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HomeMy WebLinkAboutCAG2021-542 - Original - Rainier Valley Corps - Mujer Al Volante - Women Driving - 12/21/2021ApprovalOriginator: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 12/16/2021 Original Parks, Recreation & Community ServicesDinah Wilson 10/31/2022 4 ASAP 4 10/01/2021 N/A 4 Other 10006370.64150.4765 Contract 6531 N/A 4 4 4 1851015 CONSULTANT SERVICES AGREEMENT - 1 ($20,000 or Less) CONSULTANT SERVICES AGREEMENT between the City of Kent and RAINIER VALLEY CORPS THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter the "City"), and Rainier Valley Corps, organized under the laws of the State of Washington, located and doing business at, 1225 South Weller St., Suite 400, Seattle, WA 98144 (hereinafter the "Consultant"). I. DESCRIPTION OF WORK. Consultant shall perform the following services for the City in accordance with the following described plans and/or specifications: Consultant shall increase self-sufficiency for Latina women through driving classes and helping them to obtain learner’s permits. The following exhibits are attached and incorporated by this reference as if fully set forth herein: Exhibit A, Project Scope of Services; Exhibit B, Income Guidelines; Exhibit C, Billing Voucher and Service Report; Exhibit D, Kent Annual Outcome Report; Exhibit E, Insurance Requirements; and Exhibit F, Certification Regarding Debarment and Suspension. Consultant further represents that the services furnished under this Agreement will be performed in accordance with generally accepted professional practices within the Puget Sound region in effect at the time those services are performed. II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in Section I above immediately upon the effective date of this Agreement. Consultant shall complete the work described in Section I by October 31, 2022. This Agreement, however, is contingent upon the availability of funds to be allcoated through the City's budget process. 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. III. COMPENSATION. A. The City shall pay the Consultant, based on time and materials, an amount not to exceed $6,531.00, for the services described in this Agreement. This is the maximum amount to be paid under this Agreement for the work described in Section I above, and shall not be exceeded without the prior written authorization of the City in the form of a negotiated and executed amendment to this agreement. The Consultant agrees that the hourly or flat rate charged by it for its services contracted for herein shall remain locked at the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement. The Consultant's billing rates shall be as delineated in Exhibit A. B. The Consultant shall submit quarterly payment invoices to the City for work performed, and a final bill upon completion of all services described in this Agreement. The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option to only pay that portion of the invoice not in dispute. In that event, the parties will immediately make every effort to settle the disputed portion. CONSULTANT SERVICES AGREEMENT - 2 ($20,000 or Less) IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor- Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in accordance with Ch. 51.08 RCW, the parties make the following representations: A. The Consultant has the ability to control and direct the performance and details of its work, the City being interested only in the results obtained under this Agreement. B. The Consultant maintains and pays for its own place of business from which Consultant’s services under this Agreement will be performed. C. The Consultant has an established and independent business that is eligible for a business deduction for federal income tax purposes that existed before the City retained Consultant’s services, or the Consultant is engaged in an independently established trade, occupation, profession, or business of the same nature as that involved under this Agreement. D. The Consultant is responsible for filing as they become due all necessary tax documents with appropriate federal and state agencies, including the Internal Revenue Service and the state Department of Revenue. E. The Consultant has registered its business and established an account with the state Department of Revenue and other state agencies as may be required by Consultant’s business, and has obtained a Unified Business Identifier (UBI) number from the State of Washington. F. The Consultant maintains a set of books dedicated to the expenses and earnings of its business. V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon providing the other party thirty (30) days written notice at its address set forth on the signature block of this Agreement. After termination, the City may take possession of all records and data within the Consultant’s possession pertaining to this project, which may be used by the City without restriction. If the City’s use of Consultant’s records or data is not related to this project, it shall be without liability or legal exposure to the Consultant. VI. DISCRIMINATION. In the hiring of employees for the performance of work under this Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who is qualified and available to perform the work to which the employment relates. Consultant shall execute the attached City of Kent Equal Employment Opportunity Policy Declaration, Comply with City Administrative Policy 1.2, and upon completion of the contract work, file the attached Compliance Statement. VII. INDEMNIFICATION. Consultant shall defend, indemnify and hold the City, its officers, officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's performance of this Agreement, except for that portion of the injuries and damages caused by the City's negligence. The City's inspection or acceptance of any of Consultant's work when completed shall not be grounds to avoid any of these covenants of indemnification. Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials, employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless, and Consultant’s liability accruing from that obligation shall be only to the extent of the Consultant's negligence. CONSULTANT SERVICES AGREEMENT - 3 ($20,000 or Less) IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER. In the event Consultant refuses tender of defense in any suit or any claim, if that tender was made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant’s part, then Consultant shall pay all the City’s costs for defense, including all reasonable expert witness fees and reasonable attorneys’ fees, plus the City’s legal costs and fees incurred because there was a wrongful refusal on the Consultant’s part. The provisions of this section shall survive the expiration or termination of this Agreement. VIII. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement, insurance of the types and in the amounts described in Exhibit E attached and incorporated by this reference. IX. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable accuracy of any information supplied by it to Consultant for the purpose of completion of the work under this Agreement. X. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings, designs, reports, or any other records developed or created under this Agreement shall belong to and become the property of the City. All records submitted by the City to the Consultant will be safeguarded by the Consultant. Consultant shall make such data, documents, and files available to the City upon the City’s request. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. The City’s use or reuse of any of the documents, data, and files created by Consultant for this project by anyone other than Consultant on any other project shall be without liability or legal exposure to Consultant. XI. CITY'S RIGHT OF INSPECTION. Even though Consultant is an independent contractor with the authority to control and direct the performance and details of the work authorized under this Agreement, the work must meet the approval of the City and shall be subject to the City's general right of inspection to secure satisfactory completion. XII. WORK PERFORMED AT CONSULTANT'S RISK. Consultant shall take all necessary precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the performance of the contract work and shall utilize all protection necessary for that purpose. All work shall be done at Consultant's own risk, and Consultant shall be responsible for any loss of or damage to materials, tools, or other articles used or held for use in connection with the work. XIII. MISCELLANEOUS PROVISIONS. A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its contractors and consultants to use recycled and recyclable products whenever practicable. A price preference may be available for any designated recycled product. B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the covenants and agreements contained in this Agreement, or to exercise any option conferred by this Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those covenants, agreements or options, and the same shall be and remain in full force and effect. C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington. If the parties are unable to settle any dispute, difference or claim arising from the parties’ performance of this Agreement, the exclusive means of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules CONSULTANT SERVICES AGREEMENT - 4 ($20,000 or Less) and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's right to indemnification under Section VII of this Agreement. D. Written Notice. All communications regarding this Agreement shall be sent to the parties at the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written notice hereunder shall become effective three (3) business days after the date of mailing by registered or certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this Agreement or such other address as may be hereafter specified in writing. E. Assignment. Any assignment of this Agreement by either party without the written consent of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment, the terms of this Agreement shall continue in full force and effect and no further assignment shall be made without additional written consent. F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement shall be binding unless in writing and signed by a duly authorized representative of the City and Consultant. G. Entire Agreement. The written provisions and terms of this Agreement, together with any Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this Agreement. All of the above documents are hereby made a part of this Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any language contained in this Agreement, the terms of this Agreement shall prevail. H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal laws, rules, and regulations that are now effective or in the future become applicable to Consultant's business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of the performance of those operations. I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes, emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may be subject to public review and disclosure, even if those records are not produced to or possessed by the City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City’s duties and obligations under the Public Records Act. J. City Business License Required. Prior to commencing the tasks described in Section I, Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the Kent City Code. K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts, each of which shall constitute an original, and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. CONSULTANT SERVICES AGREEMENT - 5 ($20,000 or Less) IN WITNESS, the parties below execute this Agreement, which shall become effective on the last date entered below. All acts consistent with the authority of this Agreement and prior to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed to have applied. RAINIER VALLEY CORPS: By: (signature) Print Name: ________________________ Its:_______________________________ (title) DATE: CITY OF KENT: By: (signature) Print Name: Merina Hanson Its: Manager, Human Services Division DATE: NOTICES TO BE SENT TO: RAINIER VALLEY CORPS: Reynaldo Gaon Operations Support Program Director 1225 South Weller St., Suite 400 Seattle, WA 98144 jojo@rvcseattle.org 206-436-9536 (telephone) NOTICES TO BE SENT TO: CITY OF KENT: Dinah R. Wilson Senior CDBG Program Coordinator 220 Fourth Avenue South Kent, WA 98032 drwilson@kentwa.gov 253.856.5076 (telephone) ATTEST: Kent City Clerk P:Human Services 2017-2018 Parallel Application Contracts Reynaldo JoJo Gaon (Dec 21, 2021 09:43 PST) Reynaldo JoJo Gaon 12/21/2021 Operations Support Program Director Reynaldo Gaon Merina Hanson (Dec 21, 2021 10:20 PST) 12/21/2021 EEO COMPLIANCE DOCUMENTS - 1 DECLARATION CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY POLICY The City of Kent is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City’s equal employment opportunity policies. The following questions specifically identify the requirements the City deems necessary for any contractor, subcontractor or supplier on this specific Agreement to adhere to. An affirmative response is required on all of the following questions for this Agreement to be valid and binding. If any contractor, subcontractor or supplier willfully misrepresents themselves with regard to the directives outlines, it will be considered a breach of contract and it will be at the City’s sole determination regarding suspension or termination for all or part of the Agreement; The questions are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement the prime contractor will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. Before acceptance of this Agreement, an adherence statement will be signed by me, the Prime Contractor, that the Prime Contractor complied with the requirements as set forth above. By signing below, I agree to fulfill the five requirements referenced above. By: ___________________________________________ For: __________________________________________ Title: _________________________________________ Date: _________________________________________ Reynaldo JoJo Gaon (Dec 21, 2021 09:43 PST) Reynaldo JoJo Gaon 12/21/2021 RVC dba MAV Director, Operations Support Program EEO COMPLIANCE DOCUMENTS - 2 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: January 1, 1998 SUBJECT: MINORITY AND WOMEN SUPERSEDES: April 1, 1996 CONTRACTORS APPROVED BY Jim White, Mayor POLICY: Equal employment opportunity requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Any contractor, subcontractor, consultant or supplier who willfully disregards the City’s nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to assume the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City’s equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 3 CITY OF KENT EQUAL EMPLOYMENT OPPORTUNITY COMPLIANCE STATEMENT This form shall be filled out AFTER COMPLETION of this project by the Contractor awarded the Agreement. I, the undersigned, a duly represented agent of Company, hereby acknowledge and declare that the before-mentioned company was the prime contractor for the Agreement known as that was