; Executive Order 11063; Executive Order 11246, as amended by
Executive Orders 11375, 11478, 12086 and 12107; Section 3 of the Housing and Urban
Development Act of 1968, 12 U.S.C.§ 1701(u), and implementing regulations at 24 CFR § 75;
Section 504 of the Rehabilitation Act of 1973 , 29 U.S.C. § 794, et seq.; and the Age
Discrimination Act of 1975, 42 U.S.C. § 6101, et seq. Specifically, the Agency is prohibited
from taking any discriminatory actions defined in the HUD regulations at 24 C.F.R. § 570.602
and shall take such affirmative and corrective actions as are required by the regulations at 24
C.F.R. § 570.602.
B. Specific Discriminatory Actions Prohibited:
(1) The Agency shall not, under any program or activity to which this Agreement may apply,
directly or through contractual or other arrangements, on the grounds of age, sex, marital
status, race, creed, religion, color, national origin, or the presence of any sensory, mental ,
or physical handicap:
i. Deny any person facilities, services, financial aid, or other benefits provided under the
program or activity.
ii. Provide any person with facilities, services, financial aid, or other benefits which are
different, or are provided in a form different, from that provided to others under the
program or activity.
iii. Subject any person to segregated or separate treatment in any facility or in any matter
or process related to receipt of any service or benefit under the program or activity.
iv. Restrict in any way access to or enjoyment of any advantage or privilege enjoyed by
others in connection with facilities, services, financial aid , or other benefits under the
program or activity.
v. Treat any person differently from others in determining whether the person satisfies
any admission, enrollment, eligibility, membership, or other requirement or condition
which individuals must meet in order to be provided facilities, services , or other
benefits provided under the program or activity.
vi. Deny any person any opportunity to participate in a program or activity as an
employee.
(2) The Agency shall not utilize criteria or methods of administration which have the effect of
subjecting individuals to unlawful discrimination on the basis of race, color, national origin,
sex, age, marital status, creed, religion, or presence of any sensory, mental , or physical
handicap, or which have the effect of defeating or substantially impairing accomplishment
of the objectives of the program or activity by unlawfully discriminating against individuals
of a particular race, color, national origin, sex, age, marital status, creed, religion, or
presence of any sensory, mental, or physical handicap.
(3) The Agency, in determining the site or location of housing or facilities provided in whole
or in part with funds under this Agreement, may not make selections of such site or
location which have the effect of excluding individuals from, denying them the benefits of,
or subjecting them to unlawful discrimination on the grounds of race, color, national origin,
sex, age, marital status, creed, religion, or presence of any sensory, mental , or physical
handicap; or which have the purpose or effect of defeating or substantially impairing the
accomplishment of the objectives of the Act or of HUD regulations.
C. Fair Housing – The Agency shall take necessary and appropriate actions to prevent
discrimination in federally-assisted housing and lending practices related to loans insured or
guaranteed by the federal government (The Fair Housing Act (42 U.S.C. 3601-19) and
8
implementing regulations at 24 CFR part 100 et seq.; Executive Order 11063, as amended by
Executive Order 12259 (3 CFR, 1959-1963 Comp., p. 652 and 3 CFR, 1980 Comp., p. 307)
(Equal Opportunity in Housing Programs) and implementing regulations at 24 CFR part 107.
The Agency shall also administer programs related to housing and urban development in a
manner to affirmatively further fair housing. 24 CFR Parts 5, 91, 92, 570, 574, 576, and 903.
D. Employment:
(1) In all solicitations under this Agreement, the Agency shall state that all qualified applicants
will be considered for employment. The words "equal opportunity employer" in
advertisements shall constitute compliance with this section.
(2) The Agency shall not unlawfully discriminate against any employee or applicant for
employment in connection with the Agreement because of age, sex, marital status, race,
creed, religion, color, national origin, or the presence of any sensory, mental, or physical
handicap, except when there is a bona fide occupational limitation. Such action shall
include, but not be limited to the following: employment, upgrading, demotion or transfer,
recruitment or recruitment advertising, layoff or termination, rates of pay or other forms
of compensation, and selection for training (Chapter 49.46 RCW, Executive Order 11246,
as amended).
(3) To the greatest extent feasible and consistent with existing Federal, state, and local laws
and regulations, recipients covered by this subpart shall ensure that employment and
training opportunities arising in connection with Section 3 projects are provided to Section
3 workers within the metropolitan area (or nonmetropolitan county) in which the project
is located. (Part 75-Economic Opportunities for Low-and Very Low-Income Persons,
Subpart C, § 75.19 (a).
E. Contractors and Suppliers:
(1) No contractor, subcontractor, union, or vendor engaged in any activity under this
Agreement shall engage in any unlawful discrimination as defined in any federal, state, or
local law.
(2) All firms and organizations, as required under applicable HUD regulations, shall be
required to submit to the Agency certificates of compliance demonstrating that it has, in
fact, complied with the immediately foregoing provision; provided, that certificates of
compliance shall not be required from firms and organizations with fewer than 25
employees, with yearly sales of less than $10,000, or on contracts less than $10,000.
(3) To the greatest extent feasible, the Agency shall purchase supplies and services for
activities under this Agreement from vendors and contractors whose businesses are
located in the area served by CDBG-funded activities or owned in substantial part by
project area residents (Section 3, Housing and Urban Development Act of 1968 , 12 U.S.C.
§ 1701u, as amended).
(4) CDBG funds shall not be used directly or indirectly to employ, award contracts to, or
otherwise engage the services of, or fund any contractor or sub-recipient during any period
of debarment, suspension, or placement in ineligibility status under the provisions of 2
CFR § 2424. The Agency shall certify that it and all sub -consultants and subcontractors
are not listed on the government-wide Excluded Parties List System in the System for
Award Management (SAM), in accordance with OMB guidelines at 2 CFR 180 that
implement Executive Orders 12549 and 12689, “Debarment and Suspension,” as set forth
at 2 CFR 2424. Additional policies concerning debarment and suspension are found at 2
CFR Part 180 and 2 CFR Part 2424.
F. Notice:
(1) The Agency shall include the provisions of the appropriate subsections A, B, C, D, and E
of this Part II, Section 1 in every contract or purchase order for goods and services under
9
this Agreement, and shall send to each labor union or representative of workers with which
it has a collective bargaining agreement or other contract or understanding , a notice
advising the said labor union or worker's representative of the commitments made in
these subsections.
(2) In advertising for employees, goods, or services for the activities under this Agreement,
the Agency shall utilize minority publications in addition to publications of general
circulation.
2. SECTION 504 AND AMERICANS WITH DISABILITIES ACT
If the Agency is a nonprofit corporation, the Agency warrants and represents that it has
completed a Disability Self-Evaluation Questionnaire for all programs and services offered by
the Agency (including any services not subject to this Agreement) and has evaluated its
services, programs, and employment practices for compliance with Section 504 of the
Rehabilitation Act of 1973, 29 U.S.C. § 794, as amended (“504”) and the Americans with
Disabilities Act of 1990, 42 U.S.C. §§ 12101, et seq., (“ADA”). The Agency warrants and
represents that it has completed a 504/ADA Disability Assurance of Compliance, which is
attached as Exhibit H and incorporated by this reference, and shall submit it to the City.
3. FINANCIAL MANAGEMENT AND PROCUREMENT STANDARDS
The Agency shall comply with, and shall require any sub -contractor funded in whole or in part
with CDBG funds to comply with the following financial and program management and
procurement standards:
A. Agency shall adhere to the principles and standards governin g federal grant distribution
set forth in the “Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards” (2 CFR Part 200).
B. Agency shall comply with all applicable requirements of local and state law for awarding
contracts, including but not limited to procedures for competitive bidding, contractor's
bonds, and retained percentages (Ch. 60.28 RCW, Ch. 39.12 RCW, and Ch. 39.04 RCW).
In addition, the Agency shall comply with the requirements of 2 CFR § 200.318 (General
procurement standards) through 200.326 (Contract provisions).Where federal standards
differ from local or state standards, the stricter standards shall apply.
C. Agency shall comply with 24 CFR Part 570 and 2 CFR Part 200 regarding the management
and disposition of cash and real and personal property acquired with CDBG funds.
D. Agency shall comply with 24 CFR 570.489, Program and Administrative Requirements.
E. Agency shall comply with 24 CFR 570.490.
4. UNIFORM ADMINISTRATIVE REQUIREMENTS AND COST PRINCIPLES AND RECORDKEEPING – 2 CFR Part
200, 24 CFR §§ 570.502, and 570.610.
A. Agency shall comply with 2 CFR Part 200, “Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards”, except that:
(1)Section 200.305 “Payment” is modified for lump sum drawdown for financing of
property rehabilitation activities, in accordance with § 570.513.
(2) Section 200.306 “Cost sharing or matching” does not apply.
(3) Section 200.307 “Program income” does not apply. Program incom e is governed
by § 570.504.
(4)Section 200.308 “Revisions of budget and program plans” does not apply.
10
(5) Section 200.311 “Real property” does not apply, except as provided in §
570.200(j). Real property is governed by § 570.505.
(6) Section 200.313 “Equipment” applies, except that when the equipment is sold, the
proceeds shall be program income. Equipment not needed by the sub-recipient for
CDBG activities shall be transferred to the recipient for the CDBG program or shall be
retained after compensating the recipient.
Records to be maintained include:
(i) Contract and Amendments - A complete copy of this Agreement
and all amendments thereto and notices there under.
(ii) Records of City Approvals - Copies of all requests for amendments
or revisions to this Agreement and the City’s subsequent approval
or denial of such requests as are required under this Agreement.
(iii) Subcontracts and Agreements - Complete copies of all contracts,
subcontracts, and agreements with third parties into which the
Agency enters in the performance under this Agreement; and all
correspondence, reports, and other documentation pertaining to
such contracts, subcontracts, and agreements.
(iv) Records identifying the assisted activity - A complete description of each activity assisted,
in whole or in part, with CDBG funds under this Agreement, including:
(a) Location(s), organization, operating hours, qualifications for service or participation, etc.
(b) Fees or charges for services, fee waivers, or fee scales for CDBG-assisted participants.
B. Section 200.343 “Closeout” applies to closeout of sub-recipients.
C. Additional Contract Requirements - The Agency shall submit to the City a copy of the most
recent independent financial audit and a cur rent list of the Agency’s board of directors.
5. DATA UNIVERSAL NUMBERING SYSTEM
Pursuant to 2 C.F.R. §25.100(a), the City is required to establish a Dun and Bradstreet (D &
B) Data Universal Numbering System (DUNS) as a universal identifier in order to receive
federal financial assistance. In addition, programs or sub-recipients receiving sub-awards
from the City shall establish a DUNS. 2 C.F.R. § 25.200(c)(1). The Agency shall provide its
DUNS to the City.
6. LOBBYING
In accordance with 2 CFR 200.450, the Agency shall not use CDBG funds for lobbying
purposes.
7. PROGRAM INCOME – 24 CFR § 570.504.
A. All income directly generated from the use of CDBG funds, as defined in 24 CFR § 570.500(a),
is Program Income and shall be recorded, reported, and treated as funds subject to all the
requirements of this Agreement.
B. Unless otherwise specifically provided by the special conditions herein, Program Income
received during the term of this Agreement may be retained and used by the Agency to extend
the service or other activity for which the CDBG funds are provided, subject to the regulations
of 24 CFR § 570.01, et seq., and all the same terms and conditions of this Agreement. Any
11
retained Program Income shall be disbursed to pay for eligible expenses under this Agreement
before additional funds are requisitioned from the City.
C. Any Program Income not permitted to be retained for eligible activities as defined above , shall
be refunded to the City, together with any interest earned thereon, at quarterly intervals.
D. Program Income on hand at the end of the term of this Agr eement shall, unless otherwise
provided, be used for activities envisioned under this Agreement until it is expended. Program
Income generated from the use of CDBG funds under this Agreement but received after the
term of this Agreement shall, unless otherwise provided, be governed by any succeeding
CDBG funding agreement or, if there is no succeeding agreement, shall be used for activities
eligible under 24 CFR § 570.504(c) until it is expended.
E. Rules on Program Income are established in the CDBG regulations (24 CFR § 570.504); 2 CFR
§ 200.307Program Income. Proceeds from the sale of real property, equipment, or supplies
are not program income; such proceeds will be handled in accordance with the requirements
of Subpart D--Post Federal Award Requirements of 2 CFR § 200, Property Standards §§
200.311 Real property, 200.313 Equipment, and 200.314 Supplies, or as specifically identified
in Federal statutes, regulations, or the terms and conditions of the Federal award. 2 CFR §
200.307(d).
