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City Council Meeting - Council - Regular Agenda - 02/16/2021
^*4 KENT CITY COUNCIL AGENDA • Tuesday, February 16, 2021 KENT 7:00 PM wa 5H I NGTGN THIS IS A REMOTE MEETING Due to COVID-19 and Health Safety Requirements, and by Order of the Governor, this is a remote meeting. A live broadcast is available on Kent TV21, www.facebook.com/CityofKent, and www.youtube.com/user/KentTV21 To listen to this meeting, call 1-888-475-4499 or 1-877-853-5257 and enter Meeting ID 955 8563 0464 Mayor Dana Ralph Council President Toni Troutner Councilmember Bill Boyce Councilmember Marli Larimer Councilmember Brenda Fincher Councilmember Zandria Michaud Councilmember Satwinder Kaur Councilmember Les Thomas ************************************************************** COUNCIL MEETING AGENDA - 7 P.M. 1. CALL TO ORDER 2. ROLL CALL 3. AGENDA APPROVAL Changes from Council, Administration, or Staff. 4. PUBLIC COMMUNICATIONS A. Public Recognition i. Appointments to Parks and Recreation Commission B. Community Events C. Public Safety Report 5. REPORTS FROM COUNCIL AND STAFF A. Mayor Ralph's Report B. Chief Administrative Officer's Report C. Councilmember's Reports City Council Meeting City Council Regular Meeting February 16, 2021 6. PUBLIC HEARING 7. PUBLIC COMMENT The Public Comment period is your opportunity to speak to the Council and Mayor on issues that relate to the business of the city of Kent. Comments that do not relate to the business of the city of Kent are not permitted. Additionally, the state of Washington prohibits people from using this Public Comment period to support or oppose a ballot measure or candidate for office. If you wish to provide comment to the Mayor and Council, please contact the City Clerk by 4 p.m. on the day of the meeting at 253-856-5725 or CityClerkpKentWA.aov. When called to speak during the meeting, please state your name and city of residence for the record. You will have up to three minutes to provide comment. Please address all comments to the Mayor and Council as a whole. The Mayor and Council may not be in a position to answer questions during the meeting. Alternatively, you may email the Mayor and Council at Mayor6DKentWA.aov and CityCouncilOKentWA.gov. Emails are not read into the record. 8. CONSENT CALENDAR A. Approval of Minutes 1. Council Workshop - Workshop Regular Meeting - Feb 2, 2021 5:00 PM 2. City Council Meeting - City Council Regular Meeting - Feb 2, 2021 7:00 PM 3. Committee of the Whole - Committee of the Whole - Regular Meeting - Feb 9, 2021 4:00 PM B. Payment of Bills - Authorize C. Excused Absence for Councilmember Michaud - Approve D. Accept the 2020 Plastic Markings Project as Complete - Authorize E. Accept the Historic Dvorak Barn Relocation as Complete - Authorize F. Memorandum of Understanding between the City of Kent and Avenue 55, LLC for the Naden Avenue Assemblage - Authorize G. Medical, Dental, Vision, Life and Long-term Disability and Stop Loss Insurance Vendor Contracts - Authorize H. Ratify HP Laptop Purchase Utilizing CARES Act Funds I. Ordinance Approving the Change of Indirect Control of Astound Broadband, LLC - Adopt J. Ordinance Amending KCC 9.42 Related to Unlawful Race Attendance - Adopt K. 2021 Community Development Block Grant Annual Action Plan - Approve L. Adjustment to the 2019 Community Development Block Grant Budget to Accept Third Round of CARES Act Coronavirus Funds (CDBG-CV) - Authorize Citv Council Meetinq Citv Council Regular Meetinq February 16, 2021 M. King County Flood Control District Sub -Regional Opportunity Fund: Accept and Reallocate Funds for the Lake Fenwick Aerator Improvements - Authorize N. Investment Advisory Agreement with Public Financial Management, LLC - Authorize O. Authorize the Use of accessoShoWare Center Operating Fund Balance to Purchase Scoreboard - Authorize P. Ordinance Providing Business Licensing Exemption for Parks Performers - Adopt Q. Appointmens to the Parks and Recreation Commission - Confirm 9. OTHER BUSINESS 10. BIDS A. 2021 Paint Line Striping and Raised Pavement Marking Replacement Bid - Award 11. EXECUTIVE SESSION AND ACTION AFTER EXECUTIVE SESSION 12. ADJOURNMENT NOTE:A copy of the full agenda is available in the City Clerk's Office and at KentWA.gov. Any person requiring a disability accommodation should contact the City Clerk's Office in advance at 253-856-5725. For TDD relay service, call the Washington Telecommunications Relay Service 7-1-1. 5.B Administration • The City Council held the first day of its 2021 retreat in an online format on February 5. Among the council's directions were to modify the descriptive language for two of the city's goals, return to the council committee system in the coming months, strengthen board/commission ordinances and bylaws, and require additional notice to tenants when landlords want to terminate month -to -month tenancy. The council will hold the second day of its retreat this spring - and hopefully in - person. • We hope to take big steps in our strategic planning system this year. Thank you to Government Performance Coordinator Michael Mage and Senior Financial Analyst Kathleen McConnell for creating an ambitious work plan to adopt SMART (specific, measurable, achievable, realistic, and timely) objectives and performance measures that will activate and then measure progress toward the City's goals. • We continue to advocate for the City's state legislative priorities. February 15 is the deadline for bills to pass out of committees to continue to advance in the process. Federal Way Link Extension • The City issued civil permits for utilities and drainage for the Star Lake Station area including S. 272nd Street. • Due to clearing, the north end of 30t" Ave South is closed at Kent Des Moines Road for approximately two weeks. Access is available from S. 240t" Street. Utility work will occur within 301" Avenue South to prepare for drilling of the shafts for the guideway. Drilling for shafts behind Lowe's will begin next week. • Waterline relocation on the south side o 272nd Street is ongoing this week. Work should be completed approximately February 19t" Race and Equity • Uriel has completed the first draft of the Limited English Proficiency (LEP) Plan. There is a recommended "Four Factor Analysis" that needs to be completed before the plan is ready for adoption. • Uriel has started the research and data collection phase of the plan. Part of the plan includes a community survey. The Cultural Communities Board has created fS f subcommittee that will be providing input on the survey questions and implementation. Multiple division subject matter experts continue working on the Amanda build out and are currently outlining a plan for user assisted testing of the system with IT. Long Range Planning • LRP submitted a letter to King County with a preliminary staff analysis of and position on the baseline growth targets for housing and jobs. These numbers represent what Kent will have to plan for in terms of population and job growth through 2044, Page 1 of 11 Packet Pg. 4 5.6 and are based on King County's total allocation from PSRC, several data factors mutually agreed upon with other cities, and the regional growth strategy framework of allocating growth to centers. Staff believes that the baseline target for housing is too high, and made the case for a lower target due to Kent's large household size, development history, and land capacity as recently calculated. • On January 28, 2021, the Puget Sound Regional Council's Executive Board acted to certify the Kent Downtown Strategic Action Plan and Kent Rally the Valley Plan. This action recognizes that the plans meet certification requirements for regional centers. PSRC thanked the City for continued dedication to planning for Kent's designated Regional Growth Center and Regional Manufacturing/Industrial Center as represented by these plans. This certification is a key stamp of approval for two major subarea planning efforts the LRP team has led in the last decade. • LRP facilitated a Growth Management Planning Committee (GMPC) work session breakout room on the Economy chapter of the Countywide Planning Policies (CPP) update, as part of Interjurisdictional Team (IJT) duties. This breakout room facilitation was key to ensuring GMPC members had a chance to speak with IJT chapter leads in advance of adoption of the new CPPs. LRP staff have been ensuring Kent's perspective —particularly related to Rally the Valley findings and the importance of advanced manufacturing —are well represented in the CPP process and the Economy chapter in particular. Feedback from GMPC members included appreciation for the focus on middle wage jobs and interest in seeing more links to transportation and technology topics. Economic Development • Economic development is meeting with Washington FIRST Robotics, a Kent -based non-profit facing serious difficulties due to a loss of event revenues. In a bid to survive, they plan to sever their industrial warehouse lease and are remote for the foreseeable future. They hope this step will conserve some remaining resources with which to set up once more in a post - vaccine environment. • Economic development attended the virtual Pacific Northwest Aerospace Alliance 2021 annual conference, which featured sessions and speakers drawn from Kent Valley companies. • Economic development strategized with counterparts at OneRedmond about how a county wide economic development collaboration might do more to promote the growing outer space industry. • Economic development, working with Kent Downtown Partnership, is participating in a listening session of downtown private and public property owners to talk about priorities and possible joint activities to benefit the historic business district. • Economic development reconvened with Craft3 - its financial institution partner from the Small Business Emergency Grant program - to compare notes on the past quarter, review upcoming activities, and look for alignment in setting up services in South King County for the recovery of microenterprise. • Economic development participated with current planning, building officials, and law to talk about the long -shuttered gas station at Meeker Street and set strategy in advance of a meeting with Shell's representatives on on -going liability and clean-up. • Economic development continues to work with Sound Transit to develop community engagement plans and identify technical advisors for purposes of marketing the surplus properties for transit -oriented development. • At the urging of King County, staff met with a principle member of FareStart to talk about that social enterprise's expansion plans south of Seattle and explore a potential collaboration with King County's own planning for a "food hub" type facility in south King County —possibly in the Kent Valley. • To act as the voice for our regional economic development team and website, KentValleyWA.com, staff launched a complementary LinkedIn page. Deemed the best social media platform for B2B Page 2 of 11 Packet Pg. 5 connections, the page aims to assist in growing awareness of Kent Valleys' industry mix and its world -class workforce. Follow it for industry news and updates. • Given our strong interest in space history, Boeing's Corporate Historian reached out to gauge the City's interest in being gifted an Inertial Upper Stage (IUS) booster rocket built by Boeing at its Kent Space Center. This booster was packed into the Space Shuttle and used to boost satellites and space probes into higher orbit or on their way to other planets. The IUS is 17 feet tall, 10 feet in diameter and weighs 32,OOOlbs. This space artifact is set to be rotated out of the Museum of Flight's collection. Planning is underway for a site visit with the Museum to better understand the logistics and necessary requirements should we accept this incredible offer. • Staff virtually met with leadership at Atlas Genomics who sought our assistance with company connections in order to provide COVID testing. Ongoing testing remains critical for business operations to ensure the safety of their workforce. • Staff connected Amazon's Community Operations team with leadership at the India Association of Western WA to assist under/unemployed taxi drivers to obtain driving jobs at Amazon. • As a member of the WA State Chapter of the Women in Manufacturing (WiM) association, staff connected Kent's Small Business Development Center liaison to WiM Leadership to assist a local, female - owned manufacturing company interested in selling to another female entrepreneur. • Staff virtually met with the Director of NW Tech Bridge to assist their efforts with the US Navy to recruit technologists to help minimize vessel/orca collisions in the Puget Sound. • Staff presented an update to the Port of Seattle Commission on the City/Port Partnership Grant and our use of these funds. In partnership with the Aerospace Joint Apprenticeship Committee, we established and coordinated training and employer engagement strategies to incentivize hiring/training of entry-level and low income/low skilled incumbent 5.B workers in response to COVID-impacted workplaces and local economy. • In its role as staff to Kent's Lodging Tax Advisory Committee, staff is actively monitoring the dramatic reduction in revenues compared to previously committed expenditures. An update to the committee is planned for Feb. 25 to learn their recommendations for Visit Kent marketing activities in 2021. • Staff met with a long-time local manufacturer interested in a financial sponsorship of the City's new Lunar Rover a Pa rk. Permit Center/Building Services • A new permit tech joined the permit center on February 1. Please welcome Nicholas ; Comeaux. He has a background in L) AutoCAD and permitting in the private E sector. We are excited to have him join our 0 ECD team. • Virtual intake appointments are ongoing a utilizing QLess in tandem with the COK website. • January Statistics: a 0 249 Issued Permits 0 395 New and resubmitted Applications N L 0 73 Correction Letters Issued 0 170 Fee Listings Issued • Three payrolls have been processed in Workday since it went live in December 2020. Each payroll continues to run more smoothly as employees become more familiar with the system and the new look of their pay slip. We are now hard at work documenting everything. Knowledge - transfer sessions will be held with the Payroll Team over the next two weeks to ensure everyone on the team has a solid foundation in their understanding of Workday. • Despite the IRS bringing back the 1099- NEC from the 80's and challenges with the necessary updates to JDE, the accounts payable group with monumental IT support processed and issued 1099s on the January 31 deadline. HUGE thanks to team persistence and IT all-nighters. Page 3 of 11 Packet Pg. 6 5.6 • The budget division has been continuing their work to compile data and format the 2021-2022 adopted budget book which we estimate will be published in mid -March. • Since the implementation of Workday, the budget division, in conjunction with other divisions and departments, has been exploring new ways to calculate workers compensation, which should be finalized by the end of the month. All • Auditing City policies and preparing a schedule/plan to get policies updated • Prioritizing Workday issues, currently at 40+; includes citywide and department specific requests • Reviewing roles and responsibilities; updating security roles in Workday • Continuing to fine-tune Telestaff integration with Workday Benefits • COVID-19 cases and contact traces • Correcting vendor integration issue for ICMA contribution files • REMINDER: update your beneficiaries in Workday Risk Management • Self -insured retention increases in liability and worker comp funds prompted new actuarial studies for both programs; meeting with Finance to review and discuss those studies and budgetary impacts Labor • AFSCME Labor Management meeting • Response to City of Tacoma compensation study Recruiting • Working with departments to streamline the temporary hiring process • Interview panel training for Court employees in anticipation of Judicial Specialist interviews on February 17 • Interviews for Construction Inspector (TLT) are scheduled for February 12 • We have recruitments open in Administration, Finance, IT, Public Works, Parks, Court, and Economic & Community Development and continuous openings for the Police department Information Technology Projects • Corrections Camera Upgrade - replace the jail's internal analog cameras and migrate to the digital capture, storage and retention of the OnSSI system, which will then be integrated with the jail controller and intercom. • Centracs Traffic Management System Upgrade - update and continue to maintain the City's current Traffic Management system software to ensure current and continued system functionality. The Centracs traffic management system software is currently out of update compliance resulting in the inability to bring new traffic assets online. Information Technology operational support for January 31, 2021 to February 09, 2021 • Number of tickets opened - 147 • Number of tickets closed - 246 Enterprise GIS General • Deploying Esri GIS ArcPro software installs and training to staff care laptop • Continue to update and normalize City addressing database for various city wide software implementations • Police SafeCam application legal disclosure statement • Meeting with PSRF to mirror addressing workflow for citywide software implementations • Working with both Finance and Parks to show which parcels are Parks owned • Providing support for Parks to locate assets using the GIS collector application Weekly Customer Service Requests • Transferring Connect Explorer updates from PW to IT • Transferring GIS monthly update to Enterprise GIS • Providing customer support to help staff connect to GIS data • Reviewed and amended a request for proposals for the Police Department to retain a consultant to develop a data gathering program to assist the Police c U 0 U 0 N 0 a a� Page 4 of 11 Packet Pg. 7 Department in tracking race and equity issues. • Met with Seattle's Rental Housing Program Manager to discuss Seattle's rental just cause ordinance. • Prepared an amendment to the City's Unlawful Race Attendance Ordinance to provide the Police Department with another tool in combatting illegal vehicle racing and related activities. • Prepared a response in opposition to HB 1440, a bill that would pre-empt much of the City's authority to regulate small wireless facilities within the right-of-way and on city -owned infrastructure and limit the City's ability to collect its actual costs in processing such permits. • Researched and advised staff concerning options to incorporate a portion of S. 2591n Street into the city limits of Kent as part of the Milwaukee II Levee Improvement Project. • Assisted Public Works with a complicated survey issue involving a large parcel of property on the East Hill, which currently prohibits the City from granting subdivision approval as currently requested by the applicant. • Continued to provide assistance with property acquisition for the Summit- Landsburg Culvert replacement project and the 76t" Avenue project to replace culverts. • During the month of January, prosecutors filed 59 in -custody cases and 231 out -of - custody cases with a 15% fail to appear (FTA) average rate for defendants appearing for court either in -person or via Zoom. Prosecutors also reviewed 4,056 minutes (67.6 hours) of body worn camera video footage in preparation for cases set for trial dates in February. Although jury trials are not currently being held, prosecutors must still prepare those cases as if they will be proceeding to trial and appear in court to address the matter on the scheduled trial date. • Continued to assist the Clerk's office with public records requests as needed, and Public Works, ECD, IT and Parks with a number of high priority contracts and development projects, including property 5.B rights and access issues involving Naden Avenue. • Assisted the Clerk's Office in preparing the agenda for the City Council meetings and Committee of the Whole meetings. • Assisted the HR Department in a number of sensitive employment and labor related matters. Human Services • Equitable Futures is working with the Human Services division to evaluate 2020 funding allocation processes. The consultants will be surveying organizations that have not applied for City funding to learn more about why. Focus groups with organizations that have participated in the application process will begin in mid - February. They will also conduct a focus group with the Human Services Commission to learn more from the perspective of those making the funding decisions. A report will include recommendations to further improve grantmaking processes and how to institutionalize racial equity into the application, review, and allocation system. • The Human Services division released an RFP seeking concept papers to identify strategies or programs to fund that will promote youth mental and emotional well- being, in an effort to prevent mental health challenges from becoming chronic or disabling. The City Council allocated $200,000 to this RFP as part of the 2021 budget with funds from the newly enacted 1/10 of 1% sales tax. Funding and supporting enhanced mental health support as part of Kent's pandemic recovery plan will help ensure that children and youth receive the assistance they need during the immediate crisis. Strengthening programs that help young people manage stress and build resiliency is essential to youths' current and future health. While this funding is one-time in nature, staff will work with providers to consider how to continue supporting families after the pandemic. The funding currently available c U 0 U 0 N 0 a a� Page 5 of 11 Packet Pg. 8 5.B will support 4 to 6 programs that have a high likelihood of engaging youth in ongoing services during and beyond this one-time funding opportunity. • In preparation for potential severe weather, Human Services staff is working with homeless outreach workers and nonprofit providers to identify a system for distributing survival/shelter in place gear to those living unsheltered. Supplies include emergency blankets, a small number of emergency tents, hats, gloves, towels, and hand and feet warmers. These supplies will be combined with those collected by agencies, and staff will help coordinate how and when they are distributed. Staff from Union Gospel Mission and Catholic Community Services will be the primary points of contact. Human Services staff also assessed local shelter capacity and will be working with Multi Service Center and Catholic Community Services to determine if they have unstably housed clients who could be motel vouchered over the weekend. King County has activated 12 additional severe weather shelter beds. Kent does not have a severe weather shelter option this winter due to covid-19 concerns and no available staffing. Some homeless Kent residents are currently being sheltered by Catholic Community Services in what is known as a deintensification shelter model at a hotel in SeaTac. Shelter beds have also recently been added at a motel in Federal Way. Additionally, KentHOPE recently converted transitional housing units to emergency shelter to address the increased need for non -congregate shelter due to the pandemic as well. Parks, Recreation and Cultural Services • Cultural Programs is offering access to several livestream performances in February and March. A portion of each ticket sold for these events benefits Spotlight Series. o Jon Cleary and Ivan Neville present a special Fat Tuesday duo concert on February 16 at 6 p.m. o We Banjo 3 will perform a full concert live from Galway, Ireland at 2 p.m. on Saturday, March 13. Tickets are $20 (early bird) and $25, and can be purchased at: https://shop.webanjo3.com/kent o A.J. Croce presents a two -concert series on March 18 (album release show) and March 25 (30-year career retrospective) at 5:30 p.m. Tickets are $15 for one show, and two for the series. Tickets are available at: https://boxoffice.mandolin.com/collecti ons/a-j-croce?oid=31&affid=87 • We received 54 applications for the new Downtown Rotating Mural Public Art program. A jury made up of one City Councilmember, one of the property owners, two Kent Downtown Partnership representatives, one professional artist, and one Arts Commissioner completed an initial round of scoring, resulting in 6 finalists. The jury will meet again, via Zoom, before the end of February to select the two final artists who will develop proposals for two murals to be installed in the downtown core. Projected installation is summer 2021. • Public art maintenance is underway as staff work with artist Stuart Nakamura and Servant Industries (a concrete restoration vendor) to determine options for restoring the stained concrete portions of the "Another Place, Another Time" sculpture at the Kent Historical Museum. • The Kent Creates "Looking Forward" exhibit encourages artists and creative minds to submit their work focused on the theme of looking forward to a New Year and brighter future. The deadline for this exhibit is March 31. We will also be using the Kent Creates platform to host a virtual version of the annual Student Art Exhibit in April. • The Recreation Division hosted a sold out Valentine's Day themed STEAM Activity perfect for families with kids age 4-10. These popular STEAM Activity Bags included science activities, art projects, goodies, a decorate -your -own Valentine cookie kit, and more. Pre -registered families picked up their bags on Thursday, February 11th at the Kent Commons Community Center. • Dave Hobbs and Brian Steward have continued to work with community Page 6 of 11 Packet Pg. 9 5.B organizations, churches, and outside agencies to distribute food to families in need in Kent since late March 2020. To date they have helped distributed well over 12 million pounds of food. During the weeks when there was a lull in the, "USDA Farm to Home," program they worked with other agencies such as Union Gospel Mission, The Emergency Feeding Program and, the latest, Frog Farms to receive donations of quality foods and goods to distribute to the public. Dave was recently recognized by the Rotary Club of Kent and was 1 of 25 people awarded a, "2020 Rotary Hero Award," for selfless service to many in the Kent community over the past year. We also would like to recognize Brian Steward as a "2020 Recreation Hero" for his selfless work in the community as well. • Youth, Teen, Adaptive and Commons Recreation staff took the first steps in offering new face to face programming as we moved into Phase 2 of the Healthy Washington Roadmap to Recovery. In their fourth and final week, Pickle Ball at Kent Commons and Disc Golf at Wilson Playfield have been popular activities available to fourth thru sixth graders. In the interest of participant and staff safety, we have closely adhered to all Public Health and CDC COVID guidelines. Additional sessions of these popular programs along with a wide variety of other activities are in the planning stages. • Quota International of Kent Valley generously sponsored the Kent Parks Adaptive Recreation "Love is in the Air" drive-thru event on Saturday, February 13. Quota provided 70 free Valentines- themed Sugar Cookie decorating kits. Each kit came with 4 sugar cookies, frosting and fun sprinkles to decorate. Significant crime activities/ arrests/investigations • On January 26, at 9:32 pm officers arrested a suspect for pointing a handgun at a man and his wife after they interrupted him prowling their vehicle. The suspect was booked into Juvenile Detention for 2 counts of Assault 2, Assault 3 for kicking and spitting on an officer, Resisting Arrest, plus 2 warrants for Assault 4 DV. • On January 28 at 10:09 pm, Patrol was dispatched to the Sounder Station for subjects fighting and one gunshot heard with subjects screaming. Dispatch then advised there was a male inside El Sabor (Pioneer/Central) with gunshot wounds to the stomach. Officers provided aid to the victim and he was transported to Harborview Medical Center in critical condition. Detectives are investigating. • On January 30, at 6:05 pm, officers responded to the 2400 block of S 249t" for a female who was reporting that her boyfriend assaulted her. The suspect in this case was naked and high on Acid. All three officers tried to de-escalate him, but he was not of a rational mind. All three officers moved in to detain him quickly and decisively, therefore very little force was needed to detain him. The suspect was involuntarily committed. • On January 30, at 1:37 pm a victim was driving out of the parking lot at PHS/KDM when he was confronted by a white male wielding a shotgun standing in his path. The suspect ordered the victim out of his car, then drove off with the victim's vehicle. Detectives are investigating. • On January 30, at 9:44 pm, a masked gunman entered the Little Caesar's restaurant at 27020 Pacific Hwy. He was able to get away with around $200-$800 in cash. The suspect was described as 6'4" tall, male, wearing a hooded sweatshirt and blue jeans. The suspect wore a full- faced ski mask during the robbery. Detectives are investigating. • On January 30, at 10:35 pm, a suspect shot a bow and arrow at a victim, just missing her foot. The victim safely exited the residence with her children, taking his gun out of the home as well. After surrounding the unit, PA announcements were made and with successful negotiations, the suspect exited the residence without incident. • On January 31, at 12:40 pm officers located a suicidal female in the upper portion of Earthworks Park behind the old Page 7 of 11 Packet Pg. 10 5.B Top Foods. The female had climbed up onto a partially downed tree which overhung the ravine by about 15-18 feet. She had tied a rope onto the downed log and noose around her neck. The downed tree was caught on another standing tree, which made it extremely difficult to reach her with the slope of the ravine and the slipperiness of the tree. As one officer talked with the female and established a great rapport with her, other officers on scene had several contingency plans in place in case she decided to jump. Another officer was able to work his way underneath her and cut the rope so she couldn't severely harm herself even if she did jump. A final officer climbed the ladder and was eventually able to safely escort her down where she could be provided with further assistance. • On January 31, at 7:25 pm. A victim was transported to Valley Medical Center by his girlfriend, after receiving a gunshot wound to the leg at Hawthorne Suites. Officers learned that the victim and his girlfriend were in their vehicle in the hotel parking lot and were confronted by suspects with a gun. Detectives are investigating. Major emphasis patrol • Three officers assisted WSP on a racer emphasis on January 29. One vehicle was contacted after racing and the driver was arrested for being in illegal possession of a firearm and racing. The other four occupants were also arrested for street racing type crimes. No other arrests were made on Friday or Saturday night because of the large law enforcement presence in both the South Sound and in Pierce County Events and awards • Letter of Commendation: On December 27, Officers Tessa Melville, Chellsi James, and Oscar Rodriquez responded to a Meeker Street apartment complex after an elderly male called to report his adult daughter assaulted him and she was holding a knife to her own throat. Officer Rodriguez attempted to make exigent entry into the apartment by kicking the front door, but the female appeared to barricade it. After numerous attempts to force entry, the door finally opened. Officers saw the suspect with her arms wrapped around his neck and throat while holding a hammer. The officers closed the distance on the suspect in order to rescue the victim. Officer Melville quickly snatched the hammer away from the suspect's hand. Officers Rodriguez and James physically engaged the suspect and she was taken into custody. Earlier in the night, the suspect robbed and assaulted her sister on the east hill of Kent. The suspect then went to the Muckleshoot Indian Reservation and got into a physical dispute with her boyfriend. a She then ran over him and his brother with 0 her car. They were sent to Harborview c Medical Center with serious injuries. Officers Melville, James, and Rodrigues ; received this letter of commendation as L) they demonstrated decisive action rescuing E an elderly victim from a violent assault and 0 unlawful imprisonment. Officers Melville, James, and Rodriguez exemplify the Kent a Police Department's mission to aggressively fight crime while serving with compassion. 0 n_ Land Survey/PW GIS • Land Survey field staff are staking on active capital improvement projects. Topographic mapping and as -built surveys of the Upper Mill Creek Dam, Washington Ave. pump station and Clark Springs generator projects. • Land Survey office staff are reviewing 2021 CIP project plans, calculating, mapping and writing legal descriptions for current and future capital projects. City Surveyor is calculating right of way for the 2021 overlay project. • Assistant City Surveyor vacancy recruitment in process. • GIS staff are supporting asset management software processes & updating data models with Hansen information. Staff continue fulfilling public records requests, entering CIP and private development project as- builts and developing maps for Public Works operations and the Adopt -a -street program. Page 8 of 11 Packet Pg. 11 Construction • 228t" St. Union Pacific Railroad Grade Separation Bridge and Roadway (Ph 5 of 5): SB structures placed last of monument slab on project at SE 1 last Thursday. Working on barrier forming at SE 1 this week and general wall finish work and form removal. First of BP rail on top of barrier being installed this week. Wilson Concrete poured last roadway pour on S 228t" West of bridge last week. Placed handicap ramps on East side of 76t" intersection, sidewalk pour on east end of SE 2 moment slab, curb and gutter down 6t" Ave N on East side, and new concrete driveway into International Paper on 6t". Scheduled to place last roadway pour down from bridge to 6t" Ave on East side, along with first 6t" Ave pour on Wednesday this week, weather permitting. Totem Electric placed ped pole foundation and conduit work ahead of handicap ramp pour on SE corner of 76t" last week. Stood light poles at bridge and on barrier elbows West side of fi bridge last week. Placing barrier elbows and lights where space allows on East side of bridge this week. C&P Fence installed fencing along UPRR right-of-way under bridge last week. Upper Mill Creek Dam Improvements and diversion structure replacement: startup was completed on Wednesday last week. Minor site clean-up remains. Green River Natural Resource Area (GRNRA) south stormwater pump station: testing/startup/training is rescheduled for Wednesday, February 10. Planting is complete. Fence crews are scheduling to return and place fabric. Installation of the revised skylight is scheduled for Tuesday, February 9. Installation of the remaining doors is scheduled for Friday, February 12. 5.B • Meet Me on Meeker sidewalk/Riverbend Driving Range improvements: Final electrical and signage installation is ongoing. Completion is expected this week. • Willis Street and 4t" Ave S Roundabout: concrete sandblasting is ongoing. Final electrical installations are ongoing. Landscape installation will continue for the next week. Start of LED message board construction is on hold. Revised pricing due to plan revisions is forthcoming. All lanes and adjacent streets are open to traffic with intermittent lane closures during a regular daytime hours. Cl) • 76t" Avenue South improvements: TV inspection of the new storm system is taking place this week. Landscape work is ; ongoing. 76t" Ave is now open to 2-way 0 traffic. Intermittent daytime closures will E continue. ° • Meet Me on Meeker (Russell - GRE) sidewalk improvements: forming, a reinforcing, and pouring of the sidewalk along the South edge of the ROW is ongoing. Concrete placement for the a sidewalk on the North side of Meeker St. is complete. Placement and grading crushed ) rock for new sidewalk is ongoing as L weather permits. Added storm piping on o the South side of the Russell/Meeker intersection took place on 2/8 & 2/9. Concrete Luminaire bases were poured on N Monday 2/8. :c • 2020 sanitary sewer CIPP Lining: night E time installations on East Valley Highway w (South of S 180th St) are ongoing followed °' by installations on S 192nd St between 80th Ave S and 84th Ave S beginning on c Wednesday night. The final installations are 2 scheduled to take place on Monday 2/15 on •2 42nd Ave in the daytime, and Tuesday 2/16 on EVH at night c Design: U • West Hill Reservoir: preconstruction conference held on 2/3/21 with notice to proceed (NTP) planned for end of Feb. Public outreach postcard ready to send (2 weeks prior) once NTP date finalized. • 212t" East Valley Highway to 72nd: plans completed and in review. Submitted funding package (including provisions) and Page 9 of 11 Packet Pg. 12 PS&E checklist to WSDOT for review. Met with communications group to refresh communication plan and prepare notification to businesses about upcoming project. Responding to WSDOT comments on division 1 specs. Meeting with WSDOT on 2/8. • 2021 contracted overlays: field measuring repair areas and curb ramps. 30% design distributed for review. Comments due back February 19t" • 2021 water main replacement(s): 60% plans and specifications distributed 1/29 with comments due Feb 12. Determination of concrete/asphalt on Titus to replace (currently 6" concrete and 2" asphalt) proposed in 60% design. Public outreach conducted with Gonnason Boats and Enterprise to brief them of project. Discussing including Veterans Drive 16" watermain in front of Alexan Gateway as part of this project. • King County Access to Transit (Design Only): design to be completed by June 2021. Some additional bus stop improvements requested by Metro. Survey completed, design in progress. Starting utility coordination. 30% plan review to be distributed at end of the month to include Metro. Environmental: • Staff will be working with GoldStreet to create education and outreach materials for our Fats Oils and Grease (FOG) Program, upcoming Source Control Inspection Program, and kids activities books on pollution prevention. • The Lake Fenwick hypolimnetic aerator improvement project is out to bid this week, with bids opening on February 23rd. This project will provide improvements in the water quality of the lake, which will better control algae blooms which impact people and animal health as well as the recreation on the lake. Transportation: • The public hearing for the comprehensive plan amendment to replace the transportation element with the new Transportation Master Plan (TMP) and include the TMP project list in the Capital Facilities plan was held at the Monday, 5.6 February 8t" Land Use and Planning Board meeting. The Land Use and Planning Board unanimously voted to recommend the changes be approved by the City Council. Streets: • Street maintenance crews will grind and repair sidewalks on SR 181 and 66t" Ave S, clean sidewalks on Central Ave S, sweep shoulders on 124t" Ave SE, 132nd Ave SE, SE 248t" St and SE 240t" St, core for engineering on Lake Fenwick Rd, shoulder repair at 25453 Lake Fenwick Rd, clean traffic islands on Kent Kangley and Lincoln a Ave, repair shoulder at 612 N Kennebeck co Ave and hot patch overlay at 304 Summit Ave N. — U • Signs and Markings crew will install bases ; and signs for the retro reflectivity program 0 on 140t" Ave SE, 148t" Ave SE and 152n1 E Way SE, install signs and bases on S 240tn St, 92nd Ave S, 124t" Ave SE, SE 196t" St and 134t" Ave SE and install bases on SE a 288t" PI and S 240t" St. Solid Waste crew is removing debris and illegal signs on 132nd Ave SE. a • Water Vegetation crews will be clearing debris at Armstrong Springs, KEHOC, Kent N Springs, Pump Station #5, Clark Springs L shoulders, 208t" well, Scenic Hill sites, East o Hill well and 212t" treatment plant. Street > Vegetation crews will perform excavation, soil replacement, planting and mulching on N the 6t" and Gowe planted beds, prune weed c and refurbish toe on 204t" traffic islands E and refurbish Kent Kangley traffic island. w The Sidearm crew will be mowing 94t" Ave S, 94t" PI S, SE 256t" St, 96t" Ave S, 93rd V Ave S and S 218t" St and large branch c removal on Kent Kangley and 116t" Ave SE. The Wetland Mitigation crew will be planting at the inspect Rock Creek restoration project, line trim Frager Rd and c planting and weed removal at Riverview. U The Wetland Maintenance crew will be repairing split rail fencing at Kingsley Glen on 1415t St SE, and Eagle Creek on 1361" Ave SE, Wildwood Ridge on 107t" Ave SE and split rail fencing repairs and opening view windows at Kentview on Veterans Dr. The Holding Pond crew will be removing trees from Begonia Place on 129t" Ave SE, Cedar Pointe on SE 253rd St, Mack Park on Page 10 of 11 Packet Pg. 13 5.B SE 264th St and 266th PI and 3rd Ave Holding Pond, remove brush over vaults and tree removal at Canary Hill on SE 256th St, remove trees and limb trees at Heather Glen on SE 253rd St. Water: • Staff filled and sampled our 125,000-gallon tank on the East Hill from our recoating project and will be placing it back in service once satisfactory test results are returned. This was a very successful project that will increase the life of the tank through a better coating system, added increased safety measures for staff when accessing the tank for maintenance and better protecting the drinking water inside with an upgraded roof vent. Staff are now working on the design for our next tank recoating and structural upgrade project at our 6 Million Gallon #1 tank on the East Hill. Water main cleaning and hydrant exercising will continue on the East Hill. Storm/Sewer: • Storm crews will be cleaning storm lines for 88th Ave S and 943 3rd Ave N, pothole for utilities on E Titus St, pothole and ditch maintenance at 516 Kenosia Ave S and 8011 S 222"d St, install reflectors at the 81St Ave pump station, check dams at 822 E Chicago, install asphalt berm at 26610 137th Ave SE, install tide flex check valves on S 2615t St, curb and gutter at 21303 116th St and cut root from storm line on 124th Ave SE. The crew will also be performing National Pollutant Discharge Elimination System (NPDES) assessing on Riverview Blvd and S 212th St and pumping on S 212th St and S 200th PI. • Sewer crews will perform Millcreek pump seal replacement, troubleshoot Foster Park generator fail and TV inspection on the existing sewer and storm 2021 overlays on 1001h Ave SE, SE 208th St, Jason Ave and James St. Fleet/Warehouse: • The Warehouse crew continues to maintain the shops yard keeping it clean and picked up and maintaining the wash rack, assisting with CDL training, issuing personal protection equipment (PPE's), issue hydrants and public notice boards to contractors, repairing small equipment as needed, receiving parts and inventory orders, inventory and manually open and close broken East Gate. • Fleet crews prepare for new hoist install, new vehicle set ups, scheduled and non- scheduled maintenance and City Space write ups. The Radio Shop is programing radios, data entry, prepping for Police radio change over, annual radio inspections and setting up new vehicles. Page 11 of 11 Packet Pg. 14 8.A.1 40 KEN WAS M IN G 7 0 N Date: Time: Place: I. February 2, 2021 5:00 p.m. THIS IS A REMOTE MEETING CALL TO ORDER Pending Approval City Council Workshop Workshop Regular Meeting Minutes February 2, 2021 Attendee Name Title Status Arrived Toni Troutner Council President Present Bill Boyce Councilmember Present Brenda Fincher Councilmember Present Satwinder Kaur Councilmember Present Marli Larimer Councilmember Present Zandria Michaud Councilmember Present Les Thomas Councilmember Present Dana Ralph Mayor Present II. PRESENTATIONS 1 Quarterly Sound Transit Update: Federal Way Link Extension Kelly Peterson 45 MIN. Link Light Rail Liaison, Kelly Peterson provided Council with an update on the Federal Way Link Extension project. He reviewed the extensive permitting packages that are required for the project and highlighted how far things have come and what permits will be issued soon. Peterson shared with Council the status of the Kent Des Moines Station Area as well as the Star Lake Station and provided a number of photos of the progress that has been made. He discussed the work that has taken place on both segments 1 and 2 and the portions of the project that will be underway this spring. Peterson discussed the artwork that has been installed at the Kent Des Moines Station site, including 58 murals. He also noted that there has been some vandalism that has occurred here and it is the duty of Sound Transit to maintain that artwork. He also shared a few artist concepts and renderings for the Kent Des Moines Station as well as some art glass renderings for the Star Lake Station. 2 Park Impact Fee Update Brian Levenhagen 45 MIN. Deputy Parks Director, Brian Levenhagen provided Council with an update on Park Impact Fees. Levenhagen reviewed the Park and Open Space Plan, how it aligns with the City's Comprehensive Plan and the following goals: Quality Public Spaces, Performance -based Approach, Transformation Through Reinvestment and Sustainable Funding. He discussed how a Park Impact Fee Packet Pg. 15 8.A.1 City Council Workshop Workshop Regular February 2, 2021 Meeting Kent, Washington Minutes ..............................................................................................................................................................................................................................................................................................._......................................................................................................................................................................................................... would help pay for new/expanded Parks and Recreation facilities needed to support growth in the City. Levenhagen discussed the Park Impact Fee Study and how it will be amended into the comprehensive plan with the Park Project List. He reviewed the Park Project List in more detail and discussed where the Park Impact Fee revenue would come in to play. He noted that the Park Project List and draft Park Impact Fee Study are being amended into the Comprehensive Plan which is scheduled to go to Committee of the Whole on February 23, 2021 and then on to Council on March 2, 2021. Please note that amending the Park Project List into the Comprehensive Plan does not actually create a Park Impact Fee for Kent, that will require a separate ordinance. Levenhagen reviewed the draft Park Impact Fee Code Proposal that is currently being reviewed by the Economic and Community Development Department and Legal. He indicated that additional Park Impact Fee language was taken from Tukwila and Auburn's Park Impact Fee code and much of the code language from all three sources is taken directly from RCW 82.02.060 - RCW 82.02.100. He reviewed some of the proposed changes as they affect single-family onsite recreation requirements and changes to fee - in -lieu. Levenhagen discussed proposed next steps and timeline for adoption. Meeting ended at 5:55 p.m. Ki, Ley A. Ko-vvwto- City Clerk Page 2 of 2 Packet Pg. 16 8.A.2 Date: Time: Place: 1. 2. 3. C� KENT WAS M IN G 7 0 N February 2, 2021 7:01 p.m. THIS IS A REMOTE MEETING CALL TO ORDER ROLL CALL Pending Approval Kent City Council City Council Regular Meeting Minutes February 2, 2021 Attendee Name Title Dana Ralph Mayor Status Arrived Present Toni Troutner Council President Present Bill Boyce Councilmember Present Brenda Fincher Councilmember Present Satwinder Kaur Councilmember Present Marli Larimer Councilmember Councilmember Present Present Les Thomas Zandria Michaud Councilmember Present AGENDA APPROVAL Chief Administrative Officer, Derek Matheson recommended Council add an item to the agenda 4.A.ii. a Proclamation for Black History Month. Council President Troutner moved to approved the agenda as amended, seconded by Councilmember Thomas. Motion passed 7-0. PUBLIC COMMUNICATIONS A. Public Recognition L Employee of the Month Mayor Ralph recognized the February employee of the month, Sergeant Joshua Bava. ii. Proclamation for Black History Month Mayor Ralph read the Proclamation for Black History Month and paid special recognition to Councilmembers Boyce and Fincher. B. Community Events Council President Troutner spoke about Kent 101 which begins Wednesday February 3, 2021 and will give an opportunity for 50 participants to learn more about how government is run here in Kent. Troutner also discussed AWC City Action Days which will be February 10-11 Packet Pg. 17 8.A.2 Kent City Council City Council Regular Meeting Minutes February 2, 2021 Kent, Washington and it is a virtual event for all Councilmembers to attend seminars and allow them an opportunity to speak with legislators. She noted that on February 12t" from 10 - noon there will be a drive-thru Valentine's event, referred to as the "Feel the Love" event at the Kent Senior Center for adults 50 and older - registration is required. Finally, she indicated that there will be a Valentine's Day mask give -a -way on February 14t" at accesso ShoWare Center from 10 - noon where they will be handing out "Don't Mess with Kent" masks. 5. REPORTS FROM COUNCIL AND STAFF A. Mayor Ralph's Report Mayor Ralph discussed the recent meeting she had with the Puget Sound Regional Council Executive Board in which they confirmed/passed recommendations for the Transportation Policy Board regarding funding for the West Seattle Bridge. Ralph spoke about the Meals -on -Wheels program with the Senior Center and Parks Department Employees and that it will continue through the pandemic. She noted that 1,200 meals were served to those in need last week. Mayor Ralph provided information on the grand opening of the accesso ShoWare mass vaccination site on Monday. This site will serve 500 people per day Monday through Saturday, by appointment only. They hope to increase the number of vaccinations to 1,500 per day. Currently the vaccinations are for those 75 and older and there is more information on the King County Public Health website. B. Chief Administrative Officer's Report Chief Administrative Officer, Derek Matheson spoke about the Council Retreat to be held on February 5t" from noon - 5 p.m. and noted that the agenda is available online. He also summarized the ways staff is currently advancing the Council's priorities from the 2021 - 2022 budget. Chief Rafael Padilla apologized to Council and Kent Community for misinformation that was provided during last week's Committee of the Whole meeting. He indicated that his statement about "if you can talk then you can breathe," was incorrect and outdated. He noted that although he misspoke, he assures Council and Community that the training being provided to police officers is correct. C. Councilmember's Reports Council President Troutner reviewed today's workshop presentations: Sound Transit update on the Federal Way Link Extension as well as an update on Page 2 of 5 Packet Pg. 18 8.A.2 Kent City Council City Council Regular Meeting February 2, 2021 Minutes Kent, Washington Park impact fees. Troutner sits on the Regional Transit Committee in which she was elected as Vice Chair. The committee recently approved the System Evaluation Report from Metro and reviewed the new dashboard with information regarding ridership. There is continued discussion on the work plan for 2021. Council President Troutner also sits on the Regional Law Safety and Justice Committee and during the recent meeting, they heard from multiple jurisdictions regarding the challenges they are facing due to COVID and how creative everyone is getting on communication and engagement. Councilmember Michaud sits on the Human Services Commission and last week they had three CDBG public hearings and they discussed evaluating grants. Councilmember Kaur sits on the Growth Management Planning Council where they recently had a work session to work on countywide planning policies. Councilmember Larimer sits on the King County Affordable Housing Committee where they also had a work session and focused on housekeeping, charter changes and position elections. They reviewed and edited the Affordable Housing Committee's portion of the countywide planning policy chapters and reviewed and approved the legislative agenda. Councilmember Boyce mentioned that he was recently appointed by Councilmember Dunn to serve on the Harborview Board of Trustees. Councilmember Thomas sits on the Puget Sound Regional Fire Authority and noted that the next meeting will be tomorrow night at 5:30 p.m. in Covington at Station 78. Councilmember Fincher serves on the Arts Commission and noted the judging panel selections for downtown rotating murals. Councilmember Fincher also serves on the Mental Illness and Drug Dependency Advisory Council and at the latest meeting they reviewed the budgets. She noted that the MIDD serves over 371,000 people without ever any increase in funding. 6. PUBLIC HEARING None. 7. PUBLIC COMMENT Mauricio Lopez, a resident of Kent, provided comments regarding his Page 3 of 5 Packet Pg. 19 8.A.2 Kent City Council City Council Regular Meeting Minutes February 2, 2021 Kent, Washington concerns about policing and black residents of the community. Shajaira Lopez, a resident of Kent, provided comments regarding Mayor Ralph's weekly update that was provided on January 29, 2021. 8. CONSENT CALENDAR Approve items A - G. RESULT: MOVER: SECONDER: AYES: APPROVED [UNANIMOUS] Toni Troutner, Council President Les Thomas, Councilmember Troutner, Boyce, Fincher, Kaur, Larimer, Thomas, Michaud A. Approval of Minutes 1. Council Workshop - Workshop Regular Meeting - Jan 19, 2021 5:00 PM 2. City Council Meeting - City Council Regular Meeting - Jan 19, 2021 7:00 PM 3. Committee of the Whole - Committee of the Whole - Regular Meeting - Jan 26, 2021 4:00 PM B. Payment of Bills - Authorize MOTION: Authorize the Payment of Bills received through 1/15/21 and paid on 1/15/21 and approve the checks issued for payroll 1/1/21-/15/21 and paid on 1/20/21, all audited by the Council during the 1/26/21 Committee of the Whole meeting. C. Ratify HP Laptop Purchase Utilizing CARES Act Funds - Authorize MOTION: Authorize the ratification of the purchase of 65 laptops, docking stations, and associated software and accessories utilizing CARES Act funding through a cooperative purchasing agreement administered by NASPO ValuePoint and entered into between Hewlett Packard Enterprise and the State of Minnesota as the Lead Agency; amend the budget as may be necessary to authorize that purchase using grant funds; and authorize future purchases of computer equipment and associated accessories and services through that same cooperative purchasing agreement if those purchases can be made within the City's established budgets and during the term of the master agreement, which is currently in effect through July 31, 2021. D. Ordinance Amending Chapter 9.02 "Criminal Code" of the Kent City Code - Adopt Page 4 of 5 Packet Pg. 20 8.A.2 Kent City Council City Council Regular Meeting Minutes February 2, 2021 Kent, Washington MOTION: Adopt Ordinance No. 4389, amending Chapter 9.02 of the Kent City Code to incorporate new crimes adopted by the state during the 2019 and 2020 legislative sessions. E. WSDOT Local Bridge Program Grant - Authorize MOTION: Authorize Public Works staff to seek Federal grant preservation funding through WSDOT's Local Bridge Program for the Meeker Street and South 212t" Street bridges crossing over the Green River. F. Ordinance Granting a Franchise to Soos Creek Water & Sewer District - Adopt MOTION: Adopt Ordinance No. 4388, granting a non-exclusive 10-year franchise to construct, maintain, operate, replace and repair a water and sewer system within public rights -of -way of the City of Kent. G. Accept the 2020 Paint Line Striping and Raised Pavement Markings Replacement Project as Complete - Authorize MOTION: Authorize the Mayor to accept Paint Line Striping and Raised Pavement Marking Replacement Project as complete and release retainage to Stripe Rite, Inc. upon receipt of standard releases from the State and the release of any liens. 9. OTHER BUSINESS None. 10. BIDS None. 11. EXECUTIVE SESSION AND ACTION AFTER EXECUTIVE SESSION None. 12. ADJOURNMENT Mayor Ralph adjourned the meeting. Meeting ended at 7:35 p.m. Kc ley A. KoTnoto- City Clerk Page 5 of 5 Packet Pg. 21 8.A.3 Date: Time: Place: 1. i1111111111111 3. G� KENT WAS M IN G 7 0 N February 9, 2021 4:04 p.m. THIS IS A REMOTE MEETING CALL TO ORDER Pending Approval Kent City Council - Committee of the Whole Committee of the Whole - Regular Meeting Minutes February 9, 2021 Council President Troutner called the meeting to order. ROLL CALL Attendee Name Toni Troutner Title Council President Status Arrived Present Bill Boyce Councilmember Present Brenda Fincher Councilmember Present Satwinder Kaur Councilmember Present Marli Larimer Councilmember Councilmember Present Present Zandria Michaud Les Thomas Dana Ralph Councilmember Present 5:30 PM Mayor Present AGENDA APPROVAL Chief Administrative Officer, Derek Matheson recommended adding item 5, an Executive Session to discuss the performance of a public employee and adjust Adjournment to be number 6 on the agenda. The Executive Session is expected to last 30 minutes, with no action following. DEPARTMENT PRESENTATIONS A. Memorandum of Understanding between the City of Kent and Avenue 55, LLC for the Naden Avenue Assemblage - Authorize Chief Economic Development Officer, Bill Ellis presented Council with information on the Naden Avenue Development Project, including Request for Qualifications process, objectives and Avenue 55's response. The Memorandum of Understanding ("MOU") with Avenue 55, LLC for the Naden Avenue Development Project was drafted as of January 15, 2021 and it will affirm the selection of Avenue 55, LLC by the Council President -appointed review panel for applications for Review of Qualifications for development of the Naden Avenue Assemblage. It gives Avenue 55, LLC the opportunity to market the property and will provide the City with knowledge regarding the highest and best use of the property, as well as site studies and entitlement work for 12 months from the effective date of the MOU. a Packet Pg. 22 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes Ellis reviewed the requirements and City objectives in developing the Naden site. Joe Blattner, the founder of Avenue 55 discussed the history of the company and highlighted some of their larger projects up and down the valley. Avenue 55 Senior Development Manager, Drew Zaborowski presented the vision for the Naden Ave site and reviewed some project examples that have a number of similarities to the Naden Ave site as well. Zaborowski reviewed the goals of Avenue 55 as well as next steps. MOTION: Authorize the Mayor to sign a Memorandum of Understanding with Avenue 55, LLC to provide a framework for — Avenue 55 and the City to solicit and review proposals for the development and disposition of the Naden Avenue Assemblage L or portions of it, subject to final terms and conditions a acceptable to the Economic and Community Development g Director and City Attorney. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM B. Medical, Dental, Vision, Life and Long-term Disability and Stop Loss Insurance Vendor Contracts - Authorize Human Resources Manager, Laura Horea presented Council with an overview of the agreements for medial administrative services with Premera and Kaiser Permanente, dental services with Delta Dental, Vision services through Vision Service Plan, life insurance and long-term disability benefits through Cigna and stop loss insurance with Lifewise. She requested Council approval to renew with these vendors based on the strength of their plans, overall costs, customer service, discounts, and overall administration and billing accuracy. Councilmember Fincher inquired about negotiating the contracts for longer than a year or two. Horea indicated many of the vendors did not offer a longer contract possibly due to COVID-19. Page 2 of 10 Packet Pg. 23 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes MOTION: Authorize the Mayor to enter into agreements for: • Medical administrative services with Premera for four years, and Kaiser Permanente for one year; • Dental administrative services with Delta Dental for one yea r; • Vision administrative services with Vision Service Plan, current contract extension for two additional years; • Life insurance and long-term disability benefits with Cigna for two years; and • Stop loss insurance with LifeWise for one year c 4- subject to final terms and conditions acceptable to the Human ° Resources Director and the City Attorney. o L Q RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 Q 7:00 PM C. Ratify HP Laptop Purchase Utilizing CARES Act Funds Technical Services Manager, James Endicott spoke briefly about the ratification to the HP laptop purchase utilizing CARES Act funds. He noted at the January 26, 2020, Committee of the Whole meeting, the proper contract with HP, Inc. was presented for discussion. However, a scrivener's error had identified the contracting entity as Hewlett Packard Enterprise, instead of the proper contracting entity -HP, Inc. He is again requesting Council ratify the agreement to expand the scope of authorization to include equipment purchased through HP, Inc. under the NASPO cooperative purchasing agreement. MOTION: Ratify the purchase of 65 laptops, docking stations, and associated software and accessories utilizing CARES Act funding through a cooperative purchasing agreement administered by NASPO ValuePoint and entered into between HP, Inc. and the State of Minnesota as the Lead Agency; amend the budget as may be necessary to authorize that purchase using grant funds; and authorize future purchases of computer equipment and associated accessories and services through that same cooperative purchasing agreement, if those purchases can be made within the City's established budgets and during the term of the master agreement, which is currently in effect through July 31, 2021. Page 3 of 10 Packet Pg. 24 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM D. Ordinance Approving the Change of Indirect Control of Astound Broadband, LLC - Adopt City Attorney, Christina Schuck presented an ordinance to Council that would approve the change of indirect control of Astound Broadband, LLC. On April 7, 2015 Astound Broadband, LLC entering into a franchise agreement with the City of Kent that authorizes the installation of fiber within the rights -of -way throughout the City. On December 7, 2020, Astound requested approval of an indirect change in control. Now, Stonepeak Infrastructure Partners plans to purchase 100% of the membership interests of the parent company. Astound will remain the franchisee and will be o operated under the direction of the existing management team and the same terms 0 and conditions of the original franchise agreement will remain in effect. > 0 L MOTION: Adopt Ordinance No. 4390, approving the change of a indirect control of Astound Broadband, LLC. -- RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM E. Ordinance Amending KCC 9.42 Related to Unlawful Race Attendance - Adopt Police Chief Rafael Padilla presented an ordinance that would amend Kent City Code 9.42.010 Related to Unlawful Race Attendance. Chief introduced Sergeant Josh Bava who leads the effort in the City regarding illegal street racing. Chief spoke about the increased violent crimes surrounding street racing and increased level of danger to all involved. Sergeant Bava briefed Council on the history of street racing and how it has grown and evolved over the years in the City of Kent. Chief Padilla spoke about the history of this ordinance an indicated that the purpose of this amendment is to include within the definition of "unlawful racing event" reckless vehicular activities other than traditional side -by -side racing. He noted that there are reckless vehicular activities that have been taking place such as "drifting" that pose a public health, safety and welfare risk. Councilmember Larimer inquired about how surrounding municipalities are responding to this issue as well. Sergeant Bava indicated Auburn, Federal Way, and Tukwila have similar ordinances in place. City Attorney, Pat Fitzpatrick noted that Kent has been a leader in this from day one, and naturally other municipalities have followed our lead. Page 4 of 10 Packet Pg. 25 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes MOTION: Adopt Ordinance No. 4391, relating to Chapter 9.42 of the Kent City Code, entitled 'Unlawful Race Attendance" to amend KCC 9.42.010 entitled ""unlawful race event" to include activities involving the reckless operation of vehicles other than traditional side -by -side racing. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM F. 2021 Community Development Block Grant Annual Action Plan - Approve Parks Planner, Dinah Wilson presented Council the 2021 Community Development Block Grant (CDBG) Annual Action Plan. She started by discussing the history and requirements of the CDBG with the U.S. Department of Housing and Urban Development. One of the requirements of the City is to inform HUD and the community of the specific actions that the City will execute to implement the objectives and strategies of the Consolidated Plan, which is outlined in the 2021 Action Plan. Wilson reviewed the citizen participation in the process in the form of public hearings to take in comments prior to the draft action plan being created, a public hearing requesting feedback on the draft plan as well as a public hearing to review the final plan being proposed. Following these public hearings, the Human Services Commission again reviewed the plan prior to it going to Council for approval. MOTION: Approve the proposed Community Development Block Grant 2021 Annual Action Plan, including funding allocations and contingency plans, and authorize the Mayor to execute the appropriate certifications and agreements subject to final terms and conditions acceptable to the Parks Director and City Attorney. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM G. Adjustment to the 2019 Community Development Block Grant Budget to Accept Third Round of CARES Act Coronavirus Funds (CDBG-CV) - Authorize Parks Planner, Dinah Wilson presented an adjustment to the 2019 Community Development Block Grant budget. This adjustment would be an acceptance of $859,720 in federal funds awarded to the City through the third round of CARES Act funds (CDBG-CV) for coronavirus relief. Funds will be allocated to non-profit organization (sub -recipients) to provide relief to Kent residents. Priority areas of funding include, but is not exclusive to: Rental/utility assistance Q Page 5 of 10 Packet Pg. 26 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes • Hotel/motel vouchers for those needing temporary shelter Food assistance Legal assistance for those facing evictions and/or for other legal needs Financial literacy and emergency assistance payments on behalf of unemployed and under -employed residents for food, childcare, healthcare, etc. Assistance for students who need tutors Digital literacy for under -served populations Micro -enterprise assistance Healthcare assistance (behavioral and for COVID-related services) Housing support, including furniture for tenants moving into and maintaining rental housing MOTION: Authorize the Mayor to adjust the 2019 CDBG budget, accept $859,720 in federal funds awarded to the City through the third round of CARES Act funds (CDBG-CV) for coronavirus relief and authorize the Mayor to execute the appropriate certifications and agreements, subject to final terms and conditions acceptable to the Parks Director and City Attorney. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM H. INFO ONLY: Request for Proposal for a Police Data Collection Consultant Police Chief, Rafael Padilla presented the Council with an update on the status of seeking proposals for a police data collection consultant. Chief indicated that the request for proposal is complete and he hopes to have it out for advertisement by February 15, with anticipated start time of March 1st. Chief provided an overview of the proposal and what the expectations are of the consultant. Councilmember Boyce requested that the net be cast wide for this request for proposal for the consultant. Councilmember Michaud inquired about the decision -making process following the receipt of proposals received. Chief Padilla indicated there will be a review process and he will ultimately be the one to choose the consultant with the support of Chief Administrative Officer, Derek Matheson and City Attorney, Pat Fitzpatrick. Councilmember Larimer noted that the quality of the candidate pool should outweigh expediency. Larimer would be in favor of extending the deadline to ensure we receive qualified candidates. c 4- 0 0 a a Q Page 6 of 10 Packet Pg. 27 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes Councilmember Thomas expressed concerns about the short timeline. Councilmember Fincher inquired again about the deliverables. I. King County Flood Control District Sub -Regional Opportunity Fund: Accept and Reallocate Funds for the Lake Fenwick Aerator Improvements - Authorize Public Works Environmental Specialist, Meara Heubach presented on the 2021 King County Flood Control District Sub -Regional Opportunity Funds. $312,367 to be allocated to the Lake Fenwick Aerator Improvements project and reallocate 2019 Sub -Regional Opportunity Funds, in the amount $197,147, from the Kent Airport Levee to the Lake Fenwick Aerator Improvements project. Funding from the Sub - Regional Opportunity Fund will be used to construct the aerator improvements, reduce the risk of future harmful algae blooms, remove the lake from Ecology's list of impaired water bodies, and improve the recreational experience at Lake Fenwick Park. Lake Fenwick is a valuable and important natural resource for Kent, and this critical project helps protect a key resource for the community. MOTION: Authorize the Mayor to accept 2021 King County Flood Control District Sub -Regional Opportunity Funds, in the amount of $312,367, for the Lake Fenwick Aerator Improvements project and reallocate 2019 Sub -Regional Opportunity Funds, in the amount $197,147, from the Kent Airport Levee to the Lake Fenwick Aerator Improvements project. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM J. INFO ONLY: Construction Standards Update Public Works Design Engineer, Susanne Smith provided Council with an update on the 2021 Kent Design and Construction Standards. Smith started by providing a brief history of the Design and Construction Standards for the City of Kent. She noted that the 2021 Kent Design and Construction Standards have been submitted for SEPA and to the Department of Commerce, the State Department of Health, the Master Builder Association, the Land Use and Planning Board and the King County Industrial Waste Program for review and comments. Currently, the Legal department is drafting a new ordinance which will repeal ordinance 3927 and amend Chapter 6.02 of the Kent City Code entitled "Required Public Improvements." These Standards include procedures for inspection, acceptance, warranty and variances, to establish uniform criteria to guide the City's own design, construction and improvement of City streets and utilities. K. INFO ONLY: Traffic Safety Update Interim Public Works Director, Chad Bieren provided Council with an update on measures taken to address traffic safety throughout the City. He Q Page 7 of 10 Packet Pg. 28 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes discussed the Transportation Master Plan and emphasized the major role it plays in addressing traffic safety. Safety was a top concern from residents and stakeholders in the City's outreach efforts. Bieren reviewed the Local Road Safety Plan, which is an engineering document that prioritizes an agency's roadways for traffic safety based on top crash types. This is an analysis of crash data, common risk factors, roadway networks then identifying countermeasures and developing a proposed project plan. Bieren reviewed ongoing safety efforts, grant opportunities and their participation in regular meetings with the Kent Police Department to discuss traffic safety. L. INFO ONLY: Transportation Impact Fees Senior Transportation Planner, April Delchamps and Kendra Breiland from Fehr and Peers presented Council with information about a proposed update to Transportation Impacts Fees (TIF) and its relation to the 2021 Transportation Master Plan. Delchamps discussed the current TIF program and proposed TIF assumptions and data sources. One of the first key updates to the program was to update trip rates and land uses from the 8th edition ITE to the 10th edition. Delchamps discussed further the changes to trip rates based on trip rate trends based on results of updated studies and are highly data driven. Breiland explained the methodology behind developing impact fee rates and how much a city can charge. She noted that the maximum rate does not dictate what the City must charge, but the upper limit for the rate. Cities may elect to establish a lower rate, as guided by financial realities for the community. Delchamps reviewed the TIF timeline and noted that the ordinance should be ready for adoption by Council on March 16th. M. Payment of Bills - Authorize MOTION: Authorize the payment of bills received through 1/31/21 and paid on 1/31/21 and authorize the checks issued for payroll 1/16/21-1/31/21 and paid on 2/5/21, all audited by the Committee of the Whole on 2/9/21. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM N. Investment Advisory Agreement with Public Financial Management, LLC - Authorize Q Page 8 of 10 Packet Pg. 29 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes Finance Director, Paula Painter provided Council with details on the investment advisory agreement with Public Financial Management, LLC. This agreement will allow Public Financial Management, LLC to serve as the investment advisor and manager of the City's long-term investments. Painter indicated that an increase in expenditures of approximately $42,000 annually which will be offset by additional investment income (revenue) and the amounts will vary based upon portfolio size. MOTION: Authorize the Mayor to sign a contract with Public Financial Asset Management, LLC to serve as the investment advisor and manager of the City's long-term investments, subject to final terms and conditions acceptable to the Finance Director and City Attorney. RESULT RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM O. Authorize the Use of accessoShoWare Center Operating Fund Balance to Purchase Scoreboard - Authorize Finance Director, Paula Painter discussed with Council the use of accesso ShoWare Center Operating Fund Balance to purchase a scoreboard. Painter reviewed the history of the original scoreboard that was purchased back in 2007 and indicated that now the manufacturer, Daktronics, no longer has replacement parts. The lifecycle for an item like this is typically 12-14 years. The cost of a new scoreboard will be around $800,000, and SMG has committed $500,000 to the Events Center to be used for the purchase. The remaining $300,000 will come from the accesso ShoWare Center Operating Fund Balance which has nearly a $3 million balance. accesso Showare Center General Manager, Tim Higgins indicated that the purchase of the equipment should be complete by May and the new scoreboard in place for the upcoming season. MOTION: Authorize the use of the accessoShoWare operating fund balance for the purchase of a scoreboard in the amount of $300,000. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM P. Ordinance Providing Business Licensing Exemption for Parks Performers - Adopt Finance Director, Paula Painter presented Council an ordinance that would provide business license exemptions for parks performers. Requiring a business license for these vendors significantly increases the City's program costs, as these costs would have to be added to each contract the City enters Q Page 9 of 10 Packet Pg. 30 8.A.3 Kent City Council - Committee of the Whole February 9, 2021 Committee of the Whole - Regular Meeting Kent, Washington Minutes into. Additionally, the business licensing process creates additional paperwork for the performers who tend to be unfamiliar with licensing requirements and many of whom would simply decline the work. Painter indicated this ordinance provides for an exemption from the business licensing requirements for vendors that are contracting with the City as part of an event or program facilitated by, or for a service provided to, the City's Recreation and Cultural Services Division. Parks Program Manager, Ronda Billerbeck provided some details regarding this revision and discussed some of the challenges her and her staff have faced in getting these vendors to obtain a business license. There is a desire to streamline this process and eliminate any speed bumps in contracting with some of the smaller vendors. MOTION: Adopt Ordinance No. 4392, amending Chapter 5.01 of the Kent City Code to provide a business licensing exemption for vendors whose sole business activity is accepting a contract with the City to perform or provide a service to the Recreation and Cultural Services Division of the Parks Department. RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM 5. EXECUTIVE SESSION A. To Review the Performance of a Public Employee, as per RCW 2.30.110(1)(g) Council went into executive session at 6:32 p.m. At 7:02 p.m. executive session was extended for 15 minutes. At 7:17 p.m. executive session was extended for 30 more minutes. At 7:47 p.m. executive session was extended for an additional 15 minutes 6. ADJOURNMENT At 8:02 p.m., council came out of executive session and Council President Troutner adjourned the meeting at 8:02 p.m. Meeting ended at 8:02 p.m. Ki ley A. K& o&o- City Clerk Q Page 10 of 10 Packet Pg. 31 8.B • KENT *A 3 M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: Payment of Bills - Authorize MOTION: Authorize the payment of bills received through 1/31/21 and paid on 1/31/21 and authorize the checks issued for payroll 1/16/21- 1/31/21 and paid on 2/5/21, all audited by the Committee of the Whole on 2/9/21. SUMMARY: Approval of payment of the bills received through----- 01/31/21 and paid 01/31/21 Approval of checks issued for Vouchers: Date Document Numbers Amount 01/31/21 Wire Transfers 8613 8626 $2,244,240.78 01/31/21 Regular Checks 750788 751108 $8,147,933.24 01/31/21 Payment Plus 102951 1029745 $55,477.71 Void Checks $0.00 01/31/21 Use Tax Payable $101.17 $10,447,752.90 Approval of checks issued for Payroll: 1/16/21-1/31/21 and paid 2/5/2021 Date Document Numbers Amount 2/5/2021 Checks Voids and Reissues 2/5/2021 Advices FR&P 463084 463093 $7,288.06 2/5/2021 $1,944,379.29 $1,951,667.35 BUDGET IMPACT: As described. SUPPORTS STRATEGIC PLAN GOAL: Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS Packet Pg. 32 8.B RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 33 8.0 KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Excused Absence for Councilmember Michaud - Approve MOTION: Approve an excused absence for Councilmember Michaud for the meeting of February 16, 2021. SUMMARY: Councilmember Michaud is unable to attend today's City Council meeting (February 16, 2021) and has requested an excused absence. BUDGET IMPACT: None. Packet Pg. 34 8.D KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Accept the 2020 Plastic Markings Project as Complete - Authorize MOTION: Authorize the Mayor to accept the 2020 Plastic Markings Project as complete and release retainage to Specialized Pavement Marking, Inc. upon receipt of standard releases from the State and the release of any liens. SUMMARY: This project included the installation of new plastic pavement markings including stop lines, crosswalks, traffic arrows, and traffic letters on various streets throughout the city. Related work included installation of a traffic separator curb with delineator posts on James Street near Woodford and State Avenues. The final contract total paid was $178,433.27, and the original contract amount of $150,630. BUDGET IMPACT: The project was paid for using Business and Occupation Funds. SUPPORTS STRATEGIC PLAN GOAL: Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Packet Pg. 35 8.E • KENT *A S M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: Accept the Historic Dvorak Barn Relocation as Complete - Authorize MOTION: Authorize the Mayor to accept the Historic Dvorak Barn Relocation Project as complete and release retainage to Nickel Bros. upon receipt of standard releases from the State and the release of any liens. SUMMARY: The Dvorak Barn, located near the Lower Russell Road levee, has been identified as having historical significance for Kent and the Green River Valley. As part of the levee reconstruction project, the City acquired the barn and associated property. After consultation with State and Federal agencies, the city agreed to relocate the barn and preserve it for future use. We intend to use it for agricultural purposes and as an accessory structure for our nursery activities. Pursuant to our agreement with the King County Flood District, the city relocated the Dvorak barn onto nearby property owned by the Drainage utility. The project can now be accepted as complete. The final contract total paid was $145,613.05 which is $13,881.45 under the original contract amount of $159,494.50. BUDGET IMPACT: Funds for the relocation project came from the Drainage Utility, which was included in the 2019 budget. SUPPORTS STRATEGIC PLAN GOAL: Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. Packet Pg. 36 8.F KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Memorandum of Understanding between the City of Kent and Avenue SS, LLC for the Naden Avenue Assemblage - Authorize MOTION: Authorize the Mayor to sign a Memorandum of Understanding with Avenue 55, LLC to provide a framework for Avenue 55 and the City to solicit and review proposals for the development and disposition of the Naden Avenue Assemblage or portions of it, subject to final terms and conditions acceptable to the Economic and Community Development Director and City Attorney. SUMMARY: This Memorandum of Understanding (MOU) affirms the selection of Avenue 55 by the Council President -appointed review panel for applications for Review of Qualifications for development of the Naden Avenue Assemblage. It's two -fold purpose is as follows: The MOU gives Avenue 55 the exclusive right to negotiate and finalize agreements with the City regarding the sale or long-term lease, construction, and development of the Naden Property or portions of it for the term of the MOU. The intent and purpose of this MOU is to clarify the expectations of the parties and to provide a framework for the solicitation and review of proposals for development of the Naden Property or portions of it. The parties will cooperate in an attempt, subject to City Council approval, to reach a mutually acceptable development proposal and development agreement that will help achieve the City's public objective of conditioning the disposition of the property on developing and constructing an urban manufacturing or flex tech campus and/or helping the City recruit a build -to - suit, owner -operator manufacturing/flex tech employer, or a workforce and/or business development facility (or a combination thereof) to bring more employment to the City's downtown. The anticipated result of site due diligence, feasibility, entitlements and marketing undertaken by Avenue 55 during the term of the MOU is a development proposal from Avenue 55 for Council consideration. Packet Pg. 37 8.F The proposal will include relevant details known at the time of submission for the future project including but not limited to design, prospective uses of the property, potential/initial tenants, etc. If City staff determines that a proposal fulfills the purpose of this MOU, City staff will recommend the proposal for consideration by the City Council. The City Council may, in its sole discretion, accept or reject any proposal. The Council's acceptance of a proposal will result in a good faith commitment to negotiate the terms of a development agreement. In the event the terms of a development agreement are mutually acceptable to staff and Avenue 55, the Council will then be asked to consider the development agreement and a public hearing before the Council will be held. In exchange for this MOU which provides Avenue 55 the opportunity to market the property, the City will receive the marketing services, knowledge regarding the highest and best use of the property, as well as site studies and entitlement work performed by Avenue 55. The MOU will be in effect for a period of 12 months after signature. BUDGET IMPACT: None; non -binding memorandum SUPPORTS STRATEGIC PLAN GOAL: Evolving Infrastructure - Connecting people and places through strategic investments in physical and technological infrastructure. Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. ATTACHMENTS: 1. Naden MOU (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 38 8.F.a MEMORANDUM OF UNDERSTANDING This Memorandum of Understanding ("MOU") is between the City of Kent, Washington, a municipal corporation, and Avenue 55, LLC, a limited liability corporation ("Avenue 55"). RECITALS A. The City owns certain real property located to the north of Willis Street, the south of West Meeker Street and to the east of State Route (SR) 167 and the west of the Interurban Trail within the City of Kent, King County, Washington, depicted and described in Exhibit A ("Naden Property"). The Naden Property is currently accessed through Naden Avenue South and an old access easement from West Meeker Street. B. The Naden Property is highly visible and located midway between the Ports of r Tacoma and Seattle and just a few miles east of SeaTac International Airport. o The Naden Property is also adjacent to the Interurban Trail, SR-167, and SR- U 516, and is within walking distance to the amenities and commuter rail of Kent � Station and Meeker Street —the historic Main Street of the City of Kent. Meeker LO Street is undergoing a transformation into a promenade, connecting the historic downtown to the Green River with more than 2,000 rental bedrooms Q currently being added. After decades of public -private partnership in r developments related to "play" (e.g., Kent Station) and "live" (e.g., Ethos), 3 the City now seeks to bring "work" to the Downtown Subarea Plan's vision of c a "live play work" commercial center. C. The City is authorized to dispose of real property pursuant to RCW 35A.11.010. L D. The City's Economic Development Plan, adopted in 2014, calls for "surplus city property be developed for housing & commercial" uses. Since 2014, the City has sold more than two dozen acres of surplus property for housing (excepting ° E 11,000 square feet of ground floor retail in two apartment buildings on the former Par 3 Riverbend Golf Course in the development now known as Ethos), L and comparatively little to none for commercial development. EE E. Strategic action 5.4.1 of the Economic Development Plan calls for the City to consider a dedicated master planning process for the Kent Industrial Valley (where the Naden Property lays within this real estate submarket) focusing on N opportunities for industrial campus development in order to remain a competitive economic place for advanced manufacturing. F. Strategic action 6.1.4 of the plan calls for the City to "develop a maker space" in the Kent Industrial Valley in support of workforce development collaboration. Z It is understood that the development of maker spaces often requires public - private partnerships. E r Q MOU - CITY OF KENT AND AVENUE 55 Page 1 1 Packet Pg. 39 8.F.a G. Pursuant to Resolution 1935, passed on October 14, 2016, the Naden Property is formally listed as surplus to the City's needs in accordance with the requirements of chapter 3.12 KCC. Section 2 of the resolution provides, "Public's Best Interest. It is in the public's best interest that this surplus property shall be marketed and sold in one or more sections for reinvestment a and redevelopment to enhance city revenue and stimulate economic development in the city's downtown core." E H. The City ran a competitive Request for Qualifications process, with published a advertisements and disclosures to local media, to select a developer to negotiate an option on the Naden Property with the City, subject to City Council approval, in order to partner with the City to realize a shared vision on the a site. W I. The City sought an experienced, proven, conceptually innovative and qualified o development team to partner with its Economic and Community Development department staff to: (1) help achieve the City's objective to sell or lease the L property on the condition the property be utilized as an urban manufacturing 0 or flex tech campus at this site; and/or (2) help the City recruit a build -to -suit, J owner -operator manufacturing employer (or a combination thereof) to bring Ui Ln more employment to Kent's historic downtown. J. The City Council President appointed a panel to select a development team for Council consideration. After the panel's review of four submissions and an Q interview with the panel's preferred development team on November 1, 2020, the panel chose Avenue 55. 3 K. Avenue 55 will work in partnership with the City's Economic and Community Development department staff. L. There is mutual understanding that the partnership with Avenue 55 will 0- include: joint marketing efforts for business recruitment including development of materials and media; basic conceptual site planning and SEPA 4- entitlement performed by Avenue 55 with input from City staff to assist in 0 providing confidence to potential end users of the Naden Property; cooperation to reach a mutually acceptable development proposal that achieves the public objective of this MOU. `0 M. The parties understand this partnership constitutes the parties' agreement to explore development options for the Naden Property. There is mutual understanding that the City will not offer capital to improve site development LO conditions, and that Avenue 55 is not committing to building within a specified N timeline. 0 N. In exchange for providing Avenue 55 with the exclusive right to negotiate and finalize an agreement regarding the sale or long-term lease of the Naden Property, Avenue 55 will, at its sole cost, market the property and engage with Z potential tenants on site and building designs that fulfill the purpose of this MOU. Additionally, Avenue 55 will provide preliminary design for build -out for E M U 0 a MOU - CITY OF KENT AND AVENUE 55 Page 1 2 Packet Pg. 40 8.F.a any proposal, as well as preliminary site studies and preliminary architectural and engineering design work. Therefore, the parties agree as follows: 1. Purpose. 1.1 This MOU gives Avenue 55 the exclusive right to negotiate and finalize agreements with the City regarding the sale or long-term lease, construction, and development of the Naden Property or portions of it for the term of the MOU. 1.2 The intent and purpose of this MOU is to clarify the expectations of the parties and to provide a framework for the solicitation and review of proposals for development of the Naden Property or portions of it. The parties will cooperate in an attempt, subject to City Council approval, to reach a mutually acceptable development proposal and development agreement that will help achieve the City's public objective of conditioning the disposition of the property on developing and constructing an urban manufacturing or flex tech campus and/or helping the City recruit a build -to -suit, owner -operator manufacturing/ flex tech employer, workforce and/or business development facilities (or a combination thereof) to bring more employment to the City's historic downtown. 