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CAG2023-582 - Original - St. Vincent de Paul - SLFRF: Centro Rendu Re-Route - 11/01/2023
FOR CITY OF KENT OFFICIAL USE ONLY Sup/Mgr: Agreement Routing Form Dir Asst: _e/- •4#4 For Approvals,Signatures and Records Management Dir/Dep: KENT This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms. J W A S H I N G T O N (Print on pink or cherry colored paper) (optional) Originator: Department: KateLynn Jennings for Lori Guilfoyle Parks, Recreation &Community Services Date Sent: Date Required: > 11/7/2023 11/14/2023 0 Q Authorized to Sign: Date of Council Approval: QDirector or Designee Mayor N/A Budqet Account Number: Grant?V]Yes E]No B30021.64190.4798 Budget?V1 Yes 171No Type: Federal Vend Category: St.Vincent de Paul Contract Vendor Numb e Sub-Category: 966408 Original 0 Centro Rendu Re-Route- SLFRF Project Name: E 0 Centro Rendu's Re-Route program works with youth ages 11-17 in a multi-faceted response to prevent truancy, Project Details:substance abuse,and involvement of Latino youth in high-risk behaviors,including gang involvement and other a+ unhealthy behaviors. C �1 Agreement Amount: $74,500 Basis for Selection of Contractor: Other *Memo to Mayor must be attached i Start Date:l 11/1/2023 Termination Date: 6/30/2025 Q Local Business?r7es17No* If meets requirements per KCC3.70.100,pleosecomplete"VendorPurchase-Locol Exceptions"form onCityspace. Business License Verification:171 Yes Dn-Process Exempt(KCC 5.01.045) Notice required prior to disclosure? Contract Numb E]YesONo CAG2023-582 Comments: p1 C 3 �1 N '> G1 Date Received by City Attorney: 11/15/2 01 Date Routed to the Mayor's Office: 11/171 ;Z Date Routed to the City Clerk's Office: 11/20/23 ,A223731_20 Visit Documents.KentWA.gov to obtain copies of all agreements rev.200821 City of Kent - SURF - Grant Recipient Agreement Grantee Society of Saint Vincent De Paul Council of Seattle-King County Program Title Centro Rendu Re-Route Grant Amount$ $74,500 Agreement Period From: November 1,2023 To June 30,2025 SAM Identifying number: KMHXZZTRIMQ9 This Agreement is made by and between the City of Kent, a municipal corporation ("the City") and Grantee, a Washington Non-Profit Corporation, located at 5950-4th Avenue South, Seattle, Washington 98108, to set forth the terms and conditions under which the City will provide a grant to Grantee under the Program to be used for costs incurred during the Agreement Period. Such grant is provided to Grantee as a beneficiary of the City's Coronavirus State and Local Fiscal Recovery Funds. 1. Scope of Eligible Expenditures.Grant funds may only be used to pay or reimburse eligible expenditures as described in the"Federal Terms" (Exhibit 1),and as detailed in the"Scope of Work"(Exhibit 2). No grant funds may be used to pay or reimburse costs for which Grantee has received any other funding,whether state,federal or private in nature,for that same cost. 2. Grantee Responsibilities.Grantee understands and agrees that funds provided under this Agreement may only be used in compliance with section 603(c)of the Social Security Act("the Act"),as added by section 9901 of the American Rescue Plan Act("ARPA"),the U.S. Department of Treasury's("Treasury's")regulations implementing that section,guidance issued by Treasury regarding the foregoing,and any other applicable federal provisions, including those described in the"Federal Terms" (Exhibit 1). 3. Grantee Certifications. Prior to any disbursement of funds authorized by this Agreement, Grantee shall provide the City with: Cost Certification (Exhibit 3), Civil Rights Certification Form (Exhibit 4), the Lobbying Certification Form (Exhibit 5), if applicable, the Lobbying Disclosure Form (Exhibit 6), the City EEO Compliance Documents (Exhibit 7),and proof of meeting the Insurance Requirements (Exhibit 8). 4. Request for Payment. Grantee shall submit a quarterly invoice and Cost Certification (Exhibit 3) for the expenses therein no later than fifteen (15) working days after the close of each calendar quarter throughout the term of the Agreement. S. Maintenance of and Access to Records.Grantee shall maintain all records and accounts with respect to all matters covered by this Agreement, including personnel, property, financial, and programmatic records and documents sufficient to evidence compliance with section 603(c) of the Act, Treasury's regulations implementing that section,and guidance issued by Treasury regarding the foregoing.These records shall be maintained for a period of six (6) years after all funds have been expended or returned to the City, whichever is later, to ensure proper accounting for all funds and compliance with the Agreement.The City,the Treasury Office of Inspector General,and the Government Accountability Office,or their authorized representatives,shall have the right of access to records (electronic and otherwise)of Grantee in order to conduct audits or other investigations.Grantee acknowledges that records may be subject to disclosure under the Public Records Act, Ch.42.56 RCW. 6. Publications. Any publications produced with funds from this Agreement must display the following language:"This project[is being][was]supported,in whole or in part,by federal award number SLFRP3352 awarded to the City of Kent,Washington by the U.S. Department of the Treasury." 7. Disclaimer by the City and United States. The United States has expressly disclaimed any and all responsibility or liability to the City or third persons for the actions of the City or third persons resulting in death, bodily injury,property damages,or any other losses resulting in any way from the performance of this award or any other losses resulting in any way from the performance of the award of Federal funds to the City under section Grant Beneficiary Agreement Page 1 of 3 603(c) of the Act, or any contract or subcontract under such award. The City expressly disclaims any and all responsibility or liability to Grantee or third persons for the actions of Grantee or third persons resulting in death, bodily injury, property damages, or any other losses resulting in any way from the performance of this Agreement or any other losses resulting in any way from the performance of the Agreement, or any subcontract thereto. This Agreement does not in any way establish an agency relationship between or among the United States, the City, and/or Grantee. 8. False Statements. Grantee understands that making false statements or claims in connection with this Agreement may be a violation of federal law and may result in criminal, civil, or administrative sanctions, including fines, imprisonment, civil damages and penalties, debarment from participating in federal or City awards or contracts,and/or any other remedy available by law. 9. 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 City. Grantee, by signature to this Agreement, certifies that Grantee is not currently debarred, suspended, or proposed for debarment, by any Federal department or agency. Grantee also agrees that it will not enter into a subcontract with a person or entity that is debarred,suspended,or proposed for debarment. Grantee will notify the City if it, or a subcontractor, is debarred, suspended, or proposed for debarment, by any Federal department or agency. Debarment status may be verified at https://www.sam.gov/. 10. Termination. Upon thirty (30) days-notice, the City may terminate this agreement for convenience. Any unspent grant proceeds shall be immediately returned to the City. 11. Repayment of Funds; Recoupment. If Grantee has unspent grant proceeds on hand as of June 30, 2025, Grantee shall return all unspent grant proceeds to the City within ten (10) calendar days. If any funds provided to Grantee were used in a manner that is not consistent or allowable as outlined in this Agreement or in the Federal Terms, Grantee shall return funds to City in the amount determined to be ineligible. Grantee further agrees that it is financially responsible for and will repay the City any and all indicated amounts following an audit exception which occurs due to Grantee's failure,for any reason,to comply with the terms of this Agreement.This duty to repay the City shall not be diminished or extinguished by the termination of the Agreement. 12. Conflict of Interest. Grantee designees,agents, members, officers, employees, consultants, and any other public official who exercises or who has exercised any functions or responsibilities with respect to the Program during his or her tenure,or who is in a position to participate in a decision-making process or gain inside information with regard to the Program,are barred from any interest,direct or indirect,in any grant or proceeds of the Program, or benefit there from,which is part of this Agreement at any time during or after such person's tenure. 13. Governing Laws. This Agreement shall be governed by and construed in accordance with the laws of the State of Washington.The venue for any action hereunder shall be in the Superior Court for King County,Washington, or the U.S. District Court for the Western District of Washington. 14. Indemnification.To the maximum extent permitted by law,Grantee shall,at its cost and expense, protect, defend, indemnify, and hold harmless the City, its directors, officers, employees, and agents,from and against any and all demands, liabilities, causes of action, costs and expenses (including attorneys' fees), claims,judgments, or awards of damages,arising out of or in any way resulting from the acts or omissions of Grantee,its directors,officers, employees, or agents, relating in any way to Grantee's performance or non-performance under the Agreement. Grantee agrees that its obligations underthis paragraph extend to any demands,liabilities,causes of action,or claims brought by,or on behalf of,any of its employees or agents. For this purpose,Grantee,by mutual negotiation,hereby waives, as respects the City only, any immunity that would otherwise be available against such claims under any industrial insurance act, including Title 51 RCW, other Worker's Compensation act, disability benefit act, or other employee benefit act of any jurisdiction which would otherwise be applicable in the case of such claim. These indemnification obligations shall survive the termination of the Agreement. Grant Beneficiary Agreement Page 2of3 15. Insurance. The Recipient shall procure and maintain for the duration of this Agreement, insurance of the types and in the amounts described in Exhibit 8 attached and incorporated by this reference. 16. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any number of counterparts,each of which shall constitute an original,and all of which will together constitute this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page to the other by fax or email and that signature shall have the same force and effect as if the Agreement bearing the original signature was received in person. CITY OF KENT GRANTEE Name: Dana Ralph Name: Mirya Roacy Title: Mayor Title: Executive Director Signature: LJ Signature: 'R „per, Date: 11/17/2023 Date: 11/14/2023 Exhibits 1—Federal Terms 2—Scope of Work 3—Cost Certification 4—Civil Rights Certification Form 5—Lobbying Certification Form 6—Lobbying Disclosure Form (if applicable) 7—City EEOC Compliance Documents 8—Insurance Requirements Grant Beneficiary Agreement Page 3 of 3 Grant Recipient Agreement— Exhibit 1 FEDERAL TERMS In case of conflict between these Federal Terms and the Agreement, the following order of priority shall be utilized: (1) Federal Terms, and (2) Agreement. 1. Grantee understands and agrees that funds provided under this Agreement may come from a federal source and agrees to comply with any and all additional applicable terms. A. Grantee Capacity. Grantee agrees and confirms that it has the institutional, managerial and financial capacity to ensure proper planning, management and completion of the work detailed in the Scope of Work (Exhibit 2). B. Technical Assistance. If, at any time, Grantee believes its capacity is compromised or Grantee otherwise needs any sort of assistance, it shall immediately notify the City. The City will make best efforts to provide timely technical assistance to Grantee to bring Grantee into compliance. C. Compliance with Act. Grantee understands and agrees that funds provided under the Agreement may only be used in compliance with section 603(c) of the Social Security Act (the "Act"), as added by section 9901 of the American Rescue Plan Act ("ARPA"), the U.S. Department of Treasury's ("Treasury's") regulations implementing that section, and guidance issued by Treasury regarding the foregoing. D. Definitions. The term "Grantee" shall refer to an individual or entity who receives funds from the City, but shall not include a "Subrecipient," as defined in 2 C.F.R. 200.1 and as determined in the City's sole discretion. 