HomeMy WebLinkAboutCAG2023-031 - Original - Public Health Seattle & King County (PHSKC) - Youth Marijuana Prevention & Education - 04/01/2022Ap
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Originator:Department:
Date Sent:Date Required:
Authorized to Sign:
Director or Designee
Date of Council Approval:
Grant? Yes No
Type:
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Comments:
Date Routed to the City Clerk’s Office:
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Vendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover
Sheet forms.
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 20210513
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
LETTER AGREEMENT, TERMS AND CONDITIONS
Kent Police Department
220 4th Ave S.
Kent, WA 98032
Re: PHSKC Agreement # 8674 – KC YMPEP Youth Prevention Mini-Grant 2022
This letter is to serve as the agreement between Kent Police Department and Public Health–Seattle & King
County (“PHSKC”), effective April 1, 2022 to June 30, 2022.
ACTIVITIES & COMPENSATION
Kent Police Department has agreed to accept payment in the amount of $6,849 for completion of activities
supporting Policy, Systems and Environment (PSE) change in Youth Marijuana Prevention and Education. The
schedule for payments and related deliverables and activities is as follows:
A. Required of all grantees: Learning Community Participation and Grant Accountability (up to $1450
total): Adult leads will develop a workplan for funded activities, participate in a grant kick-off meeting and
monthly learning communities, and prepare and submit monthly reporting and invoicing. Tasks and
payments for this activity are:
1. Demonstrate all adults (staff and volunteers) working with youth have a background check on file
(e.g., through Washington State Patrol) ($150).
2. Attend monthly learning community meetings from start to finish, TBD dates in April, May, and
June 2022 $100 per meeting x 3 meetings (up to $300):
a. Kick-off April 2022 learning community meeting TBD ($100).
b. May 2022 learning community meeting TBD ($100).
c. June 2022 learning community meeting TBD ($100).
3. Submit a grant workplan with roles, timeline, and resources for selected activities within two
weeks of project start date ($350).
4. Work with contract manager on any requested workplan revisions until workplan is “approved.”
Workplan must be approved prior to action plan implementation ($350).
5. Submit required monthly reporting to contract manager along with invoice for completed tasks and
deliverables – note, reporting will be used to demonstrate deliverables are complete for payment
(up to $300):
a. April reporting and contract manager check-in ($100).
b. May reporting and contract manager check-in ($100).
c. June reporting and contract manager check-in ($100).
B. Grantee can choose: Supporting youth leadership skill-building (up to $2550): Adult leads will support
youth in building leadership skills using modules and resources from the Youth 2 Youth toolkit, adapting
modules as needed. The tasks and payments for this activity are:
1. Order Youth 2 Youth toolkit from YMPEP contract manager if grantee does not already have one.
2. Attend Youth 2 Youth module trainings or review training videos and share key take-aways and
planned adaptions (up to $300, $60 per training for first five (5) trainings and take-aways).
3. Support youth group to learn at least three (3) and up to five (5) of the Dover Youth 2 Youth
modules below. Each skill session should be at a scheduled and structured youth meeting:
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a. Developing Skills: Developing Presentation Skills (Module 2B) module available on toolkit
thumb drive and updated presentation slides available here ($450).
b. Developing Knowledge: Pop Culture Influences (Module 2G) module available on toolkit
thumb drive ($450).
c. Presenting: Advertising & Media Influences (Module 3A-2) module available on toolkit
thumb drive ($450). – Note: Grantees must select this module if they plan to do activity D;
grantees will be paid once for completing this module and attending or watching the training
even though it is part of multiple activities.
d. Presenting: Short Theatrical Skits (Module 3A-4) module available on toolkit thumb
drive ($450).
e. Community Awareness: Retail Responsibility (Module 3C-8) module available on toolkit
thumb drive ($450).
C. Grantee can choose: Youth Peer to Peer Media Awareness Training (up to $2,360): Youth will adapt
an existing media awareness training to present to peers. Tasks and payments for this activity are:
1. Attend Youth 2 Youth module training for Advertising & Media Influences (Module 3A-2) or
review training video and share key take-aways and planned adaptions ($60).
2. Youth review ($450) Dover Youth 2 Youth Presenting: Advertising & Media Influences (Module
3A-2) presentation. Note – Grantees will be paid once for completing this module and attending or
watching the training even though it is part of multiple activities.
