HomeMy WebLinkAboutCAG2024-210 - Original - Communities in Schools of Kent - School Based Mentoring - 05/02/2024 FOR CITY OF KENT OFFICIAL USE ONLY
Sup/Mgr:
Agreement Routing Form Dir Asst:
IL RL
• For Approvals,Signatures and Records Management Dir/Dep:
KENT This form combines&replaces the Request for Mayor's Signature and Contract Cover Sheet forms.
W A S H I N G T O N (Print on pink or cherry colored paper) (optional)
Originator: Department:
Megan Turner for Lori Guilfoyle Parks, Recreation &Community Services
Date Sent: Date Required:
> 3/20/2024 4/2/2024
O
QAuthorized to Sign: Date of Council Approval:
CL Director or Designee May
Q
Budget Account Number: Grant? Yes F71No
10006370.64150.4715
Budget? Yes"No Type: N/A
MEV
Vendc)r Name, Category:
Communities in Schools of Kent Contract
Vendor Numbel Sub-Category:
= 88728 Original
C Communities in Schools Mentoring
Project Name:
E
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0 Provide school based individual and group mentoring for students in the Kent School District.
O Project Details:
C
O
Agreement JAgreement b$38,500 Basis for Selection of Contractor: Other
41 *Memo to Mayor must be attached
i Start Date:l 1/1/2024 Termination Date: 1 2/3 1/2024
Q Local Business?r7 Yes 17No* If meets requirements per KCC3.70.100,pleosecomplete"VendorPurchase-Locol Exceptions"form onCityspace.
Business License Verification:171 Yes Oln-Process ElExempt(KCC 5.01.045)
Notice required prior to disclosure? Contract Number:
1r7Yes J7No CAG2024-210
Comments:
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Date Received by City Attorney: 4/22/24
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Im Date Routed to the Mayor's Office: 4/30/24
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[Date Routed to the City Clerk's Office: 5/2/24
aa«W22373_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements
rev.200821
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4
KENT
W A s H-T o H
CONSULTANT SERVICES AGREEMENT
between the City of Kent and
Communities In Schools of Kent
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter
the "City"), and Communities in Schools of Kent organized under the laws of the State of Washington,
located and doing business at PO Box 62, Kent, WA, 98035 (hereinafter the "Consultant").
I. DESCRIPTION OF WORK.
The Consultant shall perform the following services for the City in accordance with the following
described plans and/or specifications:
Provide school based individual and group mentoring to students in the Kent School District.
The following exhibits are attached and incorporated by this reference as if fully set forth
herein; Exhibit A, Scope and Schedule of Work, Exhibit B, Insurance Exhibit and Exhibit C,
Debarment Certification.
The Consultant further represents that the services furnished under this Agreement will be performed
in accordance with generally accepted professional practices within the Puget Sound region in effect at the
time those services are performed.
II. TIME OF COMPLETION. The parties agree that work will begin on the tasks described in
Section I above immediately upon the effective date of this Agreement. The Consultant shall complete the
work described in Section I by December 31, 2024.
III. COMPENSATION.
A. Payment for Services. The City shall pay the Consultant, based on time and materials, an
amount not to exceed $38,500, for the services described in this Agreement. This is the
maximum amount to be paid under this Agreement for the work described in Section I above,
and shall not be exceeded without the prior written authorization of the City in the form of a
negotiated and executed amendment to this agreement. The Consultant agrees that the
hourly or flat rate charged by it for its services contracted for herein shall remain locked at
the negotiated rate(s) for a period of one (1) year from the effective date of this Agreement.
The Consultant's billing rates shall be as delineated in Exhibit A.
B. 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 Exhibit
A. 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.
CONSULTANT SERVICES AGREEMENT - 1
(Over$20,000)
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. For example,
if a Consultant contracted to provide 100 bed-nights a quarter for$5,000.00 and only provides
75 bed-nights, payment would be reduced to $3,750.00 from $5,000.00.
D. Payment Invoices. The Consultant shall submit quarterly payment invoices to the City for
work performed, and a final bill upon completion of all services described in this Agreement.
The City shall provide payment within forty-five (45) days of receipt of an invoice. If the City
objects to all or any portion of an invoice, it shall notify the Consultant and reserves the option
to only pay that portion of the invoice not in dispute. In that event, the parties will immediately
make every effort to settle the disputed portion.
E. Card Payment Program. The Consultant may elect to participate in automated credit card
payments provided for by the City and its financial institution. This Program is provided as an
alternative to payment by check and is available for the convenience of the Consultant. If the
Consultant voluntarily participates in this Program, the Consultant will be solely responsible
for any fees imposed by financial institutions or credit card companies. The Consultant shall
not charge those fees back to the City.
IV. INDEPENDENT CONTRACTOR. The parties intend that an Independent Contractor-
Employer Relationship will be created by this Agreement. By their execution of this Agreement, and in
accordance with Ch. 51.08 RCW, the parties make the following representations:
A. The Consultant has the ability to control and direct the performance and details of its
work, the City being interested only in the results obtained under this Agreement.
B. The Consultant maintains and pays for its own place of business from which the
Consultant's services under this Agreement will be performed.
C. The Consultant has an established and independent business that is eligible for a
business deduction for federal income tax purposes that existed before the City
retained the Consultant's services, or the Consultant is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
D. The Consultant is responsible for filing as they become due all necessary tax
documents with appropriate federal and state agencies, including the Internal Revenue
Service and the state Department of Revenue.