entered into on the (date) between the firm I represent and the City of Kent. I declare that I complied fully with all of the requirements and obligations as outlined in the City of Kent Administrative Policy 1.2 and the Declaration City of Kent Equal Employment Opportunity Policy that was part of the before-mentioned Agreement. By: ___________________________________________ For: __________________________________________ Title: _________________________________________ Date: _________________________________________ 2021 - 2022 RVC Seattle (FS of Mujer al Volante)-Consultant Services Agreement Scope of Services Page 1 EXHIBIT A 2021-2022 CONSULTANT SERVICES AGREEMENT PROJECT SCOPE OF SERVICES PARALLEL HUMAN SERVICES SMALL FUND GRANT RAINIER VALLEY CORPS FISCAL SPONSOR OF MUJER al VOLANTE Consultant/Consultant: Rainier Valley Corps (Fiscal Sponsor of Mujer al Volante-Women Driving) Start Date: 10/1/21 Project Title: Mujer Al Volante-Women Driving End Date: 10/31/22 Funding will provide assistance for Latina women to attend workshops that orient them to driving and securing learner’s permits. This program will benefit 10 Kent residents. Program Outcome: Project will increase self- sufficiency for Latina women. Outcomes will be measured through pre and post-surveys and the number of learner’s permits obtained, with annual results provided to the City via Exhibit D. Funding Amount: $6,531.00 Project Manager: Jacqueline Garcia Castillo Telephone: (206) 249-5504 E-mail: mujeralvolantesp@gmail.com City Contact Manager: Dinah Wilson Telephone: 253.856.5076 Fax: 253.856.6070 E-mail: drwilson@kentwa.gov RVC Seattle (hereinafter referred to as "the Consultant") shall utilize City of Kent Human Services Funds (GF budget) 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 Consultant shall apply the following funds to the project in accordance with the Line Item Budget Summary below: Line Item Budget Personnel Services $5,531.00 Consultant Services (contracts with private consultants such as childcare $1,000.00 2021 - 2022 RVC Seattle (FS of Mujer al Volante)-Consultant Services Agreement Scope of Services Page 2 providers; copies of consultant bills should be submitted to the City) Total City of Kent Funds: $6,531.00 2) Performance Measures A. Number Served The Consultant agrees to serve, at minimum, the following unduplicated number of persons: 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 3 2 3 2 10 B. Units of Service The Consultant 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 # of instruction (learner’s) permits 2 1 2 1 6 C. Definition of Services An instruction permit is defined as documentation provided by the State of Washington that allows an individual to legally practice driving. 3) Records A. Project Files The Consultant shall maintain files for this project containing the following items: 1. Notice of Grant Award. 2. Consultant Services Agreement and all contract exhibits. 3. A copy of this Scope. 4. Correspondence regarding budget revision requests. 5. Copies of all reports submitted to the City for this project. 2021 - 2022 RVC Seattle (FS of Mujer al Volante)-Consultant Services Agreement Scope of Services Page 3 6. Billing vouchers submitted for payment. 7. Client Intake Form. 8. Documentation of client income. The Consultant 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) Confirmation of participation in the free/reduced price meals program; b) IRS income tax return; c) Paystubs; or d) Documentation of qualification for participation in a “means- tested” federal or state program at least as restrictive as Federal Income Program Guidelines. Income guidelines may be adjusted periodically by the federal government. The Consultant agrees to use updated Income Guidelines, which will be provided by the City. B. Record Retention Period All records required by this Scope and the Consultant Services Agreement shall be retained by the Consultant in an accessible file for a period of three (3) years from the end of the term of this Agreement. 4) Contract Administration A. Changes in Personnel or Board Membership The Consultant shall notify the City, in writing, within ten (10) days of any changes in program personnel or board membership. The Consultant shall provide the City with a current list of its board of directors, general or limited partners, as applicable. B. Attendance at Kent Cultural Diversity Initiative Group Meetings Unless excused by the City, the Consultant will attend a minimum of three (3) Kent Cultural Diversity Initiative Group meetings during the term of the contract. C. Meetings between the Consultant, Project Manager, and the City Contract Manager 2021 - 2022 RVC Seattle (FS of Mujer al Volante)-Consultant Services Agreement Scope of Services Page 4 The Consultant, Project Manager, and/or the City Contract Manager may meet to review the contract or to discuss how to enhance services and increase funds to the Latinix population or other under-served populations needing the services provided pursuant to this agreement. 5) Reports, Invoicing and Reporting Schedule A. Reports 1. All data and required forms shall be submitted to: drwilson@kentwa.gov 2. Billing Voucher and Service Report - Data from this form will be used to track each program’s progress toward meeting the goals stipulated in the Scope of Services. It shall be submitted quarterly, no later than the 15th of the month following the end of the quarter (July 15, Oct 15, Jan 15), along with the Reimbursement Request. Because this Agreement is signed after the second quarter, Consultant shall submit first billing for the fourth quarter of 2021. 3. Annual Outcome Data Report - Outcome data shall be submitted no later than the 15th following the end of the fourth quarter. Data should demonstrate the program’s progress toward Outcomes specified in the Scope of Services. B. Invoicing and Reporting Schedule The Consultant 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 C) 15th day following each quarter 4th Quarter Billing Voucher & Service Report December 10, 2021 Final Billing Voucher & Service Report November 15, 2022 Annual Outcome Data Report (Exhibit D) November 15, 2022 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. Page 1 of 6 Exhibit C Billing Voucher & Service Report 2021-2022 To: Dinah Wilson Housing & Human Services Parks, Recreation & Community Services 220 4th Ave. South, Kent, WA 98032 drwilson@kentwa.gov Phone: 253.856.5076 Consultant/Agency: Rainier Valley Corps, Fiscal Sponsor of Mujer al Volante-Women Driving Program Contact: Jacqueline Garcia Castillo Telephone: 206.249.5504 E-mail: mujeralvolantesp@gmail.com Reporting Period Program Amount Requested Qtr. ___________ Women Driving $ SEC. 1: BUDGET SUMMARY For Department Use Only Total Contract Amount $ 6,531.00 Total Contract Amount $ 6,531.00 Amount Requested This Qtr. $ Amount Requested YTD $ Amount Remaining YTD (subtract amount requested YTD from contract amount) SEC. 2: 2021-2022 LINE-ITEM BUDGET SUMMARY (ANNUAL) COST CATEGORIES ORIGINAL BUDGET TOTAL REQUESTED REVISED BUDGET CUMULATIVE TO DATE 1 Personnel Costs $5,531.00 2 Consultant Services (contracts with private consultants such as childcare providers; copies of consultant bills should be submitted to the City) $1,000.00 GRAND TOTAL $6,531.00 Page 2 of 6 SEC. 3: ANNUAL PERFORMANCE MEASURES – 2021-2022 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 3 2 3 2 10 # of instruction (learner’s) permits 2 1 2 1 6 Sec. 4: NARRATIVE Provide a quarterly program narrative, including an explanation if you are behind in either progress toward meeting performance measures or projected expenditure rate. Page 3 of 6 Sec. 5: DEMOGRAPHIC INFORMATION Number of Households or Persons Assisted (please specify "H" or "P"; most agencies should report persons): Race Unduplicated Quarter (All) Ethnicity- 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 *Of the total number served this quarter, how many, if any, were Hispanic? For example, an individual may identify as White racially and report that he/she is of Hispanic descent. **Total should be same number served each quarter 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 6 Age Unduplicated Quarter Unduplicated Year to Date 1 2 3 4 0 - 4 years 5 - 12 years 13 - 17 years 18 - 34 years 35 - 54 years 55 - 74 years 75+ years Unknown GRAND TOTAL CLIENTS Gender Unduplicated Quarter Unduplicated Year to Date 1 2 3 4 Female Male GRAND TOTAL CLIENTS Female Headed Households Unduplicated Quarter Unduplicated Year to Date 1 2 3 4 GRAND TOTAL CLIENTS Persons with Disabilities Unduplicated Quarter Unduplicated Year to Date 1 2 3 4 GRAND TOTAL CLIENTS Page 5 of 6 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 Kent human services grant. 