3. Youth create updated and adapted peer media awareness training ($500).
4. Youth and adult leads plan presentation and invite audience ($150).
5. Youth practice delivering presentation ($200).
6. Youth deliver presentation to an audience of their peers at a scheduled class or event ($1000).
D. Grantee can choose: Youth-led Media Messaging & Placement ($999): Youth will promote tailored
messages from the “You Can” campaign on channels used by peers. This activity is an add-on to at least
one other optional activity. Tasks and payments for this activity are:
1. Request You Can toolkit information from contract manager and review contents. Youth select a
prevention message or messages from the “You Can” campaign toolkit ($99).
2. Youth adapt prevention message(s) and images to their community ($400).
3. Adult leads and youth place and screen shot placement of eight community adapted campaign
messages/images on social media (Instagram, Snapchat, and/or Facebook) ($500).
REPORTING, INVOICE & PAYMENT
Awardee agrees to submit reporting and invoicing for completed tasks on or by May 10th, June 10th, and July
10th 2022. Reports should include all workplan tasks completed since the previous report/start of grant and
copies or pictures of any products made during that time-period.
Specifically, reports should include:
- Task name and brief description of how it was completed;
- First and last names of adult staff and volunteers leading and supporting the activity;
- Initials and age of each youth participant with grade level and school of attendance;
- Dates task was worked on and date completed;
- Attachments of task products such as assessment plan or findings, presentation slides, community
invitations, flyers, links to presentation recordings, screen shots of social media, etc.
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After contract manager approves reporting, KC-YMPEP will process the invoice for payment.
ALLOWABLE EXPENSES USING GRANT FUNDS (EXAMPLES)
Grant funds are paid to grantees when they completes tasks. The following guidelines apply to use of these
funds:
• Advocacy and decision-maker education are allowed, but lobbying is not:
o YMPEP funds may not be used to ask government lawmakers to take legislative actions on specific
legislation/laws/statutes via face-to-face meetings, social and other media, etc.). This is lobbying.
o YMPEP funds may be used to educate government lawmakers (federal, state, and local) on
marijuana use by youth, protective factors, how are using state funds, etc. through advocacy.
o YMPEP funds may be used to educate, provide input, or request action on state administrative rules
(Washington Administrative Code) under consideration by state agencies.
o If you have questions about what is lobbying and what is advocacy or education, please ask the
contract manager.
• If grantees intend to use grant funds for the following, they must request pre-approval from the contract
manager who will consult with WA State Department of Health:
o Refreshments at a cost of no more than $3.25 per person for meetings of 2-4 hours in duration.
o Meals at a cost equal to or less than the King County per diem rate for meetings longer than 4
hours, not including the meal break.
o Limited incentives/stipends/prizes for youth participants.
Note that you can choose to use your own organizational funding (not from this grant) for these items without
prior approval.
REQUIREMENTS
Applicants must agree to the following:
• Participation in scheduled monthly awardee community learning calls (TBD based on times that work
for grantees);
• Submission of workplan showing how the grantee will complete selected activities;
• Submission of monthly reporting and supporting documentation to demonstrate completion tasks in the
approved workplan;
• Demonstration of completed background checks, for ALL adults who will be in contact with youth
during the activities (virtually or in-person);
• If applicable, obtain approval from KC-YMPEP prior to using award funds for incentives for youth or
for food to support meetings;
• Ensure activities are educational and do not constitute lobbying (asking government lawmakers to take
legislative action on specific legislation/laws/statutes);
• Make sure volunteers or other adults are never alone (one-on-one) with a youth for any grant or related
activities.
• Agree to and follow all Terms and Conditions in Exhibit A, including maintain County-required levels
of insurance.
Feel free to contact Sarah Ross-Viles with any questions regarding the letter agreement or deliverables at
srossviles@kingcounty.gov.
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Sincerely,
Marguerite Ro
Director of Chronic Disease and Injury Prevention
By signing below, you agree to the terms and conditions listed above and in Exhibit A, Other Terms and
Conditions.
X
Printed Name: Date:
Title:
DocuSign Envelope ID: ADEE77BE-A67B-4613-B902-690E22CF8582
Rafael Padilla
5/17/2022
Chief of Police
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EXHIBIT A: OTHER TERMS AND CONDITIONS
1. Nondiscrimination; Equal Employment Opportunity
The Recipient shall comply with all applicable federal, state and local laws regarding discrimination,
including those set forth in this Section.
A. During performance of the Agreement, the Recipient agrees that it will not discriminate against any
employee or applicant for employment because of the employee or applicant's sex, race, color, marital
status, national origin, religious affiliation, disability, sexual orientation, gender identity or expression
or age except by minimum age and retirement provisions, unless based upon a bona fide occupational
qualification. The Recipient will make equal employment opportunity efforts to ensure that applicants
and employees are treated, without regard to their sex, race, color, marital status, national origin,
religious affiliation, disability, sexual orientation, gender identity or expression or age. Additional
requirements are at http://www.kingcounty.gov/healthservices/health/partnerships/contracts; Recipients
shall read and certify compliance.