8. PUBLIC INFORMATION
A. In all news releases and other public notices related to projects funded under this Agreement,
the Agency shall include information identifying the source of funds as the City of Kent CDBG
program.
B. The Agency acknowledges that this Agreement and any other information provided by it to
the City and/or relevant to the project(s) described in the Exhibit(s), are subject to the
Washington State Public Disclosure Act, Chapter 42.56 RCW, except to the extent specifically
exempted from disclosure therein.
9. OTHER FEDERAL AND STATE REQUIREMENTS
The absence of mention in this Agreement of any other federal or state requirements, which
apply to the award and expenditure of federal funds made available by this Agreement, is not
intended to indicate that those federal or state requirements are not applicable to Agency
activities. The Agency shall comply with all other federal and state requirements relating to
the expenditure of federal funds, including but not limited to the Hatch Act (5 U.S.C. § 15)
regarding political activities and the Architectural Barrier Act of 1968 (42 U.S.C. § 4151, et
seq.).
10. LOCAL REQUIREMENTS
The activities performed under this Agreement are for the purposes of serving City residents
and the Agency shall, to the extent reasonably possible, not use said funds to provide services
outside the corporate boundary of the City, or for any other purpose, except as specifically
authorized by this Agreement.
Public service programs must comply with sections 11-12:
11. NON-SUBSTITUTION FOR LOCAL FUNDING
The CDBG funding made available under this Agreement shall not be utilized by the Agency
to reduce substantially the amount of local financial support for community development
activities below the level of such support prior to the availability of funds under this
Agreement.
12
12. FAITH-BASED ACTIVITIES – 24 CFR § 570.200(j).
A. Organizations that are religious or faith-based are eligible, on the same basis as any other
organization, to participate in the CDBG program. Neither the Federal government nor a
State or local government receiving funds under CDBG programs shall discriminate against
an organization on the basis of the organization's religious character or aff iliation.
B. Organizations that are directly funded under the CDBG program may not engage in
inherently religious activities, such as worship, religious instruction, or proselytism, as part
of the programs or services funded under this part. If an organization conducts such
activities, the activities must be offered separately, in time or location, from the programs
or services funded under this part, and participation must be voluntary for the beneficiaries
of the HUD-funded programs or services.
C. A religious organization that participates in the CDBG program will retain its independence
from Federal, State, and local governments, and may continue to carry out its mission,
including the definition, practice, and expression of its religious beliefs, provid ed that it does
not use direct CDBG funds to support any inherently religious activities, such as worship,
religious instruction, or proselytism. Among other things, faith-based organizations may
use space in their facilities to provide CDBG-funded services, without removing religious art,
icons, scriptures, or other religious symbols. In addition, a CDBG-funded religious
organization retains its authority over its internal governance, and it may retain religious
terms in its organization's name, select its board members on a religious basis, and include
religious references in its organization's mission statements and other governing
documents.
D. An organization that participates in the CDBG program shall not, in providing program
assistance, discriminate against a program beneficiary or prospective program beneficiary
on the basis of religion or religious belief.
E. CDBG funds may not be used for the acquisition, construction, or rehabilitation of structures
to the extent that those structures are used for inherently religious activities. CDBG funds
may be used for the acquisition, construction, or rehabilitation of structures only to the
extent that those structures are used for conducting eligible activities under this part.
Where a structure is used for both eligible and inherently religious activities, CDBG funds
may not exceed the cost of those portions of the acquisition, construction, or rehabilitation
that are attributable to eligible activities in accordance with the cost accounting
requirements applicable to CDBG funds in this part. Sanctuaries, chapels, or other rooms
that a CDBG-funded religious congregation uses as its principal place of worship, however,
are ineligible for CDBG-funded improvements. Disposition of real property after the term of
the grant, or any change in use of the property during the term of the grant, is subject to
government-wide regulations governing real property disposition (see 24 CFR 84 and 85).
F. If the City voluntarily contributes its own funds to supplement the federally funded activity,
the City has the option to segregate the Federal funds or commingle them. However, if the
funds are commingled, this section applies to all of the commingled funds.
Acquisition or improvement of real property projects must comply with sections 13
through 20:
13. ACCESSIBILITY
Any buildings or other facilities designed, constructed, or altered with federal funds pursuant
to this Agreement are subject to the requirements of the Architectural Barriers Act of 1968
(42 U.S.C. § 4151, et seq.) and shall comply with the Uniform Federal Accessibility Standards
(Appendix A to 24 CFR § 40.1, et seq. for residential structures, and Appendix A to 41 CFR §
101-19, et seq. for general type buildings). When applicable, certain multifamily housing
units designed and constructed for first occup ancy after March 13, 1991, with assistance
13
provided under this Agreement, must comply with the Fair Housing Accessibility Guidelines,
24 CFR § 100.1, et seq., as amended.
14. ENVIRONMENTAL REVIEW
A. National Environmental Policy Act - The City retains environmental review responsibility for
purposes of fulfilling requirements of the National Environmental Policy Act as implemented
by HUD Environmental Review Procedures (24 CFR § 58.1, et seq.). The City may require
the Agency to furnish data, information, and assistance for the City's review and assessment
in determining whether an Environmental Impact Statement must be prepared. The Agency
shall be solely responsible for the cost of compliance with all such federal laws and authorities
including the cost of preparing plans, studies, reports , and the publication of notices that may
be required.
B. Other Federal Environmental Laws -
(1) Historic Preservation - Activities affecting property listed in or found to be eligible for
inclusion in the National Register of Historic Places will be subject to requirements set
forth in HUD Environmental Review Procedures at 24 CFR § 58.1, et seq. The Agency
shall meet the historic preservation requirements of Pub. L. No. 89-665 (16 U.S.C. §
470(i)), and the Archaeological and Historic Preservation Act of 1974, Pub. L. No. 93-291
(16 U.S.C. § 469a-1), and Executive Order 11593, including the procedures prescribed by
the Advisory Council on Historic Preservation in the regulations at 36 CFR § 801, et seq.
(2) Architectural Barriers - Any facility constructed pursuant to this Agreement shall comply
with design requirements of the Architectural Barriers Act of 1968 (42 U .S.C. §§ 4151, et
seq.), and the Uniform Federal Accessibility Standards (US Gove rnment Printing Office,
1985-494-187).
(3) National Flood Insurance - When applicable, the use of CDBG funds for acquisition or
construction purposes in identified special flood hazard areas shall be subject to Agency
mandatory purchase of flood insurance as required by Section 102(a) of the Flood Disaster
Protection Act of 1973 (Pub. L. No. 93-237, 42 U.S.C. § 2414 and 42 U.S.C. §§ 4001-
4128).
(4) Lead-Based Paint – Whenever funds under this Agreement are used directly or indirectly
for construction, rehabilitation, or modernization of residential structures, the Agency shall
comply, at its sole expense, with the HUD Lead-Based Paint regulations (24 CFR § 35)
issued pursuant to the Lead-Based Paint Poisoning Prevention Act, as amended (42 U.S.C.
§§ 4801, et seq.) and the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42
U.S.C. §§ 4851, et seq.), with regard to lead-based paint, and with any and all applicable
federal, state, and local laws, regulations , or standards hereafter enacted or issued with
regard to lead-based paint. Without limiting the foregoing, the Agency shall remove or
cover, prior to the date for completion of the work funded hereunder and in compliance
with all applicable, laws, regulations, and in conformity with guidelines issued by HUD, all
lead-based paint with lead content above the threshold established by HUD on surfaces
affected by the work funded under this Agreement. The Agency shall defend, indemnify ,
and hold harmless the City from any liability, loss, damage, or expense, including costs
and attorneys’ fees, relating in any way to lead-based paint at the property or the
abatement or disposal thereof. This provision shall survive expiration and satisfaction of
this Agreement, whether by payment, forgiveness, foreclosure, or otherwise.
(5) Other - Clean Air Act as amended, 42 U.S.C. § 7401, et seq.; Water Pollution Control Act,
33 U.S.C. §§ 1367, et seq., as amended; Environmental Protection Agency regulations,
40 CFR §§ 1.1, et seq.
C. State Environmental Policy Act - Agencies which are branches of government under RCW
43.21C.030 retain responsibility for fulfilling the requirements of the State Environmental
14
Policy Act, Chapter 43.21C RCW and the regulations and ordinances adopted there under. If
the Agency is not a branch of government under RCW 43.21C.030, the City may require the
Agency to furnish data, information, and assistance, as necessary, to enable the City to
comply with the State Environmental Policy Act.
D. Satisfaction of Environmental Requirements
(1) Limitations on Activities Pending Clearance – Per 24 CFR § 58.22(a). The Agency shall not
commit assistance under this Agreement until HUD has approved the City’s Request for
Release of Funds (RROF) and the related certification from the City. In addition, until the
RROF has been approved by HUD, neither the City nor the Agency may commit non-HUD
funds on or undertake an activity or project under a program listed in § 58.1(b) if the activity
or project would have an adverse environmental impact or limit the cho ice of reasonable
alternatives. Provided; however, that an option agreement, self -Help Homeownership
Opportunity Program funds, and relocation assistance may be excluded from the limitation
above per 24 CFR § 58.22(d), (e) and (f) respectively.
(2) Notice to Proceed - Project execution under this Agreement, by either the City or the
Agency, shall not proceed until satisfaction of all applicable requirements of the nation al and
state environmental policy acts. A written notice to proceed will not be issued by the City
until all such requirements are complied with.
15. LABOR STANDARDS – 24 CFR § 570.603
A. The Agency shall require that project construction contractors and subcontractors pay their
laborers and mechanics at wage rates in accordance with the Davis-Bacon Act, as amended
(40 U.S.C. §§ 3141 and 3142), and that they comply with the Copeland Act (18 U.S.C. §
874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§ 3701, et seq.);
provided that this section shall not apply to rehabilitation of residential property only if such
property contains not less than eight (8) units. In addition to complying with these federal
labor standards, the Agency shall further require that all project construction contractors
comply with all applicable state and local public works bidding and contracting regulations,
specifically including, without limitation, the prevailing wage provisions set forth in Ch. 39.12
RCW and all regulations adopted by the State of Washington Department of Labor and
Industries.
B. The Agency shall require that project construction contractors and subcontractors comply with
Federal Labor Standards Provisions (HUD form 4010) and the Davis-Bacon wage
determinations (attached as Exhibits I and J, respectively if applicable). For construction
contracts, a copy of the Federal Labor Standards Provisions (HUD form 4010) and the current
Davis-Bacon wage determinations must be included in all construction bid specs and/or
contracts over $2,000.
16. VOLUNTEERS 24 CFR § 70
If the Agency or the Contractor/Subcontractor uses volunteers to perform services on a
federally-assisted construction project, it shall ensure that work is performed without promise,
expectation or receipt of compensation for services rendered. Volunteer files shall include:
(1) the name and address of the agency sponsoring the project; (2) a description of the
project; and (3) the number of volunteers and t he hours donated to the project.
17. ACQUISITION AND RELOCATION
A. Any acquisition of real property for any activity assisted under this Agreement shall comply
with the Federal Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970, 42 U.S.C. §§ 4601, et seq. (hereinafter the “Uniform Act” and the government-wide
15
regulations applicable to all federally-assisted projects, effective April 2, 1989, at 49 CFR §§
34.1, et seq.
B. Implementation of any project provided for in this Agreem ent will be undertaken so as to
minimize involuntary displacement of persons, businesses, nonprofit organizations, or farms
to the greatest extent feasible.
C. Any displacement of persons, businesses, nonprofit organizations, or farms occurring as the
result of acquisition of real property assisted under this Agreement shall comply with the
Uniform Act, and the regulations at 49 CFR §§ 24.1, et seq., required by federal CDBG
regulations at 24 CFR § 570.606. The Agency shall comply with the regulations pertaining to
costs of relocation and written policies, as specified by the City of Kent's Displacement Policy.
18. PUBLIC OWNERSHIP
For Agencies which are not municipal corporations organized under th e laws of the State of
Washington, it may become necessary to grant the City a property interest where the subject
project calls for the acquisition, construction, reconstruction, rehabilitation, or installation of
publicly-owned facilities and improvements.
19. REVERSION OF ASSETS – 24 CFR § 570.505.
Any real property under the Agency's control that was acquired or improved in whole or in
part with CDBG funds in excess of $25,000 must be either:
A. Used to meet one of the national objectives set forth in 24 CFR § 570.208 of the CDBG
regulations until five (5) years after expiration of the Agreement, or such longer period of
time as determined by the City. For Acquisition or improvement of real property projects, the
Agency and the City shall execute a Community Facility Covenant Agreement.