2. Agreement Requirements and Incorporated Exhibits. Grantee shall meet the requirements included in the Agreement and in the following attached exhibits, each of which is incorporated into the Agreement by reference: EXHIBIT NAME NUMBER Federal Terms Exhibit 1 Scope of Work Exhibit 2 Cost Certification Exhibit 3 Civil Rights Certification Form Exhibit 4 Lobbying Certification Form Exhibit 5 Lobbying Disclosure Form (if activity occurs) Exhibit 6 City EEO Compliance Documents Exhibit 7 A. Scope of Eligible Expenditures. Grant funds may only be used to pay or reimburse eligible expenditures as described in the Agreement, these Federal Terms (Exhibit 1), and Scope of Work (Exhibit 2). No grant funds may be used to pay or reimburse costs cannot be used for expenditures for which Grantee has received any other funding, whether state, federal or private in nature, for that same expense. B. Grantee Certifications. Prior to any disbursement of funds authorized by this Agreement, Grantee shall provide the City with: Cost Certification (Exhibit 3), Civil Rights Certification Form (Exhibit 4), the Lobbying Certification Form (Exhibit 5), and, if activity occurs, the Lobbying Disclosure Form (Exhibit 6). C. Reports. Grantee shall provide the City with additional information and documentation upon request, including completing any reports deemed necessary for the City to comply with documentation, reporting, or audit requirements. 3. Access to Records. The Treasury Office of Inspector General and the Government Accountability Office, or their authorized representatives, shall have the right of access to records (electronic and otherwise) of Grantee in order to conduct audits or other investigations. 4. Uniform Guidance Compliance. A. Remedial Actions. In the event of Grantee's noncompliance with section 603(c) of the Act, Treasury's regulations implementing that section, guidance issued by Treasury regarding the foregoing, or any other applicable federal laws or regulations, Treasury may take available remedial actions as set forth in 2 C.F.R. 200.339. B. Recoupment. 1. Grantee agrees that it is financially responsible for and will repay the City any and all indicated amounts following an audit exception which occurs due to Grantee's failure, for any reason, to comply with the terms of the Agreement. This duty to repay the City shall not be diminished or extinguished by the termination of the Agreement. 2. In the event of a violation of section 603(c) of the Act, the funds shall be subject to recoupment by the City. 3. Any funds paid to Grantee (1) in excess of the amount to which Grantee is authorized to retain under the terms of the Agreement; (2) that are determined by the Treasury Office of Inspector General to have been misused; (3) are determined by Treasury to be subject to a repayment obligation pursuant to section 603(e) of the Act; or (4) are otherwise subject to recoupment by the City, and have not been repaid by Grantee to the City shall constitute a debt to the City. 4. Any debts determined to be owed the City must be paid promptly by Grantee. A debt is delinquent if it has not been paid by the date specified in the City's initial written demand for payment, unless other satisfactory arrangements have been made or if the City knowingly or improperly retains funds that are a debt. The City will take any actions available to it to collect such a debt. C. Return of Unused Funds. If Grantee has any unspent funds on hand as of the earlier of June 30, 2025, or the termination of this Agreement, Grantee shall return all unspent funds to the City within ten (10) calendar days. 5. Disclaimer. A. The United States expressly disclaims any and all responsibility or liability to Grantee or third persons for the actions of Grantee or third persons resulting in death, bodily injury, property damages, or any other losses resulting in any way from the performance of this award or any other losses resulting in any way from the performance of this grant or any contract, or subcontract under this grant. B. The acceptance of this grant by Grantee does not in any way establish an agency relationship between the United States and Grantee. 6. Protection for Whistleblowers. A. In accordance with 41 U.S.C. § 4712, Grantee may not discharge, demote, or otherwise discriminate against an employee in reprisal for disclosing to any of the list of persons or entities provided below, information that the employee reasonably believes is evidence of gross mismanagement of a federal contract or grant, a gross waste of federal funds, an abuse of authority relating to a federal contract or grant, a substantial and specific danger to public health or safety, or a violation of law, rule, or regulation related to a federal contract (including the competition for or negotiation of a contract) or grant. B. The list of persons and entities referenced in the paragraph above includes the following: 1. A member of Congress or a representative of a committee of Congress; 2. An Inspector General; 3. The Government Accountability Office; 4. A Treasury employee responsible for contract or grant oversight or management; 5. An authorized official of the Department of Justice or other law enforcement agency; 6. A court or grand jury; or 7. A management official or other employee of Grantee, contractor, or subcontractor who has the responsibility to investigate, discover, or address misconduct. C. Grantee shall inform its employees in writing of the rights and remedies provided under this section, in the predominant native language of the workforce. 7. Increasing Seat Belt Use in the United States. Pursuant to Executive Order 13043, 62 FR 19217 (Apr. 18, 1997), Grantee is encouraged to adopt and enforce on-the-job seat belt policies and programs for its their employees when operating company-owned, rented or personally owned vehicles. 8. Reducing Text Messaging While Driving. Pursuant to Executive Order 13513, 74 FR 51225 (October 6, 2009), Grantee is encouraged to adopt and enforce policies that ban text messaging while driving, and to establish workplace safety policies to decrease accidents caused by distracted drivers 9. False Statements. Grantee understands that making false statements or claims in connection with this Agreement may be a violation of federal law and may result in criminal, civil, or administrative sanctions, including fines, imprisonment, civil damages and penalties, debarment from participating in federal or City awards or contracts, and/or any other remedy available by law. 10. Applicable Laws. A. The Agreement shall be governed by and construed in accordance with the laws of the State of Washington. B. Grantee agrees to comply with the requirements of section 603 of the Act, the Treasury's regulations implementing that section, and guidance issued by Treasury regarding the foregoing. Grantee also agrees to comply with all other applicable federal laws, regulations, and executive orders, and Grantee shall provide for such compliance by other parties in any agreements it enters into with other parties relating to this Agreement. C. Federal regulations applicable to this grant may include, without limitation, the following: 1. Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, 2 C.F.R. Part 200, including the following: a. Subpart A, Acronyms and Definitions; b. Subpart B, General Provisions; C. Subpart C, Pre-Federal Award Requirements and Contents of Federal Awards; d. Subpart D, Post-Federal Award Requirements; e. Subpart E, Cost Principles; and f. Subpart F, Audit Requirements. 2. Universal Identifier and System for Award Management (SAM), 2 C.F.R. Part 25, pursuant to which the award term set forth in Appendix A to 2 C.F.R. Part 25 is hereby incorporated by reference. 3. Reporting Subaward and Executive Compensation Information, 2 C.F.R. Part 170, pursuant to which the award term set forth in Appendix A to 2 C.F.R. Part 170 is hereby incorporated by reference. 4. OMB Guidelines to Agencies on Governmentwide Debarment and Suspension (Nonprocurement), 2 C.F.R. Part 180, including the requirement to include a term or condition in all lower tier covered transactions (contracts and subcontracts described in 2 C.F.R. Part 180, subpart B) that the award is subject to 2 C.F.R. Part 180 and Treasury's implementing regulation at 31 C.F.R. Part 19. 5. Grantee Integrity and Performance Matters, pursuant to which the award term set forth in 2 C.F.R. Part 200, Appendix XII to Part 200 is hereby incorporated by reference. 6. Governmentwide Requirements for Drug-Free Workplace, 31 C.F.R. Part 20. 7. New Restrictions on Lobbying, 31 C.F.R. Part 21. 8. Uniform Relocation Assistance and Real Property Acquisitions Act of 1970 (42 U.S.C. §§ 4601-4655) and implementing regulations. 9. Generally applicable federal environmental laws and regulations. C. Statutes and regulations prohibiting discrimination applicable to this award include, without limitation, the following: 1. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d et seq.) and Treasury's Implementing regulations at 31 C.F.R. Part 22, which prohibit discrimination on the basis of race, color, or national origin under programs or activities receiving federal financial assistance; 2. The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§ 3601 et seq.), which prohibits discrimination in housing on the basis of race, color, religion, national origin, sex, familial status, or disability; 3. Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794), which prohibits discrimination on the basis of disability under any program or activity receiving federal financial assistance; 4. The Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101 et seq.), and Treasury's implementing regulations at 31 C.F.R. Part 23, which prohibit discrimination on the basis of age in programs or activities receiving federal financial assistance; and 5. Title II of the Americans with Disabilities Act of 1990, as amended (42 U.S.C. §§ 12101 et seq.), which prohibits discrimination on the basis of disability under programs, activities, and services provided or made available by state and local governments or instrumentalities or agencies thereto. D. Hatch Act. Grantee agrees to comply, as applicable, with requirements of the Hatch Act (5 U.S.C.§§ 1501-1508 and 7324-7328), which limits certain political activities of federal employees, as well as certain other employees who work in connection with federally funded programs. E. Grantee agrees to comply with the Prohibition on Providing Funds to the Enemy (2 C.F.R. 183). Exhibit 2 KENT 2023-2025 11.5 N N G r 0 N PARKS, RECREATION S COMMUNITY SERVICES Scope and Schedule of Work Agency: Society of Saint Vincent De Paul Council of Seattle/King County Program: Centro Rendu Re Route Contact: Rian Ries (they/them) Quality Assurance Manager St. Vincent de Paul of Seattle-King County 5950 41h Ave S, Seattle, WA 98108 206-686-5287 E: rianr(@svdoseattle.org Program Description: Centro Rendu is a program of St Vincent De Paul with a location within a qualified census tract and providing a wide range of programs to residents that were disproportionally impacted by the pandemic. Centro Rendu faced significant challenges due to the pandemic's increased demand for services and changing operational needs, as well as declines in revenue sources such as grants and donations. Through this Scope of Work, Centro Rendu is addressing the unique needs of the local communities to build a strong, resilient, and equitable recovery for residents and for the organization. Centro Rendu's Re-Route program works with youth ages 11-17 in a multi-faceted response to prevent truancy, substance abuse, and involvement of Latino youth in high-risk behaviors, including gang involvement and other unhealthy behaviors. A cohort structure working with 25 youth (and their families) in weekly sessions for 6-months and weekly home visits and family case management services create a smoother transition beyond the 6-month period. The project is staffed by 2 FTE Youth Case Managers and 2 FTE Youth Navigators/Mentors. The Youth Navigators/Mentors conduct outreach to Latino youth in Kent to build awareness and recruit youth to the project and help with academic supports. Each participating youth and their family complete a comprehensive intake with a Centro Rendu Case Manager, which identifies family composition, strengths and supports, conflicts, housing situation, education, employment, physical and mental health, criminal history, substance use and legal status. Youth may be referred by the Kent School District, parents/caregivers, peers, or other community partners. This process is central to the strategy and goals of Re- Route by creating a non-threatening space for our Latino staff and peer support to build protective factors and encourage and reinforce positive behavioral changes. Consultant shall provide the approximate number of City of Kent clients with the following services during the Agreement: Unduplicated Kent Clients Contracted to Serve (specify individuals or 40 youth households) Service Unit Descriptions and Deliverables Units Contracted to Serve Service Unit 1: Workshops— 48 sessions Youth social development and positive identity workshops Service Unit 2: Intake 40 Contract Administration - The Consultant shall notify the City, in writing, within ten (10) days of any changes in agency leadership or program personnel. - The Consultant shall provide the City with a current list of its board of directors, general or limited partners, as applicable. - The Consultant shall maintain a City of Kent Business License. - In addition to reimbursement request and reporting, staff may perform desktop and at least 2 onsite monitoring visits to ensure contract compliance. Any onsite monitoring will be scheduled with adequate time to prepare for the visit. The Contractor can request a copy of the monitoring form at any time by contacting City of Kent staff. - All records related to the Agreement must be retained for six (6) years