2. Term of the MOU. 2.1. The term of the MOU is 12 months from the effective date, unless terminated or extended prior to that date. The effective date is the date the last party signs the MOU. 2.2. The MOU may be extended or terminated by mutual written agreement of the parties. 3. Property. o 2 The Naden Property consists of 23 tax parcels, for a total of approximately 7.8 acres, to the south of West Meeker Street, the north of Willis Street and to the east of SR 167 and the west of the Interurban Trail, depicted and described in Exhibit A. Z r_ aD E r Q MOU - CITY OF KENT AND AVENUE 55 Page 1 3 Packet Pg. 41 8.F.a 4. Marketing and Proposal Solicitation. 4.1. During the term of the MOU, Avenue 55 will market the Naden Property and engage with potential tenants regarding site and building designs that fulfill the purpose of this MOU. Avenue 55 will coordinate its marketing efforts with the City. Avenue 55 will solely be responsible for any costs associated with its marketing and solicitation. 4.2. The City may also solicit proposals and engage with potential tenants. The City will present any proposals or potential tenants to Avenue 55 for input; provided, the City shall have final authority to approve or disapprove any proposal. S. Proposal Review. Economic and Community Development department staff ("City staff") will first evaluate any development proposal submitted by Avenue 55. Such proposal shall include all relevant details known at the time of submission for the future project including but not limited to design, prospective uses of the property, potential/initial tenants, etc. If City staff determines that a proposal fulfills the purpose of this MOU, City staff will recommend the proposal for consideration by the City Council. The City Council may, in its sole discretion, reject any proposal. The City Council's acceptance of a proposal shall not constitute the agreement to transfer the Naden Property, nor shall such acceptance be interpreted in any manner to create liability on the part of either party in the event the transfer of property does not occur. Rather, such acceptance shall constitute a good faith commitment to negotiate the terms of a development agreement in accordance with Section 6 of this MOU. 6. Development and Disposition of the Naden Property. If the City Council accepts a proposal for development of the Naden Property or any portion of it in accordance with Section 5 of this MOU, the parties will make a good faith effort to negotiate a development agreement recorded against the property that N will be subject to City Council approval after a public hearing. Any transfer of any portion of the Naden property will be at a value agreed to by City Council. This MOU shall in no way bind the City Council to the terms of a development agreement or the transfer of any property. z c aD E r Q u�•lea.�r�-r•�r:�a►�ra►1•�_via►��»� Page 1 4 Packet Pg. 42 8.F.a 7. Access to Naden Property. During the term of this MOU, Avenue 55 and its designees will have the right to enter upon and perform inspections and tests of the Naden Property, as reasonably determined by Avenue 55 to be necessary, including performing environmental testing, land surveys, and geo-technical testing. Avenue 55's inspection and testing of the Naden Property shall be at its sole risk, and Avenue 55 indemnifies, defends and holds the City harmless from any and all claims, damages, liability, causes of action, judgments and expenses (including reasonable attorney's fees) arising out of Avenue 55's exercise of the rights granted in this Section 7. Any alteration of the Naden Property shall be preapproved by Economic and Community Development staff in writing. B. Process for Submitting and Considering Proposals. 8.1. General Expectations. When submitting proposals, Avenue 55 will provide City staff with preliminary site studies as well as preliminary architectural and engineering design work for build -out. 8.2. Pre -Application Conference Process. Avenue 55 will engage with City staff early and often through the City's pre -application conference process and other means to ensure a mutual understanding of the requirements and expectations regarding stormwater management, street construction and improvements, utility -related issues and improvements, the King County trail, off -site improvement requirements, and other development challenges, expectations, and requirements. 8.3. Phase I Environmental Site Assessment. Avenue 55 will complete a Phase I Environmental Site Assessment on the Naden Property. 8.4. SEPA. The parties acknowledge that it is in the best interest of the City and Avenue 55 to ensure that the SEPA process is broad in scope and conducted in such a manner as to allow for multiple development scenarios on the site. D O 8.5. Change to Process. The process outlined in Sections 8.1-8.4 shall serve as a guide and may be changed by mutual agreement of Avenue 55 and City staff. z a� E M U 2 a MOU - CITY OF KENT AND AVENUE 55 Page 1 5 Packet Pg. 43 8.F.a 8.6. Costs and Avenue 55 Solely Responsible. Avenue 55 will be responsible for the costs of preliminary site studies as well as preliminary architectural and engineering design work. It shall be Avenue 55's responsibility to fully understand the condition of the Naden Property, as well as the development conditions and expectations with regards to any development proposal, and nothing herein shall be interpreted to shift any responsibility to the City. 8.7. Information Sharing. Avenue 55 will provide copies to the City of all nonconfidential studies, test results, surveys, plans, designs, drafts, and all other documents or information pertaining to the condition or development of the Naden Property. 9. Miscellaneous. 9.1. This MOU is subject to the approval of the Kent City Council, and shall not be valid or enforceable until approved by the Kent City Council and signed by the City. 9.2. The City will not make any contributions to, nor incur any liabilities associated with the development of the Naden Property other than as outlined in this MOU. 9.3. Any portion of the Naden Property purchased or otherwise transferred pursuant to this MOU will be purchased or transferred in its then current condition and state of repair, "As Is." Avenue 55 will be required to satisfy itself prior to any closing for any portion of the Naden Property that the Naden Property is suitable for the intended development. 9.4. Contingent upon City of Kent's approval, which shall not unreasonably be withheld, Avenue 55's interest under this MOU may be assigned or otherwise transferred to an entity sharing common ownership with Avenue 55. 9.5. This MOU may be amended only by mutual written agreement of the o parties. No waiver, alteration, or modification of any of the provisions of this MOU shall be binding unless in writing and signed by a duly authorized representative of each party. z aD E r Q MOU - CITY OF KENT AND AVENUE 55 Page 1 6 Packet Pg. 44 8.F.a 9.6 The written provisions and terms of this MOU shall supersede all prior verbal statements of any officer or other representative of the parties, and such statements shall not be effective or be construed as entering into or forming a part of or altering in any manner this MOU. 9.7 The legal presumption that an ambiguous term of this MOU should be interpreted against the party who prepared the MOU shall not apply as this MOU was jointly prepared by the parties. 9.8 This MOU may be signed in any number of counterparts and electronically and be valid as if each authorized representative had signed the original document. AGREED AND ACCEPTED this CITY OF KENT: By: Print Name: Its DATE: (signature) (title) APPROVED AS TO FORM: Kent Law Department day of , 2021. AVENUE 55, LLC: By: Print Name: Its DATE: (signature) (title) MOU — CITY OF KENT AND AVENUE 55 Page 1 7 Packet Pg. 45 8.G • KENT *A S M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: Medical, Dental, Vision, Life and Long-term Disability and Stop Loss Insurance Vendor Contracts - Authorize MOTION: Authorize the Mayor to enter into agreements for: • Medical administrative services with Premera for four years, and Kaiser Permanente for one year; • Dental administrative services with Delta Dental for one year; • Vision administrative services with Vision Service Plan, current contract extension for two additional years; • Life insurance and long-term disability benefits with Cigna for two years; and • Stop loss insurance with LifeWise for one year subject to final terms and conditions acceptable to the Human Resources Director and the City Attorney. SUMMARY: The City of Kent contracts with Premera Blue Cross, Delta Dental of Washington and Vision Service Plan, to be third -party administrators to process medical, dental, and vision claims, and provide access to their networks of providers. The City is self -insured for these programs. The City also contracts with Kaiser Permanente for the City's fully insured health maintenance organization plan. The renewal for Premera's administrative services is 14% less than 2020. Kaiser offered a 4.97% increase in cost. Life and long-term disability insurance plans are offered through Cigna. The renewal is 12.11% less than in 2020. The City of Kent contracts with LifeWise for our individual and aggregate stop - loss insurance coverage. The best offer received for 2021 was from LifeWise with an 11.3% increase. Contracting with LifeWise provides us an additional discount from Premera on the stop -loss integration fee. This stop -loss policy provides added coverage to the City for individual medical claims exceeding $200,000 per employee or dependent for each calendar year. Medical costs Packet Pg. 46 8.G exceeding this amount are reimbursed to the City under this policy. We received $340,000 in stop -loss reimbursements in 2020. Our recommendation is to renew with these vendors based on the strength of their plans, overall costs, customer service, discounts, and overall administration and billing accuracy. BUDGET IMPACT: The cost for these contracts is budgeted in the Health and Wellness fund. Premera - $1,852,700 for a four-year contract Kaiser Permanente - $494,500 for a one-year contract Delta Dental - $59,640 for a one-year contract Vision Service Plan - $44,000 for a two-year contract extension Cigna - $473,000 for a two-year contract LifeWise - $1,082,000 for a one-year contract SUPPORTS STRATEGIC PLAN GOAL: Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. ATTACHMENTS: 1. Premera - ASC 2021_2025 (PDF) 2. Kaiser - Contract 2021 (PDF) 3. Delta Dental - ASC 2021 (PDF) 4. VSP - ASC Amendment 2021_2022 (PDF) 5. Cigna - Basic ADD Insurance Policy Amendment 2021_2022 (PDF) 6. Cigna - Basic Life Insurance Policy Amendment 2021_2022 (PDF) 7. Cigna (PDF) 8. Cigna - Vol Life Insurance Policy Amendment 2021_2022 (PDF) 9. LifeWise - Contract 2021 (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 47 8.G.a PREMEM AMENDMENT #1 TO ADMINISTRATIVE SERVICE CONTRACT BETWEEN PREMERA BLUE CROSS AND CITY OF KENT The Administrative Service Contract ("Contract") between the group named above (the "Plan Sponsor") and Premera Blue Cross (the "Claims Administrator") was issued January 1, 2020. This Amendment shall further revise and extend the Contract for the period from January 1, 2021 through December 31, 2021 (the "Contract Period"). The changes to the Contract for the new Contract Period shown below shall take effect on January 1, 2021. The changes are: Attachment D Fees Of The Claims Administrator* The Claims Administrator's fee for recovering payments through a class action suit on behalf of the Plan Sponsor has been changed to $50,000. The fee amount appears in Fee For Class Action Recoveries in the Attachment. The method of calculating the Plan Sponsor's portion of the fee has not changed, and the fee amount will continue to be deducted from the money paid to the Plan Sponsor. Each participating plan sponsor pays its part of the fee based on the proportion of the amount the Claims Administrator recovers for that plan sponsor compared to the Claims Administrator's total amount recovered for all its lines of business. Attachment F CareCompass360° • The Claims Administrator has ended its polypharmacy program. The Polypharmacy row in Appendix 1 of the CareCompass360° attachment is deleted. The Telehealth provision in Appendix 1 is revised to reflect the changes to the new Virtual Care benefit. It reads: The Claims Administrator has contracted with one or more vendors that use technology to provide Members easier and more convenient access to medical care. Providers covered under the Virtual Care benefit offer their services Virtual Care exclusively through secure chat, text, voice or audio messaging and video chat. The virtual care services do not include real-time visits via online and telephonic methods between Members and their doctors or other providers who also maintain a physical location. Attachment I Performance Guarantees The revised Attachment I attached to this Amendment is hereby made a part of the Contract. An Independent Licensee of the Blue Cross Blue Shield Association Packet Pg. 48 8.G.a All other provisions of the Contract remain unchanged. This amendment forms a part of your Contract. Please keep the amendment with your Contract. CITY OF KENT BY: Title ADDRESS: PREMERA BLUE CROSS DATE: D�n BY: DATE: January 1, 2021 Jeffrey Roe President and Chief Executive Officer P.O. Box 327 Seattle, WA 98111-0327 Packet Pg. 49 8.G.a ATTACHMENT B - CENSUS INFORMATION Administration Fees, effective January 1, 2021, are based on the following: Number of Active Members: Employee Dependents Medical/Rx 720 1,212 Other Carriers Offered: Kaiser Packet Pg. 50 8.G.a ATTACHMENT D - FEES OF THE CLAIMS ADMINISTRATOR c ti Lo N 4 Packet Pg. 51 8.G.a ATTACHMENT D to the Administrative Service Contract between PREMERA BLUE CROSS and City of Kent Group Number: 1018212 Effective: 1/1/2021 through 12/31/2021 Pursuant to the Administrative Service Contract, the Plan Sponsor shall pay the Claims Administrator the fees, as set forth below, for administrative services. Administration Fees: $53.62 per employee per month Administration Fee Breakdown: Administration Fee (Medical/Rx) $50.12 Administrative Fee (Dental) $0.00 Producer Fee 3.50 Total $53.62 Administration Fee Guarantee: The base administration fee, not including other charges such as producer fees, is guaranteed as shown below during the period from 1/1/2021 through 12/31/2024. This period shall be known as the "administration fee guarantee period." Year Amount Contract Period Begins Contract Period Ends Year 1 $50.00 1/1/2021 12/31/2021 Year $51.00 1/1/2022 12/31/2022 Year 3 $52.02 1/1/2023 12/31/2023 Year $53.06 1/1/2024 12/31/2024 Claims Runout Processing Fee: The charge for processing runout claims is an amount equal to the active administration fee at the time of termination, times the average number of subscribers for the 3-month period preceding the termination date, times two. BlueCard Fee Amount: BlueCard Fees are tracked and billed monthly in addition to claims expense. Packet Pg. 52 Value -Based Program Payments 8.G.a Provider groups enter into agreements with Premera or other Blue Cross and/or Blue Shield Licensees (Host Blues) for value -based programs. Such programs include the Blue Distinction Total Care program, Global Outcomes Contracts, accountable care organizations, patient -centered medical homes, shared savings arrangements, and global payment/total cost of care arrangements. Premera and the Host Blues may pay value - based program providers for meeting the programs' standards for treatment outcomes, cost, quality, and care coordination. The Plan Sponsor shall pay the Claims Administrator a per -member -per month (PMPM) amount established for each value -based program provider group. The PMPM amount will be multiplied by the number of the Plan Sponsor's Members that are attributed to each provider group. The PMPM amounts differ between the provider groups, and may change during the Contract Period. Fee For Class Action Recoveries The Plan Sponsor shall pay the Claims Administrator a fee for its work in pursuing class action recoveries on behalf of the Plan Sponsor as described in Subsection 3.5. The fee shall be a proportionate share of $50,000 based on the proportion of the amount recovered on behalf of the Plan Sponsor compared to the total amount recovered by the Claims Administrator for all lines of business. CareCompass3600 See Attachment F — CareCompass360° for an overview of services provided. Services are included in the Claims Administrator's Administration Fee except where stated below. Personal Health Support Not included in Administration Fee. $245 per actively (See Appendix 2) engaged Member per month of active engagement. BestBeginnings Maternity Engagement fee: $50 one-time fee per (See Appendix 3) Member when the Member registers for the program and downloads the mobile application High Risk Maternity Case $350 additional one-time Management fee for Members engaged in high -risk case management Neonatal Intensive Care Risk Assessment Fee waived & Case Management (See Appendix 4) Extended Post -Payment Recovery Services: Claims Administrator will perform the services listed below on a pay -for -performance, contingent fee ("Contingent Fee") basis, which shall be calculated as a percentage of the gross amount recovered with respect to any particular claim. See "Attachment G — Extended Post -Payment Recovery Services" for an overview of services provided. Post Payment Recovery Category Contingent Fee Coordination of Benefits 25 percent Subrogation 25 percent unless Claims Administrator, in its sole option or discretion, engages outside counsel, in which case the Contingent Fee amount shall be 35 percent, whether or not the case involves litigation or other dispute resolution process. 25 percent if, after Claims Administrator has worked a subrogation case, the Plan Sponsor takes over responsibility for the case and settles directly. Packet Pg. 53 8.G.a In all cases, Plan Sponsor is also responsible for payment of any court costs, such as filing fees, witness fees or court reporter fees. Provider Billing Errors 25 percent Credit Balance 25 percent Hospital Billing and Chart Review 35 percent M ti ti LA N N O N I r N O N U U) a L c� E L a c a� E ca Packet Pg. 54 a 8.G.a ATTACHMENT F — CARECOMPASS3600 Appendix 1 Care Facilitation Services Claims Administrator agrees to provide the following care facilitation services. Service Description Care Management Clinical review Prospective and retrospective review for medical necessity, appropriate application of benefits. Includes provision of evidence -based clinical practice and Quality Programs preventive care guidelines to Members and providers, chart tools, and quality of care program activities. NurseLine Round-the-clock access for Members to registered nurses to answer questions about their health care. Pharmacy Prescription drug formulary Development of formulary and access to providers and promotion Members on-line Physician -based pharmacy Physician education on cost-effective prescribing management Enhanced Controlled Substances Our standard program identifies and investigates Members Utilization Program (Opioid who show signs of drug misuse or addiction. When Management) warranted, these Members will only be able to get opioid Standard Option prescriptions from a particular pharmacy and may also be restricted to one prescriber. ePocrates Software to provide physicians with up-to-date drug and plan formulary information. Follow-up with Members and physicians to minimize Point -of -sale Pharmacy inappropriate or excessive drug therapies identified when drugs are dispensed. The Claims Administrator has contracted with one or more vendors that use technology to provide Members easier and more convenient access to medical care. Providers covered under the Virtual Care benefit offer their services Virtual Care exclusively through secure chat, text, voice or audio messaging and video chat. The virtual care services do not include real-time visits via online and telephonic methods between Members and their doctors or other providers who also maintain a physical location. Packet Pg. 55 8.G.a ATTACHMENT I - PERFORMANCE GUARANTEES c ti Lo N Packet Pg. 56 8.G.a ATTACHMENT PERFORMANCE GUARANTEE AGREEMENT BETWEEN Premera Blue Cross of Washington AND City of Kent EFFECTIVE 1/1/2021 THROUGH 12/31/2021 (The "Agreement Period") This Performance Guarantee Agreement is between Premera Blue Cross of Washington ("the Company"), and City of Kent ("the Group"). The Company will provide an acceptable level of service as described herein or will pay the penalties also described herein. SECTION 1. TERM The term of this Agreement shall only be the Agreement Period. Provided this Agreement is executed prior to or on the Effective Date, the Company's fulfillment of the performance guarantees set forth in this Agreement shall be measured from the Effective Date. In the event that this Agreement is not executed prior to or on the Effective Date, the Company's performance shall be measured in accordance with Section 3.C. The performance guarantees under this Agreement are contingent on the Company receiving timely payment of administrative fees or subscription charges, as applicable, from the Group. SECTION 2. PERFORMANCE GUARANTEES AND PENALTY AMOUNTS The Company guarantees its performance as stated below. The maximum amount of accumulated penalties > for the Agreement Period shall be $28,200.00 CU • o 1) Account Management: Quarterly Account Management Team Satisfaction Survey a� The Company will provide an online survey that measures the effectiveness of account management in providing superior service to the client. The Account Management Survey shall be distributed to appropriate ti members of the Group's benefits staff, and/or third party benefit consultants as selected by the Group, at the N end of each quarter. The Group and its selected associates shall complete the Online Account Management Survey within thirty (30) days of receipt. The failure of the group to respond to one of the quarterly surveys shall N nullify the Account Management Survey metric, and the Company will not pay the penalty. Ni Following the end of each quarter and receipt of the survey response(s) from the Group, the Company will r N calculate the Mean Score in each performance assessment category by using a mean score calculation. The U Account Management Commitment will be deemed as fulfilled if Question 8 "Overall Satisfaction with Account Q Management Team" is equal to or greater than 3 on a 5 point satisfaction scale. Surveys with no response will be removed from our scoring computation. Only completed survey's submitted within 30 days of distribution will be used to score Account Management performance. E L This metric is Corporate Standard and reporting will be Group Specific; Quarterly Survey; Annual Settlement The estimated penalty for this metric will be $4,300.00 a� �a a Packet Pg. 57 ATTACHMENT 8.G.a 2) Claims : Claims Accuracy - Dollars The Company guarantees that at least 99% of total benefit dollars payments shall be accurate (less than 1 % to be in error) in a contract year, when overpayments and underpayments are combined, not offset against one another. Calculated as Total Dollars Paid less Total Absolute Value of Dollar Errors, divided by Total Dollars Paid, based on annual randomly selected audit sample, not less than 99%. This metric is Corporate Standard and reporting will be Group Specific. Reported annually. The estimated penalty for this metric will be $4,300.00 3) Claims : Claims Accuracy - Frequency 95% of the Groups clean claims shall be paid without error (payment and procedural) in a contract year. Calculated as Total Claims With No Errors divided by Total Claims Paid, and based on annual randomly selected audit sample, not less than 95%. This metric is Corporate Standard and reporting will be Group Specific. Reported annually. The estimated penalty for this metric will be $4,300.00 4) Claims : Claims Clean Claims Turnaround Time within 30 Days Turnaround Time (TAT) is measured from the date a clean claim is received by the Company (either via paper o or electronic data interchanges) to the date it is processed for payment, denied, or pended for external information. A clean claim is defined as one that has been received by The Company with the relevant and correct information required to process the claim. This claim will have no defects or irregularities, includes any required substantiating documentation, and can be adjudicated without interruption. The calculation for the o Claim Turnaround Time percentage will be measured on the percentage of all Clean Claims processed within 30 Days of Receipt divided by Total Clean Claims Processed (*excluding Blue Card claims), not less than 97%. *Performance Standard will be tolled with respect to a claim during the period the claim is suspended for information outside The Company's claims processing system or scope of responsibility or control (i.e., review by other organizations not integrated into processing system). LO This metric is Corporate Standard and reporting will be Group Specific. Reported quarterly. The estimated penalty for this metric will be $4,300.00 Packet Pg. 58 8.G.a ATTACHMENT 5) Contract Services: Booklets Premera will guarantee booklet proofs within 45 business days of receipt of the group renewal confirmation. Additional drafts or final (electronic) booklets will be provided within 10 business days of producer/client edits to initial draft and repeat with each revision as necessary. Printing and mailing of booklets are not subject to performance guarantee. This metric is non-standard and reporting will be Group specific settled annually The estimated penalty for this metric will be $2,400.00 6) Customer Service: Customer Service - Abandonment Rate The Company guarantees that no more than 5 percent of incoming calls that are made to our toll -free customer service telephone line shall be dropped before speaking to a Customer Service Representative. Customer Service Abandonment Rate calculated as Total Abandoned Calls divided by Total Accepted Calls. This metric is Corporate Standard and reporting will be Combined score of all PG Groups in Customer Service Unit. Reported quarterly, settled using 12 mo avg. The estimated penalty for this metric will be $4,300.00 7) Customer Service: Customer Service - Service Level within 30 seconds The Company guarantees that 75% of all calls to their toll -free customer service telephone line will be answered in thirty seconds or less. Answered means the time from when the caller selects the option to speak with an agent until a Customer Service Representative answers the call. Results are calculated as Total Calls Answered Within 30 Seconds divided by Total Calls Received. This metric is Corporate Standard and reporting will be Combined score of all PG Groups in Customer Service Unit. Reported quarterly, settled using 12 mo avg The estimated penalty for this metric will be $4,300.00 SECTION 3. EVALUATION OF PERFORMANCE AND PAYMENT OF PENALTIES Packet Pg. 59 8.G.a ATTACHMENT A) At the end of the Agreement, the Company shall compile the necessary documentation and perform the necessary calculations to evaluate its fulfillment of each performance guarantee set forth in this Agreement and make this information available to the Group. B) If the Company fails to meet any of the performance guarantees set forth in Section 2, the Company shall pay to the Group the financial penalty based on the percentage set forth in Section 2. C) In the event that this Agreement is not executed by the Effective Date, the Company's performance shall be measured from the first day of the month following the month this Agreement is executed. In such event the applicable penalty amounts will be pro -rated for that portion of the year for which performance guarantee metrics are in force. D) Refer to Section 4 if the contract under which the Company provides insurance and/or administrative services to the Group is terminated prior to the end of the term of this Agreement. SECTION 4. TERMINATION OF AGREEMENT If this Agreement terminates prior to the last day of the Agreement Period the Group is not entitled to any penalties under Section 2 of this Agreement. This Agreement shall terminate upon the earliest of the following dates: A) the end of the Term of this Agreement; B) the effective date of any state's or other jurisdiction's action which prohibits activities of the parties under this Agreement; C) the date upon which the Group either fails to meet its obligation to sufficiently fund the bank account from which claims are paid (if applicable), or fails to make timely payments of either administrative fees or subscription charges anytime during the plan year; D) the date upon which the contract under which the Company provides services to the Group is terminated; E) any other date mutually agreeable to the Company and Group. Packet Pg. 60 8.G.b FU4 KAISER PERMANENTEe Kaiser Foundation Health Plan of Washington A nonprofit health maintenance organization Group Medical Coverage Agreement Kaiser Foundation Health Plan of Washington ("KFHPWA") is a nonprofit health maintenance organization, duly registered under the laws of the State of Washington, furnishing health care coverage on a prepayment basis. The Group identified below wishes to purchase such coverage. This Group Medical Coverage Agreement ("Group Agreement") sets forth the terms under which that coverage will be provided, including the rights and responsibilities of the contracting parties; requirements for enrollment and eligibility; and benefits to which those enrolled under this Group Agreement are entitled. The Group Medical Coverage Agreement between KFHPWA and the Group consists of the following: • Standard Provisions • Evidence of Coverage City of Kent, #0036900 This Group Agreement will continue in effect until terminated or renewed as herein provided for and is effective January 1, 2021. C472980036900 1 Packet Pg. 61 8.G.b Standard Provisions 1. KFHPWA agrees to provide benefits as set forth in the attached Evidence of Coverage (EOC) to enrollees of the Group. 2. Monthly Premium Payments. For the initial term of this Group Agreement, the Group shall submit to KFHPWA for each Member the monthly premiums set forth in the current Premium Schedule and a verification of enrollment. Payment must be received on or before the due date and is subject to a grace period of 10 days. Premiums are subject to change by KFHPWA upon 30 days written notice. Premium rates will be revised as a part of the annual renewal process. KFHPWA reserves the right to re -rate this benefit package if the demographic characteristics change by more than 15%. 3. Dissemination of Information. Unless the Group has accepted responsibility to do so, KFHPWA will disseminate information describing benefits set forth in the EOC attached to this Group Agreement. 4. Identification Cards. KFHPWA will furnish cards, for identification purposes only, to all Members enrolled under this Group Agreement. 5. Administration of Group Agreement. KFHPWA may adopt reasonable policies and procedures to help in the administration of this Group Agreement. This may include, but is not limited to, policies or procedures pertaining to benefit entitlement and coverage determinations. 6. Modification of Group Agreement. Except as required by federal and Washington State law, this Group Agreement may not be modified without agreement between both parties. No oral statement of any person shall modify or otherwise affect the benefits, limitations and exclusions of this Group Agreement, convey or void any coverage, increase or reduce any benefits under this Group Agreement or be used in the prosecution or defense of a claim under this Group Agreement. 7. Indemnification. KFHPWA agrees to indemnify and hold the Group harmless against all claims, damages, losses and expenses, including reasonable attorney's fees, arising out of KFHPWA's failure to perform, negligent performance or willful misconduct of its directors, officers, employees and agents of their express obligations under this Group Agreement. The Group agrees to indemnify and hold KFHPWA harmless against all claims, damages, losses and expenses, including reasonable attorney's fees, arising out of the Group's failure to perform, negligent performances or willful misconduct of its directors, officers, employees and agents of their express obligations under this Group Agreement. The indemnifying party shall give the other party prompt notice of any claim covered by this section and provide reasonable assistance (at its expense). The indemnifying party shall have the right and duty to assume the control of the defense thereof with counsel reasonably acceptable to the other party. Either party may take part in the defense at its own expense after the other party assumes the control thereof. 8. Compliance With Law. The Group and KFHPWA shall comply with all applicable state and federal laws and regulations in performance of this Group Agreement. 2 Packet Pg. 62 8.G.b This Group Agreement is entered into and governed by the laws of Washington State, except as otherwise pre- empted by ERISA and other federal laws. 9. Governmental Approval. If KFHPWA has not received any necessary government approval by the date when notice is required under this Group Agreement, KFHPWA will notify the Group of any changes once governmental approval has been received. KFHPWA may amend this Group Agreement by giving notice to the Group upon receipt of government approved rates, benefits, limitations, exclusions or other provisions, in which case such rates, benefits, limitations, exclusions or provisions will go into effect as required by the governmental agency. All amendments are deemed accepted by the Group unless the Group gives KFHPWA written notice of non- acceptance within 30 days after receipt of amendment, in which event this Group Agreement and all rights to services and other benefits terminate the first of the month following 30 days after receipt of non -acceptance. 10. Grandfathered Health Plan. For any coverage identified in an EOC as a "grandfathered health plan" under the Patient Protection and Affordable Care Act (a/k/a the ACA), Group must immediately inform KFHPWA if this coverage does not meet (or no longer meets) the requirements for grandfathered status including but not limited to any change in its contribution rate to the cost of any grandfathered health plan(s) during the plan year. Group represents that, for any coverage identified as a "grandfathered health plan" in the applicable EOC, Group has not decreased its contribution rate more than five percent (5%) for any rate tier for such grandfathered health plan when compared to the contribution rate in effect on March 23, 2010 for the same plan. Health Plan will rely on Group's representation in issuing and/or continuing any and all grandfathered health plan coverage 11. Confidentiality. Each party acknowledges that performance of its obligations under this Group Agreement may involve access to and disclosure of data, procedures, materials, lists, systems and information, including medical records, J employee benefits information, employee addresses, social security numbers, e-mail addresses, phone numbers and other confidential information regarding the Group's employees (collectively the "information"). The M information shall be kept strictly confidential and shall not be disclosed to any third party other than: (i) representatives of the receiving party (as permitted by applicable state and federal law) who have a need to know such information in order to perform the services required of such party pursuant to this Group Agreement, or for the proper management and administration of the receiving party, provided that such o A representatives are informed of the confidentiality provisions of this Group Agreement and agree to abide by > them, (ii) pursuant to court order or (iii) to a designated public official or agency pursuant to the requirements of - federal state or local law, statute rule or regulation. The disclosing party will provide the other artYwith c prompt notice of any request the disclosing party receives to disclose information pursuant to applicable legal requirements, so that the other party may object to the request and/or seek an appropriate protective order - against such request. Each party shall maintain the confidentiality of medical records and confidential patient and employee information as required by applicable law. 12. HIPAA. ti LO Definition of Terms. Terms used, but not otherwise defined, in this section shall have the same meaning as those terms have in the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). Transactions Accepted. KFHPWA will accept Standard Transactions, pursuant to HIPAA, if the Group elects to transmit such transactions. The Group shall ensure that all Standard Transactions transmitted to KFHPWA by the Group or the Group's business associates are in compliance with HIPAA standards for electronic transactions. The Group shall indemnify KFHPWA for any breach of this section by the Group. 13. Termination of Entire Group Agreement. This is a guaranteed renewable Group Agreement and cannot be terminated without the mutual approval of each of the parties, except in the circumstances set forth below. a. Nonpayment or Non -Acceptance of Premium. Failure to make any monthly premium payment or contribution in accordance with Subsection 2. above shall result in termination of this Group Agreement as Packet Pg. 63 8.G.b of the premium due date. The Group's failure to accept the revised premiums provided as part of the annual renewal process shall be considered nonpayment and result in non -renewal of this Group Agreement. The Group may terminate this Group Agreement upon 15 days written notice of premium increase, as set forth in Subsection 2. above. b. Misrepresentation. KFHPWA may rescind or terminate this Group Agreement upon written notice in the event that intentional misrepresentation, fraud or omission of information was used in order to obtain Group coverage. Either party may terminate this Group Agreement in the event of intentional misrepresentation, fraud or omission of information by the other party in performance of its responsibilities under this Group Agreement. c. Underwriting Guidelines. KFHPWA may terminate this Group Agreement in the event the Group no longer meets underwriting guidelines established by KFHPWA that were in effect at the time the Group was accepted. d. Federal or State Law. KFHPWA may terminate this Group Agreement in the event there is a change in federal or state law that no longer permits the continued offering of the coverage described in this Group Agreement. 14. Withdrawal or Cessation of Services. a. KFHPWA may determine to withdraw from a Service Area or from a segment of its Service Area after KFHPWA has demonstrated to the Washington State Office of the Insurance Commissioner that KFHPWA's clinical, financial or administrative capacity to service the covered Members would be exceeded. b. KFHPWA may determine to cease to offer the Group's current plan and replace the plan with another plan offered to all covered Members within that line of business that includes all of the health care services covered under the replaced plan and does not significantly limit access to the services covered under the replaced plan. KFHPWA may also allow unrestricted conversion to a fully comparable KFHPWA product. KFHPWA will provide written notice to each covered Member of the discontinuation or non -renewal of the plan at least 90 days prior to discontinuation. 15. Limitation on Enrollment. c The Group Agreement will be open for applications for enrollment as described in the group master application. Subject to prior approval by the Washington State Office of the Insurance Commissioner, KFHPWA may limit enrollment, establish quotas or set priorities for acceptance of new applications if it determines that KFHPWA's 2 capacity, in relation to its total enrollment, is not adequate to provide services to additional persons. d 16. Acceptance of Group Agreement The Group agrees as having accepted the terms and conditions of this Group Agreement and any amendments Ln issued during the term of this Group Agreement, upon receipt by KFHPWA of any amount of premium payment. 4 Packet Pg. 64 8.G.b Your Kaiser Foundation Health Plan of Washington Evidence of Coverage tAiU KAISER PERMAN ENTE® LO N Packet Pg. 65 8.G.b KAISER PERMAN ENTEG Kaiser Foundation Health Plan of Washington A nonprofit health maintenance organization 2021 Evidence of Coverage CA-1888a21 C47298-0036900 Packet Pg. 66 8.G.b Important Notice Under Federal Health Care Reform Kaiser Foundation Health Plan of Washington ("KFHPWA") recommends each Member choose a Network Personal Physician. This decision is important since the designated Network Personal Physician provides or arranges for most of the Member's health care. The Member has the right to designate any Network Personal Physician who participates in one of the KFHPWA networks and who is available to accept the Member or the Member's family members. For information on how to select a Network Personal Physician, and for a list of the participating Network Personal Physicians, please call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll -free in Washington, 1-888-901-4636. For children, the Member may designate a pediatrician as the primary care provider. The Member does not need Preauthorization from KFHPWA or from any other person (including a Network Personal Physician) to access obstetrical or gynecological care from a health care professional in the KFHPWA network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining Preauthorization for certain services, following a pre -approved treatment plan, or procedures for obtaining Preauthorization. For a list of participating health care professionals who specialize in obstetrics or gynecology, please call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll -free in Washington, 1-888-901-4636. Women's health and cancer rights If the Member is receiving benefits for a covered mastectomy and elects breast reconstruction in connection with the mastectomy, the Member will also receive coverage for: • All stages of reconstruction of the breast on which the mastectomy has been performed. • Surgery and reconstruction of the other breast to produce a symmetrical appearance. • Prostheses. • Treatment of physical complications of all stages of mastectomy, including lymphedemas. These services will be provided in consultation with the Member and the attending physician and will be subject to the same Cost Shares otherwise applicable under the Evidence of Coverage (EOC). Statement of Rights Under the Newborns' and Mothers' Health Protection Act N Carriers offering group health coverage generally may not, under federal law, restrict benefits for any hospital length > of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal @ delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or newborn earlier than 48 hours (or 96 hours as applicable). In any case, carriers may not, under federal law, require that a M provider obtain authorization from the carrier for prescribing a length of stay not in excess of 48 hours (or 96 hours). 0 Also, under federal law, a carrier may not set the level of benefits or out-of-pocket costs so that any later portion of the 48-hour (or 96-hour) stay is treated in a manner less favorable to the mother or newborn than any earlier portion of the stay. For More Information LO N KFHPWA will provide the information regarding the types of plans offered by KFHPWA to Members on request. Please call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll -free in Washington, 1- 888-901-4636. 2 C47298-0036900 Packet Pg. 67 8.G.b Table of Contents I. Introduction...................................................................................................................................................6 II. How Covered Services Work........................................................................................................................6 A. Accessing Care.........................................................................................................................................6 B. Administration of the EOC......................................................................................................................8 C. Confidentiality..........................................................................................................................................8 D. Modification of the EOC..........................................................................................................................8 E. Nondiscrimination....................................................................................................................................8 F. Preauthorization.......................................................................................................................................9 G. Recommended Treatment........................................................................................................................9 H. Second Opinions......................................................................................................................................9 I. Unusual Circumstances............................................................................................................................9 J. Utilization Management...........................................................................................................................9 III. Financial Responsibilities...........................................................................................................................10 A. Premium.................................................................................................................................................10 B. Financial Responsibilities for Covered Services....................................................................................10 C. Financial Responsibilities for Non -Covered Services............................................................................10 IV. Benefits Details............................................................................................................................................11 AnnualDeductible.........................................................................................................................................11 Coinsurance...................................................................................................................................................11 LifetimeMaximum.......................................................................................................................................11 Out-of-pocket Limit......................................................................................................................................11 Pre-existing Condition Waiting Period.........................................................................................................11 Acupuncture..................................................................................................................................................12 AllergyServices............................................................................................................................................12 Ambulance....................................................................................................................................................12 CardiacRehabilitation...................................................................................................................................12 Cancer Screening and Diagnostic Services...................................................................................................12 Circumcision.................................................................................................................................................13 ClinicalTrials................................................................................................................................................13 Dental Services and Dental Anesthesia.........................................................................................................13 Devices, Equipment and Supplies (for home use).........................................................................................14 Diabetic Education, Equipment and Pharmacy Supplies..............................................................................15 Dialysis (Home and Outpatient)....................................................................................................................15 Drugs - Outpatient Prescription.....................................................................................................................16 EmergencyServices......................................................................................................................................18 Hearing Examinations and Hearing Aids......................................................................................................19 HomeHealth Care.........................................................................................................................................19 Hospice..........................................................................................................................................................20 Hospital - Inpatient and Outpatient...............................................................................................................21 Infertility (including sterility)........................................................................................................................22 InfusionTherapy...........................................................................................................................................22 Laboratoryand Radiology.............................................................................................................................22 ManipulativeTherapy...................................................................................................................................23 Maternityand Pregnancy...............................................................................................................................23 3 C47298-0036900 Packet Pg. 68 8.G.b MentalHealth and Wellness..........................................................................................................................23 Naturopathy................................................................................................................................................... 25 NewbornServices.........................................................................................................................................25 NutritionalCounseling..................................................................................................................................25 NutritionalTherapy.......................................................................................................................................26 ObesityRelated Services...............................................................................................................................26 On the Job Injuries or Illnesses.....................................................................................................................26 Oncology.......................................................................................................................................................27 Optical(vision)..............................................................................................................................................27 OralSurgery ..................................................................................................................................................28 OutpatientServices.......................................................................................................................................28 Plastic and Reconstructive Surgery ...............................................................................................................28 Podiatry.........................................................................................................................................................29 PreventiveServices.......................................................................................................................................29 Rehabilitation and Habilitative Care (massage, occupational, physical and speech therapy) and Neurodevelopmental Therapy................................................................................................................30 ReproductiveHealth......................................................................................................................................31 SexualDysfunction.......................................................................................................................................31 SkilledNursing Facility .................................................................................................................................31 Sterilization...................................................................................................................................................32 SubstanceUse Disorder.................................................................................................................................32 TelehealthServices.......................................................................................................................................33 Temporomandibular Joint (TMJ)..................................................................................................................34 TobaccoCessation.........................................................................................................................................34 TransgenderServices....................................................................................................................................35 Transplants....................................................................................................................................................35 UrgentCare...................................................................................................................................................36 V. General Exclusions......................................................................................................................................36 VI. Eligibility, Enrollment and Termination...................................................................................................38 A. Eligibility ...............................................................................................................................................38 B. Application for Enrollment....................................................................................................................38 C. When Coverage Begins..........................................................................................................................40 D. Eligibility for Medicare..........................................................................................................................40 E. Termination of Coverage.......................................................................................................................40 F. Continuation of Inpatient Services.........................................................................................................41 G. Continuation of Coverage Options.........................................................................................................41 VII. Grievances....................................................................................................................................................42 VIII. Appeals.........................................................................................................................................................43 IX. Claims...........................................................................................................................................................44 X. Coordination of Benefits.............................................................................................................................45 Definitions.....................................................................................................................................................45 Order of Benefit Determination Rules...........................................................................................................47 Effect on the Benefits of this Plan.................................................................................................................48 Right to Receive and Release Needed Information.......................................................................................48 Facilityof Payment.......................................................................................................................................49 Rightof Recovery .........................................................................................................................................49 4 C47298-0036900 Packet Pg. 69 8.G.b Effectof Medicare.........................................................................................................................................49 XI. Subrogation and Reimbursement Rights..................................................................................................49 XII. Definitions....................................................................................................................................................51 C47298-0036900 Packet Pg. 70 8.G.b KFHPWA believes this plan is a "grandfathered health plan" under the Patient Protection and Affordable Care Act of 2010. Questions regarding this status may be directed to Kaiser Permanente Member Services at toll -free 1-888- 901-4636. Members may also contact the Employee Benefits Security Administration, U.S. Department of Labor at toll -free 1-866-444-3272 or www.dol.,gov/ebsa/healthreform. I. Introduction This EOC is a statement of benefits, exclusions and other provisions as set forth in the Group Medical Coverage Agreement between Kaiser Foundation Health Plan of Washington ("KFHPWA") and the Group. The benefits were approved by the Group who contracts with KFHPWA for health care coverage. This EOC is not the Group medical coverage agreement itself. In the event of a conflict between the Group Medical Coverage Agreement and the EOC, the EOC language will govern. The provisions of the EOC must be considered together to fully understand the benefits available under the EOC. Words with special meaning are capitalized and are defined in Section XII. Contact Kaiser Permanente Member Services at 206-630-4636 or toll -free 1-888-901-4636 for benefits questions. II. How Covered Services Work A. Accessing Care. 1. Members are entitled to Covered Services from the following: Your Provider Network is KFHPWA's Core Network (Network). Members are entitled to Covered Services only at Network Facilities and Network Providers, except for Emergency services and care pursuant to a Preauthorization. Benefits under this EOC will not be denied for any health care service performed by a registered nurse licensed to practice under chapter 18.88 RCW, if first, the service performed was within the lawful scope of such nurse's license, and second, this EOC would have provided benefit if such service had been performed by a doctor of medicine licensed to practice under chapter 18.71 RCW. A listing of Core Network Personal Physicians, specialists, women's health care providers and KFHPWA- designated Specialists is available by contacting Member Services or accessing the KFHPWA website at cc www.kp.org/wa. c m Receiving Care in another Kaiser Foundation Health Plan Service Area If you are visiting in the service area of another Kaiser Permanente region, visiting member services may 0 be available from designated providers in that region if the services would have been covered under this 3 EOC. Visiting member services are subject to the provisions set forth in this EOC including, but not limited 2 to, Preauthorization and cost sharing. For more information about receiving visiting member services in other Kaiser Permanente regional health plan service areas, including provider and facility locations, please Ln call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll -free in Washington, 1-888-901-4636. Information is also available online at www.wa.kaiserpermanente.org/html/public/services/traveling_ o KFHPWA will not directly or indirectly prohibit Members from freely contracting at any time to obtain health care services from Non -Network Providers and Non -Network Facilities outside the Plan. However, if you choose to receive services from Non -Network Providers and Non -Network Facilities except as otherwise specifically provided in this EOC, those services will not be covered under this EOC and you will be responsible for the full price of the services. Any amounts you pay for non -covered services will not count toward your Out -of -Pocket Limit. 2. Primary Care Provider Services. KFHPWA recommends that Members select a Network Personal Physician when enrolling. One personal physician may be selected for an entire family, or a different personal physician may be selected for each C47298-0036900 Packet Pg. 71 8.G.b family member. For information on how to select or change Network Personal Physicians, and for a list of participating personal physicians, call Kaiser Permanente Member Services at (206) 630-4636 in the Seattle area, or toll -free in Washington at 1-888-901-4636 or by accessing the KFHPWA website at www.kp.org/wa. The change will be made within 24 hours of the receipt of the request if the selected physician's caseload permits. If a personal physician accepting new Members is not available in your area, contact Kaiser Permanente Member Services, who will ensure you have access to a personal physician by contacting a physician's office to request they accept new Members. In the case that the Member's personal physician no longer participates in KFHPWA's network, the Member will be provided access to the personal physician for up to 60 days following a written notice offering the Member a selection of new personal physicians from which to choose. 3. Specialty Care Provider Services. Unless otherwise indicated in Section II. or Section IV., Preauthorization is required for specialty care and specialists that are not KFHPWA-designated Specialists and are not providing care at facilities owned and operated by Kaiser Permanente. KFHPWA-designated Specialist. Preauthorization is not required for services with KFHPWA-designated Specialists at facilities owned and operated by Kaiser Permanente. To access a KFHPWA-designated Specialist, consult your KFHPWA personal physician. For a list of KFHPWA-designated Specialists, contact Member Services or view the Provider Directory located at www.kp.org/wa. The following specialty care areas are available from KFHPWA-designated Specialists: allergy, audiology, cardiology, chiropractic/manipulative therapy, dermatology, gastroenterology, general surgery, hospice, mental health and wellness, nephrology, neurology, obstetrics and gynecology, occupational medicine, oncology/hematology, ophthalmology, optometry, orthopedics, otolaryngology (ear, nose and throat), physical therapy, smoking cessation, speech/language and learning services, substance use disorder and urology. 4. Hospital Services. Non -Emergency inpatient hospital services require Preauthorization. Refer to Section IV. for more information about hospital services. 5. Emergency Services. Emergency services at a Network Facility or non -Network Facility are covered. Members must notify KFHPWA by way of the Hospital notification line (1-888-457-9516 as noted on your Member identification card) within 24 hours of any admission, or as soon thereafter as medically possible. Coverage - for Emergency services at a non -Network Facility is limited to the Allowed Amount. Refer to Section IV. for more information about Emergency services. 6. Urgent Care. Inside the KFHPWA Service Area, urgent care is covered at a Kaiser Permanente medical center, Kaiser Ln Permanente urgent care center or Network Provider's office. Outside the KFHPWA Service Area, urgent N care is covered at any medical facility. Refer to Section IV. for more information about urgent care. 7. Women's Health Care Direct Access Providers. Female Members may see a general and family practitioner, physician's assistant, gynecologist, certified nurse midwife, licensed midwife, doctor of osteopathy, pediatrician, obstetrician or advance registered nurse practitioner who is unrestricted in your KFHPWA Network to provide women's health care services directly, without Preauthorization, for Medically Necessary maternity care, covered reproductive health services, preventive services (well care) and general examinations, gynecological care and follow-up visits for the above services. Women's health care services are covered as if the Member's Network Personal Physician had been consulted, subject to any applicable Cost Shares. If the Member's women's health care provider diagnoses a condition that requires other specialists or hospitalization, the Member or the chosen provider must obtain Preauthorization in accordance with applicable KFHPWA requirements. For a list of KFHPWA providers, contact Member Services or view the Provider Directory located at www.kp.org/wa. C47298-0036900 Packet Pg. 72 8.G.b 8. Process for Medical Necessity Determination. Pre -service, concurrent or post -service reviews may be conducted. Once a service has been reviewed, additional reviews may be conducted. Members will be notified in writing when a determination has been made. First Level Review: First level reviews are performed or overseen by appropriate clinical staff using KFHPWA approved clinical review criteria. Data sources for the review include, but are not limited to, referral forms, admission request forms, the Member's medical record, and consultation with the attending/referring physician and multidisciplinary health care team. The clinical information used in the review may include treatment summaries, problem lists, specialty evaluations, laboratory and x-ray results, and rehabilitation service documentation. The Member or legal surrogate may be contacted for information. Coordination of care interventions are initiated as they are identified. The reviewer consults with the requesting physician when more clarity is needed to make an informed medical necessity decision. The reviewer may consult with a board -certified consultative specialist and such consultations will be documented in the review text. If the requested service appears to be inappropriate based on application of the review criteria, the first level reviewer requests second level review by a physician or designated health care professional. Second Level (Practitioner) Review: The practitioner reviews the treatment plan and discusses, when appropriate, case circumstances and management options with the attending (or referring) physician. The reviewer consults with the requesting physician when more clarity is needed to make an informed coverage decision. The reviewer may consult with board certified physicians from appropriate specialty areas to assist in making determinations of coverage and/or appropriateness. All such consultations will be documented in the review text. If the reviewer determines that the admission, continued stay or service requested is not a covered service, a notice of non -coverage is issued. Only a physician, behavioral health practitioner (such as a psychiatrist, doctoral -level clinical psychologist, certified addiction medicine specialist), dentist or pharmacist who has the clinical expertise appropriate to the request under review with an unrestricted license may deny coverage based on Medical Necessity. B. Administration of the EOC. KFHPWA may adopt reasonable policies and procedures to administer the EOC. This may include, but is not limited to, policies or procedures pertaining to benefit entitlement and coverage determinations. C. Confidentiality. KFHPWA is required by federal and state law to maintain the privacy of Member personal and health information. KFHPWA is required to provide notice of how KFHPWA may use and disclose personal and health information held by KFHPWA. The Notice of Privacy Practices is distributed to Members and is available in Kaiser Permanente medical centers, at www.kp.org/wa, or upon request from Member Services. Ln D. Modification of the EOC. V_ No oral statement of any person shall modify or otherwise affect the benefits, limitations and exclusions of the N EOC, convey or void any coverage, increase or reduce any benefits under the EOC or be used in the prosecution or defense of a claim under the EOC. ca E. Nondiscrimination. KFHPWA does not discriminate on the basis of physical or mental disabilities in its employment practices and services. KFHPWA will not refuse to enroll or terminate a Member's coverage on the basis of age, sex, sexual orientation, gender identity, race, color, religion, national origin, citizenship or immigration status, veteran or military status, occupation or health status. C47298-0036900 Packet Pg. 73 8.G.b F. Preauthorization. Refer to Section IV. for information regarding which services KFHPWA requires Preauthorization. Failure to obtain Preauthorization when required may result in denial of coverage for those services; and the member may be responsible for the cost of these non -Covered services. Members may contact Member Services to request Preauthorization. Preauthorization requests are reviewed and approved based on Medical Necessity, eligibility and benefits. KFHPWA will generally process Preauthorization requests and provide notification for benefits within the following timeframes: • Standard requests — within 5 calendar days o If insufficient information has been provided a request for additional information will be made within 5 calendar days. The provider or facility has 5 calendar days to provide the necessary information. A decision will be made within 4 calendar days of receipt of the information or the deadline for receipt of the requested information. • Expedited requests — within 2 calendar days o If insufficient information has been provided a request for additional information will be made within 1 calendar day. The provider or facility has 2 calendar days to provide the necessary information. A decision will be made within 2 calendar days of receipt of the information or the deadline for receipt of the requested information. G. Recommended Treatment. KFHPWA's medical director will determine the necessity, nature and extent of treatment to be covered in each individual case and the judgment will be made in good faith. Members have the right to appeal coverage decisions (see Section VIII.). Members have the right to participate in decisions regarding their health care. A Member may refuse any recommended services to the extent permitted by law. Members who obtain care not recommended by KFHPWA's medical director do so with the full understanding that KFHPWA has no obligation for the cost, or liability for the outcome, of such care. H. Second Opinions. ,2 The Member may access a second opinion from a Network Provider regarding a medical diagnosis or treatment plan. The Member may request Preauthorization or may visit a KFHPWA-designated Specialist for a second opinion. When requested or indicated, second opinions are provided by Network Providers and are covered with o •N Preauthorization, or when obtained from a KFHPWA-designated Specialist. Coverage is determined by the > Member's EOC; therefore, coverage for the second opinion does not imply that the services or treatments cc recommended will be covered. Preauthorization for a second opinion does not imply that KFHPWA will authorize the Member to return to the physician providing the second opinion for any additional treatment. p Services, drugs and devices prescribed or recommended as a result of the consultation are not covered unless included as covered under the EOC. �a d I. Unusual Circumstances. 2 In the event of unusual circumstances such as a major disaster, epidemic, military action, civil disorder, labor disputes or similar causes, KFHPWA will not be liable for administering coverage beyond the limitations of , n available personnel and facilities. In the event of unusual circumstances such as those described above, KFHPWA will make a good faith effort to arrange for Covered Services through available Network Facilities and personnel. KFHPWA shall have no other liability or obligation if Covered Services are delayed or unavailable due to unusual circumstances. J. Utilization Management. Case management means a care management plan developed for a Member whose diagnosis requires timely coordination. All benefits, including travel and lodging, are limited to Covered Services that are Medically Necessary and set forth in the EOC. KFHPWA may review a Member's medical records for the purpose of verifying delivery and coverage of services and items. Based on a prospective, concurrent or retrospective review, KFHPWA may deny coverage if, in its determination, such services are not Medically Necessary. Such determination shall be based on established clinical criteria and may require Preauthorization. C47298-0036900 Packet Pg. 74 8.G.b KFHPWA will not deny coverage retroactively for services with Preauthorization and which have already been provided to the Member except in the case of an intentional misrepresentation of a material fact by the patient, Member, or provider of services, or if coverage was obtained based on inaccurate, false, or misleading information provided on the enrollment application, or for nonpayment of premiums. III. Financial Responsibilities A. Premium. The Subscriber is liable for payment to the Group of their contribution toward the monthly premium, if any B. Financial Responsibilities for Covered Services. The Subscriber is liable for payment of the following Cost Shares for Covered Services provided to the Subscriber and their Dependents. Payment of an amount billed must be received within 30 days of the billing date. Charges will be for the lesser of the Cost Shares for the Covered Service or the actual charge for that service. Cost Shares will not exceed the actual charge for that service. 1. Annual Deductible. Covered Services may be subject to an annual Deductible. Charges subject to the annual Deductible shall be borne by the Subscriber during each year until the annual Deductible is met. Covered Services must be received from a Network Provider at a Network Facility, unless the Member has received Preauthorization or has received Emergency services. There is an individual annual Deductible amount for each Member and a maximum annual Deductible amount for each Family Unit. Once the annual Deductible amount is reached for a Family Unit in a calendar year, the individual annual Deductibles are also deemed reached for each Member during that same calendar year. Individual Annual Deductible Carryover. Under this EOC, charges from the last 3 months of the prior year which were applied toward the individual annual Deductible will also apply to the current year individual annual Deductible. The individual annual Deductible carryover will apply only when expenses incurred have been paid in full. The Family Unit Deductible does not carry over into the next year. 2. Plan Coinsurance. After the applicable annual Deductible is satisfied, Members may be required to pay Plan Coinsurance for Covered Services. 3. Copayments. Members shall be required to pay applicable Copayments at the time of service. Payment of a Copayment does not exclude the possibility of an additional billing if the service is determined to be a non -Covered Service or if other Cost Shares apply. 4. Out-of-pocket Limit. Out-of-pocket Expenses which apply toward the Out-of-pocket Limit are set forth in Section IV. Total Out- of-pocket Expenses incurred during the same calendar year shall not exceed the Out-of-pocket Limit. C. Financial Responsibilities for Non -Covered Services. The cost of non -Covered Services and supplies is the responsibility of the Member. The Subscriber is liable for payment of any fees charged for non -Covered Services provided to the Subscriber and their Dependents at the time of service. Payment of an amount billed must be received within 30 days of the billing date. 10 C47298-0036900 Packet Pg. 75 8.G.b IV. Benefits Details Benefits are subject to all provisions of the EOC. Members are entitled only to receive benefits and services that are Medically Necessary and clinically appropriate for the treatment of a Medical Condition as determined by KFHPWA's medical director and as described herein. All Covered Services are subject to case management and utilization management. Annual Deductible Member pays $0 per Member per calendar year or $0 per Family Unit per calendar year Coinsurance Plan Coinsurance: Member pays nothing Lifetime Maximum No lifetime maximum on covered Essential Health Benefits Out-of-pocket Limit Limited to a maximum of $2,000 per Member or $4,000 per Family Unit per calendar year The following Out-of-pocket Expenses apply to the Out-of-pocket Limit: Ambulance coinsurance/Copayment, diagnostic laboratory and radiology Copayment, Emergency services Copayment, hospital inpatient Copayment, hospital outpatient Copayment, outpatient services Copayment, oral chemotherapy Copayment The following expenses do not apply to the Out-of-pocket Limit: Benefit -specific coinsurances, prescription drug Copayment, premiums, charges for services in excess of a benefit, charges in excess of Allowed Amount, charges for non -Covered Services Pre-existing Condition No pre-existing condition waiting period Waiting Period 11 C47298-0036900 Packet Pg. 76 8.G.b Acupuncture Acupuncture needle treatment. Member pays $10 Copayment Limited to 8 visits per medical diagnosis per calendar year without Preauthorization. Additional visits are covered with Preauthorization. No visit limit for treatment for Substance Use Disorder. Exclusions: Herbal supplements; any services not within the scope of the practitioner's licensure Allergy Services Allergy testing. Member pays $10 Copayment Allergy serum and injections. Member pays $10 Copayment Ambulance Emergency ground or air transport to any facility. Member pays 20% ambulance coinsurance Non -Emergency ground or air interfacility transfer to or from Member pays 20% ambulance coinsurance a Network Facility when Preauthorized by KFHPWA. Contact Member Services for Preauthorization. Hospital -to -hospital ground transfers: No charge; Member pays nothing Cardiac Rehabilitation Cardiac rehabilitation is covered up to a total of 36 visits per Member pays $10 Copayment cardiac event when clinical criteria is met. Preauthorization is required after initial visit. Cancer Screening and Diagnostic Services Routine cancer screening covered as Preventive Services in Member pays S 10 Copayment accordance with the well care schedule established by KFHPWA and the Patient Protection and Affordable Care Act of 2010. The well care schedule is available in Kaiser Permanente medical centers, at www.kp.org/wa, or upon request from Member Services. See Preventive Services for additional information. Diagnostic laboratory and diagnostic services for cancer. See No charge; Member pays nothing Diagnostic Laboratory and Radiology Services for additional M L c O c� LO c m m c M L c N w O J CL O a+ c M M C E L d 6) c O J c M d J c 0 .N c m M �a d 2 Q 12 C47298-0036900 Packet Pg. 77 8.G.b information. Preventive laboratory/radiology services are covered as Preventive Services. Circumcision Circumcision. Hospital - Inpatient: No charge; Member pays nothing Non -Emergency inpatient hospital services require Preauthorization. Hospital - Outpatient: Member pays $10 Copayment Outpatient Services: Member pays $10 Copayment Clinical Trials Notwithstanding any other provision of this document, the Hospital - Inpatient: Plan provides benefits for Routine Patient Costs of qualified No charge; Member pays nothing individuals in approved clinical trials, to the extent benefits for these costs are required by federal and state law. Hospital - Outpatient: Member pays $10 Copayment Routine patient costs include all items and services consistent with the coverage provided in the plan (or coverage) that is Outpatient Services: typically covered for a qualified individual who is not Member pays $10 Copayment enrolled in a clinical trial. Clinical trials are a phase I, phase II, phase III, or phase IV clinical trial that is conducted in relation to the prevention, detection, or treatment of cancer or other life -threatening disease or condition. "Life threatening condition" means any disease or condition from which the likelihood of death is probable unless the course of the disease or condition is interrupted. Clinical trials require Preauthorization. Exclusions: Routine patient costs do not include: (i) the investigational item, device, or service, itself; (ii) items and services that are provided solely to satisfy data collection and analysis needs and that are not used in the direct clinical management of the patient; or (iii) a service that is clearly inconsistent with widely accepted and established standards of care for a particular diagnosis Dental Services and Dental Anesthesia Dental services including accidental injury to natural teeth. Not covered; Member pays 100% of all charges Dental services in preparation for treatment including but not Hospital - Inpatient: No charge; Member pays limited to: chemotherapy, radiation therapy, and organ nothing transplants. Dental services in preparation for treatment require Preauthorization. Hospital - Outpatient: Member pays $10 13 C47298-0036900 Packet Pg. 78 8.G.b Dental problems such as infections requiring emergency treatment outside of standard business hours are covered as Emergency Services. Copayment Outpatient Services: Member pays $10 Copayment General anesthesia services and related facility charges for Hospital - Inpatient: No charge; Member pays dental procedures for Members who are under 7 years of age nothing or are physically or developmentally disabled or have a Medical Condition where the Member's health would be put Hospital - Outpatient: Member pays $10 at risk if the dental procedure were performed in a dentist's Copayment office. General anesthesia services for dental procedures require Preauthorization. Exclusions: Dentist's or oral surgeon's fees; dental care, surgery, services and appliances, including: treatment of accidental injury to natural teeth, reconstructive surgery to the jaw in preparation for dental implants, dental implants, periodontal surgery; any other dental service not specifically listed as covered Devices, Equipment and Supplies (for home use) • Durable medical equipment: Equipment which can Member pays 20% coinsurance withstand repeated use, is primarily and customarily used to serve a medical purpose, is useful only in the presence of an illness or injury and is used in the Member's home. Durable medical equipment includes hospital beds, Annual Deductible does not apply to glucose wheelchairs, walkers, crutches, canes, blood glucose monitors, test strips, lancets or control solutions. monitors, external insulin pumps (including related supplies such as tubing, syringe cartridges, cannulae and inserters), oxygen and oxygen equipment, and therapeutic shoes, modifications and shoe inserts for severe diabetic foot disease. KFHPWA will determine if equipment is made available on a rental or purchase basis. • Orthopedic appliances: Items attached to an impaired body segment for the purpose of protecting the segment or assisting in restoration or improvement of its function. • Ostomy supplies: Supplies for the removal of bodily secretions or waste through an artificial opening. • Post -mastectomy bras/forms, limited to 2 every 6 months. Replacements within this 6-month period are covered when Medically Necessary due to a change in the Member's condition. • Prosthetic devices: Items which replace all or part of an external body part, or function thereof. • Sales tax for devices, equipment and supplies. When provided in lieu of hospitalization, benefits will be the greater of benefits available for devices, equipment and supplies, home health or hospitalization. See Hospice for durable medical equipment provided in a hospice setting. 2 I- ti Ln N N 0 N cc c O V Lm W 0 Y c m E s 0 Q 14 C47298-0036900 Packet Pg. 79 8.G.b Devices, equipment and supplies including repair, adjustment or replacement of appliances and equipment require Preauthorization. Exclusions: Arch supports, including custom shoe modifications or inserts and their fittings not related to the treatment of diabetes; orthopedic shoes that are not attached to an appliance; wigs/hair prosthesis; take-home dressings and supplies following hospitalization; supplies, dressings, appliances, devices or services not specifically listed as covered above; same as or similar equipment already in the Member's possession; replacement or repair due to loss, theft, breakage from willful damage, neglect or wrongful use, or due to personal preference; structural modifications to a Member's home or personal vehicle Diabetic Education, Equipment and Pharmacy Supplies Diabetic education and training. Member pays $10 Copayment Diabetic equipment: Blood glucose monitors and external Member pays 20% coinsurance insulin pumps (including related supplies such as tubing, syringe cartridges, cannulae and inserters), and therapeutic Annual Deductible does not apply to glucose shoes, modifications and shoe inserts for severe diabetic foot monitors, test strips, lancets or control solutions. disease. See Devices, Equipment and Supplies for additional information. Diabetic pharmacy supplies: Insulin, lancets, lancet devices, Preferred generic drugs (Tier 1): Member pays needles, insulin syringes, insulin pens, pen needles, glucagon $10 Copayment per 30-days up to a 90-day supply emergency kits, prescriptive oral agents and blood glucose test strips for a supply of 30 days or less per item. Certain Preferred brand name drugs (Tier 2): Member brand name insulin drugs will be covered at the generic level. pays $10 Copayment per 30-days up to a 90-day See Drugs — Outpatient Prescription for additional pharmacy supply information. Non -Preferred generic and brand name drugs (Tier 3): Not covered; Member pays 100% of all charges Annual Deductible does not apply to glucose monitors, test strips, lancets or control solutions. Note: A Member will not pay more than $100 for a 30-day supply of insulin to comply with state law requirements. Diabetic retinal screening. No charge; Member pays nothing Dialysis (Home and Outpatient) Dialysis in an outpatient or home setting is covered for Outpatient Services: Member pays $10 Copayment Members with acute kidney failure or end -stage renal disease (ESRD). Dialysis requires Preauthorization. 