2. Indemnification & Hold Harmless
To the maximum extent permitted by law and except to the extent caused by the sole negligence of King
County, Recipient shall indemnify, defend, and hold harmless King County, its officers, officials, agents
and employees, from and against any and all suits, claims, actions, losses, costs, penalties and damages of
whatsoever kind or nature arising out of, in connection with, or incident to the goods and/or services
provided by or on behalf of the Recipient, its agents, employees, representatives, and invitees. The
foregoing provision specifically and expressly intends to constitute a waiver of Recipient’s immunity under
industrial insurance, Title 51 RCW, as respects King County only, and only to the extent necessary to
provide King County with a full and complete indemnity of claims made by the Recipient’s employees.
This waiver has been mutually negotiated. The provisions of this section shall survive the expiration or
termination of this Agreement.
3. Debarment and Suspension Certification
Entities that are debarred, suspended, or proposed for debarment by the U.S. Government are excluded
from receiving federal funds and contracting with the County. The Recipient, by signature to this
Agreement, certifies that the Recipient is not presently debarred, suspended, or proposed for debarment by
any Federal department or agency. The Recipient also agrees that it will not enter into a sub-agreement
with a Recipient that is debarred, suspended, or proposed for debarment. The Recipient agrees to notify
King County in the event it, or a sub-awardee, is debarred, suspended, or proposed for debarment by any
Federal department or agency.
4. Insurance Requirements
I. By the date of execution of this Agreement, the Recipient shall procure and maintain for the
duration of this Agreement, insurance against claims for injuries to persons and/or damage to
property which may arise from, or in connection with, the performance of work hereunder by the
Recipient, its agents, representatives, employees, and/or sub‐awardees. The costs of such insurance
shall be paid by the Recipient or sub‐awardee. The Recipient may furnish separate certificates of
insurance and policy endorsements for each sub‐awardee as evidence of compliance with the
insurance requirements of this Agreement. The Recipient is responsible for ensuring compliance
with all of the insurance requirements stated herein. Failure by the Recipient, its agents, employees,
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officers, sub‐ awardee, providers, and/or provider sub‐awardees to comply with the insurance
requirements stated herein shall constitute a material breach of this Agreement.
II. The following minimum coverage and limits are required:
a. Commercial General Liability: Coverage at least as broad as ISO form CG 00 01 or the
equivalent, including the following: Premises Operations; Products - Completed Operations;
Personal/Advertising Injury; Contractual Liability. Such policies must provide a limit of not less
than $1,000,000 per occurrence, and for those policies with an aggregate limit, not less than a
$2,000,000 aggregate. Stop Gap/Employers Liability coverage may be included under this
policy. The County, its officers, officials, employees, and agents are to be covered as additional
insureds for full coverage and policy limits as respects liability arising out of activities
performed by or on behalf of the Recipient in connection with this Agreement. (Form CG 2010
11/85 or its equivalent to include Ongoing Operations and Products-Completed Operations.) An
additional insured endorsement must be provided along with the certificate of insurance.
b. The Recipient is not required to maintain sexual misconduct liability coverage as 1:1 interaction
with youth is not allowed under this Agreement.
c. Workers Compensation: Recipient shall also maintain Workers' Compensation coverage in the
amount and type required by State law.
d. Stop Gap/Employers Liability: Coverage at least as broad as the protection provided by the
Workers' Compensation policy Part 2 or, in states with monopolistic state funds, the protection
provided by the "Stop Gap" endorsement to the General Liability Policy. Washington State is a
monopolistic state. Minimum limit: $ 1,000,000.
e. Automobile Liability: If a vehicle(s) will be used to perform work under this Agreement,
statutory minimum coverage and limits per accident for bodily injury and property damage.
III. Municipal or state agency provisions: If the Recipient is a Municipal Corporation or an agency of
the State of Washington or any other Public Agency, and is self-insured for any of the above
insurance requirements, a certification of self-insurance shall be attached and be incorporated by
reference and shall constitute compliance with this section.
IV. Deductibles and self-insured retentions: Any deductibles or self-insured retentions must be
declared to, and approved by, the County. The deductible and/or self-insured retention of the
policies shall not apply to the Recipient's liability to the County and shall be the sole responsibility
of the Recipient.