B. Disposed of in a manner those results in the City being reimbursed in the amount of the
current fair market value of the property, less any portion attributable to expenditures of non -
CDBG funds for acquisition of, and improvements to, the property. Such reimbursement is
not required after the period of time specified in Paragraph (A) above.
20. PROPERTY MANAGEMENT STANDARDS
A. The Agency shall meet the following procedural requirements for all property acquired in
whole or in part with CDBG funds:
(1) Property records shall be maintained accurately and provide for a description of the
property; manufacturer's serial number or other identification number; acquisition date
and cost; source of the property; percentage of CDBG funds used in the purchase of
property; and location, use, and condition of the property.
(2) A physical inventory of property taken and the results of that inventory are reconciled with
the property records at least once every two (2) years to verify the existence, current
utilization, and continued need for the property.
(3) A control system shall be in effect to ensure adequate safeguards to prevent loss, damage,
or theft of the property which shall be investigated and fully documented .
B. The disposition of real property acquired in whole or in part with CDBG funds shall be at no
less than its current appraised fair market value (or for a lease, at the current market value),
except that such property may be disposed of for a lesser value, including by donation, if the
disposition at the lesser value is for a use which qualifies under one of the criteria set forth in
24 CFR § 570.208 for meeting the national objectives and is permissible under state and local
law. Where the disposition is for a lesser value, the recipient shall maintain documentation
that the use meets one of the national objectives pursuant to 24 CFR § 570.208.
16
21. ADDITIONAL LOCAL REQUIREMENTS
A. Mortgage or Leasehold Agreement – In acquisition, rehabilitation, and con struction projects,
the City shall enter into a deed of trust or leasehold agreement with the Agency to secure and
protect the City's and the public's interest in the property.
B. Adequate Value – In acquisition projects, the City shall require evidence th rough a property
appraisal, title search, or other means to ensure that there is adequate value so as to secure
the City's financial interest.
C. City Ordinance, Codes, and Regulations – In acquisition and construction projects, the Agency
shall comply with all applicable City ordinances, codes, and regulations.
D. Additional Public Information – For all construction projects, the Agency shall erect a sign to
City specifications at the construction site, which identifies the source of funds, except that
this requirement may be waived for construction projects of $5,000 or less.
PART III - MONITORING & REPORTING REQUIREMENTS
1. MONITORING
Agency understands and agrees that it will be moni tored by the City and HUD from time to
time to assure compliance with all terms and conditions of this Agreement and all applicable
local, state, and federal laws, regulations, and promulgated policies. Monitoring by the City
under this Agreement shall include, but not be limited to: (1) on-site inspections by City
staff, (2) quarterly performance reviews, and (3) an annual evaluation.
2. PROGRAM REPORTING
A. For public service programs – A Billing Voucher and Service Report shall be submitted at least
quarterly, even if no reimbursement is requested. The report is due on in accordance
with the schedule listed in First Amendment to First Amendment to Exhibit A. If the due date
falls on a Saturday or Sunday, the Billing Voucher and Service Report are due on the prior
Friday. If the due date falls on a City holiday, the Billing Voucher and Service Report is due
the next working day following the holiday. The report shall detail information on service
units or steps/milestones accomplished during the months/quarters as outlined in First
Amendment to Exhibit A. The Final Service Report Form is provided by the City and is
attached as First Amendment to Exhibit D-1 to this Agreement; it is also due in accordance
with the schedule listed in First Amendment to Exhibit A.
B. For acquisition or improvement of real property projects – Projects qualifying to meet the
national objective to serve low- and moderate-income persons (under Part I, Section 3) shall
submit a demographic report providing income, race, and head of household information for
the beneficiaries of the CDBG Project, which shall cover a one year period extending back
from the date of the report. If the facility is and remains occupied during the project, this
report is due thirty (30) days after the date the project was closed. If the facility is first
occupied or reoccupied after the close of the project, the report is due one year from the date
of the last project closing.
3. FISCAL REPORTING RESPONSIBILITIES
The Agency shall provide fiscal statements or reports as may be required from time to time
by the City, which statements or reports, or both, must indicate the status of all accounts and
funds being used to perform under this Agreement. The Agency shall maintain proper
documentation and records of all expenditures incurred pursuant to the terms of this
Agreement in a manner as will facilitate auditing by either HUD or the City.
17
4. AUDITS
A. If the Agency is a nonprofit corporation and expends a total of $750,000 or more in federal
financial assistance and has received federal financial assistance from the City during its fiscal
year, it shall have an independent audit conducted of its financial statement and conditions,
which shall comply with the requirements of 2 CFR Part 200, Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards.
The Agency shall provide a copy of the audit report no later than thirty (30) days after the
audit’s completion or six (6) months subsequent to the end of the Agency’s fiscal year,
whichever date is sooner. The Agency shall provide to the City its response and corrective
action plan for all findings and reportable conditions contained in its audit. When reference
is made in its audit to a “Management Letter” or other correspondence made by the auditor,
the Agency shall provide copies of those communications and the Agency’s response and
corrective actions plan.
B. The Catalog of Federal Domestic Assistance (CFDA) number for the CDBG program is 14.218.
PART IV – RECORDKEEPING REQUIREMENTS
1. PROGRAM RECORDS AND INSPECTIONS
The Agency shall make, maintain, and preserve books and records, of whatever form,
detailing all CDBG-related expenditures and costs incurred by the Agency. All such books and
records shall be made available to representatives of the City or HUD, or both, for formal
inspection and, where necessary, copying. Intentional noncompliance with this provision shall
constitute a material breach of this Agreement.
Throughout the term of this Agreement, the Agency shall establish and maintain current the
records described in this Section. These records shall conform to the requirements and
specifications of their individual source authorities, which are cited herein. Be advised that
the listing in this Section is intended only to assist the Agency in identifying the required
records and their respective authorities, and is not all inclusive.
A. Time for Retention of Records - Except where otherwise specifically provided, all records as
of the end of the term of this Agreement shall be kept in an accessible file for four (4) years
thereafter (24 CFR § 570.502(b)(3)(ix)). Exceptions to the four (4) year retention period are as
follows: (1) Records that are the subject of litigation, claim, or audit findings shall be retained for
ten (10) years after the date all issues have been resolved and final action taken; and (2) Records
for real property and equipment shall be retained for three (3) years after its final disposition,
with the retention period starting from the date of the disposition, replacement, or transfer at the
direction of the City (24 CFR § 570.84(b)).
B. Contract and Amendments - A complete copy of this Agreement and all amendments thereto
and notices there under.
C. Records of City Approvals - Copies of all requests for amendments or revisions to this
Agreement and the City’s subsequent approval or denial of such requests as are required
under this Agreement.
D. Subcontracts and Agreements - Complete copies of all contracts, subcontracts, and
agreements with third parties into which the Agency enters in the performance under this
Agreement; and all correspondence, reports , and other documentation pertaining to such
contracts, subcontracts, and agreements.
E. Records identifying the assisted activity - A complete description of each activity assisted, in
whole or in part, with CDBG funds under this Agreement, including:
(1) Location(s), organization, operating hours, qualifications for service or participation, etc.;
18
(2) Fees or charges for services, fee waivers, or fee scales for CDBG-assisted participants.
F. Additional Contract Requirements - The Agency shall submit to the City a copy of the most
recent independent financial audit and a current list of the Agency’s board of directors.
2. PROGRAM BENEFIT RECORDS – 24 CFR § 570.506(b).
As applicable, the following categories of records shall be maintained, for the discrete
activities which are assisted in whole or in part with funding under this Agreement (or for all
the Agency's activities if funding under this Agreement is not specifically allocated to particular
activities) for the purpose of documenting that a majority of the beneficiaries are persons of
low- or moderate-income.
A. Records specifying by dollar amount, family size, and household income limits used to
determine income level;
B. For service activities serving individual clients without regard to their residence location within
the City/County, records documenting: (a) manner in which each client's income is
determined in all cases; (b) determination that each individual client's income is or is not
within low- or moderate-income limits; (c) date determination was made; and (d) tabulation
of the individual determinations.
C. For a service or facility which exclusively serves a class of beneficiaries, the members of which
are presumed to be low- or moderate-income eligible absent general evidence to the contrary
(abused children, battered spouses, senior citizens, adults meeting the Bureau of the Census’
Current Population Reports definition of “severely disabled,” homeless persons, illiterate
persons, persons living with AIDS and migrant farm workers), records documenting: (1) that
the facility exclusively serves the eligible class; and (2) there is no generally available data
indicating specific population served is not predominantly low- or moderate-income.
D. For a service or facility which offers benefits uniformly without regard to income to all persons
residing within a delineated area, records establishing: (1) boundaries of the service area;
(2) the income characteristics of families and unrelated individuals in the service area; and
(3) if the percent of low - and moderate-income persons in the service area is less than fifty-
one (51) percent, data showing that the area qualifies under the exception criteria set fort h
at 24 CFR § 570.208(a)(1)(ii).
3. FINANCIAL RECORDS
Agency shall maintain a financial management system in accordance with 2 CFR § 200.302 and
24 CFR 570.506(h). Agency shall maintain all accounting records that accurately record the source and
application of all funds. The records must contain information pertaining to Federal awards,
authorizations, obligations, unobligated balances, assets, expenditures, income and interest and be
supported by source documentation.
Agency shall maintain evidence to support how the CDBG funds provided to such entities are
expended. Such documentation must include, to the extent applicable, invoices, schedules
containing comparisons of budgeted amounts and actual expenditures, construction progress
schedules signed by appropriate parties (e.g., general contractor and/or a project architect),
and/or other documentation appropriate to the nature of the activity. Agency records pertaining
to obligations, expenditures, and drawdowns must be able to relate financial transactions to
either a specific origin year grant or to program income received during a specific program
year.
Financial records, supporting documents, statistical records, and all other records pertinent to a
Federal award shall be retained for a period of three years from the date of submission of the
final expenditure report or, for Federal awards that are renewed quarterly or annually, from the
19
date of the submission of the quarterly or annual financial report, respectively, as authorized by
the Federal awarding agency. The only exceptions are the following:
A. If any litigation, claim, or audit is started before the expiration of the three-year period, the
records shall be retained until all litigation, claims, or audit findings involving the records
have been resolved and final action taken.
B. Records for real property and equipment acquired with Federal funds shall be retained for
three years after final disposition.
C. When records are transferred to or maintained by the Federal awarding agency, the three-
year retention requirement is not applicable to the recip ient.
D. This section does not apply to records maintained by contractors or subcontractors.
2 CFR § 200.333.
4. RECORDS OF PROGRAM OPERATIONS, MANAGEMENT AND EVALUATION
Agency shall maintain all records of:
A. Operating policies and procedures;
B. Employee qualifications, training, and evaluation;
C. Principal operations data: work units completed; clients served, classified by client and
service characteristics; staff hours utilized; etc.
D. Self-evaluation of services, programs, and employment practices for compliance with 504 and
ADA requirements.
5. PROPERTY RECORDS
Agency shall maintain all records identifying any real and personal property acquired or improved
in whole or in part with funds under this Agreement as follows:
A. Itemized inventory of real property recording legal and common descriptions and address,
date of acquisition and/or improvements, cost of acquisition and/or improvements, and
CDBG-funded share of cost;
B. Itemized inventory of all non-expendable personal property recording full identification,
current location, date and cost of acquisition, and CDBG-funded share of cost;
C. Complete records of any authorized disposition of real or non -expendable personal property
including how and to whom disposed, date, amount of disposition proceeds, market value at
time of disposition and how determined, intended use, and any conditions governing use
following disposition;
D. At the termination of this Agreement, a record of the total purchase cost of al l remaining
unused expendable personal property.
E. Agency shall submit reports at least annually on the status of real property in which the Federal
government retains an interest, unless the Federal interest in the real property extends 15
years or longer (2 CFR 200.329).
6. NONDISCRIMINATION AND EQUAL-OPPORTUNITY RECORDS – 24 CFR § 570.506(g).
Agency shall maintain:
20
A. A recordation and tabulation of the racial classification of all individual persons or households
receiving program benefits, and of whether these benefited persons are single head of
household.
B. A tabulation of all Agency employees classified by race, position , and salary in the format of
the U.S. Equal Employment Opportunity Commission Form EEO-4.
C. Data identical to that required under A. and B. above for any subcontractor or agent employed
in the performance under this Agreement.
D. Documentation of all substantive actions taken to assure that no prohibited discrimination
occurs in the conduct of any of the Agency's operations.
