HomeMy WebLinkAboutReg 2025-03-17 Item 6C - Contracts - 2025-2026 Human Services ContractsCOUNCIL AGENDA SYNOPSIS
Initials
Meeting Date
Prepared by
Mayor's review
Council review
3/17/25
SH
ITEM INFORMATION
ITEM No.
6.C.
STAFF SPONSOR: STACY HANSEN
ORIGINAL AGENDA DATE: 03/ 17/ 25
AGENDA ITEM TITLE Human Servivces 2025-26 contracts over $60,000
St. Stephen's Housing Association Harnett Manor property lease
CATEGORY ® Discussion
Mtg Date 3-17-25
® Motion
Mtg Date 3-17-25
❑ Resolution
Mtg Date
❑ Ordinance
Mtg Date
❑ Bid Award
Mtg Date
❑ Public Hearing
Mtg Date
❑ Other
Mtg Date
SPONSOR ❑ Council ® Mayor ❑ Admit Svcs ❑ DCD ❑ Finance ❑ Fire ❑ Pcr-R ❑ Police ❑ PJF
SPONSOR'S
SUMMARY
Staff is asking Council to authorize the Mayor's signature on four Human Services
contracts that total over $60,000 each. These contracts were approved for funding as part
of the Council adopted 2025-26 budget.
Staff is also asking Council to authorize the Mayor's signature on a property lease for
Hartnett Manor in partnership with St. Stephen's Housing Association
REVIEWED BY ❑ Trans&Infrastructure Svcs ❑ Community Svcs/Safety ❑ Finance & Governance ❑ Planning & Community Dev.
❑ LTAC
DATE:
❑ Arts Comm.
❑ Parks Comm. ❑ Planning Comm.
COMMITTEE CHAIR:
RECOMMENDATIONS:
SPONSOR/ADMIN. Mayor's office/Human Servics Program
COMMII'1EE Council President requested this item be presented to COW on 3/10/25
COST IMPACT / FUND SOURCE
EXPENDITURE REQUIRED
$297,000
AMOUNT BUDGETED
$297,000
APPROPRIATION REQUIRED
$
Fund Source: GENERAL FUND
Comments:
MTG. DATE
RECORD OF COUNCIL ACTION
3/17/25
MTG. DATE
ATTACHMENTS
3/17/25
Info memo dated 2/28/25
Four Human Services contracts over $60,000
*Akin -school based mental health
*Multi Service Center-rent/utility assistance program
*Refugee Women's Alliance -basic needs/system navigation
*Tukwila Pantry - food bank
Property Lease signature for St. Stephen's Housing Association for Hartnett Manor
99
City of Tukwila
Thomas McLeod, Mayor
INFORMATIONAL MEMORANDUM
TO: Community Services and Safety
FROM: Stacy Hansen, Human Services Program Coordinator
CC: Thomas McLeod
DATE: February 27, 2025
SUBJECT: Human Services Contracts over $60,000 for the 2025-26 funding cycle & St.
Stephen Housing property lease
ISSUE
Human Services contracts with community -based organizations to support the residents' human
services needs. Four contracts are above the Mayor's signature authority and require Council
authorization.
Authorization is also requested on a property lease with non-profit St. Stephen Housing
Association regarding Hartnett Manor transitional housing located at 14688 Macadam Road
South, Tukwila, WA.
BACKGROUND
The Human Services non-profit program contracts are part of the larger 2025-2026 Mayor's
department budget. As in the past, each contract is for a two-year period. Information on the
contracts above the threshold including agency, program and budget are listed below:
Contract/Program Two-year contract total
Akin -School based mental health services $70,000 ($35,000)
Multi -Service Center-rent/utility assistance program $84,000 ($42,000)
Refugee Women's Alliance -Basic needs/system navigation $63,000 ($31,500)
Tukwila Pantry -food bank $80,000 ($30,000)
2 — year total for all contracts combined $297,000 ($148,500)
In December 2024, the Way Back Inn merged with the non-profit St. Stephen Housing
Association (SSHA). The Hartnett Manor property lease needs to reflect that St. Stephen
Housing Association is the new City partner who will be managing Hartnett Manor as transitional
housing, assisting unsheltered asylee seekers who are currently in Tukwila.
FINANCIAL IMPACT
Funding for the four non-profit contracts was approved as part of the Mayor's department
budget for the 2025-2026 biennial budget.
If repairs related to Hartnett Manor exceed $5,000, grant funding could be utilized to make
necessary repairs to keep the home in good condition which will maintain critical bed nights for
unsheltered asylee families.
RECOMNMENDATION
The Committee is being asked to forward the contract authorizations to the consent agenda on
March 17, 2025, regular meeting.
100
INFORMATIONAL MEMO
Page 2
ATTACHMENTS
Proposed — Children's Home Society — Akin contract
Proposed — Multi Service Center rent/utility assistance contract
Proposed — Refugee Women's Alliance — basic needs, system navigation
Proposed — Tukwila Pantry — food bank
Property lease agreement for Hartnett Manor between City of Tukwila and St. Stephen Housing
Association.
https://tukwilawa.sharepoint.com/sites/mayorsoffice/cc/Council Agenda Items/Human Services/2 Info Memo HS Contracts over $60K - updated.docx
101
City of Tukwila
6200 Southcenter Boulevard, Tukwila WA98188
CONTRACT FOR SERVICES
Contract Number:
This Agreement is entered into by and between the City of Tukwila, Washington, a non -charter
optional municipal code city hereinafter referred to as "the City," and, Children's Home Society, dba Akin
hereinafter referred to as "the Contractor," whose principal office is located at 12360 Lake City Way NE,
Suite 100, Seattle, WA 98125.
WHEREAS, the City has determined the need to have certain services performed for its citizens
but does not have the manpower or expertise to perform such services; and
WHEREAS, the City desires to have the Contractor perform such services pursuant to certain terms
and conditions; now, therefore,
IN CONSIDERATION OF the mutual benefits and conditions hereinafter contained, the parties
hereto agree as follows:
1. Scope and Schedule of Services to be Performed by Contractor. The Contractor shall perform
those services described on Exhibit A attached hereto and incorporated herein by this reference as if
fully set forth. In performing such services, the Contractor shall at all times comply with all Federal,
State, and local statutes, rules and ordinances applicable to the performance of such services and the
handling of any funds used in connection therewith. The Contractor shall request and obtain prior
written approval from the City if the scope or schedule is to be modified in any way.
2. Compensation and Method of Payment. The City shall pay the Contractor for services rendered
according to the rate and method set forth on Exhibit A attached hereto and incorporated herein by this
reference. The total amount to be paid shall not exceed $35,000 in 2025 and $35,000 in 2026.
3. Contractor Budget. The Contractor shall apply the funds received under this Agreement within the
maximum limits set forth in this Agreement. The Contractor shall request prior approval from the City
whenever the Contractor desires to amend its budget in any way.
4. Duration of Agreement. This Agreement shall be in full force and effect for a period commencing
January 1 , 2025, and ending December 31, 2026, unless sooner terminated under the provisions
hereinafter specified.
5. Independent Contractor. Contractor and City agree that Contractor is an independent contractor with
respect to the services provided pursuant to this Agreement. Nothing in this Agreement shall be
considered to create the relationship of employer and employee between the parties hereto. Neither
Contractor nor any employee of Contractor shall be entitled to any benefits accorded City employees
by virtue of the services provided under this Agreement. The City shall not be responsible for
withholding or otherwise deducting federal income tax or social security or contributing to the State
Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to the
Contractor, or any employee of the Contractor.
6. Indemnification. The Contractor shall defend, indemnify and hold the Public Entity, its officers,
officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or
suits including attorney fees, arising out of or in connection with the performance of this Agreement,
except for injuries and damages caused by the sole negligence of the Public Entity.
CA Revised May 2020 Page 1 of 4
102
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 Contractor and the Public Entity, its
officers, officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the
extent of the Contractor's negligence. It is further specifically and expressly understood that the
indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial
Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually
negotiated by the parties. The provisions of this section shall survive the expiration or termination of
this Agreement.
7. 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. Contractor's maintenance of insurance, its scope of coverage and limits as required
herein shall not be construed to limit the liability of the Contractor to the coverage provided by such
insurance, or otherwise limit the City's recourse to any remedy available at law or in equity.
A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types and with the limits
described below:
1. Automobile Liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident. Automobile liability insurance shall cover all
owned, non -owned, hired and leased vehicles. Coverage shall be written on Insurance Services
Office (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.
