HomeMy WebLinkAboutCAG2024-517 - Original - Alternative Counseling, Inc. - Alcohol Drug Evaluations - 11/14/24 tUK C.11 Y Ur KLN 1 UrrIC.IAL UJt UNLY
Sup/Mgr:
Agreement Routing Form D i r Asst:
• For Approvals,Signatures and Records Management Dir/Dep:
KE N T This form combines&replaces the Request for Mayor's Signature and Contract Cover (Optional)
WASH I N O T O N Sheet forms.
Originator: Department.
Margaret Yetter MU1 ),6, C I ��
Date Sent: Date Required:
> 11/14/2024 N/A
0
mDirector or Designee to Sign. Date of Council Approval:
Q N/A
Budqet Account Number: Grant? Yes E:]No
Budget? Yes:No Type: N/A
Vendor Name: Category:
Alternative Counseling Inc. Contract
Vendor Number: Sub-Category:
C Original
0
Project Name: Alcohol/Drug Evaluations
E
c Project Details:provide alcohol/drug evaluations and outpatient services for
C Community Court individuals as described in Exhibit A
C
Go
E Agreement Amount: 10000 Basis for Selection of Contractor: Direct Negotiation
40 *Memo to Mayor must be attached
Start Date: 11/14/2024 Termination Date: 12/31/2026
a Local Business?:Yes:No* If meets requirements per KCC3.70.100,please complete"VendorPurchose-LocalExceptions'formonCityspace.
Business License Verification:Yes In-Process Exempt(KCC 5.01.045)
Notice required prior to disclosure? Contract Number:
:Yes�V— No CAG2024-517
Comments:
a1
C
30
'� d
4 L
C
1M
Date Routed to the City Clerk's Office: 11/14/24 Interlocal Agreement has been uploaded to website:
dd«W22373_1_20 Visit Documents.KentWA.gov to obtain copies of all agreements
rev.20210513
KEN T
WAS „��ro
PROFESSIONAL SERVICES AGREEMENT
between the City of Kent and
Alternative Counseling Inc.
THIS AGREEMENT is made between the City of Kent, a Washington municipal corporation (hereinafter
the "City"), and Alternative Counseling Inc. organized under the laws of the State of Washington, located
and doing business at 6625 South 190t" Street, Suite B-103 Kent, WA 98032 (425) 251-1933 (hereinafter
the "Contractor").
I. DESCRIPTION OF WORK.
The Contractor shall perform the following services for the City:
Provide alcohol/drug evaluations and outpatient services for Community Court
individuals as described in Exhibit A.
The Contractor 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, and the Contractor shall complete
the work by December 31, 2026.
III. COMPENSATION. The City shall pay the Contractor a total amount not to exceed $10,000.00
for the services described in this Agreement. The Contractor shall invoice the City monthly based on time
and materials incurred during the preceding month. The hourly rates charged for the Contractor's services
shall be as delineated in the attached and incorporated Exhibit A. All hourly rates charged shall remain
locked at the negotiated rates throughout the term of this Agreement.
Card Payment Program. The Contractor 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 Contractor. If the Contractor voluntarily participates in
this Program, the Contractor will be solely responsible for any fees imposed by financial institutions or credit
card companies. The Contractor 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 Contractor 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 Contractor maintains and pays for its own place of business from which the
Contractor's services under this Agreement will be performed.
C. The Contractor 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 Contractor's services, or the Contractor is engaged in an independently
established trade, occupation, profession, or business of the same nature as that
involved under this Agreement.
PROFESSIONAL SERVICES AGREEMENT - 1
($20,000 or Less)
D. The Contractor 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 Contractor has registered its business and established an account with the state
Department of Revenue and other state agencies as may be required by the
Contractor's business, and has obtained a Unified Business Identifier (UBI) number
from the State of Washington.
F. The Contractor 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 seven (7) calendar days written notice at its address set forth on the signature
block of this Agreement.
VI. FORCE MAJEURE. 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
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 Contractor 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 Contractor 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 Contractor 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 Contractor to fulfill its obligations under
this Agreement. Except as expressly contemplated by this section, all other costs will be borne by the
Contractor.
VII. DISCRIMINATION. In the hiring of employees for the performance of work under this
Agreement or any subcontract, the Contractor, its subcontractors, or any person acting on behalf of the
Contractor 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 Contractor shall execute
the attached City of Kent Non-Discrimination Policy Declaration and comply with City Administrative Policy
1.2.
VIII. INDEMNIFICATION. The Contractor shall defend, indemnify and hold the City, its officers,
officials, employees, agents and volunteers harmless from any and all claims, injuries, damages, losses or
PROFESSIONAL SERVICES AGREEMENT - 2
($20,000 or Less)
suits, including all legal costs and attorney fees, arising out of or in connection with the Contractor'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 Contractor's work when completed shall not
be grounds to avoid any of these covenants of indemnification. The provisions of this section shall survive
the expiration or termination of this Agreement.