E. Documentation of all actions taken to make minority residents aware of the Agency's services
and provide them with equal access to benefits.
F. Record of the racial classification and gender of the majority owners of each private for -profit
business with which the Agency contracts with any funds provided under this Agreement.
7. CONFLICT OF INTEREST
A. Records documenting that all Agency board members, officers, employees and consultants
have been informed of the conflict of interest provisions of 24 CFR § 570.611 and have
acknowledged understanding those provisions.
B. Complete records of all requests for exceptions submitted under 24 CFR § 570.611(d).
8. VERIFICATION OF SUBCONTRACTOR’S ELIGIBILITY – 24 CFR § 5.
The Agency shall maintain records documenting that the Agency, all subcontractors, and
consultants have been determined not to be currently debarred, suspended, denied
participation or declared ineligible to participate in federal government funded programs.
Verification of eligibility shall be accomplished by signing the Certification Regarding
Debarment and Suspension, which is attached and incorporated as Exhibit F .
9. ADDITIONAL REQUIREMENTS FOR ACQUISITION OR IMPROVEMENT OF REAL PROPERTY
PROJECTS
A. For construction contracts over $100,000, records documenting compliance with the bonding
requirements of 24 CFR § 85.36 (h).
B. Flood Insurance, Flood Disaster Protection Act of 1973; and Federal Insurance Administration
Notice in Federal Register Vol. 24, No. 133, July 13, 1989.
(1) Record of determination whether the assisted project is located within a designated flood
plain or flood hazard area.
(2) If the project is within such area: (1) Evidence of current participation in the National
Flood Insurance Program; and (2) Evidence of flood insurance coverage in force on all
significant project structures.
C. Lead-Based Paint – Records required to document compliance with the Lead -Based Paint
Poisoning Prevention Act (42 U.S.C. §§ 4801, et seq.), as amended and the Residential Lead-
Based Paint Hazard Reduction Act of 1992 (42 U.S.C. §§ 4851, et seq.), and the implementing
regulations 24 CFR § 35.
D. Labor Standards – Records required to document compliance with all requirements of Davis -
Bacon and Related Acts (40 U.S.C. §§ 3141 and 3142); Contract Work Hours and Safety
Standards Act (40 U.S.C. § 3701, et seq.); Copeland Act (18 U.S.C. § 874); US Secretary of
Labor Regulations (29 CFR §§ 3, 5, 6, and 7).
21
E. Real Property Acquisition and Relocation – Records required to document compliance with the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, 42 U.S.C.
§§ 4601, et seq., as amended; and the implementing regulations 49 CFR § 24. The agency
shall consult the City for complete instruction prior to undertaking any action which may result
in displacement of persons as defined at 49 CFR § 24.2(g).
F. Miscellaneous Records – The Agency shall maintain such other records as may be required by
HUD or the City.
22
PUGET SOUND TRAINING CENTER :
Sign in blue or black ink only
By: _____
(signature)
Print Name: _____________________________
Its: __________________
DATE: _____
CITY OF KENT:
_____
(signature)
Print Name: Julie Parascondola, CPRE
Its: Director
Parks, Recreation & Community
Services Department
DATE: _______________________________________
NOTICES TO BE SENT TO:
PUGET SOUND TRAINING CENTER:
Krissya Escobar, Program Manager
Puget Sound Training Center
270 SW 43rd ST, Bldg. 3
Renton, WA 98057
Phone: 425.656.5950
E-mail: Kryssiae@pstrainingcenter.com
NOTICES TO BE SENT TO:
CITY OF KENT:
Dinah Wilson, Senior CDBG Coordinator
City of Kent
220 Fourth Avenue South
Kent, WA 98032
Phone: 253.856.5076
E-mail: drwilson@kentwa.gov
ATTEST:
Kent City Clerk
joseph drake (Aug 17, 2021 11:55 PDT)
joseph drake
Joseph P. Drake
8/17/2021
Executive Director
Julie Parascondola (Aug 17, 2021 14:50 PDT)
Julie Parascondola
8/17/2021
2021-2022 PSTC-Employment Services CDBG Revised Scope of Services: Agreement with City of Kent -
Page 1
EXHIBIT A
2021-2022 CDBG PROJECT SCOPE OF SERVICES
PUGET SOUND TRAINING CENTER
Project Title: Employment and Training Services Start Date: 1/1/121
Project No.: BG2126-2226 End Date: 1/31/221
City of Kent Federal Award Identity Number (FAIN) B-21-MC-53-0017
B-22-MC-53-0017
Funding will provide comprehensive employment services
to underserved individuals in Kent.
2021
Funding:
$10,000.00
2022
Funding
$10,000.00
Total City
of Kent
Funds:
$20,000.00
Project Manager: Krissya Escobar
Telephone: 425.656.5950 Fax: 425-656-5951 E-mail: Kryssiae@pstrainingcenter.com
CDBG Coordinator/City Contact: Dinah Wilson
Telephone: 253.856.5076 Fax: 253.856.6070 E-mail: drwilson@kentwa.gov
Puget Sound Training Center (hereinafter referred to as "the Agency") shall
utilize City of Kent Community Development Block Grant funds to perform the activities
specified below. Such services shall be provided in a manner which fully complies with all
applicable federal, state and local laws, statutes, rules and regulations, as are now in effect
or may be hereafter amended.
1) Project Budget
The Agency shall apply the following funds to the project in accordance with the Biennium
Line-Item Budget Summary below:
Line Item Budget
Personnel Services $20,000.00
Office or Operating Supplies $
Consultant or Purchased Services $
Construction Contracts $
Communications $
Travel and Training $
Grants $
Total City of Kent Funds: $20,000.00
1 1 Funding for 2022 is subject to change if the City’s CDBG allocation from HUD decreases.
2021-2022 PSTC-Employment Services CDBG Revised Scope of Services: Agreement with City of Kent -
Page 2
2) Performance Measures
A. Number Served
The Agency agrees to serve, at minimum, the following unduplicated number of persons
each year of the CDBG Agreement:
Quarters 1st
Quarter
JAN. –
MARCH
2nd
Quarter
APRIL –
JUNE
3rd
Quarter
JULY –
SEPT.
4th
Quarter
OCT. –
DEC.
Total
Per
year
No. of unduplicated persons
assisted 10 10 12 12 44
B. Units of Service
The Agency agrees to provide, at minimum, the following units of service by quarter:
Quarters 1st
Quarter
JAN. –
MARCH
2nd
Quarter
APRIL –
JUNE
3rd
Quarter
JULY –
SEPT.
4th
Quarter
OCT. –
DEC.
Total
Per
year
Education/Training Classes
(#of training classes) 2 2 2 2 8
C. Definition of Services
Education/Training Classes: Education/Training classes include forklift training and
certification, computer training, warehouse training, and first aid & CPR training . This
service is measured by the # of classes provided. Each training course is 40 hours of class
instruction.
3) Records
A. Project Files
The Agency shall maintain files for this project containing the following items (all Agency
files must contain items 1 – 7, however items 8 – 12 are required only if the costs
are paid for by the CDBG budget. If clients are not presumed eligible; e.g.,
homeless, #13 client income must be documented):
1. Notice of Grant Award.
2. CDBG Agreement and all contract exhibits.
3. Motions, resolutions, or minutes documenting Board or Council actions.
4. A copy of this Scope and the City’s Notice to P roceed on this project.
5. Correspondence regarding budget revision requests.
6. Copies of all invoices and reports submitted to the City for this project.
7. Bills for payment.
8. Copies of approved invoices and warrants.
2021-2022 PSTC-Employment Services CDBG Revised Scope of Services: Agreement with City of Kent -
Page 3
9. Payroll time sheets for actual salary and fringe benefit costs. Time sheets must
be signed by a supervisor and annotated to document percent of time charged
against this project if less than full time.
10. Documentation of office costs (e.g., log sheets of copy machine use, postage,
telephone use, costs of office supplies, etc.) when these costs are shared with
other programs and no invoice is available. As an alternative, annotated
invoices may be used to document charges as appropriate.
11. Documentation of mileage charges for private auto use must include: a)
odometer reading at beginning and end of trip, b) destination and starting
location, and c) purpose for trip.
12. Documentation of the solicitation process used to select vendors and
subcontractors with original purchase orders and subcontracts.
13. Documentation required by Part IV, Paragraph 5, if any funds provided under
this Scope are used to acquire equipment.
14. Documentation of client income. Unless clients are presumed eligible based on
CDBG regulations, the Agency shall screen all clients served with funds
provided under this Contract to ensure that at least 51% of the total number of
clients served do not have a gross annual family income in excess of the limits
specified in Exhibit B.
Adjusted gross income as defined by the Internal Revenue Service Form 1040
shall be used to determine persons’ or households’ income. The following
methods may be used to determine income eligibility:
a) IRS income tax return;
b) Client income certification on a form approved by the City; or
c) Documentation of qualification for participation in a “means-tested”
federal or state program at least as restrictive as CDBG with regard to
Income Guidelines.
Income guidelines may be adjusted periodically by HUD. The Agency agrees to
use updated Income Guidelines, which will be provided by the City.
B. Record Retention Period
All records required by this Scope shall be retained by the Agency for the period of time
specified in the Agreement - Part IV. The period of time shall commence on January 1 of
the year following the year in which the final invoice was paid.
4) Reports, Invoicing and Reporting Schedule
A. Reports
The Agency shall collect and report client information to the City quarterly on the Service
Units section of Exhibit D (Billing Voucher and Service Report) to be provided by the City.
Exhibits D and D-1 (including backup documents) shall be submitted electronically to
drwilson@kentwa.gov in accordance with the schedule outlined in Paragraph 3.B. below.
Copies of supporting documents shall be emailed as well or sent via the U.S. Postal
Services and postmarked within two days of the due dates listed below.2
2 If the due date falls on a Saturday or Sunday, Billing Vouchers and Service Reports are
due on the prior Friday. If the due date falls on a City holiday, Billing Vouchers and Service
Reports are due the next working day following the holiday.
2021-2022 PSTC-Employment Services CDBG Revised Scope of Services: Agreement with City of Kent -
Page 4
B. Invoicing and Reporting Schedule
The Agency shall submit Billing Vouchers and Service Reports to the City in accordance with
the following schedule:
1st 2nd & 3rd Quarter Billing Voucher &
Service Report (Exhibit D)
15th day following each quarter
CDBG Public Services Project Time
Sheet
(Exhibit G, if applicable)
15th day following each quarter
4th Quarter Billing Voucher & Service
Report (2021)
December 10, 2021
Final Service Report for 2021 (Exhibit
D-1)3
January 7, 2022
4th Quarter Billing Voucher & Service
Report (2022)
December 9, 2022
Final Service Report for 2022 (Exhibit
D-1)
January 6, 2023
3 Exhibit D-1 is due only if the service units reported by the Agency on the initial December
report (Exhibit D) is less than contractual obligations.
EXHIBIT B
2021 INCOME GUIDELINES
Effective 6/1/2021
*Median 50%
MEDIAN
80%
MEDIAN
FAMILY EXTREMELY VERY LOW
SIZE LOW
INCOME
LIMITS
LOW
INCOME
LIMITS
INCOME
LIMITS
1 $24,300 $40,500 $63,350
2 $27,800 $46,300 $72,400
3 $31,250 $52,100 $81,450
4 $34,700 $57,850 $90,500
5 $37,500 $62,500 $97,750
6 $40,300 $67,150 $105,000
7 $43,050 $71,750 $112,250
8 $45,850 $76,400 $119,500
NOTE: King County is part of the Seattle-Bellevue, WA HUD Metro FMR
Area, so all information presented here applies to all the Seattle-Bellevue,
WA HUD Metro FMR Area. HUD generally uses the Office of Management and
Budget (OMB) area definitions in the calculation of income limit program
parameters. However, to ensure that program parameters do not vary
significantly due to area definition changes, HUD has used custom geographic
definitions for the Seattle-Bellevue, WA HUD Metro FMR Area.
The Seattle-Bellevue, WA HUD Metro FMR Area contains the following
areas: King County, WA; and Snohomish County, WA.
*The FY 2014 Consolidated Appropriations Act changed the definition of extremely
low-income to be the greater of 30/50ths (60%) of the Section 8 very low-income
limit or the poverty guideline as established by the Department of Health and Human
Services (HHS), provided that this amount is not greater than the Section 8 50%
very low-income limit. Consequently, the extremely low-income limits may equal the
very low (50%) income limits.
Income Limit areas are based on FY 2021 Fair Market Rent (FMR) areas.