15 C47298-0036900 Packet Pg. 80 8.G.b Injections administered by a Network Provider in a clinical setting during dialysis. Outpatient Services: Member pays $10 Copayment Self-administered injectables. See Drugs — Outpatient Preferred generic drugs (Tier 1): Member pays Prescription for additional pharmacy information. $10 Copayment per 30-days up to a 90-day supply Preferred brand name drugs (Tier 2): Member pays $10 Copayment per 30-days up to a 90-day supply Non -Preferred generic and brand name drugs (Tier 3): Not covered; Member pays 100% of all charges Drugs - Outpatient Prescription Prescription drugs, supplies and devices for a supply of 30 Preferred generic drugs (Tier 1): Member pays days or less including diabetic pharmacy supplies (insulin, $10 Copayment per 30-days up to a 90-day supply lancets, lancet devices, needles, insulin syringes, insulin pens, pen needles and blood glucose test strips), mental health and Preferred brand name drugs (Tier 2): Member wellness drugs, self-administered injectables medications for pays $10 Copayment per 30-days up to a 90-day the treatment arising from sexual assault, and routine costs for supply prescription medications provided in a clinical trial. "Routine costs" means items and services delivered to the Member that Non -Preferred generic and brand name drugs are consistent with and typically covered by the plan or (Tier 3): Not covered; Member pays 100% of all coverage for a Member who is not enrolled in a clinical trial. charges All drugs, supplies and devices must be for Covered Services. All drugs, supplies and devices must be obtained at a Annual Deductible does not apply to glucose KFHPWA-designated pharmacy except for drugs dispensed monitors, test strips, lancets or control solutions. for Emergency services or for Emergency services obtained outside of the KFHPWA Service Area, including out of the Note: A Member will not pay more than $100 for a country. Information regarding KFHPWA-designated 30-day supply of insulin to comply with state law pharmacies is reflected in the KFHPWA Provider Directory requirements or can be obtained by contacting Kaiser Permanente Member Services. Prescription drug Cost Shares are payable at the time of delivery. Certain brand name insulin drugs are covered at the generic drug Cost Share. Members may be eligible to receive an emergency fill for certain prescription drugs filled outside of KFHPWA's business hours or when KFHPWA cannot reach the prescriber for consultation. For emergency fills, Members pay the prescription drug Cost Share for each 7-day supply or less, or the minimum packaging size available at the time the emergency fill is dispensed. A list of prescription drugs eligible for emergency fills is available on the pharmacy website at www.kp.ora/wa/formulary. Members can request an emergency fill by calling 1-855-505-8107. Certain drugs are subject to Preauthorization as shown in the 2 Q 16 C47298-0036900 Packet Pg. 81 8.G.b Preferred drug list (formulary) available at www.kp.oriz/wa/formulM. Injections administered by a Network Provider in a clinical Member pays $10 Copayment setting. Over-the-counter drugs not included under Reproductive Not covered; Member pays 100% of all charges Health Mail order drugs dispensed through the KFHPWA-designated Member pays the prescription drug Cost Share for mail order service. each 30 day supply or less Annual Deductible does not apply to glucose monitors, test strips, lancets or control solutions. Note: A Member will not pay more than $100 for a 30-day supply of insulin to comply with state law requirements. Any cost -sharing paid will apply to the annual Deductible. The KFHPWA Preferred drug list is a list of prescription drugs, supplies, and devices considered to have acceptable efficacy, safety and cost-effectiveness. The Preferred drug list is maintained by a committee consisting of a group of physicians, pharmacists and a consumer representative who review the scientific evidence of these products and determine the Preferred and Non -Preferred status as well as utilization management requirements. Preferred drugs generally have better scientific evidence for safety and effectiveness and are more affordable than Non -Preferred drugs. The preferred drug list is available at www.kp.org/wa/formulga, or upon request from Member Services. Members may request a coverage determination by contacting Member Services. Coverage determination reviews may include requests to cover non -preferred drugs, obtain Preauthorization for a specific drug, or exceptions to other utilization management requirements, such as quantity limits. If coverage of a non -Preferred drug is approved, the drug will be covered at the Preferred drug level. Prescription drugs are drugs which have been approved by the Food and Drug Administration (FDA) and which can, under federal or state law, be dispensed only pursuant to a prescription order. These drugs, including off -label use of FDA -approved drugs (provided that such use is documented to be effective in one of the standard reference compendia; a majority of well -designed clinical trials published in peer -reviewed medical literature document improved efficacy or safety of the agent over standard therapies, or over placebo if no standard therapies exist; or by the federal secretary of Health and Human Services) are covered. "Standard reference compendia" means the American Hospital Formulary Service — Drug Information; the American Medical Association Drug Evaluation; the United States Pharmacopoeia — Drug Information, or other authoritative compendia as identified from time to time by the federal secretary of Health and Human Services. "Peer -reviewed medical literature" means scientific studies printed in health care journals or other publications in which original manuscripts are published only after having been critically reviewed for scientific accuracy, validity and reliability by unbiased independent experts. Peer -reviewed medical literature does not include in-house publications of pharmaceutical manufacturing companies. Generic drugs are dispensed whenever available. A generic drug is a drug that is the pharmaceutical equivalent to one or more brand name drugs. Such generic drugs have been approved by the Food and Drug Administration as meeting the same standards of safety, purity, strength and effectiveness as the brand name drug. Brand name drugs are dispensed if there is not a generic equivalent. In the event the Member elects to purchase a brand -name drug instead of the generic equivalent (if available), the Member is responsible for paying the difference in cost in addition to the prescription drug Cost Share, which does not apply to the Out-of-pocket Limit. Drug coverage is subject to utilization management that includes Preauthorization, step therapy (when a Member tries a certain medication before receiving coverage for a similar, but non -Preferred medication), limits on drug quantity or L c O c� LO c m m c M L c N N O J a O W 13 c M M N C E L a) a) c O J c M d J c 0 .N M c m �a d 2 ti Ln N N 0 N r� t1 L c O V `m to Y c m E s Q 17 C47298-0036900 Packet Pg. 82 8.G.b days supply and prevention of overutilization, underutilization, therapeutic duplication, drug -drug interactions, incorrect drug dosage, drug -allergy contraindications and clinical abuse/misuse of drugs. If a Member has a new prescription for a chronic condition, the Member may request a coordination of medications so that medications for chronic conditions are refilled on the same schedule (synchronized). Cost -shares for the initial fill of the medication will be adjusted if the fill is less than the standard quantity. Please contact Member Services for more information. Specialty drugs are high -cost drugs prescribed by a physician that requires close supervision and monitoring for serious and/or complex conditions, such as rheumatoid arthritis, hepatitis or multiple sclerosis. Specialty drugs must be obtained through KFHPWA's preferred specialty pharmacy vendor and/or network of specialty pharmacies and are covered at the appropriate cost share above. For a list of specialty drugs or more information about KFHPWA's specialty pharmacy network, please go to the KFHPWA website at www.kp.ora/wa/fonnulga or contact Member Services at 206-630-4636 or toll -free at 1-888-901-4636. The Member's Right to Safe and Effective Pharmacy Services: State and federal laws establish standards to assure safe and effective pharmacy services, and to guarantee Members' right to know what drugs are covered and the coverage limitations. Members who would like more information about the drug coverage policies, or have a question or concern about their pharmacy benefit, may contact KFHPWA at 206-630-4636 or toll -free 1-888-901-4636 or by accessing the KFHPWA website at www.kp.org/wa. Members who would like to know more about their rights under the law, or think any services received while enrolled may not conform to the terms of the EOC, may contact the Washington State Office of Insurance Commissioner at toll -free 1-800-562-6900. Members who have a concern about the pharmacists or pharmacies serving them may call the Washington State Department of Health at toll -free 1-800-525-0127. Prescription Drug Coverage and Medicare: This benefit, for purposes of Creditable Coverage, is actuarially equal to or greater than the Medicare Part D prescription drug benefit. Members who are also eligible for Medicare Part D can remain covered and will not be subject to Medicare -imposed late enrollment penalties should they decide to enroll in a Medicare Part D plan at a later date; however, the Member could be subject to payment of higher Part D premiums if the Member subsequently has a break in creditable coverage of 63 continuous days or longer before enrolling in a Part D plan. A Member who discontinues coverage must meet eligibility requirements in order to re - enroll. Exclusions: Over-the-counter drugs, supplies and devices not requiring a prescription under state law or regulations; drugs and injections for anticipated illness while traveling; drugs and injections for cosmetic purposes; vitamins, including most prescription vitamins; replacement of lost, stolen, or damaged drugs or devices; administration of excluded drugs and injectables; drugs used in the treatment of sexual dysfunction disorders; compounds which include a non -FDA approved drug; growth hormones for idiopathic short stature without growth hormone deficiency; prescription drugs/products available over-the-counter or have an over-the-counter alternative that is determined to be therapeutically interchangeable. Emergency Services Emergency services at a Network Facility or non -Network Network Facility: Member pays $75 Copayment Facility. See Section XII. for a definition of Emergency. Non -Network Facility: Member pays $125 Emergency services include professional services, treatment Copayment and supplies, facility costs, outpatient charges for patient observation and medical screening exams required to stabilize a patient. Members must notify KFHPWA by way of the Hospital notification line within 24 hours of any admission, or as soon thereafter as medically possible. L c 0 V `0 c m m c L c N w 0 J a 0 c M M N C E d a) c 0 J c M d J c 0 .N M c m d 2 Q 18 C47298-0036900 Packet Pg. 83 8.G.b If a Member is admitted as an inpatient directly from an emergency department, any Emergency services Copayment is waived. Coverage is subject to the hospital services Cost Share. If two or more Members in the same Family Unit require Emergency services as a result of the same accident, coverage for all Members will be subject to only one Emergency services Copayment. If a Member is hospitalized in a non -Network Facility, KFHPWA reserves the right to require transfer of the Member to a Network Facility upon consultation between a Network Provider and the attending physician. If the Member refuses to transfer to a Network Facility or does not notify KFHPWA within 24 hours following admission, all further costs incurred during the hospitalization are the responsibility of the Member. Follow-up care which is a direct result of the Emergency must be received from a Network Provider, unless Preauthorization is obtained for such follow-up care from a non -Network Provider. Hearing Examinations and Hearing Aids Hearing exams for hearing loss and evaluation are covered Hospital - Inpatient: only when provided at KFHPWA-approved facilities. No charge; Member pays nothing Cochlear implants or Bone Anchored Hearing Aids (BAHA) Hospital - Outpatient: when in accordance with KFHPWA clinical criteria. Member pays $10 Copayment Covered services for cochlear implants and BAHA include Outpatient Services: diagnostic testing, pre -implant testing, implant surgery, post- Member pays $10 Copayment implant follow-up, speech therapy, programming and associated supplies (such as transmitter cable, and batteries). Hearing aids including hearing aid examinations. Not covered; Member pays 100% of all charges Exclusions: Programs or treatments for hearing loss or hearing care including, but not limited to, externally worn hearing or surgically implanted hearing aids and the surgery and services necessary to implant them except as described above; hearing screening tests required under Preventive Services Home Health Care Home health care when the following criteria are met: No charge; Member pays nothing • Except for patients receiving palliative care services, the Member must be unable to leave home due to a health problem or illness. Unwillingness to travel and/or arrange for transportation does not constitute inability to leave the home. 19 C47298-0036900 Packet Pg. 84 8.G.b • The Member requires intermittent skilled home health care, as described below. • KFHPWA's medical director determines that such services are Medically Necessary and are most appropriately rendered in the Member's home. Covered Services for home health care may include the following when rendered pursuant to a KFHPWA-approved home health care plan of treatment: nursing care; restorative physical, occupational, respiratory and speech therapy; durable medical equipment; medical social worker and limited home health aide services. Home health services are covered on an intermittent basis in the Member's home. "Intermittent" means care that is to be rendered because of a medically predictable recurring need for skilled home health care. "Skilled home health care" means reasonable and necessary care for the treatment of an illness or injury which requires the skill of a nurse or therapist, based on the complexity of the service and the condition of the patient and which is performed directly by an appropriately licensed professional provider. Home health care requires Preauthorization. Exclusions: Private duty nursing; housekeeping or meal services; any care provided by or for a family member; any other services rendered in the home which do not meet the definition of skilled home health care above Hospice Hospice care when provided by a licensed hospice care No charge; Member pays nothing program. A hospice care program is a coordinated program of home and inpatient care, available 24 hours a day. This program uses an interdisciplinary team of personnel to provide comfort and supportive services to a Member and any family members who are caring for the member, who is experiencing a life -threatening disease with a limited prognosis. These services include acute, respite and home care to meet the physical, psychosocial and special needs of the Member and their family during the final stages of illness. In order to qualify for hospice care, the Member's provider must certify that the Member is terminally ill and is eligible for hospice services. Inpatient Hospice Services. For short-term care, inpatient hospice services are covered with Preauthorization. Respite care is covered to provide continuous care of the Member and allow temporary relief to family members from the duties of caring for the Member for a maximum of 5 consecutive days per 3-month period of hospice care. Other covered hospice services, when billed by a licensed L c 0 V L0 c m m c 0 L c N w 0 J a 0 W 13 c M M N C E L d a� c 0 J c M d J c 0 5 M c m M �a d 2 ti Ln N N 0 N r� t1 L c 0 c� m A to Y c m E Q 20 C47298-0036900 Packet Pg. 85 8.G.b hospice program, may include the following: • Inpatient and outpatient services and supplies for injury and illness. • Semi -private room and board, except when a private room is determined to be necessary. • Durable medical equipment when billed by a licensed hospice care program. Hospice care requires Preauthorization. Exclusions: Private duty nursing; financial or legal counseling services; meal services; any services provided by family members Hospital - Inpatient and Outpatient The following inpatient medical and surgical services are Hospital - Inpatient: No charge; Member pays covered: nothing • Room and board, including private room when prescribed, and general nursing services. Hospital - Outpatient: Member pays $10 • Hospital services (including use of operating room, Copayment anesthesia, oxygen, x-ray, laboratory and radiotherapy services). • Drugs and medications administered during confinement. • Medical implants. • Acute chemical withdrawal (detoxification). Outpatient hospital includes ambulatory surgical centers. Alternative care arrangements may be covered as a cost- effective alternative in lieu of otherwise covered Medically Necessary hospitalization or other Medically Necessary institutional care with the consent of the Member and recommendation from the attending physician or licensed health care provider. Alternative care arrangements in lieu of covered hospital or other institutional care must be determined to be appropriate and Medically Necessary based upon the Member's Medical Condition. Such care is covered to the same extent the replaced Hospital Care is covered. Alternative care arrangements require Preauthorization. Members receiving the following nonscheduled services are required to notify KFHPWA by way of the Hospital notification line within 24 hours following any admission, or as soon thereafter as medically possible: acute chemical withdrawal (detoxification) services, Emergency psychiatric services, Emergency services, labor and delivery and inpatient admissions needed for treatment of Urgent Conditions that cannot reasonably be delayed until Preauthorization can be obtained. Coverage for Emergency services in a non -Network Facility and subsequent transfer to a Network Facility is set forth in Emergency Services. L c O V `O c m m c M c N w O J CL O rm. W 13 c M M N 0 E a`) a) c O J c M d J C O 0 M c m M �a d 2 ti Ln N N O N r� cc c O c� `m A to Y c m E s V as Q 21 C47298-0036900 Packet Pg. 86 8.G.b Non -Emergency hospital services require Preauthorization. Exclusions: Take home drugs, dressings and supplies following hospitalization; internally implanted insulin pumps, artificial larynx and any other implantable device that have not been approved by KFHPWA's medical director Infertility (including sterility) General counseling and one consultation visit to diagnose Member pays $10 Copayment infertility conditions. Specific diagnostic services, treatment and prescription drugs. Not covered; Member pays 100% of all charges Exclusions: Diagnostic testing and medical treatment of sterility and infertility regardless of origin or cause; all charges and related services for donor materials; all forms of artificial intervention for any reason including artificial insemination and in -vitro fertilization; prognostic (predictive) genetic testing for the detection of congenital and heritable disorders; surrogacy Infusion Therapy Medically Necessary infusion therapy includes, but is not Member pays $10 Copayment limited to: • Antibiotics. • Hydration. • Chemotherapy. • Pain management. Associated infused medications. No charge; Member pays nothing Laboratory and Radiology Nuclear medicine, radiology, ultrasound and laboratory No charge; Member pays nothing services, including high end radiology imaging services such as CAT scan, MRI and PET which are subject to Preauthorization except when associated with Emergency services or inpatient services. Please contact Member Services for any questions regarding these services. Services received as part of an emergency visit are covered as Emergency Services. Preventive laboratory and radiology services are covered in accordance with the well care schedule established by KFHPWA and the Patient Protection and Affordable Care Act of 2010. The well care schedule is available in Kaiser Permanente medical centers, at www.kp.org/wa, or upon request from Member Services. 22 C47298-0036900 Packet Pg. 87 8.G.b Manipulative Therapy Member pays $10 Copayment Exclusions: Supportive care rendered primarily to maintain the level of correction already achieved; care rendered primarily for the convenience of the Member; care rendered on a non -acute, asymptomatic basis; charges for any other services that do not meet KFHPWA clinical criteria as Medically Necessary Maternity and Pregnancy Maternity care and pregnancy services, including care for Hospital - Inpatient: No charge; Member pays complications of pregnancy and prenatal and postpartum care nothing are covered for all female Members including dependent daughters. Hospital - Outpatient: Member pays $10 Copayment Delivery and associated Hospital Care, including home births and birthing centers. Home births are considered outpatient Outpatient Services: Member pays $10 Copayment services. Members must notify KFHPWA by way of the Hospital notification line within 24 hours of any admission, or as soon thereafter as medically possible. The Member's physician, in consultation with the Member, will determine the Member's length of inpatient stay following delivery. Prenatal testing for the detection of congenital and heritable disorders when Medically Necessary as determined by KFHPWA's medical director and in accordance with Board of Health standards for screening and diagnostic tests during pregnancy. Termination of pregnancy. Hospital - Inpatient: No charge; Member pays nothing Non -Emergency inpatient hospital services require Preauthorization. Hospital - Outpatient: Member pays $10 Copayment Outpatient Services: Member pays $10 Copayment Exclusions: Birthing tubs; genetic testing of non -Members; fetal ultrasound in the absence of medical indications Mental Health and Wellness Mental health and wellness services provided at the most Hospital - Inpatient: No charge; Member pays clinically appropriate and Medically Necessary level of nothing mental health care intervention as determined by KFHPWA's medical director. Treatment may utilize psychiatric, Hospital - Outpatient: Member pays $10 psychological and/or psychotherapy services to achieve these Copayment objectives. Outpatient Services: Member pays $10 Copayment L O V L 0 m m c 0 L N N O J CL O 4a c 0 0 N 0 E L a) 4a a) c 0 J c 0 J c 0 .N M c m M �a d 2 Q 23 C47298-0036900 Packet Pg. 88 8.G.b Mental health and wellness services including medical management and prescriptions are covered the same as for any other condition. Applied behavioral analysis (ABA) therapy, limited to outpatient treatment of an autism spectrum disorder or, has a developmental disability for which there is evidence that ABA therapy is effective, as diagnosed and prescribed by a neurologist, pediatric neurologist, developmental pediatrician, psychologist or psychiatrist experienced in the diagnosis and treatment of autism. Documented diagnostic assessments, individualized treatment plans and progress evaluations are required. Services for any involuntary court -ordered treatment program shall be covered only if determined to be Medically Necessary by KFHPWA's medical director. Services provided under involuntary commitment statutes are covered. If a Member is admitted as an inpatient directly from an emergency department, any Emergency services Copayment is waived. Coverage is subject to the hospital services Cost Share. Coverage for services incurred at non -Network Facilities shall exclude any charges that would otherwise be excluded for hospitalization within a Network Facility. Members must notify KFHPWA by way of the Hospital notification line within 24 hours of any admission, or as soon thereafter as medically possible. Mental health and wellness services rendered to treat mental disorders are covered. Mental Disorders means mental disorders covered in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, except as otherwise excluded under Sections IV. or V. Mental Health and Wellness Services means Medically Necessary outpatient services, Residential Treatment, partial hospitalization program, and inpatient services provided by a licensed facility or licensed providers; including advanced practice psychiatric nurses, mental health and wellness counselors, marriage and family therapists and social workers, except as otherwise excluded under Sections IV. or V. Inpatient mental health and wellness services, Residential Treatment and partial hospitalization programs must be provided at a hospital or facility that KFHPWA has approved specifically for the treatment of mental disorders. Non -Emergency inpatient hospital services, including Residential Treatment and partial hospitalization programs, require Preauthorization. Group Visits: No charge; Member pays nothing 24 C47298-0036900 Packet Pg. 89 8.G.b Exclusions: Academic or career counseling; personal growth or relationship enhancement; assessment and treatment services that are primarily vocational and academic; court -ordered or forensic treatment, including reports and summaries, not considered Medically Necessary; work or school ordered assessment and treatment not considered Medically Necessary; counseling for overeating not considered Medically Necessary; specialty treatment programs such as "behavior modification programs" not considered Medically Necessary; relationship counseling or phase of life problems (Z code only diagnoses); custodial care not considered Medically Necessary; experimental or investigational therapies, such as wilderness therapy. Naturopathy Naturopathy. Member pays $10 Copayment Limited to 3 visits per medical diagnosis per calendar year without Preauthorization. Additional visits are covered with Preauthorization. Laboratory and radiology services are covered only when obtained through a Network Facility. Exclusions: Herbal supplements; nutritional supplements; any services not within the scope of the practitioner's licensure Newborn Services Newborn services are covered the same as for any other Hospital - Inpatient: No charge; Member pays condition. Any Cost Share for newborn services is separate nothing from that of the mother. During the baby's initial hospital stay while the birth Preventive services for newborns are covered under mother and baby are both confined, any applicable Preventive Services. Deductible and Copayment for the newborn are See Section VI.A.3. for information about temporary waived coverage for newborns. Hospital - Outpatient: Member pays $10 Copayment Outpatient Services: Member pays $10 Copayment Nutritional Counseling Nutritional counseling. Member pays $10 Copayment Services related to a healthy diet to prevent obesity are covered as Preventive Services. Exclusions: Nutritional supplements; weight control self-help programs or memberships, such as Weight Watchers, Jenny Craig, or other such programs 25 C47298-0036900 Packet Pg. 90 8.G.b Nutritional Therapy Medical formula necessary for the treatment of No charge; Member pays nothing phenylketonuria (PKU), specified inborn errors of metabolism, or other metabolic disorders. Enteral therapy for malabsorption and an eosinophilic Member pays 20% coinsurance gastrointestinal disorder. Necessary equipment and supplies for the administration of enteral therapy are covered as Devices, Equipment and Supplies. Parenteral therapy (total parenteral nutrition). No charge; Member pays nothing Necessary equipment and supplies for the administration of parenteral therapy are covered as Devices, Equipment and Supplies. Exclusions: Any other dietary formulas or medical foods; oral nutritional supplements not related to the treatment of inborn errors of metabolism; special diets; prepared foods/meals Obesity Related Services Bariatric surgery and related hospitalizations when KFHPWA Hospital - Inpatient: No charge; Member pays criteria are met. nothing Services related to obesity screening and counseling are Hospital - Outpatient: Member pays $10 covered as Preventive Services. Copayment Obesity related services require Preauthorization. Outpatient Services: Member pays $10 Copayment Exclusions: All other obesity treatment and treatment for morbid obesity including any medical services, drugs or supplies, regardless of co -morbidities, except as described above; specialty treatment programs such as weight control self-help programs or memberships, such as Weight Watchers, Jenny Craig or other such programs; medications and related physician visits for medication monitoring On the Job Injuries or Illnesses On the job injuries or illnesses. Hospital - Inpatient: Not covered; Member pays 100% of all charges Hospital - Outpatient: Not covered; Member pays 100% of all charges Outpatient Services: Not covered; Member pays 100% of all charges L 0 V L0 c m m c 0 L c N w 0 J a 0 4a c M M N C E L d a) c 0 J c M d J c 0 .N M c m M �a d 2 I- ti Ln N N O N r� cc L 0 c� Lm W M Y c m E s v Q 26 C47298-0036900 Packet Pg. 91 8.G.b Exclusions: Confinement, treatment or service that results from an illness or injury arising out of or in the course of any employment for wage or profit including injuries, illnesses or conditions incurred as a result of self-employment Oncology Radiation therapy, chemotherapy, oral chemotherapy. Radiation Therapy and Chemotherapy: Member pays $10 Copayment See Infusion Therapy for infused medications. Oral Chemotherapy Drugs: Preferred generic drugs (Tier 1): Member pays $10 Copayment per 30-days up to a 90-day supply Preferred brand name drugs (Tier 2): Member pays $10 Copayment per 30-days up to a 90-day supply Non -Preferred generic and brand name drugs (Tier 3): Not covered; Member pays 100% of all charges Optical (vision) Routine eye examinations and refractions, limited to once Routine Exams: Member pays $10 Copayment every 12 months. Exams for Eye Pathology: Member pays $10 Eye and contact lens examinations for eye pathology and to Copayment monitor Medical Conditions, as often as Medically Necessary. Contact lenses or framed lenses for eye pathology when Frames and Lenses: Not covered; Member pays Medically Necessary. 100% of all charges One contact lens per diseased eye in lieu of an intraocular Contact Lenses or Framed Lenses for Eye lens is covered following cataract surgery provided the Pathology: No charge; Member pays nothing Member has been continuously covered by KFHPWA since such surgery. In the event a Member's age or medical condition prevents the Member from having an intraocular lens or contact lens, framed lenses are available. Replacement of lenses for eye pathology, including following cataract surgery, is covered only once within a 12-month period and only when needed due to a change in the Member's prescription. Exclusions: Eyeglasses; contact lenses, contact lens evaluations, fittings and examinations not related to eye pathology; orthoptic therapy (i.e. eye training); evaluations and surgical procedures to correct refractions not related to eye pathology and complications related to such procedures 27 C47298-0036900 Packet Pg. 92 8.G.b Oral Surgery Reduction of a fracture or dislocation of the jaw or facial Hospital - Inpatient: No charge; Member pays bones; excision of tumors or non -dental cysts of the jaw, nothing cheeks, lips, tongue, gums, roof and floor of the mouth; and incision of salivary glands and ducts. Hospital - Outpatient: Member pays $10 Copayment KFHPWA's medical director will determine whether the care or treatment required is within the category of Oral Surgery or Outpatient Services: Member pays $10 Copayment Dental Services. Oral surgery requires Preauthorization. Exclusions: Care or repair of teeth or dental structures of any type; tooth extractions or impacted teeth; services related to malocclusion; services to correct the misalignment or malposition of teeth; any other services to the mouth, facial bones or teeth which are not medical in nature Outpatient Services Covered outpatient medical and surgical services in a Member pays $10 Copayment provider's office, including chronic disease management and treatment arising from sexual assault. See Preventive Services for additional information related to chronic disease management. See Hospital - Inpatient and Outpatient for outpatient hospital medical and surgical services, including ambulatory surgical centers. Plastic and Reconstructive Surgery Plastic and reconstructive services: Hospital - Inpatient: No charge; Member pays • Correction of a congenital disease or congenital anomaly. nothing • Correction of a Medical Condition following an injury or resulting from surgery which has produced a major effect Hospital - Outpatient: Member pays $10 on the Member's appearance, when in the opinion of Copayment KFHPWA's medical director such services can reasonably be expected to correct the condition. Outpatient Services: Member pays $10 Copayment • Reconstructive surgery and associated procedures, including internal breast prostheses, following a mastectomy, regardless of when the mastectomy was performed. Members are covered for all stages of reconstruction on the non -diseased breast to produce a symmetrical appearance. Complications of covered mastectomy services, including lymphedemas, are covered. Plastic and reconstructive surgery requires Preauthorization. Exclusions: Cosmetic services including treatment for complications resulting from cosmetic surgery; cosmetic surgery; complications of non -Covered Services L 0 V L0 c m m c L c N w 0 J a 0 W 13 c M M N 0 E L d a) c 0 J c M J c 0 .N M c m M �a d 2 ti Ln N N O N r� cc c 0 c� Lm W M Y c m E s Q 28 C47298-0036900 Packet Pg. 93 8.G.b Podiatry Medically Necessary foot care. Member pays $10 Copayment Routine foot care covered when such care is directly related to the treatment of diabetes and, when approved by KFHPWA's medical director, other clinical conditions that effect sensation and circulation to the feet. Exclusions: All other routine foot care Preventive Services Preventive services in accordance with the well care schedule Member pays $10 Copayment established by KFHPWA. The well care schedule is available in Kaiser Permanente medical centers, at www.kp.org/wa, or upon request from Member Services. Screening and tests with A and B recommendations by the U.S. Preventive Services Task Force (USPSTF). Services, tests and screening contained in the U.S. Health Resources and Services Administration Bright Futures guidelines as set forth by the American Academy of Pediatricians. Services, tests, screening and supplies recommended in the U.S. Health Resources and Services Administration women's preventive and wellness services guidelines. Immunizations recommended by the Centers for Disease Control's Advisory Committee on Immunization Practices. Flu vaccines are covered up to the Allowed Amount when provided by a non -Network Provider. Preventive services include, but are not limited to, well adult and well child physical examinations; immunizations and vaccinations; pap smears; routine mammography screening; routine prostate screening; and colorectal cancer screening for Members who are age 50 or older or who are under age 50 and at high risk. Preventive care for chronic disease management includes treatment plans with regular monitoring, coordination of care between multiple providers and settings, medication management, evidence -based care, quality of care measurement and results, and education and tools for patient self -management support. In the event preventive, wellness or chronic care management services are not available from a Network Provider, non -network providers may provide these services without Cost Share when Preauthorized. Services provided during a preventive services visit, including L O V L O c m m c M L c N N O J CL O a+ c M M N 0 E L a) 4a a) c O J c M J c O .N M c m M �a d 2 Q 29 C47298-0036900 Packet Pg. 94 8.G.b laboratory services, which are not in accordance with the KFHPWA well care schedule are subject to Cost Shares. Eye refractions are not included under preventive services. Exclusions: Those parts of an examination and associated reports and immunizations that are not deemed Medically Necessary by KFHPWA for early detection of disease; all other diagnostic services not otherwise stated above Rehabilitation and Habilitative Care (massage, occupational, physical and speech therapy) and Neurodevelopmental Therapy Rehabilitation services to restore function following illness, Hospital - Inpatient: No charge; Member pays injury or surgery, limited to the following restorative nothing therapies: occupational therapy, physical therapy, massage therapy and speech therapy. Services are limited to those Outpatient Services: Member pays $10 Copayment necessary to restore or improve functional abilities when physical, sensori-perceptual and/or communication impairment exists due to injury, illness or surgery. Group visits (occupational, physical, speech therapy or learning services): Outpatient services require a prescription or order from a Member pays one half the office visit Copayment physician that reflects a written plan of care to restore function and must be provided by a rehabilitation team that may include a physician, nurse, physical therapist, occupational therapist, massage therapist or speech therapist. Preauthorization is not required. Habilitative care includes Medically Necessary services or devices designed to help a Member keep, learn, or improve skills and functioning for daily living. Services may include: occupational therapy, physical therapy, speech therapy when prescribed by a physician. Examples include therapy for a child who is not walking or talking at the expected age. These services may include physical and occupational therapy, speech -language pathology and other services for people with disabilities in a variety of inpatient and/or outpatient settings. Neurodevelopmental therapy to restore or improve function including maintenance in cases where significant deterioration in the Member's condition would result without the services, limited to the following therapies: occupational therapy, physical therapy and speech therapy. There is no visit limit for Neurodevelopmental Therapy services. Limited to a combined total of 60 inpatient days and 60 outpatient visits per calendar year for all Rehabilitation and Habilitative care. Services with mental health diagnoses are covered with no limit. Non -Emergency inpatient hospital services require Preauthorization. 2 ti Ln N N O N cc c O c� Lm W M Y c m E s 0 Q 30 C47298-0036900 Packet Pg. 95 8.G.b Exclusions: Specialty treatment programs; inpatient Residential Treatment services; specialty rehabilitation programs including "behavior modification programs"; recreational, life -enhancing, relaxation or palliative therapy; implementation of home maintenance programs Reproductive Health Medically Necessary medical and surgical services for Hospital - Inpatient: No charge; Member pays reproductive health, including consultations, examinations, nothing procedures and devices, including device insertion and removal. Hospital - Outpatient: No charge; Member pays nothing See Maternity and Pregnancy for termination of pregnancy services Outpatient Services: No charge; Member pays nothing Reproductive health is the care necessary to support the reproductive system and the ability to reproduce. Reproductive health includes contraception, cancer and disease screenings, termination of pregnancy, maternity, prenatal and postpartum care. All methods for Medically Necessary FDA -approved No charge; Member pays nothing (including over-the-counter) contraceptive drugs, devices and products. Condoms are limited to 120 per 90-day supply. Contraceptive drugs may be allowed up to a 12-month supply and, when available, picked up in the provider's office. Sexual Dysfunction One consultation visit to diagnose sexual dysfunction conditions. Member pays S10 Copayment Specific diagnostic services, treatment and prescription drugs. Not covered; Member pays 100% of all charges Exclusions: Diagnostic testing and medical treatment of sexual dysfunction regardless of origin or cause; devices, equipment and supplies for the treatment of sexual dysfunction Skilled Nursing Facility Skilled nursing care in a skilled nursing facility when full- No charge; Member pays nothing time skilled nursing care is necessary in the opinion of the attending physician, limited to a total of 30 days per condition per calendar year. Care may include room and board; general nursing care; drugs, biologicals, supplies and equipment ordinarily provided or arranged by a skilled nursing facility; and short- term restorative occupational therapy, physical therapy and speech therapy. 31 C47298-0036900 Packet Pg. 96 8.G.b Skilled nursing care in a skilled nursing facility requires Preauthorization. Exclusions: Personal comfort items such as telephone and television; rest cures; domiciliary or Convalescent Care Sterilization FDA -approved female sterilization procedures, services and No charge; Member pays nothing supplies. Non -Emergency inpatient hospital services require Preauthorization. Vasectomy. No charge; Member pays nothing Non -Emergency inpatient hospital services require Preauthorization. Exclusions: Procedures and services to reverse a sterilization Substance Use Disorder Substance use disorder services including inpatient Hospital - Inpatient: No charge; Member pays Residential Treatment; diagnostic evaluation and education; nothing organized individual and group counseling; and/or prescription drugs unless excluded under Sections IV. or V. Outpatient Services: Member pays $10 Copayment Substance use disorder means an illness characterized by a physiological or psychological dependency, or both, on a Group Visits: No charge; Member pays nothing controlled substance and/or alcoholic beverages, and where the user's health is substantially impaired or endangered or their social or economic function is substantially disrupted. For the purposes of this section, the definition of Medically Necessary shall be expanded to include those services necessary to treat a substance use disorder condition that is having a clinically significant impact on a Member's emotional, social, medical and/or occupational functioning. Substance use disorder services must be provided at a KFHPWA-approved treatment facility or treatment program. Substance use disorder services are limited to the services rendered by a physician (licensed under RCW 18.71 and RCW 18.57), a psychologist (licensed under RCW 18.83), a substance use disorder treatment program licensed for the service being provided by the Washington State Department of Social and Health Services (pursuant to RCW 70.96A), a master's level therapist (licensed under RCW 18.225.090), an advance practice psychiatric nurse (licensed under RCW 18.79) or, in the case of non -Washington State providers, those providers meeting equivalent licensing and certification requirements established in the state where the provider's 32 C47298-0036900 Packet Pg. 97 8.G.b practice is located. Court -ordered substance use disorder treatment shall be covered only if determined to be Medically Necessary. Preauthorization is required for Residential Treatment and non -Emergency inpatient hospital services provided in out-of- state facilities. Acute chemical withdrawal (detoxification) services for Emergency Services Network Facility: Member alcoholism and drug abuse. "Acute chemical withdrawal" pays $75 Copayment means withdrawal of alcohol and/or drugs from a Member for whom consequences of abstinence are so severe that they Emergency Services Non -Network Facility: require medical/nursing assistance in a hospital setting or Member pays $125 Copayment behavioral health agency (licensed and certified under RCW 71.24.037), which is needed immediately to prevent serious Hospital - Inpatient: No charge; Member pays impairment to the Member's health. nothing Coverage for acute chemical withdrawal (detoxification) is provided without Preauthorization. If a Member is admitted as an inpatient directly from an emergency department, any Emergency services Copayment is waived. Coverage is subject to the hospital services Cost Share. Members must notify KFHPWA by way of the Hospital notification line within 24 hours of any admission, or as soon thereafter as medically possible. KFHPWA reserves the right to require transfer of the Member to a Network Facility/program upon consultation between a Network Provider and the attending physician. If the Member refuses transfer to a Network Facility/program, all further costs incurred during the hospitalization are the responsibility of the Member. Exclusions: Experimental or investigational therapies, such as wilderness therapy; facilities and treatment programs which are not certified by the Department of Social Health Services Telehealth Services Telemedicine No charge; Member pays nothing Services provided by the use of real-time interactive audio and video communications or store and forward technology between the patient at the originating site and a Network Provider at another location. Store and forward technology means sending a Member's medical information from an originating site to the provider at a distant site for later review. The provider follows up with a medical diagnosis for the Member and helps manage their care. Services must meet the following requirements: • Be a Covered Service under this EOC. • The originating site is qualified to provide the service. • If the service is provided through store and forward L 0 V L0 c m m c 0 L c N w 0 J a 0 W c M M N C E d a) c 0 J C M d J c 0 5 M c m �a d 2 ti m N N 0 N L c 0 V m A Y c m s 0 Q 33 C47298-0036900 Packet Pg. 98 8.G.b technology, there must be an associated office visit between the Member and the referring provider. • Is Medically Necessary. Telephone Services and Online (E-Visits) No charge; Member pays nothing Scheduled telephone visits with a Network Provider are covered. Online (E-Visits): A Member logs into the secure Member site at www.kp.org/wa and completes a questionnaire. A KFHPWA medical provider reviews the questionnaire and provides a treatment plan for select conditions, including prescriptions. Online visits are not available to Members during in -person visits at a KFHPWA facility or pharmacy. More information is available at https://wa.kaisep2ennanente.org/httnl/public/services/e-visit. Exclusions: Fax and e-mail; telehealth services with non -contracted providers; telehealth services in states where prohibited by law; all other services not listed above Temporomandibular Joint (TMJ) Medical and surgical services and related hospital charges for Hospital - Inpatient: No charge; Member pays the treatment of temporomandibular joint (TMJ) disorders nothing including: • Orthognathic surgery for the treatment of TMJ disorders. Hospital - Outpatient: Member pays $10 • Radiology services. Copayment • TMJ specialist services. • Fitting/adjustment of splints. Outpatient Services: Member pays $10 Copayment Non -Emergency inpatient hospital services require Preauthorization. TMJ appliances. See Devices, Equipment and Supplies for Member pays 20% coinsurance additional information. Exclusions: Treatment for cosmetic purposes; bite blocks; dental services including orthodontic therapy and braces for any condition; any orthognathic (jaw) surgery in the absence of a diagnosis of TMJ, severe obstructive sleep apnea; hospitalizations related to these exclusions Tobacco Cessation Individual/group counseling and educational materials. No charge; Member pays nothing Approved pharmacy products. See Drugs — Outpatient KFHPWA-designated tobacco cessation program: Prescription for additional pharmacy information. No charge; Member pays nothing when prescribed as part of the KFHPWA-designated tobacco cessation program and dispensed through the KFHPWA- designated mail order service L c 0 V L 0 c m m c 0 c N w 0 J a 0 4a c M M N C E L d a) c 0 J c M d J c 0 .N M c m M �a d 2 ti Ln N N O N r� t1 c0 L 0 V `m Y c m E 0 cc Q 34 C47298-0036900 Packet Pg. 99 8.G.b Other approved pharmacy products: Preferred generic drugs (Tier 1): Member pays $10 Copayment per 30-days up to a 90-day supply Preferred brand name drugs (Tier 2): Member pays $10 Copayment per 30-days up to a 90-day supply Non -Preferred generic and brand name drugs (Tier 3): Not covered; Member pays 100% of all charges Transgender Services Medically Necessary medical and surgical services for gender Hospital - Inpatient: No charge; Member pays reassignment. nothing Prescription drugs are covered the same as for any other Hospital - Outpatient: Member pays $10 condition (see Drugs - Outpatient Prescription for coverage). Copayment Counseling services are covered the same as for any other Outpatient Services: Member pays $10 Copayment condition (see Mental Health and Wellness for coverage). Non -Emergency inpatient hospital services require Preauthorization. Exclusions: Cosmetic services including treatment for complications resulting from cosmetic surgery; cosmetic surgery; complications of non -Covered Services Transplants Transplant services, including heart, heart-lung, single lung, Hospital - Inpatient: No charge; Member pays double lung, kidney, pancreas, cornea, intestinal/multi- nothing visceral, liver transplants, and bone marrow and stem cell support (obtained from allogeneic or autologous peripheral Hospital - Outpatient: Member pays $10 blood or marrow) with associated high dose chemotherapy. Copayment Services are limited to the following: Outpatient Services: Member pays $10 Copayment • Inpatient and outpatient medical expenses for evaluation testing to determine recipient candidacy, donor matching tests, hospital charges, procurement center fees, professional fees, travel costs for a surgical team and excision fees. Donor costs for a covered organ recipient are limited to procurement center fees, travel costs for a surgical team and excision fees. • Follow-up services for specialty visits. • Rehospitalization. • Maintenance medications during an inpatient stay. 35 C47298-0036900 Packet Pg. 100 8.G.b Transplant services require Preauthorization. Exclusions: Donor costs to the extent that they are reimbursable by the organ donor's insurance; treatment of donor complications; living expenses except as covered under Section J. Utilization Management Urgent Care Inside the KFHPWA Service Area, urgent care is covered at a Network Emergency Department: Member pays Kaiser Permanente medical center, Kaiser Permanente urgent $75 Copayment care center or Network Provider's office. Network Urgent Care Center: Member pays $10 Outside the KFHPWA Service Area, urgent care is covered at Copayment any medical facility. See Section XII. for a definition of Urgent Condition. Network Provider's Office: Member pays $10 Copayment Non -Network Provider: Member pays $125 Copayment V. General Exclusions In addition to exclusions listed throughout the EOC, the following are not covered: 1. Benefits and related services, supplies and drugs that are not Medically Necessary for the treatment of an illness, injury, or physical disability, that are not specifically listed as covered in the EOC, except as required by federal or state law. 2. Services Related to a Non -Covered Service: When a service is not covered, all services related to the non - covered service (except for the specific exceptions described below) are also excluded from coverage. Members who have received a non -covered service, such as bariatric surgery, and develop an acute medical complication (such as band slippage, leak or infection) as a result, shall have coverage for Medically Necessary intervention to stabilize the acute medical complication. Coverage does not include complications that occur during or M immediately following a non -covered service. Additional surgeries or other medical services in addition to Medically Necessary intervention to resolve acute medical complications resulting from non -covered services shall not be covered. ti 3. Services or supplies for which no charge is made, or for which a charge would not have been made if the N Member had no health care coverage or for which the Member is not liable; services provided by a family .. member, or self -care. N 4. Convalescent Care. 5. Services to the extent benefits are "available" to the Member as defined herein under the terms of any vehicle, homeowner's, property or other insurance policy, except for individual or group health insurance, pursuant to medical coverage, medical "no fault" coverage, personal injury protection coverage or similar medical coverage contained in said policy. For the purpose of this exclusion, benefits shall be deemed to be "available" to the Member if the Member receives benefits under the policy either as a named insured or as an insured individual under the policy definition of insured. 36 C47298-0036900 Packet Pg. 101 8.G.b 6. Services or care needed for injuries or conditions resulting from active or reserve military service, whether such injuries or conditions result from war or otherwise. This exclusion will not apply to conditions or injuries resulting from previous military service unless the condition has been determined by the U.S. Secretary of Veterans Affairs to be a condition or injury incurred during a period of active duty. Further, this exclusion will not be interpreted to interfere with or preclude coordination of benefits under Tri-Care. 7. Services provided by government agencies, except as required by federal or state law. 8. Services covered by the national health plan of any other country. 9. Experimental or investigational services. KFHPWA consults with KFHPWA's medical director and then uses the criteria described below to decide if a particular service is experimental or investigational. a. A service is considered experimental or investigational for a Member's condition if any of the following statements apply to it at the time the service is or will be provided to the Member: 1) The service cannot be legally marketed in the United States without the approval of the Food and Drug Administration ("FDA") and such approval has not been granted. 2) The service is the subject of a current new drug or new device application on file with the FDA. 3) The service is the trialed agent or for delivery or measurement of the trialed agent provided as part of a qualifying Phase I or Phase II clinical trial, as the experimental or research arm of a Phase III clinical trial. 4) The service is provided pursuant to a written protocol or other document that lists an evaluation of the service's safety, toxicity or efficacy as among its objectives. 5) The service is under continued scientific testing and research concerning the safety, toxicity or efficacy of services. 6) The service is provided pursuant to informed consent documents that describe the service as experimental or investigational, or in other terms that indicate that the service is being evaluated for its safety, toxicity or efficacy. 7) The prevailing opinion among experts, as expressed in the published authoritative medical or scientific literature, is that (1) the use of such service should be substantially confined to research settings, or (2) further research is necessary to determine the safety, toxicity or efficacy of the service. b. The following sources of information will be exclusively relied upon to determine whether a service iscc cc experimental or investigational: 1) The Member's medical records. 2) The written protocol(s) or other document(s) pursuant to which the service has been or will be 0 provided. 3 3) Any consent document(s) the Member or Member's representative has executed or will be asked to execute, to receive the service. 4) The files and records of the Institutional Review Board (IRB) or similar body that approves or reviews Ln research at the institution where the service has been or will be provided, and other information concerning the authority or actions of the IRB or similar body. 5) The published authoritative medical or scientific literature regarding the service, as applied to the N Member's illness or injury. 6) Regulations, records, applications and any other documents or actions issued by, filed with or taken by, i the FDA or other agencies within the United States Department of Health and Human Services, or any c state agency performing similar functions. �j Appeals regarding KFHPWA denial of coverage can be submitted to the Member Appeal Department, or to KFHPWA's medical director at P.O. Box 34593, Seattle, WA 98124-1593. 10. Hypnotherapy and all services related to hypnotherapy. 11. Directed umbilical cord blood donations. 37 C47298-0036900 Packet Pg. 102 8.G.b 12. Prognostic (predictive) genetic testing and related services, unless specifically provided in Section IV. Testing for non -Members. 13. Autopsy and associated expenses. VI. Eligibility, Enrollment and Termination A. Eligibility. In order to be accepted for enrollment and continuing coverage, individuals must reside or work in the Service Area and meet all applicable requirements set forth below, except for temporary residency outside the Service Area for purposes of attending school, court -ordered coverage for Dependents or other unique family arrangements, when approved in advance by KFHPWA. KFHPWA has the right to verify eligibility. 1. Subscribers. Bona fide employees as established and enforced by the Group shall be eligible for enrollment. Please contact the Group for more information. 2. Dependents. The Subscriber may also enroll the following: a. The Subscriber's legal spouse. b. The Subscriber's state -registered domestic partner (as required by Washington state law) or if specifically included as eligible by the Group, the Subscriber's non -state registered domestic partner State -registered domestic partners will be extended the same rights as spouses. c. Children who are under the age of 26. "Children" means the children of the Subscriber, spouse or eligible domestic partner, including adopted children, stepchildren, children for whom the Subscriber has a qualified court order to provide coverage and any other children for whom the Subscriber is the legal guardian. Eligibility may be extended past the Dependent's limiting age as set forth above if the Dependent is totally incapable of self-sustaining employment because of a developmental or physical disability p incurred prior to attainment of the limiting age, and is chiefly dependent upon the Subscriber for M support and maintenance. Enrollment for such a Dependent may be continued for the duration of the 0 continuous total incapacity, provided enrollment does not terminate for any other reason. Medical proof of incapacity and proof of financial dependency must be furnished to KFHPWA upon request, 2 but not more frequently than annually after the 2-year period following the Dependent's attainment of the limiting age. Ln N 3. Temporary Coverage for Newborns. When a Member gives birth, the newborn is entitled to the benefits set forth in the EOC from birth through 3 weeks of age. All provisions, limitations and exclusions will apply except Subsections F. and G. After 3 weeks of age, no benefits are available unless the newborn child qualifies as a Dependent and is enrolled. B. Application for Enrollment. Application for enrollment must be made on an application approved by KFHPWA. The Group is responsible for submitting completed applications to KFHPWA. KFHPWA reserves the right to refuse enrollment to any person whose coverage under any medical coverage agreement issued by Kaiser Foundation Health Plan of Washington Options, Inc. or Kaiser Foundation Health Plan of Washington has been terminated for cause. 38 C47298-0036900 Packet Pg. 103 8.G.b 1. Newly Eligible Subscribers. Newly eligible Subscribers and their Dependents may apply for enrollment in writing to the Group within 31 days of becoming eligible. 2. New Dependents. A written application for enrollment of a newly dependent person, other than a newborn or adopted child, must be made to the Group within 31 days after the dependency occurs. A written application for enrollment of a newborn child must be made to the Group within 60 days following the date of birth when there is a change in the monthly premium payment as a result of the additional Dependent. A written application for enrollment of an adoptive child must be made to the Group within 60 days from the day the child is placed with the Subscriber for the purpose of adoption or the Subscriber assumes total or partial financial support of the child if there is a change in the monthly premium payment as a result of the additional Dependent. When there is no change in the monthly premium payment, it is strongly advised that the Subscriber enroll the newborn or newly adoptive child as a Dependent with the Group to avoid delays in the payment of claims. 3. Open Enrollment. KFHPWA will allow enrollment of Subscribers and Dependents who did not enroll when newly eligible as described above during a limited period of time specified by the Group and KFHPWA. 4. Special Enrollment. a. KFHPWA will allow special enrollment for persons: 1) Who initially declined enrollment when otherwise eligible because such persons had other health care coverage and have had such other coverage terminated due to one of the following events: • Cessation of employer contributions. • Exhaustion of COBRA continuation coverage. • Loss of eligibility, except for loss of eligibility for cause; or 2) Who initially declined enrollment when otherwise eligible because such persons had other health care coverage and who have had such other coverage exhausted because such person reached a lifetime maximum limit. KFHPWA or the Group may require confirmation that when initially offered coverage such persons submitted a written statement declining because of other coverage. Application for coverage must be made within 31 days of the termination of previous coverage. b. KFHPWA will allow special enrollment for individuals who are eligible to be a Subscriber and their Dependents (other than for nonpayment or fraud) in the event one of the following occurs: 1) Divorce or Legal Separation. Application for coverage must be made within 60 days of the divorce/separation. 2) Cessation of Dependent status (reaches maximum age). Application for coverage must be made within 30 days of the cessation of Dependent status. 3) Death of an employee under whose coverage they were a Dependent. Application for coverage must be made within 30 days of the death of an employee. 4) Termination or reduction in the number of hours worked. Application for coverage must be made within 30 days of the termination or reduction in number of hours worked. 5) Leaving the service area of a former plan. Application for coverage must be made within 30 days of leaving the service area of a former plan. 6) Discontinuation of a former plan. Application for coverage must be made within 30 days of the discontinuation of a former plan. 39 C47298-0036900 Packet Pg. 104 8.G.b KFHPWA will allow special enrollment for individuals who are eligible to be a Subscriber and their Dependents in the event one of the following occurs: 1) Marriage. Application for coverage must be made within 31 days of the date of marriage. 2) Birth. Application for coverage for the Subscriber and Dependents other than the newborn child must be made within 60 days of the date of birth. 3) Adoption or placement for adoption. Application for coverage for the Subscriber and Dependents other than the adopted child must be made within 60 days of the adoption or placement for adoption. 4) Eligibility for premium assistance from Medicaid or a state Children's Health Insurance Program (CHIP), provided such person is otherwise eligible for coverage under this EOC. The request for special enrollment must be made within 60 days of eligibility for such premium assistance. 5) Coverage under a Medicaid or CHIP plan is terminated as a result of loss of eligibility for such coverage. Application for coverage must be made within 60 days of the date of termination under Medicaid or CHIP. 6) Applicable federal or state law or regulation otherwise provides for special enrollment. C. When Coverage Begins. 1. Effective Date of Enrollment. • Enrollment for a newly eligible Subscriber and listed Dependents is effective on the date eligibility requirements are met, provided the Subscriber's application has been submitted to and approved by KFHPWA. Please contact the Group for more information. • Enrollment for a newly dependent person, other than a newborn or adoptive child, is effective on the date eligibility requirements are met. Please contact the Group for more information. • Enrollment for newborns is effective from the date of birth. • Enrollment for adoptive children is effective from the date that the adoptive child is placed with the Subscriber for the purpose of adoption or the Subscriber assumes total or partial financial support of the child. 2. Commencement of Benefits for Persons Hospitalized on Effective Date. r_ 0 Members who are admitted to an inpatient facility prior to their enrollment will receive covered benefits 0 beginning on their effective date, as set forth in Subsection C.1. above. If a Member is hospitalized in a > non -Network Facility, KFHPWA reserves the right to require transfer of the Member to a Network Facility. The Member will be transferred when a Network Provider, in consultation with the attending physician, determines that the Member is medically stable to do so. If the Member refuses to transfer to a Network p Facility, all further costs incurred during the hospitalization are the responsibility of the Member. D. Eligibility for Medicare. d An individual shall be deemed eligible for Medicare when they have the option to receive Part A Medicare benefits. Medicare secondary payer regulations and guidelines will determine primary/secondary payer status for individuals covered by Medicare. N A Member who is enrolled in Medicare has the option of continuing coverage under this EOC while on N Medicare coverage. Coverage between this EOC and Medicare will be coordinated as outlined in Section IX. N The Group is also responsible for providing KFHPWA with a prospective timely notice of Members' ineligibility for Medicare Advantage coverage under the Group, as well as providing a prospective notice to its Members alerting them of the termination event. In the event the Group does not obtain Medicare Advantage coverage, the loss of Medicare drug coverage, other coverage options that may be available to the Member, and the possibility of late enrollment penalties if the Member does not apply for Medicare coverage within the required timeframe will also need to be provided. E. Termination of Coverage. The Subscriber shall be liable for payment of all charges for services and items provided to the Subscriber and all Dependents after the effective date of termination. 40 C47298-0036900 Packet Pg. 105 8.G.b Termination of Specific Members. Individual Member coverage may be terminated for any of the following reasons: a. Loss of Eligibility. If a Member no longer meets the eligibility requirements and is not enrolled for continuation coverage as described in Subsection G. below, coverage will terminate at the end of the month during which the loss of eligibility occurs, unless otherwise specified by the Group. b. For Cause. In the event of termination for cause, KFHPWA reserves the right to pursue all civil remedies allowable under federal and state law for the collection of claims, losses or other damages. Coverage of a Member may be terminated upon 10 working days written notice for: 1.) Material misrepresentation, fraud or omission of information in order to obtain coverage. 2.) Permitting the use of a KFHPWA identification card or number by another person or using another Member's identification card or number to obtain care to which a person is not entitled. c. Premium Payments. Nonpayment of premiums or contribution for a specific Member by the Group. Individual Member coverage may be retroactively terminated upon 30 days written notice and only in the case of fraud or intentional misrepresentation of a material fact; or as otherwise allowed under applicable law or regulation. Notwithstanding the foregoing, KFHPWA reserves the right to retroactively terminate coverage for nonpayment of premiums or contributions by the Group as described above. In no event will a Member be terminated solely on the basis of their physical or mental condition provided they meet all other eligibility requirements set forth in the EOC. Any Member may appeal a termination decision through KFHPWA's appeals process. F. Continuation of Inpatient Services. A Member who is receiving Covered Services in a hospital on the date of termination shall continue to be eligible for Covered Services while an inpatient for the condition which the Member was hospitalized, until one of the following events occurs: • According to KFHPWA clinical criteria, it is no longer Medically Necessary for the Member to be an > inpatient at the facility. • The remaining benefits available for the hospitalization are exhausted, regardless of whether a new calendar year begins. • The Member becomes covered under another agreement with a group health plan that provides benefits for M the hospitalization. .0 • The Member becomes enrolled under an agreement with another carrier that provides benefits for the hospitalization. This provision will not apply if the Member is covered under another agreement that provides benefits for the ti N hospitalization at the time coverage would terminate, except as set forth in this section, or if the Member is .. V- eligible for COBRA continuation coverage as set forth in Subsection G. below. 04 G. Continuation of Coverage Options. 1. Continuation Option. A Member no longer eligible for coverage (except in the event of termination for cause, as set forth in Subsection E.) may continue coverage for a period of up to 3 months subject to notification to and self - payment of premiums to the Group. This provision will not apply if the Member is eligible for the continuation coverage provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). This continuation option is not available if the Group no longer has active employees or otherwise terminates. 41 C47298-0036900 Packet Pg. 106 8.G.b 2. Leave of Absence. While on a Group approved leave of absence, the Subscriber and listed Dependents can continue to be covered provided that: • They remain eligible for coverage, as set forth in Subsection A., • Such leave is in compliance with the Group's established leave of absence policy that is consistently applied to all employees, • The Group's leave of absence policy is in compliance with the Family and Medical Leave Act when applicable, and • The Group continues to remit premiums for the Subscriber and Dependents to KFHPWA. 3. Self -Payments During Labor Disputes. In the event of suspension or termination of employee compensation due to a strike, lock -out or other labor dispute, a Subscriber may continue uninterrupted coverage through payment of monthly premiums directly to the Group. Coverage may be continued for the lesser of the term of the strike, lock -out or other labor dispute, or for 6 months after the cessation of work. If coverage under the EOC is no longer available, the Subscriber shall have the opportunity to apply for an individual KFHPWA group conversion plan or, if applicable, continuation coverage (see Subsection 4. below), or an individual and family plan at the duly approved rates. The Group is responsible for immediately notifying each affected Subscriber of their rights of self -payment under this provision. 4. Continuation Coverage Under Federal Law. This section applies only to Groups who must offer continuation coverage under the applicable provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended, or the Uniformed Services Employment and Reemployment Rights Act (USERRA) and only applies to grant continuation of coverage rights to the extent required by federal law. USERRA only applies in certain situations to employees who are leaving employment to serve in the United States Armed Forces. Upon loss of eligibility, continuation of Group coverage may be available to a Member for a limited time after the Member would otherwise lose eligibility, if required by COBRA. The Group shall inform Members of the COBRA election process and how much the Member will be required to pay directly to the Group. Continuation coverage under COBRA or USERRA will terminate when a Member becomes covered by Medicare or obtains other group coverage, and as set forth under Subsection E. 5. KFHPWA Group Conversion Plan. Members whose eligibility for coverage, including continuation coverage, is terminated for any reason other than cause, as set forth in Subsection E., and who are not eligible for Medicare or covered by another group health plan, may convert to an individual KFHPWA group conversion plan. If coverage under the EOC terminates, any Member covered at termination (including spouses and Dependents of a Subscriber who was terminated for cause) may convert to a KFHPWA group conversion plan. Coverage will be retroactive to the date of loss of eligibility. An application for conversion must be made within 31 days following termination of coverage or within 31 days from the date notice of the termination of coverage is received, whichever is later. A physical examination or statement of health is not required for enrollment in a KFHPWA group conversion plan. Persons wishing to purchase KFHPWA's individual and family coverage should contact KFHPWA. VII. Grievances 42 C47298-0036900 Packet Pg. 107 8.G.b Grievance means a written or verbal complaint submitted by or on behalf of a covered person regarding service delivery issues other than denial of payment for medical services or non -provision of medical services, including dissatisfaction with medical care, waiting time for medical services, provider or staff attitude or demeanor, or dissatisfaction with service provided by the health carrier. The grievance process is outlined as follows: Step 1: It is recommended that the Member contact the person involved or the manager of the medical center/department where they are having a problem, explain their concerns and what they would like to have done to resolve the problem. The Member should be specific and make their position clear. Most concerns can be resolved in this way. Step 2: If the Member is still not satisfied, they should call or write to Member Services at PO Box 34590, Seattle, WA 98124-1590.206-630-4636 or toll -free 1-888-901-4636. Most concerns are handled by phone within a few days. In some cases, the Member will be asked to write down their concerns and state what they think would be a fair resolution to the problem. An appropriate representative will investigate the Member's concern by consulting with involved staff and their supervisors, and reviewing pertinent records, relevant plan policies and the Member Rights and Responsibilities statement. This process can take up to 30 days to resolve after receipt of the Member's written or verbal statement. If the Member is dissatisfied with the resolution of the complaint, they may contact Member Services. Assistance is available to Members who are limited -English speakers, who have literacy problems, or who have physical or mental disabilities that impede their ability to request review or participate in the review process. VIII. Members are entitled to appeal through the appeals process if/when coverage for an item or service is denied due to an adverse determination made by the KFHPWA medical director. The appeals process is available for a J Member to seek reconsideration of an adverse benefit determination (action). Adverse benefit determination M (action) means any of the following: a denial, reduction, or termination of, or a failure to provide or make C M payment (in whole or in part) for, a benefit, including any such denial, reduction, termination, or failure to provide or make payment that is based on a determination of a Member's eligibility to participate in a plan, and including, a denial, reduction, or termination of, or a failure to provide or make payment, in whole or in part, for a benefit resulting from the application of any utilization review, as well as a failure to cover an item or service .N for which benefits are otherwise provided because it is determined to be experimental or investigational or not > Medically Necessary or appropriate. KFHPWA will comply with any new requirements as necessary under federal laws and regulations. Assistance is available to Members who are limited -English speakers, who have c literacy problems, or who have physical or mental disabilities that impede their ability to request review or participate in the review process. The most current information about your appeals process is available by contacting KFHPWA's Member Appeal Department at the address or telephone number below. �a d 1. Initial Appeal 2 If the Member or any representative authorized in writing by the Member wishes to appeal a KFHPWA decision to deny, modify, reduce or terminate coverage of or payment for health care services, they must Ln submit a request for an appeal either orally or in writing to KFHPWA's Member Appeal Department, specifying why they disagree with the decision. The appeal must be submitted within 180 days from the N date of the initial denial notice. KFHPWA will notify the Member of its receipt of the request within 72 N hours of receiving it. Appeals should be directed to KFHPWA's Member Appeal Department, P.O. Box 34593, Seattle, WA 98124-1593, toll -free 1-866-458-5479. P A party not involved in the initial coverage determination and not a subordinate of the party making the initial coverage determination will review the appeal request. KFHPWA will then notify the Member of its determination or need for an extension of time within 14 days of receiving the request for appeal. Under no circumstances will the review timeframe exceed 30 days without the Member's written permission. For appeals involving experimental or investigational services KFHPWA will make a decision and communicate the decision to the Member in writing within 20 days of receipt of the appeal. 43 C47298-0036900 Packet Pg. 108 8.G.b There is an expedited/urgent appeals process in place for cases which meet criteria or where delay using the standard appeal review process will seriously jeopardize the Member's life, health or ability to regain maximum function or subject the Member to severe pain that cannot be managed adequately without the requested care or treatment. The Member can request an expedited/urgent appeal in writing to the above address, or by calling KFHPWA's Member Appeal Department toll -free 1-866-458-5479. The nature of the patient's condition will be evaluated by a physician and if the request is not accepted as urgent, the member will be notified in writing of the decision not to expedite and given a description on how to grieve the decision. If the request is made by the treating physician who believes the member's condition meets the definition of expedited, the request will be processed as expedited. The request for an expedited/urgent appeal will be processed and a decision issued no later than 72 hours after receipt of the request. The Member may also request an external review at the same time as the internal appeals process if it is an urgent care situation or the Member is in an ongoing course of treatment. If the Member requests an appeal of a KFHPWA decision denying benefits for care currently being received, KFHPWA will continue to provide coverage for the disputed benefit pending the outcome of the appeal. If the KFHPWA determination stands, the Member may be responsible for the cost of coverage received during the review period. The U.S. Department of Health and Human Services has designated the Washington State Office of the Insurance Commissioner's Consumer Protection Division as the health insurance consumer ombudsman. The Consumer Protection Division Office can be reached by mail at Washington State Insurance Commissioner, Consumer Protection Division, P.O. Box 40256, Olympia, WA 98504-0256 or at toll -free 1-800-562-6900. More information about requesting assistance from the Consumer Protection Division Office can be found at http://www.insurance.wa. og_v/your-insurance/health-insurance/appeal/. 2. Next Level of Appeal If the Member is not satisfied with the decision regarding medical necessity, medical appropriateness, health care setting, level of care, or if the requested service is not efficacious or otherwise unjustified under c evidence -based medical criteria, or if KFHPWA fails to adhere to the requirements of the appeals process, o A the Member may request a second level review by an external independent review organization not legally > affiliated with or controlled by KFHPWA. KFHPWA will notify the Member of the name of the external independent review organization and its contact information. The external independent review organization c will accept additional written information for up to five business days after it receives the assignment for the appeal. The external independent review will be conducted at no cost to the Member. Once a decision is made through an independent review organization, the decision is final and cannot be appealed through 0 KFHPWA. d If the Member requests an appeal of a KFHPWA decision denying benefits for care currently being received, KFHPWA will continue to provide coverage for the disputed benefit pending the outcome of the Ln appeal. If the KFHPWA determination stands, the Member may be responsible for the cost of coverage received during the review period. A request for a review by an independent review organization must be made within 180 days after the date of the initial appeal decision notice. IX. Claims Claims for benefits may be made before or after services are obtained. KFHPWA recommends that the provider requests Preauthorization. In most instances, contracted providers submit claims directly to KFHPWA. If your provider does not submit a claim to make a claim for benefits, a Member must contact Member Services, or submit a claim for reimbursement as described below. Other inquiries, such as asking a health care provider about care or coverage, or submitting a prescription to a pharmacy, will not be considered a claim for benefits. 44 C47298-0036900 Packet Pg. 109 8.G.b If a Member receives a bill for services the Member believes are covered, the Member must, within 90 days of the date of service, or as soon thereafter as reasonably possible, either (1) contact Member Services to make a claim or (2) pay the bill and submit a claim for reimbursement of Covered Services, or (3) for out -of -country claims (Emergency care only) — submit the claim and any associated medical records, including the type of service, charges, and proof of travel to KFHPWA, P.O. Box 30766, Salt Lake City, UT 84130-0766. In no event, except in the absence of legal capacity, shall a claim be accepted later than 1 year from the date of service. KFHPWA will generally process claims for benefits within the following timeframes after KFHPWA receives the claims: • Immediate request situations — within 1 business day. • Concurrent urgent requests — within 24 hours. • Urgent care review requests — within 48 hours. • Non -urgent preservice review requests — within 5 calendar days. • Post -service review requests — within 30 calendar days. Timeframes for pre -service and post -service claims can be extended by KFHPWA for up to an additional 15 days. Members will be notified in writing of such extension prior to the expiration of the initial timeframe. X. Coordination of Benefits The coordination of benefits (COB) provision applies when a Member has health care coverage under more than one plan. Plan is defined below. The order of benefit determination rules govern the order in which each plan will pay a claim for benefits. The plan that pays first is called the primary plan. The primary plan must pay benefits according to its policy terms without regard to the possibility that another plan may cover some expenses. The plan that pays after the primary plan is the secondary plan. In no event will a secondary plan be required to pay an amount in excess of its maximum benefit plus accrued savings. If the Member is covered by more than one health benefit plan, and the Member does not know which is the primary plan, the Member or the Member's provider should contact any one of the health plans to verify which plan is d 0 primary. The health plan the Member contacts is responsible for working with the other plan to determine which is 0 primary and will let the Member know within 30 calendar days. > cc All health plans have timely claim filing requirements. If the Member or the Member's provider fails to submit the Member's claim to a secondary health plan within that plan's claim filing time limit, the plan can deny the claim. If the Member experiences delays in the processing of the claim by the primary health plan, the Member or the Member's provider will need to submit the claim to the secondary health plan within its claim filing time limit to 0 13 prevent a denial of the claim. If the Member is covered by more than one health benefit plan, the Member or the Member's provider should file all ti the Member's claims with each plan at the same time. If Medicare is the Member's primary plan, Medicare may Ln N submit the Member's claims to the Member's secondary carrier. Definitions. A. A plan is any of the following that provides benefits or services for medical or dental care or treatment. If separate contracts are used to provide coordinated coverage for Members of a Group, the separate contracts are considered parts of the same plan and there is no COB among those separate contracts. However, if COB rules do not apply to all contracts, or to all benefits in the same contract, the contract or benefit to which COB does not apply is treated as a separate plan. 1. Plan includes: group, individual or blanket disability insurance contracts and group or individual contracts issued by health care service contractors or health maintenance organizations (HMO), closed panel plans or other forms of group coverage; medical care components of long-term care contracts, 45 C47298-0036900 Packet Pg. 110 8.G.b such as skilled nursing care; and Medicare or any other federal governmental plan, as permitted by law. 2. Plan does not include: hospital indemnity or fixed payment coverage or other fixed indemnity or fixed payment coverage; accident only coverage; specified disease or specified accident coverage; limited benefit health coverage, as defined by state law; school accident type coverage; benefits for non- medical components of long-term care policies; automobile insurance policies required by statute to provide medical benefits; Medicare supplement policies; Medicaid coverage; or coverage under other federal governmental plans; unless permitted by law. Each contract for coverage under Subsection 1. or 2. is a separate plan. If a plan has two parts and COB rules apply only to one of the two, each of the parts is treated as a separate plan. B. This plan means, in a COB provision, the part of the contract providing the health care benefits to which the COB provision applies and which may be reduced because of the benefits of other plans. Any other part of the contract providing health care benefits is separate from this plan. A contract may apply one COB provision to certain benefits, such as dental benefits, coordinating only with similar benefits, and may apply another COB provision to coordinate other benefits. C. The order of benefit determination rules determine whether this plan is a primary plan or secondary plan when the Member has health care coverage under more than one plan. When this plan is primary, it determines payment for its benefits first before those of any other plan without considering any other plan's benefits. When this plan is secondary, it determines its benefits after those of another plan and must make payment in an amount so that, when combined with the amount paid by the primary plan, the total benefits paid or provided by all plans for the claim equal 100% of the total allowable expense for that claim. This means that when this plan is secondary, it must pay the amount which, when combined with what the primary plan paid, totals 100% of the allowable expense. In addition, if this plan is secondary, it must calculate its savings (its amount paid subtracted from the amount it would have paid had it been the primary plan) and record these savings as a benefit reserve for the covered Member. This reserve must be used by the secondary plan to pay any allowable expenses not otherwise paid, that are incurred by the covered person during the claim determination period. D. Allowable Expense. Allowable expense is a health care expense, coinsurance or copayments and without reduction for any applicable deductible, that is covered at least in part by any plan covering the person. When a plan provides benefits in the form of services, the reasonable cash value of each service will be considered an allowable expense and a benefit paid. An expense that is not covered by any plan covering the Member is not an allowable expense. �0 a d The following are examples of expenses that are not allowable expenses: 1. The difference between the cost of a semi -private hospital room and a private hospital room is not an Ln allowable expense, unless one of the plans provides coverage for private hospital room expenses. N 2. If a Member is covered by two or more plans that compute their benefit payments on the basis of usual and customary fees or relative value schedule reimbursement method or other similar reimbursement method, any amount in excess of the highest reimbursement amount for a specific benefit is not an allowable expense. 3. If a Member is covered by two or more plans that provide benefits or services on the basis of negotiated fees, an amount in excess of the highest of the negotiated fees is not an allowable expense. 4. An expense or a portion of an expense that is not covered by any of the plans covering the person is not an allowable expense. 46 C47298-0036900 Packet Pg. 111 8.G.b E. Closed panel plan is a plan that provides health care benefits to covered persons in the form of services through a panel of providers who are primarily employed by the plan, and that excludes coverage for services provided by other providers, except in cases of Emergency or referral by a panel member. F. Custodial parent is the parent awarded custody by a court decree or, in the absence of a court decree, is the parent with whom the child resides more than one half of the calendar year excluding any temporary visitation. Order of Benefit Determination Rules. When a Member is covered by two or more plans, the rules for determining the order of benefit payments are as follows: A. The primary plan pays or provides its benefits according to its terms of coverage and without regard to the benefits under any other plan. B. (1) Except as provided below (subsection 2), a plan that does not contain a coordination of benefits provision that is consistent with this chapter is always primary unless the provisions of both plans state that the complying plan is primary. (2) Coverage that is obtained by virtue of membership in a Group that is designed to supplement a part of a basic package of benefits and provides that this supplementary coverage is excess to any other parts of the plan provided by the contract holder. Examples include major medical coverages that are superimposed over hospital and surgical benefits, and insurance type coverages that are written in connection with a closed panel plan to provide out -of -network benefits. C. A plan may consider the benefits paid or provided by another plan in calculating payment of its benefits only when it is secondary to that other plan. D. Each plan determines its order of benefits using the first of the following rules that apply: 1. Non -Dependent or Dependent. The plan that covers the Member other than as a Dependent, for d example as an employee, member, policyholder, Subscriber or retiree is the primary plan and the plan o A that covers the Member as a Dependent is the secondary plan. However, if the person is a Medicare > beneficiary and, as a result of federal law, Medicare is secondary to the plan covering the Member as a Dependent, and primary to the plan covering the Member as other than a Dependent (e.g., a retired employee), then the order of benefits between the two plans is reversed so that the plan covering the Member as an employee, member, policyholder, Subscriber or retiree is the secondary plan and the other plan is the primary plan. �0 a d 2. Dependent child covered under more than one plan. Unless there is a court decree stating otherwise, 2 when a dependent child is covered by more than one plan the order of benefits is determined as follows: ti Ln a) For a dependent child whose parents are married or are living together, whether or not they have ever been married: • The plan of the parent whose birthday falls earlier in the calendar year is the primary plan; or N • If both parents have the same birthday, the plan that has covered the parent the longest is the primary plan. b) For a dependent child whose parents are divorced or separated or not living together, whether or o not they have ever been married: V i. If a court decree states that one of the parents is responsible for the dependent child's health care expenses or health care coverage and the plan of that parent has actual knowledge of y those terms, that plan is primary. This rule applies to claim determination periods Y commencing after the plan is given notice of the court decree; ii. If a court decree states one parent is to assume primary financial responsibility for the dependent child but does not mention responsibility for health care expenses, the plan of the parent assuming financial responsibility is primary; 47 C47298-0036900 Packet Pg. 112 8.G.b iii. If a court decree states that both parents are responsible for the dependent child's health care expenses or health care coverage, the provisions of a) above determine the order of benefits; iv. If a court decree states that the parents have joint custody without specifying that one parent has responsibility for the health care expenses or health care coverage of the dependent child, the provisions of Subsection a) above determine the order of benefits; or v. If there is no court decree allocating responsibility for the dependent child's health care expenses or health care coverage, the order of benefits for the child are as follows: • The plan covering the custodial parent, first; • The plan covering the spouse of the custodial parent, second; • The plan covering the non -custodial parent, third; and then • The plan covering the spouse of the non -custodial parent, last. c) For a dependent child covered under more than one plan of individuals who are not the parents of the child, the provisions of Subsection a) or b) above determine the order of benefits as if those individuals were the parents of the child. Active employee or retired or laid -off employee. The plan that covers a Member as an active employee, that is, an employee who is neither laid off nor retired, is the primary plan. The plan covering that same Member as a retired or laid off employee is the secondary plan. The same would hold true if a Member is a Dependent of an active employee and that same Member is a Dependent of a retired or laid -off employee. If the other plan does not have this rule, and as a result, the plans do not agree on the order of benefits, this rule is ignored. This rule does not apply if the rule under Section D.1. can determine the order of benefits. 4. COBRA or State Continuation Coverage. If a Member whose coverage is provided under COBRA or under a right of continuation provided by state or other federal law is covered under another plan, the plan covering the Member as an employee, member, Subscriber or retiree or covering the Member as a Dependent of an employee, member, Subscriber or retiree is the primary plan and the COBRA or state or other federal continuation coverage is the secondary plan. If the other plan does not have this rule, and as a result, the plans do not agree on the order of benefits, this rule is ignored. This rule does not apply if the rule under Section D.1 can determine the order of benefits. 