E. The Consultant has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by the
Consultant's business, and has obtained a Unified Business Identifier (UBI) number
from the State of Washington.
F. The Consultant maintains a set of books dedicated to the expenses and earnings of its
business.
V. TERMINATION. Either party may terminate this Agreement, with or without cause, upon
providing the other party thirty (30) days written notice at its address set forth on the signature block of
this Agreement. After termination, the City may take possession of all records and data within the
Consultant's possession pertaining to this project, which may be used by the City without restriction. If the
City's use of the Consultant's records or data is not related to this project, it shall be without liability or legal
exposure to the Consultant.
VI. FORCE MA7EURE. Neither party shall be liable to the other for breach due to delay or failure
in performance resulting from acts of God, acts of war or of the public enemy, riots, pandemic, fire, flood,
or other natural disaster or acts of government ("force majeure event"). Performance that is prevented or
delayed due to a force majeure event shall not result in liability to the delayed party. Both parties represent
CONSULTANT SERVICES AGREEMENT - 2
(Over$20,000)
to the other that at the time of signing this Agreement, they are able to perform as required and their
performance will not be prevented, hindered, or delayed by the current COVID-19 pandemic, any existing
state or national declarations of emergency, or any current social distancing restrictions or personal
protective equipment requirements that may be required under federal, state, or local law in response to
the current pandemic.
If any future performance is prevented or delayed by a force majeure event, the party whose
performance is prevented or delayed shall promptly notify the other party of the existence and nature of
the force majeure event causing the prevention or delay in performance. Any excuse from liability shall be
effective only to the extent and duration of the force majeure event causing the prevention or delay in
performance and, provided, that the party prevented or delayed has not caused such event to occur and
continues to use diligent, good faith efforts to avoid the effects of such event and to perform the obligation.
Notwithstanding other provisions of this section, the Consultant shall not be entitled to, and the City
shall not be liable for, the payment of any part of the contract price during a force majeure event, or any
costs, losses, expenses, damages, or delay costs incurred by the Consultant due to a force majeure event.
Performance that is more costly due to a force majeure event is not included within the scope of this Force
Majeure provision.
If a force majeure event occurs, the City may direct the Consultant to restart any work or
performance that may have ceased, to change the work, or to take other action to secure the work or the
project site during the force majeure event. The cost to restart, change, or secure the work or project site
arising from a direction by the City under this clause will be dealt with as a change order, except to the
extent that the loss or damage has been caused or exacerbated by the failure of the Consultant to fulfill its
obligations under this Agreement. Except as expressly contemplated by this section, all other costs will be
borne by the Consultant.
VII. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Consultant, its subcontractors, or any person acting on behalf of the
Consultant or subcontractor shall not, by reason of race, religion, color, sex, age, sexual orientation, national
origin, or the presence of any sensory, mental, or physical disability, discriminate against any person who
is qualified and available to perform the work to which the employment relates. The Consultant shall execute
the attached City of Kent Non-Discrimination Policy Declaration and comply with City Administrative
Policy 1.2.
VIII. INDEMNIFICATION. The Consultant shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
suits, including all legal costs and attorney fees, arising out of or in connection with the Consultant's
performance of this Agreement, except for that portion of the injuries and damages caused by the City's
negligence.
The City's inspection or acceptance of any of the Consultant's work when completed shall not be
grounds to avoid any of these covenants of indemnification.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115,
then, in the event of liability for damages arising out of bodily injury to persons or damages to property
caused by or resulting from the concurrent negligence of the Consultant and the City, its officers, officials,
employees, agents and volunteers, the Consultant's duty to defend, indemnify, and hold the City harmless,
and the Consultant's liability accruing from that obligation shall be only to the extent of the Consultant's
negligence.
IT IS FURTHER SPECIFICALLY AND EXPRESSLY UNDERSTOOD THAT THE INDEMNIFICATION
PROVIDED HEREIN CONSTITUTES THE CONSULTANT'S WAIVER OF IMMUNITY UNDER INDUSTRIAL
INSURANCE, TITLE 51 RCW, SOLELY FOR THE PURPOSES OF THIS INDEMNIFICATION. THE PARTIES
FURTHER ACKNOWLEDGE THAT THEY HAVE MUTUALLY NEGOTIATED THIS WAIVER.
In the event the Consultant refuses tender of defense in any suit or any claim, if that tender was
made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court
CONSULTANT SERVICES AGREEMENT - 3
(Over$20,000)
having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Consultant's part, then
the Consultant shall pay all the City's costs for defense, including all reasonable expert witness fees and
reasonable attorneys'fees, plus the City's legal costs and fees incurred because there was a wrongful refusal
on the Consultant's part.
The provisions of this section shall survive the expiration or termination of this Agreement.
IX. INSURANCE. The Consultant shall procure and maintain for the duration of the Agreement,
insurance of the types and in the amounts described in Exhibit B attached and incorporated by this reference.
X. EXCHANGE OF INFORMATION. The City will provide its best efforts to provide reasonable
accuracy of any information supplied by it to the Consultant for the purpose of completion of the work under
this Agreement.