EXHIBIT C
APPOINTMENT OF LIAISON &
AUTHORIZATION TO SIGN BILLING VOUCHERS & SERVICE REPORTS
2021-2022 CDBG AGREEMENT
Appointment of Liaison
The Agency appoints the following person as the liaison for the CDBG
Agreement between the City and the Agency; this person shall be responsible
for overall administration of the CDBG funded program:
Liaison: ________________________________________________________________
(title)
Authorization to Sign Billing Vouchers & Service Reports
The Agency authorizes the following individual(s) to sign Billing Vouchers &
Service Reports for costs incurred and services provided pursuant to the
CDBG Agreement between the Agency and the City; billing vouchers shall
not be processed for payment unless they are signed by an authorized
individual(s):
Authorized
Individual(s):
__ ___________________________________________________________________________________
(Type Name) (title)
__ ___________________________________________________________________________________
(Signature)
Additional Authorized Individual (if applicable):
_____________________________________________________________________________________
(Type Name) (title)
__ ___________________________________________________________________________________
(Signature)
_____________________________________________________________________________________
(Date)
joseph drake (Aug 17, 2021 11:55 PDT)
joseph drake
Joseph Drake Executive Director
Krissya Escobar (Aug 17, 2021 11:57 PDT)
Krissya Escobar
Krissya Escobar
Program ManagerKrissya Escobar
Program Manager
08/17/2021
Page 1 of 5
Exhibit D
Billing Voucher & Service Report
20211
To: Dinah Wilson
Housing & Human Services
Parks, Recreation & Community Services
220 4th Ave. South, Kent, WA 98032
drwilson@kentwa.gov
Phone: (253) 856-5076
From: Krissya Escobar, Program Manager
Puget Sound Training Center
E-Mail: Kryssiae@pstrainingcenter.com
Phone: 425.656.5950
Reporting
Period Program Amount
Requested
Employment and Training Services $
SEC. 1: BUDGET SUMMARY (CALCULATIONS BASED ON YEARLY BUDGET)
For Department Use Only Total Contract Amount $20,000.00
Total 2021 Contract Amount $10,000.00
Amount Requested This Qtr. $
Amount Requested YTD $
Amount Remaining YTD
(subtract amount requested
YTD from 2021 contract
amount)
SEC. 2: 2021 LINE ITEM BUDGET SUMMARY (ANNUAL)
COST CATEGORIES
ORIGINAL
BUDGET
TOTAL
REQUESTED
REVISED
BUDGET
CUMULATIVE
TO DATE
1
Personnel Costs
(Attach Time Sheets)
$10,000.00
2
Other
$0
GRAND TOTAL
$10,000.00
1 1 Exhibits D & D-1 will be updated in 2022. The City will notify the Agency when initial billing reports may
be submitted.
CDBG
Page 2 of 5
SEC. 3: PERSONNEL FUNDED IN WHOLE OR IN PART BY CDBG GRANT
SEC. 4: ANNUAL PERFORMANCE MEASURES - 2021 KENT FUNDED SERVICE UNITS
Note: Unduplicated client counts must be reported both quarterly and year-to-date
Service Unit Description Contracted to
Serve
Total
Contracted Clients Actually
Served
Year to
Date
Total
Service Unit/Performance
Measure 1st 2nd 3rd 4th
Total
Contracted
to Serve
1st 2nd 3rd 4th
Unduplicated # of Kent clients
(persons) served
10
10
12
12
44
Education/Training Classes (#
of training classes)
2
2
2
2
8
Sec. 5: NARRATIVE
Provide a narrative explanation if you are behind in either progress toward meeting
performance measures or projected expenditure rate.
Page 3 of 5
Sec. 6: DEMOGRAPHIC INFORMATION
Number of Households or Persons Assisted (please specify "H" or "P"):
Race Unduplicated
Quarter
(All)
Unduplicated
Quarter
(Hispanic)
Undup.
Year to
Date
(All)
Unduplicated
Year to Date
(Hispanic)
1 2 3 4 1 2 3 4
White
Black/African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native AND
White
Asian AND White
Black/African American AND White
American Indian /Alaska Native AND
Black/African American
Other Multi-Racial
GRAND TOTAL CLIENTS
Income Level Unduplicated Quarter Unduplicated
Year to Date
1 2 3 4
Extremely Low Income 0-30% of MFI
Low Income 31-50% of MFI
Moderate Income 51-80% of MFI
Above Moderate Income 81% + of MFI
GRAND TOTAL CLIENTS
Page 4 of 5
By signing this report, I certify to the best of my knowledge and belief that the report is true, complete,
and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives
set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or
fraudulent information, or the omission of any material fact, may subject me to criminal, civil
or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title
18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812).
Agency Authorized Signature
________________________________________
Print Name
Date
Payment Authorization (this section to be completed by City of Kent only)
Contractual Obligations Met?
YES NO (Circle one)
Enter notes if Agency underperformed:
Authorize
d By:
Date:
Page 5 of 5
Instructions
Refer to: Accomplishments by Performance Measures in your CDBG Contract.
Sec. 1: BUDGET SUMMARY
Enter the amount requested this quarter, Year to Date (YTD) and the budget balance.
SEC. 2: LINE ITEM BUDGET SUMMARY
Enter the amount requested by budget line item quarterly and YTD.
SEC. 3: PERSONNEL FUNDED IN WHOLE OR IN PART BY CDBG GRANT
Enter the names and titles of personnel being charged to the CDBG grant. Remember all hours charged to CDBG must
be tracked and a timesheet certifying the hours worked were to directly support the CDBG funded program must be
signed by the employee and supervisor and submitted to the City with the request for reimbursement.
SEC. 4: PERFORMANCE MEASURES
Unduplicated Count of Households/Persons Assisted
Projections: Circle either persons or households according to the method of counting clients specified in your CDBG
Contract Scope. Insert the projected number of clients to be served as specified in your CDBG Contract Scope.
Achievements: Insert the unduplicated number of clients served during the reporting period. Unduplicated number
means that a person or a household served by your agency may be counted only once during the calendar year. You
may report only those persons or households for which you maintain written records. This record must be established
at the time the person or household is first served by your agency.
Year to Date: Insert the total unduplicated number of clients served to date.
Service Units
Insert the service unit measures specified in your CDBG Contract Scope. Insert the projected number of service units
for the reporting period. Insert the actual number of service units provided during the Reporting Period. The actual
number of service units provided may be duplicated counts. Duplicated means that a client served by your agency
may receive service one or more times during the calendar year in one or more of the service unit categories.
SEC. 5: NARRATIVE EXPLANATION
You must provide a narrative explanation if your agency is behind in meeting either performance measures specified
in your CDBG Contract Scope or your expenditure rate. Your expenditure rate should equal approximately one quarter
of your HHS contract amount per quarter.
SEC. 6: DEMOGRAPHIC INFORMATION
Race: You are required to collect racial and ethnic information for the clients served. There are 10 race categories to
select from. Each client should select one of these categories. Clients identifying themselves as
Hispanic also need to select from the race categories.
Example: A client selects Hispanic as his ethnicity and white as his race. The grand total in the first column will not
match the grand total in the second column. You may only have a few clients who identif y as Hispanic.
Female Head of Household: Insert the unduplicated number of single female head of households with dependents
served during the reporting period.
Income Only for Non-presumed Benefit Projects which require income screening: Insert the unduplicated
clients served who are Low Income (51 –80%), Very Low-Income (31-50%) and Extremely Low-Income (0-
30%). You do not have to complete if your CDBG project directs services toward the following clients: abused
children, elderly persons, DV victims, homeless persons, those meeting the federal definition of severely disabled
persons, illiterate adults, persons living with aids, or migrant farm workers.
Homeless: For programs providing transitional and permanent housing insert the unduplicated clients served.
Page 1 of 3
Exhibit D-1
Service Report-Puget Sound Training Center
2021
To: Dinah Wilson, CDBG Coordinator
Housing & Human Services
Parks, Recreation & Community Services
220 4th Ave. South, Kent, WA 98032
drwilson@kentwa.gov
Phone: (253) 856-5076
Agency: Puget Sound Training Center
Program Contact: Krissya Escobar, Program
Manager
Telephone: 425.656.5950
E-mail: Kryssiae@pstrainingcenter.com
Reporting Period Program
Final Q4 Employment and Training Services
SEC. 1: PERFORMANCE MEASURES - 2021 KENT FUNDED SERVICE UNITS
Unduplicated client counts must be reported both quarterly and year-to-date
Service Unit Description Contracted to
Serve
Clients Actually
Served
Year to
Date Total
Service Unit/Performance
Measure 1st 2nd 3rd 4th 1st 2nd 3rd 4th
Unduplicated # of Kent clients
(persons) served 10 10 12 12
Education/Training Classes (# of
training classes)
2 2 2 2
Sec. 2: NARRATIVE
Provide a narrative explanation if you did not meet performance measures for the
contract year
CDBG
Page 2 of 3
Sec. 3: DEMOGRAPHIC INFORMATION
Number of Households or Persons Assisted (please specify "H" or "P"):
Race Unduplicated
Quarter
(All)
Unduplicated
Quarter
(Hispanic)
Undup.
Year to
Date
(All)
Unduplicated
Year to Date
(Hispanic)
1 2 3 4 1 2 3 4
White
Black/African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native AND
White
Asian AND White
Black/African American AND White
American Indian /Alaska Native AND
Black/African American
Other Multi-Racial
GRAND TOTAL CLIENTS
Income Level Unduplicated Quarter Unduplicated
Year to Date
1 2 3 4
Extremely Low Income 0-30% of MFI
Low Income 31-50% of MFI
Moderate Income 51-80% of MFI
Above Moderate Income 81% + of MFI
GRAND TOTAL CLIENTS
Page 3 of 3
Final Service Report Review (this section to be completed by City of Kent only)
Contractual Obligations Met?
YES NO (Circle one)
Agency Paid in Full?
YES NO (Circle one)
Enter explanation if Agency underperformed and paid in full:
Reviewed
By:
Date:
Page 1 of 2
EXHIBIT E
PUGET SOUND TRAINING CENTER INSURANCE REQUIREMENTS FOR 2021-2022 CDBG AGREEMENT
Insurance
The Contractor shall procure and maintain for the duration of the Agreement,
insurance against claims for injuries to persons or damage to property which
may arise from or in connection with the performance of the work hereunder
by the Contractor, their agents, representatives, employees or
subcontractors.
A. Minimum Scope of Insurance
Contractor shall obtain insurance of the types described below:
1. Commercial General Liability insurance shall be written on ISO
occurrence form CG 00 01 and shall cover liability arising from
premises, operations, independent contractors, products-completed
operations, personal injury and advertising injury, and liability
assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide the Aggregate Per Project
Endorsement ISO form CG 25 03 11 85. There shall be no
endorsement or modification of the Commercial General Liability
Insurance for liability arising from explosion, collapse or underground
property damage. 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. Excess Liability insurance covering the Commercial General Liability
policy.
B. Minimum Amounts of Insurance
Contractor shall maintain the following insurance limits:
1. Commercial General Liability insurance shall be written with limits no
less than $1,000,000 each occurrence, $1,000,000 general aggregate
and a $1,000,000 products-completed operations aggregate limit.
2. Excess Liability insurance shall be written with limits no less than
$1,000,000 per occurrence in excess of both the CGL and Auto Liability
policies cited above.
Page 2 of 2
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 A:VII.
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.