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. Consultant 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: Authorized By: Date: Page 6 of 6 Instructions Refer to: Accomplishments by Performance Measures in your Consultant Services Agreement. 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: PERFORMANCE MEASURES Unduplicated Count of Households/Persons Assisted Projections: Circle either persons or households according to the method of counting clients specified in your Consultant Services Scope. Insert the projected number of clients to be served as specified in your Consultant Services 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 pers ons 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 Consultant Services 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 servic e 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. 4: NARRATIVE EXPLANATION You must provide a narrative explanation if your agency is behind in meeting either performance measures specified in your Consultant Services Scope or your expenditure rate. Your expenditure rate should equal approximately one quarter of your HHS contract am ount per quarter. SEC. 5: DEMOGRAPHIC INFORMATION Race: You are required to collect racial and ethnic information for the clients served. There are 10 race categories to select from . Each client should select one of these categories. Clients identifying themselves as Hispanic also need to select from the race categories. Example: A client selects Hispanic as his ethnicity and white as his race. The grand total in the first column will not match the grand total in the second column. You may only have a few clients who identify as Hispanic. Female Head of Household: Insert the unduplicated number of single female head of households with dependents served during the reporting period. Income Only-All Projects 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%). Persons with Disabilities: The ADA defines a person with a disability as a person who has a physical or mental impairment that substantially limits one or more major life activity. This includes people who have a record of impairment, even if they do not currently have a disability. It also includes individuals who do not have a disability but are regarded as having a disability. The ADA also makes it unlawful to discriminate against a person based on that person’s association with a per son with a disability. Exhibit D KENT ANNUAL OUTCOME REPORT 2021-2022 Outcome Report due November 15, 2022 Agency Name: Program Title: Staff Remember Responsible for Completing Form: Staff Member’s Phone Number: E-mail Address: Outcome Measurable Indicators Data Collection Method(s) Dates Data Collected: _________________________________________________________________________ Sample Size: ______________ Number of Responses: ______________ Response Rate: _______________% Results: (Include your interpretation or explanation of the data. Attach graphics if available.) ATTACHMENT E RAINIER VALLEY CORPS INSURANCE REQUIREMENTS FOR 2021-2022 CONSULTANT SERVICES 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. Automobile Liability insurance covering all owned, non-owned, hired and leased vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. 2. 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 or a substitute endorsement providing equivalent coverage. 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. 3. Workers’ Compensation coverage as required by the Industrial Insurance laws of the State of Washington. 4. Professional Liability insurance appropriate to the Consultant’s profession. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: EXHIBIT E (Continued) 1. Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per accident. 2. Commercial General Liability insurance shall be written with limits no less than $1,000,000 each occurrence, $2,000,000 general aggregate and a $1,000,000 products-completed operations aggregate limit. 3. Professional Liability insurance shall be written with limits no less than $1,000,000 per claim and $1,000,000 policy aggregate limit. 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 EXHIBIT E (Continued ) 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. INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Great American Insurance Company 11/04/2021 USI Insurance Services LLC 601 Union Street, Suite 1000 Seattle, WA 98101 206 441-6300 Select NW Region 877 678-5842 610-362-8530 Select@usi.com Rainier Valley Corps 1225 S Weller St, Suite 400 Seattle, WA 98144 16691 A X X X PAC410388405 07/13/2021 07/13/2022 1,000,000 100,000 5,000 1,000,000 3,000,000 3,000,000 A X X PAC410388405 07/13/2021 07/13/2022 1,000,000 A N PAC410388405 WA Stop Gap 07/13/2021 07/13/2022 X 1,000,000 1,000,000 1,000,000 A A Prof Liab Abuse Molestation PAC410388405 PAC410388405 07/13/2021 07/13/2021 07/13/2022 07/13/2022 $1mil ea/ $2mil agg $1mil ea/ $3mil agg RE: Project Name (Organization): Mujer Al Volante. The General Liability policy includes an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder only when there is a written contract that requires such status, and only with regard to work performed by or on behalf of the named insured. City of Kent 220 4th Ave S Kent, WA 98032 1 of 1 #S33974509/M32803356 RAINIVAL4Client#: 1284547 DYGZP 1 of 1 #S33974509/M32803356 This page has been left blank intentionally. * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY *D/B* 260422738 253306 CG 89 70 (Ed. 11 / 14 ) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY - SIGNATURE GENERAL LIABILITY BROADENING ENDORSEMENT This Endorsement modifies and is subject to the insurance provided under the following form: COMMERCIAL GENERAL LIABILITY COVERAGE PART The following extension only applies in the event that no other specific coverage for the indicated loss exposure is provided under this Policy. If other specific coverage applies, the terms, conditions and limits of that Coverage are the exclusive coverage applicable under this Policy, unless otherwise noted in this Endorsement. This is a summary of the various additional coverages and coverage modifications Provided by this Endorsement. For complete details on specific coverages, consult the actual policy wording. Coverage Description Limit of Insurance Page Non -Owned Aircraft Included 2 Non -Owned Watercraft Included 2 Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Included 3 Medical Payments $ 20,000 3 Damage to Premises Rented to You $ 1,000,000 3 Supplementary Payments - Bail Bonds $ 3,000 4 Supplementary Payments - Loss of Earnings $ 1,000 per day 4 Newly Formed or Acquired Organizations Included 4 Unintentional Failure to Disclose Hazards Included 5 Knowledge of Occurrence, Claim or Suit Included 5 Property Damage Liability - Elevators Included 5 Property Damage Liability - Borrowed Equipment Included 5 Liberalization Clause Included 6 Amendment of Pollution Exclusion (Premises) Included 6 Limited Property Damage to Property of Others $ 5,000 6 Additional Insured - Manager or Lessor of Premises Included 7 CG 89 70 (Ed. 11 / 14) (Page 1 of 12 ) C « S1 w 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D8* 260422738 253306 Coverage Description Limit of Insurance Page Additional Insured - Funding Sources Included 7 Additional Insured - By Contract Included 8 Primary and Non -Contributory Additional Insured Extension Included 10 Additional Insureds - Protection of Your Limits Included 10 Blanket Waiver of Transfer of Rights of Recovery Against Others to Us (Subrogation) Included 11 Property Damage Extension With Voluntary Payments $ 1,000/$ 5,000 11 Who Is An Insured - Fellow Employee Extension - Management Employees Included 12 Broadened Personal and Advertising Injury Included 12 A. Non -Owned Aircraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, exclusion g. Aircraft, Auto or Watercraft does not apply to an aircraft provided: 1. it is not owned by any insured; 2. it is hired, chartered or loaned with a trained paid crew; 3. the pilot in command holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating him or her a commercial or airline pilot; and 4. it is not being used to carry persons or property for a charge. However, the insurance afforded by this provision does not apply if there is available to the Insured other valid and collectible insurance, whether primary, excess (other than insurance written to apply specifically in excess of this Policy), contingent or on any other basis, that would also apply to the loss covered under this provision. EL Non -Owned Watercraft Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (2) of exclusion g. Aircraft, Auto or Watercraft is replaced by the following: This exclusion does not apply to: (2) A watercraft you do not own that is: (a) less than 60 feet long; and CG 89 70 (Ed. 11 / 14) (Page 2 of 12) C * S1 * 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D/B* 260422738 253306 (b) not being used to carry persons or property for a charge. C. Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock Under SECTION V - DEFINITIONS, Definition 3. is replaced by the following: 3. "Bodily Injury" means physical injury, sickness, or disease, including death of a person. "Bodily Injury-- also means mental injury, mental anguish, humiliation, or shock if directly resulting from physical injury, sickness, or disease to that person. D. Medical Payments If Coverage C Medical Payments is not otherwise excluded, the Medical Payments provided by this Policy are amended as follows - The Medical Expense Limit in paragraph 7. of SECTION III - LIMITS OF INSURANCE is replaced by the following Medical expense Limit: The Medical Expense Limit provided by this Policy shall be the greater of: a. $20,000; or b. the amount shown in the Declarations for Medical Expense Limit This provision 7. is subject to all the terms of SECTION III - LIMITS OF INSURANCE. E Damage to Premises Rented to You If Damage to Premises Rented to You is not otherwise excluded from this Coverage Part: 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: 3. The fast paragraph of paragraph 2. Exclusions is deleted in its entirety and replaced by the following: Exclusions C. through n. do not apply to damage by fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water to premises while rented to you or temporarily occupied by you with permission of the owner. A separate Limit of Insurance applies to this coverage as described in SECTION III - LIMITS OF INSURANCE. However, this insurance does not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, caused by: i. rupture, bursting, or operation of pressure relief devices; ii. rupture or bursting due to expansion or swelling of the contents of any building or structure, caused by or resulting from water; iii. explosion of steam boilers, steam pipes, steam engines, or steam turbines; or iv, flood 2. Paragraph 6. Under SECTION III - LIMITS OF INSURANCE is deleted in its entirety and replaced with the following: CG 89 70 (Ed. 11/14) (Page 3 of 12) C * S1 * 05/1112020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D1B* 260422738 253306 6. Subject to paragraph 5. above, the most we will pay under Coverage A for damages because of "property damage' to any one premises, while rented to you, or in the case of damage caused by fire, lightning, explosion, smoke, leakage from automatic fire protection system or water while rented to you or temporarily occupied by you with the permission of the owner, for all such damage caused by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water proximately caused by the same event, whether such damage results from fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water or any combination of the six, is the higher of $1,000,000 or the amount shown in the Declarations for the Damage to Premises Rented to You Limit. 3. Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, subsection 4. Other Insurance, paragraph b. Excess Insurance where the words 'Fire insurance' appear they are changed to 'insurance for fire, lightning, explosion, smoke, leakage from an automatic fire protection system or water,' 4. As regards coverage provided by this provision I. Damage to Premises Rented to You - paragraph 9.a. of Definitions is replaced with the following: 9. a. a contract for a lease of premises. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire, lightning, explosion, smoke, leakage from automatic fire protection systems or water to premises while rented to you or temporarily occupied by you with the permission of the owner is not an "insured contract"; F. Supplementary Payments 1. In the Supplementary Payments - Coverages A and B provision, paragraph 11.1b. is replaced with: b. Up to $ 3,000 for the cost of bail bonds required because of accidents or traffic law violations arising out of the use of any vehicle to which the Bodily Injury Liability Coverage applies. We do not have to furnish these bonds. 2. Paragraph i.d. is replaced by the following: d. All reasonable expenses incurred by the Insured at our request to assist us in the investigation or defense of the claim or 'suit,' including actual loss of earnings up to $ 1,000 a day because of time off work. G. Newly Formed or Acquired Organizations Paragraph 3. of SECTION 11- WHO IS AN INSURED is replaced by the following: 3. Any organization you newly acquire or form and over which you maintain ownership or majority interest, will qualify as a named insured if there is no other similar insurance available to that organization. However: a. coverage under this provision is afforded only until the expiration of the policy period in which the entity was acquired or formed by you; b. coverage A does not apply to "bodily injury" or property damage that occurred before you acquired or formed the organization; and c. coverage B does not apply to "personal and advertising injury" arising out of an offense committed before you acquired or formed the organization. CC 89 70 (Ed 11114) (Page 4 of 12) C * S1* 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *DIB* 260422738 253306 d. records and descriptions of operations must be maintained by the first named insured. No person or organization is an insured with respect to the conduct