2. Commercial General Liability insurance with limits no less than $2,000,000 each occurrence,
$2,000,000 general aggregate and $2,000,000 products -completed operations aggregate
limit. Commercial General Liability insurance shall be as least at broad as ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations, independent
contractors, products -completed operations, stop gap liability, personal injury and advertising
injury, and liability assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide a per project general aggregate limit using ISO form
CG 25 03 05 09 or an equivalent endorsement. There shall be no exclusion for liability
arising from explosion, collapse or underground property damage. The City shall be named
as an additional 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 10 01 and Additional Insured -Completed Operations endorsement CG 20 37 10 01 or
substitute endorsements providing at least as broad coverage.
3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of
Washington.
B. Public Entity Full Availability of Contractor Limits. If the Contractor maintains higher insurance
limits than the minimums shown above, the Public Entity shall be insured for the full available limits
of Commercial General and Excess or Umbrella liability maintained by the Contractor, irrespective
of whether such limits maintained by the Contractor are greater than those required by this Contract
or whether any certificate of insurance furnished to the Public Entity evidences limits of liability
lower than those maintained by the Contractor.
C. Other Insurance Provision. The Contractor's Automobile Liability and Commercial General
Liability insurance policies are to contain, or be endorsed to contain that they shall be primary
insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and shall not contribute with
it.
D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating
of not less than A: VI I.
CA Revised May 2020 Page 2 of 4
103
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. Upon request by the City, the Contractor shall furnish certified copies of all required
insurance policies, including endorsements, required in this Agreement and evidence of all
subcontractors' coverage.
F. Subcontractors. The Contractor shall cause each and every Subcontractor to provide insurance
coverage that complies with all applicable requirements of the Contractor -provided insurance as
set forth herein, except the Contractor shall have sole responsibility for determining the limits of
coverage required to be obtained by Subcontractors. The Contractor shall ensure that the Public
Entity is an additional insured on each and every Subcontractor's Commercial General liability
insurance policy using an endorsement as least as broad as ISO CG 20 10 10 01 for ongoing
operations and CG 20 37 10 01 for completed operations.
G. Notice of Cancellation. The Contractor shall provide the City and all Additional Insureds for this
work with written notice of any policy cancellation, within two business days of their receipt of such
notice.
H. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the insurance as
required shall constitute a material breach of contract, upon which the City may, after giving five
business days notice to the Contractor to correct the breach, immediately terminate the contract
or, at its discretion, procure or renew such insurance and pay any and all premiums in connection
therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion
of the City, offset against funds due the Contractor from the City.
8. Record Keepina and Reporting.
A. The Contractor shall maintain accounts and records, including personnel, property, financial and
programmatic records which sufficiently and properly reflect all direct and indirect costs of any
nature expended and services performed in the performance of this Agreement and other such
records as may be deemed necessary by the City to ensure the performance of this Agreement.
B. These records shall be maintained for a period of seven (7) years after termination hereof unless
permission to destroy them is granted by the office of the archivist in accordance with RCW Chapter
40.14 and by the City.
9. Audits and Inspections. The records and documents with respect to all matters covered by this
Agreement shall be subject at all times to inspection, review or audit by law during the performance of
this Agreement.
10. Termination. This Agreement may at any time be terminated by the City giving to the Contractor thirty
(30) days written notice of the City's intention to terminate the same. Failure to provide products on
schedule may result in contract termination. If the Contractor's insurance coverage is canceled for any
reason, the City shall have the right to terminate this Agreement immediately.
11. Discrimination Prohibited. The Consultant, with regard to the work performed by it under this
Agreement, will not discriminate on the grounds of race, religion, creed, color, national origin, age,
veteran status, sex, sexual orientation, gender identity, marital status, political affiliation, the
presence of any disability, or any other protected class status under state or federal law, in the
selection and retention of employees or procurement of materials or supplies.
12. Assignment and Subcontract. The Contractor shall not assign or subcontract any portion of the
services contemplated by this Agreement without the written consent of the City.
13. Entire Agreement: Modification. This Agreement, together with attachments or addenda, represents
the entire and integrated Agreement between the City and the Contractor and supersedes all prior
negotiations, representations, or agreements written or oral. No amendment or modification of this
Agreement shall be of any force or effect unless it is in writing and signed by the parties.
CA Revised May 2020 Page 3 of 4
104
14. Severability and Survival. If any term, condition or provision of this Agreement is declared void or
unenforceable or limited in its application or effect, such event shall not affect any other provisions
hereof and all other provisions shall remain fully enforceable. The provisions of this Agreement, which
by their sense and context are reasonably intended to survive the completion, expiration or cancellation
of this Agreement, shall survive termination of this Agreement.
15. Notices. Notices to the City of Tukwila shall be sent to the following address:
City Clerk, City of Tukwila
6200 Southcenter Blvd.
Tukwila, Washington 98188
Notices to the Contractor shall be sent to the address provided by the Contractor upon the
signature line below.
16. Applicable Law: Venue: Attornev's Fees. This Agreement shall be governed by and construed in
accordance with the laws of the State of Washington. In the event any suit, arbitration, or other
proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and
agree that venue shall be properly laid in King County, Washington. The prevailing party in any such
action shall be entitled to its attorney's fees and costs of suit.
DATED this day of , 20
** City signatures to be obtained by ** Contractor signature to be obtained by
City Clerk's Staff ONLY. ** sponsor staff. **
CITY OF TUKWILA
Thomas McLeod, Mayor
ATTEST/AUTHENTICATED:
Andy Youn, City Clerk
APPROVED AS TO FORM:
Office of the City Attorney
CONTRACTOR:
By:
Printed Name:
Title:
Address:
CA Revised May 2020 Page 4 of 4
105
Exhibit A
Scope of Services City of Tukwila
2025-2026 Program Services Agreement
Agency:
CHS dba Akin
2025 Funding:
$35,000.00
Program:
Outpatient Mental Health
2026 Funding:
$35,000.00
Effective Date:
January 1, 2025 thru December 31, 2026
Total:
$70,000.00
Definition of Service Unit Provide behavioral health services in Tukwila schools/community locations
(telehealth, office, home, etc.) Therapists will work with students and their family members to address a
variety of emotional and behavioral issues. Individual and/or group settings.
Quarter
Service Unit
# of Units
Quarterly
Billable 2025/26
1st
Unduplicated Tukwila residents/students
10
Hours of counseling
40
$8750.00
2nd
Unduplicated Tukwila residents/students
3
Hours of counseling
75
$8750.00
3rd
Unduplicated Tukwila residents/students
2
Hours of counseling
35
$8750.00
4th
Unduplicated Tukwila residents/students
3
Hours of counseling
75
$8750.00
ANNUAL
GOALS
UNDUPLICATED RESIDENTS/STUDENTS
Hours of Counseling
18
225
$35,000.00
The City Of Tukwila will use a variety of measures as indicators of satisfactory contract performance. The
Agency will be expected to meet at least 90% of the performance goals (outputs) as defined above. If the
Agency does not meet the 90% of performance goals, payment for services rendered under the agreement
will be reduced by the number of percentage points below the 90% level. At a 90% success rate, the
Agency will be reimbursed at 100%. Any exceptions must be negotiated with the City. Exceptions may be
made in cases where circumstances beyond the Agency's control impact their ability to meet their service
unit goals and the Agency has shown reasonable effort to overcome those circumstances. Exceptions are
made at the discretion of the City's Human Services Program Coordinator.
The Agency shall make all reasonable efforts to ascertain the eligibility of applicants for Agency services,
such eligibility to require residence within the City, and shall provide services under this Agreement only to
eligible applicants.
2025 & 2026
Personnel
$ 35,000.00
Non -Personnel
$
Budget/Annual award total
$ 35,000.00
Contract Administration:
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.
CA Revised May 2020
106
Page 5 of 4
Demographic and Outcome Data Report
The Agency shall collect and retain demographic data from the persons served through this contract. Data
should be tracked in an ongoing manner and submitted annually by January 31 of the following year. Outcome
data shall be submitted annually in conjunction with the Demographic report. Data should be collected and
demonstrate the program's progress toward Outcomes as specified below.
Outcome: OPMH clients will make progress toward at least one goal on their individualized treatment plan
by the end of each year.
Measurement: 70% of program participants will achieve success in making progress in at least one
individual goal.
QUARTERLY REPORTS
DUE DATES
1st thru 3rd Quarter Reports
1st = April 15
2nd= July 15
3rd = October 15
4th and Final Annual Reimbursement
First week in January. Date to be announced.