5. Longer or shorter length of coverage. The plan that covered the Member as an employee, member, Subscriber or retiree longer is the primary plan and the plan that covered the Member the shorter period of time is the secondary plan. 6. If the preceding rules do not determine the order of benefits, the allowable expenses must be shared equally between the plans meeting the definition of plan. In addition, this plan will not pay more than it would have paid had it been the primary plan. Effect on the Benefits of this Plan. When this plan is secondary, it must make payment in an amount so that, when combined with the amount paid by the primary plan, the total benefits paid or provided by all plans for the claim equal one hundred percent of the total allowable expense for that claim. However, in no event shall the secondary plan be required to pay an amount in excess of its maximum benefit plus accrued savings. In no event should the Member be responsible for a deductible amount greater than the highest of the two deductibles. Right to Receive and Release Needed Information. Certain facts about health care coverage and services are needed to apply these COB rules and to determine benefits payable under this plan and other plans. KFHPWA may get the facts it needs from or give them to other organizations or persons for the purpose of applying these rules and determining benefits payable under this plan and other plans covering the Member claiming benefits. KFHPWA need not tell, or get the consent of, any Member to do this. Each Member claiming benefits under this plan must give KFHPWA any facts it needs to apply those rules and determine benefits payable. 48 C47298-0036900 Packet Pg. 113 8.G.b Facility of Payment. If payments that should have been made under this plan are made by another plan, KFHPWA has the right, at its discretion, to remit to the other plan the amount it determines appropriate to satisfy the intent of this provision. The amounts paid to the other plan are considered benefits paid under this plan. To the extent of such payments, KFHPWA is fully discharged from liability under this plan. Right of Recovery. KFHPWA has the right to recover excess payment whenever it has paid allowable expenses in excess of the maximum amount of payment necessary to satisfy the intent of this provision. KFHPWA may recover excess payment from any person to whom or for whom payment was made or any other issuers or plans. Questions about Coordination of Benefits? Contact the State Insurance Department. Effect of Medicare. Medicare primary/secondary payer guidelines and regulations will determine primary/secondary payer status, and will be adjudicated by KFHPWA as set forth in this section. KFHPWA will pay primary to Medicare when required by federal law. When Medicare, Part A and Part B or Part C are primary, Medicare's allowable amount is the highest allowable expense. When a Network Provider renders care to a Member who is eligible for Medicare benefits, and Medicare is deemed to be the primary bill payer under Medicare secondary payer guidelines and regulations, KFHPWA will seek Medicare reimbursement for all Medicare covered services. �XI. Subrogation and Reimbursement Rights The benefits under this EOC will be available to a Member for injury or illness caused by another party, subject to the exclusions and limitations of this EOC. If KFHPWA provides benefits under this EOC for the treatment of the injury or illness, KFHPWA will be subrogated to any rights that the Member may have to recover compensation or damages related to the injury or illness and the Member shall reimburse KFHPWA for all benefits provided, from any amounts the Member received or is entitled to receive from any source on account of such injury or illness, whether by suit, settlement or otherwise, including but not limited to: • Payments made by a third party or any insurance company on behalf of the third party; • Any payments or awards under an uninsured or underinsured motorist coverage policy; • Any Workers' Compensation or disability award or settlement; • Medical payments coverage under any automobile policy, premises or homeowners' medical payments coverage or premises or homeowners' insurance coverage; and • Any other payments from a source intended to compensate an Injured Person for injuries resulting from an accident or alleged negligence. This section more fully describes KFHPWA's subrogation and reimbursement rights. "Injured Person" under this section means a Member covered by the EOC who sustains an injury or illness and any spouse, dependent or other person or entity that may recover on behalf of such Member including the estate of the Member and, if the Member is a minor, the guardian or parent of the Member. When referred to in this section, " KFHPWA's Medical Expenses" means the expenses incurred and the value of the benefits provided by KFHPWA under this EOC for the care or treatment of the injury or illness sustained by the Injured Person. If the Injured Person's injuries were caused by a third party giving rise to a claim of legal liability against the third party and/or payment by the third party to the Injured Person and/or a settlement between the third party and the Injured Person, KFHPWA shall have the right to recover KFHPWA's Medical Expenses from any source available to the Injured Person as a result of the events causing the injury. This right is commonly referred to as "subrogation." KFHPWA shall be subrogated to and may enforce all rights of the Injured Person to the full extent of KFHPWA's Medical Expenses. By accepting benefits under this plan, the Injured Person also specifically acknowledges KFHPWA's right of reimbursement. This right of reimbursement attaches when this KFHPWA has provided benefits for injuries or 49 C47298-0036900 Packet Pg. 114 8.G.b illnesses caused by another party and the Injured Person or the Injured Person's representative has recovered any amounts from a third party or any other source of recovery. KFHPWA's right of reimbursement is cumulative with and not exclusive of its subrogation right and KFHPWA may choose to exercise either or both rights of recovery. In order to secure KFHPWA's recovery rights, the Injured Person agrees to assign KFHPWA any benefits or claims or rights of recovery they may have under any automobile policy or other coverage, to the full extent of the plan's subrogation and reimbursement claims. This assignment allows KFHPWA to pursue any claim the Injured Person may have, whether or not they choose to pursue the claim. KFHPWA's subrogation and reimbursement rights shall be limited to the excess of the amount required to fully compensate the Injured Person for the loss sustained, including general damages. Subject to the above provisions, if the Injured Person is entitled to or does receive money from any source as a result of the events causing the injury or illness, including but not limited to any liability insurance or uninsured/underinsured motorist funds, KFHPWA's Medical Expenses are secondary, not primary. The Injured Person and their agents shall cooperate fully with KFHPWA in its efforts to collect KFHPWA's Medical Expenses. This cooperation includes, but is not limited to, supplying KFHPWA with information about the cause of injury or illness, any potentially liable third parties, defendants and/or insurers related to the Injured Person's claim. The Injured Person shall notify KFHPWA within 30 days of any claim that may give rise to a claim for subrogation or reimbursement. The Injured Person shall provide periodic updates about any facts that may impact KFHPWA's right to reimbursement or subrogation as requested by KFHPWA, and shall inform KFHPWA of any settlement or other payments relating to the Injured Person's injury. The Injured Person and their agents shall permit KFHPWA, at KFHPWA's option, to associate with the Injured Person or to intervene in any legal, quasi -legal, agency or any other action or claim filed. The Injured Person and their agents shall do nothing to prejudice KFHPWA's subrogation and reimbursement rights. The Injured Person shall promptly notify KFHPWA of any tentative settlement with a third party and shall C M not settle a claim without protecting KFHPWA's interest. The Injured Person shall provide 21 days advance notice to KFHPWA before there is a disbursement of proceeds from any settlement with a third party that may give rise to .2 a claim for subrogation or reimbursement. If the Injured Person fails to cooperate fully with KFHPWA in recovery c of KFHPWA's Medical Expenses, and such failure prejudices KFHPWA's subrogation and/or reimbursement o A rights, the Injured Person shall be responsible for directly reimbursing KFHPWA for 100% of KFHPWA's Medical > Expenses. To the extent that the Injured Person recovers funds from any source that in any manner relate to the injury or illness c giving rise to KFHPWA's right of reimbursement or subrogation, the Injured Person agrees to hold such monies in trust or in a separate identifiable account until KFHPWA's subrogation and reimbursement rights are fully 0 determined and that KFHPWA has an equitable lien over such monies to the full extent of KFHPWA's Medical 3 Expenses and/or the Injured Person agrees to serve as constructive trustee over the monies to the extent of KFHPWA's Medical Expenses. In the event that such monies are not so held, the funds are recoverable even if they have been comingled with other assets, without the need to trace the source of the funds. Any party who distributes LO funds without regard to KFHPWA's rights of subrogation or reimbursement will be personally liable to KFHPWA N for the amounts so distributed. If reasonable collections costs have been incurred by an attorney for the Injured Person in connection with obtaining recovery, KFHPWA will reduce the amount of reimbursement to KFHPWA by the amount of an equitable apportionment of such collection costs between KFHPWA and the Injured Person. This reduction will be made only if each of the following conditions has been met: (i) KFHPWA receives a list of the fees and associated costs before settlement and (ii) the Injured Person's attorney's actions were directly related to securing recovery for the Injured Party. To the extent the provisions of this Subrogation and Reimbursement section are deemed governed by ERISA, implementation of this section shall be deemed a part of claims administration and KFHPWA shall therefore have discretion to interpret its terms. 50 C47298-0036900 Packet Pg. 115 8.G.b XII.Definitions Allowance The maximum amount payable by KFHPWA for certain Covered Services. Allowed Amount The level of benefits which are payable by KFHPWA when expenses are incurred from a non -Network Provider. Expenses are considered an Allowed Amount if the charges are consistent with those normally charged to others by the provider or organization for the same services or supplies; and the charges are within the general range of charges made by other providers in the same geographical area for the same services or supplies. Members shall be required to pay any difference between a non -Network Provider's charge for services and the Allowed Amount, except for Emergency services or services provided by a non -Network provider at a Network Facility. Convalescent Care Care furnished for the purpose of meeting non -medically necessary personal needs which could be provided by persons without professional skills or training, such as assistance in walking, dressing, bathing, eating, preparation of special diets, and taking medication. Copayment The specific dollar amount a Member is required to pay at the time of service for certain Covered Services. Cost Share The portion of the cost of Covered Services for which the Member is liable. Cost Share includes Copayments, coinsurances and Deductibles. Covered Services The services for which a Member is entitled to coverage in the Evidence of Coverage. Creditable Coverage Coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard Medicare prescription drug coverage, as demonstrated through the use of generally accepted actuarial principles and in accordance with CMS actuarial guidelines. In general, the actuarial determination measures whether the expected amount of paid claims under KFHPWA's prescription drug coverage is at least as much as the expected amount of paid claims under the standard Medicare prescription drug benefit. Deductible A specific amount a Member is required to pay for certain Covered Services before benefits are payable. Dependent Any member of a Subscriber's family who meets all applicable eligibility requirements, is enrolled hereunder and for whom the premium has been paid. Emergency The emergent and acute onset of a medical, mental health or substance use disorder symptom or symptoms, including but not limited to severe pain or emotional distress, that would lead a prudent layperson acting reasonably to believe that a health condition exists that requires immediate medical attention, if failure to provide medical attention would result in serious impairment to bodily function or serious dysfunction of a bodily organ or part, or would place the Member's health, or if the Member is pregnant, the health of the unborn child, in serious jeopardy, or any other situations which would be considered an emergency under applicable federal or state law. Essential Health Benefits set forth under the Patient Protection and Affordable Care Act of 2010, Benefits including the categories of ambulatory patient services, Emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services 51 C47298-0036900 Packet Pg. 116 8.G.b and chronic disease management and pediatric services, including oral and vision care. Evidence of Coverage The Evidence of Coverage is a statement of benefits, exclusions and other provisions as set forth in the Group Medical Coverage Agreement between KFHPWA and the Group. Family Unit A Subscriber and all their Dependents. Group An employer, union, welfare trust or bona -fide association which has entered into a Group Medical Coverage Agreement with KFHPWA. Hospital Care Those Medically Necessary services generally provided by acute general hospitals for admitted patients. KFHPWA-designated A specialist specifically identified by KFHPWA. Specialist Medical Condition A disease, illness or injury. Medically Necessary Pre -service, concurrent or post -service reviews may be conducted. Once a service has been reviewed, additional reviews may be conducted. Members will be notified in writing when a determination has been made. Appropriate and clinically necessary services, as determined by KFHPWA's medical director according to generally accepted principles of good medical practice, which are rendered to a Member for the diagnosis, care or treatment of a Medical Condition and which meet the standards set forth below. In order to be Medically Necessary, services and supplies must meet the following requirements: (a) are not solely for the convenience of the Member, their family member or the provider of the services or supplies; (b) are the most appropriate level of service or supply which can be safely provided to the Member; (c) are for the diagnosis or treatment of an actual or existing Medical Condition unless being provided under KFHPWA's schedule for preventive services; (d) are not for recreational, life -enhancing, relaxation or palliative therapy, except for treatment of terminal conditions; (e) are appropriate and consistent with the diagnosis and which, in accordance with accepted medical standards in the State of Washington, could not have been omitted without adversely affecting the Member's condition or the quality of health services rendered; (f) as to inpatient care, could not have been provided in a provider's office, the outpatient department of a hospital or a non-residential facility without affecting the Member's condition or quality of health services rendered; (g) are not primarily for research and data accumulation; and (h) are not experimental or investigational. The length and type of the treatment program and the frequency and modality of visits covered shall be determined by KFHPWA's medical director. In addition to being medically necessary, to be covered, services and supplies must be otherwise included as a Covered Service and not excluded from coverage. Medicare The federal health insurance program for people who are age 65 or older, certain younger people with disabilities, and people with End -Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD). Member Any enrolled Subscriber or Dependent. Network Facility A facility (hospital, medical center or health care center) owned or operated by Kaiser Foundation Health Plan of Washington or otherwise designated by KFHPWA, or with whom KFHPWA has contracted to provide health care services to Members. Network Personal A provider who is employed by Kaiser Foundation Health Plan of Washington or L 0 V L0 c m m c M L N w 0 J a 0 Cn 13 c M M N 0 E d a) c 0 J c M J c 0 .N M c m M �a d 2 ti Ln N N 0 N L 0 V Lm W M Y c m E s Q 52 C47298-0036900 Packet Pg. 117 8.G.b Physician Washington Permanente Medical Group, P.C., or contracted with KFHPWA to provide primary care services to Members and is selected by each Member to provide or arrange for the provision of all non -emergent Covered Services, except for services set forth in the EOC which a Member can access without Preauthorization. Network Personal Physicians must be capable of and licensed to provide the majority of primary health care services required by each Member. Network Provider The medical staff, clinic associate staff and allied health professionals employed by Kaiser Foundation Health Plan of Washington or Washington Permanente Medical Group, P.C., and any other health care professional or provider with whom KFHPWA has contracted to provide health care services to Members, including, but not limited to physicians, podiatrists, nurses, physician assistants, social workers, optometrists, psychologists, physical therapists and other professionals engaged in the delivery of healthcare services who are licensed or certified to practice in accordance with Title 18 Revised Code of Washington. Out-of-pocket Expenses Those Cost Shares paid by the Subscriber or Member for Covered Services which are applied to the Out-of-pocket Limit. Out-of-pocket Limit The maximum amount of Out-of-pocket Expenses incurred and paid during the calendar year for Covered Services received by the Subscriber and their Dependents within the same calendar year. The Out-of-pocket Expenses which apply toward the Out-of-pocket Limit are set forth in Section IV. Plan Coinsurance The percentage amount the Member is required to pay for Covered Services received. Preauthorization An approval by KFHPWA that entitles a Member to receive Covered Services from a specified health care provider. Services shall not exceed the limits of the Preauthorization and are subject to all terms and conditions of the EOC. Members who have a complex or serious medical or psychiatric condition may receive a standing Preauthorization for specialty care provider services. Residential Treatment A term used to define facility -based treatment, which includes 24 hours per day, 7 days per week rehabilitation. Residential Treatment services are provided in a facility specifically licensed in the state where it practices as a residential treatment center. Residential treatment centers provide active treatment of patients in a controlled environment requiring at least weekly physician visits and offering treatment by a multi- disciplinary team of licensed professionals. Service Area Washington counties of Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman and Yakima. Subscriber A person employed by or belonging to the Group who meets all applicable eligibility requirements, is enrolled and for whom the premium has been paid. Urgent Condition The sudden, unexpected onset of a Medical Condition that is of sufficient severity to require medical treatment within 24 hours of its onset. L c 0 V L 0 c m m c L c N w 0 J a 0 Cn 13 c M M N C E L d a) c 0 J c M J c 0 .N M c m M �a d 2 Q 53 C47298-0036900 Packet Pg. 118 8.G.b Kaiser Permanente Nondiscrimination Notice and Language Access Services KAISER PERMANENTE NONDISCRIMINATION NOTICE A KAISER PERMANENTE® Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. ("Kaiser Permanente") comply with applicable federal civil rights laws and do not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or any other basis protected by applicable federal, state, or local law. We also: Provide free aids and services to people with disabilities to help ensure effective communication, such as: • Qualified sign language interpreters • Written information in other formats (large print, audio, and accessible electronic formats) • Assistive devices (magnifiers, Pocket Talkers, and other aids) Provide free language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages If you need these services, contact Kaiser Permanente. If you believe that Kaiser Permanente has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, sex, sexual orientation, or gender identity, you can file a grievance. Please call us if you need help submitting a grievance. The Civil Rights Coordinator will be notified of all grievances related to discrimination. Kaiser Permanente ,T Phone: 206-630-4636 J Toll -free: 1-888-901-4636 C TTY Washington Relay Service: 1-800-833-6388 or 711 0 2 TTY Idaho Relay Service: 1-800-377-3529 or 711 j Electronically: kp.org/wa/feedback C N You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue SW., Room 509F HHH Building Washington, DC 20201 N 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.htmi For Medicare Advantage Plans Only: Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal. © 2018 Kaiser Foundation Health Plan of Washington 2018-XB-7_ACA_Notice_Tagli nes H5050_XB0001444_56_18 accepted 54 C47298-0036900 Packet Pg. 119 8.G.b IWet►141:10 English: ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-888-901-4636 (TTY: 1-800-833-6388 or 711). Espanol (Spanish): ATENCION: Si habla espanol, tiene a su disposici6n servicios gratuitos de asistencia lingiiistica. Hame al 1-888-901-4636 (TTY: 1-800-833-6388 / 711). T�Z (Chinese) : i_4_: �E_M : 1-888-901-4636 (TTY: 1-800-833-6388 / 711)0 Tieng Viet (Vietnamese): CHU Y: N6u ban n6i Tieng Viet, co cac dich vu ho tro' ng6n ng[r mien phi danh cho ban. Goi so 1-888-901-4636 (TTY: 1-800-833-6388 / 711). `f oi(Korean): Tol: 11 oiz �Fo-FAIL o>T, o�o1 TI A1HI_z _F olc>0 z T A&dL-IMF. 1-888-901-4636 (TTY: 1-800-833-6388 / 711) oH PYCCKHYI (Russian): BHNMAHNE: Ecim Bbl rOBOpmTe Ha pyCCKOM A3bIKe, TO BaM AOCTynHbl 6ecnnaTHble yCnyrll nepeBOAa. 3BOHt7Te 1-888-901-4636 (TeneTaOn: 1-800-833-6388 / 711). Filipino (Tagalog): PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-888-901-4636 (TTY: 1-800-833-6388 / 711). YKpdIHCbKa (Ukrainian): YBAEAI iKW,O B11 p03MOBAmeTe yKpaIHCbKOK) MOBOK), B" moweTe 3BepHyTt1CA AO 6e3KOWTOBH01 cnym611 MOBHOI niATp11MKH. Tene�OHyVI re 3a HOMepoM 1-888-901-4636 (TeneTAn: 1-800-833-6388 / 711). fnffli2S (Khmer)' SV16f l 11iS€J8Hf"gMUJ21, itfoaRlUSf n Sfi kf"irpi i IiRF566iSF wi GSq On 1-8`1 88-901-4636 (TTY: 1-800-833-6388 / 711) EMIR(J a pan ese):3 1-888-901-4636 (TTY: 1-800-833-6388 / 711) TZ, E�nt(,Zc= `*M<t=�Ui . h070r (Amharic) = 076,+ C: 4atg7e-+ `,'IA' ha9C5 htPS (rig A.Pdw+ tmg)�tcm: mQ aY.h-VAM- tTc "a)* 1-888-901-4636 (p Aa7+ A-Mq-Tm-: 1-800-833-6388 / 711). Oromiffa (Oromo): XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-888-901-4636 (TTY: 1-800-833-6388 / 711). *:11�(Punjabi)f4y4rc5 c�:r 3Ff� } t3c 3T�TF ftffAd-ft3TFN-T37-.tF7LftWUaQN8NZ-f;al 1-888-901-4636 (TTY: 1-800-833-6388 / 711) 'tzmzr I �a1s" ay i11 s �t all "Lua& u 9 c2�;11 _ASV �v 5 1311: Z,1b o L,� uLoy1%oS o toL," L,10 Ljj.=Jl L4 fi'11 (Arabic): (711 / 1-800-833-6388) : i9 �i -1' U j � 1-888-901-4636 l , Li. vL 11 A Deutsch (German): ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfugung. Rufnummer: 1-888-901-4636 (TTY: 1-800-833-6388 / 711). W151010 (Lao): 1U09t1U: 1j9&) tri^�aJc�^��J������, r��aJv On.)1)go0CMe) i°w w.)Z°1, 4)06c:�Jki.), CCJ3'1 zw,z)JJ 26M,qu. Ns 1-888-901-4636 (TTY: 1-800-833-6388 / 711). Srpsko-hrvatski (Serbo-Croatian): OBAVJESTENJE: Ako govorite srpsko-hrvatski, usluge jezicke pomoei dostupne su vam besplatno. Nazovite 1-888-901-4636 (TTY-Telefon za osobe sa ostecenim govorom ili sluhom: 1-800-833-6388 / 711). Frangais (French): ATTENTION: Si vous parlez fran�ais, des services d'aide linguistique vous sont proposes gratuitement. Appelez le 1-888-901-4636 (ATS: 1-800-833-6388 / 711). Romans (Romanian): ATENTIE: Dacs vorbiti limba romans, vs stau la dispozitie servicii de asistents lingvistics, gratuit. Sunati la 1-888-901-4636 (TTY: 1-800-833-6388 / 711). Adamawa (Fulfulde): MAANDO: To a waawi Adamawa, a woodi ballooji-ma to ekkitaaki wolde caahu. Noddu 1-888-901-4636 (TTY: 1-800-833-6388 / 711). yy� 1-888-901-4636 (TTY: 1-800-833-6388 / 711) 0381013 C L 1316711 Si E:3 55 C47298-0036900 Packet Pg. 120 8.G.c Delta Dental of Washington Dental Care Service Contract Declaration Page Group Number(s) 100611 Group Name City of Kent Effective Date 12:01 a.m. Pacific Time January 1, 2021 Term 12 Months Plan Type Delta Dental PPOs' Local Plan Group identified above agrees to a Dental Care Service Contract with Delta Dental of Washington ("DDWA"), a nonprofit corporation incorporated in Washington State. This Contract is issued and delivered in the state of Washington and is governed by Washington State laws. It is subject to the terms listed on these Declaration Page, the general Terms and Conditions, the Certificate of Coverage, and any appendices and amendments, all of which are incorporated and made part this Contract. Rates The monthly Administrative Fee payable by Group under this Contract Term during the period January 1, 2021 through December 31, 2021 shall be $7.10 per Enrolled Employee. Group's payment shall be in the form of a check or electronic transfer and shall accompany the eligibility listing. DDWA will then update the files and send a new billing to Group for the next month of coverage. Accepted By: Accepted By: City of Kent Delta Dental of Washington 220 4th Ave S Post Office Box 75983 Kent, WA 98032-5895 Seattle, WA 98175-0983 Signed: Signed: C-"G`I �• Title: Title: Date: Date: Vice President Underwriting and Actuarial November 23, 2020 M c a� U =a m ti ti uO N r N O N U N Q c m 0 r m 0 r c m E M V 2021-01-00611-RC LG PPOL 20210101 Q 1of13 Packet Pg. 121 8.G.c Defta Dental of Washington Benefit Period Benefit Period Start I January 1 1 Benefit Period End I December 31 Eligibility, Enrollment, and Termination Eligibility - Employee As defined by Group Eligibility - Dependent As defined by Group Start Date Election Yes End Date Election No Probationary Period As defined by Group Probationary Period Waiver No Retroactive Additions 180 Days Retroactive Terminations 180 Days Participation Minimum Enrollment 100 Participation % Employee Tied to Medical Participation % Dependent I Tied to Medical Plan Deductibles Individual In -Network $50 Family In -Network $150 Individual Out -of -Network $50 Family Out -of -Network $150 Deductible Waived on Class I; Orthodontic Benefits; Accidental Injury Benefits Expenses Runout Period 16 Months Plan Specific Information: Plan 02 - All Medical Plans Plan Maximums Plan Maximum $2,000 (19 years of age or older) Unlimited (under the age of 19) Orthodontic Maximum $1,800 Lifetime* TTemporomandibular Not Covered Maximum *Medically Necessary Orthodontic treatment for members under the age of 19, as defined in the Certificate of Coverage, does not accrue to the Orthodontic lifetime maximum. 2021-01-00611-RC LG PPOL 20210101 2of13 Packet Pg. 122 Delta Dental of Washington 8.G.c Plan Coinsurance Covered Dental Benefits Delta Dental PPO Dentists Delta Dental Premier Dentists Dentists Outside of Washington State Non -Participating Dentists in Washington State Class 1 100% 100% Class II 80% 80% Class III 80% 80% Temporomandibular Joint Not Covered Not Covered Orthodontic 50% 50% Accidental Injury 100% 100% Plan Specific Information: Plan 03 - Retirees Plan Maximums Plan Maximum $1,500 (19 years of age or older) Unlimited (under the age of 19) Orthodontic Maximum $1,000 Lifetime* Temporomandibular Not Covered Maximum *Medically Necessary Orthodontic treatment for members under the age of 19, as defined in the Certificate of Coverage, does not accrue to the Orthodontic lifetime maximum. Plan Coinsurance Covered Dental Benefits Delta Dental PPO Dentists Delta Dental Premier Dentists Dentists Outside of Washington State Non -Participating Dentists in Washington State Class 1 100% 100% Class II 80% 80% Class III 50% 50% Temporomandibular Joint Not Covered Not Covered Orthodontic 50% 50% Accidental Injury 100% 100% M c m M v d ti Ln N 2021-01-00611-RC LG PPOL 20210101 3of13 Packet Pg. 123 8.G.c Defta Dental of Washington Deviations All of the Terms and Conditions in this Contract apply, except if specifically modified in this Deviations section. Any modifications listed here supersede all referenced Articles in the standard Terms and Conditions section below. The following custom language is added by this reference. Section # Custom Language Global — Plan 03 For the purposes of Plan 03, the term Retiree may be inferred in place of the term Employee, where applicable. 8.9 Leave of Absence Coverage for a subscriber and enrolled dependents may be continued for up to 180 days when the employer grants the subscriber a leave of absence and premium charges continue to be paid. If a medical leave is granted, the City of Kent may pay the required monthly charge for the employee and enrolled dependents for up to 180 days. The 180-day leave of absence period counts toward the maximum COBRA continuation period, except as prohibited by the Family and Medical Leave Act of 1993. M c a� U =a m ti ti uO N. 2021-01-00611-RC LG PPOL 20210101 4of13 Packet Pg. 124 Delta Dental of Washington 8.G.c Dental Care Service Contract Terms and Conditions 1. Definitions c m 1.1. Administrative Fee: The monthly amount payable by Group as designated on the Declaration Pages. > 1.2. Benefit Period: The time period that applies to the frequencies and limitations. The Benefit Period is shown on the M C Declaration Page. 1.3. Certificate of Coverage: The benefit booklet, which describes in summary form the essential features of the Plan coverage, and to or for whom the benefits hereunder are payable. The Certificate of Coverage is incorporated into this N Contract by this reference as if it were fully written in this document. J 1.4. Contract: This agreement between DDWA and Group, including the Declaration Page, The Certificate of Coverage and any Q. $ and all appendices and amendments. This Contract constitutes the entire Contract between the parties and supersedes N any prior agreement, understanding or negotiation between the parties. 1.5. Covered Dental Benefit: Dental services that are covered under this Contract, subject to the limitations and exclusions set r forth in the Certificate of Coverage. 1.6. DDWA: Delta Dental of Washington, a nonprofit corporation incorporated in Washington State. DDWA is a member of p the Delta Dental Plans Association. E L 1.7. Declarations Page(s): The front page(s) of this Plan that provides the Group specific information and group specific' elections referred to in the Terms and Conditions. C 1.8. Delta Dental: Delta Dental Plans Association: A nationwide not -for -profit organization of dental benefit carriers offering a 0 J range of group dental benefit plans. M 1.9. Delta Dental PPO'"Dentist: A Participating Dentist who has agreed to render services and receive payment in accordance m J with the terms and conditions of a written Delta Dental PPO provider agreement, which includes looking solely to Delta C Dental for payment for covered services. g .y 1.10. Delta Dental Premier® Dentist: A Delta Dental Participating Dentist who has agreed to render services and receive > payment in accordance with the terms and conditions of a written Delta Dental provider agreement between DDWA and such Dentist. a� 1.11. Delta Dental Participating Dentist: A licensed Dentist who has agreed to render services and receive payment in accordance with the terms and conditions of a written Delta Dental Provider Agreement, which includes looking solely to 2 Delta Dental for payment for covered services. Delta Dental Participating Dentists include Delta Dental PPO Dentists and m Delta Dental Premier Dentists. 2 1.12. Dentist: A licensed dentist legally authorized to practice dentistry at the time and in the place services are performed. ti I- This Contract provides covered services only if those services are performed by or under direction of a licensed Dentist or N other Licensed Professional operating within the scope of their license. N 0 1.13. Eligibility Date: The date on which an Eligible Person becomes eligible to enroll in the Plan. N U 1.14. Eligible Dependent, Eligible Employee, or Eligible Person: Any dependent, employee or person who meets the conditions N Q of eligibility set forth on the Declaration Page. 1.15. Employee: A person who is designated as such by the Group for the purposes of this Plan. c m M 1.16. Enrolled Dependent, Enrolled Employee, or Enrolled Person: Any Eligible Dependent, Eligible Employee or Eligible 0 Person, as applicable, who has completed the enrollment process and for whom Group has submitted the monthly Administrative Fee to DDWA. 1.17. Filed Fee: The approved fee accepted by DDWA for a specific dental procedure performed by a Delta Dental Participating r 40i Dentist, who has performed the dental service and submitted that fee. t Q 2021-01-00611-RC LG PPOL 20210101 5of13 Packet Pg. 125 8.G.c Delta Dental of Washington 1.18. Group: The employer or entity that is contracting for dental benefits for its Employees in this Contract. 1.19. Licensed Professional: An individual legally authorized to perform services as defined in their license. Licensed Professional includes, but is not limited to, denturists, hygienists, and radiology technicians. 1.20. Lifetime Maximum: The maximum amount DDWA will pay in the specified Covered Dental Benefit class for an insured individual during the time that individual is on this Plan or any other Plan offered by this Employer. 1.21. Maximum Allowable Fee: The maximum dollar amount that will be allowed toward the reimbursement for any service provided for a Covered Dental Benefit. 1.22. Non -Participating Dentist: A licensed Dentist who has not agreed to render services and receive payment in accordance with the terms and conditions of a written Participating Dentist Agreement between a member of the Delta Dental Plans Association and such Dentist. 1.23. Open Enrollment Period: The annual period in which Eligible Employees can select benefits Plans and add or delete Eligible Dependents. 1.24. Participating Plan: Delta Dental of Washington and any other member of the Delta Dental Plans Association with which Delta Dental contracts to assist in administering the Covered Dental Benefits described in this Contract. 1.25. Plan Coinsurance: The applicable percentage of Maximum Allowable Fees for Covered Dental Benefits that shall be paid by DDWA as set forth in the Declaration Page. Sometimes this is referred to as the payment level. 1.26. Plan: This Contract that provides dental benefits. Any other Contract that provides dental benefits and meets the definition of a "Plan" in the "Coordination of Benefits" section of the Certificate of Coverage is a plan for the purpose of coordination of benefits only. 1.27. Service Area: Washington State, the geographic area in which DDWA will issue this policy. Dental Benefits are provided for covered services received outside of Washington State. 1.28. Standard Terms and Conditions: The non -Group specific terms and conditions that control this Contract, unless specifically modified on the Declaration Page. 2. Eligibility, Enrollment, and Termination 2.1. Employee Eligibility, Enrollment, and Termination M 2.1.1. Employees are eligible to enroll in this Plan if they meet the condition of eligibility designated on the Declaration a� Page. 2.1.2. Eligible Employees may enroll in this Plan on the effective date of this Contract. An employee hired after the effective date of this Contract may enroll in this Plan after satisfying the probationary period indicated on the Declaration m Page. 2.1.3. Employees are eligible to enroll in this Plan on the first of the month after satisfying any probationary period LO designated on the Declaration Page unless the Group has elected the 'Start Date' option on the Declaration Page. For E!! 'Start Date' election, the Employee enrollment will start on the date the Employee is eligible. An Employee shall r continue to be eligible to enroll in this Plan during the time this Contract is in effect as long as the Employee remains o an Eligible Employee. N 2.1.4. If indicated on the Declaration Page, DDWA will waive the Employee probationary period for an Employee hired after the effective date of this Contract who is transferring into the Plan from enrollment in any other dental plan. Enrollment for such Employee must be completed within 30 days of the transfer and the Employee must have been enrolled for benefits under the prior dental plan in the month of transfer or immediately prior to the month of transfer. The effective date of coverage for such Employee shall be the first day of the calendar month following enrollment. Notification of previous coverage is required at the time of enrollment. 2.1.5. Eligible Employees become Enrolled Employees after fully completing the enrollment process, including payment of Administrative Fee by Group to DDWA, and remain Enrolled Employees as long as they remain eligible under this Plan and Group has made timely payments of monthly Administrative Fees on behalf of the Employee. 2021-01-00611-RC LG PPOL 20210101 6of13 Packet Pg. 126 8.G.c Delta Dental of Washington 2.1.6. An Enrolled Employee terminates from this Plan at the end of the month that the employee is no longer eligible for enrollment unless the Group has elected the 'End Date' option on the Declaration Page. For 'End Date' election, the Employee terminates on the date the Employee is no longer eligible. An Employee will also terminate from this Plan at the end of the calendar month for which Group has made the last timely payment of the monthly Administrative Fees on behalf of the Enrolled Employee, or upon termination of this Contract, whichever occurs first. 2.2. Dependent Eligibility, Enrollment, and Termination 2.2.1. Dependent coverage under this plan is available as indicated on the Declaration Page. 2.2.2. If covered, an Eligible Dependent is a dependent of an Enrolled Employee who meets the requirements for eligibility established by the Group. Dependent eligibility validation documentation shall be maintained and verified by the Group. 2.2.3. An Eligible Dependent shall become eligible to enroll in this Plan on the date the Eligible Employee becomes eligible to enroll in this Plan, or on the first day of the calendar month following the month in which such person became an Eligible Dependent of the Eligible Employee. 2.2.4. A foster child is covered from the time of placement. 2.2.5. A newborn is covered from the moment of birth, and an adopted child is covered from the date of assumption of a legal obligation for total or partial support or upon placement of the child in anticipation of adoption of the child. 2.2.6. Eligible Dependents become Enrolled Dependents after fully completing the enrollment process, including payment of Administrative Fee by the Group to DDWA. An Enrolled Dependent shall continue to be enrolled as long as the Group has made timely payment of the monthly Administrative Fees on behalf of the Enrolled Employee to DDWA. 2.2.7. If the enrollment process is not completed within the time period selected which is represented in the Certificate of Coverage, enrollment will not be accepted until the next Open Enrollment Period unless specified, or unless there is a change in family status as defined in the Special Enrollment Period section of the Certificate of Coverage. If an additional Administrative Fee for coverage is required and enrollment is not completed within the time period selected, the newborn, adopted or foster child(ren) will be covered from the effective date of enrollment as defined in the Certificate of Coverage. 2.2.8. An Enrolled Dependent terminates from this Plan when they are no longer an Eligible Dependent of an Eligible A Employee, or at the end of the calendar month for which Group has made timely payment of the monthly Administrative Fees on behalf of the Enrolled Employee, or upon termination of this Contract, whichever occurs first. c 2.2.9. An Enrolled Employee may terminate coverage of an Enrolled Dependent or reinstate an Eligible Dependent only at p renewal or extension of this Plan, or if there is a change in family status, as defined in the Special Enrollment Period section of the Certificate of Coverage. U m 2.3. General Enrollment Information 2.3.1. An Enrolled Employee must complete the enrollment process for themselves or any newly Eligible Dependents within ti the time period represented in the Certificate of Coverage. Late enrollment will not be accepted until the next Open N Enrollment Period unless specified, or unless there is a change in family status as defined in the Special Enrollment r Period section of the Certificate of Coverage. c N 2.3.2. DDWA requests that all completed enrollment information is received from the Group within 60 days of the cc i employee or dependent's eligibility date. Q 2.3.3. Retroactive additions and terminations of enrollment for administrative purposes will only be accepted for the time c�a period indicated on the Declaration Page. m a 2.3.4. While satisfying the various requirements of the FMLA, the Paid Family and Medical Leave Act, and COBRA laws rests M r primarily with the Group, DDWA will fully cooperate with Group in complying with these laws. a) r c m E t 2021-01-00611-RC LG PPOL 20210101 Q 7of13 Packet Pg. 127 8.G.c Delta Dental of Washington 3. Participation Requirements, Administrative Fees, Invoicing, Payment, Reimbursement of Claims M 3.1. Participation Requirements r_ 0 3.1.1. This Contract requires participation of the required percentage or segment of Eligible Employees and Eligible U c Dependents as indicated on the Declaration Page. m 3.1.2. For Groups that elect a specific percentage of employee participation, Group will assure that percentage of Eligible > Employees are participating in this Plan. 3.1.3. For Groups that elect a specific percentage of dependent participation, Group will assure that specified percentage of c f° � all Enrolled Employees enroll all of their Eligible Dependents, unless those dependents are enrolled in another dental c plan. 3.1.4. For Groups that elect to have employee or dependent enrollment in this Plan tied to enrollment in their Group- J sponsored medical plan, all Eligible Employees and their Eligible Dependents who are enrolled in the Group- o sponsored medical plan must be enrolled in this Plan regardless of whether or not they are enrolled as a dependent N in another dental plan. Eligible Employees or their Eligible Dependents who are not enrolled in the Group -sponsored 0 medical plan may not enroll in this Plan. 0 3.1.5. For Groups that elect voluntary enrollment, there is no participation requirement. All other enrollment requirements r = apply. M A 3.2. Administrative Fee c 3.2.1. Group shall submit a list of Enrolled Persons to DDWA prior to the beginning of each monthly eligibility period. E L 3.2.2. Group shall permit DDWA, at DDWA's expense, on reasonable advance written notice, to inspect eligibility records to verify the accuracy of information submitted to DDWA. An equitable adjustment of Administrative Fee shall be made o in the event of errors or delays in reporting eligibility. J 3.2.3. DDWA shall not be obligated to recoup any funds paid to providers for treatment performed in good faith that the c 0 patient's eligibility was current and accurate at the time of treatment. :T J 3.2.4. Legislative Surcharge Clause. If any governmental unit imposes any new tax or assessment or increases the rate of any current tax or assessment that is measured directly by the payments made to DDWA by Group, or payment made o 'y by DDWA for claims, then DDWA is authorized to increase the monthly Administrative Fee by the amount of such > new tax, assessment or increase, or pass through the exact tax amount to the Group separately. M 3.2.5. If Group does not agree to the proposed adjustment within 30 days, DDWA may terminate this Contract at the end of c the month for which Administrative Fee had been received by DDWA prior to the date of such notice to Group and in accordance with the provisions of this Contract. U 3.2.6. The monthly Administrative Fee indicated on the Declaration Page will be remitted fully by Group as invoiced. =a 3.3. Invoicing and PaymentLO ti 3.3.1. The Group shall pay the full invoiced amount to DDWA on or before the first day of each calendar month for which ti N benefits are to be provided. r 3.3.2. Payment of Administrative Fee is by Electronic Funds Transfer (EFT) unless other specific payment methods are N N approved by DDWA. The Group may elect to have DDWA pull the funds from their bank account via an ACH debt N transfer around the first of every month. Q 3.3.3. If Group objects to any portion of an invoice, Group will notify DDWA prior to the payment due date and specify the amount and cause of the dispute. Group will pay any undisputed amounts in a timely manner. Any disputed y amounts will be resolved by direct negotiation between DDWA and Group. 0 r 3.3.4. If payment is not received within 30 days, DDWA may give written notice that payment is past due and may, at its m 0 option, terminate all benefits and be released from all further obligations as set forth herein. 3.3.5. No person shall be entitled to benefits under this Contract during any month for which Administrative Fee payment c E has not been received by DDWA. 0 Q 2021-01-00611-RC LG PPOL 20210101 8of13 Packet Pg. 128 8.G.c Delta Dental of Washington 3.4. Reimbursement of Claims 3.4.1. DDWA shall notify Group monthly of the actual amount of claims paid by DDWA for that month. Notification will be via email, which will constitute an invoice. Group will then have two business days to transfer funds electronically to the appropriate DDWA bank account an amount equal to total claims paid for the month. 3.4.2. Funds are due on the date notified. If the funds are not transferred within five days of notification, a late fee of one percent of total claim dollars on that invoice will be charged. An additional late charge of one percent of the total claim dollars on that invoice will be charged if payment is not received within 30 days of the due date and an additional late charge of one percent of the total claim dollars on that invoice for each subsequent 30-day period for which payment is not received. The charges shall be included by DDWA with a subsequent payment notification. 4. Benefits and Benefit Disputes 4.1. Benefits 4.1.1. Covered Dental Benefits, Limitations, and Exclusions are as described in the Certificate of Coverage and are subject to the Plan maximum and deductible as defined on the Declaration Page. 4.1.2. Covered Dental Benefits are available for an Enrolled Person from the enrollment date until such enrollment terminates. 4.1.3. The percentages of the Maximum Allowable Fee, Filed Fee, or the Dentists' actual charges payable by DDWA for Covered Dental Benefits provided to an Enrolled Person are defined on the Declaration Page. 4.1.4. To determine Covered Dental Benefits for certain treatments, DDWA may require an Enrolled Person to obtain an independent examination from a DDWA-appointed dentist. DDWA will pay all the charges incurred for this examination. 4.2. Providers 4.2.1. Payment for services provided by a Delta Dental Participating Dentist will be made directly to the dentist. Contracts between Delta Dental and its Delta Dental Participating Dentists provide that, if Delta Dental fails to pay the dentist any amount owed, the Enrolled Person shall not be liable to the dentist for any sums owed by Delta Dental. 4.2.2. An Enrolled Person may elect the services of any licensed dentist. DDWA is not responsible for availability of any particular licensed dentist. DDWA shall not be held liable for any act or omission on the part of the selected dentist. 4.2.3. DDWA shall be entitled to receive from any attending dentist, or from hospitals in which a dentist's care is rendered, any records relating to treatment rendered to an Enrolled Person as may be required in the administration of claims. 4.2.4. The provider dispute resolution process as outlined in individual provider contracts is available upon request. 4.2.5. Fees paid to a provider for Covered Dental Benefits under this Plan are based on the lesser of the provider's actual fee or the Maximum Allowable Fee of the fee schedule defined below: PPO Local Plan Provider Type Fee Schedule Delta Dental PPO Participating Dentist PPO Participating Dentist —State Specific Delta Dental Premier Participating Dentist Premier Participating Dentist — State Specific Non -Participating Dentist in Washington State Non -Participating Dentist — State Specific Non -Participating Dentists out of Washington State Participating Dentist 5. Plan Details 5.1. Plan Maximum 5.1.1. The maximum amount payable by DDWA for Class I, II and III Covered Dental Benefits per Enrolled Person during each Benefit Period is indicated on the Declaration Page. Charges for dental procedures requiring multiple treatment 2021-01-00611-RC LG PPOL 20210101 9of13 Packet Pg. 129 8.G.c Delta Dental of Washington dates shall be considered incurred on the date the service is completed. Amounts for such procedures shall be applied to the Plan maximum based on such incurred date. 5.1.2. If Orthodontic Benefits are covered, the annual or lifetime maximum amount payable by DDWA for Orthodontic Benefits provided to an Enrolled Person will be indicated on the Declaration Page. If Orthodontic Benefits are covered for children only, the maximum will apply only to those members. 5.1.3. If Temporomandibular Joint (TMJ) services are covered, the annual or lifetime maximum amount payable by DDWA for dental services related to the treatment of TMJ disorders will be indicated on the Declaration Page. 5.2. Plan Coinsurance Plan coinsurance amounts are indicated on the Declaration Page. 5.3. Plan Deductible 5.3.1. The plan deductible, if elected, is indicated on the Declaration Page. 5.3.2. Deductibles may apply to In -Network and Out -of -Network combined, In -Network and Out -of -Network separately, or for Out -of -Network only, as indicated on the Declaration Page. 5.3.3. DDWA is not obligated to pay for Covered Dental Benefits until the deductible amount is satisfied during each Benefit Period for each individual, unless the family deductible has been met during that Benefit Period. The family deductible is accrued by deductible payments of the Enrolled Employee or any Enrolled Dependent. 5.3.4. Any elected deductible is waived on designated classes of benefits as indicated on the Declaration Page 6. DDWA's Obligations 6.1. Certificates of Coverage 6.1.1. DDWA will issue to Group an electronic version of the Certificate of Coverage for this Plan in the form of a standard DDWA benefit booklet, which summarizes the Covered Dental Benefits and other essential features of the Plan. If any amendment to this Contract materially affects any benefits described in booklets, electronic versions of corrected booklets or booklet inserts showing the change will be issued to Group. Generally, new Booklets and/or Inserts are not issued mid -Contract Term unless as otherwise specified in this Contract. 6.1.2. Upon receipt of a written request, DDWA will provide to Group one printed booklet for each employee enrolled in the Plan, plus an additional ten percent for a reserve supply. Group will reimburse DDWA for any additional costs due to variation in booklet size or paper requested by Group. DDWA will have booklets delivered to Group within 15 business days after receipt of a signed booklet approval form from Group. 6.2. Confirmation of Treatment and Cost (also known as predetermination of benefits) 6.2.1. DDWA will provide descriptions of Confirmation of Treatment and Costs, claim review, and complaint and appeal procedures in the benefit booklets issued to Group. 6.2.2. If a dentist or an Enrolled Person submits a request for a Confirmation of Treatment and Cost, DDWA will provide a Confirmation of Treatment and Cost for the Enrolled Person. Such Confirmation of Treatment and Cost will be valid when issued based on the information available at that time. A Confirmation of Treatment and Costs is not an authorization for services nor a guarantee of payment but is a notification of Covered Dental Benefits available. 6.3. Quality Management DDWA may utilize its Quality Management and Clinical Review processes to provide professional review of the adequacy, appropriateness, and alignment with DDWA's established clinical criteria of services rendered to Enrolled Persons. 6.4. Provider Directories DDWA shall provide Delta Dental Participating Dentist Directories to Group. This directory is available online, and may also be requested by telephone as indicated in the Certificate of Coverage. It is understood that the composition of such directory is subject to change. DDWA reserves the right to change the directory without notice. 2021-01-00611-RC LG PPOL 20210101 10 of 13 Packet Pg. 130 8.G.c Delta Dental of Washington 6.5. Dental Services Obligations 6.5.1. DDWA shall not be obligated to make payment for any services rendered to a person who is not an Enrolled Person at the time the services were performed. 6.5.2. Nothing contained in this Contract shall be construed as obligating DDWA to render dental services; its sole obligation being to pay the agreed -upon portion of dentist's charges for Covered Dental Benefits in accordance with the terms of this Contract. 7. Group's Obligations 7.1. Notification to Enrolled Employees Group shall provide information to all Enrolled Employees as to the existence and terms of this Contract. Group shall make the Certificate of Coverage available to each Enrolled Employee. 7.2. Summary Plan Descriptions If Group elects to prepare and print its own summary plan description, it does so at its own risk and expense. The Group - prepared summary plan description must be based on the most current Certificate of Coverage provided by DDWA, and will be for informational purposes only, not incorporated into this Contract. Group is responsible for assuring the accuracy of any summary plan description that it elects to prepare and distribute. DDWA is not obligated to review or approve any summary plan description prepared by Group, and will not provide any warranty for the content of the Group -produced summary plan description. 7.3. Execution of Contract `m .r 7.3.1. Group shall sign and return any and all Contract documents within 30 days of the effective date or the date DDWA sends the Contract document to Group or its authorized representative or agent, whichever is later. 7.3.2. If a signed Contract is not received by DDWA from the Group or the Group's legal representative(s) by the effective date, but Group remits Administrative Fee, both parties agree to perform under this Contract in good faith until a w signed Contract is received, or until a notice of termination is received as detailed herein. n 8. General Provisions C g .y 8.1. Modification > No change in this Contract shall be valid unless evidenced by written amendment signed by an authorized representative M or agent of DDWA and an authorized representative or agent of Group. p 8.2. Legal Action ca U Legal action to recover benefits provided for in this Contract may not be initiated prior to 60 days after receipt of claim by DDWA. In addition, such legal action must commence within 6 years from the date the claim was received by DDWA. 8.3. Severability ti ti uO N Any provision of this Contract that is in conflict with any governing law or regulation of the State of Washington is hereby .. r amended to comply with the minimum requirements of such law or regulation. c 8.4. Indemnification N U 8.4.1. DDWA shall indemnify and hold harmless Group, its affiliates and their respective directors, officers, employees and Q agents, for that portion of any liability, settlement and related expense (including reasonable attorneys' fees) resulting solely and directly from DDWA's breach of this Contract, negligence, willful misconduct, criminal conduct, fraud or its breach of a fiduciary responsibility related to or arising out of this Contract. 8.4.2. Group shall indemnify and hold harmless DDWA, its affiliates and their respective directors, officers, employees and agents, for that portion of any liability, settlement and related expense (including reasonable attorneys' fees) resulting solely and directly from Group's breach of this Contract, negligence, willful misconduct, criminal conduct, m fraud or its breach of a fiduciary responsibility related to or arising out of this Contract. E t Q 2021-01-00611-RC LG PPOL 20210101 11 of 13 Packet Pg. 131 Delta Dental of Washington 8.G.c 8.5. Force Maleure In the event DDWA is unable to perform its obligations under this Contract by reason of fire, casualty, lockout, strike, labor condition, riot, war, act of God or by ordinance, law, order or decree of any legally constituted authority, then this Contract may, at the option of DDWA, be suspended. During any period of suspension, DDWA shall not be required to perform any service under this Contract, nor shall DDWA be liable for any damages arising from any event that precipitated the suspension. If this Contract is suspended pursuant to this provision, Group's obligation to make Administrative Fee payments shall also be suspended for the same period of time. 8.6. Privacy DDWA and Group will act in accordance with applicable state and federal privacy requirements and disclosure requirements, such as the Gramm -Leach -Bliley Act (GLBA) and the Health Insurance Portability and Accountability Act (HIPAA), including any applicable regulations. 8.7. Domestic Partnership and Gender For the purposes of this contract, the terms spouse, marriage, marital, husband, wife, widow, widower, next of kin, and family shall be interpreted as applying equally to domestic partnerships or individuals in domestic partnerships as well as to marital relationships and married persons. References to dissolution of marriage shall apply equally to domestic partnerships that have been terminated, dissolved, or invalidated, to the extent that such interpretation does not conflict with federal law. Where necessary, gender -specific terms such as husband and wife used in any part of this contract shall be construed to be gender neutral, and applicable to individuals in domestic partnerships. This definition does not change the election of the Group with regard to coverage for domestic partnerships. 8.8. Notice Any notice under this Contract shall be sufficient if given by either Group or DDWA by regular mail to the other addressed to the office stated on the front page of this Contract or to such other address as may be designated by written notice to the other. 9. Termination 9.1. Termination Notice This Contract may be terminated effective at the end of the term by either Group or DDWA, or by either party giving > written notice to the other at least 30 days prior to the end of the Contract term, except as otherwise specifically M provided herein. a� 9.2. DDWA Termination 9.2.1. DDWA may elect to terminate this Contract without prior approval of the Washington State Insurance U Y p pp g '0 Commissioner, if any of the events outlined in this Section occur. Termination would be effective at the end of the month for which Administrative Fees have been received by DDWA prior to the time of such election. If termination occurs, DDWA will provide written notice to Group. If DDWA elects to terminate because of default by Group, then LO Group shall be indebted to and agrees to pay DDWA the sum of all claims payments and expenses incurred for dental N services rendered from the date of default until the date of termination, including costs of recovery. r 9.2.2. Events that allow termination: A failure to pay Administrative Fee or perform Group's other obligations when due. Any violation of published policies of DDWA. C. Change or implementation of federal or state health care reform laws that no longer permit the continued offering of such coverage. 9.2.3. Events that allow termination if the Group does not take corrective action consistent with their obligations under this Contract: Enrolled Persons committing fraudulent acts against DDWA. Enrolled Persons who materially breach the terms of this Contract. 2021-01-00611-RC LG PPOL 20210101 12 of 13 Packet Pg. 132 8.G.c Delta Dental of Washington 9.3. Administrative Fee Reimbursement If on termination of this Contract, Group has paid Administrative Fee to DDWA applicable to a period of time after the termination date, DDWA shall, within 30 days after notification of termination, return such portion of Administrative Fee to Group less any amounts due to DDWA. 9.4. Reinstatement 9.4.1. Acceptance by DDWA of the proper amount of Administrative Fee, after termination of this Contract and without requiring a new application, shall reinstate the Contract as though it had never terminated, unless DDWA shall, within 5 business days of receipt of such payment, either: a. Refund the payment so made, or b. Issue to Group a new Contract accompanied by written notice stating clearly those respects in which the new Contract differs from the terminated Contract in benefits, coverage or otherwise. 9.5. Expenses Upon termination of this Plan, all claim payments and expenses incurred prior to the termination of the Plan, but not submitted to DDWA within the runout period after the date of treatment will be excluded from any benefit consideration. M c a� U =a m ti ti uO N. 2021-01-00611-RC LG PPOL 20210101 13 of 13 Packet Pg. 133 8.G.d PLEASE ATTACH TO YOUR VISION SERVICE PLAN DOCUMENT I_1iv, 14�U]►hI4ki11itexteill:12611IWAa4:1[$]I] To be attached to and made part of Vision Care Policy Number 12229020, issued to City of Kent. EXCEPT as specifically amended herein, said Policy shall remain in full force and effect. IT IS HEREBY AGREED that effective January 1, 2018, the Policy Period shall be changed to SIXTY months. VSP/AMENDTERM.DOC Packet Pg. 134 8.G.e Life Insurance Company of North America 1601 Chestnut Street Philadelphia, Pennsylvania 19192-2235 AMENDMENT Policyholder: City of Kent Policy No.: OK - 969625 This Amendment is attached to and made part of the Policy specified above. It is subject to all of the policy provisions that do not conflict with its provisions. Policyholder and We hereby agree that the Policy is amended as follows: Effective January 1, 2021, the following rates will remain in force for Class 1 for coverage under the Policy: Premium Rate: Basic Insurance Employee Rate: $0.02 per $1,000 r c m No change in rates will be made until 24 months after the effective date of this Amendment. However, the Company o reserves the right to change the rates at any time during a period for which the rates are guaranteed if the conditions M described in the Changes in Premium Rates provision under the Administrative Provisions section of the Policy apply. :a m Except for the above, this Amendment does not change the Policy in any way. ti ti LO N N Life Insurance Company of North America N 0 "&' 'Ie - William J. Smith, President Date: September 21, 2020 Amendment No. 02 GA-00-4000.00 Packet Pg. 135 8.G.f LIFE INSURANCE COMPANY OF NORTH AMERICA (herein called the Company) Amendment to be attached to and made a part of the Group Policy A Contract between the Company and City of Kent (herein called the Policyholder) Policy No.: FLX - 968145 The Company and the Policyholder hereby agree that the Policy is amended as follows: Effective January 1, 2021, the rates shown on the attached Schedule of Rates will be in force for coverage under the Policy No change in rates will be made until 24 months after the effective date of this Amendment. However, the Company reserves the right to change the rates at any time during a period for which the rates are guaranteed if the conditions described in the Changes in Premium Rates provision under the Administrative Provisions section of the Policy apply Except for the above, this Amendment does not change the Policy in any way. FOR THE COMPANY 00 � �/"/ 12 V �-z William J. Smith, President Date: September 21, 2020 Amendment No. 02 TL-004780 Packet Pg. 136 8.G.f SCHEDULE OF RATES The following monthly rates apply to all Classes of Eligible Persons unless otherwise indicated. FOR EMPLOYEE BENEFITS Basic Life Insurance $0.11 per $1,000 FOR SPOUSE AND DEPENDENT CHILD BENEFITS Basic Life Insurance $1.00 Per Employee FOR FORMER EMPLOYEE BENEFITS Monthly Rates are based on units of $1,000. Under Age 20 $.153 Age 60 - 64 $2.461 Age 20 - 24 $.144 Age 65 - 69 $4.065 Age 25 - 29 $.153 Age 70 - 74 $6.143 Age 30 - 34 $.177 Age 75 - 79 $9.792 Age 35 - 39 $.190 Age 80 - 84 $15.523 Age 40 - 44 $.243 Age 85 - 89 $24.106 Age 45 - 49 $.384 Age 90 - 94 $36.119 Age 50 - 54 $.726 Age 95 and over $51.278 Age 55 - 59 $1.347 A change in rates due to a change in the Former Employee's age will become effective on the Policy Anniversary coinciding with or following the Former Employee's birthday. FOR FORMER SPOUSES OR SPOUSES OF FORMER EMPLOYEE BENEFITS Monthly Rates are based on units of $1,000. Under Age 20 $.153 Age 60 - 64 $2.461 Age 20 - 24 $.144 Age 65 - 69 $4.065 Age 25 - 29 $.153 Age 70 - 74 $6.143 Age 30 - 34 $.177 Age 75 - 79 $9.792 Age 35 - 39 $.190 Age 80 - 84 $15.523 Age 40 - 44 $.243 Age 85 - 89 $24.106 Age 45 - 49 $.384 Age 90 - 94 $36.119 Age 50 - 54 $.726 Age 95 and over $51.278 Age 55 - 59 $1.347 Spouse rates are based on the spouse's date of birth. A change in rates due to a change in the Spouse's age will become effective on the Policy Anniversary coinciding with or following the Spouse's birthday. Packet Pg. 137 8.G.f FOR FORMER DEPENDENT CHILD BENEFITS Rates are based on $25,000 per Month. Under Age 20 $2.377 Age 45 - 49 $9.777 Age 20 - 24 $2.777 Age 50 - 54 $16.377 Age 25 - 29 $2.977 Age 55 - 59 $23.477 Age 30 - 34 $3.600 Age 60 - 64 $38.250 Age 35 - 39 $4.177 Age 65 - 69 $54.077 Age 40 - 44 $6.200 Rates are based on $50,000 per Month Under Age 20 $4.750 Age 45 - 49 $19.550 Age 20 - 24 $5.550 Age 50 - 54 $32.750 Age 25 - 29 $5.950 Age 55 - 59 $46.950 Age 30 - 34 $7.200 Age 60 - 64 $76.500 Age 35 - 39 $8.350 Age 65 - 69 $108.150 Age 40 - 44 $12.400 A change in rates due to a change in the Former Dependent Child's age will become effective on the Policy Anniversary Date coinciding with or following the Former Dependent Child's birthday. TL-004718 Packet Pg. 138 8.G.g LIFE INSURANCE COMPANY OF NORTH AMERICA (herein called the Company) Amendment to be attached to and made a part of the Group Policy A Contract between the Company and City of Kent (herein called the Policyholder) Policy No.: LK - 965532 The Company and the Policyholder hereby agree that the Policy is amended as follows: Effective January 1, 2021, the following rates will remain in force for Classes 1 and 2 for coverage under the Policy: $.29 per $100 of Covered Payroll Covered Payroll for an Employee will mean his or her Covered Earnings for the insurance month prior to the date the determination is made. However, an Employee's Covered Payroll will not include any part of his or her monthly Covered Earnings which exceed $10,499. No change in rates will be made until 24 months after the effective date of this Amendment. However, the Company reserves the right to change the rates at any time during a period for which the rates are guaranteed if the conditions described in the Changes in Premium Rates provision under the Administrative Provisions section of the Policy apply. Except for the above, this Amendment does not change the Policy in any way. FOR THE COMPANY William J. Smith, President Date: September 21, 2020 Amendment No. 02 TL-004780 Q Packet Pg. 139 8.G.h LIFE INSURANCE COMPANY OF NORTH AMERICA (herein called the Company) Amendment to be attached to and made a part of the Group Policy A Contract between the Company and City of Kent (herein called the Policyholder) Policy No.: FLX - 968146 PLEASE READ IMPORTANT: The attached amendment to your policy has been made at your request, and will be effective on the date shown within the amendment. Please review this amendment immediately and confirm that it accurately reflects your c request and is consistent with your intentions. If amended certificates have been provided, please review these as well. If there are any errors or discrepancies, please notify your account manager or account service representative immediately. If > you have not notified your account manager or account service representative of any errors or concerns, continued payment �o of premium more than 31 days after delivery of this amendment will be deemed acceptance of this amendment. m M U d u� N Packet Pg. 140 8.G.h LIFE INSURANCE COMPANY OF NORTH AMERICA (herein called the Company) Amendment to be attached to and made a part of the Group Policy A Contract between the Company and City of Kent (herein called the Policyholder) Policy No.: FLX - 968146 This Amendment is attached to and made part of the Policy specified above. It is subject to all of the policy provisions that do not conflict with its provisions. The Company and the Policyholder hereby agree that the Policy is amended as follows: 1. This Amendment will be in effect on the Effective Date(s) shown below only for insured Employees in Active Service on that date. If an Employee is not in Active Service on the date his insurance would otherwise become effective, it will be effective on the date he returns to Active Service. Effective January 1, 2021, the Annual Enrollment Period under the Schedule of Benefits for Class 1 is deleted in its entirety and is replaced by the following: Annual Enrollment Period For Employees During an Annual Enrollment Period, an Employee currently insured under the Voluntary Life Insurance portion of this Policy may increase his or her Voluntary Life Insurance Benefit by five units, as long as the total Benefit does not exceed the Guaranteed Issue Amount, without satisfying the Insurability Requirement. An Employee who is eligible for the Voluntary Life Insurance portion of this Policy but who has not previously enrolled may become insured under the Policy as long as the total Benefit does not exceed the Guaranteed Issue Amount, without satisfying the Insurability Requirement. Guaranteed Issue Amounts are shown above. Insurance will be effective on the later of the Policy Anniversary following the Annual Enrollment Period. An Employee may increase coverage or become insured for a Benefit in excess of amounts described above only if he or she satisfies the Insurability Requirement. Any excess amounts will be effective on the later of the Policy Anniversary following the Annual Enrollment Period or the date the Insurance Company agrees in writing to insure the Employee. Packet Pg. 141 8.G.h For Spouses During an Annual Enrollment Period, an eligible Employee may elect coverage for his or her eligible Spouse. If a Spouse is currently insured under the Voluntary Life Insurance portion of this Policy, his or her Voluntary Life Insurance Benefit by five units, as long as the total Benefit does not exceed the Guaranteed Issue Amount, without satisfying the Insurability Requirement. If a Spouse is eligible for the Voluntary Life Insurance portion of this Policy but has not previously enrolled, he or she may become insured under the Policy as long as the total Benefit does not exceed the Guaranteed Issue Amount, without satisfying the Insurability Requirement. Guaranteed Issue Amounts are shown above. Insurance will be effective on the later of the Policy Anniversary following the Annual Enrollment Period. A Spouse may increase coverage or become insured for a Benefit in excess of amounts described above only if he or she satisfies the Insurability Requirement. Any excess amounts will be effective on the later of the Policy Anniversary following the Annual Enrollment Period or the date the Insurance Company agrees in writing to insure the Spouse. A request for a Benefit reduction received during an Annual Enrollment Period will become effective on the later of the Policy Anniversary following the Annual Enrollment Period. TL-008025-1 2. Effective January 1, 2021, the rates shown on the attached Schedule of Rates will remain in force for coverage under M the Policy. c m No change in rates will be made until 24 months after the effective date of this Amendment. However, the Company reserves the right to change the rates at anytime during a period for which the rates are guaranteed if the conditions described in the Changes in Premium Rates provision under the Administrative Provisions section of the Policy apply. Except for the above, this Amendment does not change the Policy in any way. r� u� FOR THE COMPANY w�/"/ 12V � William J. Smith, President Date: September 21, 2020 (Revised Date: September 30, 2020) Amendment No. 01 TL-004780 Packet Pg. 142 8.G.h SCHEDULE OF RATES The following monthly rates apply to all Classes of Eligible Persons unless otherwise indicated. FOR EMPLOYEE BENEFITS Voluntary Life Insurance Monthly Rates are based on units of $1,000 Under Age 20 $.06 Age 60 - 64 $.73 c Age 20 - 24 $.06 Age 65 - 69 $1.40 0 Age 25 - 29 $.06 Age 70 - 74 $2.50 Age 30 - 34 $.08 Age 75 - 79 $3.70 M Age 35 - 39 $.09 Age 80 - 84 $6.61 JT Age 40 - 44 $.13 Age 85 - 89 $6.61 J Age 45 - 49 $.23 Age 90 - 94 $6.61 c Age 50 - 54 $.35 Age 95 and over $6.61 Age 55 - 59 $.61 > A change in rates due to a change in the Employee's age will become effective on January 1 coinciding with or following m the Employee's birthday. FOR SPOUSE OR DOMESTIC PARTNER BENEFITS M v Voluntary Life Insurance N Monthly Rates are based on units of $1,000. N Under Age 20 $.06 Age 60 - 64 $.73 N Age 20 - 24 $.06 Age 65 - 69 $1.40 N� Age 25 - 29 $.06 Age 70 - 74 $2.50 Tmm Age 30 - 34 $.08 Age 75 - 79 $3.70 N Age 35 - 39 $.09 Age 80 - 84 $6.61 �. Age 40 - 44 $.13 Age 85 - 89 $6.61 Age 45 - 49 $.23 Age 90 - 94 $6.61 E Age 50 - 54 $.35 Age 95 and over $6.61 m Age 55 - 59 $.61 E Spouse rates are based on the spouse's date of birth. A change in rates due to a change in the Spouse's age will become effective on January 1 coinciding with or following the Spouse's birthday. FOR DEPENDENT CHILD BENEFITS Voluntary Life Insurance S.20 Per S 1,000 Packet Pg. 143 8.G.h FOR FORMER EMPLOYEE BENEFITS Monthly Rates are based on units of $1,000. Under Age 20 $.153 Age 60 - 64 $2.461 Age 20 - 24 $.144 Age 65 - 69 $4.065 Age 25 - 29 $.153 Age 70 - 74 $6.143 Age 30 - 34 $.177 Age 75 - 79 $9.792 Age 35 - 39 $.190 Age 80 - 84 $15.523 Age 40 - 44 $.243 Age 85 - 89 $24.106 Age 45 - 49 $.384 Age 90 - 94 $36.119 Age 50 - 54 $.726 Age 95 and over $51.278 Age 55 - 59 $1.347 A change in rates due to a change in the Former Employee's age will become effective on the Policy Anniversary coinciding with or following the Former Employee's birthday. FOR FORMER SPOUSE OR DOMESTIC PARTNERS OR SPOUSE OR DOMESTIC PARTNERS OF FORMER EMPLOYEE BENEFITS Monthly Rates are based on units of $1,000. Under Age 20 $.153 Age 60 - 64 $2.461 Age 20 - 24 $.144 Age 65 - 69 $4.065 Age 25 - 29 $.153 Age 70 - 74 $6.143 Age 30 - 34 $.177 Age 75 - 79 $9.792 Age 35 - 39 $.190 Age 80 - 84 $15.523 Age 40 - 44 $.243 Age 85 - 89 $24.106 Age 45 - 49 $.384 Age 90 - 94 $36.119 Age 50 - 54 $.726 Age 95 and over $51.278 Age 55 - 59 $1.347 Spouse rates are based on the spouse's date of birth. A change in rates due to a change in the Spouse's age will become effective on the Policy Anniversary coinciding with or following the Spouse's birthday. Packet Pg. 144 8.G.h FOR FORMER DEPENDENT CHILD BENEFITS Rates are based on $25,000 per Month. Under Age 20 $2.377 Age 45 - 49 $9.777 Age 20 - 24 $2.777 Age 50 - 54 $16.377 Age 25 - 29 $2.977 Age 55 - 59 $23.477 Age 30 - 34 $3.600 Age 60 - 64 $38.250 Age 35 - 39 $4.177 Age 65 - 69 $54.077 Age 40 - 44 $6.200 Rates are based on $50,000 per Month Under Age 20 $4.750 Age 45 - 49 $19.550 ca Age 20 - 24 $5.550 Age 50 - 54 $32.750 JT Age 25 - 29 $5.950 Age 55 - 59 $46.950 J Age 30 - 34 $7.200 Age 60 - 64 $76.500 c Age 35 - 39 $8.350 Age 65 - 69 $108.150 Age 40 - 44 $12.400 > M A change in rates due to a change in the Former Dependent Child's age will become effective on the Policy Anniversary m Date coinciding with or following the Former Dependent Child's birthday. TL-004718 M u :a N N Packet Pg. 145 8.G.i AMENDMENT NO. 12 To be attached to and made part of Policy WA 518212 issued to City of Kent as Policyholder It is hereby agreed the Policy shall be amended as follows: Effective January 1, 2021: The following Section has been replaced: Section 1, Declarations. The following Rider renews for the 2021 Policy Year: • Specific Advance Funding Rider. All other terms and conditions of the contract remain unchanged. Name and Title of Officer Signature of Officer Date of Signature LifeWise Assurance Company Michael L. Krutt President LifeWise Assurance Company 1. Sign and return copy to LifeWise Assurance Company. 2. Retain copy with Your Policy. PSL-500 WA AM (9-18) Ame Packet Pg. 146 8.G.i This Declarations for Policy Number WA 518212 apply to the Policy Term January 1, 2021 through December 31, 2021 in its entirety. SECTION 1 — DECLARATIONS A. POLICY INFORMATION 1. Policy Number 2. Policyholder 3. Policy Term 4. Covered Underlying Plan 5. Claim Administrator WA 518212 City of Kent January 1, 2021 through December 31, 2021 City of Kent's Health Plan Premera Blue Cross B. SPECIFIC BENEFIT SCHEDULE For all Eligible Losses except those to which a Special Risk Limitation applies: 1. Covered Loss Basis Covered Services Incurred from January 1, 2010 through December 31, 2021 and Paid from January 1, 2021 through December 31, 2021. If an Eligible Claim Expense is denied by the Covered Underlying Plan and that denial is subsequently reversed by an Independent Review Organization (IRO), the date such Eligible Claim Expense was originally denied by the Covered Underlying Plan will be considered the "Paid" date under the above referenced Policy. 2. Covered Services include Medical Prescription Drug 3. Number of Covered Units Composite 721 4. Specific Deductible per Participant $200,000 (Please note: Specific deductible per Participant shall not exceed the lesser of 5% of expected claims or $100,000). 5. Specific Payable Percentage (in excess of Specific Deductible) 100% 6. Maximum Specific Benefit in excess of the Specific Deductible Per Policy Term Unlimited Per Lifetime Unlimited PSL-500 WA (9-18) 1 Packet Pg. 147 8.G.i C. AGGREGATE BENEFIT SCHEDULE For all Eligible Losses except those to which a Special Risk Limitation applies: 1. Covered Loss Basis Covered Services Incurred from January 1, 2010 through December 31, 2021 and Paid from January 1, 2021 through December 31, 2021. If an Eligible Claim Expense is denied by the Covered Underlying Plan and that denial is subsequently reversed by an Independent Review Organization (IRO), the date such Eligible Claim Expense was originally denied by the Covered Underlying Plan will be considered the "Paid" date under the above referenced Policy. 2. Covered Services include Medical Prescription Drug 3. Number of Covered Units Composite 721 4. Aggregate Payable Percentage in excess of Deductible 100% 5. Aggregate Corridor 200% (Please note: Aggregate Corridor will never be less than 120% of expected claims). 6. Minimum Aggregate Deductible The greater of: A. $27,916,630; or B. The sum of Aggregate Monthly Factors, multiplied by the corresponding number of Covered Units used to calculate premium in the first month of the Policy Term, multiplied by the number of months in the Policy Term, multiplied by 95%. 7. Annual Aggregate Deductible Is equal to the greater of A or B, where: A = The sum of the Monthly Aggregate Deductible Amounts applicable to each Policy Month in the Policy Term B = The Minimum Aggregate Deductible Please Note: Annual Aggregate Deductible cannot be finalized until the Monthly Aggregate Deductible Amounts are calculated for each Policy Month of the Policy Term. 8. Aggregate Monthly Factor per Covered Unit Composite $3,226.61 9. Maximum Aggregate Eligible Loss per Participant $200,000 10. Maximum Aggregate Benefit per Policy Term $1,000,000 PSL-500 WA (9-18) 2 Packet Pg. 148 8.G.i D. PREMIUM Specific Monthly Premium Rate Composite $128.79 Specific Rate Guarantee Period 12 Months Aggregate Monthly Premium Rate Per Covered Unit Composite $0.02 Aggregate Rate Guarantee Period 12 Months The Specific Monthly Premium Rate and the Aggregate Monthly Premium Rate apply only to this Policy Term. E. SPECIAL RISK LIMITATIONS Disabled / hospital confined, actively at work, activity of daily' living, cognitively impaired, or similar requirements waived Yes Retirees Included Yes Other: Yes Lasered Individual Member ID: 60015680802 Specific Deductible: $300,000 F. AFFILIATE Name Covered Underlying Plan None r N O N a+ V R L 0 U m N J r C d E L V a PSL-500 WA (9-18) 3 Packet Pg. 149 8.H KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Ratify HP Laptop Purchase Utilizing CARES Act Funds MOTION: Ratify the purchase of 65 laptops, docking stations, and associated software and accessories utilizing CARES Act funding through a cooperative purchasing agreement administered by NASPO ValuePoint and entered into between HP, Inc. and the State of Minnesota as the Lead Agency; amend the budget as may be necessary to authorize that purchase using grant funds; and authorize future purchases of computer equipment and associated accessories and services through that same cooperative purchasing agreement, if those purchases can be made within the City's established budgets and during the term of the master agreement, which is currently in effect through July 31, 2021. SUMMARY: On July 28t", 2020, IT made a request to purchase up to 500 laptops, docking stations, and warranty at an estimated cost of $1,001,687.00 utilizing the CARES Act funding the City had received to allow City staff to work from home during the pandemic. After completing our assessment of each user and their specific computing needs, we were able to identify 370 users that could use the Microsoft Surface Laptop 3, and then a group of 65 users that had a higher computer processing requirement. This approval relates to ratifying the purchase of 65 higher processing computers through HP, Inc. and associated equipment for $201,964.62. With this ratification, IT is still well under its original request of $1,001,687.00, however, the original request was too narrow as it only identified Microsoft as an authorized vendor. IT is not requesting an increase of the budget, just to expand the scope of authorization to include equipment purchased through HP, Inc. under the NASPO cooperative purchasing agreement. At the January 26, 2020, Committee of the Whole meeting, the proper contract with HP, Inc. was presented for discussion. However, a scrivener's error had identified the contracting entity as Hewlett Packard Enterprise, instead of the proper contracting entity -HP, Inc. That correction has been noted in the above motion. BUDGET IMPACT: None Packet Pg. 150 8.H SUPPORTS STRATEGIC PLAN GOAL: Innovative Government - Delivering outstanding customer service, developing leaders, and fostering innovation. Evolving Infrastructure - Connecting people and places through strategic investments in physical and technological infrastructure. Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. ATTACHMENTS: 1. CAG2020-404 - Original - HP, Inc. - Laptop Purchase through DES _05815- 017, (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 151 0 65 ZB Fury 15 G7 CITY OF KENT 220 4TH AVE S KENT, WA 98032-5838 8.H.a HP Customer Quote 1591701 Contract Number: 05815-017 HP PROPRIETARY INFORMATION FOR CUSTOMER USE ONLY. NOT SHl to November 25, 2020 Dear Accounts Payable, Thank you for your recent interest in HP Public Sector Sales. Attached is the price quotation you requested. Please reference this contract: 05815-017 when placing this order. The terms and conditions of this contract will apply to any order placed as a result of this inquiry; no other terms or conditions shall apply. If you should have questions regarding this quotation or need any other assistance, please contact your Inside Account Representative All Purchase Orders need to be made out to HP Inc. or HP with the Ordering address referenced below. The Purchase Order should include the Contract Number in the body of the Purchase Order. Please also be sure to include a copy of the quote, email address,the ship to location or drop ship locations, delivery date requirements and any other special information and if applicable, the HP Authorized Reseller Agent name or authorization number for the HP Agent providing you with support. Orders should be either Faxed to 800-825-2329, emailed to PSOrderProcessinagho.com. If you are faxing or emailing this order a sample Purchase Order Document can be downloaded that gives guidance on what is required to place an order with HP. Click here to download the sample Purchase Order Ordering address: HP INC. Attn: Public Sector Sales 3800 Quick Hill Road Bldg 2, Suite 100 Austin, TX 78728 Packet Pg. 152 0 65 ZB Fury 15 G7 Information & Details Organization name: City of Kent Catalog name: OS81 S-017 Created by: bonniea@unisaftnetworks.com Partner Agent ID: 10259704 Name: Bonnie Alm Email. bonniea@unisoftnetworks.com Phone:253-856-5200 Email notification: bonniea@unisoftnetworks.com Created: November 25, 2020 Expires: December 25, 2020 Payment method: Purchase Order Quote total: USD 201,964.62 Billing Information OM ID:0900308386 Company: CITY OF KENT Address: 220 4TH AVE S City: KENT State/Province: Washington Zip/postal code: 98032-5838 Country: US Attention to: Email: Phone: Fax: 8.H.a HP Customer Quote 1591701 Contract Number: 05815-017 HP PROPRIETARY INFORMATION FOR CUSTOMER USE ONLY. NOT SH{ rn Shipping Information Company: City of Kent Address: 400 West Gowe Street Suite 122 City: Kent State/Province: Washington Zip/postal code: 98032 Country: US Attention to: J Endicott IT Dept Email: bonniea@unisoftnetworks.com Phone:425-968-1022 Fax: Delivery date: Shipping options: Shipping method: Ship Partial - Ship items as the become available Comments: Invoice instructions: Email Invoice to accountspayable@kentwa.gov Subject line: IT Dept P.O. by December 30, 2020. Shipping instructions: Delivery required on or before December 30, 2020. No loading dock. Truck with Liftgate required. Quote Summary Product # Product Description Manufacturer # Quantity Zbook Fury 15 for Bonnie Reference Model: 33409101 Configuration: 33435151 9VS27AV HP IDS i9-10885H no WWAN Fury 15 G7 Base NB PC 168W1 AV Standard Packaging 45S11 AV#ABA OS Localization 9VS81 AV Win 10 Pro 54 HIE 9VS35AV NVIDIA Quadro T2000 4GB Graphics 9VT27AV Integrated HD 720p IR DM Webcam 9VS47AV 15.6 FHD AG LED UWVA 400 fHDC IR ALSflat 9VS91 AV 32GR (2x16GB) DDR4 2666 9VT20AV 512G3 PCIe NVMe TLC SSD 9VT02AV 1 TB PCIe NVMe TLC 2nd SSD 9VSS9AV No Near Field Communication (No NFU 9VT28AV IntelWiR6AX201 ax2x2MUMIM0160MHz+3TSWW2A 9VS66AV No WWAN for HD + tR 9VTOOAV 51C Fingerprint Sensor 9VS22AV 8 Cell 94 WHr Long Life 9VS20AV 150 Watt Smart PFC Slim AC Adapter Unit Price 65 USD 2,415.00 Special price valid until 70/3112021 1 1 1 1 1 1 1 1 1 1 1 1 1 1 l 1 0 Ln T- oo LO 0 Cn LLI Total F 5 o. USD 151 l U c a 2 a V a Packet Pg. 153 8.H.a 65 Z B Fury 15 G 7 CD Customer Quote 159 Contract Number: 05815-017-017 HP PROPRIETARY INFORMATION FOR CUSTOMER USE ONLY. NOT SHl N W Q-' Product # Product Description Manufacturer # Quantity Unit Price Total F a, 9VU98AV#ABA PWRCORD C5 1.Om tag PRM US 1 N 9VU94AV4ABA WARR 31310 US 1 2KY02AV DIB No Adobe Software 1 N M t 1 A342AV AMT Enabled 1 i 3 9VT64AV#ABA CNTRYLOC US 1 d Q. 0 9VT65AV#ABA KBDPM CP+PS BL SR US 1 a M 3E756AV Electronic TCO Certified labeling 1 J a X9H35AV e5tar Enable ]OPT 1 9JQ19AV Core i9 vPro sz3 G10 Label 1 3TR87AA#ABA HP TB Dock G2 wl Combo Cable 65 USD 225.00 USD 14,62 co I 0 0699;9.9; L0 N SPeda€ price valid until ... 1013112021 1� r O U09KBE HP 4 year Pickup and Return Hardware Support w1ADP for 65 USD 184.68 USD 12,0( Lo MobileWorkstations (1 claim) o LO 0 Special pricing code: 43213365 Subtotal USD 183,60, co Estimated Tax USD 18,36( o Total USD 201,96, 0 0 L t d L :i L ♦1 Unless our contract prohibits it, (a) prices are valid for 30 days from quote date and/or (b) HP may change prices or discounts and reissi 0 quotes immediately if there are increases in casts, tariffs, or other changes outside HP's control. Q- ca If the bill to company and address you wish to use is not present at the time of check out please enter it in the "Shipping Instructions" b J The order management team will make sure it is billed to the correct location. c Components of Configurable systems may not be ordered separately. Reference Model ID's and Configuration ID's are not part number S they are reference descriptions to your specific configuration. x If you are submitting a hard copy purchase order, please include a printed copy of this quote with your purchase order. if you place an order for a product that was incorrectly priced, we will cancel your order and credit you for any charges. In the event tha •a, we inadvertently shipped an order based on a pricing error, we will issue a revised invoice to you for the correct price and contact you tl 0 obtain your authorization for the additional charge, or assist you with the return of the product, if payment was not already made. If payment was already made, HP will work with the agency to correct the invoice. If the pricing error results in an overcharge to you, HP 1 Q credit your account for the amount overcharged. N 0 N 0 a U c m E t U r r Q Packet Pg. 154 8.H.a 1. WA State Participating Agreement — HP Enterprises Packet Pg. 155 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815-014 Page I of 34 This Addendum adds the State of Washington as a Participating State authorized to purchase from the NASPO ValuePoint Master Agreement number MNWNC--115 with Hewlett Packard Company through October 31, 2015 with purchasing authority transferred to MNNVP-133 Hewlett Packard, Inc. effective November 1, 2015. 1. co e: This addendum covers the NASPO Computer Equipment Contract categories identified below, led by the State of Minnesota for use by state agencies and other entities authorized by Washington State's statutes and located in the Participating State to utilize state contracts with the prior approval of the state's chief procurement official. Language contained here supersedes and is in addition to the language of the Master Pricing Agreement a. Hewlett Packard Enterprise Company Computer Equipment: Category Awards: Scope of Service 1. Band 4: Server. A server is a physical computer dedicated to ruin one or more services or applications (as a host) to serve the needs of the users of other computers on the network. This band also includes server appliances. Server appliances have their hardware and software preconfigured by the manufacturer. It also includes embedded networking components such as those found in blade chassis systems. 