of any current or past partnership, joint venture or limited liability company that is not shown as a named insured in the Declarations or qualifies as an insured under this provision. H. Unintentional Failure to Disclose Hazards Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 6. Representations: Failure of the Insured to disclose all hazards existing as of the inception date of this Policy shall not prejudice the insurance with respect to the coverage afforded by this Policy, provided such failure or omission is not intentional on the part of the Insured. I. Knowledge of Occurrence, Claim or Suit Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: Knowledge of any occurrence, claim, or suit by any agent, servant or employee of the Named Insured does not in itself constitute knowledge by the Insured unless notice of such injury, claim or suit shall have been received by: a. you, if you are an individual; b. a partner, if you are a partnership c. an executive officer or insurance manager, if you are a corporation. J. Property Damage Liability - Elevators 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraphs (3), (4) and (6) of exclusion j. Damage to Property do not apply if such property damage results from the use of elevators. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. K Property Damage Liability - Borrowed Equipment 1. Under paragraph 2. Exclusions of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability, subparagraph (4) of exclusion j. Damage to Property does not apply to "property damage" to borrowed equipment while not being used to perform operations at a job site. 2. The following is added to SECTION IV - COMMERCIAL GENERAL LIABILITY Conditions, Condition 4. Other Insurance, paragraph b. Excess Insurance: The insurance afforded by this provision of this Endorsement is excess over any property insurance, whether primary, excess, contingent or on any other basis. 00 89 70 (Ed. 11114) (Page 5 of 12) C * S1 * 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *DB* 260422738 253306 L. Liberalization Clause If we revise this Signature General Liability Broadening Endorsement to provide more coverage without additional premium charge, your policy will automatically provide the coverage as of the date the revision is effective in your state. M. Amendment of Pollution Exclusion (Premises) 1. The following is added to paragraph (1xa) of Exclusion f. of SECTION I - COVERAGE A - Bodily injury and Property Damage Liability: (iv) 'Bodily injury" or ,property damage" arising out of the actual discharge, dispersal, seepage, migration, release or escape of "pollutants." As used in this Endorsement, the actual discharge, dispersal, seepage, migration, release or escape of pollutants must: (aa) commence on a clearly identifiable day during the policy period; and (bb) end, in its entirety, within seventy-two (72) hours of the commencement of the discharge, dispersal, seepage, migration, release or escape of "pollutants"; and (cc) be discovered and reported to us within fifteen (15) days of the clearly identifiable day that the discharge, dispersal, seepage, migration, release or escape of "pollutants" commences; and (dd) be neither expected nor intended from the standpoint of any insured; and (ee) be unrelated to any previous discharge, dispersal, seepage, migration, release or escape; and (ff) not originate at or from a storage tank or other container, duct or piping which: a, is below the surface of the ground or water; or b. at any time has been buried under the surface of the ground or water and then is subsequently exposed. 2. For the purposes of this coverage, the following is added to the definition of "property damage" of SECTION V - DEFINITIONS and applies only as respects this coverage: Land or water, whether below ground level or not, is not tangible property. 3. Coverage provided hereunder does not apply to any discharge, dispersal, seepage, migration, release or escape that is merely threatened or alleged rather than shown to have actually occurred. N. Limited Property Damage to Property of Others The following is added under SECTION I - SUPPLEMENTARY PAYMENTS - COVERAGES A and Bt 3. We will pay up t o $ 5,000 for loss to personal property of others while in the temporary care, custody or control of an insured caused by any person participating in your organized activities. For the purpose of this supplementary payment, loss shall mean damage or destruction but does not include mysterious disappearance or loss of use. In the event of a theft, a police report must be filed. This supplementary payment does not apply if: a. coverage is otherwise provided by the Property Coverage part (if any) of this Policy; or CG 89 70 (Ed. 11 f 14) (Page 6 of 12) C * S1* 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D/B* 260422738 253306 b. the loss is covered by any other insurance you have or by any insurance of such person who causes such loss. These payments will not reduce the Limits of Insurance. O. Additional Insured - Manager or Lessor of Premises 1. SECTION 11- WHO IS AN INSURED is amended to include as an additional insured any person or organization from whom you lease or rent property and which requires you to add such person or organization as an additional insured on this Policy under: (a) a written contract; or (b) an oral agreement or contract where a Certificate of Insurance showing that person or organization as an additional insured has been issued; but the written or oral contract or agreement must be an "insured contract," and, (i) currently in effect or become effective during the term of this Policy; and (ii) executed prior to the "bodily injury," "property damage," "personal and advertising injury." 2. With respect to the insurance afforded to the Additional Insured identified in paragraph 1. above, the following additional provisions apply: (a) This insurance applies only with respect to the liability arising out of the ownership, maintenance or use of that part of the premises leased to you. (b) The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy_ The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. (c) In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. (d) Coverage provided herein is excess over any other valid and collectible insurance available to the Additional Insured whether the other insurance is primary, excess, contingent or on any other basis unless a written contractual arrangement specifically requires this insurance to be primary. (a) This insurance applies only to the extent permitted by law. 3. This insurance does not apply to: (a) Any 'occurrence" or offense which takes place after you cease to be a tenant in that premises. (b) Structural alterations, new construction or demolition operations performed by or on behalf of the Additional Insured. P. Additional Insured - Funding Sources 1. SECTION 11- WHO IS AN INSURED is amended to include as an additional insured any Funding Source which requires you in a written contract to name the Funding Source as an additional insured but only with respect to liability arising out of: CG 89 70 (Ed. 11114) (Page 7 of 12 ) C * S1 *05/11/2020* PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D/B* 260422738 253306 a. your premises; or b. "your work" for such additional insured; or c. acts or omissions of such additional insured in connection with the general supervision of "your work" and only to the extent set forth as follows: a. The Limits of Insurance applicable to the Additional Insured are the lesser of those specified in the written contract or agreement or in the Declarations for this Policy and subject to all the