XI. OWNERSHIP AND USE OF RECORDS AND DOCUMENTS. Original documents, drawings,
designs, reports, or any other records developed or created under this Agreement shall belong to and
become the property of the City. All records submitted by the City to the Consultant will be safeguarded by
the Consultant. The Consultant shall make such data, documents, and files available to the City upon the
City's request. The Consultant acknowledges that the City is a public agency subject to the Public Records
Act codified in Chapter 42.56 of the Revised Code of Washington. As such, the Consultant agrees to
cooperate fully with the City in satisfying the City's duties and obligations under the Public Records Act. The
City's use or reuse of any of the documents, data, and files created by the Consultant for this project by
anyone other than the Consultant on any other project shall be without liability or legal exposure to the
Consultant.
XII. CITY'S RIGHT OF INSPECTION. Even though the Consultant is an independent contractor
with the authority to control and direct the performance and details of the work authorized under this
Agreement, the work must meet the approval of the City and shall be subject to the City's general right of
inspection to secure satisfactory completion.
XIII. WORK PERFORMED AT CONSULTANT'S RISK. The Consultant shall take all necessary
precautions and shall be responsible for the safety of its employees, agents, and subcontractors in the
performance of the contract work and shall utilize all protection necessary for that purpose. All work shall
be done at the Consultant's own risk, and the Consultant shall be responsible for any loss of or damage to
materials, tools, or other articles used or held for use in connection with the work.
XIV. MISCELLANEOUS PROVISIONS.
A. Recyclable Materials. Pursuant to Chapter 3.80 of the Kent City Code, the City requires its
contractors and consultants to use recycled and recyclable products whenever practicable. A price
preference may be available for any designated recycled product.
B. Non-Waiver of Breach. The failure of the City to insist upon strict performance of any of the
covenants and agreements contained in this Agreement, or to exercise any option conferred by this
Agreement in one or more instances shall not be construed to be a waiver or relinquishment of those
covenants, agreements or options, and the same shall be and remain in full force and effect.
C. Resolution of Disputes and Governing Law. This Agreement shall be governed by and
construed in accordance with the laws of the State of Washington. If the parties are unable to settle any
dispute, difference or claim arising from the parties' performance of this Agreement, the exclusive means
of resolving that dispute, difference or claim, shall only be by filing suit exclusively under the venue, rules
and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in
writing to an alternative dispute resolution process. In any claim or lawsuit for damages arising from the
parties' performance of this Agreement, each party shall pay all its legal costs and attorney's fees incurred
in defending or bringing such claim or lawsuit, including all appeals, in addition to any other recovery or
award provided by law; provided, however, nothing in this paragraph shall be construed to limit the City's
right to indemnification under Section VIII of this Agreement.
CONSULTANT SERVICES AGREEMENT - 4
(Over$20,000)
D. Written Notice. All communications regarding this Agreement shall be sent to the parties at
the addresses listed on the signature page of the Agreement, unless notified to the contrary. Any written
notice hereunder shall become effective three (3) business days after the date of mailing by registered or
certified mail, and shall be deemed sufficiently given if sent to the addressee at the address stated in this
Agreement or such other address as may be hereafter specified in writing.
E. Assignment. Any assignment of this Agreement by either party without the written consent
of the non-assigning party shall be void. If the non-assigning party gives its consent to any assignment,
the terms of this Agreement shall continue in full force and effect and no further assignment shall be made
without additional written consent.
F. Modification. No waiver, alteration, or modification of any of the provisions of this Agreement
shall be binding unless in writing and signed by a duly authorized representative of the City and the
Consultant.
G. Entire Agreement. The written provisions and terms of this Agreement, together with any
Exhibits attached hereto, shall supersede all prior verbal statements of any officer or other representative
of the City, and such statements shall not be effective or be construed as entering into or forming a part of
or altering in any manner this Agreement. All of the above documents are hereby made a part of this
Agreement. However, should any language in any of the Exhibits to this Agreement conflict with any
language contained in this Agreement, the terms of this Agreement shall prevail.
H. Compliance with Laws. The Consultant agrees to comply with all federal, state, and municipal
laws, rules, and regulations that are now effective or in the future become applicable to the Consultant's
business, equipment, and personnel engaged in operations covered by this Agreement or accruing out of
the performance of those operations.
I. Public Records Act. The Consultant acknowledges that the City is a public agency subject to
the Public Records Act codified in Chapter 42.56 of the Revised Code of Washington and documents, notes,
emails, and other records prepared or gathered by the Consultant in its performance of this Agreement may
be subject to public review and disclosure, even if those records are not produced to or possessed by the
City of Kent. As such, the Consultant agrees to cooperate fully with the City in satisfying the City's duties
and obligations under the Public Records Act.
J. City Business License Required. Prior to commencing the tasks described in Section I,
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the
Kent City Code.
CONSULTANT SERVICES AGREEMENT - 5
(Over$20,000)
K. Counterparts and Signatures by Fax or Email. This Agreement may be executed in any
number of counterparts, each of which shall constitute an original, and all of which will together constitute
this one Agreement. Further, upon executing this Agreement, either party may deliver the signature page
to the other by fax or email and that signature shall have the same force and effect as if the Agreement
bearing the original signature was received in person.
IN WITNESS, the parties below execute this Agreement, which shall become effective on
the last date entered below. All acts consistent with the authority of this Agreement and prior
to its effective date are ratified and affirmed, and the terms of the Agreement shall be deemed
to have applied.