plus the current year. Performance Measures The City uses a variety of measures as indicators of satisfactory contract performance. The Consultant will be expected to meet 100% of the performance measures as set forth in the Scope of Work. If the Consultant fails to fulfill the performance measures, payment for services rendered under this Agreement will be reduced by the rate calculated for each service unit. Exceptions may be made if circumstances beyond the Consultant's control impact its ability to fulfill the required units of service and if the Consultant has shown reasonable effort to overcome those circumstances. Exceptions are made at the sole discretion of the City's Human Services Manager. Reporting Requirements and Timeline All data and required forms shall be submitted electronically. Please use Attachment A for reporting. Service Unit and Narrative Report - Data from this form will be used to track each program's progress toward meeting the goals stipulated in the Scope of Work. The narrative should include updates regarding outreach and partnership building, any successes and challenges the program is experiencing, or any significant changes to the program model or budget. It shall be submitted quarterly, no later than the 15th of the month following the end of the quarter (i.e. April 15, July 15, Oct 15, Jan 30), along with the Reimbursement Request. Reimbursement Request - This form will be filled out electronically and serve as the invoicing mechanism for payment to your agency/program. It shall be submitted quarterly, no later than the 15th of the month following the end of the quarter (i.e. April 15, July 15, Oct 15, Jan 10), unless otherwise specified. Demographic Data Report - The agency shall collect and retain the data requested on the Demographics form from the persons served through this contract. Data should be tracked in an ongoing manner and submitted at the end of contract. Report Due Date Service Unit Report and Reimbursement 15' day following each quarter Request Final Reimbursement Request July 30, 2025 Demographic Data Report July 30, 2025 DEMOGRAPHIC INFORMATION - The following information should be collected and reported annually. Number of Households or Persons Assisted (please specify "H" or "P"): Race Unduplicated Unduplicated Year to Date Year to Date All (Hispanic) White Black/African American Asian American Indian or Alaska Native Native Hawaiian or Other Pacific Islander American Indian or Alaska Native AND White Asian AND White Black/African American AND White American Indian /Alaska Native AND Black/African American Other Multi-Racial GRAND TOTAL CLIENTS Income Level Unduplicated Year to Date Extremely Low Income 0-30% of MFI Low Income 31-50% of MFI Moderate Income 51-80% of MFI Above Moderate Income 81% + of MFI GRAND TOTAL CLIENTS Homeless * Complete only for individuals & families Unduplicated Quarter Unduplicated who have been assisted with transitional and Year to Date permanent housing 1 2 3 4 Individuals Families Total Homeless 40 Attachment A ARPA KEN• T WASH IN G T O N PARKS, RECREATION & Request for Payment & Service Report COMMUNITY SERVICES From: To: Lori Guilfoyle Agency: Email: LGuilfoyle@kentwa.gov Address: Phone: (253) 856-5061 Email: Phone: Program Reporting Period Program name Re-Route Costs incurred from to Reimbursement Request Award Request This Quarter Total Requested to Date Balance Remaining Amount 74,500.00 74,500.00 PERFORMANCE MEASURES —KENT FUNDED SERVICE UNITS Contracted to Clients Served in Service Unit Description Serve Reporting Period Life to Date Total Unduplicated # of Kent 40 youth clients (persons) Workshops-Youth social development and positive identity workshops 48 sessions Intake 40 Sec. 5: NARRATIVE Provide a narrative explanation if you are behind in either progress toward meeting performance measures or projected expenditure rate. Include information about any program or staff changes and how the funds were utilized. Page 1 of 2 By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812). Agency Authorized Signature Date Print Name Payment Authorization this section to be completed by City of Kent only) Contractual Obligations Met? YES NO Circle one Enter notes if Agency underperformed: Authorized Date:By: Page 2 of 2 Grant Recipient Agreement— Exhibit 3 COST CERTIFICATION I certify that: 1. 1 have authority and approval from the governing body on behalf of Society of Saint Vincent de Paul of Seattle-King County("Grantee")to accept proceeds from the City of Kent(the "City") per the Agreement by and between the City and Grantee from the City's allocation of the Coronavirus State Local Fiscal Recovery Fund ("CLFR") as created by the American Rescue Plan Act of 2021, Section 9901 ("ARPA") for eligible expenditures included on the corresponding invoice voucher for report period November 01, 2023 through June 30, 2025. 2. 1 understand that as additional federal guidance becomes available, an amendment to the Contract between the City and Grantee may become necessary and agree to execute necessary amendments. 3. 1 understand the City will rely on this certification as a material representation in processing reimbursements or payment requests. 4. 1 understand the Grantee receiving funds pursuant to this certification shall retain documentation of all uses of the funds, including but not limited to invoices and/or sales receipts in a manner consistent with §200.333 Retention requirements for records of 2 CFR 200 Uniform Administrative Requirements,Cost Principles, and Audit Requirements for Federal Awards(Uniform Guidance). Such documentation shall be produced to the City upon request and may be subject to audit by the State Auditor. 5. 1 understand any funds provided pursuant to this certification cannot be used for expenditures for which Grantee has received any other funding whether state, federal or private in nature,for that same expense. I hereby certify that I have read the above certification, and that the information and my statements provided herein by me are true and correct to the best of my knowledge, and by my signature on this document, acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any of the information in this document could subject me to punishment under federal and/or civil liability and/or in criminal penalties,including but not limited to fine or imprisonment or both under Title 18, United States Code, Sec. 1001, et seq. and punishment under federal law. Mirya Roach _ . Printed Name Signature Executive Director 11/14/2023 Title Date Grant Recipient Agreement— Exhibit 4 CIVIL RIGHTS CERTIFICATION FORM The funds provided to the grantee named below (hereinafter referred to as the "Grantee") are available under section 603 of the Social Security Act, as added by section 9901 of the American Rescue Plan Act. Grantee understands and acknowledges that: As a condition of receipt of federal financial assistance from the Department of the Treasury, with monies distributed through the City of Kent, Grantee provides the assurances stated herein.The federal financial assistance may include federal grants, loans and contracts to provide assistance to Grantee,the use or rent of Federal land or property at below market value, Federal training, a loan of Federal personnel, subsidies, and other arrangements with the intention of providing assistance. Federal financial assistance does not encompass contracts of guarantee or insurance, regulated programs, licenses, procurement contracts by the Federal government at market value, or programs that provide direct benefits. The Civil Rights Restoration Act of 1987 provides that the provisions of the assurances apply to all of the operations of Grantee's program(s) and activity(ies), so long as any portion of Grantee's program(s) or activity(ies) is federally assisted in the manner prescribed above Grantee certifies the following: 1. Grantee ensures its current and future compliance with Title VI of the Civil Rights Act of 1964, as amended,which prohibits exclusion from participation, denial of the benefits of, or subjection to discrimination under programs and activities receiving federal financial assistance, of any person in the United States on the ground of race, color, or national origin (42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury Title VI regulations at 31 CFR Part 22 and other pertinent executive orders such as Executive Order 13166, directives, circulars, policies, memoranda, and/or guidance documents. 2. Grantee acknowledges that Executive Order 13166, "Improving Access to Services for Persons with Limited English Proficiency," seeks to improve access to federally assisted programs and activities for individuals who, because of national origin, have Limited English proficiency(LEP). Grantee understands that denying a person access to its programs,services, and activities because of LEP is a form of national origin discrimination prohibited under Title VI of the Civil Rights Act of 1964 and the Department of the Treasury's implementing regulations. Accordingly, Grantee shall initiate reasonable steps, or comply with the Department of the Treasury's directives,to ensure that LEP persons have meaningful access to its programs, services, and activities. Grantee understands and agrees that meaningful access may entail providing language assistance services, including oral interpretation and written translation where necessary, to ensure effective communication in Grantee's programs, services, and activities. 3. Grantee agrees to consider the need for language services for LEP persons when Grantee develops applicable budgets and conducts programs,services, and activities. As a resource, the Department of the Treasury has published its LEP guidance at 70 FIR 6067. For more information on taking reasonable steps to provide meaningful access for LEP persons, please visit http://www.lep.gov. 4. Grantee acknowledges and agrees that compliance with the assurances constitutes a condition of continued receipt of federal financial assistance and is binding upon Grantee and its successors,transferees, and assignees for the period in which such assistance is provided. 5. Grantee shall comply with Title VI of the Civil Rights Act of 1964,which prohibits Grantees of federal financial assistance from excluding from a program or activity, denying benefits of, or otherwise discriminating against a person on the basis of race,color, or national origin (42 U.S.C. § 2000d et seq.), as implemented by the Department of the Treasury's Title VI regulations, 31 CFR Part 22,which are herein incorporated by reference and made a part of this contract (or agreement).Title VI also includes protection to persons with "Limited English Proficiency" in any program or activity receiving federal financial assistance, 42 U.S.C. § 2000d et seq., as implemented by the Department of the Treasury's Title VI regulations, 31 CFR Part 22, and herein incorporated by reference and made a part of this contract or agreement. 6. Grantee understands and agrees that if any real property or structure is provided or improved with the aid of federal financial assistance by the Department of the Treasury,this assurance obligates Grantee,or in the case of a subsequent transfer,the transferee,for the period during which the real property or structure is used for a purpose for which the federal financial assistance is extended or for another purpose involving the provision of similar services or benefits. If any personal property is provided,this assurance obligates the Contractor for the period during which it retains ownership or possession of the property. 7. Grantee shall cooperate in any enforcement or compliance review activities by the Department of the Treasury of the aforementioned obligations. Enforcement may include investigation, arbitration, mediation, litigation, and monitoring of any settlement agreements that may result from these actions. Grantee shall comply with information requests, on-site compliance reviews and reporting requirements. 8. Grantee shall maintain a complaint log and inform the Department of the Treasury of any complaints of discrimination on the grounds of race, color, or national origin, and limited English proficiency covered by Title VI of the Civil Rights Act of 1964 and implementing regulations and provide, upon request, a list of all such reviews or proceedings based on the complaint, pending or completed, including outcome.Grantee also must inform the Department of the Treasury if Contractor has received no complaints under Title VI. 9. Grantee must provide documentation of an administrative agency's or court's findings of non- compliance of Title VI and efforts to address the non-compliance, including any voluntary compliance or other agreements between the Contractor and the administrative agency that made the finding. If Grantee settles a case or matter alleging such discrimination, Grantee must provide documentation of the settlement. If Grantee has not been the subject of any court or administrative agency finding of discrimination, please so state. 