V. Other insurance provisions: The insurance policies required in this Agreement are to contain, or
be endorsed to contain, the following provisions:
a. Liability Policies (except Workers Compensation):
i. The Recipient's insurance coverage shall be primary insurance as respects the County, its
officers, officials, employees, and agents. Any insurance and/or self-insurance maintained by
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the County, its offices, officials, employees, or agents shall not contribute with the
Recipient's insurance or benefit the Recipient in any way.
ii. The Recipient's insurance shall apply separately to each insured against whom claim is made
and/or lawsuit is brought, except with respect to the limits of the insurer's liability.
b. All policies:
i. Coverage shall not be suspended, voided, canceled, reduced in coverage or in limits, except
by the reduction of the applicable aggregate limit by claims paid, until after forty-five (45)
days prior written notice has been given to the County.
ii. Each insurance policy shall be written on an "occurrence" form; except that insurance on a
"claims made" form may be acceptable with prior County approval. If coverage is approved
and purchased on a "claims made" basis, the Recipient warrants continuation of coverage,
either through policy renewals or the purchase of an extended discovery period, if such
extended coverage is available, for not less than three (3) years from the date of Agreement
termination and/or conversion from a "claims made" form to an "occurrence" coverage form.
VI. Acceptability of Insurers: Unless otherwise approved by the County, insurance is to be placed
with insures with a Bests' rating of no less that A: VIII, or, if not rated with Bests, with minimum
surpluses the equivalent of Bests' surplus size VIII. If, at any time, the foregoing policies shall fail
to meet the above minimum requirements, the Recipient shall, upon notice to that effect from the
County, promptly obtain a new policy, and shall submit evidence of the same to the County, with
appropriate certificates and endorsements, for approval.
VII. Verification of coverage: The Recipient shall furnish to the County certificates of insurance and
endorsements required by this contract. Such certificates and endorsements, and renewals thereof,
shall be attached as exhibits to the Agreement. The certificates and endorsements for each policy
are to be signed by a person authorized by that insurer to bind coverage on its behalf and are to be
on forms approved by the County prior to the commencement of activities associated with the
contract. The County reserves the right to require complete, certified copies of all required
insurance policies at any time.
VIII. All coverages and requirements: Nothing contained within these insurance requirements shall be
deemed to limit the scope, application and/or limits of the coverage afforded by said policies, which
coverage will apply to each insured to the full extent provided by the terms and conditions of the
policy(s). Nothing contained within this provision shall affect and/or alter the application of any
other provision contained within this Agreement.
IX. For this body of work, the contractor is not required to maintain sexual misconduct liability
insurance since 1:1 interaction with youth is not allowed under this agreement
5. Adult background check guidance (based on RCW 43.216.270): Any staff or volunteers that will work
directly/engage with youth 17 years and younger are required to successfully complete a background check
and keep it on file. Additionally, organizations/programs which use adult leaders (staff or volunteers) to
bring youth to activities/events are responsible for ensuring that those leaders have successfully completed
background checks on file.
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ALL FIELDS MUST BE COMPLETED FOR PROMPT PAYMENT PROCESSING
Purchase Order #
Supplier Name City of Kent
Contract Number: 8674 CDIP Supplier # 1585
Exhibit: B Supplier Pay Site Police Dept
Remit to Address 220 4th Ave S
Kent, WA 98032
Kent Police Department Invoice Date
220 4th Ave S Invoice #
Kent, WA 98032 Amount to be Paid
Note to AP
Payment Type
Print on Remittance
PH Program name & phone
Youth Marijuana Prevention Education Program
Start End
Date Date
MM/DD/YY
Project DPH Acct CPA
1123493
Deliverables
Signed Date PH Program Manager Approval Date
Print Name
King County Accounts Payable Information
Check
‐$
$0.00
Mike vu 263‐2128
117216
Cumulative
CFDA
Attach sheet for multiple POETAs
Task Award Amount
I, the undersigned, do hereby certify under the laws of the State of Washington penalty of perjury, that this is a true and correct claim for reimbursement services rendered. I understand that any
false claims, statements, documents, or concealment of material fact may be prosecuted under applicable Federal and State laws. This certification includes any attachments which serve as
supporting documentation to this reimbursement request.
Grand Total ‐$ 7,359.00$ 7,359.00$ ‐$
Amount Due
Balance
‐$
Expend Acct
7,359.00$
‐$
7,359.00$ ‐$
CurrentPreviously Billed
‐$
001
INVOICE
Contract Period of Performance: 4/1/22 ‐ 6/30/22
Sarah Ross‐viles
Public Health ‐ Seattle & King County
Submit signed hardcopy invoice to:
401 5th Ave., Suite 1110
Seattle, WA 98104
Invoice for services rendered under this
contract for the period of:
Direct Costs Budget
53180
Organization
800107
DocuSign Envelope ID: ADEE77BE-A67B-4613-B902-690E22CF8582