CONSULTANT: CITY OF KENT:
V-g 4
By:David de la Fuente(Apr 12,202411:55 PDT) BW. LS,.dJ
Print Name: David de la Fuente Print Name: Dana Ralph 11-
Its Executive Director Its Mayor
DATE: Apr 12,2024 DATE: 05/02/2024
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONSULTANT: CITY OF KENT:
David de la Fuente Lori Guilfoyle
Communities In Schools of Kent City of Kent
PO Box 62 220 Fourth Avenue South
Kent, WA, 98035 Kent, WA 98032
(253) 867-5637 (telephone) (253) 856-5061 (telephone)
ddelafuentel(a)ciskent.org (email) Iguilfoyle@kentwa.gov (email)
APPROVED AS TO FORM:
J'C-� oltk
Kent L'w Department
ATTEST:
et4� 606
Kent City Clerk
[In this field,you may enter the electronic filepath where the contract has been saved]
CONSULTANT SERVICES AGREEMENT - 6
(Over$20,000)
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
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,
EEO COMPLIANCE DOCUMENTS - 2
or is threatened with litigation by a subcontractor, or supplier because of such
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;
EEO COMPLIANCE DOCUMENTS - 3
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
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.
V-¢dl
By:David de la Nente(Apr 12,202411:55 PDT)
For: Communities In Schools of Kent
Title: Executive Director
Date: Apr 12,2024
EEO COMPLIANCE DOCUMENTS - 4
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
Exhibit A
KENO wo5—Iro� Scope and Schedule of Work
PARKS, RECREATION
COMMUNITY SERVICES 9 2024 Consultant Services Agreement
Agency: Communities In Schools of Kent
Program: Mentoring
Funds $38,500
Awarded
Contact: David de la Fuente
PO Box 62
Kent, WA, 98035
(253) 867-5637 (telephone)
ddelafuentel ciskent.or email
Program Provide school based individual and group mentoring for students in the Kent School
Description: District. Sessions are 30 minutes sessions.
Unduplicated Kent Clients Contracted 100
to Serve
Service Unit Descriptions and Deliverables
Service Unit 1: Mentoring
Description: Number of 30 minute mentoring sessions
Number of units: 500
Quarter # of Units Cumulative
Service Unit Total
1st Unduplicated City of Kent clients served 25 25
Service Unit 1 Mentoring 125 125
2nd Unduplicated City of Kent clients served 25 50
Service Unit 1 Mentoring 125 250
3rd Unduplicated City of Kent clients served 25 75
Service Unit 1 Focus Group 125 375
4th Unduplicated City of Kent clients served 25 100
Service Unit 1 Focus Group 125 500
The above services shall be provided by December 31, 2024.
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.
- In addition to quarterly and annual reporting, staff may perform desktop or onsite monitoring 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 CSA must be retained for six (6) years plus the current year.
Performance Measures
The consultant will be expected to meet 100% of the performance measures as set forth within this
Exhibit A. Exceptions may be made only in accordance with Section III.C. of the CSA. If the performance
measures are not fulfilled, payment for services rendered will be reduced in accordance with Section III.0
of the CSA.
Reporting Requirements and Timeline
All data and required forms shall be submitted electronically.
Service Unit Report - Data from this form will be used to track each program's progress toward meeting
the goals stipulated in the Scope of Work. 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 this form from
the persons served through this contract. Data should be tracked in an ongoing manner and submitted
annually (by January 30).
Report Due Date
Service Unit Report and Reimbursement 15th day following each quarter
Request
Final Reimbursement Request (4th Qtr.) January 101h, 2025
Demographic Data Report January 30th, 2025
Annual Outcome Data Report January 30th, 2025
Exhibit B
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 $1,000,000 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.
Issue Date 2/22/2024 Cert#:0000040407
Non Profit Insurance Program
Certificate of Coverage
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONVEYS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES
NOTAMEND,EXTEND ORALTERTHE COVERAGE AFFORDED BYTHE POLICIES BELOW.THIS CERTIFICATE OF COVERAGE 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 SUBROGRATION IS WAIVED,subject to the terms and conditions of
the policy,certain coverage may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER COMPANIES AFFORDING COVERAGE
Clear Risk Solutions GENERAL LIABILITY
451 Diamond Drive American Alternative Insurance Corporation,et al.
Ephrata,WA 98823
AUTOMOBILE LIABILITY
American Alternative Insurance Corporation,et al.
INSURED PROPERTY
American Alternative Insurance Corporation,et al.
Communities in Schools of Kent
MISCELLANEOUS PROFESSIONAL LIABILITY
PO Box 62 Princeton Excess and Surplus Lines Insurance Company
Kent,WA 98035
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE COVERAGE PERIOD
INDICATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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.
TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP DESCRIPTION LIMITS
DATE DATE
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY N1-A2-RL-000001 3-14 6/1/2023 6/1/2024 PER OCCURRENCE $1,000,000
OCCURRENCE FORM PER MEMBER AGGREGATE $2,000,000
INCLUDES STOP GAP PRODUCT-COMP/OP $1,000,000
PERSONAL&ADV.INJURY $1,000,000
(LIABILITY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $50,000,000
AUTOMOBILE LIABILITY
ANY AUTO N1-A2-RL-0000013-14 6/1/2023 6/1/2024 COMBINED SINGLE LIMIT $1,000,000
(LIABILITY IS SUBJECT TO A 350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
PROPERTY
N1-A2-RL-0000013-14 6/1/2023 6/1/2024 ALL RISK PER OCC EXCL EQ&FL $75,000,000
EARTHQUAKE PER OCC Excluded
FLOOD PER OCC Excluded
(PROPERTY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE NONE
MISCELLANEOUS PROFESSIONAL LIABILITY
N1-A3-RL-0000060-14 6/1/2023 6/1/2024 PER CLAIM $1,000,000
(LIABILITY IS SUBJECT TO A$350,000 SIR PAYABLE FROM PROGRAM FUNDS) ANNUAL POOL AGGREGATE $40,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Regarding the Consultant Services Agreement between the City of Kent and Communities in Schools of Kent.City of Kent is named as Additional Insured regarding the
services in this agreement only,and is subject to policy terms,conditions,and exclusions.Additional Insured endorsement is attached.The NPIP retained limit is primary
and non-contributory.Sexual Abuse is included in the General Liability Coverage Part with a limit of$1,000,000.