Outcomes and Demographics
January 31, 2026 / January 31, 2027
CA Revised May 2020 Page 6 of 4
107
City of Tukwila
6200 Southcenter Boulevard, Tukwila WA98188
CONTRACT FOR SERVICES
Contract Number:
This Agreement is entered into by and between the City of Tukwila, Washington, a non -charter
optional municipal code city hereinafter referred to as "the City," and Multi -Service Center, hereinafter
referred to as "the Contractor," whose principal office is located at 1200 S. 336th St., Federal Way, WA
98003.
WHEREAS, the City has determined the need to have certain services performed for its citizens
but does not have the manpower or expertise to perform such services; and
WHEREAS, the City desires to have the Contractor perform such services pursuant to certain terms
and conditions; now, therefore,
IN CONSIDERATION OF the mutual benefits and conditions hereinafter contained, the parties
hereto agree as follows:
1. Scope and Schedule of Services to be Performed by Contractor. The Contractor shall perform
those services described on Exhibit A attached hereto and incorporated herein by this reference as if
fully set forth. In performing such services, the Contractor shall at all times comply with all Federal,
State, and local statutes, rules and ordinances applicable to the performance of such services and the
handling of any funds used in connection therewith. The Contractor shall request and obtain prior
written approval from the City if the scope or schedule is to be modified in any way.
2. Compensation and Method of Payment. The City shall pay the Contractor for services rendered
according to the rate and method set forth on Exhibit A attached hereto and incorporated herein by this
reference. The total amount to be paid shall not exceed $42,000 in 2025 and $42,000 in 2026.
3. Contractor Budget. The Contractor shall apply the funds received under this Agreement within the
maximum limits set forth in this Agreement. The Contractor shall request prior approval from the City
whenever the Contractor desires to amend its budget in any way.
4. Duration of Agreement. This Agreement shall be in full force and effect for a period commencing
January 1 , 2025, and ending December 31, 2026, unless sooner terminated under the provisions
hereinafter specified.
5. Independent Contractor. Contractor and City agree that Contractor is an independent contractor with
respect to the services provided pursuant to this Agreement. Nothing in this Agreement shall be
considered to create the relationship of employer and employee between the parties hereto. Neither
Contractor nor any employee of Contractor shall be entitled to any benefits accorded City employees
by virtue of the services provided under this Agreement. The City shall not be responsible for
withholding or otherwise deducting federal income tax or social security or contributing to the State
Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to the
Contractor, or any employee of the Contractor.
6. Indemnification. The Contractor shall defend, indemnify and hold the Public Entity, its officers,
officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or
suits including attorney fees, arising out of or in connection with the performance of this Agreement,
except for injuries and damages caused by the sole negligence of the Public Entity.
CA Revised May 2020 Page 1 of 6
108
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 Contractor and the Public Entity, its
officers, officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the
extent of the Contractor's negligence. It is further specifically and expressly understood that the
indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial
Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually
negotiated by the parties. The provisions of this section shall survive the expiration or termination of
this Agreement.
7. 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. Contractor's maintenance of insurance, its scope of coverage and limits as required
herein shall not be construed to limit the liability of the Contractor to the coverage provided by such
insurance, or otherwise limit the City's recourse to any remedy available at law or in equity.
A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types and with the limits
described below:
1. Automobile Liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident. Automobile liability insurance shall cover all
owned, non -owned, hired and leased vehicles. Coverage shall be written on Insurance Services
Office (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.
2. Commercial General Liability insurance with limits no less than $2,000,000 each occurrence,
$2,000,000 general aggregate and $2,000,000 products -completed operations aggregate
limit. Commercial General Liability insurance shall be as least at broad as ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations, independent
contractors, products -completed operations, stop gap liability, personal injury and advertising
injury, and liability assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide a per project general aggregate limit using ISO form
CG 25 03 05 09 or an equivalent endorsement. There shall be no exclusion for liability
arising from explosion, collapse or underground property damage. The City shall be named
as an additional 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 10 01 and Additional Insured -Completed Operations endorsement CG 20 37 10 01 or
substitute endorsements providing at least as broad coverage.
3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of
Washington.
B. Public Entity Full Availability of Contractor Limits. If the Contractor maintains higher insurance
limits than the minimums shown above, the Public Entity shall be insured for the full available limits
of Commercial General and Excess or Umbrella liability maintained by the Contractor, irrespective
of whether such limits maintained by the Contractor are greater than those required by this Contract
or whether any certificate of insurance furnished to the Public Entity evidences limits of liability
lower than those maintained by the Contractor.
C. Other Insurance Provision. The Contractor's Automobile Liability and Commercial General
Liability insurance policies are to contain, or be endorsed to contain that they shall be primary
insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and shall not contribute with
it.
D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating
of not less than A: VI I.
CA Revised May 2020 Page 2 of 6
109
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. Upon request by the City, the Contractor shall furnish certified copies of all required
insurance policies, including endorsements, required in this Agreement and evidence of all
subcontractors' coverage.
F. Subcontractors. The Contractor shall cause each and every Subcontractor to provide insurance
coverage that complies with all applicable requirements of the Contractor -provided insurance as
set forth herein, except the Contractor shall have sole responsibility for determining the limits of
coverage required to be obtained by Subcontractors. The Contractor shall ensure that the Public
Entity is an additional insured on each and every Subcontractor's Commercial General liability
insurance policy using an endorsement as least as broad as ISO CG 20 10 10 01 for ongoing
operations and CG 20 37 10 01 for completed operations.
G. Notice of Cancellation. The Contractor shall provide the City and all Additional Insureds for this
work with written notice of any policy cancellation, within two business days of their receipt of such
notice.
H. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the insurance as
required shall constitute a material breach of contract, upon which the City may, after giving five
business days notice to the Contractor to correct the breach, immediately terminate the contract
or, at its discretion, procure or renew such insurance and pay any and all premiums in connection
therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion
of the City, offset against funds due the Contractor from the City.
8. Record Keepina and Reporting.
A. The Contractor shall maintain accounts and records, including personnel, property, financial and
programmatic records which sufficiently and properly reflect all direct and indirect costs of any
nature expended and services performed in the performance of this Agreement and other such
records as may be deemed necessary by the City to ensure the performance of this Agreement.
B. These records shall be maintained for a period of seven (7) years after termination hereof unless
permission to destroy them is granted by the office of the archivist in accordance with RCW Chapter
40.14 and by the City.
9. Audits and Inspections. The records and documents with respect to all matters covered by this
Agreement shall be subject at all times to inspection, review or audit by law during the performance of
this Agreement.
10. Termination. This Agreement may at any time be terminated by the City giving to the Contractor thirty
(30) days written notice of the City's intention to terminate the same. Failure to provide products on
schedule may result in contract termination. If the Contractor's insurance coverage is canceled for any
reason, the City shall have the right to terminate this Agreement immediately.
11. Discrimination Prohibited. The Consultant, with regard to the work performed by it under this
Agreement, will not discriminate on the grounds of race, religion, creed, color, national origin, age,
veteran status, sex, sexual orientation, gender identity, marital status, political affiliation, the
presence of any disability, or any other protected class status under state or federal law, in the
selection and retention of employees or procurement of materials or supplies.
12. Assignment and Subcontract. The Contractor shall not assign or subcontract any portion of the
services contemplated by this Agreement without the written consent of the City.
13. Entire Agreement: Modification. This Agreement, together with attachments or addenda, represents
the entire and integrated Agreement between the City and the Contractor and supersedes all prior
negotiations, representations, or agreements written or oral. No amendment or modification of this
Agreement shall be of any force or effect unless it is in writing and signed by the parties.
CA Revised May 2020 Page 3 of 6
110
14. Severabilitv and Survival. If any term, condition or provision of this Agreement is declared void or
unenforceable or limited in its application or effect, such event shall not affect any other provisions
hereof and all other provisions shall remain fully enforceable. The provisions of this Agreement, which
by their sense and context are reasonably intended to survive the completion, expiration or cancellation
of this Agreement, shall survive termination of this Agreement.
15. Notices. Notices to the City of Tukwila shall be sent to the following address:
City Clerk, City of Tukwila
6200 Southcenter Blvd.
Tukwila, Washington 98188
Notices to the Contractor shall be sent to the address provided by the Contractor upon the
signature line below.
16. Applicable Law: Venue: Attorney's Fees. This Agreement shall be governed by and construed in
accordance with the laws of the State of Washington. In the event any suit, arbitration, or other
proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and
agree that venue shall be properly laid in King County, Washington. The prevailing party in any such
action shall be entitled to its attorney's fees and costs of suit.