10. The United States of America has the right to seek judicial enforcement of the terms of this assurances document and nothing in this document alters or limits the federal enforcement measures that the United States may take in order to address violations of this document or applicable federal law. I hereby certify that I have read and understood the obligations described above,that Grantee is in compliance with the above-described nondiscrimination requirements, and by my signature on this document, acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any information submitted in conjunction with this document could subject me to punishment under federal,civil liability and/or in criminal penalties, including but not limited to fine or imprisonment or both under Title 18, United States Code, Sec. 1001, et seq. and punishment under federal law. Mirya Roach _ iN�na a�a ia n Printed Name Signature Executive Director 11/14/2023 Title Date Grant Recipient Agreement— Exhibit 5 LOBBYING CERTIFICATION FORM The undersigned certifies, to the best of the undersigned's knowledge and belief,that: (1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of an 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, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions, as attached. (3)The undersigned shall require that the language of this 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. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. I hereby certify that I have read the above certification, and that the information and my statements provided herein by me are true and correct to the best of my knowledge, and by my signature on this document, acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any of the information in this document could subject me to punishment under federal and/or civil liability and/or in criminal penalties,including but not limited to fine or imprisonment or both under Title 18, United States Code,Sec. 1001, et seq. and punishment under federal law. Mirya Roach Printed Name Signature Executive Director 11/14/2023 Title Date Exhibit 6 Pt. 21, App. B 31 CFR Subtitle A (7-1-06 Edition) APPENDIX B TO PART 21—DISCLOSURE FORM TO REPORT LOBBYING DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB 0348-0046 Complete this form to disclose lobbying activities pursuant to 31 U.S.C.1352 (See reverse for public burden disclosure.) 1. Type of Federal Action: 2. Status of Federal Action: 3. Report Type: a. contract a. bid/offer/application a. initial filing b.grant El b.initial award b.material change c. cooperative agreement d.loan c. post-award For Material Change Only: e.loan guarantee year quarter I. loan insurance date of last report 4. Name and Address of Reporting Entity: 5. If Reporting Entity in No.4 is Subawardee,Enter Name ❑ Prime ❑ Subawardee and Address of Prime: Tier ,if known: Congressional District,if known: Congressional District,if known: 6. Federal Department/Agency: 7. Federal Program Name/Description: CFDA Number,if applicable: 8. Federal Action Number,if known: 9. Award Amount,if known: $ 10. a. Name and Address of Lobbying Entity b.Individuals Performing Services(including address if fif individual,last name,first name,MII: -different from No.l0a) (last name,first name,MB: attach Connnvalion Sheets SF-LLL-A if necessa. 11. Amount of Payment(check all that apply): 13. Type of Payment(check all that apply): $ ❑actual ❑planned ❑ a. retainer ❑ b.one-time fee 12. Form of Payment(check all that apply): ❑ c. commission ❑ a.cash ❑ d.contingent fee ❑ b.in-kind;specify: nature ❑ e.deferred p value ❑ f. other;specify: P N 14. Brief Description of Services Performed or to be Performed and Date(s)of Service,including officer(s),employee(s), or Member(s)contacted,for Payment Indicated in Item 11: attach Continuation Sheets SF-ILL- if necess 15. Continuation Sheet(s)SF-LLL-A attached: ❑Yes ❑No 16. lnb, Ma reque thm%h thn fours is authonzM by title 31 U.S.C. wn 13sx.Thia di:<baare d lobbymn,<ti. is a maredd representnan Signature: d fact upon whkh reliance was placed by the tier above when this sa was made or ant into.rem dN 10 b,equirM pursuant to Print Name: 31 U.S.C.135I.This i4-1m will be mport to the Congms semi- annudly and win be available 1 r publk inspec+ion.My person who fins m Title: fik the repuired dmcb shall be subi—to a civil penalty d not kss than s+o.aao area�t more man loW.000 fur each,t,th W.— Telephone No.: Date: . Authorized for L—I Reproduction Standard Fwm-LLL 262 Office of the Secretary of the Treasury Pt. 21, App. B INSTRUCTIONS FOR COMPLETION OF SF-LLL,DISCLOSURE OF LOBBYING ACTIVITIES This disclosure forth shall be completed by the reporting entity,whether subawardee or prime Federal recipient,at the initiation or receipt of a covered Federal action,or a material change to a previous filing,pursuant to title 31 U.S.C. section 1352.The filing of a form is required for each payment or agreement to make payment to any lobbying entity 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 a covered Federal action.Use the SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate.Complete all items that apply for both the initial filing and material change report.Refer to the implementing guidance published by the Office of Management and Budget for additional information. 1. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the outcome of a covered Federal action. 2. Identity the status of the covered Federal action. 3. Identity the appropriate classification of this report. If this is a followup report caused by a material change to the information previously reported,enter the year and quarter in which the change occurred.Enter the date of the last previously submitted report by this reporting entity for this covered Federal action. 4. Enter the full name, address,city, state and zip code of the reporting entity. Include Congressional District, if known.Check the appropriate classification of the reporting entity that designates if if is,or expects to be,a prime or subaward recipient.Identify the tier of the subawardee,e.g.,the first subawardee of the prime is the 1st tier. Subawards include but are not limited to subcontracts,subgrants and contract awards under grants. 5. If the organization filing the report in item 4 checks"Subawardee",then enter the full name,address,city,stale and zip code of the prime Federal recipient.Include Congressional District,if known. 6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational level below agency name,if known. For example,Department of Transportation,United States Coast Guard. 7. Enter the Federal program name or description for the covered Federal action(item 1). If known,enter the full Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans, and loan commitments. 8. Enter the most appropriate Federal identifying number available for the Federal action identified in item 1(e.g., Request for Proposal(RFP)number;Invitation for Bid(IFB)number;grant announcement number;the contract, grant,or loan award number;the application/proposal control number assigned by the Federal agency). Include prefixes,e.g.,"RFP.DE-90-001." 9. For a covered Federal action where there has been an award or loan commitment by the Federal agency,enter the Federal amount of the award/loan commitment for the prime entity identified in item 4 or 5. 10. (a)Enter the full name,address,city,state and zip code of the lobbying entity engaged by the reporting entity identified in item 4 to influence the covered Federal action. (b)Enter the full names of the individual(s)performing services,and include full address if different from 10(a). Enter Last Name,First Name,and Middle Initial(MI). 11. Enter the amount of compensation paid or reasonably expected to be paid.by the reporting entity(item 4)to the lobbying entity(item 10). Indicate whether the payment has been made(actual)or will be made(p!anned). Check all boxes that apply. If this is a material change report,enter the cumulative amount of payment made or planned to be made. 12. Check the appropriate box(es).Check all boxes that apply. If payment is made through an in-kind contribution, specify the nature and value of the in-kind payment. 13. Check the appropriate box(es). Check all boxes that apply. If other,specify nature. 14. Provide a specific and detailed description of the services that the lobbyist has performed,or will be expected to perform,and the dates)of any services rendered.Include all preparatory and related activity,not just time spent in actual contact with Federal officials. Identify the Federal official(s) or employee(s) contacted or the officer(s), employee(s),or Member(s)of Congress that were contacted. 15. Check whether or not a SF-LLL-A Continuation Sheet(s)is attached. 16. The certifying official shall sign and date the form,print his/her name,title,and telephone number. Public reporting burden for this collection of information is estimated to average 30 mintues 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(0348-0046).Washington,D.C.20503. 263 Pt. 21, App. B 31 CFR Subtitle A (7-1-06 Edition) DISCLOSURE OF LOBBYING ACTIVITIES Approved by OMB 0348-0046 CONTINUATION SHEET Reporting Entity. Page of Authorized for Local Rqw doclion Standard form-UL•A 264 EXHIBIT 7 DECLARATION CITY OF KENT NON-DISCRIMINATION POLICY The City of Kent (City) is committed to conform to Federal and State laws regarding equal opportunity. As such all contractors, subcontractors, consultants, vendors, and suppliers who perform work with relation to this Agreement shall comply with the regulations of the City's equal employment opportunity policies. The City of Kent and its contractors are subject to and will comply with the following: • Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits discrimination on the basis of race, color, national origin); • 49 C.F.R. Part 21 (entitled Non-discrimination In Federally-Assisted Programs Of The Department Of Transportation-Effectuation Of Title VI Of The Civil Rights Act Of 1964); • 28 C.F.R. section 50.3 (U.S. Department of Justice Guidelines for Enforcement of Title VI of the Civil Rights Act of 1964). • Ch. 49.60 RCW (Washington Law Against Discrimination) The preceding statutory and regulatory cites hereinafter are referred to as "the Acts and Regulations". The following statements specifically identify the requirements the City deems necessary for any contractor, subcontractor, or supplier on this specific Agreement to adhere to. An affirmation of all of the following is required for this Agreement to be valid and binding. If any contractor, subcontractor, or supplier willfully misrepresents themselves with regard to the directives outlined below, it will be considered a breach of contract and it will be at the City's sole determination regarding suspension or termination for all or part of the Agreement. The statements are as follows: 1. I have read the attached City of Kent administrative policy number 1.2. 2. During the time of this Agreement I will not discriminate in employment on the basis of sex, race, color, national origin, age, or the presence of all sensory, mental or physical disability. 3. During the time of this Agreement I, the prime contractor, will provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 4. During the time of the Agreement I, the prime contractor, will actively consider hiring and promotion of women and minorities. 5. During the performance of this contract, the contractor, for itself, its assignees, and successors in interest (hereinafter referred to as the "contractor") agrees as follows: EEO COMPLIANCE DOCUMENTS - 1 of 5 A. Compliance with Regulations: The contractor, subcontractor, consultant, vendor, and supplier (hereinafter "Contractor") will comply with all Acts and the Regulations relative to non-discrimination, including those applicable to Federally- assisted programs of the U.S. Department of Transportation, State-assisted programs through the Washington State Department of Transportation, and generally under Washington's Law Against Discrimination, Ch. 49.60 RCW, as they may be amended from time to time, which are herein incorporated by reference and made a part of this contract. B. Non-discrimination: The contractor, with regard to the work performed by it during the contract, will not discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors, including procurements of materials and leases of equipment. The contractor will not participate directly or indirectly in the discrimination prohibited by the Acts and the Regulations, including employment practices when the contract covers any activity, project, or program set forth in Appendix B of 49 CFR Part 21. C. Solicitations for Subcontracts, Including Procurements of Materials and Equipment: In all solicitations, either by competitive bidding, or negotiation made by the contractor for work to be performed under a subcontract, including procurements of materials, or leases of equipment, each potential subcontractor or supplier will be notified by the contractor of the contractor's obligations under this contract and the Acts and the Regulations relative to non-discrimination on the grounds of race, color, or national origin. D. Information and Reports: The contractor will provide all information and reports required by the Acts and Regulations and directives issued pursuant thereto and will permit access to its books, records, accounts, other sources of information, and its facilities as may be determined applicable to contractor's contract by the City or the Washington State Department of Transportation to be pertinent to ascertain compliance with such Acts and Regulations and instructions. Where any information required of a contractor is in the exclusive possession of another who fails or refuses to furnish the information, the contractor will so certify to the City or the Washington State Department of Transportation, as appropriate, and will set forth what efforts it has made to obtain the information. E. Sanctions for Noncompliance: In the event of a contractor's noncompliance with the non-discrimination provisions of this contract, the City will impose such contract sanctions as it or the Washington State Department of Transportation may determine to be appropriate, including, but not limited to: a. withholding payments to the contractor under the contract until the contractor complies; and/or b. cancelling, terminating, or suspending a contract, in whole or in part. F. Incorporation of Provisions: The contractor will include the provisions of paragraphs (A) through (F) above in every subcontract, including procurements of materials and leases of equipment, unless exempt by the Acts and Regulations and directives issued pursuant thereto. The contractor will take action with respect to any subcontract or procurement as the City or the Washington State Department of Transportation may direct as a means of enforcing such provisions including sanctions for noncompliance. Provided, that if the contractor becomes involved in, or is threatened with litigation by a subcontractor, or supplier because of such EEO COMPLIANCE DOCUMENTS - 2 of 5 direction, the contractor may request the City to enter into any litigation to protect the interests of the City. In addition, the contractor may request the United States to enter into the litigation to protect the interests of the United States. 