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE
WITH THE POLICY PROVISIONS.
CERTIFICATE HOLDER AUTHORIZED REPRESENTATIVE City of Kent "��l
220 Fourth Ave South
Kent,WA 98032
AMERICAN ALTERNATIVE
INSURANCE COMPANY
ADDITIONAL INSURED-DESIGNATED PERSON OR ORGANIZATION
(GENERAL LIABILITY)
Named Insured
Non Profit Insurance Program (NPIP)
Policy Number Endorsement Effective
N 1-A2-RL-0000013-14 6/1/2023
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
This endorsement modifies insurance provided under the following:
GENERAL LIABILITY COVERAGE PART
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated above.
Schedule
Person or Organization(Additional Insured): As Per Schedule on file with Clear Risk Solutions,Underwriting Administrator
City of Kent
220 Fourth Ave South
Kent,WA 98032
Regarding the Consultant Services Agreement between the City of Kent and Communities in Schools of Kent.City of
Kent is named as Additional Insured regarding the services in this agreement only,and is subject to policy terms,
conditions,and exclusions.Additional Insured endorsement is attached.The NPIP retained limit is primary and non-
contributory.Sexual Abuse is included in the General Liability Coverage Part with a limit of$1,000,000.
A. With respects to the General Liability Coverage Part only,the definition of Insured in the Liability Conditions,Definitions and Exclusions
section of this policy is amended to include as an Insured the Person or Organization shown in the above Schedule.Such Person or
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 acts or omissions or the acts or omissions of those acting on your behalf:
1. In performance of your ongoing operations;or
2. In connection with your premises owned or rented to you.
B. The Limits of Insurance applicable to the additional Insured are those specified in either the:
1. Written contract or written agreement;or
2. Declarations for this policy,
whichever is less.These Limits of Insurance are inclusive and not in addition to the Limits Of Insurance shown in the Declarations.
All other terms and conditions remain unchanged.
Form:RL 2124 10 21
Includes copyrighted material of the Insurance Services Office,Inc.,with its permission
Non Profit Insurance Program
Member Coverage Certificate
Communities in Schools of Kent
Policy Period: 6/1/2023 to 6/1/2024
Member Since: April 28, 2022
The coverages and deductibles shown here are reflections of the Non Profit Insurance Program(NPIP). Full policy limits,terms,and conditions
are listed in the American Alternative Insurance Corp., Princeton Excess and Surplus Lines Insurance Co., and other excess coverage
forms.These coverage forms can be accessed through the NPIP Broker portal. NPIP will pay those sums that the insured becomes legally
obligated to pay as damages to which the above insurance applies. NPIP will have the right and duty to defend the insured against any"suit"
seeking those damages. However, NPIP will have no duty to defend the insured against any"suit" seeking damages for which the above
insurance does not apply.NPIP's right and duty to defend and pay damages ends when the applicable limit of insurance has been used up in
the payment of judgments or settlements subject to the terms,conditions,and limits of this certificate. NPIP retained limit is primary and non-
contributory.
Commercial Property Coverage
Coverage Form Follows:American Alternative Insurance Corporation-Munich Reinsurance Company(Admitted)
- Policy #N1-A2-RL-0000013-14; Lexington Insurance Company (Non-Admitted) - Policy #62503238; Arch
Specialty Insurance Company(Non-Admitted)-Policy#ESP7303040-06; StarStone Specialty Insurance Company
(Non-Admitted) - Policy#N83307231CSP and #83PRX2313368; Axis Insurance Company (Non-Admitted) - Policy
#EAF781394-23; Landmark American Ins Co (RSUI) (Admitted) - Policy #LHT933917; Westfield Specialty
Insurance Company (Non-Admitted) - Policy #XAR-330606W-00; Allied World Assurance Company (Non-
Admitted)-Policy#0313-8657-1A; Ironshore Specialty Insurance Company(Non-Admitted)-Policy#1000602276-
01; National Fire & Marine Ins Company (Non-Admitted) - Policy #42-XPR-328893-01; Steadfast Insurance
Company(Zurich)(Non-Admitted)-Policy#XPP 3104631-00; Lloyd's of London(Beazley)(Non-Admitted)-Policy
#W35254230101; Lloyd's of London(London)(Non-Admitted)-Policy#BMBP127480r; Lloyd's of London(Hiscox
Insurance Company Inc.)(Non-Admitted) -Policy#UTS2573015.23