DATED this day of , 20
** City signatures to be obtained by ** Contractor signature to be obtained by
City Clerk's Staff ONLY. ** sponsor staff. **
CITY OF TUKWILA
Thomas McLeod, Mayor
ATTEST/AUTHENTICATED:
Andy Youn-Barnett, City Clerk
APPROVED AS TO FORM:
Office of the City Attorney
CONTRACTOR:
By:
Printed Name:
Title:
Address:
CA Revised May 2020 Page 4 of 6
111
Exhibit A
Scope of Services City of Tukwila
2025-2026 Program Services Agreement
Agency:
Multi -Service Center
2025 Funding:
$42,000.00
Program:
EARNS Program
2026 Funding:
$42,000.00
Effective Date:
January 1, 2025 thru December 31, 2026
Total:
$84,000.00
Definition of Service Unit Emergency assistance vouchers which include rent and utility assistance
Quarter
Service Unit
# of Units
Quarterly
Billable 2025/26
1st
Unduplicated Tukwila residents
12
Number of Tukwila vouchers written
6
2nd
Unduplicated Tukwila residents
12
Number of Tukwila vouchers written
6
3rd
Unduplicated Tukwila residents
13
Number of Tukwila vouchers written
7
4th
Unduplicated Tukwila residents
13
Number of Tukwila vouchers written
7
ANNUAL
GOALS
Unduplicated Tukwila residents
Tukwila vouchers
50
26
$42,000.00
The City Of Tukwila will use a variety of measures as indicators of satisfactory contract performance. The
Agency will be expected to meet at least 90% of the performance goals (outputs) as defined above. If the
Agency does not meet the 90% of performance goals, payment for services rendered under the agreement
will be reduced by the number of percentage points below the 90% level. At a 90% success rate, the
Agency will be reimbursed at 100%. Any exceptions must be negotiated with the City. Exceptions may be
made in cases where circumstances beyond the Agency's control impact their ability to meet their service
unit goals and the Agency has shown reasonable effort to overcome those circumstances. Exceptions are
made at the discretion of the City's Human Services Program Coordinator.
The Agency shall make all reasonable efforts to ascertain the eligibility of applicants for Agency services,
such eligibility to require residence within the City, and shall provide services under this Agreement only to
eligible applicants.
2025 & 2026
Personnel/Ops/Admin
$ 10,161.00
Non -Personnel
$ 31,839.00
Budget/Annual award total
$ 42,000.00
Contract Administration:
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.
CA Revised May 2020 Page 5 of 6
112
Demographic and Outcome Data Report
The Agency shall collect and retain demographic data from the persons served through this contract. Data
should be tracked in an ongoing manner and submitted annually by January 31 of the following year. Outcome
data shall be submitted annually in conjunction with the Demographic report. Data should be collected and
demonstrate the program's progress toward Outcomes as specified below.
Outcome: After receiving assistance, participants are able to maintain housing.
Percentage of clients who will achieve result: 75%
QUARTERLY REPORTS
DUE DATES
1st thru 3rd quarter reports
1st = April 15th
2nd = July 15th
3rd = October 15th
4th and final annual reimbursement
First week in January. Date to be announced.
Outcomes and demographics
January 31st, 2026 / January 31st 2027
CA Revised May 2020 Page 6 of 6
113
City of Tukwila
6200 Southcenter Boulevard, Tukwila WA98188
CONTRACT FOR SERVICES
Contract Number:
This Agreement is entered into by and between the City of Tukwila, Washington, a non -charter
optional municipal code city hereinafter referred to as "the City," and Refugee Women's Alliance,
hereinafter referred to as "the Contractor, "whose principal office is located at 4008 Martin Luther King Jr.
Way S., Seattle, WA 98108
WHEREAS, the City has determined the need to have certain services performed for its citizens
but does not have the manpower or expertise to perform such services; and
WHEREAS, the City desires to have the Contractor perform such services pursuant to certain terms
and conditions; now, therefore,
IN CONSIDERATION OF the mutual benefits and conditions hereinafter contained, the parties
hereto agree as follows:
1. Scope and Schedule of Services to be Performed by Contractor. The Contractor shall perform
those services described on Exhibit A attached hereto and incorporated herein by this reference as if
fully set forth. In performing such services, the Contractor shall at all times comply with all Federal,
State, and local statutes, rules and ordinances applicable to the performance of such services and the
handling of any funds used in connection therewith. The Contractor shall request and obtain prior
written approval from the City if the scope or schedule is to be modified in any way.
2. Compensation and Method of Payment. The City shall pay the Contractor for services rendered
according to the rate and method set forth on Exhibit A attached hereto and incorporated herein by this
reference. The total amount to be paid shall not exceed $31,500 in 2025 and $31,500 in 2026.
3. Contractor Budget. The Contractor shall apply the funds received under this Agreement within the
maximum limits set forth in this Agreement. The Contractor shall request prior approval from the City
whenever the Contractor desires to amend its budget in any way.
4. Duration of Agreement. This Agreement shall be in full force and effect for a period commencing
January 1 , 2025, and ending December 31, 2026, unless sooner terminated under the provisions
hereinafter specified.
5. Independent Contractor. Contractor and City agree that Contractor is an independent contractor with
respect to the services provided pursuant to this Agreement. Nothing in this Agreement shall be
considered to create the relationship of employer and employee between the parties hereto. Neither
Contractor nor any employee of Contractor shall be entitled to any benefits accorded City employees
by virtue of the services provided under this Agreement. The City shall not be responsible for
withholding or otherwise deducting federal income tax or social security or contributing to the State
Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to the
Contractor, or any employee of the Contractor.
6. Indemnification. The Contractor shall defend, indemnify and hold the Public Entity, its officers,
officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or
suits including attorney fees, arising out of or in connection with the performance of this Agreement,
except for injuries and damages caused by the sole negligence of the Public Entity.
CA Revised May 2020 Page 1 of 6
114
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 Contractor and the Public Entity, its
officers, officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the
extent of the Contractor's negligence. It is further specifically and expressly understood that the
indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial
Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually
negotiated by the parties. The provisions of this section shall survive the expiration or termination of
this Agreement.
7. 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. Contractor's maintenance of insurance, its scope of coverage and limits as required
herein shall not be construed to limit the liability of the Contractor to the coverage provided by such
insurance, or otherwise limit the City's recourse to any remedy available at law or in equity.
A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types and with the limits
described below:
1. Automobile Liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident. Automobile liability insurance shall cover all
owned, non -owned, hired and leased vehicles. Coverage shall be written on Insurance Services
Office (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.
2. Commercial General Liability insurance with limits no less than $2,000,000 each occurrence,
$2,000,000 general aggregate and $2,000,000 products -completed operations aggregate
limit. Commercial General Liability insurance shall be as least at broad as ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations, independent
contractors, products -completed operations, stop gap liability, personal injury and advertising
injury, and liability assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide a per project general aggregate limit using ISO form
CG 25 03 05 09 or an equivalent endorsement. There shall be no exclusion for liability
arising from explosion, collapse or underground property damage. The City shall be named
as an additional 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 10 01 and Additional Insured -Completed Operations endorsement CG 20 37 10 01 or
substitute endorsements providing at least as broad coverage.
3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of
Washington.
B. Public Entity Full Availability of Contractor Limits. If the Contractor maintains higher insurance
limits than the minimums shown above, the Public Entity shall be insured for the full available limits
of Commercial General and Excess or Umbrella liability maintained by the Contractor, irrespective
of whether such limits maintained by the Contractor are greater than those required by this Contract
or whether any certificate of insurance furnished to the Public Entity evidences limits of liability
lower than those maintained by the Contractor.
C. Other Insurance Provision. The Contractor's Automobile Liability and Commercial General
Liability insurance policies are to contain, or be endorsed to contain that they shall be primary
insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and shall not contribute with
it.
D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating
of not less than A: VI I.
CA Revised May 2020 Page 2 of 6
115
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. Upon request by the City, the Contractor shall furnish certified copies of all required
insurance policies, including endorsements, required in this Agreement and evidence of all
subcontractors' coverage.
F. Subcontractors. The Contractor shall cause each and every Subcontractor to provide insurance
coverage that complies with all applicable requirements of the Contractor -provided insurance as
set forth herein, except the Contractor shall have sole responsibility for determining the limits of
coverage required to be obtained by Subcontractors. The Contractor shall ensure that the Public
Entity is an additional insured on each and every Subcontractor's Commercial General liability
insurance policy using an endorsement as least as broad as ISO CG 20 10 10 01 for ongoing
operations and CG 20 37 10 01 for completed operations.