2. Band 5: Storage. Storage is hardware with the ability to store large amounts of data. This band includes SAN switching necessary for the proper functioning of the storage environment. Ruggedized equipment is not included in the Product and Service Schedule for this band. 3. Examples of peripherals/accessories/options: Include but are not limited to: monitors, audiovisual equipment, instructional equipment, cabling, modems, network to support servers, storage and client applications such as routers, switches. Software is an option which must be related to the purchase of equipment and subject to configuration limits. Third party products are allowed to be offered as peripherals/accessories/options and may be offered only in bands awarded. b. Products and Services NOT allowed or provided by this Participating Addendum: Packet Pg. 156 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 2 of 35 • Ruggedized Devices, Printers, Multifunction Printers, Cell Phones • Lease Agreements, Managed Print, Cloud Service c. Use of Purchase Card is allowable at time of order placement. 2. Participation— _ Use of specific WSCA-NASPO cooperative contracts by all state agencies, political subdivisions and other entities (including cooperatives) located within the state of Washington authorized by state statutes to use state contracts are subject to the prior approval of the respective State Chief Procurement Official. Issues of interpretation and eligibility for participation are solely within the authority of the State Chief Procurement Official. - Individual Customer: Each state agency and political subdivision, as a Participating Entity, that purchases products/services will be treated as if they were individual customers. Except to the extend modified by this Participating Addendum, each agency and political subdivision shall be responsible to follow the terms and conditions of the Master Agreement; and they shall have the same rights and responsibilities as the Lead State has in the Master Agreement. Each agency and political subdivision shall have the same rights to any indemnity or to recover any costs allowed in the contract for their purchases. The Contractor shall apply the charges to each Participating Entity individually. Political and non-profit entities within the State of Washington may use this contract without further process provided they have completed, filed and accepted in the Washington State's Master Contract Agreement (MCUA) process. Use by others then those stated above is not a valid use. Use of the contract in conflict with its language is not binding on any party and does not satisfy requirements. A list of all members is available at: h t :1Jd.9.w-a,gov/services/ContrctinciPuLchinci/Purchaging-/—Pactes/Ma.sterContractsUs a eA reement.as x THIS AGREEMENT IS NOT FOR PERSONAL USE. Packet Pg. 157 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 3 of 35 3. Effective Date: This PA's initial term will begin upon final executed signatures and shall be coterminous with the head State's (Minnesota) Master Agreement and any extensions of the Master Agreement. 4. Participating State Modifications or Additions to Master Agreement: Contractor and DES agree to the following modifications and additions to the Master Agreement for Computer Equipment and apply only to actions and relationships within the Participating Entity. Department of Enterprise Services (DES) State Master Contract Standard Terms and Conditions. The following standard terms and conditions are added to the Participating Addendum for the State of Washington. This section consists of general provisions and terms for contracts issued by the Washington State Department of Enterprise Services (DES), acting under the authority of RCW 39.26 which regulates the manner in which state agencies may acquire services. 4.1 Contract Modifications or Additional Terms and Conditions to the Master Agreement: DES reserves the right to modify the resulting contract (including but not limited to adding or deleting products, services, or delivery locations) by mutual agreement between DES and the Contractor, as long as such modification is substantially within the scope of the original contract. Such modification(s) shall be memorialized in a signed, written document, (Amendment) describing the agreed upon change, including any terms and conditions required to support such change. Changes to point of contact information may be updated without the issuance of a mutually agreed contract amendment. 4.2 Restrictions: In accordance with the Master Pricing Agreement the Participating Addendum identifies the following restrictions of product; a. Software 1. Software is restricted to operating systems and commercial off -the -shelf (COTS) software and is subject to equipment configuration limits. 2. Software is an option which must be related to the procurement of equipment. 3. Software must be pre -loaded or provided as an electronic link with the initial purchase of equipment. Packet Pg. 158 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 4 of35 4. Software such as middleware which is not always installed on the equipment is allowed and may be procured after the initial purchase of equipment. b. SerNices L Services must be related to the procurement of equipment. 2. Service shall be unlimited. 3. Wireless phone and internet service is not allowed. 4, Cloud Services including acquisitions structured as managed on -site services are not allowed. S. Managed Print Services are not allowed. c_Third Party Products. 1. Contract Vendors shall only offer Third Party Products in the bands they have been awarded. 2. Contract Vendor is restricted to purchases of computer hardware manufactured by Contractor. d. Additional Product/S e 1. Hardware and software required to solely support wide area network (WAN) operation and management are not allowed. 2. Lease/Rentals of equipment shall not be allowed. 3. Cellular Phone Equipment shall not be allowed. 4. EPEAT Bronze requirement may be waived, on a State case by case basis, if approved by the State's Chief Procurement Officer. 4.3 Contract Administration • State Contract Administrator DES will appoint a single point of contact that shall be the Contract Administrator for this contract and shall provide contract oversight. The Contract Administrator shall be the principal contact for the contractor for business activities under this contract. DES shall notify the contractor in writing, when there is a new Contract Administrator assigned to this contract. • Administration of Term Contract Packet Pg. 159 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: NINNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 5 of 35 DES may maintain contract information and pricing and make it available on DES's website. The contract prices are the maximum price contractor can charge. The contractor may offer volume discounts to purchasers. 4.4 Contractor Supervision and Coordination Contractor shall: a. Competently and efficiently supervise and coordinate the implementation and completion of all contract requirements specified herein. b. Identify the contractor's Authorized Representative, who will be the principal point of contact for DES concerning contractor's performance under this contract. c. Immediately notify the Contract Administrator in writing of any change of designated Authorized Representative assigned to this contract. d. Be bound by all written communications given to or received from the contractor's Authorized Representative. Violation of any provision of this section may be considered a material breach of contract and may be grounds for contract termination. 4.5 Term Contract Management Upon award of a term contract, the contractor shall: a. Promote and market the use of this contract to all authorized contract purchasers. b. Ensure that those who endeavor to utilize this contract are authorized purchasers under this contract. c. At no additional charge, assist purchasers in making the most cost effective, value based purchases which may include, but is not limited to: - Having representatives available to provide information regarding products and services, including visiting the purchaser site if needed, and providing purchaser with materials/supplies/equipment recommendations. Packet Pg. 160 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page G of 35 Providing purchasers with a detail list of contract items including current contract pricing and part numbers. The contractor shall designate a customer service representative who will be responsible for addressing purchaser issues including but not limited to: Logging requests for service, ensuring repairs are completed in a timely manner, dispatching service technicians and processing warranty claim documentation. Providing purchasers with regular and timely status updates in the event of a delay in repair or order fulfillment. - Acting as the lead and liaison between the manufacturer and purchaser in resolving warranty claims for contract items purchased. 4.6 Changes Alterations to any of the terms, conditions, or requirements of this contract shall only be effective upon written issuance of a mutually agreed contract amendment by DES. Changes to point of contact information may be updated without the issuance of mutually agreed contract amendment. 4.7 Statewide Payee Desk Contractors must register with the Statewide Payee Desk, maintained by DES, to be paid for contract sales. Washington state agencies cannot make payments to a contractor until it is registered. Registration materials are available here: Receiving Payment from the State. 4.8 Management Fee Contractor will pay a management fee of 2 percent to DES on all state contract sales/purchase prices for work orders. The purchase price is defined as total invoice price less sales tax. Packet Pg. 161 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Adrninistered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 7 of 35 The management fee must be rolled into the contractor's current pricing; the fee must not be shown as a separate line item on an invoice unless specifically requested and approved by DES. How to determine the fee: Total sales (not including sales tax) x .0200 = management fee. DES may increase, reduce or eliminate the management fee, and reserves the right to negotiate contract pricing with the contractor when adjustment of the management fee might justify an increase in pricing. For purposes of the management fee, the parties agree that the initial management fee is included in the pricing. Therefore, any increase or reduction of the management fee must be reflected in contract pricing commensurate with the adjustment. Taxability (if applicable): In 2013, the Washington Department of Revenue ruled that if the underlying transaction requires sales tax, the DES management fee portion of the transaction is also subject to a sales tax. The state reserves the right to audit, or have a designated third party audit, applicable records to ensure that the state has been properly invoiced and all management fees have been paid. Failure to accurately report total net sales, to submit a timely sales report, or remit timely payment of the management fee may be cause for contract termination, the charging of interest or penalties, or the exercise of other remedies provided by law. The management fee does not include or supersede fees owed to other entities such as the NASPO ValuePoint or government entities other than the state of Washington. DES will invoice the contractor every quarter based on sales reported by contractor. Contractors are not to remit payment until they receive an invoice from DES. Management fee payment must reference the contract number, work request number (if applicable), the year and quarter for which the management fee is being remitted, and the contractor's name as it is known to DES, if not already included on the face of the check. Packet Pg. 162 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Adrni,nistered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: M NVP-134 and WNWNC- l IS Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 8 of 35 Remit management fee to: Washington State Department of Enterprise Services Finance Office PO Box 41460 Olympia, WA 98504-1460 NOTE: DO NOT send payment to the DES Contract Administrator and do not pay prior to receiving the invoice. 4.9 Contract Sales/Usage Report The management fee will be based on total contract sales, which must be reported quarterly by the contractor m the Contract Saly.5 lgepoKjma-�yatem. DES will provide a login password and a vendor number. Each sales report must identify every authorized purchaser by name as it is known to DES and its total combined sales amount invoiced during the reporting period (i.e., sales of an entire agency or political subdivision, not its individual subsections). The "Miscellaneous" option may be used only with prior approval by DES, and use of this option without prior approval by DES may be cause for contract termination. USAGE REPORT DUE DATE: Reports must be submitted electronically within 30 days after the end of the calendar quarter: For sales invoiced during... Due date Q l (Jan / Feb / March) April 30 Q2 (April / May / June) July 31 Q3 (July / Aug / Sept.) Oct. 31 Packet Pg. 163 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 9 of 35 04 (Oct / Nov / Dec.) ,fan. 31 Failure to provide reports in accordance with the schedule above may be cause for contract termination. The report may be corrected or modified by DES with subsequent written notice to the contractor. Upon request, contractor shall provide contact information for all purchasers during the term of this contract. Refer sales reporting questions to the Contract Administrator. 4.10 Other Required Term Contract Reports DES may require the contractor to provide a detailed annual contract sales history report. This report, if requested, will include at a minimum, but is not limited to: product description, part number or other product identifier, per unit quantities sold, and contract price. This report must be provided to DES in an electronic format that can be read by MS Excel. Unless the solicitation specifies otherwise, all other required reports will be designed and approved by the parties by mutual agreement. 4.11 Common Vendor Registration and Sid Notification System Contractor shall be registered in the state's common vendor registration and bid notification system, RCW 39.29.006, known as Washington's Electronic Business Solutions (WEBS) at www.ga.wa.aoy/webs. Contractors already registered need not re- register. It is the sole responsibility of contractors to properly register and maintain an accurate vendor profile. 4.12 Payment a. Advance payment prohibited: Packet Pg. 164 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: NU%ITVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 10 of 35 No advance payment shall be made for the products and services furnished by contractor under this contract. Notwithstanding the above, maintenance payments, if any, may be made up to one year in advance. b. Payment: Payment is the sole responsibility of, and will be made by, the purchaser Under Chapter 39.76 RCW , if purchaser fails to make timely payment(s), contractor may invoice for 1 percent per month on the amount overdue or a minimum of $1. Payment will not be considered late if a check or warrant is mailed within the time specified. if no terms are specified otherwise in the solicitation, net 30 days will automatically apply. Payment(s) made in accordance with contract terms shall fully compensate the contractor for all risk, loss, damages or expense of whatever nature and acceptance of payment shall constitute a waiver of all claims submitted by contractor. Payment for materials, supplies and/or equipment received and for services rendered shall be made by purchaser and be redeemable in U.S. dollars. Unless otherwise specified, the purchaser's sole responsibility shall be to issue this payment. Any bank or transaction fees or similar costs associated with currency exchange procedures or the use of purchasing/credit cards shall be fully assumed by the contractor. Note: when the state has been overcharged or otherwise reimbursed, the purchaser may elect to have either direct payments or written credit memos issued. If the contractor fails to make timely payment(s) or issuance of credit memos, the purchaser may impose a 1 % per month on the amount overdue 30 days after notice to the contractor. c. Invoicing and discounts Contractor must provide a properly completed invoice to purchaser. All invoices are to be delivered to the address indicated in the purchase order. Packet Pg. 165 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page ] 1 of 35 Each invoice must be identified by the associated contract number; the contractor's statewide vendor registration number assigned by the Washington State Office of Financial Management (OFM), the applicable purchaser's order number, and must be in U.S. dollars. Invoices must be prominently annotated by the contractor with all applicable prompt payment and/or volume discount(s) and shipping charges unless otherwise specified in the solicitation. Invoices for payment will accurately reflect all discounts due the purchaser. Invoices will not be processed for payment, nor will the period of prompt payment discount commence, until receipt of a properly completed invoice denominated in U.S. dollars and until all invoiced items are received and satisfactory performance of contractor has been accepted by the purchaser. If an adjustment in payment is necessary due to damage or dispute, any prompt payment discount period shall commence on the date final approval for payment is authorized. 4.13 Taxes, fees and licenses a. Taxes Where required by statute or regulation, the contractor shall pay for and maintain in current status all taxes that are necessary for contract performance. Unless otherwise indicated, the purchaser agrees to pay State of Washington taxes on all applicable materials, supplies, services and/or equipment purchased. No charge by the contractor shall be made for federal excise taxes and the purchaser agrees to furnish contractor with an exemption certificate where appropriate. b. Collection of retail sales and use taxes In general, contractors engaged in retail sales activities within the State of Washington are required to collect and remit sales tax to Department of Revenue (DOR). In general, out-of-state contractors must collect and remit "use tax" to Department of Revenue if the activity carried on by the seller in the State of Washington is significantly associated with contractor's ability to establish or maintain a market for its products in Washington. Examples of such activity include where the contractor either directly or by an agent or other representative: Packet Pg. 166 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-i 15 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 12 of 35 - Maintains an in -state office, distribution house, sales house, warehouse, service enterprise, or any other in -state place of business; -- Maintains an in -state inventory or stock of goods for sale; - Regularly solicits orders from purchasers located within the State of Washington via sales representatives entering the State of Washington; - Sends other staff into the State of Washington (e.g. product safety engineers, etc.) to interact with purchasers in an attempt to establish or maintain market(s); or - Other factors identified in WAC 458-20. c. Department of Revenue registration for out-of-state contractors Out-of-state contractors meeting any of the above criteria must register and establish an account with the Department of Revenue. Refer to WAC 458-20-193, and call the Department of Revenue at 800-647-7706 for additional information. When out-of-state contractors are not required to collect and remit "use tag," Purchasers located in the State of Washington are responsible for paying this tag, if applicable, directly to the Department of Revenue. d. Taxes on invoice Contractor shall calculate and enter the appropriate state and local sales tax on all invoices. Tax is to be computed on new items after deduction of any trade-in in accordance with WAC 458-20-247. e. Overpayments to contractor Contractor shall refund to purchaser the fail amount of any erroneous payment or overpayment under this contract within 30 days' written notice. If contractor fails to make timely refund, purchaser may charge contractor 1 percent per month on the amount due, until paid in full. f. Proprietary or confidential information Packet Pg. 167 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 13 of 35 To the extent consistent with Chapter 42.56 RCW, the Public Disclosure Act, DES shall maintain the confidentiality of contractor's information marked confidential or proprietary. If a request is made to view contractor's proprietary information, DES will notify contractor of the request and of the date that the records will be released to the requester unless contractor obtains a court order enjoining that disclosure. If contractor fails to obtain the court order enjoining disclosure, DES will release the requested information on the date specified. The state's sole responsibility shall be limited to maintaining the above data in a secure area and to notify contractor of any request(s) for disclosure for so long as DES retains contractor's information in DES records. Failure to so Iabel such materials or failure to timely respond after notice of request for public disclosure has been given shall be deemed a waiver by contractor of any claim that such materials are exempt from disclosure. 4.14 Insurance The following are general insurance provisions for the State of Washington. Additional requirements specific to a good/service may be detailed elsewhere in a solicitation or its appendices. a. General, requirements Contractor shall, at its own expense, maintain insurance as follows until completion of the contract. Upon request, contractor shall furnish evidence in the form of a certificate of insurance satisfactory to the State of Washington that insurance, in the following kinds and amounts, has been secured. failure to provide proof of insurance, as required, will result in contract cancellation. Subcontractor(s) must comply fully with all insurance requirements stated herein. Failure of subcontractor(s) to comply with insurance requirements does not limit contractor's liability or responsibility. All insurance provided in compliance with this contract shall be primary as to any other insurance or self-insurance programs afforded to or maintained by the state. Packet Pg. 168 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 14 of35 b. Specific requirements Employer's Liability (Stop Gap): The contractor will at all times comply with all applicable workers' compensation, occupational disease, and occupational health and safety laws, statutes, and regulations to the full extent applicable and will maintain Employers Liability insurance with a minimum limit of $1,000,000.00. The State of Washington will not be held responsible in any way for claims filed by the contractor or their employees for services performed under the terms of this contract. Commercial General liability Insurance: The contractor shall at all times during the term of this contract, carry and maintain commercial general liability insurance and if necessary, commercial umbrella insurance for bodily injury and property damage arising out of services provided under this contract. This insurance shall cover such claims as may be caused by any act, omission, or negligence of the contractor or its officers, agents, representatives, assigns, or servants. The insurance shall also cover bodily injury, including disease, illness and death, and property damage arising out of the contractor's premises/operations, independent contractors, products/completed operations, personal injury and advertising injury, and contractual liability (including the tort liability of another assumed in a business contract), and contain separation of insured's (cross liability) conditions. Contractor waives all rights against the State of Washington for the recovery of damages to the extent they are covered by general liability or umbrella insurance. The limits of liability insurance shall be as follows: General aggregate limits (other than products -completed $2 million operations) I Products -completed operations aggregate I $2 million Personal and advertising injury aggregate 1 $1 million Each occurrence (applies to all of the above) $1 million Packet Pg. 169 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 201.4-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Fire damage limit (per occurrence) Medical expense limit (any one person) c. Business Auto Policy (BAP) Page 15 of35 $50,000 $5,000 In the event that services delivered pursuant to this contract involve the use of vehicles, or the transportation of clients, automobile liability insurance shall be required. The coverage provided shall protect against claims for bodily injury, including illness, disease, and death; and property damage caused by an occurrence arising out of or in consequence of the performance of this service by the contractor, subcontractor, or anyone employed by either_ Contractor shall maintain business auto liability and, if necessary, commercial umbrella liability insurance with a combined single limit not less than $1,000,000 per occurrence. The business auto liability shall include Hired and Non -Owned coverage. Contractor waives all rights against the State of Washington for the recovery of damages to the extent they are covered by business auto liability or commercial umbrella liability insurance. d. Additional insurance provisions All above insurance policies shall include, but not be limited to, the following provisions: o Additional insured: State of Washington and all authorized purchasers shall be included as an additional insured on all general liability, umbrella, excess, and property insurance policies. All policies shall be primary over any other valid and collectable insurance. c Notice of policy cancellation/Non-renewal: For insurers subject to Chapter 48.18 RCW (admitted and regulated by the Washington State Insurance Commissioner) a written notice shall be given to the Packet Pg. 170 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No. MNNVP-134 and WN INC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 16 of 35 director of purchasing or designee 45 calendar days prior to cancellation or any material change to the policy as it relates to this contract. Written notice shall include the affected contract reference number. o Cancellation for non-payment of premium: If cancellation on any policy is due to non-payment of premium, a written notice shall be given the director of purchasing or designee 10 calendar days prior to cancellation. Written notice shall include the affected contract reference number. o Identification: Certificates of insurance shall include the affected contract reference number. e. Insurance carrier gating The insurance required above shall be issued by an insurance company authorized to do business within the State of Washington. Insurance is to be placed with a carrier that has a rating of A- Class VII or better in the most recently published edition of Best's Reports. Any exception must be reviewed and approved by the Risk Manager for the State of Washington, by submitting a copy of the contract and evidence of insurance before contract commencement. if an insurer is not admitted, all insurance policies and procedures for issuing the insurance policies must comply with Chapter 48.15 RCW and Chapter Z84-15 WA.0 . f. Excess coverage The limits of all insurance required to be provided by the contractor shall be in the amounts specified. However, coverage in the amounts of these limits shall not be construed to relieve the contractor from liability in excess of such limits. g. Limit adjustments The state reserves the right to increase or decrease limits as appropriate. Packet Pg. 171 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVR-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 17 of 35 4.15 Antitrust The state maintains that, in actual practice, overcharges resulting from antitrust violations are borne by the purchaser. Therefore, the contractor hereby assigns to the State of Washington any and all of the contractor's claims for such price fixing or overcharges which arise under federal or state antitrust laws, relating to the materials, supplies, services and/or equipment purchased under this contract, to the extent the assignment is necessary for the State of Washington to overcome the Federal or State's bar on indirect purchaser. 4.16 Disputes and remedies a. Problem resolution and disputes Problems arising out of the performance of this contract shall be resolved in a timely manner at the lowest possible level with authority to resolve such problem. if a problem persists and cannot be resolved, it may be escalated within each organization. In the event a bona fide dispute concerning a question of fact arises between DES or the purchaser and contractor and it cannot be resolved between the parties through the normal problem escalation processes, either party may initiate the dispute resolution procedure provided herein. The dispute shall be handled by a Dispute Resolution Panel in the following manner. Each party to this contract shall appoint one member to the Panel. These two appointed members shall jointly appoint an additional member. The Dispute Resolution Panel shall review the facts, contract terms and applicable statutes and rules and make a determination of the dispute as quickly as reasonably possible. The determination of the Dispute Resolution Panel shall be final and binding on the parties hereto. DES and/or purchaser and contractor agree that, the existence of a dispute notwithstanding, they will continue without delay to carry out all their respective responsibilities under this contract that are not affected by the dispute. Packet Pg. 172 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 18 of 35 Should reconciliation be in Contractor's favor, the disputed amount will be due and payable within thirty (30) calendar days of the new invoice issued by Contractor. The initiating party shall reduce its description of the dispute to writing and deliver it to the responding party. The responding party shall respond in writing within three business days. The initiating party shall have three business days to review the bid. If after this review a resolution cannot be reached, both parties shall have three business days to negotiate in good faith to resolve the dispute. If the dispute cannot be resolved after three business days, a Dispute Resolution Panel may be requested in writing by either party who shah also identify the first panel member. Within three business days of receiving the request, the other party will designate a panel member. Those two panel members will appoint a third individual to the Dispute Resolution Panel within the next three business days. The Dispute Resolution Panel will review the written descriptions of the dispute, gather additional information as needed, and render a decision on the dispute in the shortest practical time. Each party shall bear the cost for its panel member and share equally the cost of the third panel member. Both parties agree to be bound by the determination of the Dispute Resolution Panel. Both parties agree to exercise good faith in dispute resolution and to settle disputes prior to using a Dispute Resolution Panel whenever possible. DES, the purchaser and contractor agree that, the existence of a dispute notwithstanding, they will continue without delay to carry out all their respective responsibilities under this contract that are not affected by the dispute. If the subject of the dispute is the amount due and payable by purchaser for materials, supplies, services and/or equipment being provided by contractor, contractor shall continue providing materials, supplies, services and/or equipment pending resolution of the dispute provided purchaser pays contractor the amount purchaser, in good faith, believes is due and payable, and places in escrow the Packet Pg. 173 8.H.a PARTICIPATING .ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter"Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC- I IS Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 19 o f 3 5 difference between such amount and the amount contractor, in good faith, believes is due and payable. However, DES will pay Contractor for equipment ordered or services rendered to the date of termination and contract will be obligated to provide the equipment. b. Administrative suspension When it in the best interest of the state, DES may at any time, and without cause, suspend the contract or any portion thereof for a period of not more than 30 calendar days per event by written notice from DES to the contractor's Representative. Contractor shall resume performance on the next business day following the 30th day of suspension unless an earlier resumption date is specified in the notice of suspension. If no resumption date was specified in the notice of suspension, the contractor can be demanded and required to resume performance within the 30-day suspension period by DES providing the contractor's Representative with written notice of such demand. c. Force majeure The term "force majeure" means an occurrence that is beyond the control of the party affected and could not have been avoided by exercising reasonable diligence. Force majeure shall include acts of war, riots, strikes, fire, floods, windstorms, epidemics or other similar occurrences. Exceptions: Except for payment of sums due, neither party shall be liable to the other or deemed in breach under this contract if, and to the extent that, such party's performance of this contract is prevented by reason of force majeure. Notification: If either party is delayed by force majeure, said party shall provide written notification within 48 hours. The notification shall provide evidence of the force majeure to the satisfaction of the other party. Such delay shall cease as soon as practicable and written notification of same shall likewise be provided. So far as consistent with the Rights Reserved below, the time of completion shall be extended by contract amendment for a period of time equal to the time that the results or effects Packet Pg. 174 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MI NVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 20 of 35 of such delay prevented the delayed party from performing in accordance with this contract. Rights reserved: DES reserves the right to authorize an amendment to this contract, terminate the contract, and/or purchase materials, supplies, equipment and/or services from the best available source during the time of force majeure, and contractor shall have no recourse against the state. d. Alternative dispute resolution fees and costs In the event that the parties engage in arbitration, mediation or any other alternative dispute resolution forum to resolve a dispute in lieu of litigation, both parties shall share equally in the cost of the alternative dispute resolution method, including cost of mediator or arbitrator. In addition, each party shall be responsible for its own attorneys' fees incurred as a result of the alternative dispute resolution method. e. Non-exclusive remedies The remedies provided for in this contract shall not be exclusive but are in addition to all other remedies available under law. 4.17 Liquidated damages a. Liquidated damages - General DES and or the purchasers and the contractor agree that the liquidated damages provisions in the contract are a reasonable forecast of the actual damages that would be suffered by the purchaser in the event of contractor's nonperformance, that such liquidated damages are not a penalty but represent the reasonable compensation due purchaser in the event of a breach, and that such liquidated damages will be assessed as appropriate. Any delay by contractor in meeting the Delivery Date, Installation Date, maintenance or repair date, or other applicable date set forth in this contract will interfere with the proper implementation of purchaser's programs and will result in loss and damage to purchaser. Packet Pg. 175 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNVYNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 21 of 35 As it would be impracticable to fix the actual damage sustained in the event of any such failure(s) to perform and/or purchaser and contractor agrees that in the event of any such failure(s) to perform, the amount of damage which will be sustained will be assessed as appropriate based upon the purchasers inability to perform their function and the parties agree that contractor shall pay such amounts as liquidated damages and not as a penalty. Liquidated damages provided under the terms of this contract are subject to the same limitations as provided in the section titled Limitation of Liability. b. Limitation of liability See Master Agreement, Exhibit A, Terms and Conditions, Section C17. c. Federal funding (if applicable) In the event that a federally funded acquisition results from this procurement, the contractor may be required to provide additional information (free of charge) at the request of DES or purchaser. Further, the contractor may be subject to those federal requirements specific to the commodity. d. Federal restrictions on lobbying (if applicable) Contractor certifies that under the requirements of Lobbying Disclosure Act, 2 U.S.C., Section 1601 et seq., no federal appropriated funds have been paid or will be paid, by or on behalf of the contractor, to any person for influencing or attempting to influence an officer or employee of any agency, a member of Congress, an officer or employee of Congress, or an employee of a member of Congress in connection with the awarding of any federal contract, the making of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement. 4.18 Debarment and suspension Respondent certifies, by submitting this bid or proposal, that neither it nor its affiliates presently are debarred, suspended, proposed for debarment, declared Packet Pg. 176 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC -115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 22 of 35 ineligible or voluntarily excluded from participation in this procurement/contract by any government agency. Respondent also agrees to notify DES if its debarment status changes during the bid process or after receiving notice of contract award, if any. If respondent cannot certify this statement, attach a written explanation to the bid response for review. 4.19 Contract termination a. Material breach A contractor may be terminated for cause by DES, at the sole discretion of DES, for failing to perform a material contractual requirement or for a material breach of any term or condition. Material breach of a term or condition of the contract may include but is not limited to: • Contractor failure to perform services or deliver materials, supplies, or equipment by the date required or by an alternate date as mutually agreed in a written amendment to the contract; • Contractor failure to carry out any warranty or fails to perform or comply with any mandatory provision of the contract; • Contractor becomes insolvent or in an unsound financial condition so as to endanger performance hereunder; • Contractor becomes the subject of any proceeding under any law relating to bankruptcy, insolvency or reorganization, or relief from creditors and/or debtors that endangers the contractor's proper performance hereunder; • Appointment of any receiver, trustee, or similar official for contractor or any of the contractor's property and such appointment endangers the contractor's proper performance hereunder; • A determination that the contractor is in violation of federal, state, or local laws or regulations and that such determination renders the contractor unable to perform any aspect of the contract. Packet Pg. 177 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MIVNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page23 of35 b. Opportunity to cure In the event that Contractor fails to perform a contractual requirement or materially breaches any term or condition, DES may issue a written cure notice. The contractor may have a period of time in which to cure. DES is not required to allow the contractor to cure defects if the opportunity for cure is not feasible as determined solely within the discretion of DES. Time allowed for cure shall not diminish or eliminate contractor's liability for liquidated or other damages, or otherwise affect any other remedies available against contractor under the contract or by law. If the breach remains after contractor has been provided the opportunity to cure, DES may do any one or more of the following; Exercise any remedy provided by law; - Terminate this contract and any related contracts or portions thereof; - Procure replacements and impose damages as set forth elsewhere in this contract; -- Impose actual or liquidated damages; -- Suspend or bar contractor from receiving future solicitations or other opportunities; - Require contractor to reimburse the state for any loss or additional expense incurred as a result of default or failure to satisfactorily perform the terms of the contract. If DES completes the project through a third Party, DES may as its exclusive remedy recover from Contractor reasonable costs incurred to complete the project. DES will mitigate damages and provide Contractor with detailed invoices substantiating the charges. C. Termination for cause In the event DES, in its sole discretion, determines that the contractor has failed to comply with the conditions of this contract in a timely manner or is in material breach, DES has the right to suspend or terminate this contract, in part or in whole. DES shall Packet Pg. 178 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC- 1 IS Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 24 of 35 notify the contractor in writing of the need to take corrective action. If corrective action is not taken within 30 calendar days or as otherwise specified by DES, or if such corrective action is deemed by DES to be insufficient, the contract may be terminated. DES reserves the right to suspend all or part of the contract, withhold further payments, or prohibit the contractor from incurring additional obligations of funds during investigation of the alleged breach and pending corrective action by the contractor or a decision by DES to terminate the contract. In the event of termination, DES shall have the right to procure for all purchasers any replacement materials, supplies, services and/or equipment that are the subject of this contract on the open market. In addition, the contractor shall be liable for damages as authorized by law including, but not limited to, any price difference between the original contract and the replacement or cover contract and all administrative costs directly related to the replacement contract, e.g., cost of the competitive bidding, mailing, advertising and staff time. If DES completes the project through a third Party, DES may as its exclusive remedy recover from Contractor reasonable costs incurred to complete the project. DES will mitigate damages and provide Contractor with detailed invoices substantiating the charges. If it is determined that: (1) the contractor was not in material breach; or (2) failure to perform was outside of contractor's or its subcontractor's control, fault or negligence, the termination shall be deemed to be a "termination for convenience." The rights and remedies of DES and/or the purchaser provided in this contract are not exclusive and are in addition to any other rights and remedies provided by law. DES will be liable to Contractor for equipment ordered or services rendered to the date of termination. d. Termination for convenience Except as otherwise provided in this contract, DES, at the sole discretion of DES, may terminate this contract, in whole or in part by giving 30 calendar days or other appropriate time period written notice beginning on the second day after mailing to the contractor. If this contract is so terminated, purchasers shall be liable only for payment required under this contract for properly authorized services rendered, or Packet Pg. 179 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 25 of 35 materials, supplies and/or equipment delivered to and accepted by the purchaser prior to the effective date of contract termination. Neither DES nor the purchaser shall have any other obligation whatsoever to the contractor for such termination. This Termination for Convenience clause may be invoked by DES when it is in the best interest of the State of Washington. DES will be liable to Contractor for equipment ordered or services rendered to the date of termination. e. Termination for withdrawal of authority In the event that DES and/or purchaser's authority to perform any of its duties is withdrawn, reduced, or limited in any way after the commencement of this contract and prior to normal completion, DES may terminate this contract, in whole or in part, by seven calendar day's written notice, or other appropriate time period, to contractor. f. Termination for non -allocation of funds If funds are not allocated to purchaser(s) to continue this contract in any future period, DES may terminate this contract with seven calendar days written notice, or other appropriate time period, to contractor, or work with contractor to arrive at a mutually acceptable resolution of the situation. Purchaser will not be obligated to pay any further charges for materials, supplies, services and/or equipment including the net remainder of agreed -to consecutive periodic payments remaining unpaid beyond the end of the then -current period. DES and/or purchaser agree to notify contractor in writing of such non -allocation at the earliest possible time. No penalty shall accrue to the purchaser in the event this section shall be exercised. This section shall not be construed to permit DES to terminate this contract in order to acquire similar materials, supplies, services and/or equipment from a third party. g. Termination for conflict of interest DES may terminate this contract by written notice to contractor if it is determined, after due notice and examination, that any party to this contract has violated Chapter 42.52 RCW, Ethics in Public Service, or any other laws regarding ethics in public acquisitions and procurement and performance of contracts. In the event this contract Packet Pg. 180 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 26 of 3 S is so terminated, DES and/or purchaser shall be entitled to pursue the same remedies against contractor as it could pursue in the event that the contractor breaches this contract. It. Termination by mutual agreement DES and the contractor may terminate this contract in whole or in part, at any time, by mutual agreement. i. Termination procedure In addition to the procedures set forth below, if DES terminates this contract, contractor shall follow any procedures DES specifies in the termination notice. Upon termination of this contract and in addition to any other rights provided in this contract, DES may require the contractor to deliver to the purchaser any property specifically produced or acquired for the performance of such part of this contract as has been terminated. The purchaser shall pay to the contractor the agreed upon price, if separately stated, for completed work and service(s) Accepted by the purchaser, and the amount agreed upon by the contractor and the purchaser for (i) completed materials, supplies, services rendered and/or equipment for which no separate price is stated, (ii) partially completed materials, supplies, services rendered and/or equipment, (iii) other materials, supplies, services rendered and/or equipment which are Accepted by the purchaser, and (iv) the protection and preservation of property, unless the termination is for cause, in which case DES and the purchaser shall determine the extent of the liability of the purchaser_ Failure to agree with such determination shall be a dispute within the meaning of the "Disputes" clause of this contract. The purchaser may withhold from any amounts due the contractor such sum as DES and purchaser determine to be necessary to protect the purchaser against potential loss or liability. The rights and remedies of DES and/or the purchaser provided in this section shall not be exclusive and are in addition to any other rights and remedies provided by law or under this contract. Packet Pg. 181 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 27 of 35 After receipt of a termination notice, and except as otherwise expressly directed in writing by DES, the contractor shall: • Stop all work, order fulfillment, shipments, and deliveries under the contract on the date, and to the extent specified, in the notice; • Place no further orders or subcontracts for materials, services, supplies, equipment and/or facilities in relation to the contract except as is necessary to complete or fulfill such portion of the contract that is not terminated; • Complete or fulfill such portion of the contract that is not terminated in compliance with all contractual requirements; • Assign to the purchaser, in the manner, at the times, and to the extent directed by DES on behalf of the purchaser, all of the rights, title, and interest of the contractor under the orders and subcontracts so terminated, in which case the purchaser has the right, at its discretion, to settle or pay any or all claims arising out of the termination of such orders and subcontracts. • Settle all outstanding liabilities and all claims arising out of such termination of orders and subcontracts, with the approval or ratification of DES and/or the purchaser to the extent DES and/or the purchaser may require, which approval or ratification shall be final for all the purposes of this clause; • Transfer title to the purchaser and deliver in the manner, at the times, and to the extent directed by DES on behalf of the purchaser any property which, if the contract had been completed, would have been required to be furnished to the purchaser•, • Take such action as may be necessary, or as DES and/or the purchaser may direct, for the protection and preservation of the property related to this contract which is in the possession of the contractor and in which DES and/or the purchaser has or may acquire an interest. Packet Pg. 182 8.H.a PARTICIPATING ADDENDUM W 3CA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MIVNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 28 of 35 S. Primary Contacts: The primary contact individual (or their named successor) for this Participating Addendum is as follows: Contractor Name Stacey Kearns Address 355 Ledgeiawn Drive, Conway, AR 72204 Telephone 512-319-3018 Fax 501-339-2377 Email_ Stacey.lyn.kearns@hpe.com Participating Ent! Name Address _ Telephone _ Email Momi Friedlander Contract Specialist Department of Enterprise Services _ 1500 Jefferson Street SE, Olympia, WA 98501 _ 360-407-8505 Momi.friedlander@des.wa.cjov 6. Minority and Women's Business Enterprises (MWBE) In accordance with the legislative findings and policies set forth in RQM 39,19, the State of Washington encourages participation in all of its contracts by minority and woman -owned businesses firms certified by the Office PJ MiR and Women' Busines En a ri_ (OMWBE). While the state does not give preferential treatment, it does seek equitable representation from the minority and women's business community. In addition, the state welcomes participation by self -identified minority and woman owned firms and strongly encourages such firms to become certified by OMWBE. Hewlett Packard Co. shall consider and encourage minority and women owned firms in their pool of subcontractors, However, unless required by federal statutes, regulations, grants, or contract terms no preference will be included in the evaluation of bids Any affirmative action requirements set forth in federal regulations or statutes included or referenced in the original solicitation shall apply. Contact OMWBE for information on other certified firms for potential sub -contracting arrangements. DES encourages participation by non-MWBE firms as well as MWBE firms. Prior to performance, an awarded bidder that is a Packet Pg. 183 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 29 of 35 MWBE or intends to use MWBE subcontractors is encouraged to identify the participating firm(s) to DES. 6.1. Public records and exempt information All documents submitted by said Contractor to DES during the performance of this agreement shall become public records. They are subject to disclosure unless specifically exempt under Revised Code of Washington (RCW) 42.56 (The Public Records Act). Confidential documents: DES strongly discourages submittal of any confidential material. DES considers confidential material to be any portion of your submittal clearly marked all or in part "Confidential," "Proprietary" or "Trade Secret" (or the equivalent). • DES reserves the right to return, reject or disqualify any submittal that includes confidential material. Public records requests: If a public records request seeks to view or obtain a copy of your RFP submittal, and if your submittal includes content clearly marked "Confidential," "Proprietary" or "Trade Secret" (or the equivalent), DES will: • Notify you of the date DES will disclose the requested records; Give you an opportunity to seek a court order that stops DES from disclosing the records. DES shall not: Evaluate or defend your claim of confidentiality. It is your responsibility to support your claim and take appropriate legal action to do so; • Withhold or redact your documents without a court order. Questions about the confidentiality of your submittal can be directed to the Procurement Coordinator or the DES Public Records Officer at (360) 407-8768 or ublicrecor des.w ov. Packet Pg. 184 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Adrninistered by the State of Minnesota (hereinafter "Lead State") Master Agreement No: MNNV`P- 134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 30 of 35 6.2 Legal notices Any notice or demand or other communication required or permitted to be given under the contract or applicable law (except notice of malfunctioning Equipment) will be effective only if it is in writing and signed by the applicable party, properly addressed, and either delivered in person, or by a recognized courier service, or deposited with the United States Postal Service as first-class mail, postage prepaid, certified mail, return receipt requested, via facsimile or by electronic mail, to the parties at the addresses and fax numbers, e-mail addresses provided in the Authorized Offer and Contract Signature Page below. For purposes of complying with any provision in the contract or applicable law that requires a "writing," such communication, when digitally signed with a Washington State Licensed Certificate, shall be considered to be "in writing" or "written" to an extent no less than if it were in paper form. Notices will be effective upon receipt or four business days after mailing, whichever is earlier. The notice address as provided herein may be changed by written notice given as provided above. In the event that a subpoena or other legal process commenced by a third party in any way concerning the Equipment or Services provided pursuant to the contract is served upon contractor or DES, such party agrees to notify the other party in the most expeditious fashion possible following receipt of such subpoena or other legal process. The contractor and DES further agree to cooperate with the other party in any lawful effort by the other party to contest the legal validity of such subpoena or other legal process commenced by a third party. 6.3. Liens, claims and encumbrances All materials, equipment, supplies and/or services shall be free of all liens, claims, or encumbrances of any kind, and if DES or the purchaser requests, a formal release of same shall be delivered to the respective requestor. 6.4 Payment a. Advance payment prohibited: No advance payment shall be made for the products and services furnished by contractor under this contract. Packet Pg. 185 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: NHVNVP-134 and WNWNC-1 15 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 31 of 35 Notwithstanding the above, maintenance payments, if any, may be made on a quarterly basis at the beginning of each quarter. b. Payment: Payment is the sole responsibility of, and will be made by, the purchaser. Under Chapter 39.76 RCW , if purchaser fails to make timely payment(s), contractor may invoice for 1 percent per month on the amount overdue or a minimum of $1. Payment will not be considered late if a check or warrant is mailed within the time specified. If no terms are specified otherwise in the solicitation, net 30 days will automatically apply_ Payment(s) made in accordance with contract terms shall fully compensate the contractor for all risk, loss, damages or expense of whatever nature and acceptance of payment shall constitute a waiver of all claims submitted by contractor. Payment for materials, supplies and/or equipment received and for services rendered shall be made by purchaser and be redeemable in U.S. dollars. Unless otherwise specified, the purchaser's sole responsibility shall be to issue this payment. Any bank or transaction fees or similar costs associated with currency exchange procedures or the use of purchasing/credit cards shall be fully assumed by the contractor. Note: when the state has been overcharged or otherwise reimbursed, the purchaser may elect to have either direct payments or written credit memos issued. If the contractor fails to make timely payment(s) or issuance of credit memos, the purchaser may impose a 1 % per month on the amount overdue 30 days after notice to the contractor. c. Invoicing and discounts Contractor must provide a properly completed invoice to purchaser. All invoices are to be delivered to the address indicated in the purchase order. Each invoice must be identified by the associated contract number; the contractor's statewide vendor registration number assigned by the Washington State Office of Financial Management (OFM), the applicable purchaser's order number, and must be in U.S. dollars. Invoices must be prominently annotated by the contractor with all applicable Packet Pg. 186 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: M94NVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 32 of 35 prompt payment and/or volume discount(s) and shipping charges unless otherwise specified in the solicitation. Invoices for payment will accurately reflect all discounts due the purchaser. Invoices will not be processed for payment, nor will the period of prompt payment discount commence, until receipt of a properly completed invoice denominated in U.S. dollars and until all invoiced items are received and satisfactory performance of contractor has been accepted by the purchaser. If an adjustment in payment is necessary due to damage or dispute, any prompt payment discount period shall commence on the date final approval for payment is authorized. 6.5 Taxes, Fees and Licenses a. Taxes Where required by statute or regulation, the contractor shall pay for and maintain in current status all taxes that are necessary for contract performance. Unless Otherwise indicated, the purchaser agrees to pay State of Washington taxes on all applicable materials, supplies, services and/or equipment purchased. No charge by the contractor shall be made for federal excise taxes and the purchaser agrees to furnish contractor with an exemption certificate where appropriate. b. Collection of retail sales and use taxes In general, contractors engaged in retail sales activities within the State of Washington are required to collect and remit sales tax to Department of Revenue (DQR). In general, out-of-state contractors must collect and remit "use tax" to Department of Revenue if the activity carried on by the seller in the State of Washington is significantly associated with contractor's ability to establish or maintain a market for its products in Washington. Examples of such activity include where the contractor either directly or by an agent or other representative: -- Maintains an in -state office, distribution house, sales house, warehouse, service enterprise, or any other in -state place of business; - Maintains an in -state inventory or stock of goods for sale; Packet Pg. 187 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 33 of 35 Regularly solicits orders from purchasers located within the State of Washington via sales representatives entering the State of Washington; Sends other staff into the State of Washington (e.g. product safety engineers, etc.) to interact with purchasers in an attempt to establish or maintain market(s); or - Other factors identified in WAC 458-20. c. Department of Revenue registration for out-of-state contractors Out-of-state contractors meeting any of the above criteria must register and establish an account with the Department of Revenue. Refer to WAC 458-20-193, and call the Department of Revenue at 800-647-7706 for additional information. When out-of-state contractors are not required to collect and remit "use tax," purchasers located in the State of Washington are responsible for paying this tax, if applicable, directly to the Department of Revenue. d. Taxes an invoice Contractor small calculate and enter the appropriate state and local sales tax on all invoices. Tax is to be computed on new items after deduction of any trade-in in accordance with WAC 488-20-247. e. Overpayments to Contractor Contractor shall refund to purchaser the full amount of any erroneous payment or overpayment under this contract within 30 days' written notice. if contractor fails to make timely refund, purchaser may charge contractor l percent per month on the amount due, until paid in full. 6.6 Information and Communications Proprietary or confidential information To the extent consistent with Chapter 42.56 RCW, the Public Disclosure Act, DES shall maintain the confidentiality of contractor's information marked confidential or proprietary. If a request is made to view contractor's proprietary information, DES will notify contractor Packet Pg. 188 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 34 of 35 of the request and of the date that the records will be released to the requester unless contractor obtains a court order enjoining that disclosure. If contractor fails to obtain the court order enjoining disclosure, DES will release the requested information on the date specified. The state's sole responsibility shall be limited to maintaining the above data in a secure area and to notify contractor of any request(s) for disclosure for so long as DES retains contractor's information in DES records. Failure to so label such materials or failure to timely respond after notice of request for public disclosure has been given shall be deemed a waiver by contractor of any claim that such materials are exempt from disclosure. T. Subcontractors: All Hewlett Packard Co. dealers and resellers authorized in the State of Washington are approved to provide sales and service support to participants authorized by this Participating Addendum and shall be in accordance with the terms and conditions set forth in the aforementioned Master Agreement. 8. Orders: Any Order placed by a Participating Entity or Purchasing Entity for a Product and/or Service available from this Participating Addendum shall be deemed to be a sale under (and governed by the prices and other terms and conditions) of the Master Agreement unless the parties to the Order agree in writing that another contract or agreement applies to such Order. Purchase orders must be submitted with a valid quote and written acceptance from agency prior to contract performance. Packet Pg. 189 8.H.a PARTICIPATING ADDENDUM WSCA-NASPO COOPERATIVE PURCHASING ORGANIZATION, LLC MN 2014-2019 Computer Equipment (Servers and Storage including Related Peripherals & Services) Administered by the State of Minnesota (hereinafter "Lead State") MASTER AGREEMENT Master Agreement No: MNNVP-134 and WNWNC-115 Hewlett Packard Company (hereinafter "Contractor") And State of Washington, Department of Enterprise Services (hereinafter "Participating State") Participating State Contract #05815 Page 35 of 35 IN WITNESS WHEREOF, the parties have executed this Addendum as of the date of execution by both parties below. Participating State: Contractor: By: By: *� Name: Name: Matthew C. Keck Title: Title: Senior Counsel Date: Date: 9/ 16/ 1$ PaIting State: Participa ' g State: B Signa } By{Si azure) Alit N e: i{/ e• f ,Tale Title:p % Date: fry Date: Packet Pg. 190 8.H.a 2. Assignment to HP Enterprise and HP Inc (June 2015) and Master Agreement (Feb 2015) Packet Pg. 191 8.H.a ASSIGNMENT AGREEMENT This Assignment Agreement is by and among the State of. Minnesota, acting through its commissioner of Administration (State), Hewlett Packard Company, ("Original Contract Vendor") 3000 Hanover Street, Palo Alto, CA 94304, HP Inc., ("Assigned Contract Vendor") 1501 Page Mill Road, Palo Alto, CA 94304 and Hewlett Packard Enterprise, ("Assigned Contract Vendor") 3000 Hanover Street, Palo Alto, CA 94304. WHEREAS, the State has an agreement with the Original Contract Vendor, Master Agreement No. MNWNC-115, ("Master Agreement") effective April 1, 2015 through March 31, 2017 to provide Computer Equipment (Desktops, Laptops, Tablets, Servers and Storage including related peripherals & services); and WHEREAS, the Original Contract Vendor wishes to separate Hewlett Packard Company into two independent companies and assign all its interests and obligations in the Master Agreement to the Assigned Contract Vendors; WHEREAS, the assignment provision of the Master Agreement provides assignment of the agreement only upon written consent of the State. NOW THEREFORE, the parties agree to the following: Effective November 1, Master Agreement No. MNWNC-115 is assigned to two independent companies, the Assigned Contract Vendors The products have been divided as noted below: Master Agreement No. MNNVP-133 HP Inc. Master Agreement Administrator: Debra Lee; debra.lee a@hp com, 847-537-0344 or 847-922-2977 HP Inc. will provide Desktops, Laptops andTablets including related peripherals and services (Bands 1, 2, & 3) Master Agreement No. MNNVP-134 Hewlett Packard Enterprise Master Agreement Administrator: Stacy Kearns; Stacey. ln.kearns h .com, 512-319-3018 Hewlett Packard Enterprise will provide Servers and Storage including related peripherals and services. (Bands 4 & 5). This Agreement will become effective upon its approval and execution by the parties and approval of the appropriate State officials, pursuant to Minn. Stat. §16C.05, subd. 2. The State hereby approves the request of the Original Contract Vendor to assign to the Assigned Contract Vendors all its interests, rights, responsibilities, duties,.and other provisions set forth in the Master Agreement, which is attached and incorporated as Exhibit C, provided the Original Contract Vendor and the Assigned Contract Vendors agree to all provisions set forth in this Assignment Agreement. Furthermore the Assigned Contract Vendors agree to the Pricing Schedules attached and incorporated as Exhibit A and B. These Pricing Schedules provide clarity to the established products and discounts assigned to each vendor and fully replace the Original Contract Vendor Master Agreement Pricing Schedule. 3. The Original Contract Vendor and the Assigned Contract Vendors jointly and severally represent and warrant to the State that: a. the Original Contract Vendor is not in default of any of its obligations underthe Contract; and b. the Original Contract Vendor has assigned to the Assigned Contract Vendors, under separate agreement, sufficient information, rights to technology, and key personnel sufficient to enable the Assigned Contract Vendors to properly perform the duties, responsibilities, obligations, and all other provisions assigned to the Assigned Contract Vendors; in addition, Original Contract Vendor assigns all prepaid funds paid by the Participating Entity under the Master Agreement for services, storage or subscriptions to.the applicable Assigned Contract Vendor who has received transfer of such services, storage and subscriptions and c. the Assigned Contract Vendors are ready, willing, and able to perform all of the duties, obligations, and responsibilities of the Master Agreement. 4, The Assigned Contract Vendors accept assignment of all the provisions of the Master Agreement, 5. Ordering and invoicing for Hewlett Packard Company acting through Hewlett Packard Enterprise may begin on or E after 8/1/2015. r r a Assignagree7 (07/13) Assignment Agreement, Master Agreement No. MNWNC-115 Page 2 of 6 Packet Pg. 192 Ordering and invoicing for IMP Inc. may begin on or after 11/1/2015. 8.H.a Any and all amounts due to Hewlett Packard Company by the Participating Entity for goods and/or services provided by the Hewlett Packard Company Vendor prior to November 1, 2015, under the Master Agreement will be paid to Hewlett Packard Company by the Participating Entity. Any and all amounts due under the Master Agreement on or after !November 1, 2015, will be paid to the Assigned Contract Vendors by the Participating Entity. 6. When applicable, payment for remaining work and travel expenses from the Master Agreement will be paid at the rates set in the Master Agreement. The amount to be paid to the Assigned Contract Vendors will not exceed the Contract's total costs, minus the total payments made to the Original Contract Vendor. The Assigned Contract Vendors will provide proof of insurance with the coverage and in the amounts called for in the original solicitation document, attached herein. It is understood currently Hewlett Packard Enterprise is a subsidiary of Hewlett Packard Company and therefore insured as required. Once the separation occurs November 1, 2015, insurance certificates will be provided for each new company. The Assigned Contract Vendors will supply Affirmative Action Certification if so required by MN.Stat.§ 36A.36, or if applicable certify Assigned Vendor is in federal affirmative action compliance pursuant to MN.Stat.§ 363A.36. IN WITNESS WHEREOF, the parties have caused this Assignment Agreement to be duly executed intending to be bound thereby. 9. ORIGINAL CONTRACT VENDOR HEWLETT PACKARD COMPANY 4. ASSIGNED CONTRACT VENDOR The Original Contract Vendor certifies that the appropriate HP Inc, person(s) have executed this document on behalf of the Contract The Assigned Contract Vendor certifies that the appropriate Vendor as required by . pplicable arti Ies, bylaws, resolutions, or person(s) have executed the Contract on behalf of the Contract ordinances. Vendor as required by applicable. articles, bylaws, resolutions, or ordinances. . By: Title: Senior Counsel By: Date: June 30, 2015 By: Title: Date: 2. MATERIALS MANAGEMENT DIVISION and NASPO ValuePoint (formerly WSCA-NASPO) Master Agreement Administrator] In accordance with Minn. §16C.03, Subd. 3. By:•� Title: Acquisition Management Specialist Date: 3. COMMISSIONER OF ADMINISTRATION Or delegated r sentative. By: Date:7�z Title: Senior Counsel Date: June 30, 2015 By: Title: Date: 5. ASSIGNED CONTRACT VENDOR HEWLETT PACKARD ENTERPRISE The Assigned Contract Vendor certifies that the appropriate person(s) have executed the Contract on behalf of the Contract Vendor as required by applicable articles, bylaws, resolutions, or ordinances By: Title: Senior Counsel Date: June 30, 2015 By: Title: Date: Assignagree7 (07113) Assignment Agreement, Master Agreement No. MNWNC-115 Page 3 of 6 Packet Pg. 193 8.H.a EXHIBIT A The Assigned Contract Vendors accept assignment of all the provisions of the Master Agreement MNWNC-115. The following pricing schedule reflects the products (Desktops -Band 1, Laptops Band 2, & Laptops Band 3) assigned to Hewlett Packard Inc. and replaces Exhibit B of Master Agreement MNWNC-115 held by Hewlett Packard Company. HP INC. MNNVP-133 EXHIBIT B - PRICING SCHEDULE COMPUTER EQUIPMENT: DESKTOPS, LAPTOPS, TABLETS 1. BASELINE , PRICING _ . INC. LIST PRICE 2. E DISCOUNTS CATEGORY O■ DISCOUNT BAND 1 DESKTOP BAND 2 LAPTOP -' 0', Category Exception: Promotions/Smart Bus PROMO 1 % IMPORTANT: The minimum discount is provided, refer to Contract Vendor's Website for any additional discounts and request a quote for bulk/volume discounts. All prices shall be FOB Destination, prepaid and allowed (with freight included in the price). If there is a special case where inside delivery fee must be charged, the Contract Vendor will notify the customer in advance. 3. THIRD PARTY PRODUCTS TPH 10% 7a—tegory Exception: Third Party Software TPS 5% See HP NASPOValuePoint Website for Approved Third Party Software & Hardware Manufacturers. 4. SERVICES - Offered at 7-22% - Contact HP for Time and Materials Rates and Custom Services Services are at the option of the Participating State. The Participating Addendum by each State may address service agreement terms. The majority of HP Branded products include up to a 3 year warranty and HP provides options to upgrade to 2, 3, 4 and 5 year warranty through HP Care Packs for some products as available. For product specifications & standard warranty included with system see: http:Ilh7lO69.www7.hp.com/auickspecs/overview.htm1#1ntro 6. LEASING Partici atin1 Addendum may identify if and how leasing agreement terms will be conducted. 6. ADDITIONAL DISC•UNTS — Request a quote • discounts on bulk/volume purchases. a. Big Deal Pricing: Contact HP sales for additional savings provided through "special,fixed pricing" (Big Deal). HP offers Multiple Transaction Volume based on the quantity, specific product or products purchased in a given time period. b. Cumulative and Special Discounts:_ Based on annual volume, HP will evaluate yearly sales on the Master Agreement and may elect to provide potential increased discount per band or provide specials for select products for the product category or series life cycle. c. Additional BulklVolurne Discount Options: HP may provide procuring entities with different flexible savings options based on what meets their specific needs and requirements. HP may provide opportunities in the form of additional equipment if allowed by the Participating Entity. d. Contact HP for detailed list of additional discounts provided. Assignagree7 (07/13) Assignment Agreement, Master Agreement No. MNWNC-1115 Page 4 of 5 Packet Pg. 194 8.H.a EXHIBIT B The Assigned Contract Vendors accept assignment of all the provisions of Master Agreement MNWNC-115. The following pricing schedule reflects the products (Servers Band 4, Storage Band 5) assigned to Hewlett Packard Enterprise and replaces Exhibit B of Master Agreement MNWNC-115 held by Hewlett Packard Company. HEWLETT PACKARD ENTERPRISE MNNVP-134 EXHIBIT B - PRICING SCHEDULE COMPUTER EQUIPMENT. SERVERS & STORAGE 1 PRICING ■ ENTERPRISE 1. BASELINE 2. BAND DISCOUNTS CATEGORY CODE DISCOUNT a / SERVER / A`1 1 BAND 1 • B STORAGE 1 1 IMPORTANT: The minimum discount is provided, refer to Contract Vendor's Website for any additional.discounts and request a quote for bulklvolume discounts. All prices shall be FOB Destination, prepaid and allowed (with freight included in the price). If there is a special case where inside delive fee must be char ed, the Contract Vendor will notiN the customer in advance. 1 PRODUCTS ■ , 1 / THIRD3. PARTY Category Exception: Third Party Software TPS 5% Cate o Exception: Microsoft OIS when purchased with Band 4 items 4M16 0% See HP WSCA-NASPO Website for Approved Third Partv Software & Hardware Manufacturers. OfferedSERVICES - ', - for Time and Materials Rates and Custom Services Services are at the option of the Participating State. The Participating Addendum by each State may address service agreement terms. The majority of HP Branded products include up to a 3 year warranty and HP provides options to upgrade to 2, 3, 4 and 5 year warranty through HP Care Packs for some products as available. For product specifications & standard warranty included with system see: http://h7lO69.www7.hp.comlguickspecs/overview.html#intro 5. LEASING ParticiL:)atinq Addendum may identify if and how leasing agreement terms will be conducted. 6. ADDITIONAL i •UNTS — Request a quote • discounts on bulk/volume purchases. a. Big Deal Pricing: Contact HP sales for additional savings provided through "special fixed pricing" (Big Deal). HP offers Multiple Transaction Volume based. on the quantity, specific product or products purchased in a given time period. b. Cumulative and Special Discounts: Based on annual volume, HP will evaluate yearly sales on the Master Agreement and may elect to provide potential increased discount per band or provide specials for select products for the product category or series life cycle. c. Additional BulkNolume Discount Options: HP may provide procuring entities with different flexible savings options based on what meets their specific needs and requirements. HP may provide opportunities in the form of additional equipment if allowed by the Participating Entity. d. Contact HP for detailed list of additional discounts provided. Assignagree7 (07113) Assignment Agreement, Master Agreement No. MNWNC-115 Page 6 of 6 Packet Pg. 195 8.H.a EXHIBIT C MASTER AGREEMENT MNWNC-I IS Assignagree7 (07/13) Assignment Agreement, Master Agreement No. MNWNC-115 Page 6 of 6 Packet Pg. 196 L3E1�A`k�I�I N3F AUfii3Nf5Tt ATI(i1J' STATE OF MINNESOTA Materials Management Division 112Administration Building 50 Sherburne Avenue St. Paul, MN 55155 Voice. 661.296.2600 Fax; 651.297.3996 J � C�4kr>�teATtua, x;�t�riI74�1rdG MINNESOTA WSCA-NASPQ MASTER AGREEMENT AWARD WITH. Hewlett Packard Company . FOR COMPUTER EQUIPMENT. (Desktops, Laptops, Tablets, Servers, and Storage including Related Peripherals & Services) To: Hewlett-Packard Company 3000 Hanover Street Palo Alto, CA 94304 Contract Vendor Administrator: Debra Lee Email: debra.lee@hp.corn Phone: 847.537.0344 CONTRACT NO: CONTRACT PERIOD:. . Through EXTENSION OPTION: MNWNC-116 April I 2015, or upon final executed signatures, whichever is later March 31, 2017 UP TO 36 MONTHS You. are hereby notified that your response to our solicitation, Which opened January 31, 2014, is accepted. The following documents, in order of precedence, are incorporated herein by reference and constitute the entire Contract between you and the State: 1. A Participating Entity's Participating Addendum ("PA") A Participating Entity's Participating Addendum shall not diminish, change, or impact the rights of the Lead State with regard to the tread State's contractual relationship with the Contract Vendor under the Terms of Minnesota WSCA-NASPO Master Agreement.; 2. Minnesota WSCA-NASPO Master Agreement (includes negotiated Terms and Conditions); 3. The Solicitation; and 4. the Contract Vendor's response to the Solicitation. These documents shall be read to be consistent and complemerytary. Any conflict among these documents shall be resolved by giving priority to these documents in the order listed above. IN WITNESS WHEREOF, the parties have caused this Agreement to be duly executed intending to be bound thereby 1. HEWLETT PACKARD COMPANY 2. MINNESOTA MATERIALS MANAGEMENT DIVISION The Contractor certiiles that the appropriate person(s) have In accordance with Minn. 5tat. § 1 03, subd. 3. executed this Agreernent on behalf of the Contractor as required by app! able des, bylaws resolutions, or ordinances, By. By ( ' ue i„j_`� + Tie: MasterA r ementAdminist ralaF- Title: ma 11�'�` ��lik. j Date: -2-Z -� Data: By. 3. MINNESOTA COMMISSIONER OF ADMINISTRATION Or delegated representative. Title: . By. Original,signed Date: Data: FEB 2 6 2015 By Lucas J. Jannett 1 CONTRACT NO_ MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 197 4 COMPUTER EQUIPMENT 2014-2019 i Cite tk��F .. MINNESOTA WSCA-NASPO MASTER AGREEMENT AWARD TABLE OF CONTENTS TABLEOF CONTENTS ................................... ....................................................:.......................................................2 SUMMARY................................................................................................:...................................................:................3 EXHIBITA - TERMS & CONDITIONS .............................. .............................................. ............................. ..................... 5 EXHIBITB - PRICING....................................................................................................................................................23 EXHIBIT - PRICING SCHEDULE..........................................................................I.... ...................................26 EXHIBIT C - PRODUCT AND SERVICE SCHEDULE (PSS).......................................................................................26 EXHIBIT-D-WEBSITE.......................................................................................................................................27 EXHIBIT E-ACTION REQUEST UPDATE FORM(ARF) ............................................. ............. .......................28 EXHIBITF - REPORTING...........................................................................................................................................30 EXHIBITG — DEFINITIONS.............................................................................................................. ........................31 2. CONTRACT NO. MHWNC415 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWL.ETT PAC{CARD COMPANY Packet Pg. 198 COMPUTER EQUIPMENT 2014-2019 EPARTI EAi:?'.b .i4MIN hAt-1604- MINNESGTA llfllSCA-NASPQ MASTER AGREEMENT AWARD SUMMARY 1. BACKGROUND. The State of Minnesota, Department of Administration, Materials Management Division publicly posted a Request for Proposal on behalf of the State of Minnesota and WSCA-NASPO Cooperative Procurement . Program ("WSCA-NASPO") resulting in a Master Agreement Award. After evaluation by a multi -state sourcing team the solicitation resulted in this Minnesota WSCA-NASPO Master Agreements with qualified manufacturers,for Computer Equipment (Desktops, Laptops, Tablets, Servers, and Storage including related Peripherals & Services). The original solicitation contains the requirements and definitions establishing the following Product Bands allowed on the Master Agreement. The configuration limits and restrictions for this Master Agreement are provided below. Participating Entities may revise these in their Participating Addendum. Bands awarded are identified below: Band 1: Desktop Band 3: Tablet Rand 5: Storage Band 2: Laptop Band 4: Server The original solicitation included Band B: Ruggedized. This band has been removed and ruggedized equipment will be allowed in Bands 1-5. The original solicitation and responses may be found on the WSCA-NASPO.Website. 2. EFFECTIVE DATE. The Master Agreement contract term will begin on April 1, 2015, or upon final executed signatures, whichever is later, through March 31, 2017, with the option to extend up to 36 months, upon agreement by both parties. Contract Sales may not begin until the Website,'Product and Service Schedule and third party products have been approved by the Master Agreement Administrator. 3. PARTICIPATION, All authorized governmental entities in any State are welcome to use the resulting Master Agreements through WSCA-NASPO with the approval of the State Chief Procurement Official. Contract Vendors are able to sign Participating Addendum (PA) at the option of Participating States. Participating States reserve the right to add State specific terms and conditions and modify the scope of -the contract in their Participating Addendum as allowed by the Master Agreement. 4. .CONFIGURATION DOLLAR LIMITS. The following configuration limits apply to the Master Agreement, Participating States may define their configuration limits in their participating addendum. The Participating State's Chief Procurement Official may increase or decrease the configuration limits, as defined in their Participating Addendum. The Participating. State wilt determine with the Contract Vendor how to approve these modifications to the StaWs Product and Service Schedule. The dollar limits identified below are based on a SINGLE computer configuration. This is NOT a restriction on the purchase of multiple configurations (e.g. an entity could purchase 10 laptops @ $10,000 for a total purchase price of $100, 000). ITEM CONFIGURATION* Server $500, 000 Storage $500,000 Desktops $ 10,000 Laptops $ 10,000 Tablets $ .5,000 Peripherals $ 5,000 Services Addressed by each State in participating addendum Configuration is defined as the combination of hardware and software components that make up the total functioning system. Software purchases are considered a part of the configuration limit of the equipment. CONTRACT NO, MNVVNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY 0 0 LO N ti 0 M 00 LO 0 U) w 0 a� 0 t m t a Q. 0 Q. CU J Packet Pg. 199 5. RESTRICTIONS. The following restrictions apply to the Master Agreement. A Participating State may set further restrictions of products in'their Participating Addendum. The Participating State will determine with the Contract Vendor how to approve these modifications to the States Product and Service Schedule. a. Software 1. Software is restricted to operating systems and c6mmercial off -the -shelf (COTS) software and is subject to equipment configuration limits. 2.' Software is an option which must be related to the procurement of equipment. 3. Software must be pre -loaded or provided as an electronic link with the initial purchase of equipment. 4. Software such as middleware which is not always installed on the equipment, but is related to storage and server equipment (Band 4&5) purchased, is allowed and may be procured after the initial purchase of equipment. b. Services 1. Services must be related to the procurement of equipment. 2. Service limits will be addressed by each State. 3. Wireless phone and internet service is not allowed. 4. Cloud Services including acquisitions structured.as managed on-ske,services are not allowed. S. Managed Print Services are not allowed. c. Third Pauly, Products. 1. Contract Vendors can only offer Third Party Products in the bands they have been awarded. 2. Contract Vendor cannot offer products manufactured by another Contract Vendor holding a Minnesota WSCA-NASPO Master Agreement unless approved by the Lead State. d. Additional Product/Services ti 1. Hardware and software required to solely support wide area network (WAN) operation and management are o not allowed. 2. Lease/Rentals of equipment may be allowed and will be addressed by each State. 00 3. Cellular Phone Equipment is not allowed. O 4. EPEAT Bronze requirement may be waived, on a State case by case basis, if approved by the State's Chief U) Procurement Officer. w 0 6. 'PARTNER UTILIZATION; Each state represented by WSCA-NASPO that chooses to participate in this Master a� Agreement independently has the optiori of utilizing partners. Only partners approved by the Participating State may o be deployed. The participating State will define the process to add and remove partners in their participating t addendum. 4 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT t L) L 3 O Q R J C d 2 ZA O O O N O N c� Q U c HEWLETT PACKARD COMPANY E v R .r r Q Packet Pg. 200 8.H.a tS£AA'tti'H7"ffFl1'Cr�tiiVtSTR�I�lOht' ' COMPUTER EQUIPMENT 2014-2019 MINNESOTAWSCA-NASPO MASTER AGREEMENT AWARD EXHIBIT A - TERMS & CONDITIONS MASTER AGREEMENT TERMS AND CONDITIONS A. GENERAL TERMS, CONDITIONS & INSTRUCTIONS 1. ACCEPTANCE OF TERMS AND CONDITIONS. The contents of the RFP and the response of the successful responder will become Master Agreement contractual obligations, along with the final Master Agreement, if acquisition action ensues. A statement of acceptance of -the proposed Contract Terms and Conditions, unless taken exception to,' as specified in the RFP must be included in the response. Any suggestions for alternate language shall be presented. The Lead State is under no obligation to accept wording changes submitted by the responder. The Lead State is solely responsible for rendering decisions in matters of interpretation on all terms and conditions. Any response which falls to comply with this requirement may be disqualified as nonresponsive. All general proposal terms, specifications and WSCA-NASPO Terms & Conditions for n a part of this RFP and will apply to any Master Agreements entered into as a result thereof. 2.: CONFLICT OF TERMSIORDER OF PRECEDENCE: a. A Participating Entity's Participating Addendum ('PA"); b. Minnesota WSCA-NASPO Master Agreement (includes negotiated Terms & Conditions) c. The Solicitation including all Addendums; and d.. Contract Vendor's response to the Solicitation These documents shall be read to be consistent and complementary. Any conflict among these documents shall be resolved by giving. priority to these documents in the order listed above, Contract Vendor terms and conditions that apply to this Master Agreement are only those that are expressly accepted by the Lead State and must be in writing and attached to the Master Agreement as an 1=xhibit or Attachment. No other terms and conditions shall apply, including terms and conditions listed in the Contract Vendor's response to the Solicitation, or terms listed or referenced on the Contract Vendor's website, in the Contract Vendor quotation/sales order or in similar documents subsequently provided by the Contract Vendor. The solicitation language prevails unless a mutually agreed exception has been negotiated.. 3. ADDENDA TO THE RFP. Any addendum issued will become apart of the RFP. The Lead State may modify or clarify the RFP by issuing one or more addenda to all parties who have received the RFP. Each responder must follow the directions on the addendum. Addenda will be numbered consecutively in the order they are issued. 4.. AWARD. The award of this solicitation will be based upon the total accumulated points as established in the RFP, for separate items, by grouping items, or by total lot, and where at its sole discretion the Lead State believes it will receive the best value. The Lead State reserves the right to award this solicitation to a single responder, or to multiple responders, whichever is in the best interest of the Lead State. It is the Statte's intent to award to multiple responders. The Lead State reserves the right to accept all or part of an offer, to reject all offers, to cancel the solicitation, or to re- issue the solicitation, whichever is in the best interest of the Lead State. The Sourcing Team will make a recommendation on the award of this.RFP. The commissioner of Administration or designee may accept or reject the recommendation of the Sourcing Team. The final award decision will be made by the Commissioner of Administration and the WSCA-HASP© Management Board. 5. CLARIFICATION. If a responder discovers any significant ambiguity, error, conflict, discrepancy, omission, or other deficiency in the RFP, the responder shall immediately notify the Acquisition Management Specialist in writing, as 5 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLE,TT PACKARD COMPANY Packet Pg. 201 8.H.a I specified in the introduction, of such,error and request modification or clarification of the document. This notification is due no later than seven calendar days prior to the proposal due date and time. U) Responders are cautioned that any activity or communication with a State employee or officer, or a member of the Evaluation Team, regarding this Solicitation's contents or process, is strictly prohibited and may, as a result, have its response rejected. Any communication regarding this Solicitation, its content or process, must be directed to the Acquisition Management Specialist listed in the Solicitation documents. S. COMPLETION OF RESPONSES. A response maybe rejected if it is conditional or incomplete. Responses that ---contain,conflicting;- false, -or -misleading statements or that provide references that contradict or do not support an - attribute or condition stated by the responder, may be rejected. 