NPIP Self Insured Retention: $350,000 all Perils Each Occurrence
Member deductible: See Schedule-all Perils Except Earthquake and Flood Each Occurrence
$250 Personal Property of Employees—Damage&Theft
Member deductible-Earthquake: Excluded
Member deductible-Flood: Excluded
Terrorism: Included
Automobile Physical Damage Coverage
Coverage Form Follows: American Alternative Insurance Corporation-Munich Reinsurance Company(Admitted)
- Policy #N1-A2-RL-0000013-14; Lexington Insurance Company (Non-Admitted) - Policy #62503238; Arch
Specialty Insurance Company(Non-Admitted)-Policy#ESP7303040-06; StarStone Specialty Insurance Company
(Non-Admitted) - Policy#N83307231CSP and #83PRX236368; Axis Insurance Company (Non-Admitted) - Policy
#EAF781394-23; Landmark American Ins Co (RSUI) (Admitted) - Policy #LHT933917; Westfield Specialty
Insurance Company (Non-Admitted) - Policy #XAR-330606W-00; Allied World Assurance Company (Non-
Admitted)-Policy#0313-8657-1A; Ironshore Specialty Insurance Company(Non-Admitted)-Policy#1000602276-
01; National Fire & Marine Ins Company (Non-Admitted) - Policy #42-XPR-328893-01; Steadfast Insurance
Company(Zurich)(Non-Admitted)-Policy#XPP 3104631-00; Lloyd's of London(Beazley)(Non-Admitted)-Policy
#W35254230101; Lloyd's of London(London)(Non-Admitted)-Policy#BMBP127480r; Lloyd's of London(Hiscox
Insurance Company Inc.)(Non-Admitted) -Policy#UTS2573015.23
NPIP Self Insured Retention: $350,000 Each Occurrence
Member deductible: See Vehicle Schedule for specific Deductibles per Vehicle; Rental Vehicles: $500 Per
Occurrence; $0 Rock Chip Repair; Broken Windshield Replacement is subject to APD Deductible
per vehicle
Note:Auto Physical Damage on non-owned autos is excess of any owner's primary coverage.
11/22/2023
Non Profit Insurance Program
Member Coverage Certificate
Communities in Schools of Kent
Policy Period: 6/1/2023 to 6/1/2024
Member Since: April 28, 2022
General Liability Insurance Coverage
Coverage Form Follows: American Alternative Insurance Corp, a member of Munich-American Holding
Corporation (Admitted) -Policy#N1-A2-RL-0000013-14
NPIP Self Insured Retention: $350,000 Each Occurrence/Claim
Member deductible: $5,000 Each Occurrence/Claim
Member Employee Benefits retroactive date(claims made form): 4/28/2022
Member Sex Abuse and Molestation retroactive date(if claims made form): 412812022(see policy for member
sublimit if applicable)
Traumatic Events Response: $100,000 Each Occurrence; $250,000 Group Aggregate
Terrorism: Included
CLAIMS MADE FORM (Claims made coverages only): We will provide one or more Extended Reporting Periods. The
additional annual premium for the Extended Reporting Period will NOT exceed 200%of the annual premium for this Coverage
Part.
Automobile Liability Coverage
Coverage Form Follows: American Alternative Insurance Corp, a member of Munich-American Holding
Corporation (Admitted) -Policy#N1-A2-RL-0000013-14
NPIP Self Insured Retention: $350,000 Each Accident
Member deductible: See Vehicle Schedule for Specific Deductibles per Vehicle, Each Accident
UIM Member deductible: Excluded
Terrorism: Included
Wrongful Acts Liability Coverage (Directors, Officers and Employees Liability, including
Employment Practices Liability, Third Party Employment Practices Liability, and Fiduciary
Liability)
Coverage Form Follows: Princeton Excess & Surplus Lines Ins Co, a member of Munich-American Holding
Corporation (Non-Admitted)- Policy#N1-A3-RL-0000060-14
NPIP Self Insured Retention: $350,000 Each Wrongful Act
Member deductible: $5,000 Each Wrongful Act
Member retroactive date: 412812022
Member Sexual Harassment retroactive date: 412812022
Terrorism: Included
CLAIMS MADE FORM: We will provide one or more Extended Reporting Periods. The additional annual premium for the
Extended Reporting Period will be a minimum of 100%of the annual premium for this Coverage Part.
Miscellaneous Professional Liability Coverage
Coverage Form Follows: Princeton Excess & Surplus Lines Ins Co, a member of Munich-American Holding
Corporation (Non-Admitted)- Policy#N1-A3-RL-0000060-14
NPIP Self Insured Retention: $350,000 Each Wrongful Act
Member deductible: $1,000 Each Wrongful Act
Member retroactive date: 4/28/2022
CLAIMS MADE FORM: We will provide one or more Extended Reporting Periods. The additional annual premium for the
Extended Reporting Period will be a minimum of 100%of the annual premium for this Coverage Part.