G. Notice of Cancellation. The Contractor shall provide the City and all Additional Insureds for this
work with written notice of any policy cancellation, within two business days of their receipt of such
notice.
H. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the insurance as
required shall constitute a material breach of contract, upon which the City may, after giving five
business days notice to the Contractor to correct the breach, immediately terminate the contract
or, at its discretion, procure or renew such insurance and pay any and all premiums in connection
therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion
of the City, offset against funds due the Contractor from the City.
8. Record Keepina and Reporting.
A. The Contractor shall maintain accounts and records, including personnel, property, financial and
programmatic records which sufficiently and properly reflect all direct and indirect costs of any
nature expended and services performed in the performance of this Agreement and other such
records as may be deemed necessary by the City to ensure the performance of this Agreement.
B. These records shall be maintained for a period of seven (7) years after termination hereof unless
permission to destroy them is granted by the office of the archivist in accordance with RCW Chapter
40.14 and by the City.
9. Audits and Inspections. The records and documents with respect to all matters covered by this
Agreement shall be subject at all times to inspection, review or audit by law during the performance of
this Agreement.
10. Termination. This Agreement may at any time be terminated by the City giving to the Contractor thirty
(30) days written notice of the City's intention to terminate the same. Failure to provide products on
schedule may result in contract termination. If the Contractor's insurance coverage is canceled for any
reason, the City shall have the right to terminate this Agreement immediately.
11. Discrimination Prohibited. The Consultant, with regard to the work performed by it under this
Agreement, will not discriminate on the grounds of race, religion, creed, color, national origin, age,
veteran status, sex, sexual orientation, gender identity, marital status, political affiliation, the
presence of any disability, or any other protected class status under state or federal law, in the
selection and retention of employees or procurement of materials or supplies.
12. Assignment and Subcontract. The Contractor shall not assign or subcontract any portion of the
services contemplated by this Agreement without the written consent of the City.
13. Entire Agreement: Modification. This Agreement, together with attachments or addenda, represents
the entire and integrated Agreement between the City and the Contractor and supersedes all prior
negotiations, representations, or agreements written or oral. No amendment or modification of this
Agreement shall be of any force or effect unless it is in writing and signed by the parties.
CA Revised May 2020 Page 3 of 6
116
14. Severability and Survival. If any term, condition or provision of this Agreement is declared void or
unenforceable or limited in its application or effect, such event shall not affect any other provisions
hereof and all other provisions shall remain fully enforceable. The provisions of this Agreement, which
by their sense and context are reasonably intended to survive the completion, expiration or cancellation
of this Agreement, shall survive termination of this Agreement.
15. Notices. Notices to the City of Tukwila shall be sent to the following address:
City Clerk, City of Tukwila
6200 Southcenter Blvd.
Tukwila, Washington 98188
Notices to the Contractor shall be sent to the address provided by the Contractor upon the
signature line below.
16. Applicable Law: Venue: Attornev's Fees. This Agreement shall be governed by and construed in
accordance with the laws of the State of Washington. In the event any suit, arbitration, or other
proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and
agree that venue shall be properly laid in King County, Washington. The prevailing party in any such
action shall be entitled to its attorney's fees and costs of suit.
DATED this day of , 20
** City signatures to be obtained by ** Contractor signature to be obtained by
City Clerk's Staff ONLY. ** sponsor staff. **
CITY OF TUKWILA
Thomas McLeod, Mayor
ATTEST/AUTHENTICATED:
Andy Youn-Barnett, City Clerk
APPROVED AS TO FORM:
Office of the City Attorney
CONTRACTOR:
By:
Printed Name:
Title:
Address:
CA Revised May 2020 Page 4 of 6
117
Exhibit A - DRAFT
Scope of Services City of Tukwila
2025-2026 Program Services Agreement
Agency:
Refugee Women's Alliance
2025 Funding:
$31,500.00
Program:
Basic Needs Program
2026 Funding:
$31,500.00
Effective Date:
January 1, 2025 thru December 31, 2026
Total:
$63,000.00
Definition of Service Unit ReWA's services unit measures the number of case management hours.
Services include advocacy, barrier removal, housing assistance, health, employment and social services
TO BE CONFIRMED AT 3-6-25 CONTRACT MEETING
Quarter
Service Unit
# of Units
Quarterly
Billable 2025/26
1st
Unduplicated Tukwila residents served
13
Number of hours of case management
125
$7875.00
2nd
Unduplicated Tukwila residents served
12
Number of hours of case management
124
$7875.00
3rd
Unduplicated Tukwila residents served
12
Number of hours of case management
124
$7875.00
4th
Unduplicated Tukwila residents served
12
Number of hours of case management
124
$7875.00
ANNUAL
GOALS
Unduplicated Tukwila residents
Number of hours of case management
50
497
$31,500.00
The City Of Tukwila will use a variety of measures as indicators of satisfactory contract performance. The
Agency will be expected to meet at least 90% of the performance goals (outputs) as defined above. If the
Agency does not meet the 90% of performance goals, payment for services rendered under the agreement
will be reduced by the number of percentage points below the 90% level. At a 90% success rate, the
Agency will be reimbursed at 100%. Any exceptions must be negotiated with the City. Exceptions may be
made in cases where circumstances beyond the Agency's control impact their ability to meet their service
unit goals and the Agency has shown reasonable effort to overcome those circumstances. Exceptions are
made at the discretion of the City's Human Services Program Coordinator.
The Agency shall make all reasonable efforts to ascertain the eligibility of applicants for Agency services,
such eligibility to require residence within the City, and shall provide services under this Agreement only to
eligible applicants.
2025 & 2026
Personnel
$
Non -Personnel
$
Budget/Annual award total
$ 31,500.00
Contract Administration:
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.
CA Revised May 2020 Page 5 of 6
118
Demographic and Outcome Data Report
The Agency shall collect and retain demographic data from the persons served through this contract. Data
should be tracked in an ongoing manner and submitted annually by January 31 of the following year. Outcome
data shall be submitted annually in conjunction with the Demographic report. Data should be collected and
demonstrate the program's progress toward Outcomes as specified below.
Outcome: Basic needs participants will have increased knowledge of available resources and support in
accessing them.
Percentage of clients who will achieve this: 85%
QUARTERLY REPORTS
DUE DATES
1st thru 3rd quarter reports
1st = April 15th
2nd = July 15th
3rd = October 15th
4th and final annual reimbursement
First week in January. Date to be announced.
Outcomes and demographics
January 31st, 2026 / January 31st 2027
CA Revised May 2020 Page 6 of 6
119
City of Tukwila
6200 Southcenter Boulevard, Tukwila WA98188
CONTRACT FOR SERVICES
Contract Number:
This Agreement is entered into by and between the City of Tukwila, Washington, a non -charter
optional municipal code city hereinafter referred to as "the City," and Tukwila Pantry, hereinafter referred
to as "the Contractor, "whose principal office is located at 3118 S. 140th St., Tukwila, WA 98168.
WHEREAS, the City has determined the need to have certain services performed for its citizens
but does not have the manpower or expertise to perform such services; and
WHEREAS, the City desires to have the Contractor perform such services pursuant to certain terms
and conditions; now, therefore,
IN CONSIDERATION OF the mutual benefits and conditions hereinafter contained, the parties
hereto agree as follows:
1. Scope and Schedule of Services to be Performed by Contractor. The Contractor shall perform
those services described on Exhibit A attached hereto and incorporated herein by this reference as if
fully set forth. In performing such services, the Contractor shall at all times comply with all Federal,
State, and local statutes, rules and ordinances applicable to the performance of such services and the
handling of any funds used in connection therewith. The Contractor shall request and obtain prior
written approval from the City if the scope or schedule is to be modified in any way.
2. Compensation and Method of Payment. The City shall pay the Contractor for services rendered
according to the rate and method set forth on Exhibit A attached hereto and incorporated herein by this
reference. The total amount to be paid shall not exceed $40,000 in 2025 and $40,000 in 2026.
3. Contractor Budaet. The Contractor shall apply the funds received under this Agreement within the
maximum limits set forth in this Agreement. The Contractor shall request prior approval from the City
whenever the Contractor desires to amend its budget in any way.