7. MASTER AGREEMENT ADMINISTRATOR. The Master Agreement Administrator designated by VIISCA-NASPO and the State of Minnesota, Department of Administration is: Susan Kahle. Direct all correspondence and inquiries, legal questions, general issues, or technical issues regarding this RFP to: Susan Kahle . Acquisition Management Specialist Department of Administration Materials Management Division 50 Sherburne Avenue 112 Administration Building St. Paul, MN 56155 Fax: 651,297.3996 E-mail: susan.kahle state•mmus S. DISPOSITION OF DATA SUBMITTED BY CONTRACT VENDOR. All materials submitted in response to this RFP will become property of the Lead State and will become public record after the evaluation process is completed. The r evaluation process is complete when negotiations with the selected vendors are final. C By executing this Contract, the Contract Vendor certifies and agrees that all information provided in the Contract and 00 LO in response to the solicitation will be made public in accordance with the solicitation and that no information has been ei designated Trade Secret pursuant to the Minnesota Government Data Practices Act. If the Contract Vendor submits information after execution of this Contract that it believes to be trade secret w materials, as defined by the Minnesota Government Data Practices Act, Minn. Slat. § 13.37, the Contract Vendor a, must: 3 o a, clearly mark all trade secret materials at the time the information is submitted; t b, include a statement with regard to the information justifying the trade secret designation for each item; and, c. defend any action seeking release of the materials it believes to be trade secret, and indemnify and mold harmless the Lead State, its agents and. employees, from any judgments awarded against the Lead State in favor of the party requesting the materials, and.any and all costs connected with that defense. This indemnification survives L the Lead State's award of a Master Agreement. In submitting a response to the RFP, the responder agrees that a - this indemnification survives as long as the trade secret materials are in possession of the Lead State. The Lead o State will not consider the prices submitted by the responder to be trade secret materials. Q. CU 9. DISPUTE RESOLUTION PROCEDURES. Any issue a responder has with the RFP document, which includes, but is J not limited to, the terms, conditions, and specifications, must be submitted in writing to and received by the Master d Agreement Administrator prior to the opening due date and time. Any issue a responder has with the Master Agreement award must be submitted in writing to the Master Agreement Administrator within five working days from ri the time the notice of the intent to award is issued. This notice may be made by any of the following methods: _ notification by letter, fax or email, or posted on the Materials Management website, www.mmd.admin.state.mn.us. The ' Lead State will respond to any protest received that follows the above procedure. For those protests that meet the c above submission requirements, the appeal process is, in sequence. The responsible Master Agreement a� Administrator, the Materials Management Division (MMD)Assistant Director, and the MMD Director. p 10. ELECTRONIC FILES TO DOWNLOAD, COMPLETE, AND RETURN, Responders must download a Word(Excel , c document. o N 11. ENTIRE AGREEMENT. A written Master Agreement (including the contents of this RFP and selected portions of Contract Vendor's response incorporated therein by reference) and any written addenda thereto constitute the entire Q agreement of the parties to the Maste.rAgreement. c� 4J c aD 6 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLEwTT PACKARD COMPANY t v R Q Packet Pg. 202 8.H.a 12. IRREVOCABLE OFFER. In accordance with this Request for Proposal, and subject to all conditions thereof, the undersigned agrees that its response to this RFP, or any part thereof, is an irrevocable offer for 180 days following the submission deadline date unless stated otherwise in the RFP. It is understood and agreed that the response, or any W part thereof, When accepted by the appropriate department and State officials in writing, may become part of a legal Q and binding Master Agreement between the undersigned vendor and the State of Minnesota. U 13. MATERIAL. DEVIATION. A responder shall be presumed to be in agreement with these terms and conditions unless it takes specific exception to one or more of the conditions. Submission by the responder of its proposed language shall not be viewed as an exception unless the responder specifically states in the response that its proposed changes are intended to supersede the -terms and -conditions. RESPONDERS ARE CAUTIONED THAT BY TAKING ANY EXCEPTION THEY MAY BE MATERIALLY DEVIATING FROM THE REQUEST FOR PROPOSAL. IF A RESPONDER MATERIALLY DEVIATES FROM THE GENERAL TERMS, CONDITIONS AND INSTRUCTIONS OR THE WSCA�NASPO TERMS AND CONDITIONS AND/OR SPECIFICATIONS, ITS RESPONSE MAY BE REJECTED. A material deviation is an exception to the Request for Proposal general or WSCA-NASPO terms and conditions andlor specifications that: a, gives the responder taking the exception a competitive advantage over other vendors; or, b.. gives the Lead State something significantly different from that which the Lead State requested. 14. NONRESPONSIVE RESPONSES. Responses that do not comply with the provisions in the RFP may be considered nonresponsive and may be rejected. 16. NOTICES. If one party is required to give notice to the other under the Master Agreement, such notice shall be in writing and shall be effective upon receipt. Delivery may be by certified United States mail or by'hand, in which case a ti signed receipt shall be obtained. A facsimile transmission shall constitute sufficient notice, provided the receipt of -the c transmission is confirmed by the receiving party. Either party must notify the other of a change in address for �n notifoataon purposes. All notices to the Lead State shall be addressed as follows: o STATE OF MINNESOTA: MN WSCA-NASPO COMPUTER EQUIPMENT CONTRACT ADMINISTRATOR 112 Administration Bldg: 50 Sherburne Avenue St. Paul, MN 55155 651-2962600 7 CONTRACT NO. MNWNC-116 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT LO 0 I w 0 t a� 0 t m rn t L) L 3 O Q R J d 2 �L O , ti 0 0 N C N c� Q U c HEWLETT PACKARD COMPANY E v R .r r Q Packet Pg. 203 8.H.a 3 MASTER AGREEMENT TERMS AND CONDITIONS B. WSCA-NASPO TERMS AND CONDITIONS w 1. ADMINISTRATIVE_FEES� The Contract Vendor shall pay a WSCA-NASPO Administrative Fee of one tenth of one Q percent (0.1%or 0.001) in accordance with the Terms and Conditions of the, Master Agreement no later than 60 days following the end of each calendar quarter. The WSCA-NASPO.AdministratiVe Fee shall be submitted quarterly and is c based on sales of products and services (less any charges for taxes or shipping). The WSCA-NASPO Administrative Fee is not negotiable. This fee is to be included as part of the pricing submitted with proposal. Additionally, -some states may require an additional fee be paid directly to the state on purchases made by Purchasing a� Entities within that state. For all such requests, the fee level, payment method and schedule for such. reports and payments will be incorporated into the Participating Addendum that is made a part of the Master Agreement. The � Contract Vendor may adjust the Master Agreement pricing accordingly for purchases made by Purchasing Entities a - within the jurisdiction of the state..Ali such agreements may not affect the WSCA-NASPO Administrative Fee or the a 0 prices paid by the Purchasing Entities outside the jurisdiction of the state requesting the additional fee.CL 2. AGREEMENT ORDER OF ELtECEDENCE. The Master Agreement shall consist of the following documents: J a a. A Participating Entity's Participating Addendum ("PA"); _ b. Minnesota WSCA-NASPO Master Agreement (includes negotiated Terms and Conditions) c. The Solicitation including all addendums; and d. Contract Vendor's response to the Solicitation These documents shall be read to be consistent and complementary. Any conflict among these documents shall be co resolved by giving priority to these documents in the order listed above. Contract Vendor terms and conditions that co apply to this Master Agreement are only those that are expressly accepted by the Lead State and must be in writing and attached to this Master Agreement as an Exhibitor Attachment. No other terms and conditions shall apply, including. terms and conditions listed in the Contract Vendor's response to the Solicitation, or terms listed or c referenced on the Contract Vendor's website, in the Contract Vendor quotation/sales order or in similar documents 9 subsequently provided by the Contract Vendor. The solicitation language prevails unless a mutually agreed exception 00 has been negotiated. c 3. AMENDMENTS. The terms of this Master Agreement shall not be waived, altered, modified, supplemenfed or w amended in any manner whatsoever without prior written approval of the WSCA-NASPO Master Agreement. o Administrator. a� 4. ASSIGNMENT OFANTITRUSTRIGHTS, NEGOTIATED. Contract Vendor irrevocably assigns to a Participating 0 Entity any claim for relief or cause of action which the Contract Vendor now has or which may accrue to the Contract Vendor in the future by reason of any violation of state or federal antitrust laws (15 U.S.C. § 1-15 or a Participating N Entity's state antitrust provisions), as now in effect and as may be amended from time to time, in connection with any goods or services provided to the Contract Vendor for the purpose of carrying out the Contract Vendor's obligations L under this Master Agreement or Participating Addendum, including, at a Participating Entity's option, the right to a control any such litigation on such claim for relief or cause of action to the extent the assignment is necessary far the Q. Participating Entity to overcome Federal or State's bar on indirect purchases. Q. CU 5. ASSIGNMENTISUBCONTRACT. NEGOTIATED Contract Vendor shall not assign, sell, transfer, subcontractor J sublet rights, or delegate responsibilities under this Master Agreement, in whole or in part, without the prior written approval of the WSCA-NASPO Master Agreement Administrator. c Lead State, or Participating Entity, shall not assign, delegate or otherwise transfer all or any part of this Agreement _ without prior written consent from Contractor, except for assignment or delegation to a Participating Entity State ' agency or eligible Purchasing Entity. 6. CANCIwL.LATION. Unless otherwise stated in the terms and conditions, any Master Agreement may be canceled by O elther party upon 60 days' notice, in writing, prior to the effective date of the cancellation. Further, any Participating , Entity may cancel its participation upon 30.days written notice, unless otherwise limited or stated in the special terms c and conditions of this solicitation or in the applicable Participating Addendum. Cancellation may be in whole br in part. Any cancellation under this provision shall not affect the rights and obligations attending orders outstanding at N the time of cancellation, including any right of a Participating Entity to indemnification by the Contract Vendor, rights of N payment for goodstservices delivered and accepted, and rights attending any warranty or default in performance in Q association with any order. Cancellation of the Master Agreement due to Contract Vendor default maybe immediate v if defaults cannot be reasonably cured as allowed per Default and Remedies term. c aD 8 CONTRACT NO. MNVVNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY E L v R .r Q Packet Pg. 204 8.H.a A CONFIDENTIALITY, NQN-1221ACLQUIRE AND INJUNCTIVE RELIEF. NEGOTIATED cn 7.1 Confidentiality. Contract Vendor acknowledges that it and its employees or agents may, in the course of w providing the Product under this Master Agreement, be exposed to or acquire.information that is confidential to Q Participating Entity or Participating Entity's clients. Any and all information of any form that is marked as confidential v or would by its nature be deemed confidential obtained by Contract Vendor or its employees or agents in the performance of this -Master Agreement, including, but not necessarily limited to (a) any Participating Entity records, N (b) personnel records, and: (c) information concerning individuals, is confidential information of Participating Entity w ("Confidential Information").. Any reports or other documents or items (including software) that result from the use of the Confidential Information by Contract Vendor shall be treated in the same manner as the Confidential Information. Confidential Information does not include information that (a) is or becomes (other than by disclosure by Contract t Vendor) publicly known; (b) is furnished by Participating Entity to others without restrictions similar to those imposed by this Master Agreement; (c) is rightfully in Contract Vendor's possession without the obligation.of nondisclosure a prior to the time, of its disclosure under this Master Agreement; (d)'is obtained from a source other than Participating o Entity without the obligation of confidentiality, (e) is disclosed with the written consent of Participating Entity or; (f) is a independently developed by employees, agents or subcontractor of Contract Vendor who can be shown to have had J no access to the Confidential Information IL 7.2 Non -Disclosure. Contract Vendor shall hold Confidential Information in confidence, using at least the industry = standard of confidentiality, and not to copy, reproduce, sell, assign, license, market, transfer or otherwise dispose of, give, or disclose Confidential Information to third parties or use Confidential Information for any purposes whatsoever other than the performance of this Master Agreement to Participating Entity hereunder, and to advise each of its employees and agents of their obligations to keep Confidential Information confidential. Contract Vendor shall use co commercially reasonable efforts to assist Participating Entity in identifying and preventing any unauthorized use or co disclosure of any Confidential Information. Without limiting the generality of the foregoing, Contract Vendor shall v advise Participating Entity immediately if Contract Vendor learns, or has reason to believe that any person who has had access to Confidential information has violated or intends to violate the terms of this Master Agreement and r Contract Vendor shall at its expense cooperate with Participating Entity in seeking injunctive or other equitable relief in the name of Participating Entity or Contract Vendor against any such person. Except as directed by Participating co Entity, Contract Vendor will not at any time during or after the term of this Master Agreement disclose, directly or c indirectly, any Confidential Information to any person, except in accordance with this Master Agreement, and that i ..upon termination of this MasterAgraement or at Participating Entity's request, Contract Vendor shall turn over to � :Participating Entity all documents, papers, and other matter in Contract Vendor's possession that embody Confidential o Information. Notwithstanding the foregoing, Contract Vendor may keep one copy of such Confidential Information necessary for quality assurance, audits and evidence of the performance of this Master Agreement. 3 7.3 Iniunctilve Relief. Contract Vendor acknowledges that breach of this Section, including disclosure of any ° Confidential Information, will cause irreparable injury to Participating Entity that is inadequately compensable in damages. Accordingly, Participating Entity may seek and obtain injunctive relief against the breach or threatened N breach of the foregoing undertakings, in addition to any other legal remedies that may be available. Contract Vendor acknowledges and agrees that the covenants contained herein are necessary for the protection of the legitimate L business interests of Participating Entity and are reasonable in scope and content. a 7A. Contrag2E 113L rmation, Contractor information exchanged under this Agreement will be treated as confidential 0. if identified and labeled as such at disclosure and if the circumstances of disclosure would reasonably indicate such $ treatment to the extent is is protected from disclosure under governing law. Confidential information may only.be 0. CU used for the purpose'of fulfilling obligations or exercising rights under this Agreement, and shared with employees, agents (including WSCA-NASD© Cooperative Purchasing Organization LLC) or contractors with a need to know such ' information to support that, purpose. Confidential information will be protected using a reasonable degree of care to c prevent unauthorized use or disclosure for three (3) years from the date of receipt or (if longer) for such period as the a information remains confidential. These obligations do not cover information that: i) was known or becomes known to _ the receiving party without obligation of confidentiality; ii) is independently developed by the receiving party; or ill) where disclosure is required by law or a governmental agency. Contractor acknowledges that pricing, reported usage, and other provisions of this Agreement that describe the products and services available under the master agreement may be made publicly available. by WSCA-NASPO to.promote use of the Agreement and shall not be considered 0 Confidential information. 7.6. Personal Information. Each party shall comply with their respective obligations under applicable data protection c legislation. Contractor does not intend to have access to personally identifiable information ("PIl") of Participating Entity in providing services. To the extent Contractor has access to Participating Entity PII stored on a system or device of Participating Entity, such access will likely be incidental and Participating Entity will remain the data N controller of Participating Entity PII at all times. Contractor will use any PH to which it has access strictly for purposes c9 of delivering the services ordered. Q U 4J c y 9 GONiRACT NO. MNYVNC-116 MASTER AGREEMENT AWAR©COMPUTER EQUIPMENT HEWLETT PACKARD COMPA14Y v R .r r Q Packet Pg. 205 8.H.a 1.6 Participating Entity is agreeing to the above language to the extent is not in conflict with Participating Entities public disclosure laws. 8. DEBARMENT. The Contract Vendor certifies that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntary excluded from participation in this transaction (Master Agreement) by any governmental department or agency. If the Contract Vendor cannot certify this statement, attach a written explanation for review by WSCA-NASPO. In any order against this Master Agreement for a requirement established by a Purchasing Entity that discloses the use of federal funding, to the extent another form of certification is not required by a Participating Addendumorthe order of the Purchasing Entity, the Contractor's quote represents a recertification consistent with the terms of paragraph a, Section 2D, Minnesota Terms and Conditions 9. DEFAULTS &REMEDIES. NEGOTIATED. a. The occurrence of any of the following events shall be an event of default underthis Master Agreement: is Nonperformance of contractual requirements; or H. A material breach of any term. or condition of this Master Agreement; or ili_ Any representation or warranty by Contract Vendor in response to the solicitation or in this Master Agreement proves to be untrue or materially misleading; or iv. Institution of proceedings under any bankruptcy, insolvency, reorganization or similar law, by.or against Contract Vendor, or the appointment of a receiver or similar officer for Contract Vendor or any of its property, which is not vacated or fully stayed within thirty (30) calendar days after the institution or occurrence thereof, or v. - Any default specified in another section of this Master Agreement. b. Upon the occurrence of an event of default, Lead State shall issue a written notice of default, identifying the. nature of the default, and providing a period of 30 calendar days in which Contract Vendor shall have an opportunity to cure the default. The Lead State shall not be required to provide advance written notice or a cure period and may immediately terminate this Master Agreement in whole. or in part if the Lead State, in its sole . discretion, determines that it is reasonably necessary to preserve public safety or prevent immediate public crisis_ 'rime allowed for cure shall not diminish or eliminate Contract Vendor's liability for damages, including liquidated damages to the extent provided for under this Master Agreement. c. If Contract Vendor is afforded an opportunity to cure and fails to cure the default within the period specified in the written notice of default, Contract Vendor shall be in breach of its obligations under this Master Agreement and Lead State shall have the right to exercise any or all of the following remedies: i. Exercise any remedy provided by law; and H. Terminate this Master Agreement and any related Master Agreements or portions thereof; and iii. Imposer I iquidated damages as provided in this Master Agreement; and iv. Suspend Contract Vendor from receiving future bid solicitations; and v. Suspend Contract Vendor's performance; and vi: Withhold payment until the default is remedied. d. In the event of a default under a Participating Addendum, a Participating Entity shall provide a written notice of default as described in this section and have all of the rights and remedies under this paragraph regarding its participation in the Master Agreement, in addition to those set forth in its Participating Addendum. Unless otherwise specified in a Purchase. Order, a Purchasing Entity shall provide written notice of default as described in this section and have all of the rights and remedies under this paragraph and any applicable Participating Addendum with respect to an Order placed by the Purchasing Entity. Nothing in these Master Agreement Terms and Conditions shall be construed to limit the rights and remedies available to a Purchasing Entity under the applicable commercial code. e: Contractor may discontinue performance with any Purchasing Entity if Purchasing Entity falls to pay any undisputed sum due, or with any Participating Entity if after thirty (30) days. written notice Participating Entity has not cured any other material failure to perform under this Agreement. 10. DELIVERY. Unless otherwise indicated in the Master Agreement, the prices are the delivered price to any. Purchasing Entity. All deliveries shall be i=_O:B_ destination with all transportation and handling charges paid by the Contract Vendor_ Additional delivery charges will not be allowed for back orders. 11. FORCE MAJEURE. Neither party to this Master Agreement shall be held responsible for delay or default caused by fire, riot, acts of God and/or war which is beyond that party's reasonable control. The WSCA-NASPO Master Agreement Administrator may terminate this Master Agreement after determining such delay or default will reasonably prevent successful performance of the Master Agreement, 10 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 206 8.H.a 12. GOVERNING LAI�i1 . This procurement and the resulting agreement shall be governed by and construed in accordance with the laws of the Lead State sponsoring and administering the procurement. The construction and effect of any Participating Addendum or order against the Master Agreements shall be governed by and construed in accordance with the laws of the Participating Entity's State. Venue for any claim, dispute or action concerning an 'order placed against the Master Agreements or the effect of a Participating Addendum shall be in the Purchasing Entity's State. 13, INDEMNIFICATION. ION. DELETED SEE SECTION 2C17 14. INDE NIFICATI -- INTELLECTUAL PROPERTY. DELETED SEE SECTION 2C17 15. INDEPENDENT CONTRACT VENDQR. The Contract Vendor shall be an independent Contract Vendor, and as such shall have no authorization, express or implied to bind WSCA-NASPO or the respective states to any agreements, settlements, liability or understanding whatsoever, and agrees not to perform any acts as agent for WSCA-NASPO or the states, except as expressly set forth herein. 16. INDIVIDUAL CUSTOMER. Except to the extent modified by a Participating Addendum, each Participating Entity shall follow the terns and conditions of the Master Agreement and applicable Participating Addendum and will have the same rights and responsibilities for their purchases as the Lead State has in the Master Agreement, including but not limited to, any indemnity or to recover any costs allowed in the Master Agreement and applicable Participating Addendum for their purchases. Each Purchasing Entity will be responsible for its own charges, fees, and liabilities. The Contract Vendor will apply the charges and invoice each Purchasing Entity individually. 17. INSURANCE. NEGOTIATED. Except to the extent modified by a Participating Addendum, Contract Vendor shall, during the term of this Master Agreement,. maintain in full force and affect, the insurance described in this section. Contract Vendor shall acquire such insurance from an insurance carrier or carriers licensed to conduct business in the Participating Entity's state and having a rating of A-, Class VII or better, in the most recently published edition of Best s Reports. Failure to buy and maintain the required insurance may result in this Master Agreement's termination or at a Participating Entity's option, result in termination of its Participating Addendum. Coverage shall be written on an occurrence basis. The minimum acceptable limits shall be as indicated below, for each of the following categories: a. Commercial General Liability covering the risks of bodily injury (including death), property damage and personal injury, including coverage for contractual liability, with a limit of not less than $1 million per occurrencet$2 million general aggregate; b. Contract Vendor must comply with any applicable State Workers Compensation or Employers Liability Insurance requirements. The Contract Vendor is responsible for payment of Contact related prem iurris on all insurance policies, and. deductibles. Prior to commencement of the work, Contract Vendor shall provide to the Participating Entity a written endorsement to the Contract Vendor's general liability insurance policy that (i) includes the Participating Entity as an additional insured; which endorsement may be met through the use of what is referred to as a "blanket' additional insured endorsement, and (ii) provides that the Contract Vendor's liability insurance policy shall be primary, with any liabilib/ insurance of the Participating Entity as secondary and noncontributory. Contract Vendor shall furnish to Participating Entity copies of certificates'of all required insurance within thirty (30) calendar days of the Participating Addendum's effective date and prior to performing any work. Copies of renewal certificates of all required insurance shall be furnished, upon request. These certificates of insurance must expressly indicate compliance with each and every insurance requirement specified in this section. Failure to provide evidence of coverage may, at the Lead State Master Agreement Administrator's sole option, result in this Master Agreement's termination. Coverage and limits shall not limit Contract Vendor's liability and obligations under this Master Agreement. 1t3. LAWS AND REGULATIONS: NEGOTIATED, Any and all supplies, services and equipment offered and furnished shall comply fully with all applicable Federal and State laws and regulations. 11 CONTRACT NO. MNWNC-116 MASTER AGREEMENT AWARE) COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 207 8.H.a If software is licensed to Participating Entity for use in the performance of a US Government prime contract or subcontract, Participating Entity agrees that consistent with FAR 12.211 and 12.212, commercial computer software, cn documentation and technical data for commercial items are -licensed under publisher's standard commercial license. N Products and services provided under these terms are for Participating Entity s internal use and not for further commercialization. Participating Entity is responsible for complying with applicable laves and regulations, including but not limited to, obtaining any required export or import authorizations if Purchasing Entity exports, imports or otherwise transfers products and/or deliverables provided under this Agreement. 19. LICENSE OF PRE-EXISTING INTELLECTYA L PROPERTY. DELETED —SEE SECTION 21330 FOR REVISED TERM ADDRESSING TITLE OF PRODUCT. -- - -20. ;NO-WAIVER-OFVEREGN-II�TY The Lead State, Participating Entity or Purchasing Entity to the extent it- applies does not waive its sovereign immunity by entering into this Contract and fully retains all immunities and defenses provided by law with regard to any action based on this Contract. If a claim must be brought in a federal forum, then it must be brought and adjudicated solely and. exclusively within the United States District Court of the Participating Entity's State. 21. ORDER NUMBERS. NEGOTIATED Contract order and purchase order numbers shall be clearly shown on all acknowledgments, shipping labels (if possible), packing slips, invoices, and on all correspondence. "Order" means the accepted order including any supporting materials which the parties identify as incorporated either by attachment or reference ("Supporting Materials°). Supporting Materials may include (as examples) product lists, hardware or software specifications, standard or negotiated service descriptions, data sheets and their supplements, and statements of -work (SOWS), published warranties and service level agreements, and may be available to Participating Entity in hard copy or by accessing a designated Contractor website. 22. PARTICIPANTS. WSCA-NASPO Cooperative Purchasing Organization LLC is not a party to the pilaster Agreement. It is a nonprofit cooperative purchasing: organization assisting -states in administering the WSCA/NASPO cooperative purchasing program for state government departments, institutions, agencies and political subdivisions (e.g., colleges, school districts, counties, cities, etc.,) for all 50 states and the District of Columbia. Obligations under this Master Agreement are limited to those Participating States who have signed a Participating Addendum where contemplated by the solicitation. Financial obligations of Participating States are limited to the orders placed by the departments. or other state agencies and institutions having available funds. Participating States incur no financial obligations on behalf of political subdivisions. Unless otherwise specified in the solicitation, the resulting award will be permissive_ 23. PARTICIPATION OF ENTITIES.. Use of specific WSCA-NASPO cooperative Master Agreements by state agencies, political subdivisions and other. entities (including cooperatives) authorized by individual state's statutes to use state contracts are subject to the approval of the respective State Chief Procurement Official. Issues of interpretation and eligibility for participation are solely within the authority of the respective State Chief Procurement Official. 24. PAYMENT,. NEGOTIATED. Payment for completion of an order under this Master Agreement is normally made within 30 days following the date the. entire order is delivered or the date a correct invoice is received, whichever is later. After 45 days the Contract Vendor may assess overdue account charges up to a maximum rate of one percent per month on the outstanding balance. Payments will be remitted by mail. Payments may be made via a State or political subdivision "Purchasing Card" with no additional charge. Prices are exclusive of taxes, duties, and fees, unless otherwise quoted. If a withholding tax is required by law, the tax will be added and identified on the applicable invoice. Prices include the fee as specified in. section 1. 25. PUBLIC INFORMATION. The Master Agreement and all related documents are subject to disclosure pursuant to the Participating Entity's public information laws. 26. RECORDS ADMINISTRATION AND AUDIT. NEGOTIATED. The disclosure of records in Participating States relating to Participating addenda and orders placed against the Master Agreement shall be governed by the laws of the Participating State and entity who placed the order. The Contractor shall maintain books, records, documents, and other evidence pertaining to this Master Agreement and orders placed by Purchasing Entities under it to the extent and In such detail as shall adequately reflect performance and administration of payments and fees. Contractor shall permit the Lead State, a Participating Entity, 12 CONTRACT NO- MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETr PACKARD COMPANY Packet Pg. 208 8.H.a a Purchasing Entity, the federal government (including its grant awarding entities and the U.S. Comptroller General), and any other duly authorized agent of a governmental agency, to audit, inspect, examine, copy and/or transcribe Contractor's books, documents, papers and records directly pertinent to this Master Agreement or orders placed by a Purchasing Entity under it for the purpose of making audits, examinations, excerpts, and transcriptions. This right shall survive for a period of five (5) years following termination of this Agreement or final payment for any order placed by a Purchasing Entity against this Agreement, whichever is later, to assure compliance with the terms hereof or to evaluate performance hereunder. Without limiting any other remedy available to any governmental entity; the Contractor shall reimburse the.applicable Lead State, Participating Entity, or Purchasing Entity for an overpayments inconsistent with the terms of the Master Agreement or orders or underpayment of fees found as a result of the examination of the Contractor's records. - The rights -and -obligations -herein -right exist in addition to -any quality assurance -obligation -in the Master Agreement requiring the Contractor to self -audit contract obligations and that permits the Lead State Master Agreement Administrator to review compliance with those obligations. Records will be retained longer if required by Participating Entity's law. Contractor will be advised with reasonable prior written notice of each audit. The parties will work together in good faith to establish an audit process that does not interfere with Contractor's ability to perform its obligations under this. Agreement or any other agreement, or compromise any reasonable security processes or procedures. Contractor 'Will provide the auditor with information reasonably required to effect the audit, provided however that Contractor reserves the right to impose limitation or require additional assurances from Customer and its auditor as may be necessary to protect the Confidential Information of Contractor to the extent such limitations and assurances are not in conflict with Participating Entity's governing laws. In no event will Contractor be required to provide Customer or its auditor with access to Contractor's internal costs and resource utilization data, or data related to employees or other customers of Contractor to the extent it's not in conflict with Participating Entity's governing law. 27. REPORTS - SUMMARY AND DETAILED USAGE. In addition to other reports that may be required by this " solicitation, the Contract Vendor shall provide the following WSCA-NASPO reports. a. Summary Sales Data. The Contractor shall submit quarterly sales reports directly to WSCA-NASPO using the WSCA-NASPO Quarterly Sales/Administrative Pee Reporting Tool found at htto:/Avww..nasPo.oroNVNCPO/Calculator.aWx. Any/all sales made under the contract shall be reported as cumulative totals by state: Even if Contractor experiences zero sales during a calendar quarter, a report is still required. Reports shall be due no later than the last day of the month following the end of the calendar quarter (as specified in the reporting tool)- b. Detailed Sales Data. Contract Vendor shall also report detailed sales data by: state; entity/customer type, e.g., local government, higher education, K12, non-profit; Purchasing Entity name; Purchasing Entity bill -to and ship -to locations; Purchasing Entity and Contract Vendor Purchase Order identifierinumber(s); Purchase Order Type e.g., sales order, credit, return, upgrade, determined by industry practices); Purchase Order date; Ship Date; and line item description, including product number if used. The report shall be submitted in any -form required by the solicitation. Reports are due on a quarterly basis and must be received by the Lead State- •no later than the last day of the month following the end of the reporting period. Reports shall be delivered to the Lead State and to the WSCA-NASPO Cooperative Development Team electronically through email; CD -Rom, jump drive or other electronic matter as determined- by the Lead State. Detailed sales data reports shall include sales information for all sales under Participating Addenda executed under this Master Agreement. The format for the detailed sales data report is in Section 6, Attachment H. c. Reportable sales for the summary sales data report and detailed sales data report includes sales to employees for personal use where authorized by the Participating Addendum. Specific data in relation to sales to employees for personal use to be defined in the final contract award to ensure only public information is reported. d. Timely submission of these reports is a material requirement of the Master Agreement. The recipient of the reports 'shall have exclusive ownership of the media containing the reports. The Lead State and WSCA-NASPO shall have a perpetual, irrevocable, non-exclusive, royalty free, transferable right to display, modify, copy, and otherwise use reports, data and information provided under this section. . 28. ACCEPTANCE AND ACCEPTANCE TESTING NEGOTIATED - a. Acceptance. Purchasing Entity (the entity authorized under the terms of any Participating Addendum to place orders under this Master Agreement) shall determine whether all Products and Services delivered meet the 13 CONTRACTNo. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY U) w a U a� c N rr a� t L 3 IL 0. 0 a J IL 0 0 LO ti r 0 0 LO 0 I 0 w 0 t a� 0 L t M t L) a 0. 0 Q. CU J c O 0 0 N 0 N c� Q U 4J c aD E t v R .r r Q Packet Pg. 209 8.H.a Contractor's published specifications (a.k.a. "Specifications"): No payment steal! be made for any Products or Services until the Purchasing Entity has accepted the Products or Services. The Purchasing Entity will make every effort to notify the Contractor within thirty (30) calendar days following delivery of nonacceptance of a Product or completion of Service. In the event that the Contractor has not been notified within 30 calendar days from delivery of Product or completion of Service, the.Product and.Servi= will ba deemed accepted on the 31 at day after delivery of Product or completion of Services. This clause shall not be applicable, if acceptance testing and corresponding terms have been mutually agreed to by both parties in writing. . b. Acceptance Testing. The Purchasing Entity (the entity authorized under the terms of any Participating Addendumto place orders under -this Master Agreement) and thew Contract Vendor shall determine if Acceptance _Testing -is -applicable andlor required for the purchase. The terms in regards to acceptance testing will be negotiated, in writing, as mutually agreed. If Acceptance Testing is NOT applicable, the terms regarding Acceptance in the Contract shall prevail. - c. -installation- if Contractor is providing installation with the product purchase, Contractor's site guidelines - '(ava€lab€e upon -request) will describe the facilities Participating Entity is required to provide. Contractor -will -- -conduct its standard installation and test procedures to confirm completion. 29. §X§IEM FAILURE OR DAMAGE, In the event of system failure or damage caused by the Contract Vendor or its Product, the Contract Vendor agrees.to use its commercially reasonable efforts to restore or assist in restoring the system to operational capacity. The Contract Vendor shall be responsible under this provision to the extent a 'system` is defined at the time of the Order, otherwise the rights of the Purchasing Entity shall be governed by the Warranty. 30. TITLE OF PRODUCT. NEGOTIATED OWNERSHIP N a. Intellectual.Property Rights. No transfer of ownership of any intellectual property will occur under this Agreement. Purchasing Entity grants Contractor a non-exclusive, worldwide, royalty -free right and license to any intellectual property that is necessary for Contractor and its designees to perform the ordered services. If deliverables are c created by Contractor specifically for Purchasing Entity and identified as such in Supporting Material, Contractor hereby grants Purchasing Entity a worldwide, nonexclusive, fully paid, royalty -free license to reproduce and use 0 copies of the deliverables internally. o b. Title. Title for hardware products will pass upon delivery to Customer or its designee. Where permitted by taw, �I HP retains a security interest in products sold until full payment its received. w 0 31. WAIVER OF BREACH. Failure of Lead State. Master Agreement Administrator, Participating Entity, or Purchasing Entity to declare a default or enforce any rights and remedies shall not operate as a waiver under this Master. o Agreement or Participating Addendum. Any waiver by the Lead State or Participating Entity must be in writing. Waiver by the Lead State Master Agreement Administrator, Participating Entity, or Purchasing Entity of any default, m right or remedy under. this Master Agreement or Participating Addendum, or breach of any terms or requirements shall not be construed or operate as a waiver of any subsequent default or breach of such term or requirement, or of any other term or requirement under this Master Agreement, a Participating Addendum, or order. a 32. WARRANTY. NEGOTIATED. The warranty provided must be the manufacturers written warranty tied to the product o at the time of purchase and must include the following;: (a) the Product performs according to the Specifications (b) �. the Product is suitablefor the ordinary purposes for which such Product is used, and, (c) the Product is designed andCU manufactured in a commercially reasonable manner. Products and services are provided with the standard' manufacturer's published warranty; support, and software licensing terms ("Specifications')_ Services are performed d using generally recognized commercial practices and standards. Customer agrees to provide prompt notice of any service concerns, o= For third party products sold by the Contract Vendor that are not Contractor -branded, the Contract Vendor sells the _ third party products with the manufacturer or publisher's standard warranty, license, and maintenance "AS IS". The @ Contract Vendor will provide warranty and maintenance call numbers and assist the customer in engaging the S manufacturer on warranty and maintenance issues. O Upon breach of the warranty, the .Contract Vendor will repair or replace (at no charge to the Purchasing Entity) the Product whose nonconformance is discovered and made known to the Contract Vendor. If the repaired and/or replaced Product proves to be inadequate, or fails of its essential purpose, the Contract Vendor will refund the full c amount of any payments that have been made. The rights and remedies of the parties under this warranty are in c addition to any other rights and remedies of tha parties provided by law or so ordered by the court. N t9 Q This Agreement states all remedies for warranty claims. To the extent permitted bylaw, Contractor disclaims all other v warranties. 4 ' c 14 CONTRACTNO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY aD E t v R .r r Q I Packet Pg. 210 8.H.a MASTER AGREEMENT TERMS AND CONDITIONS C. MINNESOTA TERMS AND CONDITIONS 1. ACCEPTANCE OF PROPOSAL CONTENT. The contents of this RFP and selected portions of response of the successful Proposer will become contractual obligations, along with the final Master Agreement, if acquisition action ensues. The Lead State is solely responsible for rendering the decision in matters of interpretation of all terms and conditions. - - 2.-ACCESSIBILITY STANDARDS. _The_State_ofMinnesota has developed IT Accessibility Standards effective_ September 1, 2010, which entails, in part, the Web Content Accessibility Guidelines (WCAG) 2.0 (Level AA) and Section 508 Subparts A D which can be viewed at http;/Iwww.mmd.admin.state.mri.us/pdf/accessibiliti p—tp:/Iwww.mmd.admin.state.m.us/pdf/accessibility ,standard.Adf Responders_must_completethe WCAG-VPAT-4brm-included in the FORMS section-ofthe-Rl=P:-T'he cam Ie -VPAT------- form will be scored based on its compliance with the Accessibility Standards. The requested WCAG VPAT applies to the responder's website to be offered under the Contract. For products offered, VPATS are only to be provided upon request by the participating entity. Upon request by the participating entity, the, responder must make best efforts to provide Voluntary Product Accessibility Templates (VPATS) for all products offered in its response. Click here for link to VPATS far both Section 508 VPAT and WCAG 2.0 VPAT tt :ifmn. ovloet/ olicies-an - rds/accessibilit I#. 3. ADMINISTRATIVE PERSONNEL CHANGES. The Contract Vendor must notify the Contract Administrator of changes in the Contract Vendor's key administrative personnel, in advance and in writing. Any employee of the Contract Vendor who, in the opinion of the State of Minnesota, is unacceptable, shall be removed from the project upon written notice to the Contract Vendor. In the event that an employee is removed pursuant to a written request from the Acquisition Management Specialist, the Contract Vendor shall have 10 working days in which to fill the vacancy with an acceptable employee. 4. AMENDMENT(S). Master Agreement amendments shall be negotiated by the Lead State with the Contract Vendor whenever necessary to address changes in the terms and conditions; costs, timetable,or increased or decreased scope of work. An approved Master Agreement amendment means one approved by the authorized signatories of the Contract Vendor and the Lead State as required by law. 6v AMERICANS WITH DISABILITIES ACT (ADA). DELETED. 8. AWARD OF' RELATED CONTRACTS. In the event the Lead State undertakes or awards supplemental Contracts for work related to the Master Agreement or any portion thereof, the Contract Vendor shall cooperate fully with all other Contract Vendors and the State in all such cases. All Master Agreements between subcontractors and the. Contract Vendor shall include a provision requiring compliance With this section. 7. AWARD OF SUCCESSOR CONTRACTS. In the event the State undertakes or awards a successor for work related to the Contract or any portion thereof, the current Contract Vendor shall cooperate fully during the transition with all other Contract Vendors and the State in all such cases. All Master Agreements between subcontractors and the -Contract Vendor shall include a provision requiring compliance with this section. 8. CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY (EXCLUSION. a. Certification regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Lower Tier Covered Transactions. Instructions for certification: 1. By signing and submitting this proposal, the prospective lower tier participant (responder] 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 lowertier participant knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 15 CONTRACT NO. MNWNC415 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 211 8.H.a 3. The prospective lower tier participant shall provide immediate written notice to the person to whore this proposal [response] is submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted or had become erroneous by reason of changed circumstances. w 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 meaning set out in the Definitions and Coverages section of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaining a copy of those regulations. 5. The prospective lower tier participant agrees by submitting #his response that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction [subcontract equal to or exceeding $25,000] with a person who is proposed for debarment under 48 CFR part 9, -- subpart 9.4, debarred,suspended, declared ineligible, or. voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with -which this transactionoriginated 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 proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from covered transactions, 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 list of parties excluded from federal procurement and nonprocurement programs. 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 covered transaction knowingly enters into a -lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, suspended, debarred, ineligible, or voluntarily excluded from ..participation in this transaction, in addition to other remedies available to the Federal government, the department or agency with which this transaction originated may pursue available remedies, including suspension andlor debarment. b. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion —Lower Tier Covered Transactions. 1. The prospective lower tier participant certifies, by submission ofINS 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. 8. CHANGE REQUESTS. NEGOTIATED. The Lead State reserves the right to request, during the term of the Master Agreement, changes to the products offered. Products introduced during the term of the Master Agreement shall go through a formal review process. A formal process of changing the Master Agreement shall be developed during the negotiation of the Master Agreement. The Contract Vendor shall evaluate and recommend products for which agencies have an expressed need. The Lead State shall require the Contract Vendor to provide a summary of its research of those products being recommended for inclusion in the Master Agreement as well as defining how adding the product will enhance the Master Agreement. The Lead State may request that products, other than those recommended, are added to the Master Agreement. In the event that the Lead State desires to add new products and services that are not included in the original Master Agreement, the Lead State requires that independent. manufacturers and resellers cooperate with the aiready 16 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARE) COMPUTER EQUIPMENT HEWLETT.PACKARI7 COMPANY Packet Pg. 212 8.H.a established Contract Vendor in order to meet the Lead StaWs requirements. Evidence of the need to add products or services should be demonstrated to the Lead State. The Master Agreement shall be modified via supplement or w amendment. The Lead State will negotiate the inclusion of the products and services with the Contract Vendor. No products or services will be added to the Master Agreement without the Lead State's prior approval. v Requests to change the scope of services or deliverables, on a per -Order basis; will require a change order signed by S the Purchasing Entity and Contractor. w 10. CONFLICT MINERALS. Contract Vendor must provide information to the public on its website regarding the use of � conflict minerals, as required by Section 13(p) of the Securities Exchange Act of 1934, as amended, and the rules promulgated thereunder. See: http:!/wWw.sec.gov/rulesfFinal/2012/34-67716.odf. . L 11. COPYRIGHTED MATERIAL WAIVER. The Lead State reserves the right to use, reproduce and publish proposals in a- any manner necessary for State agencies and local units of government to access the responses and/or to respond to 0 request for information pursuant to Minnesota Government Data Practices Act, , including but not limited to emailing, a photocopying, State Intranet/Internet postings, broadcast faxing, and direct mailing. In the event that the response contains copyrighted or trademarked materials, it is the responder's responsibility to obtain permission for the Lead a State to reproduce and publish the information, regardless of whether the responder is the manufacturer or reseller of = the products listed in the materials. By signing its response, the responder certifies that it has obtained all necessary approvals for the reproduction and/or distribution of the contents of its response and agrees to indemnify, protect, save and hold the Lead State, its representatives and employees harmless from any and all claims arising from the violation of this section and agrees to pay all legal fees incurred by the Lead State in the defense of any such action. ao 00 LO 12. EFFECTIVE DATE, Pursuant to Minnesota law, the Master Agreement arising from this RI+P shall be effective upon the date of final execution by the Lead State, unless a later date is specified in the Master Agreement. 13. FOREIGN OUTSOURCING OF WORK. Upon request, the Contract Vendor is required to provide information r 9 regarding the location of where services, data storage and/or.location of data processing. under the Master Agreement 00 will be performed. c 14. bOVERNMENT DATA PRACTICES. The Contract Vendor and the Lead State must comply with the Minnesota w Government. Data Practices Act, Minn. Stat. Ch. 13, (and where applicable, if the Lead State contracting party is part o of the judicial branch, with the Rules of Public Access to Records of the Judicial Branch promulgated by the Minnesota Supreme Court as the same may be amended from time to time) as it applies to all data provided by the 3 Lead State to the Contract Vendor and all data provided to the Lead State by the Contract Vendor. In addition, the ° Minnesota Government Data Practices Act applies to all data created, collected, received, stored, used, maintained, or disseminated by the Contract Vendor in accordance with the Master Agreement that is private, nonpublic, protected. nonpublic, or confidenttalas defined -by the Minnesota Government Data Practices Act, Ch. 13 (and where applicable, that is not accessible to the public tinder the Rules of Public Access to Records of the Judicial Branch). o_ In the event the Contract Vendor receives a request to release the data referred to in this article, the Contract Vendor Q. must immediately notify the Lead State_ The Lead State will give the Contract Vendor instructions concerning the Q. release of the data to the requesting party before the data is released. The civil remedies of Minn. Stat. § 13.08, CU apply to th a release of the data by either the Contract Vendor or the Lead State. J The Contract Vendor agrees to indemnify, save, and hold the State of Minnesota, its agent and employees, harmless S from all claims arising out of, resulting from, or in any manner attributable to any violation of any provision of the a Minnesota Government Data Practices Act (and where applicable, the Rules of Public Access to Records of the x Judicial Branch), including legal fees and disbursements paid or incurred to enforce this provision of the Master ' Agreement. In the event that the Contract Vendor subcontracts any or all of the work to be performed under the Master Agreement, the Contract Vendor shall retain responsibility under the terms of this article for such work. a� 'L 16. HAZARDOUS SUBSTANCES. To the extent that the goods to be supplied by the Contract Vendor contain or may 0 create hazardous substances, harmful physical agents or infectious agents as set forth in applicable State and federal c laws and regulations, the Contract Vendor must provide Material Safety Data Sheets regarding those substances. A copy must be included with each delivery. N 16. HUMAN RIGHTS/AFFIRMATIVE ACTION. The Lead State requires affirmative action compliance by its Contract 0 N Q Vendors in accordance with Minn. Stat. § 363A.36 and Minn. R. 5000.3400 to 5000.3600. v - c aD E 17 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUPMENT KEWLETT PACKARD COMPANY L V R r Q Packet Pg. 213 8.H.a a. Covered contracts and Contract Vendors. One-time acquisitions, or a contract for a predetermined amount of U) goods and/or services, where the amount of your response is in excess of $100,000 requires completion of the w Affirmative Action Certification page. If the solicitation is for a contract for an indeterminate amount of goods Q and/or services, and the State estimated total value of the contract exceeds $100,000 whether it will be a rnultiple v award contract or not, you must complete the Affirmative Action Certification page. If the contract dollar amount or c the State estimated total contract amount exceeds $100,000 and the Contract Vendor employed more than N 40 full-time employees on a single working day during the previous 12 months in Minnesota or in the state where w it has its principal place of business, tha Contract. Vendor must comply with the requirements of Minn. Stat, § 363A.36, subd. 1 and Minn. R. 5000.3400 to 5000.3600. A Contract Vendor covered by Minn. Stat. § 363A.36, subd. 1 and Minn. R. 5000.3400 to 5000.3600 that had more than 40 full-time employees within Minnesota on a t single working day during the previous 12 months must have a certificate of compliance issued by the commissioner of the Department of Human Rights (certificate of compliance). A Contract Vendor covered by a- Minn:-Stag-§-363A 36, subd.1 that did not have more than 40 full-time employees on a single Working day during o the previous 12 months within Minnesota but that did have more than.40 full-time employees in the state where it a has its principal place of business and that does not have a certificate of compliance must certify that it is in J compliance with federal affirmative action requirements. IL b. Minn. Stat. § 363A.36, subd. / requires the Contract Vendor to have an affirmative action plan for the employment = of minority persons, women, and qualified disabled individuals approved by the commissioner of the Department of Human Rights (Commissioner) as indicated by a certificate of compliance. Minn. $tat. § 363A.36 addresses suspension or revocation of a certificate of compliance and contract_ consequences in that event. A contract awarded without a certificate of compliance may be voided. 00 c. Minn. R. 5000.340D-5000.3600 implement Minn. Stat. § 363A.36. These rules include, but are not limited to, co LO criteria for contents, approval, and implementation of affirmative action plans; procedures for issuing certificates of v compliance and criteria for determining a Contract Vendor's compliance status; procedures for addressing deficiencies, sanctions, and notice and hearing; annual compliance reports; procedures for compliance review; c and contract consequences for noncompliance. The specific criteria for approval or rejection of an affirmative 9 action plan are contained in various provisions of Minn. R. 5000.3400-5000.3600 including, but not limited to, 00 parts 5000.3420-5000.3500 and parts 5000.3552-5000.3559. Ln d. Disabled Workers. Minn. R. 5000.3650 provides the Contract Vendor must comply with the following affirmative eI action requirements fot disabled workers. w AFFIRMATIVE ACTION FOR DISABLED WORKERS � (a) The Contract Vendor must not discriminate against any employee or applicant for employment because of o physical or mental disability in regard to any position for which the employee or applicant for employment is qualified. The Contract Vendor agrees to take affirmative action to employ, advance in employment, and N otherwise treat qualified disabled persons without discrimination based upon their physical or mental disability in all employment practices such as the following: employment, upgrading, demotion or transfer, recruitment, L advertising, layoff or termination, rates of pay or other forms of compensation, and selection for training, 3 L Including apprenticeship. 0. (b) The Contract Vendor agrees to corriply with the rules and relevant orders of the Minnesota Department of .r Q- CU Human Rights issued pursuant to the Minnesota Human Rights Act. (c) In the event of the Contract Vendor's noncompliance with the requirements of this clause, actions for c noncompliancemay be taken in accordance with Minn. Stat. § 363A.36 and the rules and relevant orders of Q the Minnesota Department of Human Rights issued pursuant to the.Minnesota Human Rights Act. _ (d) The Contract Vendor agrees to post in conspicuous places, available to employees and applicants for emplaynment, notices in a form to be prescribed by the commissioner of the Minnesota Department of Human Rights. Such notices must state the Contract Vendors obligation under time law to take affirmative action to 0 employ and advance in employment qualified disabled employees and applicants for employment, and the , rights of applicants and employees. c (e) The Contract Vendor must notify each labor union or representative of workers with which it has a collective N bargaining agreement or other contract understanding, that the Contract Vendor is bound by the terms of e Minn. Stat. § 363A.36 of the Minnesota Human Rights Act and is committed to take affirmative action to c� • employ and advance. in employment physically and mentally disabled persons. Q U c 18 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY E v R r Q Packet Pg. 214 8.H.a e. Consequences, The consequences of a Contract Vendor's failure to implement its affirmative action plan or make a good faith effort to do so include, but are not limited to, suspension or revocation of a certificate of compliance rn by the commissioner, refusal by the commissioner to approve subsequent plans, and termination of all or part of W the Contract by the commissioner or the State. Q U f. Certification. The Contract Vendor hereby certifies that it is in compliance with the requirements of Minn. Stat, § 363A.36, subd.-1 and Minn. R. 6000.3400-5000.3600 and is aware of the consequences for noncompliance. It N is agreed between the parties that Minn. Stat. 363.36 and Minn. R. 5000.3400 to 5000.3600 are incorporated into w, any contract between these parties based upon this specification or any modification of it. A Copy of Minn, Stet. § 363A.36 and Minn. R. 5000.3400 to 5000-3600 are available upon request from the contracting agency. uo, 17. INDEMNIFICATION. NEGOTIATED. The Contract Vendor shall indemnify, protect, save and hold harmless the Lead State and the Participating Entity, its representatives and employees, from any and all third party claims or causes of action, -including all legal fees incurred by the Lead State and the Participating Entity arising from the negligence or willful misconduct in performance of the Master Agreement by the Contract Vendor or its agents, employees, or subcontractors. This clause shall not be construed to bar any legal remedies the Contract Vendor may have with the Lead State's and Participating Entity's failure to fulfill its obligations pursuant to the Master Agreement. If the Participating Entity's laws require approval of a third party to defend Participating Entity, Participating Entity will seek such approval and if approval is not received, Contract Vendor is not required to defend that Participating Entity 18. INTELLECTUAL PROPERTY INDEMNIFICATION. The Contract Vendor warrants that any Contractor -branded materials or products provided or produced by the Contract Vendor or utilized by the Contract Vendor in the performance of this Master Agreement will not infringe upon or violate any patent, copyright, trade secret, or any other proprietary right of any third party. In the event of any such claim by any third party against the Particlpating Entity the Participating Entity shall promptly notify the Contract Vendor. The Contract Vendor, at its own expense, shall r indemnify; defend or settle, and hold harmless the Participating Entity against any loss, cost, expense, or liability C (including legal fees) arising out of such a claim, whether or not such claim is successful against the Participating Entity. LO if such a claim has occurred, or in the Contract Vendor's opinion is likelyto occur, the Contract Vendor shall either CD procure for the Participating Entity the right to continue using the materials or products or replacement or modified w materials or products, if an option satisfactory to the Participating Entity is not reasonably available, the Participating p Entity shall return the materials or products to the Contract Vendor, upon written request of the Contract Vendor and t at the Contract Vendor's expense. a' 0 L The Contractor has no obligation for any claim of infringement arising from: a.. The Contractor's compliance with the Purchasing Entity's or by a third party on the Purchasing'Entity's behalf N designs, specifications, or instructions; b. The Contractor's use of technical information or technology provided by the Purchasing Entity; L c. Product modifications by the Purchasing Entity or a third party; a d. Product'use prohibited by Specifications or related application notes; or e. Product use with Products that are not the Contractor -branded. o 19. LIMITATION OF LIABILITY. Contractor will be responsible for damages that Purchasing Entity may incur as a result .r a � of purchasing products and services from HP, up to $10,000,000 (ten million dollars). Except for unauthorized use of Purchasing Entity's or Contractor's intellectual property, neither Purchasing Entity nor S Contractor will be liable for lost revenues or profits, downtime costs, loss or damage to data or indirect, special or a consequential costs or damages. Contractor does not limits its liability for death or bodily injury caused by its negligence, acts of fraud, willful repudiation of the agreement, nor any liability which may not be excluded or limited by applicable law. 20. JURISDICTION AND VENUE". This RFP and any ensuing Master Agreement, its amendments and supplements 0 thereto, shall be governed by the laws of the State of Minnesota, USA. Venue for all legal proceedings arising out of � the Master Agreement, or breach thereof, shall be in the State or federal court with competent jurisdiction in Ramsey County, Minnesota. By submitting a response to this Request for Proposal, a Responder voluntarily agrees to be N . subject to the jurisdiction of Minnesota for all proceedings arising out of this RFP, any ensuing Master Agreement, or any breach thereof_ N 0 Q U c 10 CONTRACT N.O. MNwNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HENILETT PACKARD COMPANY E v R Q Packet Pg. 215 21. LAWS AND REGULATIONS. Any and all services, articles or equipment offered and furnished must comply fully with all local, State and federal laws and regulations, including Minn. Stat, § 181.59 prohibiting discrimination and business registration requirements of the Office of the Minnesota Secretary of State, w 22. NONVISUAL ACCESS STANDARDS. Pursuant to Minn, Stat. § 16C.145, the Contract Vendor shall comply with the following nonvisual technology access standards: a. That the effective interactive control and use of the technology, including the operating system applications programs, prompts, and format of the data presented, are readily achievable by nonvisual means; b. That the nonvisual access technology must be compatible with information technology used by other individuals with whom the blind or visually impaired individual must interact; c. That nonvisual access technology must be integrated into networks used to share communications among employees, program participants, and the public; and d. -That the nonvisual access technology must have the capability of providing equivalent access by nonvisual means to telecommunications or other interconnected network services used by persons who are not blind or Visually impaired. - These standards do not require the installation of software or peripheral devices used for nonvisual access when the information technology is being used by individuals who are not blind or visually impaired. 23. NOTICE TO RESPONDERS. Pursuant to Minn. Stat. § 270C.65, subd. 3, Contract Vendors are required to provide their Federal Employer Identification Number or Social Security Number. This information may be used in the enforcement of federal and State tax laws_ Supplying these numbers could result in action to require a Contract Vendor to file tax returns and pay delinquent tax liabilities. These numbers will be available to federal and State tax authoritios and State personnel involved in the payment of State obligations. 24. ORGANIZATIONAL CONFLICTS OF INTEREST. The responder warrants that, to the best of its knowledge and belief, and except as otherwise disclosed, there are'no relevant facts or circumstances which could give rise to organizational conflicts of'interest. An organizational conflict of interest exists when, because of existing or planned .activities or because of relationships with other persons: • a Contract Vendor is unable or potentially unable to render impartial assistance or advice to the State; • the Contract Vendor's objectivity in performing the work is or might be otherwise impaired; or • the Contract Vendor has an unfair competitive advantage. The Contract Vendor agrees that if an organizational conflict of interest is discovered after award, an immediate and full disclosure in writing shall be made to the Assistant Director of the Department of Administration's Materials Management Division that shall include a description of the action the Contract'Vendor has taken or proposes to take to avoid or mitigate such conflicts. If an organizational conflict of interest is determined to exist, the State may, at its discretion, cancel the Master Agreement. In the event the Contract Vendor was aware of an organizational conflict of interest prior to the award of the Master Agreement and did not disclose the conflict to the Master Agreement Administrator, the State may terminate the Master Agreement for defadit. The provisions of this clause shall be included in all subcontracts for work to be performed, and the terms "Contract," "Contract Vendor," "Master Agreement", "Master Agreement Administrator" and 'Contract Administrator" modified appropriately to preserve the State's rights. 26. PAYMENT CARD INDUSTRY DATA SECURITY STANDARD AND CARDHOLDER INFORMATION SECURITY. NEGOTIATED. NOT APPLICABLE TO CONTRACT VENDOR. 26. PERFORMANCE WHILE'DISPUTE IS PENDING. Notwithstanding the existence of a dispute, the parties shall continue without delay to carry out all of their responsibilities under the Master Agreement that are not affected by the dispute. If a party fails to continue without delay to perform its responsibilities under the Master Agreement, in the accomplishment of all undisputed wont, any additional cost incurred by the other parties as a result of such failure to proceed shall be borne by the responsible party. 27. PREFERENCE. Targeted/Economically Disadvantaged. In accordance with Minn_ Stat. § 16C.16, subds. 6 and 7, eligible certified targeted group (TG) businesses and certified economically disadvantaged (ED) businesses will receive a 6 percent preference on the basis of award for this RFP. The preference is applied only to the first $500,000 of the response to the RFP. Eligible TG businesses must be currently certified by the Materials Management Division prior to the bid opening date and time. 20 CONTRACT No. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 216 8.H.a To verify TGIED certification, refer to the Materials Management Division's web site at www.mmd.admin.state.mn.usunder "Vendor Information, Directory of Certified TG/ED Vendors." To verify TG eligibility for preference, refer to the Materials Management Division's web site under"Vendor Informatlon, Targeted Groups Eligible for Preference in State Purchasing" or call the Division's Helpi-ine at 651.296.2600. Reciprocal Preference. In accordance with Minn. Stat. §18C.06, subd 7, the acquisition of goods or services shall be allowed a preference over a non-resident vendor from a state that gives or requires a preference to vendors from that state, the preference shall be equal to the preference given or required by the state of the non-resident vendor. if you wish to be considered a Minnesota Resident vendor you must claim that by filling out the Resident Vendor Form included in this solicitation and include it in your response. Veteran. In accordance with Minn. Stat. § 16CA 6, subd. 6a, (a) Except when mandated by the federal government as a - a condition of receiving federal funds, the commissioner shall award up to a six percent preference in -the amount bid o on state procurement to certified small businesses that are majority -owned and operated by: r (1) recently separated veterans who have served in active military service, at anytime on or after September 11, CL 2001, and who have been discharged under honorable conditions from active service, as indicated by the o- person's United States Department of Defense form DD-214 or by the commissioner of veterans affairs; _ (2) veterans with service -connected disabilities, as determined at any time by the United States Department of Veterans Affairs; or (3) any other veteran -owned small businesses certified under section 16C.19, paragraph (d). IX In accordance with Minn. Stat.' § 16C.19 (d), a veteran -owned small business, the principal place of business of co which is in Minnesota, is certified K it has been verified by the United States Department of Veterans Affairs as v being either a veteran -owned small business or a service disabled veteran -owned small business, in accordance with Public Law 109-461 and Code of Federal Regulations, title 38, part 74. r o To receive a preference the veteran -owned small business must meet the statutory, requirements above by the solicitation opening date'and time. The preference is applied only to the first $500,000 of the.response. 00 c If responder is claiming the veteran -owned preference, attach documentation, sign and return form with I response'to the solicitation. Only eligible veteran -owned small businesses that -meet the statutory requirements w and provide adequate documentation will be given the preference. p 28. PUBLIC INFORMATION. Once the informatiori contained in the responses is deemed public information, interested t � parties may request to obtain the public information. You may call 651,201.2413 between the hours of 8.00 a.m. to 0 4:30 p.m. to arrange this. 29» PUBLICITY. Any publicity given to the program, publications or services provided resulting from a State contract for m goods or services, including but not-limiteflo notices, informatlonal pamphlets, press releases, research, reports, L signs and similar public notices prepared by or for the Contract Vendor, or its employees individually or jointly with Ii others, or any subcontractors, shall identify the State as the sponsoring agency and shall not be released, unless a such release is a specific part of an approved work plan included in the Master Agreement prior to its approval by the r State's Authorized Representative and the State's Assistant Director or designee of Materials Management Division. Q- The Contract Vendor shall make no representations of the State's opinion or position as to the quality or effectiveness � of the products and/or services that are the subject of the Master Agreement without the prior written consent of the ' State's Assistant Director or designee of Materials Management Division. Representations include any publicity, c including but not limited to advertisements, notices, press releases, reports, signs, and similar public notices. a x 30. PURCHASE ORDERS. The State requires that there will be no minimum order reglirements or charges to process ' an. individual purchase order. The Master Agreement number and the PO number must appear on all documents (e.g., invoices, packing slips, etc.). The Ordering Entity's purchase order constitutes a binding contract 31. RIGHTS RESERVED. Notwithstanding anything to the contrary, the State reserves the right to: a. reject any and all responses received; b. select, for Master Agreements or for negotiations, a response other than that with the lowest cost; c. waive or modify any informalities, irregularities, or inconsistencies in the. responses received; d. negotiate any aspect of the proposal with any responder and negotiate with more than one responder; e. request a BEST and FINAL OFFER, if the State deems it necessary and desirable; and 21 CONTRACT NO. MNWNC1415 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT O 0 0 N 0 N c� Q U 4J c HEWLETT PACKARD COMPANY v R r Q Packet Pg. 217 8.H.a f. terminate negotiations and select the next response providing the best value for the State, prepare and release a i new RFP, or take such other action as the State deems appropriate if negotiations fail to result in a successful Master. Agreement. W 32. RISK OF LOSS OR DAMAGE. The State is relieved of all risks of loss or damage to the goods and/or equipment during periods of transportation, and installation by the Contract Vendor and in the possession of the .contract Vendor or their authorized agent. 33. 8EVERABILITY. If any provision of the Master Agreement, including items incorporated by reference, is found to be illegal, unenforceable, or void, then both the State and the Contract Vendor shall be relieved of all obligations arising under such provisions, If the remainder of the Master Agreement is capable of performance it shall not be affected by such declaration or finding and shall be fully performed. 34, STATE AUDITS (Minn. Stat. § 160.05, subd. 5). The books, records, documents, and accounting procedures and practices of the Contract Vendor or other party, that are relevant to the Master Agreement or transaction are subject to examination by the contracting agency and either the Legislative Auditor or the State Auditor as appropriate for a minimum of six years after the end of the Master Agreement or transaction. The State reserves the right to authorize delegate(s) to audit this Master Agreement and transactions. 36. SURVNABILITY. NEGOTIATED. The following rights and duties of the State and responder will survive the expiration or cancellation of the resulting Master Agreements. These rights and duties include, but are not limited to paragraphs: Indemnification, Hold Harmless and Limitation of Liability, State Audits, Government Data Practices, Governing Law, Jurisdiction and Benue, Publicity, Intellectual Property indemnification, and Admin Fees. Software licenses, warranty, and service agreement that were entered into under the terns -and conditions of the Agreement shall survive the expiration or termination of this Agreement - 36. TRADE SECRET/CONFIDENTIAL INFORMATION. Any information submitted as Trade Secret must be identified c and submitted per the Trade Secret Form and roust meet Minnesota Trade Secret as defined in Minn. Stat. § 13.37 o LO o W t a� 3 0 L d U) R L) L 3 rL 0 Q R J V • C d 2 O O O N O N c� Q U c 22 CONTRACT No. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY E L v R r Q • i Packet Pg. 218 COMPUTER EQUIPMENT 2014-20'19 MINNESOTA WSCA-NASPO MASTER AGREEMENT AWARD EXHIBIT B - PRICING 1. BAND(S) AWARDED: Band 1: Desktop Band 2: Laptop Band 3: Tablet Hand 4: Server Band 5: Storage.. 2. PRICE STRUCTURE. The contract employs a MINIMUM discount -off baseline price list structure with category exceptions for each band. The category discounts may be higher or lower than the than the band discount. The. minimum discount and categorized exceptions will be applied to all "quantity one" procurements. An end user will be able to verify pricing using the named base line price list and the minimum discounts with the categorized exceptions provided in the Master Agreement. 3. PRICE GUARANTEE. These discounts must remain firm,. or the discount may be Increased, during the term of the Master -Agreement. 4. BASELINE PRICE LIST. The Base Line Price is designated in the Pricing Discount Schedule. The Base Line Price List must be accessible and verifiable by potential end users preferably on the Contract Vendor Website. All historic versions of the Baseline Prig List must be made available upon request pursuant to the audit provisions. 5. PRODUCT AND SERVICE SCHEDULE (PSS). The Product and Service Schedule (PSS) identifies a complete listing of all products and services included in the awarded Master Agreement. The PSS serves as the Contract Catalog. The PSS will be submitted to the Lead State fallowing contract award and must be approved by the Lead State prior to the start of any sales. The PSS must be available on the Contract Vendor website for end users to verify pricing based on the minimum discounts with category exceptions provided off a designated base line price list. The Contract Vendor will work with each State to develop a satisfactory PSS reflecting the individual States restrictions. B. CHANGES TO THE PSS. Contract Vendor will request changes to the PSS utilizing an Action Request Form (ARF) Submittals will be reviewed by the Lead State quarterly. Obsolete and discontinued products will be removed. 7. SULKfVOLUME PRICING. Further bulk/quantity savings may be obtained when additional quantities are requested. Additional savings are expected when competing awarded vendors for volume pricing. 8. PROMOTIONAL OFFERS. Contract Vendors may provide promotions for deeply discounted products based on their inventory and sales. The Contract Vendors will be responsible to market these offers. 9. PREMIUM SAVINGS PACK --AGE PROGRAM. Contract Vendors participating in the Premium Savings Package (PSP) Program will commit to the standard configurations. The standards currently are refreshed every six months (May and November). Refresh schedule is subject to change..See current configurations: httl}:/fwww.wnpso.comfindex.html. States and other Participating Entities_ can choose to purchase these packages without any signing additional documents. 10. TRADE-IN. Trade-in Programs are the option of the Participating Entity. The Participating Addendum by each State may address the allowance of Trade -Ins. 11. SERVICES. Services are at the option of the Participating Entity. The Participating Addendum by each State may address service agreement terms and related travel. 23 CONTRACT No. MNwNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 219 8.H.a 12. LEASING. The Discount schedule will indicate if the Contract Vendor provides leasing. Participating Entities may ' enter in to lease agreements if they have the legal authority to enter into these types of agreements. The participating cn Addendum by each State will identify if and how leasing agreement terms will be conducted. W N 13. FREIGHT. All prices shall be FOB Destination, prepaid and allowed (with freight included in the price), to the address, receiving dock or warehouse as specified on the ordering agency's purchase order; In those situationSL in which the "deliver -to" address has no receiving dock or agents, the Contract Vendor must be able to deliver to the person specified on the PO without additional cost. If there is a special case where inside delivery fee must be charged, the Contract Vendor will notify the customer in advance in order for the customer to determine if the additional cost will affect the decision to utilize the Contract Vendor. 14. DELIVERY. Delivery of ordered product should be completed within thirty (30) calendar days after receipt of an order, unless otherwise agreed to by the ordering agency. L . 24 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT ti r O Lf') CO LO O I rn W t 3 O L d R t ci L 3 0. 0 Q R J d 2 2 �L O 0 0 N O N c� Q U c O HEWLETT PACKARD COMPANY E V R Q Packet Pg. 220 COMPUTER EQUIPMENT 2014-2019 r�5 sl+l�g�nilvF�i�iiti�'tansrr:�r, MINNESOTA WSCA-NASPO MASTERAGREEMENT AWARD EXHIBIT B - PRICING SCHEDULE PRICE1. BASELINE PRICING HP LIST 2. :i ■ DISCOUNTS CODE DISCOUNT BAND ■ • BAND LAPTOP 1 BAND TABLET • 1 1ND E SERVER • BAND • • , Category Exce tinn: Promotions7mart Bus I PROMO 117% IMPORTANT: The minimum discount is provided, refer to Contract Vendor's Website for any additional discounts and request a quote for bulkivolume discounts. All prices shalt be FOB Destination, prepaid and allowed (with freight included in the price). If there is a special case where inside delivery fee must be charged, the Contract Vendor will notify the customer in advance. PARTY3. THIRD PRODUCTS • 1 CategoryExee lion: Third Party. Software TPS 5% Category Exception. Microsoft O1S whenpurchased with Band 4 items 4M16 ©% See HP WSCA-NASPO Website for AbDroved Third Party Software & Hardware Manufacturers. 4- SERVICES - •Services Services are -at the option of the Participating State. The Participating Addendum by each State may'address service agreement terms. The majority of HP Branded products include up to a 3 year warranty and HP provides options to upgrade to 2, 3, 4 and 5 year -warranty through HP Care Packs for some products as available. For product specifications & standard warranty included with system see: httu:llh7lQ59.www7.hlp.comiauich§nocsloverylw.ht l#intr© Partici atin Addendum may ldenl:2 if and how leasin a reem ant terms will be conducted. a. B!g Deal Pricing: Contact HP sales for additional savings provided through "special fixed pricing" (Big Deal). HP offers Multiple Transaction Volume based on the quantity, specific product or products purchased in a given time period. b. Cumulative and Special Discounts: Based on annual volume, HP will evaluate yearly sales on the Master Agreement and may elect to provide potential increased discount per band or provide specials for select products for the product category or series life cycle. c. Additional BulklVolume Discount Options: HP may provide procuring entities with different flexible savings options based on what meets their specific needs and requirements..HP may provide opportunities in the form of additional equipment if allowed by the Participating Entity. & Contact HP for detailed list of additional discounts provided. ti 0 00 LO 0 I W 0 t a� 0 L t m L 3 a a 0 Q. J a x �L O 0 0 N O N c� Q U c O >_ 25 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY L v R r Q Packet Pg. 221 COMPUTER EQUIPMENT 2014-2019 MINNESOTA WSCA-NASPO MASTER AGREEMENT AWARD EXHIBIT C - PRODUCT AND SERVICE SCHEDULE (PSS) 0 I. MAINTAINING THE PSS. The Product and Service Schedule (PSS) identifies a complete listing of all products and services included in the awarded Master Agreement. The PSS serves as the WSCA-NASPO Contract Catalog. The- PSS will be -submitted to the Lead State following contract award and must be approved by the Lead State a prior to the start of any sales. The PSS must be available on the Cont€act Vendor Website for end users to verify = pricing based on the minimum discounts with category exceptions provided off a designated base line price list. The +, Contract Vendor will work with each State to develop a satisfactory PSS reflecting the individual States restrictions. The Contract Vendor Will work to develop a PSS satisfactory to the Lead State prior to the start of sales and containing the following information: co a. Band number LO b.- Part # - SKU # c. Manufacturer ti d. Description c e. Minimum Discount �n f. • Category Code (This code will be refined during the approval process) o g. Other fields approved by the Lead State L' 0 2. CHANGES TO THE PSS: Contract Vendor will request changes to the PSS utilizing an Action Request Form (ARF) w Submittals will be reviewed by the Lead State quarterty. Obsolete and discontinued products will be removed. t 3. FORMAT: The format for the final product and service schedule will be approved within 30 days of contract award. o Suggested format is provided below: MANUFACTURER NAME: DATE: BASELINE PRICE LIST: - - LINK: a MINIMUM CATEGORY o BAND Part # - SKU# MANUFACTURER DESCRIPTION DISCOUNT CODECU Q- XYZ ABC DESKTOP 60% 1M J A'3 550 ZZZZZZZ LAPTOP' CART 10% 2TM ' 123A ABC SUPER TABLET 25% .3A c 4. THIRD PARTY PRODUCTS: A list of third party products is to be submitted to the Lead State. Approval must be _ received from the Lead State prior to adding third party products to the Product and Service Schedule. Master Agreement restrictions of third party products. include: c S a. Contract Vendors can only offer Third Party Products in the bands they have been awarded. b. Contract Vendor cannot offer products manufactured by another Contract Vendor holding a Minnesota . O WSCA-NASPO Master Agreement unless'approved by the Lead State. , c. The Contract Vendor will assign the manufacturer or publisher's warranty and maintenance. The Contract Vendor c will provide warranty and maintenance call numbers and assist the customer in engaging the manufacturer on 1* warranty and maintenance issues. o N d. Any additions to the Third Party Product list must be submitted utilizing the Action Request Form. o N e. The approved Third Pa Product.list will be clean p p pp Party y posted an the Vendor provided website and updated as Q products are approved. V aD 26 CONTRACT NO. MNWNC-116 MASTER AGREEMENT AWARD COMPUTER EQUWMENT HEWLETT PACKARD COMPANY E v R .r r Q Packet Pg. 222 8.H.a 3' COMPUTER EQUIPMENT 2014-2019 �ii��+A'1�1',wEN:T�S�.p,�lRlll�i�i`)tATtON' MINNESOTA WSCA-NASPO MASTER AGREEMENT AWARD EXHIBIT Q-'VSI'EBSITE 1. IMPLEMENTATION. Within 30 calendar days of Master Agreement award, the Contract Vendor must provide a, sample URL of the Master Agreement webpage to the lead State for review and approval. The Lead State wiill review and determine acceptability of the website format and data. If the information is determined to be unacceptable or incorrect, the Contract Vendor will have 15 calendar days to provide revisions to the Lead Stale. Once the website is approved, the Contract Vendor may not make material changes to the website without notifying the Lead State and receiving written approval of the changes ubUing the Action Request Form. The Contract Vendor must continue to monitor and update the website throughout the life of the contract. Periodic audits maybe conducted to ensure websites are updated and Contract Vendors will be expected to correct deficiencies, 2. WEBSITE CONTENT. The website must be separate from the Contract Vendor's commercially available (i.e., public) on-line catalog and ordering systems. Contract Vendor agrees to pursue design of a website to include the items listed below. The lead State will review and determine acceptability of the website format and data as stated in Item 1 c above. a. Baseline Price List and historic versions 00 LO b. Approved Product and Service Schedule (PSS) e c. Product specifications, pricing, and configuration aids for the major product categories proposed that can be used �� ' to obtain an on-line quote uj � d. -Third Party Product list will be clearly posted on the Vendor provided website and updated as products are t approved e. "Link to the WSCA-NASPO EmarketCenter o f. Online ordering capability with the ability to remember multiple ship to locations if applicable to product g. Contact information for order placement, service concerns (warranty and maintenance), problem reporting, and billing concerns h. .Sales representatives for participating entities � i. Purchase order tracking j. Available Twenty-four (24) hours per day, seven (7) days per week availability, except for regularly scheduled a maintenance Q• O k.: Additional Terms may not be posted on the Website without written approval of the Lead State Q. 1. Link to the WSCA-NASPO EmarketCenter if a State is participating U m. Information on accessibility and accessible products n., If participating in'Premium Savings Package Program, lead with these products and display prominently on the website — o. Links to environmental certification, including but not limited to take-backlrecycling programs, a- p. Information regarding the use of Conflict minerals, as required by Section 13(p) of the Securities Exchange Act of = 1934, as amended, and the rules promulgated thereunder. See: htip:d=.sec.00v/rules/finaV2012134-67716.odf q. Service options, service agreements for negotiations when allowed by a participating addendum r. EPEAT, Energy Star, etc. s. Link to Signed Participating Addendums O t. Link to Signed Master Agreement u. Linkto solicitation and Response 3. TERMINATION Upon termination or expiration of the Master Agreement awarded from this RFP all websites, on-line 0 c offering systems and Electronic Catalog functions supported and/or available as part of the Master Agreement will N cease and be removed from public viewing access without redirecting to another website. Q U c O >_ 27 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT 14EWLETT PACKARD COMPANY L v R r Q Packet Pg. 223 COMPUTER EQUIPMENT 2014-20'19 �"Zi�jjs�iE.4Y'Ei�E k"+:JFk'"ffR�IT+€+ MINNESOTA WSCA-NASPO MASTER AGREEMENT AWARD EXHIBIT E - ACTION REQUEST UPDATE FORM (ARF) The Action Request Form (ARF) provided in this document must be utilized by the Contract Vendor to provide quarterly updates of. PSS and to make requests. The Action Request Forms may be reviewed quarterly by the Lead State. DATE: ATTN: WSGA-NASPO Master Agreement Administrator RE: Master Agreement # with _ (Contract Vendor) 0 co LO N_ Dear VVSCA-NASPO Master Agreement Administrator: (Contract Vendor) is providing the following update and/or r 9 requesting the action noted. below.00 Action Requested: ' m o Action Log; Verify Log is attached w • o SELECT ACTION BELOW AND PROVIDE REQUIREO INFORMATION: Update of Product & Service Schedule Provide summary of additions; deletions and pricing changes. ° NOTE: THIS WILL BE -A NOTIFICATION OF CHANGES TO THE PSS, APPROVAL WILL NOT BE NEEDED Quarterly Self Audit Check this box to verify the Quarterly Self Audit has been completed vi t Third Party Product Addition Provide warranty Guarantee a ^Marketing Approval Attach Materials fog review Q. 0 Material Website Change Describe and provide link for review CU J Miscellaneous Inquiry Provide detail (e.g. key contact change, etc_) c The'Contract Vendor certifies Products and Services provided meet the terms and conditions of the Master Agreement o: and understands they may be audited for compliance. Additional information may be requested upon submission. The _ Lead State may remove previously approved items throughout the life of the Master Agreement if in the best interest at its ' sole discretion. f° c Contract Vendor: Name of Requester: O Title of Requester: c 0 N O N Q U c O 28 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETr PACKARD COMPANY E ' v R .r ` Q Packet Pg. 224 COMPUTER EQUIPMENT 2014-2019' wn ',;tics` Rt°tl rf��Y'EL'ec t MINNESOTA- WSCA-NAS PO MASTER AGREEMENT AWARD' EXHIBIT E - ACTION REQUST FORM (ARF) ACTION REQUEST FORM LOG Submit updated Action Lag with each update. Log must provide history of previous update. CONTRACT VENDOR: Contact Name and'Emall (for questions): DATE: DATE I ACTION REQUESTED: DATE APPROVED SUBMITTED 29 CONTRACT NO. MNWNC415 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 225 COMPUTER EQUIPMENT 2014-2019 DLW;rtRi hi7'�F 34Ai1##hf?Sri�AifQN �C= xE'�MhliTfVE z=`�F��ILL�If�Sf�1�- - MIN_ NESOT_A_il_il'SCA-NASPO_MASTER AGREEMENT-AWARD� EXHIBIT F - REPORTING 1. OWNERSHIP: Recipient of the reports shall have exclusive ownership of the media containing the reports-. The Lead State and WSCA-NASPO shall have a perpetual, irrevocable, non-exclusive, royalty free, transferable right to display, modify, copy, and otherwise use reports, data and information: provided. 