ACORD'*-'
PUGET-3
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDTYYYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON TH
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE
BELOW. THIS CERTIFICATE OF INSUMNCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSU
E CERTIFICATE HOLDER. THIS
AFFORDED BY THE POLICIES
ING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER'
MPORTANT:orons endorsed,beITIONALUtNsDREustmADprovisihaveADDITIOnNALthetfcertificatethetsholderaNSURED,policy(ies)
statement onAanreendorsement,ncertai rcrespol requimaycondandofitionsthetermstotheISSUBROGAtfTIONWAIVED,
suchrtificateceholdernnotdoesnconferthis
lnsurance CoOhio
425-235-8674
IW
PHONE
24082
425-255-2486
Hubbard, CISR,
PRODUCER
HUB INSURANCE AGENCY
1102 Bronson Way North
P. O. Box 796
Renton, WA 98057-0796
Hub lnsurance AgencY
wA 98057
u
43rd St, Ste 3-D&E
nd Training Center
nd OIC lnc dba
EXP
POLICY NUMBERTYPE OF INSURANCE LIMITS
THSTANDI
MAY PERTAIN,
POLICIES,
CYPOLI PERIODABOVENAMEDTHEFORTOINSTHEUREDEDHAVEBELOWISSUBEENOFPOLICIESNSURANCLISTEDETOISTHACERTIFYTHETTHTOTHWHICHJRESWITHECTPOREROTHUMENTDOCOROFCONDITIONCONTRACTANYREQANYUTREMENTERMNOTWINGDICATEDINTOTHEALLTERMSEHEREIDNeECTUBJBYPOTHECIESLIDESCRIAFFORDEDNSURANCETHEORtcAMATEBEYISSUEDCERTIFDEPAIBYDMS.LAIMAYHOWNHAVEEEREDUCNLITSIMSOFSUCHDANoNNDITIOeEXCLUSIONS
'l
1
07t2512021 07t2512022X8KW57913345XOCCUR
A LIABILIry
PER:
LOC
GEN'L AGGREGATE LIMIT APPLIES
' ,or'., ] 5g.ot ii-
SINGLE
_lr I ANYAUTOa I owtleoi AUTOS ONLYI I rrngo.i AUTOS ONLY
r
SCHEDULED
AUTOS
NON-OWNED
AUTOS ONLY
AUTOMOBILE LIABILITY
1,000,000
1,0
0712512021 07t25t20221 3345
] UMBRELLA LIAB OCCUR
CLAIMS-MADE
X
1,000
1,000
2,000
07t021202207t0212021
N/A STOP GAP
3345
WORKERS COMPENSATION
AND EMPLOYERS' LIABILIry
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/IVIE[/BER EXCLUDED?
(Mandatory in NH)
describe under
!_l
A
DEscRtpT|oNoFopERATtoNs/LocATloNs/vEHtcLEs (AcoRDl0l,AdditionalRemarksschedule,maybeattachedifmorespaceisrequired)
Certificate holder is named as an additional insured as respe-cts to their
iniLi'6sTi-n ali operations of the named insured subject to pblicy terms and
conditions. Foim CG8810 attached.
CITYKEN
Gity of Kent
Human Services DePt
220 4th Avenue South
Kent, WA 98032-5895
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVEgg^$r\Rndoi
O 1988-2015 ACORD CORPORATION. All rights reseryedACORD 25 (2016t031
The ACORD name and logo are registered marks of AGORD
COMMERCIAL GENERAL LIABILITY
cc 88 10 04 13
THI9 ENDORSEM=NT CHANGfiS TTIE POLICY. PLEASE READ IT CARHFULLY
COMMERCI,AL GHNERAL LIABILITY EXTENSION
This endorsement modifies insurance provided under the foilowing:
COMMERCIAL GTNHRAL LIABILITY COVERAGE PART
INDFX.
$UgJECT
NON-OWNED AIRCfiAFT
NON-OWNED WATERCRAFT
FROPERTY ilAMAGE LIABILITY . ELEVATORS
EXTHNNED DAMAGE TO PROFERTY RENTED TO YOU (Tenant's Property Damago}
MHDICAL PAVMENTS EXTfiNSION
EXTEN$ION OFSUPPLEMENTARY PAYMENTS . COVERAGE$ A AND B
ADFITIONAL INSUREDS . BY CONTRACT, AGREEMENT OR PHRMIT
FR;MARY AND NON.CONTRIBUTORY. ADDITIONAL INSURED EXTENS'ON
ADNITIONAL INSURED$ . EXT*NDED PROTECTION OF YOUR "LIMITS OF INSURANCE"
WHO IS AN INSURED . INCIDENTAL MEDICAL ERRORS'MALPRACTICE AND WHO IS AN
INSURHD - FELLOW EMPLOYEE EXTENSION . MANA,GEMENT EMPLOYEES
NHWLY FORII4ED OR ADDITIANALLY ACQUIRED ENTITIES
FAILURE TO DISCLOSE HAZARDS AND PRIOR OCCURRENCES
KNOWLEDGE OF CICCURRHNCE, OFFENSE, CLAIM AR SUIT
LIBERALIZATION CLAUSE
BODILY INJURY REDEFINEil
EXTENDED PROPERTY OAMAGE
WAIVER OF TRANSFER CIF RIGHT$ OF RHCOVERY AGAI',IST OTHERS TO U$ .
WHEN REQUIREO IN A CONTKACT OR AGREEMENT WITH YOU
@ 2013Liherty Mulua! lnsurance
lncludes copyrighted material of lnsurance Services Qffice, lnc,, wilh its permission,
.PAGE
2
2
2
2
3
3
3
$
b
6
7
7
7
7
7
I
B
*
cG 88 10 04 f3 Page 1 of I
Wlh respect to coverage afforded by this endorsernent, the provisions of tlre policy flpply unless rnodified by
the sndorsement,
A. NON-OWNED AIRCRAFT
Under Faragraph 2. Exclusions of Section I . Coverage A - Bodily tnjury And Proporty Damage Liability,
exclusion g. Aircraft, Auto Or Watercraft does not apply to an aircraft provided:
1. lt is not owned by any insured;
2, lt is hired, chartered or loaned with a trained paid crewi
3. The pilot in comnrand holds a currently effective certificate, issued by the duly corrstituted authority of
lhe United $tates of America or Canada, designating her or hin: a commercial or airline pilo[ and
4. lt is not being used to carry persons or prcperty for a charge.
However, the insurance afforded by this provision does nol apply if there is available to the lnsured other
valid and coltectible insurance, whether primary, excess {other llran insurance written lo apply specifisfilly
iil excess of this policy), contingent or on any oiher basis. that would alsc apply t* the loss covared under
lhis provisiorr.
NCIN.OWNED WATERCRAFT
Under Paragraph 2' Exclusions of $ection I - Coverage A - Bodily lnjury And Property Damage Liability,
Subparagraph {2) of exclusion g. Aircraft, Auto Or Watercraft is replaced by the following:
Tiris exclusion does nat apBly lo:
t2) A watercratt you do not own thilt i$:
(a) Less than 52 feet long; and
(b) Not being used to carry persons or property for a charge^
C. FROPFRTY DAMAGg LIABILITY - ELEVATORS
1. Under Faragraph 2" Exclusions of Section I " Coverage A - Bodily lnjury And Property Damage Liabil.
ity, Subp*ragraphs (31, {4} and t6) of exclusion j. Damage To Property do not apply if such "property
damage" results frotn the use of elevators. For lhe pilrpose of this provision, elevators do not include
vehicls lifts. Vehicle lifts are lifts or hoists used in autamobile service or repair operations.
2. The following is added to $ecticn lV - Commercial General Liability ,Conditions, Condition 4. Other
lnsurance, Paragraph b. Excess lnsurance:
The insurance afforded by this provision of this endorsernent is excecs over any property insurance.
whether primary, axcess, contingent or on any other basis.
D. EXTENDflD DA,MAGE TO PROPERTY RENTED TO YOU (Tenant's property Damage)
lf Damage To Premises Rented To Yot"t is not otlreruise excludeci from ttris Coverage Farl:
1' Under Pnragraph 2. Exclusions of Section l" coverage A - Bodily lnjury and Proporty Damsge Liability;
a. The fourlh frotn the lasl paragraplr of exclnsion j. Damage To Property is replaced by the follow
ing;
Paragraplrs {1}, {3} and {4} of tlris exclusion dc nol apply to "property damage" (olher than damage
by fire, lighlning, explosion, smoke, or leakago from an automatic fire protection systonr) lo:
(ll Promises rented to you for a period of 7 or fewer consecutive days; or
(ii) Contents that you rent or leaso as part of a prenrises relrtal or lease agreemenl for a period of
more than 7 days.
Paragraphs {f }, (3} and (4) of lhis exclusion do not apply to "property dflmage" to contents sf
premises renled to you for a period of 7 or fewer consecutive days.
A separate limit of insurance applies to this coverage as described in Section lll - Limits of
lnsurance.
I
fi
s e0t3Liberty Muluat lnsurance
Inclu<ies copyrighled material of lnsurance Services Office. fnc., with its permissioncG 8S 10 04 13 Page 2 of I
3
b. The last paragraph of subsection 2. Exelusions is replaced by the following:
Exclusions c. through n. do nol apply to damago by fire, lightning, explosion, smoke or leakago
from automatic fire protection syslems to premises while rented to you or temporarily occupied by
you with permission of the owner. A separate limit of insurance applies lo Damage To Premises
Rented To You as described in Section lll . Limits Of lnsurance-
2. Paragraph 6. under Section lll - Limits Of lnsurance is replaced by the following:
6" Subiect to Paragraph 5. above, the Damage To Premises Rented To You Lirnit is ths most ure vr,rill
pay under Goverage A lor damages because of "property damage" to:
a, Any one prernise;
{1} White rented t0 you; or
(f) While rented 1o you or ternporarily occupied lry you with perrnission of lhe owner for
damage by fire, lightning; explosion, smoke or leakage from autornatic protection sys-
tenrs; or
b. Gontents thflt you rent or lease as part of a premises rental or lease agreement.
3. As regards coverage provided by this provision D. EXTHNDED DAMAGE TO PROpEftTY RENTEO TO
YOU (Tenant's Property Damage) - Paragraph La. of Oefinitions is replaced with the following;
La. A conlract for a lease of premises. However. that portion of llre contract for a lease of premises
that indemnifies any porson or organieation for damage by fire, lightning, explosion, smoke, or
leakage from autornatic fire protection syst€ms ta premises while rented to you or temporarily
occupied by you with ihe perrrissiorr of tlre owner, or for damage to content$ of such premises
lhat are included in your prernises rental or lease agreement, is not an "ingured conlract".
H. MEDICAL PAYMENTS EXTENSION
lf Coverago C Medical Payments is not othenrise excluded, the Medieal Payments provided by this policy
are amended as follows:
Under Paragraph 1. lnsuring Agreement of Section I - Coverage C - Medical Fayments, Subparagraph
{b)of Paregraph a. is reptaced by the following:
{b} The expenses are incuned and reported within three years of the date ol lhe accident; and
F. EXTENSION OF SUPPTEMSNTARY PAYMENT$ - COVERAGH.S A ANN S
1. Under Supplementary Faymonts - Coverages A and B, Paragraph 1,b, is replaced by the following:
b. Up to $3,000 for cost of bail bonds required because of accidents or iraffic law violations arising
out of lhe use of any vehicle to which the Bodily lnjury Liabilily Coverage applies. We do not have
to furnish these bonds.
2, Paragraph 1,d. is replaeed by the following;
d. Al[ reasonable expenses incurred by tlre insured at our request to assist us in the invesiigation or
defense of the claim or "suit", includiilg actual loss of earnings up to $500 a day because of time
off from work.
G. ADPITIONAL INSUREDS . BY CONTRACT, AGREEMENT OR PERMIT
1. Paragraph 2, under $ection ll - Who ls An lnsured is amended io include as an insured any person or
organization whom you have agreed to add as an additional insured in a written contract, written
agreement or permit. Snch person or organization is an additional insureri but anly with respeot to
liability for "bodily injury", "propefiy damage" or "per$onal and adverti$ing injury" caused in whole
or in part by:
a. Your acts or onrissions, or the acts or omissions of those acting on your behalf, in the performance
of your on going operations for the additional insured lhat are the subject of the writlen conlract or
written agreenrent provided that thc "bodily injury" or "property darncgo" occur$, or the "per-
sonal and advertising injury" is committed, subsequont to the signing af such written contract or
wrilten agreenrent; or
o 2otsLiberty Mulual lnsurance
lnc!udes copyrightod material of lnsurunce Services Office, lnc.,lvilh ils pem:ission.cG 88 10 04 13 Page 3 of I
s.s
b- Premlses or facilities rented by you or used b.y you; orc' The maintenance, operation or use by you of equipment rented or leased to you by such person ororganiealion; or
d' operations performed. by you- or on your behalf for which the state or political subdivision hasissued a perrnit subject to the following addilional provisions:
(1) This i|isurance does not appry to "bodiry injury," ,'properly damase,,, or ,,personar ancr ad_vertising injury" arising oui oitt're op.r"tion*'piinnn"-i"ior the slate or polilcat subdivision;
(2) This insurance does not apply to "bodily injury" or "property damase,' includetl within lhe"completed operations hazard-".