4. Duration of Aareement. This Agreement shall be in full force and effect for a period commencing
January 1, 2025, and ending December 31, 2026, unless sooner terminated under the provisions
hereinafter specified.
5. Independent Contractor. Contractor and City agree that Contractor is an independent contractor with
respect to the services provided pursuant to this Agreement. Nothing in this Agreement shall be
considered to create the relationship of employer and employee between the parties hereto. Neither
Contractor nor any employee of Contractor shall be entitled to any benefits accorded City employees
by virtue of the services provided under this Agreement. The City shall not be responsible for
withholding or otherwise deducting federal income tax or social security or contributing to the State
Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to the
Contractor, or any employee of the Contractor.
6. Indemnification. The Contractor shall defend, indemnify and hold the Public Entity, its officers,
officials, employees and volunteers harmless from any and all claims, injuries, damages, losses or
suits including attorney fees, arising out of or in connection with the performance of this Agreement,
except for injuries and damages caused by the sole negligence of the Public Entity.
Should a court of competent jurisdiction determine that this Agreement is subject to RCW 4.24.115,
CA Revised May 2020 Page 1 of 6
120
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 Contractor and the Public Entity, its
officers, officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the
extent of the Contractor's negligence. It is further specifically and expressly understood that the
indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial
Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually
negotiated by the parties. The provisions of this section shall survive the expiration or termination of
this Agreement.
7. 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. Contractor's maintenance of insurance, its scope of coverage and limits as required
herein shall not be construed to limit the liability of the Contractor to the coverage provided by such
insurance, or otherwise limit the City's recourse to any remedy available at law or in equity.
A. Minimum Scope of Insurance. Contractor shall obtain insurance of the types and with the limits
described below:
1. Automobile Liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident. Automobile liability insurance shall cover all
owned, non -owned, hired and leased vehicles. Coverage shall be written on Insurance Services
Office (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.
2. Commercial General Liability insurance with limits no less than $2,000,000 each occurrence,
$2,000,000 general aggregate and $2,000,000 products -completed operations aggregate
limit. Commercial General Liability insurance shall be as least at broad as ISO occurrence
form CG 00 01 and shall cover liability arising from premises, operations, independent
contractors, products -completed operations, stop gap liability, personal injury and advertising
injury, and liability assumed under an insured contract. The Commercial General Liability
insurance shall be endorsed to provide a per project general aggregate limit using ISO form
CG 25 03 05 09 or an equivalent endorsement. There shall be no exclusion for liability
arising from explosion, collapse or underground property damage. The City shall be named
as an additional 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 10 01 and Additional Insured -Completed Operations endorsement CG 20 37 10 01 or
substitute endorsements providing at least as broad coverage.
3. Workers' Compensation coverage as required by the Industrial Insurance laws of the State of
Washington.
B. Public Entity Full Availability of Contractor Limits. If the Contractor maintains higher insurance
limits than the minimums shown above, the Public Entity shall be insured for the full available limits
of Commercial General and Excess or Umbrella liability maintained by the Contractor, irrespective
of whether such limits maintained by the Contractor are greater than those required by this Contract
or whether any certificate of insurance furnished to the Public Entity evidences limits of liability
lower than those maintained by the Contractor.
C. Other Insurance Provision. The Contractor's Automobile Liability and Commercial General
Liability insurance policies are to contain, or be endorsed to contain that they shall be primary
insurance with respect to the City. Any insurance, self-insurance, or insurance pool coverage
maintained by the City shall be excess of the Contractor's insurance and shall not contribute with
it.
D. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M. Best rating
of not less than A: VI I.
CA Revised May 2020 Page 2 of 6
121
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. Upon request by the City, the Contractor shall furnish certified copies of all required
insurance policies, including endorsements, required in this Agreement and evidence of all
subcontractors' coverage.
F. Subcontractors. The Contractor shall cause each and every Subcontractor to provide insurance
coverage that complies with all applicable requirements of the Contractor -provided insurance as
set forth herein, except the Contractor shall have sole responsibility for determining the limits of
coverage required to be obtained by Subcontractors. The Contractor shall ensure that the Public
Entity is an additional insured on each and every Subcontractor's Commercial General liability
insurance policy using an endorsement as least as broad as ISO CG 20 10 10 01 for ongoing
operations and CG 20 37 10 01 for completed operations.
G. Notice of Cancellation. The Contractor shall provide the City and all Additional Insureds for this
work with written notice of any policy cancellation, within two business days of their receipt of such
notice.
H. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the insurance as
required shall constitute a material breach of contract, upon which the City may, after giving five
business days notice to the Contractor to correct the breach, immediately terminate the contract
or, at its discretion, procure or renew such insurance and pay any and all premiums in connection
therewith, with any sums so expended to be repaid to the City on demand, or at the sole discretion
of the City, offset against funds due the Contractor from the City.
8. Record Keepina and Reporting.
A. The Contractor shall maintain accounts and records, including personnel, property, financial and
programmatic records which sufficiently and properly reflect all direct and indirect costs of any
nature expended and services performed in the performance of this Agreement and other such
records as may be deemed necessary by the City to ensure the performance of this Agreement.
B. These records shall be maintained for a period of seven (7) years after termination hereof unless
permission to destroy them is granted by the office of the archivist in accordance with RCW Chapter
40.14 and by the City.
9. Audits and Inspections. The records and documents with respect to all matters covered by this
Agreement shall be subject at all times to inspection, review or audit by law during the performance of
this Agreement.
10. Termination. This Agreement may at any time be terminated by the City giving to the Contractor thirty
(30) days written notice of the City's intention to terminate the same. Failure to provide products on
schedule may result in contract termination. If the Contractor's insurance coverage is canceled for any
reason, the City shall have the right to terminate this Agreement immediately.
11. Discrimination Prohibited. The Consultant, with regard to the work performed by it under this
Agreement, will not discriminate on the grounds of race, religion, creed, color, national origin, age,
veteran status, sex, sexual orientation, gender identity, marital status, political affiliation, the
presence of any disability, or any other protected class status under state or federal law, in the
selection and retention of employees or procurement of materials or supplies.
12. Assianment and Subcontract. The Contractor shall not assign or subcontract any portion of the
services contemplated by this Agreement without the written consent of the City.
13. Entire Agreement: Modification. This Agreement, together with attachments or addenda, represents
the entire and integrated Agreement between the City and the Contractor and supersedes all prior
negotiations, representations, or agreements written or oral. No amendment or modification of this
Agreement shall be of any force or effect unless it is in writing and signed by the parties.
14. Severability and Survival. If any term, condition or provision of this Agreement is declared void or
CA Revised May 2020 Page 3 of 6
122
unenforceable or limited in its application or effect, such event shall not affect any other provisions
hereof and all other provisions shall remain fully enforceable. The provisions of this Agreement, which
by their sense and context are reasonably intended to survive the completion, expiration or cancellation
of this Agreement, shall survive termination of this Agreement.
15. Notices. Notices to the City of Tukwila shall be sent to the following address:
City Clerk, City of Tukwila
6200 Southcenter Blvd.
Tukwila, Washington 98188
Notices to the Contractor shall be sent to the address provided by the Contractor upon the
signature line below.
16. Applicable Law: Venue: Attornev's Fees. This Agreement shall be governed by and construed in
accordance with the laws of the State of Washington. In the event any suit, arbitration, or other
proceeding is instituted to enforce any term of this Agreement, the parties specifically understand and
agree that venue shall be properly laid in King County, Washington. The prevailing party in any such
action shall be entitled to its attorney's fees and costs of suit.
DATED this day of , 20
** City signatures to be obtained by ** Contractor signature to be obtained by
City Clerk's Staff ONLY. ** sponsor staff. **
CITY OF TUKWILA
Thomas McLeod, Mayor
ATTEST/AUTHENTICATED:
Andy Youn-Barnett, City Clerk
APPROVED AS TO FORM:
Office of the City Attorney
CONTRACTOR:
By:
Printed Name:
Title:
Address:
CA Revised May 2020 Page 4 of 6
123
Exhibit A
Scope of Services City of Tukwila
2025-2026 Program Services Agreement
Agency:
Tukwila Pantry
2025 Funding:
$40,000.00
Program:
Tukwila Pantry
2026 Funding:
$40,000.00
Effective Date:
January 1, 2025 thru December 31, 2026
Total:
$80,000.00
Definition of Service Unit Report pounds of food distributed to all Tukwila residents. Report number of
unduplicated Tukwila residents.
No goal set. REPORT ON function.