2. DUE DATE: Deports shall be due no later than the last day of the month following'the' end of the calendar quarter. Q1 January 1 March 31 Aril 30 ao Q2 Aril t June 30 Jul 31 LO Q3 July 1 Se tember 30 October 31 Q4 October 1 December 31 January 31 r 3. REQUIRED REPORTS: 9 0 Report Name Submitted to Purpose & Submittal LO 0 1 WSCA-NASPO Administrative Fee WSCA- Identify total sales and administrative fee due to WSCA- __ .. NASPO NASPO u7 w 1) Go to: h :flwww.nas o.ar MINCPOfCalculator.as x o 2) Complete all contract report information fields a, 3) Enter total sales per State or Select "no sales for quarter" ° chsckbox ° 4) Click on Submit button m 2 WSCA-NASPO Detailed Sales WSCA- Detailed sales data by line item. Currently via an Excel Report NASPO template. Future MAY involve a portal_ No modifications may be made by the Contract Vendor to the template. This report a may also fulfill the reporting requirements of self audits, premium savings sales, and Bring Your Own Device Employee. a 0 Sales. a CU 3 Participating States Participating Contract Vendor may utilize the detailed sales report to report J State to individual States unless otherwise directed by the State, c; States may require additional reporting. S 4 Participating Addendum Status WSCA- Provides status of Participating Addendums. Excel Template = NASPO to be provided by WSCA-NASPO. 5 Premium Saving Package (PSP) PSP Lead Additional reporting may be requested. S 6 Quarterly Updates of PSS and Self Lead State Utilize the Action Request Form (ARF) O Audit 30 CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQujPMENT 0 0 N 0 N Q U c O HEWLETTPACKARDCOMPANY E v R r Q Packet Pg. 226 T. >. COMPUTER EQUIPMENT :. 2014-2019 Cijlt rit-0IaF � (�'31L --MINNESO_T_A WSCA-NASPO MASTED AGREEMENT AWARD EXHIBIT G - DEFINITIONS Acceptance. See Master Agreement Terms regarding Acceptance and Acceptance Testing. Accessory. Accessories do not extend the functionality of the computer, but enhances the user experience i.e., mouse pad, monitor stand. For the purposes of this proposal, accessories are considered peripherals. Bands: For the purpose of this solicitation, there are six product bands which may be awarded. Each product band includes related peripherals and services. Responders must only respond to Bands in which they manufacture the defined product. Responder may receive an award in one or more bands for which they manufacture a product based on the evaluation. BAND 1: DESKTOP. A desktop computer is a personal computer intended for regular use at a single location. A desktop computer typically comes in several units connected together during installation: 1) the processor, 2) display monitor and 3) input devices usually a keyboard and a mouse. All operating systems for tablets are allowed. zero Clients, Thin clients, all in ones and workstations will also be included under desktops. Ruggedized equipment may also be included in the Product and Service schedule for this band. BAND 2: LAPTOP.. A laptop computer is a personal computer for mobile use. A laptop includes a display, keyboard, point device such as a touchpad and speakers into a single unit. A laptop can be used away from an outlet using a rechargeable battery. All operating systems for tablets are allowed. Laptops will include notebooks, ultrabook, mobile thin clients, chromebooks and netbooks. Computers with mobile operating systems will also be included under laptops. Tablets that have the option to be utilized with a keyboard can be sold in this band. Ruggedized equipment may also be included in the Product and Service Schedule for this band. BANE} 3: TABLET. A tablet is a mobile computer that provides a touchscreen which acts as the primary means of control: All operating systems for tablets are allowed. Ruggedized equipment may also be included as a category in the Product and Service Schedule for this band. BAND 4. SERVER.. A server is a physical computer dedicated to run one or more services or applications (as a host) to serve the needs of4he users of other computers on a network. This band also includes server appliances. Server appliances have their hardware and software preconfigured by the manufacturer. It also includes embedded networking components such as those found in blade chassis systems. Ruggedized equipment may also be included in the Product and Service Schedule for this band. BAND 5: STORAGE. Storage is hardware with the ability to store large amounts of data. This band includes SAN switching necessary for the proper functioning of the storage environment. Ruggedized equipment may also be included in the Product and Service Schedule for this band. BAND B REMOVED. RUGGEDIZED EQUIPMENT MAY BE SOLD IN {SANDS 1-5, PROVIDED IT MEETS BAND REQUIREMENTS. Cloud Services. Delivery of computing as a service rather than a product, whereby shared resources, software and information are provided to computers and other devices as a utility over a network, such as the Internet. (Cloud Services including acquisitions structured as managed on -site services are not allowed.) Contract Vendor or Contractor. The manufacturer responsible for delivering products or performing services under the terms and conditions set forth in the Master Agreement, The Contract Vendor must ensure partners utilized in the performance of this contract adhere to all the terms and conditions. For the purposes of this RFP, the term Partner will be utilized in naming the relationship a manufacturer has with another company to market and sell the contract. Participating States will have final determinationfapprovaI if a Partner may be approved for that state in the role identified by the Contract Vendor. Components. Parts that make up a computer configuration. Configuration. The combination of hardware and software components that make up the total functioning system. Desktop. This is Band 'I of this solicitation. A desktop computer is a personal computer intended for regular use at a single location. A desktop computer typically -comes in several units connected together during installation: 1) the processor, M CONTRACT NO. MNWNC-115 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY Packet Pg. 227 8.H.a 2) display monitor and 8) input devices usually a keyboard and a mouse. Desktop virtualization endpoints such as zero and thin clients will also be included under the Desktop Band. Energy StarO A voluntary energy efficiency program sponsored by the U.S. Environmental Protection Agency. The w Energy Star program makes identification of energy efficient computers easy by labeling products that deliver the same or better performance as comparable models while using less energy and saving money. Energy Star qualified computers coo and monitors automatically power down to 15 wafts or less when not in use and may actually last longer than conventional products because they spend a large portion of time in a low -power sleep mode.. For additional information on the Energy N Star program, including product specifications and a list of qualifying products, visit the Energy Star website at - http:/Iwww.energystar.00v. EPEAT. A system for identifying more environmentally preferable computer desktops, laptops, and monitors. It includes an y ANSI standard - the IEEE 1680 EPEAT standard — and website www.e eat.net to identify products manufacturers have declared as meeting the stardard- EPEAT provides a clear and consistant set of performance criteria for -the design of products. It is not a third -party certification program. Instead, Manufacturers self -certify that their products are in rL conformance with.the environmental performance standard for electronic products. FOB Destination. Shipping charges are included in the price of the item and the shipped item becomes the legal o property and responsibility of the receiver when it reaches its destination unless there is acceptance testing required. FOB Inside Delivery. Special Shipping arrangements, such as inside delivery, may include additional fees payable by —J the Purchasing Entity_ Any FOB inside delivery must be annotated on the Purchasing Entity ordering document. a General Consutting. Services related to advising agencies on how best to use information technology to meet lousiness objectives. Examples of such services would include management and administration of IT systems. Each State wilt have varying laws, rules, policies and procedures surrounding general consulting which need adherence. Minnesota Statute section 16C.08 defines general consulting for the State of Minnesota. https:/Iwww. revisor.mn.gov/statutes/?id=lQC.08 Laptop. This is Band 2 of this solicitation. A laptop computer is a personal computer for mobile use. A laptop includes a co display, keyboard, point device such as a touchpad and speakers into a single unit. A laptop can be used away from ran N outlet using a rechargeable battery. Laptop Band may include notebooks, ultrabooksi and netbooks. Computers with mobile operating systems will also be included under the Laptop Band, Lead State. The State conducting this cooperative solicitation and centrally administering'any resulting Master. c Agreement with the permission of the Signatory States. Minnesota is the Lead State for this procurement and the laws of Minnesota Statute Chapter 16C apply to this procurement. 00 LO Manufacturer. A company that, as one of its primary business function, designs, assembles ovens the trademark/patent and markets branded computer equipment. �I Master Agreement. The underlying agreement executed by and between the Lead State and the Contract Vendor.. w Middlewere. Middieware is the software "glue" that helps programs and databases (which may be on different computers) work together. Its most basic function is to enable communication between different pieces of software. Options. An item of equipment or a feature that may be chosen as an addition to or replacement for standard equipment o and features. t Carder. A purchase order, sales order, or other document used by a Purchasing Entity to order the Equipment. a, Participating Addendum. A written statement of agreement signed by the Contract Vendor and a Participating State or other Participating Entity that clarifies the operation of this Master Agreement for the Participating Entity (e.g., ordering procedures specific to a Participating State) and may add other state-specific.language or other requirements. A Participating Addendum evidences the Participants willingness to purchase and the Contract Vendor's willingness to a - provide equipment under the terms and conditions of this Master Agreement with any and all exceptions noted and o agreed upon. Q. Participating States. States that utilize the Master Agreement established by the RFP and enter into a Participating U Addendum which further defines their participation. Participating Entity. A Participating State, or other legal entity, properly authorized by a Participating State to enter into the Master Agreement through a Participating Addendum and that authorizes orders from the Master Agreement by — Purchasing Entities. Under the WSCA-NASPO program, in some cases, local governments, political subdivisions or other a entities in a State may be authorized by the chief procurement official to execute its own Participating Addendum where a = Participating Addendum is not executed by the chief procurement, official for that state that covers local governments, political subdivisions, or other government entities in the state_ S Partner. A company, authorized by the Contract Vendor and approved by the Participating State, to provide marketing, •L support, or other authorized contract services on behalf of the Contract Vendor in accordance with the terms and conditions 0 of the Contract Vendor's Master Agreement, In the RFP, Partner is the term that is used to call out the many different relationships a manufacturer may have with another company to market their product including, but not limited to agents, subcontractors, partners, fulfillment partners, channel partners, business partners, servicing subcontractor, etc. c Peripherals. A peripheral means any hardware product that can be attached to, added within or networked with personal c computers, servers and storage. Peripherals extend the functionality of a computer without modifying the core N components of the system. For the purposes of this proposal, peripherals are defined as including accessories. Q Peripherals may be manufactured by a third party, however, Contract Vendor shall not offer any peripherals manufactured U by another Contract Vendor holding a Master Agreement. The Contract Vendors shall provide the warranty service and 32 CONTRACT NO. MNWNC-116 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLE TT PACKARD COMPANY aD E L v R .r Q I Packet Pg. 228 8.H.a maintenance for all peripherals on the Master Agreement. Examples of peripheraIsla ccessoriesloptions: Include but are not limited to: printers, monitors, multifunction printers, audiovisual equipment, instructional equipment, cabling, rn modems, networking to support server, storage and client applications such as routers, switches. Software is an option which must be related to the purchase of equipment and subject to configuration limits. Third party products are v allowed to be offered as peripherals/accessoriesloptions and may be offered in any related band. Per Transaction Multiple Unit Discount. A contractual volume discount based on dollars in a single purchase order or combination of purchase orders submitted at one time by Participating Entity or multiple entities conducting a cooperative purchase. Premium Savings Packages. Deeply discounted standard configurations available to Purchasing Entities using the Master Agreement. This specification includes a commitment to maintain and upgrade (keep pace with the advance of --technology) the -standard configurations fora-stated-polod-of time-orintervals. WSCA-NASPO-reserves the -right to - expand and modify the PSP throughout the life of the contract. See http://www.wnpsr).com/index.htm]. L Purchasing Entity — means a state, city, county, district, other political subdivision of a State, and a nonprofit o- organization under the laws of some states if by a Participating Addendum, that Issues an order against the o Master Agreement and becomes financially committed to the purchase_ a Ruggedized. This was band 6 of this solicitation. Ruggedized refers to equipment specifically designed to operate reliably in harsh usage environments and conditions, such as strong vibrations, extreme temperatures and wet or dusty conditions. IL Services. Broadly classed as installation/de-installation, maintenance, support, training, migration, and optimization of = products offered or supplied under the Master Agreement. These types of services may include, but are not limited to: warranty services, maintenance, installation, de -installation, factory integration (software or equipment components), asset management, recycling/disposal, training and certification, pre -implementation design, disaster recovery planning and support, service desk/helpdesk, and any other directly related technical support service required for the effective 00 operation of a product offered or supplied. Contract Vendors may offer, but participating States and entities do not have to n accept, limited professional services related ONLY to the equipment and configuration of the equipment purchased through the resulting contracts. EACH PARTICIPATING STATE DETERMINES RESTRICTIONS AND NEGOTIATES TERMS FOR SERVICES. r Server. This is Band 4 of this solicitation- A server is a physical computer dedicated to run one or more services or applications (as a host) to serve the needs of the users of other computers on a network. This band also includes server 00 appliances. Server appliances have their hardware and software preconfigured by the manufacturer. It also includes c embedded networking components such as those found in blade chassis systems. Ruggedized equipment may also be included in the Product and Service Schedule for this band. w Storage. This is Band 5 of this solicitation. Storage is hardware with the ability to store large amounts of data. This band o includes SAN switching necessary for the proper functioning of the storage environment. Ruggedized equipment may also a� be included in the Product and Service Schedule for this band. o Storage Area Network. A storage area network (SAN) is a high-speed special-purpose network (or subnetwork) that interconnects different kinds of data storage devices with associated data servers on behalf of a larger network of users. Storage as a Service (STaaS). An architecture model by Which a provider allows a customer to rent or lease storage space on the provider's hardware infrastructure on a subscription basis. E.g., manage onsite or cloud services. Software. For the purposes of this proposal, software is commercial operating off the shelf machine-readable object code L) instructions including microcode, firmware and operating system software that are preloaded on equipment. The term a - "Software" applies to all parts of software and documentation, including new releases, updates, and modifications of Q. software. Tablet. This is Band 3 of this solicitation. A tablet is a mobile computer that provides a touchscreen which acts as the CU primary means of control. Tablet band may include notebooks, ultrabooks, and netbooks that are touchscreen capable. J Takeback Program. The Contract Vendor's process for accepting the return of the equipment or other products at the and of life_ _ Third Party Products. Products sold by the Contract Vendor which are manufactured by another company. Q Upgrade. Refers to replacement of existing software, hardware or hardware component with a newer version. x Warranty. The Manufacturers general warranty tied to the product at the time of purchase. ' Wide Area Network or WAN. A data network that serves users across a broad geographic area and often uses � transmission devices provided by common carriers. a� WSCA-NASPO. The WSCA-NASPO cooperative purchasing program, facilitated by the WSCA-NASPO Cooperative O Purchasing organization LLC, a 501(c)(3) limited liability company that is a subsidiary organization of the National Association of State Procurement Officials (NASPO). The WSCA-NASPO Cooperative Purchasing Organization c facilitates administration of the cooperative group contracting consortium of state chief procurement officials for the benefit of state departments, institutions, agencies, and political subdivisions.and other eligible entities (i.e., colleges, school N districts, counties, cities, some nonprofit organizations, etc.) for all states and the District of Columbia. The e N WSCA-NASPO Cooperative Development Team is identified in the Master Agreement as the recipient of reports and may O be performing contract administration functions as assigned by the Lead State Contract Administrator, v c aD E 33 CONTRACT NO. MNVVNC-116 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HEWLETT PACKARD COMPANY L Packet Pg. 229 8.H.a HP, Inc. (MNNVP-133) 3. Amendment 1 - 2017 - HP Enterprise Packet Pg. 230 8.H.a AMENDMENT NO. 1 TO CONTRACT NO. MNNVP-133 THIS AMENDMENT is by and between the State of Minnesota, acting through its commissioner of Administration ("State"), and HP Inc., 1501 Page Mill Road, Palo Alto, CA 94304 ("Contract Vendor"). WHEREAS, the State has a Contract with the Contract Vendor identified as Contract No. MNNVP-133, April 1, 2015, through March 31, 2017 ("Contract"), to provide Computer Equipment: (Desktops, Laptops and Tablets, including Related Peripherals and Services); and WHEREAS, Minn. Stat. § 16C.03, subd. 5, affords the commissioner of Administration, or delegate pursuant to Minn. Stat. § 16C,03, subd.. M.the authority to amend contracts; and WHEREAS, the terms of the Contract allow the State to amend the Contract as specified herein, upon the mutual agreement of the Materials Management Division and the Contract Vendor in a fully executed amendment to the Contract. NOW, THEREFORE, it is agreed by the parties to amend the Contract as follows: 1. That Contract No. MNNVP-133 is extended through March 31, 2020, at the same terms and conditions. 2. The Contract Vendor shall provide Computer Equipment: (Desktops, Laptops and Tablets, including Related Peripherals and Services) at the prices set forth on the following schedule: HP Inc. Price Schedule, This Amendment is effective beginning April 1, 2017, or upon the date that the final required signatures are obtained, whichever occurs later, and shall remain in effect through contract expiration, or until the Contract is canceled, whichever occurs first. Except as herein amended, the provisions of the Contract between the parties hereto are expressly reaffirmed and remain in full force and effect. IN WITNESS WHEREOF, the parties have caused this Amendment to be duly executed intending to be bound thereby 1. HP INC. The Contractor certifies that the appropriate person(s) have executed this Amendment on behalf of the Contractor as required by appl' ble articles, bylaws, resolutions, or ordinances. By: gnature Deborah Kaiser Printed Name Title: Contract Administrator Date: 1 /24117 By: Signature Printed Name , Title: Date: 2. MATERIALS MANAGEMENT DIVISION In accordance with Minn. Stat. § 16C.03, subd. 3. By: 1 Title: Acquisition Management Specialist Date: 3. COMMISSIONER OF ADMINISTRATION Or delegated r esentative. By:-�� 57 Date: CONTRACT NO. MNNVP-133 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HP INC. Packet Pg. 231 .n1 X DO 3a MU a9 m o o g 0- � ti ao $ y T n A o 1G 2 m d co d Nj R Q 'D 7 o 60f O_ a E� o Vi "3 N OE CL Qn. ay+ chi -.cp, ui 2h g c IL d e ti m d E m O m o c 7E m O y 0 p C K a H E N Y9 �m+ i53 � V b G o a o Ys P g° tmm qm+ a m V UMn w S K W'e 2 Uc H aU, LO Mg, D y Cr d d r CJ a: E �y;,�, � 7 d :i 4 � C1 inl N In In ill M O1 Z N N Gt O U 4 f� P1 O g Z F^o ro u �o Cd add dCr �d� cr�G n a o o 4 N m H Z 0 z W ', °�S,",�'., c7 C1 d d d [7 D' � d r V! LU a w Packet Pg. 232 1 N m •� �L c L t 2 O � O p N M � u O N (� a U a 7 d Z �.i i d Z V C Packet Pg. 233 N a C Packet Pg. 234 00 Co un N T- O LO T- oo LO 0 Cn W t L t d t V L a Q. 0 a 0 J C1 C o N m x � ry � �L b m 6 0 U Q a u Q N a 0 N V a Ua a � d Z ti V Z +� a Packet Pg. 235 Packet Pg. 236 O •� m ' w L O m O a � 2 N O N o Q CL a i 0 a z t V z a Packet Pg. 237 Packet Pg. 238 bt g C Packet Pg. 239 8.H.a Packet Pg. 240 8.H.a Packet Pg. 241 8.H.a STATE OF MINNESOTA - WORKFORCE CERTIFICATE INFORMATION Required by state law for ALL bids or proposals that could exceed $:100,000 Complete this form and return it with your bid or proposal. The State of Minnesota is under no obligation to delay proceeding with a contract until a company becomes compliant with the Workforce Certification requirements in Minn. Stat. §363A.36. BOX A — MINNESOTA COMPANIES that have employed more than 40 full-time employees within this state on any single working day during the previous 12 months, check one option below: ® Attached is our current Workforce Certificate issued by the Minnesota Department of Human Rights (MDHR). ❑ Attached is confirmation that MDHR received our application for a Minnesota Workforce Certificate on (date). BOX B — NON-MINNESOTA COMPANIES that have employed more than 40 full-time employees on a single working day during the previous 12 months in the state where it has its primary place of business, check one option below: ❑ Attached is our current Workforce Certificate issued by MDHR. ❑ We certify we are in compliance with federal affirmative action requirements. Upon notification of contract award, you must send your federal or municipal certificate to MDHR at compliance.MDIHIR state..„mn us. If you are unable to send either certificate, MDHR may contact you to request evidence of federal compliance. The inability to provide sufficient documentation may prohibit contract execution. BOX C — EXEMPT COMPANIES that have not employed more than 40 full-time employees on a.single working day in any state during the previous 12 months, check option below if applicable: ❑ We attest we are exempt. If our company is awarded a contract, we will submit to MDHR within 5 business days after the contract is fully signed, the names of our employees during the previous 12 months, the date of separation, if applicable, and the state in which the persons were employed. Send to com liance.MDHR state.mn.us. By signing this statement, you certify that the information provided is accurate and that you are authorized to sign on behalf of your company. Name of Company: HP Inc Date 1124117 Authorized Signature: Telephone number: 281-927-8498 Printed Name: Deborah Kaiser For assistance with this form, contact: Title: Contract Administrator Minnesota Department of Human Rights, Compliance Services Web: http://mn.gov/mdhr/ TC Metro: 651-539-1095 Email: compliance.m&r@state.mn.us CONTRACT NO. MNNVP-133 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT Toll Free: 800-657-3704 TTY: 651-296-1283 HP INC. Packet Pg. 242 8.H.a POWER OF ATTORNEY HP Inc., a corporation incorporated and existing under the laws of the state of Delaware, having its principal place of business at 1501 Page Mill Road, Palo Alto, California 94304 (the "Company"), represented by its Deputy General Counsel and Assistant Secretary, Ruairidh Ross, who is authorized to represent the Company individually, hereby authorizes to the below listed individuals to sign all bids, quotations, leases and contracts with customers and government agencies, up to the limits indicated below, including such bids, and bonds as may be required in connection with such bids and contracts on behalf of the Company in accordance with the chart below. All prior powers of attorney in effect for these individuals named herein, as of the date hereof, are hereby revoked. This power of attorney shall be valid until one year from the date hereof and may be revoked at any time for any reason prior thereto without notice. This power of attorney shall automatically be revoked for each such person named herein, effective as of the date that each such person ceases to be employed by the Company or any of its subsidiaries. H tc.t"� Ruairidh Ross Deputy General Counsel and Assistant Secretary Date: February L— ; 2016 Page 1 of 1 Packet Pg. 243 8.H.a ACKNOWLEDGEMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA COUNTY OF SANTA CLARA On Febru 22 2016 before me, Valnn Valandani Noaa Public personally appeared Ruairidh Ross, who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the sane in his/ authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. SIGNAIVRE OF NOTARY PUBLIC VALYNN VALANDANI Commission # 1999216 z :+ Notary Public - California z Santa Clara County My Comm. I xpires Dec 22.2016 (SEAL) Packet Pg. 244 8.H.a W ii $ n D.01000fiain of Seonaturo AxAbori#y — ACO SLED Contruct Administrators 1, Jim Ranalli, Americus Contracts Operotions Manager, give the SLI C) Contracts Administraturs listed below, fill signaturo power to sign on behalf of lip in-, up to $5010. Tfiis delegoAon of signature oighority is granted for the fallowing purpose; signature a;whoriz-Aon required for raids, quota ions, and contrads. This delegr;tion CAI signature ai3thC74y is valid' un it kinuary 31, 2017 Lind may be revoked n, rww time prior thereto for zany reason without notice, This power (if attorney shall Ise auiorr,rytically re'mk d shmild Conlmcts Administrator chrunge his/her position within the Comipony or cease tr, be errplioyelc by the Company, Contracts I-- diombilistratair Delegation ele ation Of Expiry Hoes SLA Level Level Amount note Dote Catharine Up to —_ 3ini :3z_.. ' --$5,000,000 CS$50,000,000 ? /02/2Di6 31/01/2017 Fer nL'ifi!:l« i..ias Sllt7 UP to Vold -ovine "z'000'000 �C-5 $50,0)0,000 25/02/2016 31/01/2017 Up to Deborah Kaiser $10,000,000 c;.� $50,000,000 25/02/20 ° /0 /2017 Lop Nancy Lonkowsk $5,000,000 C5 $-10,000,000 25/02/20161/0'i/:0#' Alejandro Marin t wtea del Campo I�,� to Valencia $5,000,000 C5 $50,000,000 25/02/2016 31/01/2017 Sandra Andrea Up to Perez Fernandez $5,000,000 w,�5 J c0,000,000 25/02/2016 31/`,1-1/"0'I'7 Fatima Renteria �� ;� $5,000,000 C5 $50,000,000 25/02/2016 3IMi/2017 Signed this 25th day of February 2016. C c i Jim Ranalli Aniericae Corrimc'ts Operariens Manager HP Packet Pg. 245 8.H.a Minnesota Department of HUMAN RIGHTS CERTIFICATE OF C OMPLUNCE HEWLETT-PACKARD COMPANY is hereby certified as a contractor by the Minnesota Department of Human Rights. This certificate is valid from 412/2014 to 4/112018. This certification is subject to revocation or suspension prior to its expiration if the department issues a finding of noncompliance or if your organization fails to make a good faith effort to implement its affirmative action plan. Minnesota Department of Human Rights FOR THE DEPARTMENT BY; i - Kevin M. Lindsey, Commissioner AN EQUAL OPPORTUNITY EMPLOYER Freeman BUildilig • 625 Rcaherl Slw.0 Narlh • Saint Palrl, Minnesnl r 5515.5 3el 651.539.1100 • MN Relay 711 or 1 .i300.627.:3529 • Toll Free 1.900.67.3704 • Fax 65)1 ."J.96,9042 • mn.gov/nullir Packet Pg. 246 8.H.a HP, Inc. 5. Amendment 3 - 2019 - HP Enterprise and Extend July 2021 Packet Pg. 247 8.H.a AMENDMENT NO. 3 TO CONTRACT MNNVP-133 THIS AMENDMENT is by and between the State of Minnesota, acting through its commissioner of Administration ("State"), and HP Inc., 1501 Page Mill Road, Palo Alto, CA 94304 ("Contract Vendor"). WHEREAS, the State has a Contract with the Contract Vendor identified as Contract No. MNNVP-133, April 1, 2015, through March 31, 2020 ("Contract"), to provide Computer Equipment: Desktops, Laptops, and Tablets, including Related Peripherals and Services; and WHEREAS, Minn. Stat. § 16C.03, subd. 5, affords the commissioner of Administration, or delegate pursuant to Minn. Stat. § 16C.03, subd. 16, the authority to amend contracts; and WHEREAS, the terms of the Contract allow the State to amend the Contract as specified herein, upon the mutual agreement of the Office of State Procurement and the Contract Vendor in a fully executed amendment to the Contract. NOW, THEREFORE, it is agreed by the parties to amend the Contract as follows: 1. That Contract No. MNNVP-133 is extended through July 31, 2021, at the same terms, conditions, and prices This Amendment is effective beginning April 1, 2020, or upon the date that the final required signatures are obtained, whichever occurs later, and shall remain in effect through contract expiration, or until the Contract is canceled, whichever occurs first. Except as herein amended, the provisions of the Contract between the parties hereto are expressly reaffirmed and remain in full force and effect. IN WITNESS WHEREOF, the parties have caused this Amendment to be duly executed intending to be bound thereby 1. HP INC. The Contractor certifies that the appropriate person(s) have executed this Amendment on behalf of the Contractor as required by applicable articles, byyllJaws, r solutions, or ordinances. By: t . Signature Colleen F Lively Printed Name Title: Contract Administrator Date: 11/13/2019 Signature Printed Name Title: Date: 2. OFFICE OF STATE PROCUREMENT In acc ;la with MiAt-3tat: § 16C.03, subd. 3. By: Title: Acquisition Management Specialist Date: IV 3. COMMISSIONER OF ADMINISTRATION Or delegated rep esentative. By: Date: //,�ItI2a11? - — CONTRACT NO. MNNVP-133 MASTER AGREEMENT AWARD COMPUTER EQUIPMENT HP Inc. Packet Pg. 248 8.H.a *' o CD M CD M u? O N N qtT N O 0 N f-� V w 0 (C N O co N CD CD C0 m CO 00 r O 00 r O +_ r N ca C :R C C E N v I,: N O (n - L!] r d O Q O o �o p o o N Tl-acn �+ U N N 0 0 L N .. X r C? u i L6 v O r fC W C CNO r J N LO CD NO O IQ r+ N W m fnco O H a o x c° 0 ui cc0o �r CO m N N �O O O O Siam° a '- m U�� (D (0 ED o O o y a a� E L m E3 oV U � O Cp Q Q Z3 O 'h V♦ C O .�CY) CD O a} d > LO to s C O N p (D 72 N L 1 O cu _ L (� E E 7+�0� cozo m o m <D m O o C N 3 U o O v ¢'ate _ a Z N Q. mc: o co ti Gf -p Y o a7 � 400 Q 0 u) O = U O C O U N CU I-- o 0 r c� m<NYIL o co I� w co cvy O _ o m L U N cu 22 ¢ O C O CL O Q 0 li= � w U O '' 1� ���C LLmD CD a l( }� 0O -0 70 J:m co U r •r m u) N a 2 C� o __3 O Lp OY~U L • zo �? m UaO a) CDcn a) aC3 0 m CD E (u p 0 o U7 Q Q N N m > 0 {� W E CL _ Q A H.-- (n{n Packet Pg. 249 8.1 • KENT *A S M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: Ordinance Approving the Change of Indirect Control of Astound Broadband, LLC - Adopt MOTION: Adopt Ordinance No. 4390, approving the change of indirect control of Astound Broadband, LLC. SUMMARY: Astound Broadband, LLC (Astound) holds a franchise that authorizes the installation of fiber within the rights -of -way throughout the City. The City adopted this 10-year franchise on April 7, 2015. In 2017, the City approved an indirect transfer of control when Radiate Holdco, LLC, acquired all of the outstanding membership interests of Astound's parent company. The City approved this indirect change in control and Astound remained the franchisee and as such is bound by the terms of the franchise. On December 7, 2020, Astound again requested approval of an indirect change in control. Now, Stonepeak Infrastructure Partners plans to purchase 100% of the membership interests of the parent company. This transaction will occur on the parent company level and Astound will remain the franchisee and will continue to be bound to the terms of the franchise. Section 28.2 of the franchise requires that Astound notify the City of the impending change in control and provide supporting documents for the City's review. The City must approve or deny the request for transfer within 120 days. The City has reviewed the materials provided and learned that the new parent company has no current plans to change the local operations or structure of the operations or the services offered. Astound will remain the franchisee and will be operated under the direction of the existing management team. Additionally, the same terms and conditions of the franchise will remain in place. For these reasons, it is recommended that the City Council approve the indirect change of control as described in this proposed ordinance. BUDGET IMPACT: None SUPPORTS STRATEGIC PLAN GOAL: Evolving Infrastructure - Connecting people and places through strategic investments in physical and technological infrastructure. Packet Pg. 250 8.1 Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. ATTACHMENTS: 1. Ordinance - Astound Broadband, LLC - Approval of Change Control (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 251 ORDINANCE NO. 4390 AN ORDINANCE of the City Council of the City of Kent, Washington, approving the change of indirect control of Astound Broadband, LLC, a Franchisee of the City. RECITALS A. Astound Broadband, LLC ("Franchisee") owns, operates and maintains a telecommunications system (the "System") in the City of Kent pursuant to a franchise ("Franchise") granted by the City of Kent ("City") - Ordinance No. 4144 - and Franchisee is the current duly authorized holder of the Franchise. B. Pursuant to an Agreement and Plan of Merger ("Agreement"), funds associated with Stonepeak Infrastructure Partners ("Acquirer"), a Delaware limited liability company, will purchase 100% of the membership interests of Radiate Holdings, L.P., a Delaware limited partnership, (which owns 100% of the indirect ownership interests in Franchisee), and, as a result, the indirect control of Franchisee will change (the "Change of Control") C. Franchisee and Acquirer have requested the consent of the City to the Change of Control in accordance with the requirements of the 1 Astound Broadband, LLC Approval of Change of Control -Ordinance Packet Pg. 252 Franchise Section 28.2, and have provided the City with all information necessary to facilitate a decision by the City (the "Application"). D. The City has reviewed the Application, followed all required procedures in order to consider and act upon the Application, and finds Acquirer to be suitable to indirectly control Franchisee. E. Per Section 28.2 of the Franchise, Franchisee must reimburse the City for all direct and indirect costs and expenses reasonably incurred by the City in considering this request to transfer. NOW THEREFORE, THE CITY COUNCIL OF THE CITY OF KENT, WASHINGTON, DOES HEREBY RESOLVE AS FOLLOWS: ORDINANCE SECTION 1. - Recitals Incorporated. The above Recitals are incorporated into this Ordinance and constitute findings of the Kent City Council. SECTION 2. - Consent to Change of Control. The City Council hereby consents to the Change of Control, all in accordance with the terms of the Franchise and applicable law. SECTION 3. - Franchise Authority. The City confirms that the Franchise is valid and outstanding and in full force and effect and there are no defaults under the Franchise. Subject to compliance with the terms of this Ordinance, any action necessary with respect to the Change of Control has been duly and validly taken. 2 Astound Broadband, LLC Approval of Change of Control -Ordinance Packet Pg. 253 SECTION 4. - Terms of Franchise. This Change of Control does not change any of the terms contained within the Franchise. Franchisee must continue to comply with all such terms of the Franchise. SECTION 5. - Continuing Ac7reement. This Ordinance shall have the force of a continuing agreement with Franchisee and Acquirer, and the City shall not amend or otherwise alter this Ordinance without the consent of Franchisee and Acquirer. SECTION 6. - Severability. If any one or more section, subsection, or sentence of this ordinance is held to be unconstitutional or invalid, such decision shall not affect the validity of the remaining portion of this ordinance and the same shall remain in full force and effect. SECTION 7. - Corrections by City Clerk or Code Reviser. Upon approval of the City Attorney, the City Clerk and the Code Reviser are authorized to make necessary corrections to this ordinance, including the correction of clerical errors; ordinance, section, or subsection numbering; or references to other local, state, or federal laws, codes, rules, or regulations. SECTIONS. - Effective Date. This ordinance shall take effect and be in force 30 days from and after its passage, as provided by law. DANA RALPH, MAYOR ATTEST: KIMBERLEY A. KOMOTO, CITY CLERK February 16, 2021 Date Approved February 16, 2021 Date Adopted February 19, 2021 Date Published 3 Astound Broadband, LLC Approval of Change of Control -Ordinance Packet Pg. 254 APPROVED AS TO FORM: ARTHUR "PAT" FITZPATRICK, CITY ATTORNEY 4 Astound Broadband, LLC Approval of Change of Control -Ordinance Packet Pg. 255 8.J KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Ordinance Amending KCC 9.42 Related to Unlawful Race Attendance - Adopt MOTION: Adopt Ordinance No. 4391, relating to Chapter 9.42 of the Kent City Code, entitled "Unlawful Race Attendance" to amend KCC 9.42.010 entitled "unlawful race event" to include activities involving the reckless operation of vehicles other than traditional side -by -side racing. SUMMARY: On June 5, 2001, the City of Kent became the first municipality in Washington, and possibly the nation, to pass an ordinance that makes it a crime to attend an illegal street race in certain areas of the City and permits a judge to order those convicted of illegal street racing to stay out of certain areas of the City designated as no racing zones. Other municipalities in the south King County region followed suit by passing similar ordinances. Kent's ordinance can be found in chapter 9.42 KCC. Street racing has been a criminal activity for decades. In some cases, many hundreds of people attend these illegal events. While police face challenges in catching racers in the act of racing, this ordinance targets attendance at these events as opposed to just the act of racing. These codes have proven effective in reducing the incidents of illegal street racing and the attendance of spectators at illegal street racing events. Street racing events typically occur at night, draw large crowds, and are associated with criminal behaviors. Street racing has been associated with violent crime including homicide, property damage, and large quantities of refuse left behind. The events are also dangerous to both drivers and spectators. Those who organize illegal street racing events tend to be well-connected through social media, and street racing behaviors continue to evolve. While racing continues to be a main attraction of these events, the events also have included drifting whereby cars are purposely slid around corners. Moreover, the illegal racing community has been known to take over private parking lots and roadways and intersections to perform burnouts and donuts where cars are slid in a circular motion in close proximity of spectators, other vehicles, and public facilities. The City Council finds that it is in the interest of the public health, safety, and Packet Pg. 256 8.J welfare to amend the Kent City Code to include within the definition of an "unlawful racing event" reckless vehicular activities other than traditional side -by -side racing. BUDGET IMPACT: None SUPPORTS STRATEGIC PLAN GOAL: Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. ATTACHMENTS: 1. Ordinance —Unlawful Race Attendance - Racing Definition Amendment (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 257 8.J.a ORDINANCE NO. 4391 AN ORDINANCE of the City Council of the City of Kent, Washington, amending Chapter 9.42 of the Kent City Code, entitled "Unlawful Race Attendance," to amend the definition of "unlawful race event" to include activities involving the reckless operation of vehicles other than traditional side -by -side racing. RECITALS A. On June 5, 2001, the City of Kent became the first municipality in Washington, and possibly the nation, to pass an ordinance that makes it a crime to attend an illegal street race in certain areas of the City and permits a judge to order those convicted of illegal street racing to stay out of certain areas of the City designated as no racing zones. Other municipalities in the south King County region followed suit by passing similar ordinances. Kent's ordinance can be found in chapter 9.42 KCC. B. Street racing has been a criminal activity for decades. In some cases, many hundreds of people attend these illegal events. While police face challenges in catching racers in the act of racing, this ordinance targets attendance at these events as opposed to just the act of racing. These codes have proven effective in reducing the incidents of illegal street racing and the attendance of spectators at illegal street racing events. C. Street racing events typically occur at night, draw large crowds, and are associated with criminal behaviors. Street racing has been associated 1 Unlawful race Attendance Definition Amendment Packet Pg. 258 8.J.a with violent crime including homicide, property damage, and large quantities of refuse left behind. The events are also dangerous to both drivers and spectators. D. Those who organize illegal street racing events tend to be well- connected through social media, and street racing behaviors continue to evolve. While racing continues to be a main attraction of these events, the events also have included drifting whereby cars are purposely slid around corners. Moreover, the illegal racing community has been known to take over private parking lots and roadways and intersections to perform burnouts and donuts where cars are slid in a circular motion in close proximity of spectators, other vehicles, and public facilities. E. The City Council finds that it is in the interest of the public health, safety and welfare to amend the Kent City Code to include within the definition of an "unlawful racing event" reckless vehicular activities other than traditional side -by -side racing. NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF KENT, WASHINGTON, DOES HEREBY ORDAIN AS FOLLOWS: ORDINANCE SECTION 1. - Amendment - Section 9.42.010. Section 9.42.010 of the Kent City Code, entitled "Definitions," is amended as follows: Sec. 9.42.010. Definitions. Unless the context clearly requires otherwise, the definitions in this section shall apply throughout this chapter. A. Public place means an area, whether publicly or privately owned, generally open to the public and includes, without limitation, the doorways and entrances to buildings or dwellings and the grounds enclosing them, streets, sidewalks, bridges, alleys, plazas, parks, driveways, and parking lots. 2 Unlawful race Attendance Definition Amendment Packet Pg. 259 8.J.a B. Unlawful race event means an event wherein persons willfully compare or contest relative speeds by operation of one (1) or more motor vehicles or wherein persons willfully demonstrate, exhibit, or compare speed, maneuverability, or the power of one or more motor vehicles, in a straight or curved direction, in a circular direction, around corners, or in circles in an activity commonly referred to as "drifting," or by breaking trartinn SECTION 2. - Severability. If any one or more section, subsection, or sentence of this ordinance is held to be unconstitutional or invalid, such decision shall not affect the validity of the remaining portion of this ordinance and the same shall remain in full force and effect. SECTION 3. - Corrections by City Clerk or Code Reviser. Upon approval of the city attorney, the city clerk and the code reviser are authorized to make necessary corrections to this ordinance, including the correction of clerical errors; ordinance, section, or subsection numbering; or references to other local, state, or federal laws, codes, rules, or regulations. SECTION 4. - Effective Date. This ordinance shall take effect and be in force 30 days from and after its passage. DANA RALPH, MAYOR ATTEST: KIMBERLEY A. KOMOTO, CITY CLERK 3 February 16, 2021 Date Approved February 16, 2021 Date Adopted February 19, 2021 Date Published Unlawful race Attendance Definition Amendment Packet Pg. 260 8.J.a APPROVED AS TO FORM: ARTHUR "PAT" FITZPATRICK, CITY ATTORNEY 4 Unlawful race Attendance Definition Amendment Packet Pg. 261 8.K KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: 2021 Community Development Block Grant Annual Action Plan - Approve MOTION: Approve the proposed Community Development Block Grant 2021 Annual Action Plan, including funding allocations and contingency plans, and authorize the Mayor to execute the appropriate certifications and agreements subject to final terms and conditions acceptable to the Parks Director and City Attorney. SUMMARY: The City of Kent receives Community Development Block Grant (CDBG) funds from the U.S. Department of Housing and Urban Development (HUD) as an Entitlement City. To receive this funding, the City is required to submit a Five -Year Consolidated Plan for Housing & Community Development. The City's Consolidated Plan is in effect from 2020-2024. Each year the City must inform HUD and the community of the specific actions that the City will execute to implement the objectives and strategies of the Consolidated Plan; this is outlined in the 2021 Action Plan. The City estimates that it will receive $1,139,685 in 2021 CDBG funds -the same amount that was allocated in 2020. (After the City receives notice of the exact amount of CDBG, it will update the amount before the Action Plan is submitted to HUD.) The Action Plan indicates the objectives and strategies that will guide investments, along with a description of each program that will receive funds. In addition to investing the full 15% allowable by law into public service activities and 20% in planning and administration, the City recommends that a significant portion of CDBG funds be used to support the City's Home Repair Program. This program serves many low/moderate-income homeowners in Kent by providing needed repairs to maintain and preserve housing. The City also uses funds to support transitional housing, short-term shelter, and permanent housing. In past years, CDBG entitlement funds have been used for rental assistance, but this year CDBG Coronavirus funds are used instead, and more General Funds are invested in rental assistance. It's important to invest human services funds in both residents who own their own homes and renters who cannot afford to own homes. Citizen Participation: August 5, 2020, the City held its first public hearing to receive comments from Packet Pg. 262 8.K Kent residents, low/moderate-income persons, non -governmental organizations (AKA nonprofits), and other interested parties regarding the development of the City's 2021 CDBG Annual Action Plan (this was a hearing to take comments before the draft Action Plan was released). January 14, 2021, the City of Kent published a public notice on its website and informed the community, organizations, and stakeholders that the draft 2021 CDBG Annual Action Plan was available for review and comment for a period of thirty (30) days (the 30-day comment period will not expire before the Annual Action Plan is considered for final approval during the February 16' Council meeting) On January 21, 2021, the Human Services Division convened a public hearing for the purpose of taking comments on the 2021 Annual Action Plan Human Services Commission Review: The Human Services Commission reviewed the Action Plan during its meeting on January 21, 2021. BUDGET IMPACT: The estimate of $1,139,685. may increase or decrease depending upon the final federal appropriations bill Congress passes and how much money is allocated to HUD. Therefore, the recommended funding includes a contingency plan to address any potential fund changes that may occur when the City receives its award notification letter from HUD. This budget was adopted as part of the 2021/2022 Adopted Budget. SUPPORTS STRATEGIC PLAN GOAL: Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Inclusive Community - Embracing our diversity and advancing equity through genuine community engagement. ATTACHMENTS: 1. 2021—CDBG-Action Plan (PDF) 2. Exhibit (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 263 8.K.a CITY OF KENT 2021 COMMUNITY BLOCK GRANT ANNUAL ACTION PLAN AP-05 Executive Summary - 91.200(c), 91.220(b) 1. Introduction The City of Kent became a Community Block Grant (CDBG) entitlement City in in 2003. Entitlement cities receive a CDBG entitlement grant directly from the U.S. Department of Housing and Urban Development (HUD), managing and staffing their own programs.' Cities are eligible to apply for a direct grant only if they have at least 50,000 residents and submit a multi -year Consolidated Plan (CP); the City submits its plan every five years through the King County Consortium. In addition to King County and Kent, the Consortium includes the cities of Auburn, Bellevue, and Federal Way. The most recent five-year plan was approved by HUD and is effective for 2020-2024. An Action Plan is submitted each year of the 2020-2024 CP; this Annual Action Plan (AAP) is for the 2021 program year, the second year of the CP. The CP identifies the objectives and outcomes that will guide the City as it determines how to invest its grant. The objective of the CDBG Entitlement Program is to develop urban communities by providing decent housing, a suitable living environment, and economic opportunities, principally for low/moderate-income persons. Low/moderate income persons are those earning less than 80% of the area median income (AMI). The 2021 AAP will continue to pursue the objectives outlined in the CP, tracking outcomes for each funded project. 2021 CDBG Allocation: The City of Kent estimates that it will receive the same amount of CDBG in 2021 that HUD allocated in 2020: $1,139,685. Once HUD confirms the City's final allocation, the City will adjust its budget before submitting the 2021 Action Plan to HUD. The City anticipates that HUD will verify the final allocation by March or April 2. Summary of the objectives and outcomes identified in the Plan Needs Assessment The outcomes and objectives are: • Accessibility to decent housing • Accessibility to a suitable living environment 1 The federal government uses a formula to calculate the amount of funding the City will receive each year; the formula factors in several measures of community need, including population, population growth lag in relationship to other metropolitan areas, residents in poverty, age of housing, and overcrowded units. Packet Pg. 264 8.K.a • Accessibility to economic opportunities The mission of the City's Human Services Division, which awards CDBG grants to sub -recipients, is to create a healthy, thriving, and inclusive community for all Kent residents by ensuring access to opportunity and high -quality services. 3. Evaluation of past performance In 2020, the City used its CDBG funds to provide a wide variety of services which met the objectives of the CDBG Entitlement Program. Work was primarily executed by nonprofits (sub -recipients); however, City staff provided home repair services to Kent homeowners and hired private contractors as needed. In addition, the City collaborated regionally with consortium cities, suburban cities, foundations, new and emerging organizations, businesses, faith -based organizations, and government (county, federal, and State). Accomplishments in 2020 were: 2020: $1,139,685 The City successfully addressed the goals of meeting basic needs, affordable housing to homeless and at -risk persons, increasing self-sufficiency, and planning and administration. Sub -recipients used Kent CDBG funds to provide: • Rent and utility assistance • Home repair assistance • Case management services to youth with intellectual disabilities and their families • Case management and referral services to African women • Shelter • Transitional housing • Employment and training • Legal services to West African residents • Planning and administration activities Outcomes for 2020 were: Accessibility to decent housing • 95 households received home repair assistance • 111 persons received transitional housing • 11 individuals received shelter • 66 housing stability grants were provided (these grants are largely unduplicated) Packet Pg. 265 8.K.a Accessibility to suitable living environment 79 youth with intellectual disabilities received case management services • 68 persons received employment and training assistance • 80 African women and individuals received case management and referral services 17 West African and individuals received legal services 4. Summary of citizen participation process and consultation process Citizen participation (hereinafter referred to as Community Participation Process or community participation) is the lifeblood of the Consolidated Plan. Regarding this AAP, the City convened the first public hearing on August 5, 2020 (evening), before this draft AAP was released, and a second one will be held on January 21, 2021 (afternoon), after the draft AAP is released. At the August 5, 2020 hearing, the City solicited comments and input from low/moderate income persons and households, non -governmental organizations, nonprofits, and other interested parties regarding the development of the 2021 AAP. The City will take comments and input from the public regarding the proposed use of funds for the 2021 program year at the hearing on January 21st. 5. Summary of public comments To be updated after the second public hearing. 6. Summary of comments or views not accepted and the reasons for not accepting them All comments were accepted. 7. Summary N/A PR-05 Lead & Responsible Agencies — 91.200(b) 1. Describe agency/entity responsible for preparing the Consolidated Plan and those responsible for administration of each grant program and funding source The following are the agencies/entities responsible for preparing the Consolidated Plan and those responsible for administration of each grant pro ram and funding source. Agency Role Name Department/Agency Lead Agency City of Kent Parks, Recreation & Community Services Department, Housing & Human Services Division CDBG Merina Hanson, Housing & Human Services Manager & Dinah Administrator Wilson, Senior CDBG Coordinator Narrative Packet Pg. 266 8.K.a The City of Kent, Housing and Human Services Division, is the lead agency for the CDBG Program. Merina Hanson, Housing and Human Services Manager, is the program administrator, and Dinah Wilson, Senior CDBG Coordinator, is the program manager. In addition, sub -recipients that receive CDBG funds are responsible for executing programs on behalf of the City and were consulted during the development of the AAP. These agencies are listed in the AP-10 Consultation section of this document. Consolidated Plan Public Contact Information Merina Hanson Housing and Human Services Manager City of Kent 220 4th Ave S Kent, WA 98032 253.856.5070 mhanson@kentwa.gov Dinah Wilson Senior CDBG Coordinator 253.856.5070 drwilson(akentwa.gov AP-10 Consultation — 91.100, 91.2OO(b), 91.215(1) 1. Introduction The City of Kent consulted with multiple entities, including South King County cities (the cities of Auburn and Federal Way are the two other entitlement cities in South County), the King County Housing Authority, King County Department of Community and Human Services, nonprofit agencies delivering services in Kent and the sub -region, Washington State Department of Social and Health Services, Public Health -Seattle and King County, Kent Cultural Diversity Initiative Group, and United Way of King County. The City of Kent carries out homeless planning and coordination both sub -regionally and regionally. Kent works with All Home (transitioning to the Regional Homeless Authority), which includes King County, cities, mainstream systems, Safe Harbors, housing funders, community agencies, United Way, the private sector (including businesses), and homeless people. Provide a concise summary of the jurisdiction's activities to enhance coordination between public and assisted housing providers and private and governmental health, mental health and service agencies. Kent Housing and Human Services Division meets regularly with other King County jurisdictions, public housing authorities and State Departments to develop Packet Pg. 267 8.K.a strategies and to implement plans to improve the quality of service and access for low-income residents in the City and throughout the region. Additionally, the City participates in quarterly meetings with King County staff, including Public Health Seattle/King County, to review implementation and delivery of services funded through regional efforts. The City will continue to participate in All Home strategic planning efforts, funding review panels for Continuum of Care (CoQ, Emergency Shelter Grant, McKinney funding, and other housing funding application review teams. Since the COVID-19 pandemic, staff are actively engaged in local and regional emergency service coordination, including securing funding, PPE supplies, etc. The City also participates in the Refugee Housing Task Force hosted by DSHS, Office of Refugee and Immigrant Assistance, and attends quarterly briefings provided by local refugee resettlement organizations. The CDBG Coordinator sits on the King County Climate Equity Community Task Force. The Task Force developed a new Sustainable and Resilient Communities section for the 2020-2025 King County Strategic Climate Action Plan (SCAP), which include goals and guide priority areas for climate action based on community values and concerns. The King County Council is currently taking public comments on the SCAP. Describe coordination with the Continuum of Care and efforts to address the needs of homeless persons (particularly chronically homeless individuals and families, families with children, veterans, and unaccompanied youth) and persons at risk of homelessness Staff worked extensively in 2018 to develop an Interlocal Agreement, creating a formal collaboration on housing and homelessness issues between six cities in South King County, including Kent. Kent has contributed funds to the South King Housing and Homelessness Partnership since 2016; this partnership provided additional staff capacity for tracking, developing, and implementing policies related to affordable housing and homelessness to participating cities. City staff and the Mayor attended collaborative meetings in 2018 to plan the future of the South King Housing and Homelessness Partnership project. Meetings were held in March, June, and October and drove the resolve of nine cities and King County to sign an Interlocal Agreement starting in 2019. The City funds this project with Human Services General Funds. Kent staff and other South King County stakeholders continue to meet to deepen cross -jurisdictional coordination, create a common understanding for housing and homelessness needs and strategies for South King County, and move forward strategies in the South King County Response to Homelessness. Two separate groups currently meet - the South King County Homeless Action Committee and the South King County Joint Planners. The local Continuum of Care (CoQ, A// Home, serves nearly all cities within King County, and Kent City staff regularly participate in regional CoC discussions. Describe consultation with the Continuum(s) of Care that serves the jurisdiction's area in determining how to allocate ESG funds, develop Packet Pg. 268 8.K.a performance standards and evaluate outcomes, and develop funding, policies and procedures for the administration of HMIS All Home, King County, City of Seattle, and staff from local jurisdictions collaborated to define and design a unified Regional Homeless System. This work was coordinated in partnership with people with lived experience of homelessness, homeless advocates, housing and service providers, Sound Cities Association (SCA) members, and local business and philanthropy. This ongoing collaboration seeks to address the fragmentation that currently exists and is meant to improve outcomes for people experiencing homelessness by placing persons experiencing homelessness at the center of the system design. The National Innovation Service (NIS) was brought in to analyze the current homeless response system through policy analysis and customer and provider engagement, and to make recommendations to unify and redesign the system for equity and impact. Their findings and recommendations are summarized in Actions to guide the system transformation. The Corporation for Supportive Housing (CSH) was also brought in to provide support for the transition of the Continuum of Care (CoC) governance. In December 2018, County Executive Constantine and Seattle Mayor Durkan accepted the NIS actions to transform and unify the region's homeless services. Joining All Home, King County, and the City of Seattle, leaders from the Sound Cities Association, business, philanthropy, and the Lived Experience Coalition identified the following four actions as top priorities to begin the work: • Institute a system -wide theory of change • Consolidate homelessness response systems under one regional authority • Become accountable to customers • Create a defined public/private partnership utilizing a funder collaborative model NIS was chosen to serve as project managers to support the development of these four actions. Simultaneously, philanthropic partners contracted with CSH to develop a Regional Action Plan, a critical tool to guide and align our work across the community. Data and investment analyses conducted in late 2018 and early 2019 provided a baseline of local data to inform the development of the Regional Action Plan. The pandemic slowed progress in 2020, however the work continues to move forward. The City consults with All Home staff and those working on the Regional Homeless Authority, and they in turn, consult with the State on behalf of local jurisdictions, including Kent. Staff participates in the Continuum of Care Application and Rank Order Committee and Joint Recommendations Committee, which review recommendations for allocation of funds. Staff consults with King County on HUD Homeless Management Information System (HMIS) data standards and Packet Pg. 269 8.K.a performance indicators to capture and evaluate the CoC's performance regarding the reduction of homelessness through investments in homeless housing and services, and rapid re -housing. Describe Agencies, groups, organizations, and others who participated in the process and describe the jurisdictions consultations with housing, social service agencies and other entities TO BE ADDED In 2020 Kent was one of several jurisdictions (including Auburn, Burien, Federal Way, Renton, and Tukwila) that jointly applied for a Department of Commerce grant. Part of the focus was on existing and projected housing needs for all income levels, household characteristics, population and employment trends, and projections. The work emphasized land use policy analysis and regulatory strategies, including preservation and anti -displacement, affordable housing production, middle housing, and Transportation Oriented Development & Urban Centers. Additional attention was on perceptions in the development community (both for profit and non-profit) along with development of a tool that explores construction feasibility for middle housing types and higher density housing. The grant also funded some city -specific focus on strategies to increase the supply of housing, minimize displacement, and evaluate our current housing goals. As a result of the work, Kent created a draft Housing Options Plan policy document that establishes routes for Kent to meet the growing demand for housing. The intent of the plan is to identify how much and what housing types Kent has and needs, how the City can preserve options and affordability for existing residents, how City policies can better serve people who want to live in Kent but can't find housing, where we can improve, etc. This work is led by the city's Long -Range Planning Manager who consults with Human Services staff at key points during the process. Kent also continues to partner with other jurisdictions as part of SKHHP. SKHHP's primary objectives include sharing technical information and resources to promote sound housing policy, coordinating public resources to attract greater private and public investment, and providing unified voice for South King County. Identify any Agency Types not consulted and provide rationale for not consulting All agency types were consulted. Packet Pg. 270 8.K.a Describe other local/regional/state/federal planning efforts considered when oreoarina the Plan Name of Plan Lead Organization How do the goals of your Strategic Plan overlap with the goals of each plan? 2020-2024 King County King County Both plans prioritize Consortium Consolidated Affordable Housing and Plan Homelessness Prevention 2019 King County King County Kent worked with the Analysis of Impediments county to develop a plan to Fair Housing Choice for fair housing testing in Kent. The Regional AI includes goals that indicate need for more affordable housing and greater access to housing for communities experiencing a disproportionate need. AP-12 Participation - 91.4101, 91.105, 91.200(c) 1. Summary of citizen participation process/Efforts made to broaden citizen participation Summarize citizen participation process and how it impacted goal - setting While HUD uses the term Citizen Participation, the City calls its participation process Community Participation; this title is more inclusive of all Kent residents. Community participation and engagement are critical to the successful execution of the City's Consolidated Plan. The goals of community participation are to: • Inform the community of the rules that the City follows to ensure adequate opportunity for resident and stakeholder involvement • Hear the community's recommendations on how the City should invest CDBG dollars • Consult with individuals who may not initiate contact with the City because of language/cultural differences or who do not come from experiences where government sought their opinions; and • Convene public hearings and meetings, initiate surveys, host community and individual conversations, etc., to increase opportunities for nonprofits and Kent residents to come together and discuss how they can leverage opportunities, share ideas, coordinate services and pool funding to achieve the greatest impact Packet Pg. 271 8.K.a The City developed and implemented a community participation process for the AAP; (this number will be updated after the 2nd public hearing) individuals attended meetings, submitted comments, or responded to surveys. The City intentionally reached out to Ethnic Community -Based Organizations and small organizations, People of Color, disabled individuals, LGBTQ, elders, and other under -served populations. Packet Pg. 272 8.K.a Expected Resources AP-15 Expected Resources (91.420(b), 91.220(c)(1,2) The City of Kent supports human services programs through its CDBG (federal) and General Fund (City of Kent tax dollars) budgets. The City uses a two-year budget cycle which is contingent upon economic stability. The City does not receive notice of its CDBG award until Congress passes its budget. As a result, CDBG sub -recipients receive funds during the spring or early summer of the Kent CDBG fiscal year (January -December). Since 2013, the City has dedicated a per -capita amount of its General Fund budget to support human services programs. Prior to that, one percent of the City's budget supported human services programs. Anticipated Resources Program Source of Uses of Funds Ex ected Amount Available Expected Amount Narrative Description Annual Program Prior Year Total: Funds Allocation: Income: Resources: $ Available $ $ $ Remainder of ConPlan CDBG HUD- Capital and $1,139,685 $0 $184,9482 $1,139,685 $3,419,055 CDBG funds federal public service leverage projects; additional planning & federal and administration state funds. Agencies may combine funding sources to provide a comprehensive menu of services to the community. 2 The City diverted $184,948 from the 2020 CDBG entitlement budget to use for COVID-related relief and used unspent CDBG entitlement funds from 2003 to 2018 to backfill those funds. Packet Pg. 273 8.K.a Explain how federal funds will leverage those additional resources (private, state and local funds), including a description of how matching requirements will be satisfied CDBG funds do not require a match; however, the City looks for opportunities to solicit additional resources. If appropriate, describe publicly owned land or property located within the jurisdiction that may be used to address the needs identified in the plan N/A Packet Pg. 274 8.K.a AP-20 Annual Goals and Objectives - 91.420, 91.220(c)(3)&(e) Goals Summary Information Sort Goal Name Start End Category Geographic Needs Funding Goal Outcome Order Year Year Area Addressed Indicator 1 Affordable 2020 2024 Affordable Affordable CDBG: Public service Housing Housing Housing $739,815 activities for Homeless Low/Moderate Income Housing Benefit: Rehabilitated: 130 Household Housinc_ Unit 2 Prevent 2020 2024 Homeless Homeless CDBG: Public service Homelessness Non -Housing $49,000 activities other Community than Low/Moderat( Development Income Housing Benefit: 41 Persons Assisted 3 Increase Self 2020 2024 Non -Housing Economic CDBG: Other: 54 Other Sufficiency Community Opportunities $73,500 Development 4 Basic Needs 2020 2024 Homeless Basic Needs CDBG: Public service Non -Housing Services $49,453 activities other Community than Low/Moderat( Development Income Housing Benefit: 84 Persons Assisted 5 Planning and 2020 2024 Planning and Planning and CDBG: Other: 0 Other Administration Administration Administration $227,917 Estimate the number of extremely low-income, low-income, and moderate -income families to whom the jurisdiction will provide affordable housing as defined by HOME 91.215(b) _ 0 Q _ Q c �a C9 Y V 0 ca r a� E a 0 a� a� 0 E E 0 U N O N O 00 c a _ U0 Q m 0 U _I N 0 N C aD E t U �a r a Packet Pg. 275 8.K.a Goal Descriptions 1 Goal Name Maintain Affordable Housing Goal Investment of funds to preserve and maintain existing affordable housing. Planned Description activities include rehabilitation of single-family residential housing (home repair services) and energy efficiency assistance 2 Goal Name Prevent Homelessness Goal Assistance to chronically homeless individuals and families and those at -risk for Description homelessness to move to shelter and permanent housing. Planned activities include transitional housing, emergency shelter, case management, rental assistance, and supportive services 3 Goal Name Support Economic viability Goal Assistance, including micro -enterprise development, for those unemployed and under - Description employed 4 Goal Name Opportunity to Meet Basic Needs Goal Assistance to preserve and maintain the safety net for those at -risk of losing basic services, Description including legal services, system navigation, case management, and supports for under - served residents 5 Goal Name Planning and Administration Support Goal Investment in planning & implementation strategies & CDBG staff to improve quality of life Description in the community for low /moderate -income residents c 0 r Q c Q c� Y V 0 CO r c a) E 0 m a� 0 C E E 0 U N 0 N CD 00 LO N C M a 0 Q m 0 U I N O N C W E L V fC r Q Packet Pg. 276 8.K.a AP-35 Projects - 91.420, 91.220(d) Introduction # Project Name 1 Catholic Community Services: Katherine's House 2 Multi -Service Center: Shelter & Supportive Housing 3 Open Doors for Multicultural Families: Special Needs Youth 4 Partner in Employment: Job Readiness & Training 5 St. Stephen's: Transitional Housing 6 Puget Sound Training Center: Employment & Training 7 Utopia: Street Outreach Services 8 West African Community Council: Immigration Legal Program 9 World Relief: Paradise Parking Plot Community Garden 10 YWCA: Anita Vista Transitional Housing it City of Kent: Home Repair Program -Minor Home Repair 12 East Hill Capital Project 13 Planning and Administration The City is investing in a range of needed services for Kent residents that include minor home repair, transitional housing, shelter, educational services for individuals with intellectual disabilities, legal immigration services, outreach to provide healthcare resources and testing for individuals in the sex industry, training and employment, and a community garden for new Americans. The City will also target a portion of its investments on the East Hill of Kent, a Racially/Ethnically Concentrated Area of Poverty (R/ECAP). City staff will work with residents to respond to emerging needs and plan for future use of funds. Describe the reasons for allocation priorities and any obstacles to addressing underserved needs The City's distribution of funds aligns with the City's objectives of accessibility to decent housing, a suitable living environment, and economic opportunities. CONTINGENCY PLANS Public Services In the event of a funding increase, the amount of the increase will be awarded to Puget Sound Training Center and Utopia, which received under $10,000. In the event of a funding decrease, the amount of the decrease will be deducted from a project(s) guided by an equity lens. If possible, the City will provide at least $10,000 to each project. Capital In the event of a funding increase, funds will be allocated to the City's Home Repair Program and/or an East Hill capital project. In the event of a funding decrease, the Home Repair Program budget will be reduced. AP-38 Project Summary 14 Packet Pg. 277 8.K.a Project Summary Information 1 Project Name Catholic Community Services: Katherine's House Target Area City of Kent Goals Supported Prevent Homelessness Needs Addressed Homeless Prevention Funding CDBG: $14,000 Description Public Service: Sub -recipient provides shelter and case management services to women residing in transitional shelter Target Date 12/31/2021 Estimate the number and type of families that will benefit from the proposed activities It is estimated that 2 individuals will benefit. Location Description City of Kent Planned Activities Shelter and case management services to women in recovery residing in transitional shelter 2 Project Name Multi -Service Center: Titusville Station Permanent Housing Target Area City of Kent Goals Supported Prevent Homelessness Needs Addressed Homeless Prevention Funding CDBG: $49,000 Description Public Service: Funding used to provide comprehensive case management and permanent housing to homeless single adults. Target Date 12/31/2021 Estimate the number and type of families that will benefit from the proposed activities It is estimated that 30 individuals will benefit. Location Description City of Kent Planned Activities Permanent housing & case management 3 Project Name Open Doors for Multicultural Families: Special Needs Youth Target Area City of Kent Goals Supported Opportunity to Meet Basic Needs Needs Addressed Opportunity to Meet Basic Needs Funding CDBG: $15,000 15 ., c a c 0 r a c a r ,L^ V 0 m c a� E 0. 0 a� a� 0 .E E E 0 U N O N 00 N c CU a r_ 0 r Q c� m 0 U I r N O N c a� E r r a Packet Pg. 278 8.K.a Description Public Services: This project provides case management services to youth with intellectual disabilities and their families. Target Date 12/31/2021 Estimate the number and It is estimated that 22 individuals will benefit. type of families that will benefit from the proposed activities Location Description City of Kent Planned Activities Education support, family activities, information & referral 4 Project Name Partner in Employment: Job Readiness & Training Target Area City of Kent Goals Supported Support Economic Viability Needs Addressed Economic Viability Funding CDBG: $15,000 Description Public Services: Funds used to provide culturally responsive case management & job readiness skills to prepare Kent immigrants and refugees find employment. Target Date 12/31/2021 Estimate the number and It is estimated that 10 individuals will benefit. type of families that will benefit from the proposed activities Location Description City of Kent Planned Activities Culturally responsive case management & job readiness skills to prepare individuals for employment 5 Project Name St. Stephen's: Transitional Housing Target Area City of Kent Goals Supported Prevent Homelessness Needs Addressed Homeless Prevention Funding CDBG: $15,000 Description Public Services: This project provides transitional housing to homeless families. Target Date 12/31/2021 Estimate the number and It is estimated that 25 individuals will benefit. type of families that will benefit from the proposed activities 16 ., c a c 0 r Q a c c a L c� 0 m aD 0. 0 a� aD 0 r .E E E 0 U N O N 00 LO c a c 0 Q c� m 0 U _I N O N u c as E M r a Packet Pg. 279 8.K.a Location Description City of Kent Planned Activities Housing 17 N O N to CO 0 N Packet Pg. 280 8.K.a 6 Project Name Puget Sound Training Center Target Area City of Kent Goals Supported Support Economic Viability Needs Addressed Support Economic Viability Funding CDBG: $8,500 Description Public Services: This project provides employment and training services to under -served individuals. Target Date 12/31/2021 Estimate the number and type of families that will benefit from the proposed activities It is estimated that 44 individuals will benefit. Location Description City of Kent - Renton residential/industrial area that borders Kent Planned Activities Employment and training services 7 Project Name Utopia: Street Outreach Services Target Area City of Kent Goals Supported Opportunity to Meet Basic Needs Needs Addressed Opportunity to Meet Basic Needs Funding CDBG: $5,000 Description Public Services: This project provides healthcare resources and testing for individuals in the sex industry. Target Date 12/31/2021 Estimate the number and type of families that will benefit from the proposed activities It is estimated that 19 individuals will benefit. Location Description City of Kent Planned Activities Street outreach to provide healthcare resources and testing for individuals in the sex industry $ Project Name West African Community Council: Immigration and Legal Program Target Area City of Kent & Kent R/ECAP Goals Supported Opportunity to Meet Basic Needs Needs Addressed Opportunity to Meet Basic Needs Funding CDBG: $15,000 Description Public Services: This project provides culturally responsive legal assistance to immigrants. Target Date 12/31/2021 In :, c a c 0 r a c a c� 0 m T c aD E 0. 0 a� aD 0 E E 0 U N 0 N 00 LO N c CU a c 0 r Q c� m 0 U I r N 0 N a� C a� E r a Packet Pg. 281 8.K.a Estimate the number It is estimated that 11 individuals will benefit. and type of families that will benefit from the proposed activities Location Description City of Kent, warehouse area running along 68th Ave. S Planned Activities Culturally responsive legal assistance 9 Project Name World Relief: Paradise Parking Plot Community Garden Target Area City of Kent Goals Supported Opportunity to Meet Basic Needs Needs Addressed Opportunity to Meet Basic Needs Funding CDBG: $14,453 Description Public Services: This project provides a community arden for new Americans to prevent food insecurity. Target Date 12/31/2021 Estimate the number It is estimated that 32 individuals will benefit. and type of families that will benefit from the proposed activities Location Description City of Kent Planned Activities Community Gardening & Classes to prevent food insecurity 10 project Name YWCA: Anita Vista Transitional Housing Target Area City of Kent & Kent R/ECAP Goals Supported Prevent Homelessness Needs Addressed Homeless Prevention Funding CDBG: $20,000 Description Public Service: Project provides transitional housing to domestic violence survivors and their children. Target Date 12/31/2021 Estimate the number It is estimated that 14 individuals will benefit. and type of families that will benefit from the proposed activities Location Description City of Kent Planned Activities Transitional housing to domestic violence survivors and their children 11 project Name City of Kent: Home Repair Program -Minor Home Repair Target Area City of Kent & Kent R/ECAP 19 ., c a c 0 r a c c a c� O m aD 0. 0 a� aD 0 r E E 0 U N O N 00 LO N c E a r_ 0 r Q c� m 0 U i r N O N c a� r a Packet Pg. 282 8.K.a Goals Supported Maintain Affordable Housing Needs Addressed Affordable Housing Funding CDBG: $690,815 Description Capital: Low/moderate-income homeowners in Kent receive minor home repairs Target Date 12/31/2021 Estimate the number and type of families that will benefit from the proposed activities It is estimated that 100 households will benefit. Location Description City of Kent Planned Activities Minor home maintenance and rehabilitation 12 Project Name East Hill Capital Project Target Area City of Kent Goals Supported Support Economic Viability Needs Addressed Support Economic Viability: Poverty Funding CDBG: $50,000 Description Funds will be invested on the East Hill of Kent, a Racially/Ethnically Concentrated Area of Poverty (R/ECAP). City staff will work with residents to respond to emerging needs and plan for future use of funds. Funds will be used to mitigate poverty. Target Date 12/31/2021 Estimate the number and type of families that will benefit from the proposed activities TBD Location Description City of Kent - East Hill Planned Activities Povertymiti ation activities 13 project Name Planning & Administration Target Area of Kent Goals Supported -City Planning and Administration Needs Addressed Planning and Administration Funding CDBG: $227,917 Description City uses funds to administer the CDBG program, to monitor sub -recipients, and to deliver strategies outlined in the 2020-2024 Consolidated Plan. Target Date 12/31/2021 20 ., c a c 0 r a c c a r c ,L^ V 0 m a� E 0. 0 a� a� 0 E 0 U N O N 00 LO N C CU FL c 0 r Q m 0 U _I N O N r c a� E r a Packet Pg. 283 8.K.a Estimate the number N/A and type of families that will benefit from the proposed activities Location Description City of Kent Planned Activities Planning and administration activities to carry out the CDBG program. 21 ,� O CO 0 N C R a C 0 r Q c� CO 0 U I r N O N r C 0 E t 0 f3 r Packet Pg. 284 8.K.a AP-50 Geographic Distribution - 91.420, 91.220(f) Description of the geographic areas of the entitlement (including areas of low-income and minority concentration) where assistance will be d i rected Historically, low/moderate-income households were dispersed throughout the City, and CDBG funds were distributed accordingly. Data now indicates that the East Hill of Kent has the highest concentration of poverty in the City. The federal government categorizes the East Hill as a Racially or Ethnically Concentrated Area of Poverty (R/ECAP). A R/ECAP is defined as a census tract that is majority non-White and has a poverty rate greater than 40% or is three times the average census tract poverty rate for the metro/micro area, whichever threshold is lower. (Kent is the only City in the CDBG Consortium that includes a R/ECAP; cities in the Consortium include Auburn, Bellevue, and Federal Way.) Neighborhoods with high concentrations of poverty can serve as a tipping point to a family's ability to reach positive outcomes; therefore, the City will work will residents and nonprofits in the East Hill Area to develop a strategy for investing in East Hill beginning in 2021. The City will begin with an investment of five percent (5%) of its HUD allocation in 2021 and could increase its investment as opportunities arise between 2022-2024. Geographic Distribution Target Area Percentage of Funds City of Kent 950/0 East Hill 50/03 Rationale for the priorities for allocating investments geographically Because low/moderate-income families reside throughout Kent, investments will be dispersed widely. A 5% portion of the City's funds will be targeted on the East Hill to address the high concentration of poverty in that area. Discussion According to the American Community Survey (2019), the poverty rate in Kent is 13.4 %. This rate was determined before the pandemic struck; therefore, it is a low estimate. According to YCHARTS, the unemployment rate ranged from a low of 3.2% in January 2020 when rumblings of the COVID-19 virus first started to a high of 19.3% in May 2020 when the area experienced a full-fledged pandemic. When the 2020-2024 Consolidated Plan was drafted in 2020, poverty in pockets throughout the City was just over 20%, and just over half of the students in the Kent School District qualified for free and reduced lunches. Economic disadvantage and poverty associated with the pandemic led to increased dependence on public assistance and forced many households to use public services for basic needs, including food, utility assistance, rental assistance, medical services, childcare, etc. Housing costs continue to rise in Kent. According to the apartment web service, Rent Cafe, the average cost for an apartment in Kent is $1,565 (average one -bedroom size), and this represents a 3% increase from the average cost over a year. 3 This percentage does not include households receiving home repair assistance. 22 Packet Pg. 285 8.K.a Additionally, the East Hill of Kent is defined by the federal government as a R/ECAP. This high poverty rate justifies targeted investment on the East Hill. AP-75 Action Plan Barriers to Affordable Housing - 91.420, 91.220(j) Introduction Actions it planned to remove or ameliorate the negative effects of public policies that serve as barriers to affordable housing such as land use controls, tax policies affecting land, zoning ordinances, building codes, fees and charges, growth limitations, and policies affecting the return on residential investment: In 2021, the City is planning to adopt a Housing Action Plan that identifies actionable code amendments that will increase overall residential building capacity. The plan assesses housing needs including affordability at all income levels and adopts strategies to improve housing outcomes. Draft strategies include strengthening partnerships, increasing access to homeownership, and adjusting development regulations. It is anticipated that implementation will begin in late 2021 and continue with nearer and longer -term steps as resources allow. Discussion: Economic and Community Development staff presented the Housing Action Plan to the Kent Cultural Diversity Initiative Group and is seeking comments from under -served communities. Human Services Division staff is also collaborating with Economic and Community Development staff on identifying opportunities for non-profit affordable housing developers to work in Kent. AP-85 Other Actions - 91.420, 91.220(k) Introduction The City is actively involved in many initiatives and ongoing commitments to improve the life of Kent residents. 