In the event the Contractor refuses tender of defense in any suit or any claim, if that tender was
made pursuant to this indemnification clause, and if that refusal is subsequently determined by a court
having jurisdiction (or other agreed tribunal) to have been a wrongful refusal on the Contractor's part, then
the Contractor 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 Contractor's part.
IX. INSURANCE. The Contractor 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. CONTRACTOR'S WORK AND RISK. The Contractor 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
Contractor's business, equipment, and personnel engaged in operations covered by this Agreement or
accruing out of the performance of those services. All work shall be done at the Contractor's own risk, and
the Contractor 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.
XI. ARPA FUNDING; DEBARMENT AND SUSPENSION CERTIFCATION. Contractor
understands and agrees that some or all of the funds provided under this Agreement derive from federal
sources, specifically State and Local Fiscal Recovery Funds authorized by the American Rescue Plan Act, and
agrees to comply with any and all additional applicable terms and regulations associated with this funding.
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. The Contractor, by signature to this Agreement,
certifies that the Contractor is not currently debarred, suspended, or proposed for debarment, by any
Federal department or agency. Contractor also agrees that it will not enter into a subcontract with a person
or entity that is debarred, suspended, or proposed for debarment. Contractor 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/.
XII. 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.
PROFESSIONAL SERVICES AGREEMENT - 3
($20,000 or Less)
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.
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
Contractor.
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. 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. Public Records Act. The Contractor 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 Contractor 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 Contractor agrees to cooperate fully with the City in satisfying the City's duties
and obligations under the Public Records Act.
I. City Business License Required. Prior to commencing the tasks described in Section I, the
Contractor agrees to provide proof of a current city of Kent business license pursuant to Chapter 5.01 of the
Kent City Code.
PROFESSIONAL SERVICES AGREEMENT - 4
($20,000 or Less)
J. 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.
CONTRACTOR: CITY OF KENT: �l
By: By� � � 1110
Print Name: Oksana Kimpel Print Name: arga6/ r Yetter, Court Administrator
Its: Vice President Its: Court Administrator
DATE. 11/13/2024 DATE: C�— V
NOTICES TO BE SENT TO: NOTICES TO BE SENT TO:
CONTRACTOR: CITY OF KENT:
Alternative Counseling Inc Kent Municipal Court
6625 South 1901h Street, Suite B-103 1220 Central Ave South
Kent, WA 98032 Kent, WA 98032
(253) 856-5730 (telephone)
Myetter kentwa.gov (email)
(425) 251-1933 (telephone)
Oksana@altcounseling.com (email)
ATTEST:
Kent City Clerk
PROFESSIONAL SERVICES AGREEMENT - 5
($20,000 or Less)
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 Tit►e 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 seven requirements referenced above.
By:
For: Oksana Kimpel
Title:
Vice President
Date, 11/13/2024
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
Alternative Counseling Kent
6625 S 190th St.,Ste.B-103 Kent,WA 98032
Phone:(425)251-1933 Fax:(425)251-4996
Agency#BHA.FS.60874026
Alternative Counseling is a WA State certificated behavioral health agency,providing Substance Use Disorder/Mental
Health/Behavioral Health services.
Fee Schedule
Alcohol/Drug Evaluation $125
Alcohol/Drug Evaluation Collateral $800
Anger Management Evaluation $250
SUD Intensive Outpatient Services per group session $90
SUD Outpatient Services per group session $75
Individual Counseling per session $100
Anger Management Level 1 $275
Anger Management Level 2 $600
Moral Reconation Treatment program $950
Drug test/6 panel/lab $70
Drug test/21 panel/lab $150
If you have any questions feel free to contact us at 425-251-1933.
Sincerely,
--Digitally Signed: 11/12/2024 01:18 pm Oksana Kimpel,MS,NCAC I,SUDP
Printed from BestNotes CRM Oksana Kimpel,DOB: ,ID/CID: 1897/1897 Page 1 of 1
Exhibit B
Insurance Requirements
Insurance
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.
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.
Professional Liability or Errors & Omissions insurance appropriate to
the Contractor's profession.
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, $2,000,000 general aggregate,
and $2,000,000 products-completed operations aggregate limit.
Primary Non-Contributory Additional Insured coverage for the City of
Kent, et. al.
Waiver of Subrogation
Professional Liability or Errors & Omissions insurance shall be written
with limits no less than $1,000,000 per occurrence, $1,000,000
general aggregate.
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 for Commercial General Liability and Automobile Liability
insurance:
1. 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 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 endorsements 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.
HEALTHCARE PROVIDERS SERVICE
ORGANIZATION PURCHASING GROUP mHPSO
Certificate of �Q| «�|ir8]ice
CAfA OCCURRENCE PROFESSIONAL LIABILITY POLICY FORM
Print Date: 4/18/2024
The application for the Policy and any and allsupplementary information, materials, and statements submitted therewith shall
be maintained on file by us or our Program Administrator and will be deemed attached to and incorporated into the Policy as
if physically a ached.