Quarter
Service Unit
# of Units
Quarterly
Billable 2025/26
1st
Pounds of food distributed
# of duplicated Tukwila residents
# of unduplicated Tukwila residents
$10,000.00
2nd
Pounds of food distributed
# of duplicated Tukwila residents
# of unduplicated Tukwila residents
$10,000.00
3rd
Pounds of food distributed
# of duplicated Tukwila residents
# of unduplicated Tukwila residents
$10,000.00
4th
Pounds of food distributed
# of duplicated Tukwila residents
# of unduplicated Tukwila residents
$10,000.00
ANNUAL
GOALS
Report on: Pounds of food distributed,
Duplicated residents, Unduplicated residents
$40,000.00
The City Of Tukwila will use a variety of measures as indicators of satisfactory contract performance. The
Agency will be expected to meet at least 90% of the performance goals (outputs) as defined above. If the
Agency does not meet the 90% of performance goals, payment for services rendered under the agreement
will be reduced by the number of percentage points below the 90% level. At a 90% success rate, the
Agency will be reimbursed at 100%. Any exceptions must be negotiated with the City. Exceptions may be
made in cases where circumstances beyond the Agency's control impact their ability to meet their service
unit goals and the Agency has shown reasonable effort to overcome those circumstances. Exceptions are
made at the discretion of the City's Human Services Program Coordinator.
The Agency shall make all reasonable efforts to ascertain the eligibility of applicants for Agency services,
such eligibility to require residence within the City, and shall provide services under this Agreement only to
eligible applicants.
2025 & 2026
Personnel
$ 40,000.00
Non -Personnel
$
Budget/Annual award total
$ 40,000.00
Contract Administration:
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.
CA Revised May 2020
124
Page 5 of 6
Demographic and Outcome Data Report
The Agency shall collect and retain demographic data from the persons served through this contract. Data
should be tracked in an ongoing manner and submitted annually by January 31 of the following year. Outcome
data shall be submitted annually in conjunction with the Demographic report. Data should be collected and
demonstrate the program's progress toward Outcomes as specified below.
Outcome: Clients will report via survey that the food supplements have helped stabilize their nutritional
needs.
Percentage of patrons who will achieve this result: 75%
QUARTERLY REPORTS
DUE DATES
1st thru 3rd Quarter Reports
1st = April 15
2nd= July 15
3rd = October 15
4th and Final Annual Reimbursement
First week in January. Date to be announced.
Outcomes and Demographics
January 31, 2026 / January 31, 2027
CA Revised May 2020 Page 6 of 6
125
RESIDENTIAL LEASE AGREEMENT
HARTNETT MANOR
This lease is made effective January 1, 2025, between the City of Tukwila, a municipal
corporation, as "Lessor," and St. Stephen Housing Association, a Washington non-profit
corporation, as "Lessee" (collectively, the "Parties").
WHEREAS, homelessness continues to be an issue for residents of the City of
Tukwila and the greater community at large; and
WHEREAS, Lessor, a Washington municipal corporation, has determined that
the provision of transitional housing to homeless and impoverished members of the
community serves a fundamental governmental purpose as it protects the public health,
safety, and welfare; and
WHEREAS, Lessee is a Washington non-profit corporation that provides
temporary and transitional housing to the homeless;
Now, therefore, the Parties agree as follows:
1. PREMISES: Lessor shall lease to Lessee the Residence currently situated at 14688
Macadam Road South, Tukwila, Washington ("Premises").
2. TERM: The term of this lease shall be for one year, commencing on January 1, 2025
and shall terminate on December 31, 2025, unless sooner terminated as a result of
Lessee's default hereunder in accordance with the termination provisions set forth
in paragraph 19. The Lessor reserves the right to terminate the lease at its
convenience prior to the completion of the five-year term at any time for any
reason with 90 days' prior written notice.
3. POSSESSION: Lessee shall be deemed to have accepted possession of the leased
premises in an "as -is" condition. Lessor has made no representations to Lessee
respecting the condition of the lease premises.
4. CONSIDERATION: In consideration of Lessee providing housing to homeless
members of the Tukwila community, Lessee may occupy the leased premises rent
free for the duration of this Lease; provided, Lessee shall make any and all
necessary improvements to the Premises, including the Residence located thereon,
at Lessee's sole expense. Such improvements shall not be commenced without the
express written consent of Lessor and shall be subject to final inspection and the
approval of the Lessor. Further, Lessee shall be responsible for costs associated
with or arising out of the maintenance and operation of the leased Premises as set
forth herein.
5. USE: Lessee shall use the leased premises to provide free, temporary single-family
dwellings for homeless families with children whose income falls below 50% of
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King County median income and all current uses incidental thereto, and for no
other purpose without first obtaining Lessor's prior written consent. Lessee shall
screen all housing applicants to ensure that applicants meet the income
qualifications set forth herein. Lessee shall provide Lessor with an annual report
each year reflecting data regarding the populations served by Lessee at the
Premises.
6. MAINTENANCE AND REPAIR RESPONSILIBITY: Lessee shall, when and if
needed, at Lessee's sole expense, make any and all necessary minor repairs to the
Premises and every part thereof. For purposes of this provision, the term "minor
repair" means any repair for which the sum total of parts and labor is under $5,000
per occurrence. Lessee shall not be required to pay more than a total of [$5,000] on
minor repairs during the term of this agreement. Lessee shall notify Lessor
immediately when Lessee has spent a total of $5,000 on minor repairs during the
terms of this agreement. Lessee shall also notify Lessor immediately of any needed
major repairs or unsafe conditions existing in or around the Premises. Lessor shall,
when and if needed, at Lessor's sole expense, make all necessary major repairs to
the Premises and every part thereof. For purposes of this provision, the term
"major repair" means any repair for which the sum total of parts and labor is $5,000
or more. Lessee shall maintain the Premises in a neat, clean, and sanitary condition.
Lessee shall surrender the leased Premises to Lessor in good condition upon the
termination of this lease, reasonable wear and tear expected.
7. UTILITIES: Lessee shall pay prior to delinquency for all heat, light, water and
other utility services supplied to the Premises.
8. ALTERATIONS AND ADDITIONS BY LESSEE: After obtaining the prior
consent of Lessor, Lessee may make, at its sole expense, such additional
improvements or alterations to the leased premises, which it may deem necessary
or desirable. Any repairs or new construction by Lessee shall be done in conformity
with plans and specifications approved by Lessor. All work performed shall be
done in a workmanlike manner and shall become the property of the Lessor.
9. LIENS: Lessee shall keep the leased premises free from any liens arising out of any
work performed, materials furnished, or obligations incurred by Lessee.
10. INSURANCE: Lessee shall procure and maintain for the duration of this Lease,
insurance against claims for injuries to persons or damage to property which may
arise from or in connection with the Lessee's operation and use of the leased
Premises. Lessee's maintenance of insurance as required by the agreement shall
not be construed to limit the liability of the Lessee to the coverage provided by
such insurance, or otherwise limit the Lessor's recourse to any remedy available at
law or in equity. Lessee shall maintain Commercial General Liability insurance
written with limits no less than $1,000,000 each occurrence, $2,000,000 general
aggregate. Commercial General Liability insurance shall be at least as broad as
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Insurance Services Office (ISO) occurrence form CG 00 01 and shall cover premises
and contractual liability. The Lessor shall be named as additional an insured on
Lessee's Commercial General Liability insurance policy using ISO Additional
Insured -Managers or Lessors of Premises Form CG 20 11 or a substitute
endorsement providing at least as broad coverage. Lessee shall also maintain
property insurance, which shall be written covering the full value of Lessee's
property and improvements with no coinsurance provisions. Property insurance
shall be written on an all risk basis. The Lessee's Commercial General Liability
insurance policy or policies are to contain, or be endorsed to contain that they shall
be primary insurance as respect the Lessor. Any Insurance, self-insurance, or self -
insured pool coverage maintained by the Lessor shall be excess of the Lessee's
insurance and shall not contribute with it. Insurance is to be placed with insurers
with a current A.M. Best rating of not less than A: VII. Lessee shall furnish the
Lessor 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 Lessee. Lessee and Lessor hereby
release and discharge each other from all claims, losses and liabilities arising from
or caused by any hazard covered by property insurance on or in connection with
the premises or said building. This release shall apply only to the extent that such
claim, loss or liability is covered by insurance. The Lessee shall provide the Lessor
with written notice of any policy cancellation within two business days of their
receipt of such notice. Failure on the part of the Lessee to maintain the insurance
as required shall constitute a material breach of lease, upon which the Lessor may,
after giving five business days' notice to the Lessee to correct the breach, terminate
the Lease or, at its discretion, procure or renew such insurance and pay any and all
premiums in connection therewith, with any sums so expended to be repaid to the
Lessor on demand. If the Lessee maintains higher insurance limits than the
minimums shown above, the Lessor shall be insured for the full available limits of
Commercial General and Excess or Umbrella liability maintained by the Lessee,
irrespective of whether such limits maintained by the Lessee are greater than those
required by this contract or whether any certificate of insurance furnished to the
Lessor evidences limits of liability lower than those maintained by the Lessee.