(tl
ff:ffi:* applies to premlses yor'l own, rent, or controJ but onty with respect to the foltowing
(a) The existence, mainlenance, repair, construction, erection, or removal of advertisingsigns, awnings, canopies, cellar entrances. coal holes, driveways, manholes, marquees.hoist away openings, sidewalk vaults, street banneis, or decorations and similar expo-sures; or
(b) The conslrustion, erection, or removal of elevators; or
(c) Ttte owtrership, maintenance, or use of any efevators covered by this insurance,
However:
1' The insurance alfordod to stlch additional insured only applies to the extent psrmilted by lawi find2' lf coverago provided lo the adclitional insured is required by a conlract or agreeilent, ths insur-ance afforded to stjch additional insured will noi u*'nroacer'rhan that which you are required bythe contract or agreement to provide for sr"rch additionar insured.
lArth respect to Paragraph l.a, above, a per$on'$ or organization's status as an additional insuredunder this endorsement ends when:
{t} All work, including,. matorials. parts or equipment furnished in connection with such work, onlhe project (other than service, mainlenance or repairs) to be perforrned by or on behalf of theadditional insured(s) at lhe location of the covere;'il;rtilr has been co,nptet€d; or(?) That portion of "your work" oul of which the injury or damage arises has been put to itsintended use by any person or organizalion other itran anotner csntractor or subcontractorengaged in perfsrftring op*rfrtions ior a principal a$ a pan ot thu .u,nu projecr.
- -*'
lillilh respect to Paragraph 1.b. above, a person's or orgarrization's stalus as arr additional insL'edunder this endorsement ends when their written contrait oi *ritLn agreement with you far suchpremises or facilities encls. avrvLrrrErlr vvrrtr yu
l/Vilh rq$pects to Paragraph i.c. above, this insurance cloes not apply to anyr,0ccurreflce,, wlrich takesplace after lhe equipment rental or lease agreement rras expireu oi you trave returnecJ such equipmontto the lessor, -.- --'r"vv v' t
rfte insurance provided by this endorsentent applies only if lhe wri[en contract or wrilten agreementis signed prior to tlre .'bocliiy injury" or ,'property 'damagei.
we have no <tuty to defend an additional insured under this endorsement until we receive wrinennotice of a "suif' bv the additional insured "r r*quireJ-in'F;-r";ruprr b. of condition z. ouii""""lrrir.,o
ff:: "t occHrrence, offense, claim orr suit under $ection tv l'commerclal General Liability condi-
$
cG 88 .t0 04 13
o
rncrudes copvrisr,t"o n,atu,i,?Xll#Hyrylllil#Uft[::
'*.,
wirh ns permission.Page 4 of I
*
2. \Mtlr respecl lo lhe insurance provided bv this endorsemenl, lhe following are added to paragraph Z.
Exclusions under Section I - Coverage A - Bodily lnjury And property oamage Liability:
This insurance does not appiy to:
a. "Bodily injury" or "property damage" arising from the sole negligence of the aclcjilional insured.
b' 'iBodily injury" or "property damage" that occurs prior to you comnrencing operations at lhe
lucation where such "bodily injury,' or,'property darnage" occur$.
c- "Bodily injury", "property darnage" or "personal encJ advertising iryury" arising out of the render-
ing of, or lhe failure to rerrder, any professional arclritectural, engineering or surveying services,
including:
({l The preparing, approving, or failing to prepare or aBprove, maps, slrop drawings, opinions,
reports, surveyc. lield orders, change orders or drawings and sBecifications; or
(2) Supervisory, inspection, architectural orengineering activities.
This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in
the supervision, hiring, employmcnt, training or nronitoring of others by that insured, if thi "oCcur-
rence" which caused the "bodily injury" or "property damage", or the offense which caused llre"personal and advertising injury", involved lhe rendering of, or tlre failure to render, any professional
arcl'iiteclural, engineering or surveying seruices.
d. "Bodily injury" or "properly clarnage,, occurring after;
(1) All work, including nraterials, pafts or equlpment furnished in connection wirh such work, on
the project (other than scrvice, maintenance or repairs) to be performed by or on behalf of the
additional insured(s) at the location of the covered operations has been completed; or
{2) That portion of "your work" out of which the injury or damage arises has been pul to its
inlended use by alry person or orgatrization other than anolher contractor or subconlractor
engaged in performing operations for a principal as a parl of the same project.
s. Any Berson or organization specifically clesignated as an additional insured for ongoing operalions
by a separate ADDITIONAt INSURUD -OWNERS, LES$EES OR CONTRACTORS endorsemenl is-
sued by us and made a part of this policy.
3. Wth respect to the insurance afforded to these additional insureds. the following is added to Section ln
- Limits Of lnsurance:
tf coverage providecl to the additional insured is required by a conlract or agreoment, lho most we \'jill
pay on beh*lf of the aclelitional insured is the amount of insurance:
a. Required by the contract or agreemenl; or
b. Available under the applicable Limits of lnsurance shown in the Declaralions;
whichever is less.
This endorsement shall not increase the applicable Limits of lnsurance shown in the Deciaratio ns.
H, FRIMARY AND NON.CONTRISUTORY ADDITTONAL INSURED EXTENSION
This provition applies lo any person or organization who qualifies as an addilional insurocl under any form
nr endorsement under this policy.
Condition 4. Othgr lnsurance of SECTI0N lV - COMMERCIAL GENERAL LtABlilTy cONDtTtoNS is amend-
ed as follows:
*" The,following is addsd to Paragraph a. primary lfl$urance:
lf an additianat insured's' policy has an Otlrer lnsurance provision making its policy excess, and you
have agreed in a written contract or written agreement to provide the addiiional insured couerage on aprimary and noncontributoly basis, this policy shall be prinrary and we will not seek contribution from
the additional insuredls policy for clamages we cover.
cG 88 10 04 13
@ 2013Liberty l,{uluai lngurance
lneludes copyrighted material of lnsurance services office, lnc., wilh its permission,Page 5 of I
it
ffi
ffi:
b. The following is added to Paragraph b, Excess lnsurance;
Wun a written contract or wdtten agreement, olher than a premises lease, facilities rental contract oragreement' an equipment rsntfll or lease contract or agreernent, or permit issued by a state or political
subdivrsion between you and an additional insured does not require ihis insurancb lo be primary orprimary and non'contributory, this insurance is excesg over any other insurance for which the addi-tional insured is designated as a Nanred lnsured.
Regardless of tlre written agreement bet\A/een you and an additional insured, this insurance is excessover any other insurance whethor primary, excess, contingent or on any other basis far which theadditional insured has been added as an additional insured on other policiei.
ABDITIONAL IN$UREDS . EXTENDED PROTECTION OF YOUR ''LIMITS OT INSURANCE"
This provision applies lo any person or organization who qualifies as an additional insured under any fcrmor endorsement urrder lhis policy.
1. The following is addecJ to Condiiion 2. Duties lnThe EvsntOf Occurrence, Offense, clalff orsuit:
An additional insured uncler this endorsement will as soon as praclicable:
a' Give writlen notice of an "oscurrence" or an offense that rnay result in a clairn or',suif' underthis insurance to us;
b. Tender the defense and indernnity of any claim or "sult" to all insurers whom also havein$uranco available to the additional insured; and
c- Agree to make available any other insurance whictr the aclditiorral insurecl has for a loss wecover uncJer this Coverage part.
d' We have no duty to defend or indemnif,T an additional insured uncler lhis endorsement untitwe receive nrritten notice of a "suit" by the additionar insured.
2' The limits of itrsurance applicable to ihe additianal insured are tho$e upecilied in a written contractor written agreement or the limits of insurance as slated in lhe Declarations of this policy anddefined in soction lll ' Limits of lnsurance of this policy, whichever are less. These limits areittclusive of and not in addition to the limits of insurance available under fhis policy.
WHO IS AN INSURED - INCIDENTAL MEDICAL ERRORS/ MALPRACTICE
WHO IS AN lN$UftFD . FHLLOW EMPLOYEE EXTEN$ION - MANAGEMENT HMPLOYEES
Paragraph 2.a.(1) of section lt-who tsAn lnsured ls replaced with the folfowing:
{1} "Bodily injr.rry" or "personat and advertising injury":
tal To you, to your partners or metnbers (if you are a partnership or joint vcnture), ro your members {ifyou ars a limited liability companyi. to a co-"employee" while in the course of his or her enrploy-ment or performing duties related to the conduct of your business, oi in yo,,r other ,,volunteer
workers" white perforrning duties related to lhe conduci cf your business;
(b) To the $pouse, cftlld, parent, brother or sister of that co-"emptoyee" or "volunleer worke1, as aconsequence of paragraph {{} {a} above:
{c} For rvhislr there is any obligation to shars dainage$ with or repay someone el$e vrho must paydamages bocause of the injury cJescribed in paragiaptrs {1) (a} or {bj above: or
{d} Arising out of ltis or her providing or faiiing to provide professional health care services. Howevor,if you are not in the business of providing professional health care services or providing profes*sional heallh care per$onnel to others, or if coverage for providing professional health care ser-vices is not othenvise exclucled by separate endorsement, this .prdvision (paragraph (d)) does not
apply.
Faragraphs {a) and {b) above do not apply io "bodily injury" or "personal and advertising injury'. caused byan "entployee" who is acting in asupervisory capacity for you. bupervisory capacity "iu**c it"t"in-*unnJthe."employeo's" job responsibilities assigned by you, includes ihe direct supervisicn of other "employ-ees" of yours' Flowever, none of these "employees" are insr-rreds for ,'lrodily injury', or "porsonal and
.J
'l!
J.
cG 88 10 04 f3
@ zol3Liberty Muluat lnsurance
lncludes copyrighl*qt material ot lnsurfince services office. lnc.,wilh its perfiission.Page 6 of 8
I
B
fidvedising injury" arisfng out of lheir willful conduct, which is defined as the purposeful or wiilful intent tocause "bodily injury" or "personal and advertising injury", or caused in whole or in part by- rheir intoxica-tion by liquor or controlled substances.
The coverage provided by provision J. is excess over any other valid and collectablo insuranco available loyour "employee".
K. NEWLY FORMHP OR ADilITIONALLY ACOUIRED ENTITIES
Paragraph G, of section ll - who ls An lnsured is replaced by the following:
3. Any organiration you newly acquire or form and over which you maintain ownership or majorityinlerest, will qualify as a Named lnsured if there is no other similar insurance avaifable t; th;torganiza!ion, Hnweyer:
a. Coverage under tlris provision is afforded only until the expiration of lhe policy period inwhictr lhe entity was acquired or formed by you;
b, Coverage A does not apply to "bodily injury" or "property damage" tbat occurred before youacquired or formed ttre organizaticn; and
c. Coverage B does not apply to "personat and adverlising injury" arising out of an offensecommitted beforo you acquired or formed the organizationl
d. Records and descriptions of operations must be maintainecl by ihe first Named lnsured.
No person or organization is an insured wilh respect to the conduct of any cr]rrunt or past partnership, jointventuro or lintited tiabifity comfrany that is no: shown as a Named tnsured in the D+claralions or quatifiesas an insured under this provision.
L. FAILURE TO DI$CLOSE HAZ,ARDS AND PRIOR OCCURRENCES
Y::,:::j,"n lV ' Comrnercial General Liability Conditians, the foilowing is atided to Condirion 6. Repre-senlatrons:
Your failure to disclose all hazards or prior 'bccunences" existing as of the inception date of the policyshall not prejuclice lhe coverage afforded by lhis policy provided such failure to djsclose all hazards orprior 'loccurrences,, is not intentional.
M. KNOWLEDGE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT
Under $ection lv ' commercial Gonerat Liability conditions, the following is added to eondition 2, DutiesIn The Event of Occurrence, Offense, Clairn Or $uit:
Knowledge of an "occurrencel', offenss,. cja1n or ,,suif, by an agent, servant or .emp[oyee,, of anyinsured shall not in itself conslilute knowledge of lhe insured unless an insured listecl under paragraph
1' of $ection ll - who le An lnsured or a Ferson who has been designated by them to receive reports of"occurrences", offenses, claitns or "suils' shall have received suih notice from the agent, servfrnl or"ernployee',.
N. LIEERALIZATIONCLAUSE
lf we revise thls Commercial Goneral Liability Extension Endorsement to provide more coverage wilhoutadditional premium charge, your poiicy will automaticatty provide tne cove[ge ;;; il;; day the revision iseffective in your state.