Named Insured and Address: Prociram Administered by:
Counseling Services of Washington LLC Healthcare Providers Service Organization
422 West Titus Street 1100 Virginia Drive, Suite 250
Kent, WA 98032 Fort Washington, PA 19034
1-888-288-3534
Medical S ecialtV: Code: Insurance Provided bV:
Licensed Professional Counselor Firm Q-0723 American Casualty Company of Reading, Pennsylvania
151 N. Franklin Street
Excludes Cosmetic Procedures Chicago, IL 60606
PRODUCER BRANCH PREFIX POLICY NUMBER POLICY PERIOD
$ aggregate
Your professional liability limits shown above include the following:
° Good Samaritan Liability ° [Wa|p\ooam*nt Liability ° Personal Injury Liability
^ Sexual Misconduct Included in the PL limit shown above Subject to $25,000 aggregate sublimit
Coverage Extensions
License Protection $ 1,000 per day limit $25,000 aggregate
Defendant Expense Benefit $ 10,000 per deposition $ 10,000 aggregate
Deposition Representation
Assault $25,000 per incident $25,000 aggregate
Includes Workplace Violence Counseling $ 100,000 aggregate
Medical Payments $25,000 per person
First Aid $ 10,000 per incident $ 10,000 aggregate
Damage to the Property of Others $ 10,000 per incident $ 10,000 aggregate
Enterprise Privacy Protection - Claims Made $ 25,000 per incident $ 25,000 aggregate
Retroactive Date: 5/18/2023 (Defense inside limits) per incident $ 25,000 aggregate
Media Expense $ 25,000
Workplace Liabiii
Workplace Liability Included in Professional Liability Limit shown above blimit
Fire &Water Legal Liability Included in the PL limit shown above subject to $150,000 aggregate su
Personal Liability Excluded
Total $ 600.00
Base Premium $800.00
Policy Forms and Endorsements (Please see attached list Vf policy forms and endorsements)
Chairman of the nard Secretary
Keep this Certificate of Insurance in a safe place. It and proof of payment are your proof of coverage. There is no coverage in
force unless the premium is paid in full. To activate your coverage, please remit premium in full by the effective date of this
Certificate ofInsurance.
Coverage Change Date: Endorsement Date: Master Policy: 188711433
CNA93692 (11-2018)
@ Copyright owA All Rights Reserved,
NTE
NEWCONN-05 CVAN A
l^' DATE(MMIDDIYYYY)
,a►�CORL7„ CERTIFICATE OF LIABILITY INSURANCE 4/25/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such
endorsement(s).
CONTACT
PRODUCER PHONE
Lynden,WA-Guide Insurance-Hub International Northwest LLC Arc,E Ext:(360)354-2200 rAAic.No): 360 933-4145
PO Box 473 LAIC,
Lynden,WA 98234 Naic a
INSURER 5 AFFORDING COVERAGE
-INSURER A:Western National Mutual Insurance Company 15377
INSURER B:Western National Assurance Com an 24465
INSURED
New Connections of South King County INSURER C
422 West Titus INSURER
Kent,WA 98032 INSURERS: --•--
INSURER F
COVERAGES GERTIFICATE 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.
IN ADOL SUBR POLICY NUMBER POLICD YYYY� POLICY EXP LIMITS
TYPE OF INSURANCE 1,000,000
A X COMMERCIAL GENERAL LIABILITY EAC11 0 RRENCE
� DAMAGE TO RENTED 1 OO,000
CLAIMS-MADE [X]OCCUR X CPP 1281971 2/25/2024 2/25/2025 _..-
MED EXP An one arson l 3 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: 2,000,000
X POLICY El s C7 D LOC PRODUCTS-COM JQP AGG $
$
OTHER' —COMBINED SINGLELIMIT $ 1,000,000
B AUTOMOBILE LIABILITY (Ea accidgint),
""'-"—ANY AUTO CPP128196702 2/25/2024 2/25/2025 BGDILY INJURY{Por person $
OWNED SCHEDULED BODILY INJURY Per accident $
AUTOS ONLY AUTOS PROPER1Y DAMAGE
HIRED NON-AWNED (Poraccident) $
X AUTOS ONLY X AUTOS ONLY
A X UMBRELLA LIAe OCCUR EACH OCCURRENCE S 1,()00,000
UMB 1047609 2/25/2024 2125/2025 1,000,000
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DED X RETENTION$ 10,000 $
PER OTW-
WORKERS COMPENSATION -I- T- -
AND EMPLOYERS'LIABILITY
YIN E.L.EAChI ACCIDENT $
ANY PROPRIETORJPARTNERIEXEGU7tVE ❑
WN/A
story in NH)
FFICandER/MEMBER EXCLUDED? G.L.DISEASE•EA EMPLOYE
rt
If yes,describe under E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS below
A D&O CPP 1281971 2/25/2024 2/25/2025 Directors&Officers 1,000,000
A SAM Endorsement CPP 1281971 2/25/2024 2125/2025
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Certificate holder is named as additional insured per the attached forms.
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
ACORD 25(2016/03) p 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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