During the term of this Lease, the Lessor shall maintain all-risk property insurance
covering the Residence located on the Premises for its full replacement value.
Lessee expressly agrees that should damage arise to the Premises or Residence that
is covered by Lessor's insurance but not Lessee's, Lessee shall reimburse Lessor for
the cost of Lessor's deductible. Such reimbursement shall be made within thirty
days of Lessor's written request for reimbursement.
11. INDEMNIFICATION: Lessee shall bear the sole risk for all personal property on
the Premises. Lessor, its officials, employees and agents shall not be liable for any
injury to or death of any person, or damage to property, sustained or alleged to
have been sustained by Lessee, invitees or others as a result of any condition
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(including future conditions) in, on or about the Premises, or the improvements
comprising any portion of the Premises; or as a result of the Premises becoming out
of repair, or caused by fire or by the bursting or leaking of water, gas, sewer or
steam pipes, or due to or the result of mold, fungus, water intrusion, asbestos, lead
or other toxic materials or chemicals, or due to or the result of any accident from
whatsoever cause in and about the Premises. Lessee agrees to indemnify, defend
and hold Lessor, and its officials, staff, employees and agents, harmless from any
and all claims, liabilities, losses, damages, actions, costs and expenses of any kind
(including reasonable attorneys' fees) arising out of or related to Lessee's use of the
Premises or the operation and/or conduct of its business or any activity or thing
occurring on or about the Premises, and for property damage or bodily injury
(including death) suffered on or about the Premises by any person, firm or
corporation, except to the extent such loss or damage resulting from the gross
negligence of the Lessor or a breach of the terms of this Lease. The terms of this
Section 11 shall survive any expiration or termination of this Lease.
The indemnification obligations contained in this Section 11 shall not be limited by
any worker's compensation benefits or disability laws, and Lessee hereby waives
any immunity that it may have under the Industrial Insurance Act, Title 51 RCW
and similar worker's compensation benefits or disability laws.
Lessee agrees that they have read the above provision and that any questions they
had concerning it were fully explained to their satisfaction by Lessee's attorney or
agent. Lessee understands that they will be the party held financially responsible
under all conditions and not the City of Tukwila or its officials, employees, or
agents.
12. ASSIGNMENT AND SUBLETTING: Lessee shall not assign this lease or any part
thereof, either by operation of law or otherwise, without first obtaining the prior
written consent of Lessor.
13. DEFAULT: Failure by Lessee to observe or perform any of the covenants,
conditions, or provisions of this lease, where such failure shall continue for a
period of ten days after written notice from Lessor to cure the default, shall
constitute a default and breach of the lease by the Lessor. Lessee shall notify Lessor
promptly of any default not by its nature necessarily known to Lessor.
14. ACCESS: Lessee shall permit Lessor to enter the leased premises at reasonable
times for the purpose of inspecting the leased premises and ascertaining
compliance with the provisions hereof by Lessee, but nothing herein shall be
construed as imposing any obligation on Lessor to perform any such work or
duties. Lessor reserves the right to property inspection and testing for the Lessor's
future development purposes. Lessor will give Lessee at least 48 hours' notice in
the event of access needed for property testing.
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15. COMPLIANCE WITH LAWS, RULES AND REGULATIONS: Lessee shall, at its
sole cost and expense, promptly comply with all laws, statutes, ordinances, and
governmental rules, regulations or requirements now in force or which may
hereafter be in force relating to or affecting the conditions, use, or occupancy of the
leased premises. Lessee shall faithfully observe and comply with the rules and
regulations that Lessor shall from time to time promulgate, including, without
limitation, those regulations affecting signage on the Property.
16. PERMITS: Lessee shall, at its sole cost and expense, be responsible for obtaining
any permits or licenses that are necessary to perform the work and covenants of
this lease Agreement.
17. LEASEHOLD EXCISE TAXES: The Parties believe that this Lease is exempt from
the requirements of chapter 82.29A RCW; however, in the event that the
Washington State Auditor's Office determines that leasehold excise tax is owing,
such costs shall be born by Lessee. In such case, Lessor may make payment of the
amount determined to be owed, and Lessee shall reimburse Lessor for such costs
within 30 days of receipt of Lessor's request for reimbursement.
18. NOTICE: All notices under this lease shall be in writing and shall be effective
when mailed by certified mail or delivered to Lessor at the address below stated, or
to Lessee at the address below stated or to such other address as either party may
designate from time to time:
LESSOR: CITY OF TUKWILA LESSEE: St. Stephen Housing Association
ATTN: Mayor's Office 13055 SE 192nd Street
6200 Southcenter Boulevard Renton, Washington 98058-7604
Tukwila, Washington 98188
19. TERMINATION: Either party has the right to terminate this Lease if the other
party is in default of any material obligation or representation of this lease which
default is incapable of cure, or which being capable of cure, is not cured within ten
days after receipt of written notice of such default.
20. GENERAL PROVISIONS:
A. TIME IS OF THE ESSENCE OF THIS LEASE.
B. In the event of any action or proceeding brought by either party against the
other under this lease, the Prevailing party shall be entitled to recover for the
fees of its attorneys in such action or proceeding, including costs of appeal, if
any, in such amount as the court may adjudge reasonable Attorneys' fees. For
the purposes of this provision, the terms "action" or "proceeding" shall include
arbitration, administrative, bankruptcy, and judicial proceedings, including
appeals therefrom.
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C. This lease shall be construed and governed by the laws of the State of
Washington.
D. Upon termination of this lease, Lessee shall surrender all keys to the Lessor at
the place then fixed for notice.
21. AUTHORITY OF LESSEE: Lessee, and each individual executing this lease on
behalf of Lessee, represent and warrant that s/he is duly authorized to execute and
deliver this lease, and that this lease is binding upon Lessee in accordance with its
terms.
22. WAIVER AND FORBEARANCE: No waiver by Lessor of any breach or default by
lessee of any of its obligations or agreement or covenants herein, shall be deemed
to be a waiver of any subsequent breach or default of the same or any other
covenant, agreement or obligation, nor shall forbearance by Lessor to seek remedy
for any breach or default of Lessee be deemed a waiver by Lessor or its rights and
remedies with respect to such breach or default.
THIS LEASE IS SUBJECT TO ACCEPTANCE BY LESSOR.
IN WITNESS THEREOF, the parties hereto have executed this Lease the date and
year above written.
LESSOR: LESSEE:
By: By:
Its: Its:
Date: Date:
APPROVED AS TO FORM:
Office of the City Attorney
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STATE OF WASHINGTON )
) ss.
COUNTY OF KING )
On this day of , 2024, personally appeared before me the undersigned, a
Notary Public, in and for the State of Washington, duly commissioned and sworn,
, to me known to be the Mayor of the City of Tukwila, a Washington
state municipal corporation, that executed the foregoing instrument and acknowledged the said
instrument to be the free and voluntary act and deed of said City of Tukwila, for the uses and
purposes therein mentioned, and on oath stated that they are authorized to execute the said
instrument.
WITNESS MY HAND AND OFFICIAL SEAL hereto affixed the day and year first
above written.
(Signature of Notary)
(Legibly Print or Stamp Name of Notary)
Notary public in and for the State of Washington,
residing at
My appointment expires
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STATE OF WASHINGTON )
) ss.
COUNTY OF KING )
On this day of , 2024, personally appeared before me the undersigned, a
Notary Public, in and for the State of Washington, duly commissioned and sworn,
, to me known to be the of the St. Stephen
Housing Association, a Washington non-profit corporation, that executed the foregoing
instrument and acknowledged the said instrument to be the free and voluntary act and deed of
said St. Stephen Housing Association, for the uses and purposes therein mentioned, and on oath
stated that they are authorized to execute the said instrument.
WITNESS MY HAND AND OFFICIAL SEAL hereto affixed the day and year first
above written.
(Signature of Notary)
(Legibly Print or Stamp Name of Notary)
Notary public in and for the State of Washington,
residing at
My appointment expires
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