11/22/2023
Non Profit Insurance Program
Member Coverage Certificate
Communities in Schools of Kent
Policy Period: 6/1/2023 to 6/1/2024
Member Since: April 28, 2022
Crime Insurance Coverage
Coverage Form Follows: American Alternative Insurance Corp, a member of Munich-American Holding
Corporation (Admitted) -Policy#N1-A2-RL-000001 3-14
NPIP Self Insured Retention: $350,000 Each Occurrence
Member deductible: $500 Each Occurrence Per Member
Equipment Breakdown Coverage
Coverage Form Follows:American Alternative Insurance Corporation-Munich Reinsurance Company(Admitted)
- Policy #N1-A2-RL-0000013-14; Lexington Insurance Company (Non-Admitted) - Policy #62503238; Arch
Specialty Insurance Company(Non-Admitted)-Policy#ESP7303040-06; StarStone Specialty Insurance Company
(Non-Admitted) - Policy#N83307231CSP and #83PRX2313368; Axis Insurance Company (Non-Admitted) - Policy
#EAF781394-23; Landmark American Ins Co (RSUI) (Admitted) - Policy #LHT933917; Westfield Specialty
Insurance Company (Non-Admitted) - Policy #XAR-330606W-00; Allied World Assurance Company (Non-
Admitted)-Policy#0313-8657-1A; Ironshore Specialty Insurance Company(Non-Admitted)-Policy#1000602276-
01; National Fire & Marine Ins Company (Non-Admitted) - Policy #42-XPR-328893-01; Steadfast Insurance
Company(Zurich)(Non-Admitted)-Policy#XPP 3104631-00; Lloyd's of London(Beazley)(Non-Admitted)-Policy
#W35254230101; Lloyd's of London(London)(Non-Admitted)-Policy#BMBP127480r; Lloyd's of London(Hiscox
Insurance Company Inc.)(Non-Admitted) -Policy#UTS2573015.23
NPIP Self Insured Retention: $100,000 Each Accident; Service Interruption—24 Hours
Member deductible: $1,000 Each Accident; Service Interruption—24 Hours
Terrorism: Included
Notes/Other
Authorized Signature:
Notice of Cancellation for Non-payment
Please note that if payment is not received, NPIP shall have the right to cancel coverage. Notice of cancellation shall be no less than 10 days, per
Membership Agreement Section 3.12. Notice of cancellation will be emailed to the Named Insured's last known email address and will indicate the
date on which coverage is terminated.A copy will be emailed to the broker of record on file.
11/22/2023
�- T
Exhibit C
PARKS, RECREATION
COMMUNITY$ERVICE$ City of Kent
Certification Regarding Debarment and Suspension
Communities in Schools of Kent Communities In Schools Mentorina
Agency Name of Program(s)
Certification A: Certification Regarding Debarment, Suspension, and Other
Responsibility Matters - Primary Covered Transactions
1. The prospective primary participant certifies to the best of its knowledge and belief that
its principals;
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal debarment or agency;
b) Have not within a three-year period preceding this proposal, been convicted of or had a
civil judgment rendered against them for commission of fraud or a criminal offense in
connection with obtaining, attempting to obtain, or performing a public (Federal, State,
or local) transaction or contract under a public transaction; violation of Federal or State
antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification, or
destruction of records, making false statements, or receiving stolen property;
c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental
entity (Federal, State, or local) with commission of any of the offenses enumerated in
paragraph (1)(b) of this certification; and
d) Have not within a three-year period preceding this application/ proposal had one or more
public transactions (Federal, State, or local) terminated for cause or default.
2. Where the prospective primary participant is unable to certify to any of the statements in
this certification, such prospective participant shall attach an explanation to this proposal.
Instructions for Certification (A)
1. By signing and submitting this proposal, the prospective primary participant is
providing the certification set out below.
2. The inability of a person to provide the certification required below will not necessarily
result in denial of participation in this covered transaction. The prospective participant
shall submit an explanation of why it cannot provide the certification set out below.
The certification or explanation will be considered in connection with the department
or agency's determination whether to enter into this transaction. However, failure of
the prospective primary participant to furnish a certification or an explanation shall
disqualify such person from participation in this transaction.
3. The certification in this clause is a material representation of fact upon which reliance
was placed when the department or agency determined to enter into this transaction.
If it is later determined that the prospective primary participant knowingly rendered
an erroneous certification, in addition to other remedies available to the Federal
Government/City of Kent, the department or agency may terminate this transaction
for cause of default.
4. The prospective primary participant shall provide immediate written notice to the
department or agency to whom this proposal is submitted if at any time the
prospective primary participant learns that its certification was erroneous when
submitted or has become erroneous by reason of changed circumstances.
5. The terms covered transaction, debarred, suspended, ineligible, lower tier
covered transaction, participant, person, primary covered transaction,
principal, proposal, and voluntarily excluded, as used in this clause, have the
1 of 3
meanings set out in the Definitions and Coverage sections of the rules implementing
Executive Order 12549. You may contact the department or agency to which this
proposal is being submitted for assistance in obtaining a copy of these regulations.
6. The prospective primary participant agrees by submitting this proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into
any lower tier covered transaction with a person who is debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the department or agency entering into this
transaction.
7. The prospective primary participant further agrees by submitting this proposal that it
will include the clause titled "Certification Regarding Debarment, Suspension,
Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction," provided by
the department or agency entering into this covered transaction, without
modification, in all lower tier covered transactions and in all solicitations for lower tier
covered transactions.
8. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended,
ineligible, or voluntarily excluded from the covered transaction, unless it knows that
the certification is erroneous. A participant may decide the method and frequency by
which it determines this eligibility of its principals. Each participant may, but is not
required to, check the Non-procurement List.
9. Nothing contained in the foregoing shall be construed to require establishment of a
system of records in order to render in good faith the certification required by this
clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business
dealings.
10. Except for transactions authorized under paragraph (6) of these instructions, if a
participant in a covered transaction
11. Knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this
transaction, in addition to other remedies available to the Federal Government/City of
Kent, the department or agency may terminate this transaction for cause of default.
Certification B: Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transactions
1. The prospective lower tier participant certifies, by submission of this proposal, that
neither it nor its principals is presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any
Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements
in this certification, such prospective participant shall attach an explanation to this
proposal.