6. During the performance of this contract, the contractor, for itself, its assignees, and successors in interest agrees to comply with the following non-discrimination statutes and authorities; including but not limited to: Pertinent Non-Discrimination Authorities: i. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252), (prohibits discrimination on the basis of race, color, national origin); and 49 CFR Part 21. ii. The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. § 4601), (prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or Federal-aid programs and projects); iii. Federal-Aid Highway Act of 1973, (23 U.S.C. § 324 et seq.), (prohibits discrimination on the basis of sex); iv. Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits discrimination on the basis of disability); and 49 CFR Part 27; V. The Age Discrimination Act of 1975, as amended, (42 U.S.C. § 6101 et seq.), (prohibits discrimination on the basis of age); vi. Airport and Airway Improvement Act of 1982, (49 USC § 471, Section 47123), as amended, (prohibits discrimination based on race, creed, color, national origin, or sex); vii. The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and applicability of Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to include all of the programs or activities of the Federal-aid recipients, sub-recipients and contractors, whether such programs or activities are Federally funded or not); viii. Titles II and III of the Americans with Disabilities Act, which prohibit discrimination on the basis of disability in the operation of public entities, public and private transportation systems, places of public accommodation, and certain testing entities (42 U.S.C. §§ 12131-12189) as implemented by Department of Transportation regulations at 49 C.F.R. parts 37 and 38; ix. The Federal Aviation Administration's Non-discrimination statute (49 U.S.C. § 47123) (prohibits discrimination on the basis of race, color, national origin, and sex); X. Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations, which ensures Non-discrimination against minority populations by discouraging programs, policies, and activities with disproportionately high and adverse human health or environmental effects on minority and low-income populations; xi. Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and resulting agency guidance, national origin discrimination includes discrimination because of Limited English proficiency (LEP). To ensure EEO COMPLIANCE DOCUMENTS - 3 of 5 compliance with Title VI, you must take reasonable steps to ensure that LEP persons have meaningful access to your programs (70 Fed. Reg. at 74087 to 74100); xii. Title IX of the Education Amendments of 1972, as amended, which prohibits you from discriminating because of sex in education programs or activities (20 U.S.C. 1681 et seq). xiii. Washington Law Against Discrimination (Ch. 49.60 RCW) 7. The submission of the final invoice for this contract will constitute a reaffirmation that the preceding statements were complied with during the course of the contract's performance. By signing below, I agree to fulfill the five requirements referenced above. _. By: Mirva Rnar rni 14,90911197 PST) For: Centro Rendu of St. Vincent de Paul Title: Executive Director Date: 11/14/2023 EEO COMPLIANCE DOCUMENTS - 4 of 5 CITY OF KENT ADMINISTRATIVE POLICY NUMBER: 1.2 EFFECTIVE DATE: October 20, 2022 SUBJECT: INCLUSIVE CONTRACTING SUPERSEDES: January 1, 1998 APPROVED BY Dana Ralph, Mayor POLICY: Equal employment opportunity and non-discrimination in contracting requirements for the City of Kent will conform to federal and state laws. All contractors, subcontractors, consultants, and suppliers of the City must guarantee equal employment opportunity within their organization and, if holding Agreements with the City amounting to $10,000 or more within any given year, must take the following affirmative steps: 1. Provide a written statement to all new employees and subcontractors indicating commitment as an equal opportunity employer. 2. Actively consider for promotion and advancement available minorities and women. Further, all contractors, subcontractors, consultants, suppliers, grantees, or subgrantees of the City, regardless of the value of the Agreement, are required to sign the City's Non-Discrimination Policy Declaration, prior to commencing performance. Any contractor, subcontractor, consultant or supplier who willfully disregards the City's nondiscrimination and equal opportunity requirements shall be considered in breach of contract and subject to suspension or termination for all or part of the Agreement. Contract Compliance Officers will be appointed by the Directors of Planning, Parks, and Public Works Departments to coordinate with the City's Title VI coordinator, and perform the following duties for their respective departments. 1. Ensuring that contractors, subcontractors, consultants, and suppliers subject to these regulations are familiar with the regulations and the City's equal employment opportunity policy. 2. Monitoring to assure adherence to federal, state and local laws, policies and guidelines. EEO COMPLIANCE DOCUMENTS - 5 of 5 Exhibit 8 Insurance Requirements Insurance The Contractor shall procure and maintain for the duration of the Agreement, insurance against claims for injuries to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contractor, their agents, representatives, employees, or subcontractors. A. Minimum Scope of Insurance Contractor shall obtain insurance of the types described below: Commercial General Liability insurance shall be written on Insurance Services Office (ISO) occurrence form CG 00 01 and shall cover liability arising from premises, operations, independent contractors, products-completed operations, personal injury and advertising injury, and liability assumed under an insured contract. The Commercial General Liability insurance shall be endorsed to provide the Aggregate Per Project Endorsement ISO form CG 25 03 11 85. The City shall be named as an insured under the Contractor's Commercial General Liability insurance policy with respect to the work performed for the City using ISO additional insured endorsement CG 20 10 11 85 or a substitute endorsement providing equivalent coverage. If a general aggregate limit applies, either the general aggregate limit shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. The Contractor may use Umbrella or Excess Policies to provide the liability limits as required in this Agreement. This form of insurance will be acceptable if all the Primary and Umbrella or Excess Policies shall provide all the insurance coverages herein required. The Umbrella or Excess policies shall be provided on a true "following form" or broader coverage basis, with coverage at least as broad as provided on the underlying Commercial General Liability insurance. Automobile Liability insurance providing bodily injury and property damage liability coverage for all autos used in the performance of this Agreement. This coverage must be on a primary and non-contributory basis only. Coverage shall be written on ISO form CA 00 01, or a substitute form providing equivalent liability coverage. If necessary, the policy shall be endorsed to provide contractual liability coverage. Sexual Abuse or Molestation (SAM) Liability insurance endorsed to a standard liability policy to include affirmative coverage or obtained on a specially purchased stand-alone policy. Workers' Compensation coverage for the employees of Contractor and subcontractors as required by the Industrial Insurance laws of the State of Washington. B. Minimum Amounts of Insurance Contractor shall maintain the following insurance limits: Commercial General Liability insurance shall be written with limits no less than $2,000,000 per occurrence, and $2,000,000 products- completed operations aggregate limit. Stop Gap Liability - $1,000,000/$1,000,000/$1,000,000 Primary Non-Contributory Additional Insured coverage for the City of Kent, et. al. Waiver of Subrogation Automobile Liability insurance with a minimum combined single limit for bodily injury and property damage of $1,000,000 per occurrence. Sexual Abuse or Molestation (SAM) Liability insurance with a limit no less than $1,000,000 per occurrence or claim. If the Contractor maintains broader coverage and/or higher limits than the minimums shown above, the City requires and shall be entitled to the broader coverage and/or the higher limits maintained by the Contractor. Any available insurance proceeds in excess of the specified minimum limits of insurance and coverage shall be available to the City. The above policy limits may be obtained with excess liability (umbrella) insurance. C. Other Insurance Provisions The insurance policies are to contain, or be endorsed to contain, the following provisions: 1. The Contractor's insurance coverage shall be primary insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage maintained by the City shall be in excess of the Contractor's insurance policies and shall not contribute to the Contractor's insurance policies. 2. Contractor's insurer must deliver or mail written notice of cancellation to the named insured at least forty-five (45) days before the effective date of the cancellation. The Contractor's insurance policy shall include an endorsement that provides the City with written notice of cancellation forty-five (45) days before the effective date of the cancellation. If Contractor's insurer fails to provide the City with a copy of the notice of cancellation endorsement, the Contractor must notify the City and all Additional Insureds of any cancellation, nonrenewal or termination within two (2) business days of their receipt of such notice. 3. The City of Kent shall be named as an additional insured on all policies (except Professional Liability) with respect to work performed by or on behalf of the Contractor and a copy of the endorsement naming the City as an additional insured shall be attached to the Certificate of Insurance. The City reserves the right to receive a certified copy of all required insurance policies. The Contractor's Commercial General Liability insurance shall also contain a clause stating that coverage shall apply separately to each insured against whom claims are made or suit is brought, except with respect to the limits of the insurer's liability. D. Acceptability of Insurers Insurance is to be placed with insurers with a current A.M. Best rating of not less than A:VII. E. Verification of Coverage Contractor shall furnish the City with original certificates and a copy of the amendatory endorsements, including but not necessarily limited to the additional insured endorsement, evidencing the insurance requirements of the Contractor before commencement of the work. The City waives no rights, and the Contractor is not excused from performance if Contractor fails to provide the City with a copy of the endorsement naming the City as a Primary Non-Contributory Additional Insured. F. Subcontractors Contractor shall include all subcontractors as insureds under its policies or shall furnish separate certificates and endorsements for each subcontractor. All coverage for subcontractors shall be subject to all the same insurance requirements as stated herein for the Contractor. A CERTIFICATE OF LIABILITY INSURANCE DAT9/22/2023 Y) 09/22/2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Parker,Smith&Feek Insurance, LLC. PHONE 253-359-9700 FAX 1707 Dock Street A/C Ext: (A/C,No E-MAIL Tacoma,WA 98402 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Philadelphia Indemnity Insurance Co. INSURED INSURER B: Society of Saint Vincent de Paul Council of Seattl 5950 4th Ave.S. INSURER C: Seattle,WA 98108 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBRTYPE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF POLICY EXP LTR MMIDD/YYYY MM/DD/YYYY LIMITS A GENERAL LIABILITY PHPK2561092 06/01/2023 06/01/2024 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE RENTED X X PREMISES(Ea ccurrence $ 1,000,000 o CLAIMS-MADE lxl OCCUR MED EXP(Any one person) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 X POLICY PRO- LOC Sexual/Physical Abuse $ $1,000,000/$3,000 A AUTOMOBILE LIABILITY PHPK2561092 06/01/2023 06/01/2024 E(COMBINED accidenSINGLE $ 1,000,000 X ANY AUTO X X Commercial Auto BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident A UMBRELLA LIAB X OCCUR PHUB866474 06/01/2023 06/01/2024 EACH OCCURRENCE $ 5,000,000 X EXCESS LIAB CLAIMS-MADE X X Commercial Umbrella AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ A WORKERS COMPENSATION PHPK2561092 X ORY IMPS OTH- ER AND EMPLOYERS'LIABILITY .f06/01/2023 06/01/2024 ANY PROPRIETOR/PARTNER/EXECUTIVE Stop Gap E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A **WA Stop Gap (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liability PHPK2561092 06/01/2023 06/01/2024 $1,000,000/$3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Centro Rendu Re Route The City of Kent is named as additional insured per attached endorsements forms:General Liability-PI-GLD-HS1011,Umbrella Liability-PI-CXL-041 0516, Waiver of subrogation/transfer of rights of recovery applies per forms PI-GLD-HS 1011,CA00011013 and PI-CXL-001. Primary and Non-Contributory and Notice of Cancellation endorsements to follow from carrier. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. 220 4th Ave S Kent,WA 98032 AUTHORIZED REPRESENTATIVE US ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1 of 14 (AWI00) PI-GLD-HS (10111) m. State or Political Subdivisions—Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury,""property damage"or"personal and advertising injury"arising out of operations performed for the state or municipality; or (b) "Bodily injury"or"property damage"included within the"products-completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the"occurrence"or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or"suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose ali such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10of12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ©2011 Philadelphia Indemnity Insurance Company PI-GLD-HS (10111) Recovery Against Others To Us is deleted in its entirety and replaced by the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring"suit" or transfer those rights to us and help us enforce them. Therefore, the insured can waive the insurer's rights of recovery prior to the occurrence of a loss, provided the waiver is made in a written contract. P. Liberalization SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, is amended to include the following: If we revise this endorsement to provide more coverage without additional premium charge, we will automatically provide the additional coverage to all endorsement holders as of the day the revision is effective in your state. 0. Bodily injury—Mental Anguish SECTION V—DEFINITIONS, Paragraph 3. Is deleted in its entirety and replaced by the following: "Bodily injury"means: a. Bodily injury, sickness or disease sustained by a person, and includes mental anguish resulting from any of these; and b. Except for mental anguish, includes death resulting from the foregoing (Item a. above) at any time. R. Personal and Advertising Injury—Abuse of Process, Discrimination If COVERAGE B PERSONAL AND ADVERTISING INJURY LIABILITY COVERAGE is not otherwise excluded from this Coverage Part, the definition of"personal and advertising injury"is amended as follows: 1. SECTION V—DEFINITIONS, Paragraph 14.b. is deleted in its entirety and replaced by the following: b. Malicious prosecution or abuse of process; 2. SECTION V—DEFINITIONS, Paragraph 14. is amended by adding the following: Discrimination based on race, color, religion, sex, age or national origin, except when: a. Done intentionally by or at the direction of, or with the knowledge or consent of: (1) Any insured; or (2) Any executive officer, director, stockholder, partner or member of the insured; b. Directly or indirectly related to the employment, former or prospective employment, termination of employment, or application for employment of any person or persons by an insured; Page 11 of 12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ©2011 Philadelphia Indemnity Insurance Company PI-GLD-HS(10/11) Coverage Part, Paragraph 3.a. is deleted in its entirely and replaced by the following: a. Coverage under this provision is afforded until the end of the policy period. 2. Each of the following is also an insured: a. Medical Directors and Administrators—Your medicat directors and administrators, but only while acting within the scope of and during the course of their duties as such. Such duties do not include the furnishing or failure to furnish professional services of any physician or psychiatrist in the treatment of a patient. b. Managers and Supervisors—Your managers and supervisors are also insureds, but only with respect to their duties as your managers and supervisors. Managers and supervisors who are your"employees"are also insureds for"bodily injury"to a co- "employee"while in the course of his or her employment by you or performing duties related to the conduct of your business. This provision does not change Item 2.a.(1)(a)as it applies to managers of a limited liability company. c. Broadened Named Insured—Any organization and subsidiary thereof which you control and actively manage on the effective date of this Coverage Part. However, coverage does not apply to any organization or subsidiary not named in the Declarations as Named Insured, if they are also insured under another similar policy, but for its termination or the exhaustion of its limits of insurance. d. Funding Source—Any person or organization with respect to their liability arising out of. (1) Their financial control of you; or (2) Premises they own, maintain or control while you lease or occupy these premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. e. Home Care Providers—At the first Named Insured's option, any person or organization under your direct supervision and control while providing for you private home respite or foster home care for the developmentally disabled. f. Managers, Landlords, or Lessors of Premises—Any person or organization with respect to their liability arising out of the ownership, maintenance or use of that part of the premises leased or rented to you subject to the following additional exclusions: This insurance does not apply to: (1) Any"occurrence" which takes place after you cease to be a tenant in that premises; or (2) Structural alterations, new construction or demolition operations performed by or on behalf of that person or organization. g. Lessor of Leased Equipment—Automatic Status When Required in Lease Agreement With You—Any person or organization from whom you lease equipment when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is to be added as an additional insured on your policy. Such person or Page 7 of 12 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. ©2011 Philadelphia Indemnity Insurance Company PI-GLD-H5(10/11) organization is an insured only with respect to liability for"bodily injury,""property damage"or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person or organization. A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any"occurrence"which takes place after the equipment lease expires. h. Grantors of Permits—Any state or political subdivision granting you a permit in connection with your premises subject to the following additional provision: (1) This insurance applies only with respect to the following hazards for which the state or political subdivision has issued a permit in connection with the premises you own, rent or control and to which this insurance applies: (a) The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies, cellar entrances, coal holes, driveways, manholes, marquees, hoist away openings, sidewalk vaults, street banners or decorations and similar exposures; (b) The construction, erection, or removal of elevators; or (c) The ownership, maintenance, or use of any elevators covered by this insurance. i. Vendors—Only with respect to"bodily injury" or"property damage"arising out of"your products" which are distributed or sold in the regular course of the vendor's business, subject to the following additional exclusions: (1) The insurance afforded the vendor does not apply to: (a) "Bodily injury" or"property damage"for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement.This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement; (b) Any express warranty unauthorized by you; (c) Any physical or chemical change in the product made intentionally by the vendor; (d) Repackaging, except when unpacked solely for the purpose of inspection, demonstration, testing, or the substitution of parts under instructions from the manufacturer, and then repackaged in the original container; (e) Any failure to make such inspections, adjustments,tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f) Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of the product; Page 8 of 12 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. C 2011 Philadelphia Indemnity Insurance Company PI-GLD-HS(10/11) (g) Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vend% cr (h) "Bodily injury" or"property damage"arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i) The exceptions contained in Sub-paragraphs (d) or(f); or (ii) Such inspections, adjustments, tests or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products. (2) This insurance does not apply to any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying or containing. j. Franchisor—Any person or organization with respect to their liability as the grantor of a franchise to you. k. As Required by Contract—Any person or organization where required by a written contract executed prior to the occurrence of a loss. Such person or organization is an additional insured for"bodily injury,""property damage"or"personal and advertising injury" but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are included within and not in addition to the limits of insurance shown in the Declarations I. Owners, Lessees or Contractors—Any person or organization, but only with respect to liability for"bodily injury,""property damage"or"personal and advertising injury"caused, in whole or in part, by: (1) Your acts or omissions; or (2) The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured when required by a contract With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to"bodily injury" or"property damage"occurring after: (a) All work, including materials, parts or equipment furnished in connection with such work, on the project(other than service, maintenance or repairs)to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or (b) That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 9 of 12 Includes copyrighted material of Insurance Services Office, Inc.,with its permission. Q 2011 Philadelphia, Indemnity Insurance Company PI-GLD-HS (10111) m. State or Political Subdivisions—Any state or political subdivision as required, subject to the following provisions: (1) This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit, and is required by contract. (2) This insurance does not apply to: (a) "Bodily injury,""property damage"or"personal and advertising injury"arising out of operations performed for the state or municipality; or (b) "Bodily injury"or"property damage"included within the"products-completed operations hazard." M. Duties in the Event of Occurrence, Claim or Suit SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 2. is amended as follows: a. is amended to include: This condition applies only when the"occurrence"or offense is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. b. is amended to include: This condition will not be considered breached unless the breach occurs after such claim or"suit" is known to: (1) You, if you are an individual; (2) A partner, if you are a partnership; or (3) An executive officer or insurance manager, if you are a corporation. N. Unintentional Failure To Disclose Hazards SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS,6. Representations is amended to include the following: It is agreed that, based on our reliance on your representations as to existing hazards, if you should unintentionally fail to disclose ali such hazards prior to the beginning of the policy period of this Coverage Part, we shall not deny coverage under this Coverage Part because of such failure. O. Transfer of Rights of Recovery Against Others To Us SECTION IV—COMMERCIAL GENERAL LIABILITY CONDITIONS, 8. Transfer of Rights of Page 10of12 Includes copyrighted material of Insurance Services Office, Inc., with its permission. ©2011 Philadelphia Indemnity Insurance Company Philadelphia Indemnity Insurance Company PI-CXL-441 (05116) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY FOLLOW FORM ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY INSURANCE POLICY This policy is intended to include Commercial General Liability Coverage. The Commercial General Liability insurance provided will follow the same provisions, exclusions and limitations that are contained in the applicable"underlying insurance"shown in the Schedule of Underlying Insurance unless otherwise directed by this policy, or an endorsement to this policy. To the extent that such provisions differ or conflict,the provisions of this policy will apply. However,the coverage provided under this policy will not be broader than that provided by the applicable"underlying insurance." Any per location or per project aggregate limit of insurance that is extended in the applicable"underlying insurance"shown in the Schedule of Underlying Insurance will not apply to the coverage provided by this endorsement. PI-CXL-041 (05116) Page 1 of 1 PI-CXL-001 (03/14) (2) The total of all deductible and self-insured amounts under all that other insurance. 