23 • The City is actively engaged with refugee and immigrant communities by staffing a and facilitating the Kent Cultural Diversity Initiative Group (KC -DIG). a. r_ • In 2020, the City hired a Race and Equity Manager, who began concentrating on 2 racial justice issues facing the City on a full-time basis in 2021. a • The City's Human Services Division hired consultants to work with the Kent Human m Services Commission and staff to prioritize and direct 2021-2022 human services U investments using a racial equity lens. A consultant was also hired to evaluate the N 2021-2022 human services funding cycle. N • In 2016, the City appointed a Cultural Communities Advisory Board to advise the Mayor and City Council on how to engage with and provide culturally responsive E services to the cultural communities residing in Kent. • The CDBG Coordinator participates in the King County Climate Equity Community Q Task Force, where frontline racial and ethnic communities collaborated and developed the Sustainable and Resilient Communities section of the 2020 Packet Pg. 286 8.K.a Strategic Climate Action Plan (SCAP). The Task Force recommended that the King County Council to adopt this new section of the SCRAP. • The CDBG Coordinator is on the board of Communities Rise, which fosters movements to build power in communities impacted by systemic oppression. • Kent's Human Services Manager has been actively involved in regional discussions about governance in the Seattle/King County homelessness system. In August of o 2018 the City of Seattle and King County partnered with Future Laboratories to E launch a community -driven process of listening, and ultimately, designing a a stronger regional response. A key part of the process going forward will be to design with equity in mind, building a system that is responsive to the needs of those who are at the highest risk for prolonged or multiple episodes of ° homelessness. While service systems are traditionally built with the input of a experts" as the guiding voices, delivering services that are effective means the input of people utilizing those services must be understood as the primary data a source. Actions planned to address obstacles to meeting underserved needs • Staff will continue to play a leadership role in emergency and COVID-19 service coordination. • Staff will administer and manage CDBG Coronavirus (CDBG-CV ) grants (total of $1,530,361), which are provided to organizations assisting individuals and families impacted by COVID-19. • Human Services Division staff will continue to work with Economic Development Division staff on outreach and engagement and provide recommendations on best practices to ensure culturally responsive service to under -served communities. • Staff will continue to work with The Seattle Foundation and King County on the Communities of Opportunity Grant which provides funds to organizations whose activities reduce inequities in the areas of health, housing, and economic opportunities. • Staff will continue to participate on the King County Refugee Housing Task Force, which is led by DSHS, Office of Immigrant and Refugee Assistance. This stakeholders' group works collaboratively to influence policies, resources, and the public's interest to increase affordable housing for refugees. • The City will continue to provide educational support to the Kent School District to improve outcomes for students. • Kent's Human Services Manager will continue to participate in regional discussions about governance in the Seattle/King County homelessness system. Actions planned to foster and maintain affordable housing The City will continue its long-term collaboration and participation on Boards, committees, funding review teams; etc., to foster and maintain affordable housing for 24 Packet Pg. 287 8.K.a the South County Region. Through sub -regional efforts, City staff and stakeholders will engage in discussions with elected officials and Land Use and Planning Board members about the impact that affordable housing has on the long-term viability of the community. As part of the South King Housing and Homelessness Partnership project, staff will review opportunities to implement strategies recommended by the Regional Affordable Housing Task Force. Additionally, in 2020 the state legislature gave counties and cities authority to impose a N 1/10 of one percent sales tax for affordable housing. Kent was one of eight city councils 0 that chose to impose it within their city limits and then the county imposed it countywide (minus the eight cities). The eight cities are Bellevue, Issaquah, Snoqualmie, North a Bend, Renton, Kent, Covington, and Maple Valley. State law places the same requirement on every county and city that imposes the tax: spend 60% of the proceeds a to construct affordable housing and 40% on human services. City staff is currently 0 working on some options and recommendations on implementation for city council a consideration. Actions planned to reduce lead -based paint hazards No actions are planned. Actions planned to reduce the number of poverty -level families Actions to reduce the number of poverty level families maintaining relationships with local training schools, encouraging business to hire low-income residents and outreach to increase opportunities for low-income residents to obtain livable wage jobs. The City also collaborates with the Financial Empowerment Network. Based on homelessness research, it is evident the City must prioritize economic stability to reduce inflow into homelessness. Research data and coordination will help guide the City's planning process. Actions planned to develop institutional structure In 2018, the City hired a consultant to evaluate its Parallel Human Services Application process (PAP). PAP was piloted in 2017-2018 and extended to 2019-2020. The purpose was to use a streamlined application process to increase funds to under -served and under-resourced organizations that received a disproportional percentage of human services funds but provided a great deal of services to Kent residents. We used lessons learned from the Parallel Application pilot to simplify the human services and CDBG-CV application process and to increase investments to Ethnic Community -Based Organizations and under -served residents. Actions planned to enhance coordination between public and private housing and social service agencies The City was instrumental in developing relationships between public and private housing and social service agencies and will continue to collaborate with these entities, including the Homeless Forum (a monthly meeting of housing and support service providers), South King Council of Human Services, South King County Housing Development Group, and the King County Housing Development Consortium. The South King County Housing and Homelessness Partnership will be a key driver of enhancing coordination in this area 25 c a r_ 0 r a c� m 0 U N O N r c a� E a Packet Pg. 288 in 2021 as well. 8.K.a Discussion The City will diligently engage in actions to support its residents and the goals of the Five -Year Consolidated Plan. 26 N O N O CO 0 N Packet Pg. 289 8.K.a Program Specific Requirements AP-90 Program Specific Requirements - 91.420, 91.220(1)(1,214) Introduction The City of Kent will use CDBG funds to benefit low/moderate-income residents. The full amount allowable by regulation will be used for Public Services and Planning and Administration. The balance of funds will be used for housing rehabilitation services and micro -enterprise. The City will not receive program income from prior years. Community Development Block Grant Program (CDBG) Reference 24 CFR 91.220(1)(1) Projects planned with all CDBG funds expected to be available during the year are identified in the Projects Table. The following identifies program income that is available for use that is included in projects to be carried out. 1. The total amount of program income that will have been received before the start of the next program year and that has not yet been reprogrammed 0 2. The amount of proceeds from section 108 loan guarantees that will be used during the year to address the priority needs and specific objectives identified in the grantee's strategic plan. 0 3. The amount of surplus funds from urban renewal settlements 0 4. The amount of any grant funds returned to the line of credit for which the planned use has not been included in a prior statement or plan 0 5. The amount of income from float -funded activities 0 Total Program Income: 0 Other CDBG Requirements 1. The amount of urgent need activities 0 2. The estimated percentage of CDBG funds that will be used for activities that benefit persons of low and moderate income. Overall Benefit - A consecutive period of one, two or three years may be used to determine that a minimum overall benefit of 70% of CDBG funds is used to benefit persons of low and moderate income. Specify the years covered that include this Annual Action Plan. 100.00% Discussion All CDBG funds will be used to benefit low/moderate-income individuals and households. 27 N 0 N O co 0 N a 0 r Q m 0 U i r N O N r C d E t V r r a Packet Pg. 290 8.K.a For Immediate Publication/Release Posted on City of Kent Web Page January 14, 2021 4^6S>. KENT WASHINGTON PUBLIC NOTICE CITY OF KENT Department of Parks, Recreation & Community Services Human Services Division NOTICE OF SECOND PUBLIC HEARING REGARDING THE COMMUNITY DEVELOPMENT BLOCK GRANT (CDBG) 2021 ANNUAL ACTION PLAN In accordance with 24 CFR 91.105, notice is hereby given that the City of Kent will hold its second public hearing on January 21, 2021 to receive comments from Kent residents, low/moderate-income persons, non -governmental organizations (AKA nonprofits), and other interested parties regarding the development of the City's CDBG 2021 Annual Action Plan for Housing and Community Development. Comments will be received by the Kent Human Services Commission and/or CDBG Program staff. The 2021 Annual Action Plan outlines the City's proposed use of 2021 Community Development Block Grant (CDBG) funds awarded to the City by the U.S. Department of Housing and Urban development (HUD) under Title 1 of the Housing and Community Development Act of 1974 as amended, known as the Community Development Block Grant (CDBG) Program. The Plan also identifies the objectives and strategies that will guide the City's investments. The City's Program Year for investing these funds runs from January 1, 2021 to December 31, 2021. In PY 2020, the City received $1,139,685 in CDBG funds and estimates that it will receive the same amount or less in 2021. COMMUNITY PARTICIPATION PROCESS All interested persons are invited to attend a public hearing to provide comments and recommendations to the City on how CDBG funds should be invested in 2021. This is an opportunity for residents, stakeholders, non-profit organizations and others to influence the Annual Action Plan before the initial written draft is completed. DATE/TIME OF PUBLIC HEARING Thursday, January 21, 2021 3:00 p.m. Virtual Hearing Link: https://citvofkent.zoom.us/j/96234547881 A draft copy of the 2021 CDBG Annual Action Plan can be found on the City's web site at the following address: http://www.kentwa.gov/residents/human-social-services. a Packet Pg. 291 8.K.a Written comments will be accepted and may be mailed or e-mailed to: Dinah R. Wilson, Senior CDBG Program Coordinator City of Kent, 220 4t" Ave. South, Kent, WA 98032 E-mail: drwilson@kentwa.gov The comment period will remain open for 30 days from the date that this notice was posted on the City's website. ADA Information: This notice is available in alternate formats for individuals with disabilities upon request. Reasonable accommodations at the public hearing such as sign language interpretation or alternate formats for printed material are available for individuals with disabilities with a minimum of four (4) days advance notice. Please call (253) 856-5070 directly, email drwilson@kentwa.gov, or: • For TDD call (253) 856-5499 • For Braille Relay Service call 1-800-833-6385 • For Hearing Impaired Relay Service call 1-800-833-6388 Merina Hanson, Housing & Human Services Director Housing and Human Services Division I Parks, Recreation & Community Services Department Signature 111412021 Date 29 Packet Pg. 292 CERTIFICATIONS 8.K.a In accordance with the applicable statutes and the regulations governing the consolidated plan regulations, the jurisdiction certifies that: Affirmatively Further Fair Housing --The jurisdiction will affirmatively further fair housing. Uniform Relocation Act and Anti -displacement and Relocation Plan -- It will comply with the acquisition and relocation requirements of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended, (42 U.S.C. 4601-4655) and implementing regulations at 49 CFR Part 24. It has in effect and is following a residential anti -displacement and relocation assistance plan required under 24 CFR Part 42 in connection with any activity assisted with funding under the Community Development Block Grant or HOME programs. Anti -Lobbying --To the best of the jurisdiction's knowledge and belief: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of it, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement; 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, it will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; and 3. It will require that the language of paragraph 1 and 2 of this anti -lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. Authority of Jurisdiction --The consolidated plan is authorized under State and local law (as applicable) and the jurisdiction possesses the legal authority to carry out the programs for which it is seeking funding, in accordance with applicable HUD regulations. Consistency with plan --The housing activities to be undertaken with Community Development Block Grant, HOME, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS funds are consistent with the strategic plan in the jurisdiction's consolidated plan. Section 3 -- It will comply with section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701u) and implementing regulations at 24 CFR Part 135. Signature of Authorized Official Date Mayor Title 30 Packet Pg. 293 Specific Community Development Block Grant Certifications 8.K.a The Entitlement Community certifies that: Citizen Participation -- It is in full compliance and following a detailed citizen participation plan that satisfies the requirements of 24 CFR 91.105. Community Development Plan -- Its consolidated plan identifies community development and housing needs and specifies both short-term and long-term community development objectives that that have been developed in accordance with the primary objective of the CDBG program (i.e., the development of viable urban communities, by providing decent housing and expanding economic opportunities, primarily for persons of low and moderate income) and requirements of 24 CFR Parts 91 and 570. Following a Plan -- It is following a current consolidated plan that has been approved by HUD. Use of Funds -- It has complied with the following criteria: 1. Maximum Feasible Priority. With respect to activities expected to be assisted with CDBG funds, it has developed its Action Plan so as to give maximum feasible priority to activities which benefit low- and moderate -income families or aid in the prevention or elimination of slums or blight. The Action Plan may also include CDBG-assisted activities which the grantee certifies are designed to meet other community development needs having particular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community, and other financial resources are not available (see Optional CDBG Certification). 2. Overall Benefit. The aggregate use of CDBG funds, including Section 108 guaranteed loans, during program year(s) 2021, shall principally benefit persons of low and moderate income in a manner that ensures that at least 70 percent of the amount is expended for activities that benefit such persons during the designated period. 3. Special Assessments. It will not attempt to recover any capital costs of public improvements assisted with CDBG funds, including Section 108 loan guaranteed funds, by assessing any amount against properties owned and occupied by persons of low and moderate income, including any fee charged or assessment made as a condition of obtaining access to such public improvements. However, if CDBG funds are used to pay the proportion of a fee or assessment that relates to the capital costs of public improvements (assisted in part with CDBG funds) financed from other revenue sources, an assessment or charge may be made against the property with respect to the public improvements financed by a source other than CDBG funds. In addition, in the case of properties owned and occupied by moderate -income (not low-income) families, an assessment or charge may be made against the property for public improvements financed by a source other than CDBG funds if the jurisdiction certifies that it lacks CDBG funds to cover the assessment. Excessive Force -- It has adopted and is enforcing: 1. A policy prohibiting the use of excessive force by law enforcement agencies within its jurisdiction against any individuals engaged in non-violent civil rights demonstrations; and 31 Packet Pg. 294 8.K.a 2. A policy of enforcing applicable State and local laws against physically barring entrance to or exit from a facility or location which is the subject of such non-violent civil rights demonstrations within its jurisdiction. Compliance with Anti -discrimination laws -- The grant will be conducted and administered in conformity with title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d) and the Fair Housing Act (42 U.S.C. 3601-3619) and implementing regulations. Lead -Based Paint -- Its activities concerning lead -based paint will comply with the requirements of 24 CFR Part 35, Subparts A, B, J, K and R. Compliance with Laws -- It will comply with applicable laws. Signature of Authorized Official Date Maw Title 32 Packet Pg. 295 8.K.a This page left intentionally blank. Ef IL c 0 :r a c c a r c ,L^ V V 0 CO T d E 0. 0 0 d 0 0 cE C 0 U T N O N w CO LO N C a c 0 r a c� m 0 U N O N r C E L 0 2 a Packet Pg. 296 8.K.b OMB Number: 4040-0004 Expiration Date: 12/31/2022 Application for Federal Assistance SF-424 " 1. Type of Submission: ❑ Preapplication ® Application ❑ Changed/Corrected Application • 2. Type of Application: " If Revision, select appropriate letter(s): New ® Continuation " Other (Specify): ❑ Revision * 3. Date Received: 4. Applicant Identifier: 01/01/2021 5a. Federal Entity Identifier: 5b. Federal Award Identifier: State Use Only: 6 Date Received by State: 7. State Application Identifier: B. APPLICANT INFORMATION: "a. Legal Name: City of Kent " b. Employer/Taxpayer Identification Number (EIN/TIN): " c. Organizational DUNS: 0205026130000 I916001254 d. Address: *Streetl: 220 4th Ave. South Streetl: "City: County/Parish: Kent • State: Province: WA: Washington `Country: "Zip / Postal Code: USA: UNITED STATES 98032-5895 e. Organizational Unit: Department Name: Division Name: Human Services f. Name and contact information of person to be contacted on matters involving this application: Prefix: I == • First Name: pinah Middle Name: Last Name: Suffix: Wilson Title: Senior CDBG Coordinator Organizational Affiliation: Telephone Number: 2538565070 Fax Number: "Email: drwilson@kentwa.gov El to Co rA N t K W C d E z tt to a Packet Pg. 297 8.K.b Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: iC: City or Township Government Type of Applicant 2: Select Applicant Type: f Type of Applicant 3: Select Applicant Type: I * Other (specify): * 10. Name of Federal Agency: Department of Housing & Urban Development 11. Catalog of Federal Domestic Assistance Number: 14218 CFDA Title: Community Development Block Grant Entitlement Grants * 12. Funding Opportunity Number: n/a * Title: Community Development Block Grant -Entitlement 13. Competition Identification Number: Title: 14. Areas Affected by Project (Cities, Counties, States, etc.): Add Attachment Delete Attachment View Attachment * 15. Descriptive Title of Applicant's Project: Community Development Block Grant Entitlement funds (CDBG) will be allocated to sub -recipients & within the Parks Division to provide public services and capital projects to Kent residents, Attach supporting documents as specified in agency instructions. Add Attachments I Delete Attachments I View Attachments El O Co ILLS N t K W r C d E z 0 cc ++ a Packet Pg. 298 8.K.b Application for Federal Assistance SF-424 16. Congressional Districts Of: * a. Applicant 9th * b. Program/Project wA-9 Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 17. Proposed Project: * a. Start Date: O1/O1/2021 * b. End Date: 12/31/2021 O +s+ 7 Q 18. Estimated Funding ($): C to *a. Federal f 1,139, 685.00 d * b. Applicant C * c. State r v a * d. Local to 7 * e Other O C Q * f. Program Income 1,139,685.00 *g.TOTAL O * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? Y C ❑ a. This application was made available to the State under the Executive Order 12372 Process for review on m ❑ b. Program is subject to E.O. 12372 but has not been selected by the State for review. 4) ® c. Program is not covered by E.O. 12372 0 * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) d Yes ® No If "Yes", provide explanation and attach O Add Attachment Delete Attachment View Attachment E O 21. *By signing this application, I certify (1) to the statements contained in the list of certifications** and (2) that the statements V herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances— and agree to j comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may G subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) N ® **IAGREE 00 N ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions Authorized Representative: t W Prefix: * First Name: Dana C Middle Name: d E * Last Name: Ralph cc r� Q Suffix: * Title: l�ayar *Telephone Number: 2538565720 Fax Number: *Email: dralph@kentwa.gov * Signature of Authorized Representative: * Date Signed: Packet Pg. 299 8.K.b ASSURANCES - CONSTRUCTION PROGRAMS OMB Number: 4040-0009 Expiration Date: 01/31/201 Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0042), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the Awarding Agency. Further, certain Federal assistance awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant:, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project costs) to ensure proper planning, management and completion of project described in this application. 2. Will give the awarding agency, the Comptroller General of the United States and, if appropriate, the State, the right to examine all records, books, papers, or documents related to the assistance; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will not dispose of, modify the use of, or change the terms of the real property title or other interest in the site and facilities without permission and instructions from the awarding agency. Will record the Federal awarding agency directives and will include a covenant in the title of real property acquired in whole or in part with Federal assistance funds to assure non- discrimination during the useful life of the project. 4. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review and approval of construction plans and specifications. 5. Will provide and maintain competent and adequate engineering supervision at the construction site to ensure that the complete work conforms with the approved plans and specifications and will furnish progressive reports and such other information as may be required by the assistance awarding agency or State. 6. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency 7. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. Previous Edition Usable 8. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards of merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 9. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead -based paint in construction or rehabilitation of residence structures. 10. Will comply with all Federal statutes relating to non- discrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681 1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29) U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statue(s) under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statue(s) which may apply to the application. Authorized for Local Reproduction Standard Form 424D (Rev. 7-97) Prescribed by OMB Circular A-102 x w c m E t U M r Q Packet Pg. 300 8.K.b 11. Will comply, or has already complied, with the requirements of Titles 11 and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal and federally -assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 12. Will comply with the provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 13. Will comply, as applicable, with the provisions of the Davis - Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333) regarding labor standards for federally -assisted construction subagreements. 14. Will comply with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 15. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL Federal actions to State (Clean Air) implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205). 16. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 17. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a-1 et seq). 18. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non -Profit Organizations." 19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program. 20. Will comply with the requirements of Section 106(g) of the Trafficking Victims Protection Act (TVPA) of 2000, as amended (22 U.S.C. 7104) which prohibits grant award recipients or a sub -recipient from (1) Engaging in severe forms of trafficking in persons during the period of time that the award is in effect (2) Procuring a commercial sex act during the period of time that the award is in effect or (3) Using forced labor in the performance of the award or subawards under the award. TITLE Mayor APPLICANT ORGANIZATION DATE SUBMITTED }, City of Kent t K W SF-424D (Rev. 7-97) Back c m E t v cv r r Q Packet Pg. 301 8.L KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Adjustment to the 2019 Community Development Block Grant Budget to Accept Third Round of CARES Act Coronavirus Funds (CDBG-CV) - Authorize MOTION: Authorize the Mayor to adjust the 2019 CDBG budget, accept $859,720 in federal funds awarded to the City through the third round of CARES Act funds (CDBG-CV) for coronavirus relief and authorize the Mayor to execute the appropriate certifications and agreements, subject to final terms and conditions acceptable to the Parks Director and City Attorney. SUMMARY: The Department of Housing and Urban Development (HUD) informed the City that it will receive an additional $859,720. (Round 3) in Community Development Block Grant Coronavirus funds (CDBG-CV). These funds are awarded through The Coronavirus Aid, Relief, and Economic Security Act (H.R. 748), also known as the CARES Act. All funds must be used to prevent, prepare for, and respond to the coronavirus. To accept these funds, the City amended its 2019 CDBG Action Plan and must adjust its 2019 CDBG budget. Funds will be allocated to non-profit organization (sub -recipients) to provide coronavirus relief to Kent residents. The City will use a streamlined process to select these organizations, with the Kent Human Services Commission submitting final funding recommendations to Council for approval. Priority areas of funding include, but is not exclusive to: Rental/utility assistance Hotel/motel vouchers for those needing temporary shelter Food assistance Legal assistance for those facing evictions and/or for other legal needs Financial literacy and emergency assistance payments on behalf of unemployed and under -employed residents for food, childcare, healthcare, etc. Assistance for students who need tutors Packet Pg. 302 8.L Digital literacy for under -served populations Micro -enterprise assistance Healthcare assistance (behavioral and for COVID-related services) Housing support, including furniture for tenants moving into and maintaining rental housing BUDGET IMPACT: As described. SUPPORTS STRATEGIC PLAN GOAL: Thrivinq City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. ATTACHMENTS: 1. 2019_ CDBG_ Amend2-Exhibits (PDF) 2. 2019_ CDBG_ Amend2-Exhibit2 (PDF) 3. Exhibit (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 303 8.L.a PZMENTQ, U.S. DEPARTMENT OF HOUSING AND URBAN aG IIIIIIII �= DEVELOPMENT WASHINGTON, DC 20410-7000 9g4N D EVE��e ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT September 11, 2020 The Honorable Dana Ralph Mayor of Kent 220 4th Avenue S Kent, WA 98032- 5838 Dear Mayor Ralph: I am pleased to inform you of a special allocation to your jurisdiction of Community Development Block Grant funds to be used to prevent, prepare for, and respond to the coronavirus (COVID-19). This allocation was authorized by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), Public Law 116-136, which was signed by President Trump on March 27, 2020, to respond to the growing effects of this historic public health crisis. The CARES Act made available $5 billion in Community Development Block Grant Coronavirus (CDBG-CV) funds. Of this amount, the Department immediately allocated $2 billion on March 27, 2020, the same day President Trump signed the Act, based on the fiscal year 2020 CDBG formula; this constituted the first round of CDBG-CV funds. Next, $1 billion was required by the Act to be allocated to States and insular areas within 45 days of enactment of the Act; HUD accomplished this on May 11, 2020, and this constituted the second round of CDBG-CV funds. Finally, the remaining $2 billion in CDBG-CV funds was required by the Act to be allocated to states and local governments at the discretion of the Secretary on a rolling basis; HUD accomplished this on September 11, 2020, and this constituted the third round of CDBG-CV funds. Additionally, up to $10 million will be set aside for technical assistance. Accordingly, this letter informs you that your jurisdiction's allocation for the third round is $859,720. Your cumulative amount for all allocation rounds is $1,530,261. The CARES Act adds additional flexibility for both the CDBG-CV grant and, in some cases, for the annual FY2019 and FY2020 CDBG grants in these unprecedented times. The public comment period is reduced to not less than 5 days, grantees may use virtual public hearings when necessary for public health reasons, the public services cap is suspended during the emergency, and States and local governments may reimburse costs of eligible activities incurred for pandemic response regardless of the date. Packet Pg. 304 8.L.a In addition, the CARES Act authorizes the HUD Secretary to grant waivers and alternative requirements of statutes and regulations the HUD Secretary administers in connection with the use of CDBG-CV funds and fiscal year 2019 and 2020 CDBG funds (except for requirements related to fair housing, nondiscrimination, labor standards, and the environment). Waivers and alternative requirements can be granted when necessary to expedite and facilitate the use of funds to prevent, prepare for, and respond to coronavirus. The CDBG CARES Act Federal Register Notice (FR-6218-N-01) was released on August 10, 2020. The notice describes the allocations and grant procedures applicable to the CDBG-CV grants. It also describes the program flexibilities, waivers, and alternative requirements that apply to the CDBG-CV grants as well as the fiscal year 2019 and 2020 CDBG grants. As further such flexibilities become available, they will be posted on HUD's website and distributed to grantees. The Department will also support grantees with technical assistance. As you develop your plan for the use of these grant funds, we encourage you to consider approaches that prioritize the unique needs of low- and moderate —income persons and the development of partnerships between all levels of government and the private for -profit and non-profit sectors. You should coordinate with state and local health authorities before undertaking any activity to support state or local pandemic response. CDBG-CV grants will be subject to oversight, reporting, and the requirement that each grantee have adequate procedures to prevent the duplication of benefits (DOB). HUD will provide guidance and technical assistance on DOB, the prevention of fraud, waste, and abuse, and on documenting the impact of this program for beneficiaries. Reminder, all CPD Grantees must ensure they maintain active Dun and Bradstreet Numbering System (DUNS) numbers in the System for Award Management (SAM) system. Entities must have an active and unexpired DUNS before execution of grant agreements to avoid delays in the obligation of funds- which will delay your ability to drawdown funds in the Integrated Disbursement & Information System (IDIS). Grantees are required to maintain an active SAMs registration by re -activating their DUNS number annually in the SAM system for the entire drawdown period of their grants. DUNS numbers can be registered and renewed each year at the following website: https://www.sam.gov/SAMJ. The Office of Community Planning and Development (CPD) is looking forward to working with you to successfully meet the urgent and complex challenges faced by our communities. If you or any member of your staff has questions, please contact your local CPD Field Office Director or CPDQuestionsAnswered(a,hud.gov. Sincerely, /A& John Gibbs Acting Assistant Secretary 11 Packet Pg. 305 8.L.a 12 for Community Planning and Development U.S. Department of Housing and Urban Development 0 I 0 N �.i a d E t 0 O r r Q Packet Pg. 306 8.L.b • KEN T WASHINGTON For Immediate Publication/Release Posted on City of Kent Webpage January 14, 2021 PUBLIC NOTICE AND AMENDMENT CITY OF KENT Department of Parks, Recreation & Community Services - Human Services Division Notice of Public Hearing Regarding the Second Amendment to the 2019 Community Development Block Grant (CDBG) Annual Action Plan CARES ACT FUNDING (CDBG-CV) On March 27, 2020, the U.S. Congress passed The Coronavirus Aid, Relief, and Economic Security Act (H.R. 748), also known as the CARES Act. During the first round of funding, the bill allocated $670,541 in supplemental Community Development Block Grant (CDBG) funding to the City of Kent (hereinafter referred to as "the City") for grants to prevent, prepare for, and respond to the coronavirus (CDBG-CV). Those funds have been allocated. During this third round of funding, the City will receive $859,720 in Community Development Block Grant Coronavirus funds (CDBG-CV) from the U.S. Department of Housing and Urban Development (HUD). This is the second amendment to the 2019 Annual Action Plan to allow the City to receive and administer CDBG-CV funds. Subrecipients receiving these funds will be directed to assist low/moderate-income persons, and it is estimated that over 80% of funds will be used to benefit low/moderate- income persons. To respond quickly to the immediate needs faced by our community, the CARES Act provides flexibilities reducing the public comment period to not less than 5 days. The City will accept comments through the hearing date (January 21, 2021). The CARES Act also allow the City to convene virtual public hearings because of public health reasons associated with the coronavirus and to suspend the public service cap (normally 15% of the CDBG budget). Second Amendment to the 2019 Annual Action Plan 3 Packet Pg. 307 8.L.b In accordance with 24 CFR 91.105 of the federal regulations relative to citizen participation for Community Planning and Development Programs and applicable waivers made available to those requirements through the CARES Act, the City of Kent hereby amends the 2019 Annual Action Plan to reflect the following changes: The City proposes to allocate its CDBG-CV funds as follows: ACTIVITY ALLOCATED AMOUNT SUB -RECIPIENT' Public ServiceS2 $657,776.00 TBD Micro -enterprise $30,000.003 TBD Planning & Administration $171,944.00 City of Kent TOTAL ROUND 3 CDBG- CV FUNDS: $859,720.00 CITIZEN PARTICIPATION PROCESS All interested persons are invited to comment on these amendments at the public hearing and during the five-day comment period. DATE/TIME OF PUBLIC HEARING Thursday, January 21, 2021, 3:00 p.m. You may join the virtual public hearing by clicking on this link: Join Zoom Meeting: https://cityofkent.zoom.us/j/96234547881 Community members wishing to submit written comments during the public comment period may email them to Dinah Wilson, Senior CDBG Coordinator, no later than 5:00 pm on January 21, 2021: drwilson@kentwa.gov. This notice, which includes the Second Amendment to the 2019 Annual Action Plan can be found on the City's web site at the following address: http://www.kentwa.gov/residents/human-social-services. ADA Information: This notice is available in alternate formats for individuals with disabilities upon request. Reasonable accommodations at the public hearing such as alternate formats for printed material are available for individuals with disabilities with a minimum of three (3) days advance notice. Please e-mail Dinah at drwilson@kentwa.gov. 1 Sub -recipients receiving funds will be posted on City of Kent website: https://www.kentwa.gov/city-hall/human-social- services. The City will use a streamlined concept paper process to select sub -recipients. 2 City of Kent public service activities may address the following needs: services for the unhoused, healthcare, rent and utility assistance, food assistance, emergency assistance payments, financial literacy/management services, legal services, trauma counseling, digital literacy, and COVID-related supplies. This list is not exhaustive and may expand to meet community needs. 3 This amount could be adjusted depending on need. If the City does not receive a micro -enterprise project concept paper, these funds will be used for other COVID-19 related needs. 4 Up to 20% may be used for P & A; the City is using the full amount allowed by federal regulation. 2 Packet Pg. 308 8.L.b Merina Hanson, Housing and Human Services Manager Kent Parks, Recreation & Community Services, Human Services Division Signature 111412021 Date 5 Packet Pg. 309 8.L.b CERTIFICATIONS In accordance with the applicable statutes and the regulations governing the consolidated plan regulations, the jurisdiction certifies that: Affirmatively Further Fair Housing --The jurisdiction will affirmatively further fair housing. Uniform Relocation Act and Anti -displacement and Relocation Plan -- It will comply with the acquisition and relocation requirements of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended, (42 U.S.C. 4601-4655) and implementing regulations at 49 CFR Part 24. It has in effect and is following a residential anti -displacement and relocation assistance plan required under 24 CFR Part 42 in connection with any activity assisted with funding under the Community Development Block Grant or HOME programs. Anti -Lobbying --To the best of the jurisdiction's knowledge and belief: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of it, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement; 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, it will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions; and 3. It will require that the language of paragraph 1 and 2 of this anti -lobbying certification be included in the award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose accordingly. Authority of Jurisdiction --The consolidated plan is authorized under State and local law (as applicable) and the jurisdiction possesses the legal authority to carry out the programs for which it is seeking funding, in accordance with applicable HUD regulations. Consistency with plan --The housing activities to be undertaken with Community Development Block Grant, HOME, Emergency Solutions Grant, and Housing Opportunities for Persons With AIDS funds are consistent with the strategic plan in the jurisdiction's consolidated plan. Section 3 -- It will comply with section 3 of the Housing and Urban Development Act of 1968 (12 U.S.C. 1701u) and implementing regulations at 24 CFR Part 135. Signature of Authorized Official Date R Packet Pg. 310 8.L.b Title Q Packet Pg. 311 8.L.b Specific Community Development Block Grant Certifications The Entitlement Community certifies that: Citizen Participation -- It is in full compliance and following a detailed citizen participation plan that satisfies the requirements of 24 CFR 91.105. Community Development Plan -- Its consolidated plan identifies community development and housing needs and specifies both short-term and long-term community development objectives that that have been developed in accordance with the primary objective of the CDBG program (i.e., the development of viable urban communities, by providing decent housing and expanding economic opportunities, primarily for persons of low and moderate income) and requirements of 24 CFR Parts 91 and 570. Following a Plan -- It is following a current consolidated plan that has been approved by HUD. Use of Funds -- It has complied with the following criteria: 1. Maximum Feasible Priority. With respect to activities expected to be assisted with CDBG funds, it has developed its Action Plan so as to give maximum feasible priority to activities which benefit low- and moderate -income families or aid in the prevention or elimination of slums or blight. The Action Plan may also include CDBG-assisted activities which the grantee certifies are designed to meet other community development needs having particular urgency because existing conditions pose a serious and immediate threat to the health or welfare of the community, and other financial resources are not available (see Optional CDBG Certification). 2. Overall Benefit. The aggregate use of CDBG funds, including Section 108 guaranteed loans, during program year(s) 2021-2026, shall principally benefit persons of low and moderate income in a manner that ensures that at least 70 percent of the amount is expended for activities that benefit such persons during the designated period. 3. Special Assessments. It will not attempt to recover any capital costs of public improvements assisted with CDBG funds, including Section 108 loan guaranteed funds, by assessing any amount against properties owned and occupied by persons of low and moderate income, including any fee charged or assessment made as a condition of obtaining access to such public improvements. However, if CDBG funds are used to pay the proportion of a fee or assessment that relates to the capital costs of public improvements (assisted in part with CDBG funds) financed from other revenue sources, an assessment or charge may be made against the property with respect to the public improvements financed by a source other than CDBG funds. In addition, in the case of properties owned and occupied by moderate -income (not low-income) families, an assessment or charge may be made against the property for public improvements financed by a source other than CDBG funds if the jurisdiction certifies that it lacks CDBG funds to cover the assessment. Excessive Force -- It has adopted and is enforcing: 1. A policy prohibiting the use of excessive force by law enforcement agencies within its jurisdiction against any individuals engaged in non-violent civil rights demonstrations; and Packet Pg. 312 8.L.b 2. A policy of enforcing applicable State and local laws against physically barring entrance to or exit from a facility or location which is the subject of such non-violent civil rights demonstrations within its jurisdiction. Compliance with Anti -discrimination laws -- The grant will be conducted and administered in conformity with title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d) and the Fair Housing Act (42 U.S.C. 3601-3619) and implementing regulations. Lead -Based Paint -- Its activities concerning lead -based paint will comply with the requirements of 24 CFR Part 35, Subparts A, B, J, K and R. Compliance with Laws -- It will comply with applicable laws. Signature of Authorized Official Date Maw Title 0 Packet Pg. 313 8.L.c OMB Number: 4040-0004 Expiration Date: 12/31/2022 Application for Federal Assistance SF-424 " 1. Type of Submission: Preapplication ® Application Changed/Corrected Application * 2. Type of Application: * If Revision, select appropriate letter(s): ❑ New A: Increase Award ❑ Continuation "Other (Specify): ® Revision ` 3. Date Received: 4. Applicant Identifier: 09/11/2020 5a. Federal Entity Identifier: 5b. Federal Award Identifier: B-20-mw-53-0017 State Use Only: 6. Date Received by State: 7. State Application Identifier: 8. APPLICANT INFORMATION: `a. Legal Name: lCity of Kent * b. Employer/Taxpayer Identification Number (EIN/TIN): * c. Organizational DUNS: 0205026130000 916001254 d. Address: *Streetl: 220 4th Ave. South Street2: " City: County/Parish: Kent * State: Province: 1KA: Washington "Country: (USA: UNITED STATES * Zip / Postal Code: 98032-5895 e. Organizational Unit: Department Name: Parks Division Name: Human Services f. Name and contact information of person to be contacted on matters involving this application: Prefix: * First Name: Dinah Middle Name: * Last Name: Wilson Suffix: Title: Senior CDBG Coordinator Organizational Affiliation: *Telephone Number: 2538565076 Fax Number: *Email: drwilson@kentwa.gov Q Packet Pg. 314 8.L.c Application for Federal Assistance SF-424 * 9. Type of Applicant 1: Select Applicant Type: C: City or Township Government Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: f * Other (specify): * 10. Name of Federal Agency: Department of Housing & Urban Development 11. Catalog of Federal Domestic Assistance Number: 14218 CFDA Title: ffffDe velopment Block Grant Coronavirus Funds * 12. Funding Opportunity Number: n/a * Title: Coronavirus Aid, Relief, and Economic Security Act (CARES Act) 13. Competition Identification Number: Title: 14. Areas Affected by Project (Cities, Counties, States, etc.): F Add Attachment Delete Attachment View Attachment * 15. Descriptive Title of Applicant's Project: Community Development Block Grant coronavirus funds (CDBG-CV) will be allocated to sub -recipients Co serve Kent residents and prevent, prepare for, and respond to the coronavirus. Attach supporting documents as specified in agency instructions. Add Attachments Delete Attachments View Attachments U r` 0 LO N r t K W C N E t U W Q Packet Pg. 315 8.L.c Application for Federal Assistance SF-424 16. Congressional Districts Of: * a. Applicant 9th * b. Program/Project wA-9 Attach an additional list of Program/Project Congressional Districts if needed. Add Attachment Delete Attachment View Attachment 17. Proposed Project: * a. Start Date: O1/O1/2021 * b. End Date: 12/31/2026 18. Estimated Funding ($): *a. Federal 1,530,261.001 * b. Applicant * c. State * d. Local * e. Other * f. Program Income *g.TOTAL 1,530,261.00 * 19. Is Application Subject to Review By State Under Executive Order 12372 Process? ❑ a. This application was made available to the State under the Executive Order 12372 Process for review on ❑ b. Program is subject to E O 12372 but has not been selected by the State for review. ® c. Program is not covered by E.O. 12372. * 20. Is the Applicant Delinquent On Any Federal Debt? (If "Yes," provide explanation in attachment.) ❑ Yes ® No If "Yes", provide explanation and attach Add Attachment Delete Attachment r View Attachment 21. "By signing this application, I certify (1) to the statements contained in the list of certifications" and (2) that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances"* and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious, or fraudulent statements or claims may subject me to criminal, civil, or administrative penalties. (U.S. Code, Title 218, Section 1001) ® **IAGREE ** The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency specific instructions. Authorized Representative: Prefix: 1 * First Name: Dana Middle Name: * Last Name: .Ralph Suffix: * Title: Mayor * Telephone Number: 2538565720 Fax Number: *Email: dralph@kentwa.gov * Signature of Authorized Representative: * Date Signed: U Q cn W d' Q U 0 c O 'a t H d v v Q 0 r N Cl 3 m .r C ca L Y v 0 m c m E am 0 m m c O E O U o� 0 N d t 0 r c 0 E N 'a Q ti Co LO r Z t K W C N E t U R Q Packet Pg. 316 8.L.c ASSURANCES - CONSTRUCTION PROGRAMS OMB Number: 4040-0009 Expiration Date: 01/31/201 Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Office of Management and Budget, Paperwork Reduction Project (0348-0042), Washington, DC 20503. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE OFFICE OF MANAGEMENT AND BUDGET. SEND IT TO THE ADDRESS PROVIDED BY THE SPONSORING AGENCY. NOTE: Certain of these assurances may not be applicable to your project or program. If you have questions, please contact the Awarding Agency. Further, certain Federal assistance awarding agencies may require applicants to certify to additional assurances. If such is the case, you will be notified. As the duly authorized representative of the applicant:, I certify that the applicant: 1. Has the legal authority to apply for Federal assistance, and the institutional, managerial and financial capability (including funds sufficient to pay the non -Federal share of project costs) to ensure proper planning, management and completion of project described in this application. Will give the awarding agency, the Comptroller General of the United States and, if appropriate, the State, the right to examine all records, books, papers, or documents related to the assistance; and will establish a proper accounting system in accordance with generally accepted accounting standards or agency directives. 3. Will not dispose of, modify the use of, or change the terms of the real property title or other interest in the site and facilities without permission and instructions from the awarding agency. Will record the Federal awarding agency directives and will include a covenant in the title of real property acquired in whole or in part with Federal assistance funds to assure non- discrimination during the useful life of the project. 4. Will comply with the requirements of the assistance awarding agency with regard to the drafting, review and approval of construction plans and specifications. 5. Will provide and maintain competent and adequate engineering supervision at the construction site to ensure that the complete work conforms with the approved plans and specifications and will furnish progressive reports and such other information as may be required by the assistance awarding agency or State. 6. Will initiate and complete the work within the applicable time frame after receipt of approval of the awarding agency. 7. Will establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest, or personal gain. Previous Edition Usable 8. Will comply with the Intergovernmental Personnel Act of 1970 (42 U.S.C. §§4728-4763) relating to prescribed standards of merit systems for programs funded under one of the 19 statutes or regulations specified in Appendix A of OPM's Standards for a Merit System of Personnel Administration (5 C.F.R. 900, Subpart F). 9. Will comply with the Lead -Based Paint Poisoning Prevention Act (42 U.S.C. §§4801 et seq.) which prohibits the use of lead -based paint in construction or rehabilitation of residence structures. 10. Will comply with all Federal statutes relating to non- discrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681 1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29) U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) §§523 and 527 of the Public Health Service Act of 1912 (42 U.S.C. §§290 dd-3 and 290 ee 3), as amended, relating to confidentiality of alcohol and drug abuse patient records; (h) Title VI I of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (i) any other nondiscrimination provisions in the specific statue(s) under which application for Federal assistance is being made; and 0) the requirements of any other nondiscrimination statue(s) which may apply to the application. Authorized for Local Reproduction Standard Form 424D (Rev. 7-97) Prescribed by OMB Circular A-102 r t K w c a� E t U ca Q Packet Pg. 317 8.L.c 11. Will comply, or has already complied, with the requirements of Titles II and III of the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (P.L. 91-646) which provide for fair and equitable treatment of persons displaced or whose property is acquired as a result of Federal and federally -assisted programs. These requirements apply to all interests in real property acquired for project purposes regardless of Federal participation in purchases. 12. Will comply with the provisions of the Hatch Act (5 U.S.C. §§1501-1508 and 7324-7328) which limit the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 13. Will comply, as applicable, with the provisions of the Davis - Bacon Act (40 U.S.C. §§276a to 276a-7), the Copeland Act (40 U.S.C. §276c and 18 U.S.C. §874), and the Contract Work Hours and Safety Standards Act (40 U.S.C. §§327- 333) regarding labor standards for federally -assisted construction subagreements. 14. Will comply with flood insurance purchase requirements of Section 102(a) of the Flood Disaster Protection Act of 1973 (P.L. 93-234) which requires recipients in a special flood hazard area to participate in the program and to purchase flood insurance if the total cost of insurable construction and acquisition is $10,000 or more. 15. Will comply with environmental standards which may be prescribed pursuant to the following: (a) institution of environmental quality control measures under the National Environmental Policy Act of 1969 (P.L. 91- 190) and Executive Order (EO) 11514; (b) notification of violating facilities pursuant to EO 11738; (c) protection of wetlands pursuant to EO 11990; (d) evaluation of flood hazards in floodplains in accordance with EO 11988; (e) assurance of project consistency with the approved State management program developed under the Coastal Zone Management Act of 1972 (16 U.S.C. §§1451 et seq.); (f) conformity of SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL APPLICANT ORGANIZATION City of Kent Federal actions to State (Clean Air) implementation Plans under Section 176(c) of the Clean Air Act of 1955, as amended (42 U.S.C. §§7401 et seq.); (g) protection of underground sources of drinking water under the Safe Drinking Water Act of 1974, as amended (P.L. 93-523); and, (h) protection of endangered species under the Endangered Species Act of 1973, as amended (P.L. 93-205). 16. Will comply with the Wild and Scenic Rivers Act of 1968 (16 U.S.C. §§1271 et seq.) related to protecting components or potential components of the national wild and scenic rivers system. 17. Will assist the awarding agency in assuring compliance with Section 106 of the National Historic Preservation Act of 1966, as amended (16 U.S.C. §470), EO 11593 (identification and protection of historic properties), and the Archaeological and Historic Preservation Act of 1974 (16 U.S.C. §§469a-1 et seq). 18. Will cause to be performed the required financial and compliance audits in accordance with the Single Audit Act Amendments of 1996 and OMB Circular No. A-133, "Audits of States, Local Governments, and Non -Profit Organizations." 19. Will comply with all applicable requirements of all other Federal laws, executive orders, regulations, and policies governing this program. 20. Will comply with the requirements of Section 106(g) of the Trafficking Victims Protection Act (TVPA) of 2000, as amended (22 U.S.C. 7104) which prohibits grant award recipients or a sub -recipient from (1) Engaging in severe forms of trafficking in persons during the period of time that the award is in effect (2) Procuring a commercial sex act during the period of time that the award is in effect or (3) Using forced labor in the performance of the award or subawards under the award. TITLE Mayor DATE SUBMITTED SF-424D (Rev. 7-97) Back Q Packet Pg. 318 8.M • KENT *A S M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: King County Flood Control District Sub -Regional Opportunity Fund: Accept and Reallocate Funds for the Lake Fenwick Aerator Improvements - Authorize MOTION: Authorize the Mayor to accept 2021 King County Flood Control District Sub -Regional Opportunity Funds, in the amount of $312,367, for the Lake Fenwick Aerator Improvements project and reallocate 2019 Sub - Regional Opportunity Funds, in the amount $197,147, from the Kent Airport Levee to the Lake Fenwick Aerator Improvements project. SUMMARY: The King County Flood Control District collects an annual levy from properties within King County. Through the District's Sub -Regional Opportunity Fund, ten percent of the levy collected within each jurisdiction is redistributed to the jurisdictions for use in stormwater or habitat projects. In 2018 and 2020, Kent's King County Flood Control District Sub -Regional Opportunity Funds were allocated to the Lake Fenwick Aerator Improvements. In 2019, City staff recommended and Council authorized allocation of Kent's King County Flood Control District Sub -Regional Opportunity Funds to the Kent Airport Levee project. Since that time, the District has prioritized other levee reaches in their work plan, including the Lower Russell Levee and Signature Pointe Levee, and has not moved forward on the Kent Airport Levee project. This request is to reallocate the 2019 Sub -Regional Opportunity Funds ($197,147) and the 2021 Sub - Regional Opportunity Funds (two agreements, $172,367 and $140,000, for a total of $312,367) to the Lake Fenwick Aerator Project. As the city has completed designs on a retrofit of the existing Lake Fenwick Aerator Improvements, the next phase of work is construction. Funding from the Sub - Regional Opportunity Fund will be used to construct the aerator improvements, reduce the risk of future harmful algae blooms, remove the lake from Ecology's list of impaired water bodies, and improve the recreational experience at Lake Fenwick Park. Lake Fenwick is a valuable and important natural resource for Kent, and this critical project helps protect a key resource for the community. BUDGET IMPACT: Funding from the King County Sub -Regional Opportunity Funds will supplement previously budgeted funds for the project. The total project cost is estimated to be approximately $1,400,000-$1,500,000. Packet Pg. 319 8.M SUPPORTS STRATEGIC PLAN GOAL: Evolving Infrastructure - Connecting people and places through strategic investments in physical and technological infrastructure. Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. 02/09/21 COUNCIL BY CONSENSUS RESULT: Committee of the Whole RECOMMENDED TO RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 320 8.N • KENT *A S M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: Investment Advisory Agreement with Public Financial Management, LLC - Authorize MOTION: Authorize the Mayor to sign a contract with Public Financial Asset Management, LLC to serve as the investment advisor and manager of the City's long-term investments, subject to final terms and conditions acceptable to the Finance Director and City Attorney. SUMMARY: At the end of 2016, PFM Asset Management, LLC (PFM) was engaged to manage the City's long-term investment portfolio which at that time totaled $25 million. Since then the portfolio has grown to approximately $125 million. The annual fee structure is based on the size of the portfolio as is as follows: Average Assets Under Management Fees Initial $25 Million 10 basis points (0.10%) Next $25 Million 8 basis points (0.08%) Next $50 Million 7 basis points (0.07%) Above $100 Million 6 basis points (0.06%) With the current size of the portfolio, the annual fee is approximately $92,000 falling within the signing authority of the Mayor. However, it is the City's intent to increase the size of the portfolio in 2021 by transitioning $70 million from the City's short-term investment portfolio managed by the Local Government Investment Pool to the long-term portfolio managed by PFM. Historically, we have seen significantly higher returns on investments for those held in the long-term portfolio. Under this contract, the fee structure remains the same. It is anticipated that with an additional $70 million invested with PFM, the annual cost will increase by approximately $42,000 totally $134,000 annually. This amount will vary based on the size of the portfolio. BUDGET IMPACT: An increase in expenditures of approximately $42,000 annually which will be offset by additional investment income (revenue). These amounts will vary based on the size of the portfolio. Packet Pg. 321 8.N SUPPORTS STRATEGIC PLAN GOAL: Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. ATTACHMENTS: 1. PFM Kent Contract Final Draft (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 322 8.N.a INVESTMENT ADVISORY AGREEMENT THIS AGREEMENT, entered into as of the_day of December, 2020 (the "Agreement"), by and between CITY OF KENT, WASHINGTON, a Washington municipality (hereinafter the "Client"), and PFM ASSET MANAGEMENT LLC, a Delaware limited liability company withan office in Portland, Oregon (hereinafter the "Advisor") WITNESSETH WHEREAS, the Client has funds available for investment purposes (the "Initial Funds") for which it intends to conduct an investment program; and WHEREAS, the Client desires to avail itself of the experience, sources of information, advice, assistance and facilities available to the Advisor; to have the Advisor undertake certain duties and responsibilities; and to perform certain services as investment advisor on behalf of the Client, as provided herein; and WHEREAS, the Advisor is willing to provide such services on the terms and conditions hereinafter set forth; NOW, THEREFORE, in consideration of the premises and mutual covenants herein contained, the parties hereto, intending to be legally bound, agreed as follows: 1. SERVICES OF ADVISOR. The Client hereby engages the Advisor to serve as investment advisor under the terms of this Agreement with respect to the Initial Funds and such other funds as the Client may from time to time assign by written notice to the Advisor (collectively the "Managed Funds"), and the Advisor accepts such engagement. In connection therewith, the Advisor will provide investment research and supervision of the Managed Funds investments and conduct a continuous program of investment and evaluation of the Managed Funds assets. The Advisor shall continuously monitor investment opportunities and evaluate investments of the Managed Funds. The Advisor shall furnish the Client with statistical information and reports with respect to investments of the Managed Funds. The Advisor shall place all orders for the purchase, sale, loan or exchange of portfolio securities for the Client's account with brokers or dealers recommended by the Advisor and/or the Client, and to that end the Advisor is authorized as agent of the Client to give instructions 1 Packet Pg. 323 8.N.a to the custodian designated by the Client (the "Custodian") as to deliveries of securities and payments of cash for the account of the Client. In connection with the selection of such brokers and dealers and the placing of such orders, the Advisor is directed to seek for the Client the most favorable execution and price, the determination of which may take into account, subject to any applicable laws, rules and regulations, whether statistical, research and other information or services have been or will be furnished to the Advisor by such brokers and dealers. Both the Client and the Advisor agree on the following explicit roles in the conduct of investment decisions, and Advisor's authority to implement those decisions. The Advisor shall have no discretionary authority under this Agreement. The Advisor shall make investment recommendations to the Client, in accordance with the Client's written Investment Policy Statement. The Client agrees to evaluate the Advisor's recommendations, and to either accept, reject, or modify the investment recommendations. The Client is not limited to the Advisor's recommendations in the choice of investment decisions regarding the investments for the Managed Funds or the allocation of the Managed Funds among those recommended investments, and Advisor may assist in the implementation of some or all investment decisions, without responsibility, however, for assuring compliance with the Investment Policy Statement as to investments directed by the Client that have not been recommended by the Advisor. The Client authorizes the Advisor to follow any written instructions provided by the agent designated by the Client for communicating those instructions with regard to investments and allocation of investments within the Managed Funds. Such written instructions may be sent by first class mail, fax, electronic mail or otherwise. The Custodian shall have custody of cash, securities and other assets of the Client. The Advisor shall not take possession of or act as custodian for the cash, securities or other assets of the Client and shall have no responsibility in connection therewith. Authorized investments shall include only those investments which are currently authorized by the Investment Policy Statement, state investment statutes and applicable covenants and as supplemented by such other written instructions as may from time to time be provided by the Client to the Advisor. The Advisor shall be entitled to rely upon the Client's written advice with respect to anticipated drawdowns of Managed Funds. The Advisor will observe the instructions of the Client with respect to broker/dealers who are approved to execute transactions involving the Managed Funds and in the absence of such instructions will engage broker/dealers which the Advisor reasonably believes to be reputable, qualified and financially sound. 2 Packet Pg. 324 8.N.a 2. COMPENSATION. (a) For services provided by the Advisor pursuant to this Agreement, the Client shall pay the Advisor an annual fee, in monthly installments, based on the daily net assets under management according to the schedule below: Average Assets Under Management Fees Initial $25 million 10 basis points (0.10%) Next $25 million 8 basis points (0.08%) Next $50 million 7 basis points (0.07%) Above $100 million 6 basis points (0.06%) "Daily net assets" is defined to include the amortized value of securities, accrued interest and cash or any money market fund balance. The minimum annual fee is $25,000, to be applied in equal monthly installments. (b) The Advisor will bill the Client monthly for service performed under this Agreement, said bill to include a statement indicating the basis upon which the fee was calculated. The Client shall pay to the Advisor the amount payable pursuant to this Agreement not later than on the 30th day of the month following the month during which the Advisor's statement was rendered. (c) Assets invested by the Advisor under the terms of this Agreement may from time to time be invested in (i) a money market mutual fund managed by the Advisor or (ii) a local government investment pool managed by the Advisor (either, a "Pool"), or in individual securities. Average daily net assets subject to the fees described in this section shall not take into account any funds invested in the Pool. Expenses of the Pool, including compensation for the Advisor and the Pool custodian, are described in the relevant prospectus or information statement and are paid from the Pool. (d) If and to the extent that the Client shall request the Advisor to render services other than those to be rendered by the Advisor hereunder, such additional services shall be compensated separately on terms to be agreed upon between the Advisor and the Client. Packet Pg. 325 8.N.a 3. EXPENSES. (a) The Advisor shall furnish at its own expense all necessary administrative services, office space, equipment, clerical personnel, telephone and other communication facilities, investment advisory facilities, and executive and supervisory personnel for managing the Managed Funds. (b) Except as expressly provided otherwise herein, the Client shall pay all of its own expenses including, without limitation, taxes, commissions, fees and expenses of the Client's independent auditors and legal counsel, if any, brokerage and other expenses connected with the execution of portfolio security transactions, insurance premiums, and fees and expenses of the Custodian. 4. REGISTERED ADVISOR; DUTY OF CARE. The Advisor hereby represents it is a registered investment advisor under the Investment Advisers Act of 1940, as amended. The Advisor shall immediately notify the Client if at anytime during the term of this Agreement it is not so registered or if its registration is suspended. The Advisor agrees to perform its duties and responsibilities under this Agreement with reasonable care. The federal securities laws impose liabilities under certain circumstances on persons who act in good faith. Nothing herein shall in any way constitute a waiver or limitation of any rights which the Client may have under any federal securities laws. The Client hereby authorizes the Advisor to sign I.R.S. Form W-9 on behalf of the Client and to deliver such form to broker -dealers or others from time to time as required in connection with securities transactions pursuant to this Agreement. 5. ADVISOR'S OTHER CLIENTS. The Client understands that the Advisor performs investment advisory services for various other clients which may include investment companies, commingled trust funds and/or individual portfolios. The Client agrees that the Advisor, in the exercise of its professional judgment, may give advice or take action with respect to any of its other clients which may differ from advice given or the timing or nature of action taken with respect to the Managed Funds. The Advisor shall not have any obligation to purchase, sell or exchange any security for the Managed Funds solely by reason of the fact that the Advisor, its principals, affiliates, or employees may purchase, sell or exchange such security for the account of any other client or for itself or its own accounts. 4 Packet Pg. 326 8.N.a 6. TERM. This Agreement may be terminated by the Client any time, on not less than thirty (30) days' written notice to the Advisor. The Advisor may terminate this Agreement immediately upon any material breach of its terms by the Client, or at any time after one year upon thirty (30) days' written notice to the Client. 7. FORCE MAJEURE. The Advisor shall have no liability for any losses arising out of the delays in performing or inability to perform the services which it renders under this Agreement which result from events beyond its control, including interruption of the business activities of the Advisor or other financial institutions due to acts of God, acts of governmental authority, acts of war, terrorism, civil insurrection, riots, labor difficulties, or any action or inaction of any carrier or utility, or mechanical or other malfunction. 8. DISCIPLINARY ACTIONS. The Advisor shall promptly give notice to the Client if the Advisor shall have been found to have violated any state or federal securities law or regulation in any final and unappealable judgment in any criminal action or civil suit in any state or federal court or in any disciplinary proceeding before the Securities and Exchange Commission ("SEC") or any other agency or department of the United States, any registered securities exchange, the Financial Industry Regulatory Authority, or any regulatory authority of any State based upon the performance of services as an investment advisor. 9. INDEPENDENT CONTRACTOR. The Advisor, its employees, officers and representatives shall not be deemed to be employees, agents (except as to the purchase or sale of securities described in Section 1), partners, servants, and/or joint ventures of the Client by virtue of this Agreement or any actions or services rendered under this Agreement. 5 Packet Pg. 327 8.N.a 10. BOOKS. The Advisor shall maintain records of all transactions in the Managed Funds. The Advisor shall provide the Client with a monthly statement showing deposits, withdrawals, purchases and sales (or maturities) of investments, earnings received, and the value of assets held on the last business day of the month. The statement shall be in the format and manner that is mutually agreed upon by the Advisor and the Client. The Advisor shall provide the Client with the necessary data to complete the Deposits and Investments Footnote in the Client's CAFR as required in GASB 40 and GASB 72. The data shall include market and book values sorted and subtotaled by investment type and maturity by years and include the percentage of the portfolio. The Advisor will also provide a list of securities sorted by type, and percentage of the portfolio and include ratings by Moody's and S&P. In addition, the Advisor will provide the Fair Value Measurements by security as required in GASB 72. As accounting standards change, the Advisor shall provide the data in accordance with updated accounting standards issued by GASB, and communicated by the Client to the Advisor. The Advisor shall provide such information to the City no later than February 28 of each year, and the Client agrees to provide the format needed for such information no later than February 1 of each year. 11. THE ADVISOR'S BROCHURE AND BROCHURE SUPPLEMENT. The Advisor warrants that it has delivered to the Client prior to the execution of this Agreement the Advisor's current SEC Form ADV, Part 2A (brochure) and Part 213 (brochure supplement). The Client acknowledges receipt of such brochure and brochure supplement prior to the execution of this Agreement. 12. MODIFICATION. This Agreement shall not be changed, modified, terminated or discharged in whole or in part, except by an instrument in writing signed by both parties hereto, or their respective successors or assigns. 13. SUCCESSORS AND ASSIGNS. The provisions of this Agreement shall be binding on the Advisor and its successors and assigns, provided, however, that the rights and obligations of the Advisor may not be assigned without the consent of the Client. 6 Packet Pg. 328 8.N.a 14. NOTICE. Written notices required under this Agreement shall be sent by regular mail, certified mail, overnight delivery or courier, and shall be deemed given when received at the parties' respective addresses shown below. Either party must notify the other party in writing of a change in address. Client's Address City of Kent, Washington 220 4rh Ave. S. Kent, WA 98032 Attn: Finance Department Advisor's Address PFM Asset Management LLC 650 NE Holladay Street Suite 1600 Portland, OR 97232 Attn: Luke Schneider 15. APPLICABLE LAW. With copy to: PFM Asset Management LLC 1735 Market Street 43' Floor Philadelphia, PA 19103 Attn: Controller This Agreement shall be construed, enforced, and administered according to the laws of the State of Washington. The Advisor and the Client agree that, should a disagreement arise as to the terms or enforcement of any provision of this Agreement, each party will in good faith attempt to resolve said disagreement prior to filing a lawsuit. 16. EXECUTION AND SEVERABILITY. Each party to this Agreement represents and warrants that the person or persons signing this Agreement on behalf of such party is authorized and empowered to sign and deliver this Agreement for such party. The invalidity in whole or in part of any provision of this Agreement shall notvoid or affect the validity of any other provision. 7 Packet Pg. 329 8.N.a 17. PARTICIPATION IN AGREEMENT. With the consent of the Advisor, this Agreement may be extended for use to other Washington public agencies and other similar eligible entities. Any such use by other such entities must be in accordance with applicable Washington state law, including RCW 39.34.030, and any ordinance, charter or procurement rules and regulations of such respective entity. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their authorized representatives as of the date set forth in the first paragraph of this Agreement. PFM ASSET MANAGEMENT LLC Name: Title: CITY OF KENT, WASHINGTON In Name: Title: Packet Pg. 330 8.0 KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Authorize the Use of accessoShoWare Center Operating Fund Balance to Purchase Scoreboard - Authorize MOTION: Authorize the use of the accessoShoWare operating fund balance for the purchase of a scoreboard in the amount of $300,000. SUMMARY: As part of the accessoShoWare Center Sales, Marketing and Operational Management Services Agreement with the City, SMG has committed to contribute $500,000 to the Events Center to be used for the purchase of a new scoreboard. The estimated cost of a new scoreboard is $800,000. The scoreboard, which also includes the video and control room equipment, was purchased in 2007 and installed in 2008 for the arena's grand opening in 2009. It is now 14 years later and the manufacturer, Daktronics, no longer has replacement parts for it. There are issues with the scoreboard, and we can longer find parts for repairs. The Everett arena's experience was similar and they, too, needed to replace their scoreboard after 12 years. A replacement cycle of 12-14 years is typical for this piece of equipment. Since the accessoShoWare Center opened in 2009, admissions tax for the accessoShoWare Center and the Thunderbirds have been transferred from the General Fund to the City's accessoShoWare Center operating fund. A portion of these funds have been accumulating in fund balance which currently nears $3.0 million. $545,000 of the current fund balance is CARES funding reserved for reopening expenses, which leaves approximately $2.4 million in fund balance. The City would like to use approximately $300,000 of the accessoShoWare operating fund balance to pay for the remaining cost of the scoreboard. The Finance Department plans to come back to Council in the future with a proposal for the future use of the accessoShoWare operating fund balance. BUDGET IMPACT: $300,000 of fund balance SUPPORTS STRATEGIC PLAN GOAL: Packet Pg. 331 8.0 Innovative Government - Delivering outstanding customer service, developing leaders, and fostering innovation. Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. Inclusive Community - Embracing our diversity and advancing equity through genuine community engagement. 02/09/21 COUNCIL BY CONSENSUS RESULT: Committee of the Whole RECOMMENDED TO RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 332 8.P • KENT *A S M IN G T O N DATE: February 16, 2021 TO: Kent City Council SUBJECT: Ordinance Providing Business Licensing Exemption for Parks Performers - Adopt MOTION: Adopt Ordinance No. 4392, amending Chapter 5.01 of the Kent City Code to provide a business licensing exemption for vendors whose sole business activity is accepting a contract with the City to perform or provide a service to the Recreation and Cultural Services Division of the Parks Department. SUMMARY: Under the Kent City Code, a business license is required for any vendor who enters into a contract with the City, regardless of whether the vendor physically steps foot within the City. This requirement poses significant challenges for many of the contracts within the Recreation and Cultural Services Division of the Parks and Community Services Department, who contract with several small non- profit organizations and touring artists as part of its programming. Requiring a business license for these particular vendors increases the City's program costs significantly, as these costs would have to be added to each contract the City enters into. In addition, the business licensing process creates additional paperwork for the performers who tend to be unfamiliar with licensing requirements and many of whom would simply decline the work. These artists are touring for multiple months, stopping in a different city for only a few nights. It simply does not make logistical sense for them to take the time to apply for a business license and pay a business license fee for a few hours of work before they move on to a different city. This ordinance provides for an exemption from the business licensing requirements for vendors that are contracting with the City as part of an event or program facilitated by, or for a service provided to, the City's Recreation and Cultural Services Division. In addition, it makes a housekeeping change to move an already existing exemption for businesses owned by minors into the revised exemptions section of the code. BUDGET IMPACT: None SUPPORTS STRATEGIC PLAN GOAL: Packet Pg. 333 8.P Thriving City - Creating safe neighborhoods, healthy people, vibrant commercial districts, and inviting parks and recreation. Sustainable Services - Providing quality services through responsible financial management, economic growth, and partnerships. ATTACHMENTS: 1. Business License Exemption Rec and Cultural (PDF) 02/09/21 Committee of the Whole RECOMMENDED TO COUNCIL BY CONSENSUS RESULT: RECOMMENDED TO COUNCIL BY CONSENSUS Next: 2/16/2021 7:00 PM Packet Pg. 334 8.P.a ORDINANCE NO. 4392 AN ORDINANCE of the City Council of the City of Kent, Washington, amending sections 5.01.040 and 5.01.045 of the Kent City Code to: (i) provide a business licensing exemption for vendors who contract with the City as part of an event or program facilitated by, or for a service provided to, the Recreation and Cultural Services Division of the City's Parks Department, and (ii) to make a housekeeping change to group an existing exemption with this new exemption within section 5.01.045 of the Kent City Code. RECITALS A. The Recreation and Cultural Services Division of the City's N Parks and Community Services Department contracts with several small L non-profit organizations and touring artists as part of its programming. B. Requiring business licenses and associated fees for these types of vendors adds significant programming costs as the business license fees would necessarily be built into the project cost billed back to the City. Furthermore, due to the additional paperwork, and lack of familiarity with licensing requirements, many of the touring artists would simply decline to work with the City. These artists are touring for multiple months on the road, stopping in a different city for only a few nights. It simply does not make logistical sense for them to take the time to apply for a business 1 Amend KCC 5.01.040, 5.01.045 - Re: Business License Exemptions Packet Pg. 335 8.P.a license and pay a business license fee for a few hours of work before they move on to a different city. C. If not exempted from the business licensing requirements, these small contracts would require significant additional City expense by raising the cost of each contract, and could deter potential cultural services vendors from working with the City. D. This ordinance provides the necessary exemption from the business licensing requirements for vendors that contract with the City as part of an event or program facilitated by, or for a service provided to, the City's Recreation and Cultural Services Division, and moves the current exemption for businesses owned by minors into the revised exemptions section of the Kent City Code. NOW, THEREFORE, THE CITY COUNCIL OF THE CITY OF KENT, WASHINGTON, DOES HEREBY ORDAIN AS FOLLOWS: ORDINANCE SECTION 1. - Amendment - KCC 5.01.040. Section 5.01.040 of the n r1 Kent City Code, entitled "General business license required", is hereby L amended as follows: Sec. 5.01.040. General business license required. Except as provided in KCC 5.01.045, it is unlawful for any business to operate in the city without having first obtained a general business license for the current calendar year or unexpired portion thereof and paid the fees prescribed in this chapter. A business with premises, primary places of business, or main offices outside the city limits must be licensed before conducting business within the city limits. 2 Amend KCC 5.01.040, 5.01.045 - Re: Business License Exemptions Packet Pg. 336 8.P.a SECTION 2. - Amendment - KCC 5.01.045. Section 5.01.045 of the Kent City Code, entitled "Threshold exemption", is hereby amended as follows: Sec. 5.01.045. Exemptions. To the extent set forth in this section, the following persons and businesses shall be exempt from the registration, license and/or license fee requirements as outlined in this chapter: A. Any person or business whose annual value of products, gross proceeds of sales, or gross income of the business in the city is equal to or less than $2,000 and who does not maintain a place of business within the city. The exemption does not apply to regulatory license requirements or activities that require a specialized permit. B. Any person or business whose sole business activity conducted within :2 0 the city is accepting or executing a contract or grant agreement with the city a. a) as part of an event or program facilitated by, or for a service provided to, 0 the recreation and cultural services division of the parks and community L services department. a� LO C. A business solely owned and operated by a person under the age of 18 years shall not be required to have a business license. y SECTION 3. - Severability. If any one or more section, subsection, or sentence of this ordinance is held to be unconstitutional or invalid, such decision shall not affect the validity of the remaining portion of this ordinance and the same shall remain in full force and effect. SECTION 4. - Corrections by City Clerk or Code Reviser. Upon approval of the city attorney, the city clerk and the code reviser are authorized to make necessary corrections to this ordinance, including the 3 Amend KCC 5.01.040, 5.01.045 - Re: Business License Exemptions Packet Pg. 337 8.P.a correction of clerical errors; ordinance, section, or subsection numbering; or references to other local, state, or federal laws, codes, rules, or regulations SECTION 5. - Effective Date. This ordinance shall take effect and be in force thirty days from and after its passage, as provided by law. DANA RALPH, MAYOR ATTEST: KIMBERLEY A. KOMOTO, CITY CLERK APPROVED AS TO FORM: February 16, 2021 Date Approved February 16, 2021 Date Adopted February 19, 2021 Date Published ARTHUR "PAT" FITZPATRICK, CITY ATTORNEY 4 Amend KCC 5.01.040, 5.01.045 - Re: Business License Exemptions LO N Packet Pg. 338 8.Q KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: Appointmens to the Parks and Recreation Commission - Confirm MOTION: Confirm the Mayor's appointments of Kathleen Meehan, Sarah Veele, Roberto Arellano, Jr., and Edith Gonzales to the Kent Parks and Recreation Commission for a three-year term expiring February 15, 2024 SUMMARY: I am pleased to recommend Kathleen Meehan, Sarah Veele, Roberto Arellano, Jr., and Edith Gonzales for appointments to the Kent Parks and Recreation Commission for a three-year term expiring on February 15, 2024. Kathleen Meehan Kathleen is committed to our city's vitality and believes in Parks and Recreation as one of the foundational pillars and opportunities to promote community health, safety, and connection. Kathleen values that local government that includes communities foster genuine opportunities for the involvement of its citizens. As a public health professional with over 15 years of community and public health experience, her perspective and expertise exist at the intersection of how larger community environments support overall health and community cohesion. Sarah Veele Sarah is a sixteen year resident of Kent. She is excited to be a part of the work the Commission is doing with its commitment to maintaining green spaces, improving recreational accessibility, and building upon Kent's diverse community's skill set and resources. She believes the Commission plays an active role in addressing inequity by intentionally planning and supporting Kent's diverse community's needs. With a Ph.D. in public health from the University of Wa, she is knowledgeable about the role that the community and recreation play in individual and community health. She has worked for over a decade for the State of Washington, researching to inform and improve the way we serve our most vulnerable populations. Roberto Arellano, Jr. Growing up an underprivileged minority in Los Angeles near a city park, he experienced all the awful things humanity has to offer. Roberto, a father of three, wants to ensure parks remain a positive attraction for families and community members and one day watch his grandchildren enjoying them as well. As a disabled U.S. Wartime veteran, he was the Co -Founder of Latinos Unidos at the Port, an Packet Pg. 339 8.Q Employee Resource Group dedicated to assisting Latinx employees and the Latinx communities around the region. He has also served as PTA and PTSA President and Vice President at his children's Elementary schools. Roberto currently serves on the negotiating team of IBEW Local 46 Edith Gonzales Edith enjoys spending time at different parks and in various cities. She has extensive experience in marketing, graphic design, and social media. BUDGET IMPACT: None. SUPPORTS STRATEGIC PLAN GOAL: Innovative Government - Delivering outstanding customer service, developing leaders, and fostering innovation. Inclusive Community - Embracing our diversity and advancing equity through genuine community engagement. Packet Pg. 340 10.A KENT DATE: February 16, 2021 TO: Kent City Council SUBJECT: 2021 Paint Line Striping and Raised Pavement Marking Replacement Bid - Award MOTION: Award the 2021 Paint Line Striping and Raised Pavement Marking Replacement Project to Specialized Pavement Marking, Inc. in the amount of $255,780 and authorize the Mayor to sign all necessary documents, subject to final terms and conditions acceptable to the City Attorney and Public Works Director. SUMMARY: This project includes repainting painted lane line markings and installing replacement raised pavement markers on select City streets. The bid opening for the 2021 Paint Line Striping and Raised Pavement Marking Replacement Project was held on February 9, 2021 with three bids received. The lowest responsible and responsive bid was submitted by Specialized Pavement Marking, Inc. in the amount of $255,780. Bid Tab Summary 01. Specialized Pavement Marking, Inc. $255,780 02. Stripe Rite, Inc. $261,480 03. Apply -A -Line LLC $271,120 Engineer's Estimate $307,030 BUDGET IMPACT: The project will be paid for using budgeted B&O Funds. SUPPORTS STRATEGIC PLAN GOAL: Evolving Infrastructure - Connecting people and places through strategic investments in physical and technological infrastructure. ATTACHMENTS: 1. Paint Line Striping & RPM Repl Bid Tab (PDF) Packet Pg. 341 10.A.a 2021 Paint Line Striping and RPM 1 2 3 Replacement Bid Opening: February 9, 2021, 11:00 AM Specialized Pavement Marking, Inc. Stripe Rite, Inc. Apply -A -Line LLC Engineer's Estimate 11095 SW Industrial Way, Suite A 1813 137th Ave. E. 175 Roy Rd. SW, Bldg. C Joe Araucto Disclaimer: These preliminary bid results are provided as a convenience to Tualatin, OR 97062 Sumner, WA 98390 Pacific, WA 98047 contractors for informational purposes only and do not identify lowest responsible bidder. Bid review by staff and final award pending. TOTAL $255,780.00 $261,480.00 $271,120.00 $307,030.00 ITEM DESCRIPTION QTY UNIT UNIT TOTAL UNIT TOTAL UNIT TOTAL UNIT TOTAL NO. PRICE AMOUNT PRICE AMOUNT PRICE AMOUNT PRICE AMOUNT 1000 Mobilization 1 LS 8,500.00 $8,500.00 4,000.00 $4,000.00 6,850.00 $6,850.00 10,000.00 $10,000.00 1005 Painted Double Solid Line 405,000 LF 0.14 $56,700.00 0.14 $56,700.00 0.16 $64,800.00 0.15 $60f750.00 1010 Painted Single Solid Line 634,000 LF 0.08 $50,720.00 0.10 $63,400.00 0.08 $50,720.00 0.12 $76,080.00 1015 Painted Skip Lane Line 140,000 LF 0.06 $8,400.00 0.06 $8,400.00 0.07 $9,800.00 0.10 $14,000.00 1020 Painted Dotted Line 20,000 LF 0.13 $2,600.00 0.11 $2,200.00 0.07 $1,400.00 0.16 $3,200.00 1025 Painted TWLTL Line 140,000 LF 0.12 $16,800.00 0.13 $18,200.00 0.10 $14,000.00 0.16 $22,400.00 1030 Painted Wide Lane Line 32,000 LF 0.19 $6,080.00 0.15 $4,800.00 0.18 $5,760.00 0.26 $8,320.00 1035 Painted Bike Lane Line 128,000 LF 0.16 $20,480.00 0.15 $19,200.00 0.18 $23,040.00 0.16 $20,480.00 1040 Raised Pavement Marker Type 1 80 HUND 275.00 $22,000.00 299.00 $23,920.00 265.00 $21,200.00 310.00 $24,800.00 1045 Raised Pavement Marker Type 2 80 HUND 350.00 $28,000.00 377.00 $30,160.00 350.00 $28,000.00 450.00 $36,000.00 1050 Project Temporary Traffic Control 1 LS 30,000.00 $30,000.00 25,000.00 $25,000.00 40,000.00 $40,000.00 25,000.00 $25,000.00 1055 SPCC Plan 1 LS 500.00 $500.00 500.00 $500.00 550.00 $550.00 1,000.00 $1,000.00 1060 Minor Changes 1 CALC 5,000.00 $5,000.00 5,000.00 $5,000.00 5,000.00 $5,000.00 5,000.00 $5,000.00 CONSTRUCTION CONTRACT TOTAL $255,780.00 $261,480.00 $271,120.00 $307,030.00 Z3 An Z3 c 0Y C Q �L r d C J a+ C M IL N 0 N Packet Pg. 342