terms, conditions and exclusions for this Policy. The Limits of Insurance applicable to the Additional Insured are inclusive of and not in addition to the Limits of Insurance shown in the Declarations. b. The insurance afforded to the Additional Insured only applies to the extent permitted by law c. If coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. d. In no event shall the coverages or Limits of Insurance in this Coverage Form be increased by such contract. Q. Additional Insureds - By Contract 1. SECTION 11 - WHO IS AN INSURED is amended to 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. Such person or organization is an additional insured but only with respect to liability for "bodily injury," "property damage" or "personal and advertising injury" arising out of: a. your acts or omissions, or the acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the Additional Insured that are subject of the written contract or written agreement provided that the "bodily injury" or "property damage occurs, or the "personal and advertising injury" is committed, subsequent to the signing of such written contract or written agreement; or b. the maintenance, operation or use by you of equipment rented or leased to you by such person or organization; or c. the Additional Insureds financial control of you; or d. operations performed by you or on your behalf for which the state or political subdivision has issued a permit However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide such additional insured. With respect to paragraph 1.a. above, a person's or organization's status as an additional insured under this Endorsement ends when: CO 89 70 (Ed. 11/14) (Page 8 of 12) C * S1 * 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D1B* 260422738 253306 (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for 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 put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. With respect to paragraph 1.b. above, this insurance does not apply to any "occurrence" which takes place after the equipment rental or lease agreement has expired or you have returned such equipment to the lessor. The insurance provided by this Endorsement applies only if the written contract or written agreement is signed prior to the "bodily injury" or "property damage." We have no duty to defend an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured as required in paragraph b. of Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITION. 2. With respect to the insurance provided by this Endorsement, the following are added to paragraph 2. Exclusions under SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: This insurance does not apply to: a. "Bodily injury" or "property damage" that occurs prior to your commencing operations at the location where such "bodily injury" or "property damage" occurs. b. "Bodily injury," "property damage" or "personal and advertising injury" arising out of the rendering of, or failure to render, any professional architectural, engineering or surveying services, including: (1) the preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders or drawings and specifications; or (2) supervisory, inspection, architectural or engineering activities. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that Insured, if the "occurrence" which caused the "bodily injury" or "property damage," or the offense which caused the "personal and advertising injury," involved the rendering of, or failure to render, any professional architectural, engineering or surveying services. m "Bodily injury" or "property damage" occurring after: (1) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed for 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 put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. CG 89 70 (Ed. 11114) (Page 9 of 12) C * S1 * 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D/B* 260422738 253306 d. Any person or organization specifically designated as an additional insured for ongoing operations by a separate additional insured endorsement issued by us and made part of this Policy_ 3. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III - LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: a. required by the contract or agreement; or b. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This Endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. R. Primary and Non -Contributory Additional Insured Extension This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. Condition 4. Other Insurance of SECTION I V - COMMERCIAL GENERAL LIABILITY CONDITIONS is amended as follows: a. The following is added to paragraph a. Primary Insurance: This insurance is primary to and will not seek contribution from any other insurance available to an additional insured under your policy provided that: (1) the Additional Insured is a named insured under such other insurance; and (2) you have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to the Additional Insured. b. The following is added to paragraph b. Excess Insurance: When a written contract or written agreement, other than a premises lease, facilities rental contract or agreement, an equipment rental or lease contract or agreement or permit issued by a state or political subdivision between you and an additional insured does not require this insurance to be primary or primary and non-contributory, this insurance is excess over any other insurance for which the Additional Insured is designated as a named insured. Regardless of the written agreement between you and an additional insured, this insurance is excess over any other insurance whether primary, excess, contingent or on any other basis for which the Additional Insured has been added as an additional insured on other policies. S. Additional Insureds - Protection of Your Limits This provision applies to any person or organization who qualifies as an additional insured under any form or endorsement under this Policy. 1. The following is added to Condition 2. Duties in the Event of Occurrence, Offense, Claim or Suit: An additional insured under this Endorsement will as soon as practicable: CG 89 70 (Ed. 11 / 14) (Page 10 of 12) C * S1 * 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY "D/B" 260422738 253306 a. give written notice of an "occurrence" or an offense that may result in a claim or "suit" under this insurance to us; b. tender the defense and indemnity of any claim or "suit" to all insurers whom also have insurance available to the Additional Insured; and c. agree to make available any other insurance which the Additional Insured has for a loss we cover under this Coverage Part. d. we have no duty to defend or indemnify an additional insured under this Endorsement until we receive written notice of a "suit" by the Additional Insured. 2. The Limits of Insurance applicable to the Additional Insured are those specified in a written contract or written agreement or the Limits of Insurance stated in the Declarations of this Policy and defined in SECTION III- LIMITS OF INSURANCE of this Policy, whichever are less. These limits are inclusive of and not in addition to the Limits of Insurance available under this Policy. T. Blanket Waiver of Transfer of Rights of Recovery Against Others to Us (Subrogation) Under SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, the following is added to Condition 8. Transfer of Rights of Recovery Against Others to Us: If required by a written contract or written agreement, we waive any right of recovery we may have against a person or organization because of payment we make for injury or damage arising out of your ongoing operations or "your work" done under a contract for that person or organization and included in the "products -completed operations hazard" provided that the injury or damage occurs subsequent to the execution of the written contract or written agreement. U_ Property Damage Extension with Voluntary Payments 1. The following is added to paragraph 1. Insuring Agreement of SECTION I - COVERAGE A - Bodily Injury and Property Damage Liability: At your request we will pay for "loss" to property of others caused by your business operations for which this Policy provides liability insurance. Such payment will be made without regard to your legal obligation to do so. The 'loss" must occur during the policy period and must take place in the "coverage territory." 