11. Transfer of Rights of Recovery Against Others to Us a. If any insured has rights to recover from any other person or organization all or part of any payment we have made under this policy, those rights are transferred to us. The insured must do nothing after loss to impair those rights. At our request, the insured will bring"suit" or transfer those rights to us and help us enforce them. b. Any such recovery shall be applied as follows: (1) First, any person or organization (including the insured)that has paid an amount in excess of the applicable limits of insurance of this policy will be reimbursed for the actual excess amount paid under this policy; (2) Then,we will be reimbursed up to the amount we have paid; and (3) Last, any insured or issuer of scheduled"underlying insurance"is entitled to claim the remainder, up to the amount that insured or issuer of scheduled"underlying insurance" has paid. c. Expenses incurred in the exercise of such rights of recovery shall be apportioned among such persons or organizations, including the insured, in the same ratio as their respective recoveries are finally shared. 12. Premium a. The first Named Insured has primary responsibility for the payment of all premiums and will be the payee for any return premiums. b. If the premium is a flat charge, it is not subject to adjustment except as provided in d. below. c. If the premium is other than a flat charge, it is an advance premium only. The earned premium will be computed at the end of each year in which this insurance is in force at the rate shown in the Declarations, subject to the Minimum Annual Premium. d. Additional premium may become payable when coverage is provided for additional insureds; and Named Insureds under the provisions of SECTION II—WHO IS AN INSURED, Items 3. d., e., and f. 13. Premium Audit a. You must keep record of the information we need for premium computation and send us copies at such times as we may request; b. At the close of each audit period we will compute the earned premium for that period; and c. Audit premiums are due and payable on notice to you. 14. Representations or Fraud By accepting this insurance, you agree: a. The statements in the Declarations and any subsequent notice relating to"underlying Page 21 of 29 Includes copyrighted material of Insurance Services Office, inc.,with permission. PI-CXL-WA 1 (05113) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WASHINGTON CHANGES This endorsement modifies insurance provided under the following: COMMERCIAL UMBRELLA LIABILITY INSURANCE POLICY SECTION IV—CONDITIONS, Paragraph 11.Transfer of Rights of Recovery Against Others to Us is revised by the addition of the following: We shall be entitled to a recovery only after the insured has been fully compensated for damages. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc.with permission. 19 Mobile Only those"autos"that are land vehicles and that would qualify under the definition Equipment of"mobile equipment" under this policy if they were not subject to a compulsory or Subject To financial responsibility law or other motor vehicle insurance law where they are Compulsory Or licensed or principally garaged. Financial Responsibility Or Other Motor Vehicle Insurance Law Only B. Owned Autos You Acquire After The Policy SECTION II—COVERED AUTOS LIABILITY Begins COVERAGE 1. If Symbols 1, 2, 3, 4, 5, 6 or 19 are entered A. Coverage next to a coverage in Item Two of the We will pay all sums an "insured" legally must pay Declarations, then you have coverage for as damages because of"bodily injury" or"property "autos" that you acquire of the type described damage" to which this insurance applies, caused for the remainder of the policy period. by an "accident' and resulting from the ownership, 2. But, if Symbol 7 is entered next to a coverage maintenance or use of a covered"auto". in Item Two of the Declarations, an "auto" you We will also pay all sums an "insured"legally must acquire will be a covered "auto" for that pay as a "covered pollution cost or expense" to coverage only if: which this insurance applies, caused by an a. We already cover all "autos" that you own "accident' and resulting from the ownership, for that coverage or it replaces an "auto" maintenance or use of covered "autos". However, you previously owned that had that we will only pay for the "covered pollution cost or coverage; and expense" if there is either "bodily injury" or b. You tell us within 30 days after you acquire "property damage" to which this insurance applies it that you want us to cover it for that that is caused by the same"accident'. coverage. We have the right and duty to defend any C. Certain Trailers, Mobile Equipment And "insured" against a "suit'asking for such damages Temporary Substitute Autos or a"covered pollution cost or expense". However, we have no duty to defend any"insured"against a If Covered Autos Liability Coverage is provided by "suit' seeking damages for "bodily injury" or this Coverage Form, the following types of "property damage" or a "covered pollution cost or vehicles are also covered "autos" for Covered expense" to which this insurance does not apply. Autos Liability Coverages We may investigate and settle any claim or "suit' 1. "Trailers" with a load capacity of 2,000 pounds as we consider appropriate. Our duty to defend or or less designed primarily for travel on public settle ends when the Covered Autos Liability roads. Coverage Limit of Insurance has been exhausted 2. "Mobile equipment' while being carried or by payment of judgments or settlements. towed by a covered "auto". 1. Who Is An Insured 3. Any "auto" you do not own while used with the The following are"insureds": permission of its owner as a temporary a. You for any covered"auto". substitute for a covered "auto" you own that is out of service because of its: b. Anyone else while using with your permission a covered "auto" you own, hire a. Breakdown; or borrow except: b. Repair; (1) The owner or anyone else from whom c. Servicing; you hire or borrow a covered"auto". d. "Loss"; or This exception does not apply if the e. Destruction. covered "auto" is a "trailer" connected to a covered"auto"you own. Page 2 of 12 ©Insurance Services Office, Inc., 2011 CA 00 01 10 13 (2) Your"employee" if the covered "auto" is These payments will not reduce the Limit of owned by that "employee" or a member Insurance. of his or her household. b. Out-of-state Coverage Extensions (3) Someone using a covered "auto' while While a covered "auto" is away from the he or she is working in a business of state where it is licensed, we will: selling, servicing, repairing, parking or storing "autos" unless that business is (1) Increase the Limit of insurance for yours. Covered Autos Liability Coverage to (4) Anyone other than your "employees", meet the limits specified by a compulsory or financial responsibility partners (if you are a partnership), law of the jurisdiction where the covered members (if you are a limited liability "auto" is being used. This extension company) or a lessee or borrower or does not apply to the limit or limits any of their "employees", while moving specified by any law governing motor property to or from a covered"auto". carriers of passengers or property. (5) A partner (if you are a partnership) or a (2) Provide the minimum amounts and member (if you are a limited liability types of other coverages, such as no- company)for a covered"auto"owned by fault, required of out-of-state vehicles by him or her or a member of his or her the jurisdiction where the covered "auto" household. is being used. c. Anyone liable for the conduct of an We will not pay anyone more than once for "insured" described above but only to the the same elements of loss because of extent of that liability. these extensions. 2. Coverage Extensions B. Exclusions a. Supplementary Payments This insurance does not apply to any of the We will pay for the"insured": following: (1) All expenses we incur. 1. Expected Or Intended Injury (2) Up to $2,000 for cost of bail bonds "Bodily injury' or "property damage" expected (including bonds for related traffic law or intended from the standpoint of the violations) required because of an "insured". "accident" we cover. We do not have to 2. Contractual furnish these bonds. Liability assumed under any contract or (3) The cost of bonds to release agreement. attachments in any "suit against the "insured" we defend, but only for bond But this exclusion does not apply to liability for amounts within our Limit of Insurance, damages: (4) All reasonable expenses incurred by the a. Assumed in a contract or agreement that is "insured" at our request, including actual an "insured contract", provided the "bodily loss of earnings up to $250 a day injury" or "property damage" occurs because of time off from work. subsequent to the execution of the contract (5) All court costs taxed against the or agreement: or "insured" in any "suit" against the b. That the "insured" would have in the "insured" we defend. However, these absence of the contract or agreement. payments do not include attorneys' fees 3. Workers' Compensation or attorneys' expenses taxed against the Any obligation for which the "insured" or the "insured". "insured's" insurer may be held liable under (6) All interest on the full amount of any any workers' compensation, disability benefits judgment that accrues after entry of the or unemployment compensation law or any judgment in any "suit" against the similar law. "insured"we defend, but our duty to pay interest ends when we have paid, offered to pay or deposited in court the part of the judgment that is within our Limit of Insurance. CA 00 01 10 13 ©Insurance Services Office, Inc., 2011 Page 3 of 112 4. Loss Payment—Physical Damage S. Other Insurance Coverages a. For any covered "auto" you own, this At our option,we may: Coverage Form provides primary a. Pay for, repair or replace damaged or insurance, For any covered "auto"you don't stolen property: own, the insurance provided by this Coverage Form is excess over any other b. Return the stolen property, at our expense. collectible insurance. However, while a We will pay for any damage that results to covered "auto' which is a "trailer" is the"auto"from the theft,or connected to another vehicle, the Covered c. Take all or any part of the damaged or Autos Liability Coverage this Coverage stolen property at an agreed or appraised Form provides for the"trailer"is: value. (1) Excess while it is connected to a motor If we pay for the "loss", our payment will vehicle you do not own;or include the applicable sales tax for the (2y Primary while it is connected to a damaged or stolen property. covered"auto"you own. S. Transfer Of Rights Of Recovery Against b. For Hired Auto Physical Damage Coverage, Others To Us any covered "auto" you lease, hire, rent or If any person or organization to or for whom we borrow is deemed to be a covered "auto" make payment under this Coverage Form has you own. However, any "auto" that is rights to recover damages from another, those leased, hired, rented or borrowed with a rights are transferred to us. That person or driver is not a covered"auto". organization must d❑ everything necessary to c. Regardless of the provisions of Paragraph secure our rights and must do nothing after a. above, this Coverage Form's Covered "accident"or"loss"to impair them. Autos Liability Coverage is primary for'.asy, B. General Conditions liability assumed under an "ins0t6d 1. Bankruptcy contract". Bankruptcy or insolvency of the"insured"or the d. When this Coverage Form and any other "insured's" estate will not relieve us of any Coverage Form or policy covers on the obligations under this Coverage Form. same basis, either excess or primary, we will pay only our share. Our share is the 2. Concealment, Misrepresentation Or Fraud proportion the Limit of Insurance of our This Coverage Form is void in any case of the total of the fraud by you at any time as it relates to this limits of all the Coverage Forms and Coverage Form. It is also void if you or any policies covering on the same basis. other "insured", at any time, intentionally S. Premium Audit conceals or misrepresents a material fact a. The estimated premium for this Coverage concerning: Form is based on the exposures you told us a. This Coverage Form; you would have when this policy began. We b. The covered"auto"; will compute the final premium due when c_ Your interest in the covered"auto'; or we determine your actual exposures. The estimated total premium will be credited d. A claim under this Coverage Form. against the final premium due and the first 3. Liberalization Named Insured will be billed for the balance, if any. The due date for the final If we revise this Coverage Form to provide premium or retrospective premium is the more coverage without additional premium date shown as the due dale on the bill. If charge, your policy will automatically provide the estimated total premium exceeds the the additional coverage as of the day the final premium due, the first Named Insured revision is effective in your state. will get a refund. 