O. BODILY INJURY REDEFINHN
under soction v - Definitions, Delinition 3, is replaced by lhe foltowing:
3. "Eodily lnjury' means physicar injury. sickness or disease sustained bv a.person. This incrudesmental anguish. mental injury, shoek, fright or deatli that results from suctl'physical injury, sick-ness or disease,
c0 88 10 04 13 rncrudescopyr.igr,r*o *,3,i.ix1iffljyryi*ilJJiHfii[1,,...,*ilh irs permission Page 7 of I
',
:;t)
H
#
P. €XTENDED PROPERTYDAMAGE
EXCIUSiON A, Of COVERAGE A. BOOILY INJURY AND PROPERTY DAMAGE LIABILITY iS replaced by lhe
following:
a, Hxpected 0r lntonded lnjury
"Sodily injury" or "properly damage" expected or intended from the stanclpoint of the insured,
This exclusion does not apply to "bodily injury" or "property damage" resuiting fronr llre use qf
reasonable farce to proiect persons or property,
A. WAIVER OF TRANSTER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US - WHEN REQUIRED IN A
CONTRACT OR AGRIHMENT WITH YOU
Under $ection IV . Commercial General Llability Ccnditions, the following is added to Conditlon g. Trans-
fer Of Rights Of Recovery Against Others To Usl
We waive any right of recovery we may have against a person or organization because of payments wemake for injury or damage arisittg out of your ongoing operations or "your work', done under acontract with that per$on or organization and included in tlre I'products-compteteO operalions lazard"provided:
1. You and that person or organization have agreed in writing in a contract or agreement thai you
waive such rights against that person or organizalion; and
2, Tho injury or damage occurs subsoquent ia the execution of the written conlract or wriiten agroe-
nrenl.
t?
t>
o zolg Llberty Muluat lnsurancs
lncludes copyrighted fiaterial of lnsurance services office, lnc., with ils permission,cG 8& 10 04 13 Page 8 of S
1 of 4
EXHIBIT F
City of Kent
2021-2022 Certification Regarding Debarment and Suspension
Puget Sound Training Center Employment and Training Services /BG2126-
2226
Agency Name of Project/Project Number
Certification A: Certification Regarding Debarment, Suspension, and Other
Responsibility Matters - Primary Covered Transactions1
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
1 The Agency shall notify the City if it is disbarred after this certification is signed. The City is responsible
for checking the excluded parties list in SAM on an annual basis.
2 of 4
the certification set out below. The certification or explanation will be
considered in connection with the department or agency’s determination
whether to enter into this transaction. However, failure of the prospective
primary participant to furnish a certification or an explanation shall disqualify
such person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon
which reliance was placed when the department or agency determined to
enter into this transaction. If it is later determined that the prospective
primary participant knowingly rendered an erroneous certification, in addition
to other remedies available to the Federal Government/City of Kent, the
department or agency may terminate this transaction for cause of default.
4. The prospective primary participant shall provide immediate written notice
to the department or agency to which this proposal is submitted if at any
time the prospective primary participant learns that its certification was
erroneous when submitted or has become erroneous by reason of changed
circumstances.
5. The terms covered transaction, debarred, suspended, ineligible,
lower tier covered transaction, participant, person, primary covered
transaction, principal, proposal, and voluntarily excluded, as used in
this clause, have the meanings set out in the Definitions and Coverage
sections of the rules implementing Executive Order 12549. You may contact
the department or agency to which this proposal is being submitted for
assistance in obtaining a copy of these regulations.
6. The prospective primary participant agrees by submitting this proposal
that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covered transaction, unless authorized by the department
or agency entering into this transaction.
7. The prospective primary participant further agrees by submitting this
proposal that it will include the clause titled “Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier
Covered Transaction,” provided by the department or agency entering into
this covered transaction, without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
8. A participant in a covered transaction may rely upon a certification of a
prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A participant
may decide the method and frequency by which it determines this eligibility
of its principals. Each participant may, but is not required to, check the Non-
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
3 of 4
instructions, if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in
this transaction, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency may terminate this
transaction for cause of default.
Certification B: Certification Regarding Debarment, Suspension, Ineli-
gibility 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 whom this proposal is submitted if at any time the
prospective lower tier participant learns that its certification was erroneous
when submitted or has become erroneous by reason of changed
circumstances.
4. The terms covered transaction, debarred, suspended, ineligible,
lower tier covered transaction, participant, person, primary covered
transaction, principal, proposal, and voluntarily excluded, as used in
this clause, have the meanings set out in the Definitions and Coverage
sections of rules implementing Executive Order 12549. You may contact the
person to which this proposal is submitted for assistance in obtaining a copy
of these regulations.
5. The prospective lower tier participant agrees by submitting this proposal
that, should the proposed covered transaction be entered into, it shall not
knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, declared ineligible, or voluntarily excluded from
participation in this covered transaction, unless authorized by the department
or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this
4 of 4
proposal that it will include this clause titled “Certification Regarding
Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier
Covered Transaction,” without modification, in all lower tier covered
transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a
prospective participant in a lower tier covered transaction that it is not
debarred, suspended, ineligible, or voluntarily excluded from the covered
transaction, unless it knows that the certification is erroneous. A participant
may decide the method and frequency by which it determines the eligibility
of its principals. Each participant may, but is not required to, check the Non-
procurement List.
8. Nothing contained in the foregoing shall be construed to require
establishment of a system of records in order to render in good faith the
certification required by this clause. The knowledge and information of a
participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph (5) of these
instructions, if a participant in a lower covered transaction knowingly enters
into a lower tier covered transaction with a person who is suspended,
debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency with which this trans-
action originated may pursue available remedies including suspension and/or
debarment.
Agency/Sub-Recipient
(Print Below)
Date Date
Authorized Signature of Agency/Sub-Recipient
(Sign Below)
Title
joseph drake (Aug 17, 2021 11:55 PDT)
joseph drake
8/17/2021Joseph Drake
executive director
Agency
Name:
PSTC PSTC
Exhibit G - 2021-2022 CDBG Public Services Project Time Sheet
Name
Program
Period Ending
Calendar Days
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Project
Project
Acct #Description 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Total
Employment 0
& Training 0
Services 0
0
0
0
0
0
0
Other 0
Sick Leave 0
Holiday 0
Personal Day 0
Vacation 0
Total For Each Day 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Total for Pay Period:
I certify to the best of my knowledge that the foregoing is true and correct.
Employee Signature Authorizing Signature
Date Date
Not for Payroll Use
504/ADA Contract Form 9/17
Page 1
EXHIBIT H
504/ADA DISABILITY ASSURANCE OF COMPLIANCE
COMPLETE AND RETURN WITH SIGNED CONTRACT
Complying with Section 504 of the Rehabilitation Act of 1973, as amended, and the Americans With Disabilities
Act of 1990, two federal laws which prohibit discrimination against qualified people with disabilities.
I understand that federal and state laws prohibit discrimination in public accommodations and employment
based solely on disability. In addition, I recognize that Section 504 requires recipients of federal funds (either
directly or through contracting with a governmental entity receiving federal funds) to make their programs,
services, and activities, when viewed in their entirety, accessible to qualified and/or eligible people with
disabilities. I agree to comply with, and to require that all subcontractors comply with, the Section 504/ADA
requirements. I understand that reasonable accommodation is required in both program services and
employment, except where to do so would cause an undue hardship or burden.
I agree to cooperate in any compliance review and to provide reasonable access to the premises of all places
of business and employment and to records, files, information, and employees therein to the City of Kent for
reviewing compliance with Section 504 and ADA requirements.
I agree that any violation of the specific provisions and terms of the 504/ADA Disability Assurance of
Compliance and/or Corrective Action Plan required herein or Section 504 or the ADA, shall be deemed a
breach of a material provision of the Contract between the City of Kent and the Contractor. Such a breach shall
be grounds for cancellation, termination, or suspension, in whole or in part, of this Contract by the City of Kent.
According to the responses to the questions in the 504/ADA Self-Evaluation
Questionnaire, (company name)______________________________________
_______________________________________ is in compliance with 504/ADA.
If the above response is NO, the following corrective actions will be taken:
YES
NO
Corrective Action Plan
The following Corrective Action Plan is submitted to comply with Section 504 and ADA requirements.
General Requirements
Actions To Be Taken Completion Date
Program Access
Actions To Be Taken Completion Date
Puget Sound Training Center
Puget Sound Training Center
504/ADA Contract Form 9/17
Page 2
504/ADA DISABILITY ASSURANCE OF COMPLIANCE (continued)
Employment and Reasonable Accommodation
Actions To Be Taken Completion Date
Physical Accessibility
Actions To Be Taken Completion Date
I Declare Under Penalty of Perjury under the Laws of the State of Washington that the
Foregoing is True and Correct.
Signature of authorized signatory
Type or print name of authorized signatory Title Telephone
joseph drake (Aug 17, 2021 11:55 PDT)
joseph drake
14253516432joseph Drake executive director
Signature:
Email:
Signature:
Email:
Signature:
Email:
Merina Hanson (Aug 17, 2021 11:19 PDT)
mhanson@kentwa.gov rlashley@kentwa.gov
Melissa McCormick (Aug 17, 2021 15:31 PDT)
Melissa McCormick
cityclerk@kentwa.gov
CDBG - PSTC Employment and Training
Services
Final Audit Report 2021-08-17
Created:2021-08-16
By:KateLynn Jennings (kjennings@kentwa.gov)
Status:Signed
Transaction ID:CBJCHBCAABAAHIaQyz8Z23JIY87QvIdLdCDhLDwUIEGI
"CDBG - PSTC Employment and Training Services" History
Document created by KateLynn Jennings (kjennings@kentwa.gov)
2021-08-16 - 6:06:35 PM GMT- IP address: 146.129.252.126
Document emailed to Merina Hanson (mhanson@kentwa.gov) for signature
2021-08-16 - 6:11:35 PM GMT
Email viewed by Merina Hanson (mhanson@kentwa.gov)
2021-08-17 - 6:18:35 PM GMT- IP address: 174.246.16.135
Document e-signed by Merina Hanson (mhanson@kentwa.gov)
Signature Date: 2021-08-17 - 6:19:06 PM GMT - Time Source: server- IP address: 174.246.16.135
Document emailed to joseph drake (joed@pstrainingcenter.com) for signature
2021-08-17 - 6:19:08 PM GMT
Email viewed by joseph drake (joed@pstrainingcenter.com)
2021-08-17 - 6:42:10 PM GMT- IP address: 24.17.49.76
Document e-signed by joseph drake (joed@pstrainingcenter.com)
Signature Date: 2021-08-17 - 6:55:32 PM GMT - Time Source: server- IP address: 24.17.49.76
Document emailed to Krissya Escobar (kryssiae@pstrainingcenter.com) for signature
2021-08-17 - 6:55:34 PM GMT
Email viewed by Krissya Escobar (kryssiae@pstrainingcenter.com)
2021-08-17 - 6:56:47 PM GMT- IP address: 24.17.49.76
Document e-signed by Krissya Escobar (kryssiae@pstrainingcenter.com)
Signature Date: 2021-08-17 - 6:57:21 PM GMT - Time Source: server- IP address: 24.17.49.76
Document emailed to Ronald Lashley (rlashley@kentwa.gov) for signature
2021-08-17 - 6:57:24 PM GMT
Email viewed by Ronald Lashley (rlashley@kentwa.gov)
2021-08-17 - 7:09:00 PM GMT- IP address: 146.129.252.126
Document e-signed by Ronald Lashley (rlashley@kentwa.gov)
Signature Date: 2021-08-17 - 7:12:03 PM GMT - Time Source: server- IP address: 146.129.252.126
Document emailed to Julie Parascondola (jparascondola@kentwa.gov) for signature
2021-08-17 - 7:12:05 PM GMT
Email viewed by Julie Parascondola (jparascondola@kentwa.gov)
2021-08-17 - 9:49:36 PM GMT- IP address: 146.129.252.126
Document e-signed by Julie Parascondola (jparascondola@kentwa.gov)
Signature Date: 2021-08-17 - 9:50:04 PM GMT - Time Source: server- IP address: 146.129.252.126
Document emailed to Kim Komoto (kkomoto@kentwa.gov) for signature
2021-08-17 - 9:50:06 PM GMT
Email viewed by Kim Komoto (kkomoto@kentwa.gov)
2021-08-17 - 10:26:41 PM GMT- IP address: 146.129.252.126
Document e-signed by Kim Komoto (kkomoto@kentwa.gov)
Signature Date: 2021-08-17 - 10:26:58 PM GMT - Time Source: server- IP address: 146.129.252.126
Document emailed to Melissa McCormick (cityclerk@kentwa.gov) for signature
2021-08-17 - 10:27:00 PM GMT
Email viewed by Melissa McCormick (cityclerk@kentwa.gov)
2021-08-17 - 10:27:52 PM GMT- IP address: 146.129.252.126
Document e-signed by Melissa McCormick (cityclerk@kentwa.gov)
Signature Date: 2021-08-17 - 10:31:00 PM GMT - Time Source: server- IP address: 146.129.252.126
Agreement completed.
2021-08-17 - 10:31:00 PM GMT