Instructions for Certification (B)
1. By signing and submitting this proposal, the prospective lower tier participant is
providing the certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance
was placed when this transaction was entered into. If it is later determined that the
prospective lower tier participant knowingly rendered an erroneous certification, in
addition to other remedies available to the Federal Government/City of Kent, the
department or agency with which this transaction originated may pursue available
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remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the
person to which this proposal is submitted if at any time the prospective lower tier
participant learns that its certification was erroneous when submitted or has become
erroneous by reason of changed circumstances.
4. The terms covered transaction, debarred, suspended, ineligible, lower tier
covered transaction, participant, person, primary covered transaction,
principal, proposal, and voluntarily excluded, as used in this clause, have the
meanings set out in the Definitions and Coverage sections of rules implementing
Executive Order 12549. You may contact the person to which this proposal is
submitted for assistance in obtaining a copy of these regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should
the proposed covered transaction be entered into, it shall not knowingly enter into
any lower tier covered transaction with a person who is debarred, suspended,
declared ineligible, or voluntarily excluded from participation in this covered
transaction, unless authorized by the department or agency with which this trans-
action originated.
6. The prospective lower tier participant further agrees by submitting this proposal that
it will include this clause titled "Certification Regarding Debarment, Suspension,
Ineligibility and Voluntary Exclusion - Lower Tier Covered Transaction," without
modification, in all lower tier covered transactions and in all solicitations for lower tier
covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended,
ineligible, or voluntarily excluded from the covered transaction, unless it knows that
the certification is erroneous. A participant may decide the method and frequency by
which it determines the eligibility of its principals. Each participant may, but is not
required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a
system of records in order to render in good faith the certification required by this
clause. The knowledge and information of a participant is not required to exceed that
which is normally possessed by a prudent person in the ordinary course of business
dealings.
9. Except for transactions authorized under paragraph (5) of these instructions, if a
participant in a lower covered transaction knowingly enters into a lower tier covered
transaction with a person who is suspended, debarred, ineligible, or voluntarily
excluded from participation in this transaction, in addition to other remedies available
to the Federal Government/City of Kent, the department or agency with which this
transaction originated may pursue available remedies including suspension and/or
debarment.
Executive Director (Print) Title
David de la Fuente Executive Director
Signature of Executive Director Date
David 00L pr12,202411:55PDT) Apr 12, 2024
(3
Adopted from HUD Form-2992
09/04
3of3
Signature: . Signature: 204ad LalG�Ge�
Merin�n(Par 20,202408:31 PDT) Ronald Lashley Jr.(Mar 21,202 10:53 PDT)
Email: mhanson@kentwa.gov Email: parkscontracts@kentwa.gov
Signature:
Juli arascondola(Apr 19,2024 08:05 PDT)
Email: jparascondola@kentwa.gov
CIS Kent CSA_2024
Final Audit Report 2024-04-19
Created: 2024-03-20
By: Megan Turner(MTurner@kentwa.gov)
Status: Signed
Transaction ID: CBJCHBCAABAAatmKCMXJAnWN30vHWCnhyUU7h9Qv5ckg
"CIS Kent CSA 2024" History
Document created by Megan Turner(MTurner@kentwa.gov)
2024-03-20-3:23:59 PM GMT
Document emailed to mhanson@kentwa.gov for signature
2024-03-20-3:29:01 PM GMT
Email viewed by mhanson@kentwa.gov
2024-03-20-3:31:17 PM GMT
Signer mhanson@kentwa.gov entered name at signing as Merina Hanson
2024-03-20-3:31:49 PM GMT
ca Document e-signed by Merina Hanson (mhanson@kentwa.gov)
Signature Date:2024-03-20-3:31:51 PM GMT-Time Source:server
Document emailed to Kent Parks (parkscontracts@kentwa.gov)for signature
2024-03-20-3:31:55 PM GMT
3 Email viewed by Kent Parks (parkscontracts@kentwa.gov)
2024-03-21 -5:04:05 PM GMT
} Signer Kent Parks (parkscontracts@kentwa.gov) entered name at signing as Ronald Lashley Jr.
2024-03-21 -5:53:05 PM GMT
Document e-signed by Ronald Lashley Jr. (parkscontracts@kentwa.gov)
Signature Date:2024-03-21 -5:53:07 PM GMT-Time Source:server
Document emailed to David de la Fuente (ddelafuente1 @ciskent.org)for signature
2024-03-21 -5:53:12 PM GMT
.; Email viewed by David de la Fuente (ddelafuente1 @ciskent.org)
2024-04-12-6:54:36 PM GMT
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E= Document e-signed by David de la Fuente (ddelafuentel @ciskent.org)
Signature Date:2024-04-12-6:55:16 PM GMT-Time Source:server
Document emailed to Julie Parascondola Qparascondola@kentwa.gov)for signature
2024-04-12-6:55:20 PM GMT
Email viewed by Julie Parascondola (jparascondola@kentwa.gov)
2024-04-12-7:13:47 PM GMT
Email viewed by Julie Parascondola (jparascondola@kentwa.gov)
2024-04-19-3:04:53 PM GMT
E= Document e-signed by Julie Parascondola Qparascondola@kentwa.gov)
Signature Date:2024-04-19-3:05:26 PM GMT-Time Source:server
Agreement completed.
2024-04-19-3:05:26 PM GMT
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