4. No Benefit To Bailee—Physical damage b. If this policy is issued for more than one Coverages _ year, the premium for this Coverage Form We will not recognize any assignment°ror grzw& will be computed annually based on our any coverage for the benefit of any person or rates or premiums in effect at the beginning ir ��ration holding, storing or transporting of each year of the policy. property for a fee regardless of any other provision of this Coverage Form. CA 00 01 10 13 O Insurance Services Office, Inc., 2011 Page 9 of 12 2. The Transfer Of Rights Of Recovery Against 3. The following is added to the Legal Action Others To Us Condition is replaced by the Against Us Condition: following: If this action is brought pursuant to Sec. 3 of Transfer Of Rights Of Recovery Against RCW 48.30, then 20 days prior to filing such an Others To Us action, you are required to provide written a. If any person or organization to or for whom notice of the basis for the cause of action to us we make payment under this Coverage and the Office of the Insurance Commissioner. Form has rights to recover damages from Such notice may be sent by regular mail, another, those rights are transferred to us registered mail, or certified mail with return for that payment. That person or receipt requested. organization must do everything necessary to secure our rights and must do nothing after"accident"or'loss"to impair them. b. We are entitled to a recovery only after the person or organization has been fully compensated for damages by another party. CA 01 35 10 13 ©Insurance Services Office, Inc., 2012 Page 3 of 3 PI-CANXCH-002-WA(09/11) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CANCELLATION NOTICE TO SCHEDULED CERTIFICATE HOLDER This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PROFESSIONAL LIABILITY COVERAGE PART COMMERCIAL CRIME COVERAGE PART COMMERCIAL INLAND MARINE COVERAGE PART COMMERCIAL PROPERTY COVERAGE PART COMMERCIAL AUTOMOBILE COVERAGE PART SCHEDULE OF CERTIFICATE HOLDERS CH Certificate Holder Address CH City of Kent 220 4th Ave S Kent WA 98032 The following is added to A. CANCELLATION of the Common Policy Conditions of the above applicable coverage part: A. In the event we cancel the policy in accordance with the policy's terms and conditions, we will endeavor to mail written notice of cancellation to Certificate Holders, shown in the above SCHEDULE within the time frame listed below. However, failure to mail such notice shall impose no obligation of any kind upon us, our agents or representatives. 1. 30 days before the effective date of cancellation if we cancel for any reason other than for non - payment of premium. Page 1 of 1 PI-GL-005 (07/12) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Effective Date: 09/22/2023 Name of Person or Organization (Additional Insured): "per written contract" SECTION II—WHO IS AN INSURED is amended to include as an additional insured the person(s) or organization(s)shown in the endorsement Schedule, but only with respect to liability for"bodily injury," "property damage" or"personal and advertising injury" arising out of or relating to your negligence in the performance of"your work"for such person(s) or organization(s) that occurs on or after the effective date shown in the endorsement Schedule. This insurance is primary to and non-contributory with any other insurance maintained by the person or organization (Additional Insured), except for loss resulting from the sole negligence of that person or organization. This condition applies even if other valid and collectible insurance is available to the Additional Insured for a loss or"occurrence"we cover for this Additional Insured. The Additional Insured's limits of insurance do not increase our limits of insurance, as described in SECTION III—LIMITS OF INSURANCE. All other terms, conditions, and exclusions under the policy are applicable to this endorsement and remain unchanged. Page 1 of 1 Includes copyrighted material of Insurance Services Office, Inc., with its permission. PI-CA-003 (04/14) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BLANKET ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. SECTION II—COVERED AUTOS LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured is amended by adding the following: The following are also"insureds": Any person or organization for whom you are required by an "insured contract"to procure"bodily injury" or"property damage" liability insurance arising out of the operation of a covered "auto"with your permission. However, this additional insurance does not apply to: 1. The owner or anyone else from whom you hire or borrow a covered "auto." This exception does not apply if the covered "auto" is a "trailer" connected to a covered "auto" you own; 2. Your"employee" if the covered "auto" is owned by that"employee" or a member of his or her household; 3. Anyone using a covered "auto"while he or she is working in a business of selling, servicing, repairing, parking or storing "autos" unless that business is yours; 4. Anyone other than your"employees," partners (if you are a partnership), members (if you are a limited liability company), or a lessee or borrower or any of their"employees,"while moving property to or from a covered "auto"; or 5. A partner(if you are a partnership), or a member(if you are a limited liability company) for covered "auto" owned by him or her or a member of his or her household. B. The"insured contract" must be in effect during the policy period shown in the Declarations and must have been executed prior to the"bodily injury" or"property damage". C. This person or organization is an "insured" only to the extent you are liable due to your ongoing operations for that"insured", whether the work is performed by you or for you, and only to the extent you are held liable for an "accident" occurring while a covered "auto" is being driven by you or one of your employees. D. There is no coverage provided to this person or organization for"bodily injury" to its employees or for "property damage"to its property. E. Coverage for this person or organization shall be limited to the extent of your negligence or fault according to the applicable principles of comparative negligence or fault. F. The defense of any claim or"suit" must be tendered by this person or organization as soon as practicable to all other insurers which potentially provide insurance for such claim or"suit". G. A person's or organization's status as an "insured" under this endorsement ends when your operations for that"insured" are completed. Page 1 of 2 PI-CA-003 (04/14) H. The coverage extended to any additional insured by this endorsement is limited to, and subject to all terms, conditions, and exclusions of the Coverage Part to which this endorsement is attached. In addition, coverage shall not exceed the terms and conditions that are required by the terms of the written agreement to add any"insured," or to procure insurance. I. The following additional exclusions apply: The insurance afforded to any person or organization as an "insured" under this endorsement does not apply to"loss": 1. Which occurs prior to the date your contract is effective with such person or organization; 2. Arising out of the sole negligence of any person or organization that would not be an "insured" except for this endorsement; or 3. Which occurs after you returned the leased or rented "auto"to the lessor or the policy period ends, whichever occurs first. Page 2 of 2 Last updated by EDWARD DELMORE on Feb 02,2023 at 03:34 PM SOCIETY OF ST.VINCENT DE PAUL COUNCIL,OF SEATTLE/KING COUNTY Jd.=11SAM*Gov° SOCIETY OF ST. VINCENT DE PAUL COUNCIL, OF SEATTLE/KING COUNTY Unique Entity ID CAGE/NCAGE Purpose of Registration KMHXZZTRIMQ9 841381 Federal Assistance Awards Only Registration Status Expiration Date Active Registration Feb 2,2024 Physical Address Mailing Address 5950 4TH AVE S 5950 4TH AVE S Seattle,Washington 98108-3208 Seattle,Washington 98108-3208 United States United States Doing Business as Division Name Division Number (blank) (blank) (blank) Congressional District State/Country of Incorporation URL Washington 07 Washington/United States https://svdpseattle.org Registration Dates Activation Date Submission Date Initial Registration Date Feb 6,2023 Feb 2,2023 Aug 25,2017 Entity Dates Entity Start Date Fiscal Year End Close Date Sep 22,1922 Sep 30 Immediate Owner CAGE Legal Business Name (blank) (blank) Highest Level Owner CAGE Legal Business Name (blank) (blank) Executive Compensation Registrants in the System for Award Management(SAM)respond to the Executive Compensation questions in accordance with Section 6202 of P.L.110-252,amending the Federal Funding Accountability and Transparency Act(P.L.109-282).This information is not displayed in SAM.It is sent to USAspending.gov for display in association with an eligible award.Maintaining an active registration in SAM demonstrates the registrant responded to the questions. Proceedings Questions Registrants in the System for Award Management(SAM.gov)respond to proceedings questions in accordance with FAR 52.209-7,FAR 52.209-9, or 2.C.F.R.200 Appendix XII.Their responses are displayed in the responsibility/qualification section of SAM.gov.Maintaining an active registration in SAM.gov demonstrates the registrant responded to the proceedings questions. Active Exclusions Records? No I authorize my entity's non-sensitive information to be displayed in SAM public search results: Yes Business Types Entity Structure Entity Type Organization Factors Corporate Entity(Tax Exempt) Business or Organization (blank) Aug 30,2023 01:56.53 PM GMT https://sam.gov/entity/KMHXZZTRIMQ91coreData?status=Active Pagel of Last updated by EDWARD DELMORE on Feb 02,2023 at 03:34 PM SOCIETY OF ST.FINCENT DE PAUL COUNCIL,OF SEATTLE/KING COUNTY Profit Structure Non-Profit Organization Socio-Economic Types Check the registrant's Reps&Certs,if present,under FAR 52.212-3 or FAR 52.219-1 to determine if the entity is an SBA-certified HUBZone small business concern.Additional small business information may be found in the SBA's Dynamic Small Business Search if the entity completed the SBA supplemental pages during registration. Accepts Credit Card Payments Debt Subject To Offset No No EFT Indicator CAGE Code 0000 84D81 Electronic Business 5950 4TH AVE S Vera Kovalevich,Staff Accountant 2 Seattle,Washington 98108 United States Mirya Munoz,Executive Director 5950 Fourth Avenue South Seattle,Washington 98108 United States Government Business 5950 4TH AVE South Mirya T Roach,Executive Director Seattle,Washington 98108 United States Mirya Munoz,Executive Director 5950 Fourth Avenue South Seattle,Washington 98108 United States NAICS Codes Primary NAICS Codes NAICS Title This entity does not appear in the disaster response registry. Aug 30,2023 01:56.53 PM GMT https://samgov/entity/KMHAZZTRIMQ9/coreData?status=Active Page 2 of 2 Signature: Merino hanson 6v7,202313:57PST) Signature: Email: mhanson@kentwa.gov Email: rlashley@kentwa.gov Signature: Juli arascondola(Nov 14,202314:07 PST) Email: jparascondola@kentwa.gov H HS_SVd P_ReRouteSLFRF_11072023 Final Audit Report 2023-11-14 Created: 2023-11-07 By: KateLynn Jennings(kjennings@kentwa.gov) Status: Signed Transaction ID: CBJCHBCAABAACLhEoi3SOfE5b-Ap9LKEorzgo7ZQ-qX9 "HHS_SVdP_ReRouteSLFRF_11072023" History "; Document created by KateLynn Jennings (kjennings@kentwa.gov) 2023-11-07-9:51:51 PM GMT-IP address: 146.129.252.126 Document emailed to mhanson@kentwa.gov for signature 2023-11-07-9:54:17 PM GMT Email viewed by mhanson@kentwa.gov 2023-11-07-9:57:05 PM GMT-IP address: 174.204.65.8 Signer mhanson@kentwa.gov entered name at signing as Merina Hanson 2023-11-07-9:57:36 PM GMT-IP address: 174.204.65.8 ca Document e-signed by Merina Hanson (mhanson@kentwa.gov) Signature Date:2023-11-07-9:57:38 PM GMT-Time Source:server-IP address: 174.204.65.8 Document emailed to Ronald Lashley (rlashley@kentwa.gov)for signature 2023-11-07-9:57:42 PM GMT 3 Email viewed by Ronald Lashley (rlashley@kentwa.gov) 2023-11-14-9:19:39 PM GMT-IP address: 104.47.65.254 Document e-signed by Ronald Lashley (rlashley@kentwa.gov) Signature Date:2023-11-14-9:21:10 PM GMT-Time Source:server-IP address: 146.129.252.126 Document emailed to miryar@svdpseattle.org for signature 2023-11-14-9:21:15 PM GMT Email viewed by miryar@svdpseattle.org 2023-11-14-9:21:49 PM GMT-IP address: 104.47.55.254 EY Signer miryar@svdpseattle.org entered name at signing as Mirya Roach 2023-11-14-9:27:18 PM GMT-IP address: 172.56.105.226 Powered by r � Adobe ` � T Acrobat Sign E= Document e-signed by Mirya Roach (miryar@svdpseattle.org) Signature Date:2023-11-14-9:27:20 PM GMT-Time Source:server-IP address: 172.56.105.226 Document emailed to Julie Parascondola Qparascondola@kentwa.gov)for signature 2023-11-14-9:27:25 PM GMT Email viewed by Julie Parascondola (jarascondola@kentwa.gov) 2023-11-14-10:07:23 PM GMT-IP address: 104.47.65.254 E= Document e-signed by Julie Parascondola Qparascondola@kentwa.gov) Signature Date:2023-11-14-10:07:37 PM GMT-Time Source:server-IP address: 146.129.252.126 Agreement completed. 2023-11-14-10:07:37 PM GMT Powered by r � Adobe � � T Acrobat Sign