2. With respect to the coverage afforded under paragraph 1. above, paragraph 2. Exclusions of SECTION I - COVERAGES A - Bodily Injury and Property Damage Liability is amended as follows; Exclusions j.(3), j.(4), i.(5) and j.(6) are deleted. 3. As respects coverage afforded by this coverage, SECTION III - LIMITS OF INSURANCE is replaced by the following: Regardless of the number of insureds, claims made or "suits" brought or persons or organizations making claims or bring "suits": 1. Subject to 2. Below, the most we will pay for one or more "loss" arising out of any one "occurrence" is $ 1,000. 2. The aggregate amount we will pay for the sum of all 'loss" in an annual period is $ 5,000. This aggregate amount is part of and not in addition to the General Aggregate Limit described in paragraph 2. of SECTION III - LIMITS OF INSURANCE. CG 89 70 (Ed. 11 / 14) (Page 11 of 12 ) C * S1 * 05/11/2020 * PAC 4103884 05 GREAT AMERICAN ASSURANCE COMPANY ORIGINAL COPY *D/B* 260422738 253306 V. Who Is an Insured - Fellow Employee Extension - Management Employees 1. The following is added to paragraph 2.a.(1) of SECTION II - WHO IS AN INSURED: Paragraph (a) and (b) above do not apply to "bodily injury" or "personal and advertising injury" caused by an "employee" who is acting in a supervisory capacity for you. Supervisory capacity as used herein means the "employee's" job responsibilities assigned by you, including the direct supervision of other "employee" of yours. However, none of these "employees" are insureds for "bodily injury" or "personal and advertising injury" arising out of their willful conduct, which is defined as the purposeful or willful intent to cause "bodily injury" or "personal and advertising injury," caused in whole or in part by their intoxication by liquor or controlled substances. This coverage is excess over any other valid and collectable insurance available to your "employee." W. Broadened Personal and Advertising Injury 1. Unless 'Personal and Advertising Injury" is excluded from this Policy, the following is added to SECTION V - DEFINITIONS Item 14.: h. mental injury, mental anguish, humiliation, or shock, if directly resulting from Items 14.8. through 14.e. CG 89 70 (Ed. 11 f 14) (Page 12 of 12) 1 of 4 EXHIBIT F City of Kent Certification Regarding Debarment and Suspension Rainier Valley Corps Mujer Al Volante-Women Driving Agency Name of Project Certification A: Certification Regarding Debarment, Suspension, and Other Responsibility Matters - Primary Covered Transactions 1. The prospective primary participant certifies to the best of its knowledge and belief that its principals; a. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal debarment or agency; b. Have not within a three-year period preceding this proposal, been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification, or destruction of records, making false statements, or receiving stolen property; c. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and d. Have not within a three-year period preceding this application/ proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. 2. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. Instructions for Certification (A) 1. By signing and submitting this proposal, the prospective primary participant is providing the certification set out below. 2. The inability of a person to provide the certification required below will not necessarily result in denial of participation in this covered transaction. The prospective participant shall submit an explanation of why it cannot provide the certification set out below. The certification or explanation will be considered in connection with the department or agency’s determination whether to enter into this transaction. However, failure of the prospective primary participant to furnish a certification or an explanation shall disqualify such person from participation in this transaction. 3. The certification in this clause is a material representation of fact upon 2 of 4 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 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. 3 of 4 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 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 4 of 4 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. Primary Contractor/Sub-Contractor (Print Below) Date Date Authorized Signature of Primary Contractor/Sub-Contractor (Sign Below) Title Reynaldo JoJo Gaon (Dec 21, 2021 09:43 PST) Reynaldo JoJo Gaon 12/21/2021Reynaldo Gaon Director, Operations Support Program Signature: Email: Signature: Email:kjennings@kentwa.gov Melissa McCormick (Dec 23, 2021 09:10 PST) Melissa McCormick cityclerk@kentwa.gov Rainier Valley Corps - Mujer Al Volante-Women Driving Final Audit Report 2021-12-23 Created:2021-12-16 By:KateLynn Jennings (kjennings@kentwa.gov) Status:Signed Transaction ID:CBJCHBCAABAA1rC5Pq691AANN2emi8aQ6OXAe5RqdwEl "Rainier Valley Corps - Mujer Al Volante-Women Driving" History Document created by KateLynn Jennings (kjennings@kentwa.gov) 2021-12-16 - 11:46:40 PM GMT- IP address: 146.129.252.126 Document emailed to Reynaldo JoJo Gaon (jojo@rvcseattle.org) for signature 2021-12-16 - 11:50:50 PM GMT Email viewed by Reynaldo JoJo Gaon (jojo@rvcseattle.org) 2021-12-20 - 8:18:54 PM GMT- IP address: 73.254.65.39 Document e-signed by Reynaldo JoJo Gaon (jojo@rvcseattle.org) Signature Date: 2021-12-21 - 5:43:34 PM GMT - Time Source: server- IP address: 73.254.65.39 Document emailed to Merina Hanson (mhanson@kentwa.gov) for signature 2021-12-21 - 5:43:39 PM GMT Email viewed by Merina Hanson (mhanson@kentwa.gov) 2021-12-21 - 6:20:01 PM GMT- IP address: 104.28.116.132 Document e-signed by Merina Hanson (mhanson@kentwa.gov) Signature Date: 2021-12-21 - 6:20:42 PM GMT - Time Source: server- IP address: 174.204.81.237 Document emailed to KateLynn Jennings (kjennings@kentwa.gov) for signature 2021-12-21 - 6:20:44 PM GMT Email viewed by KateLynn Jennings (kjennings@kentwa.gov) 2021-12-21 - 6:39:49 PM GMT- IP address: 146.129.252.126 Document e-signed by KateLynn Jennings (kjennings@kentwa.gov) Signature Date: 2021-12-21 - 6:44:21 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Kim Komoto (kkomoto@kentwa.gov) for signature 2021-12-21 - 6:44:23 PM GMT Email viewed by Kim Komoto (kkomoto@kentwa.gov) 2021-12-22 - 5:20:28 PM GMT- IP address: 146.129.252.126 Document e-signed by Kim Komoto (kkomoto@kentwa.gov) Signature Date: 2021-12-22 - 5:20:52 PM GMT - Time Source: server- IP address: 146.129.252.126 Document emailed to Melissa McCormick (cityclerk@kentwa.gov) for signature 2021-12-22 - 5:20:54 PM GMT Email viewed by Melissa McCormick (cityclerk@kentwa.gov) 2021-12-23 - 5:07:10 PM GMT- IP address: 146.129.252.126 Document e-signed by Melissa McCormick (cityclerk@kentwa.gov) Signature Date: 2021-12-23 - 5:10:42 PM GMT - Time Source: server- IP address: 146.129.252.126 Agreement completed. 2021-12-23 - 5:10:42 PM GMT