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Home My WebLink AboutAG 20-229 - Family and Wellness Medicinei RETURN TO: TIM JOHNSON EXT: 2412 CITY OF FEDERAL WAY LAW DEPARTMENT ROUTING FORM . ORIGINATING DEPT/DIV: ECONOMIC DEVELOPMENT ■ STAFF PERSON: jim jOHNSON EXT: 2412 3. DATEREQBY. ASAP TYPE • DOCUMENT (CHECK ❑ PUBLIC WORKS CONTRACT ❑ SMALL OR LIMITED PUBLIC WORKS CONTRACT ❑ PROFESSIONAL SERVICE AGREEMENT ❑ MAINTENANCE AGREEMENT ❑ GOODS AND SERVICE AGREEMENT ❑ HUMAN SERVICES/ CDBG ❑ REAL ESTATE DOCUMENT ❑ SECURITY DOCUMENT (E.G. BOND RELATED DOCUMENTS) ❑ ORDINANCE ❑ RESOLUTION ❑ CONTRACT AMENDMENT (AG#):_ DINTERLOCAL * OTHER CARES ACT FUNDS BUSINESS SUPPORT GRANT AGREEMENT PROJECT NAME: —CARES ACT GRANT —ROUND 1................... NAME OF CONTRACTOR: FAMILY AND WELLNESS MEDICINE ADDRESS: 34004 16TH AVE S, #100, FEDERAL WAY, WA, 98003 TELEPHONE: (253) 944-1223 E-MAIL: FAMILYMEDICINE@FWMWA.COM SIGNATURE NAME: NGUYEN NGUYEN TITLE: SEEATTACHED TOTAL COMPENSATION$ (INCLUDE EXPENSES AND SALES TAX, IF ANY) Two THOUSAND AND NO/100 ($2,000.00) (IF CALCULATED ON HOURLY LABOR CHARGE - ATTACH SCHEDULES OF EMPLOYEES TITLES r• RATES) REIMBURSABLE EXPENSE: ■ YES X NO IF YES, MAXIMUM DOLLAR AMOUNT: $,— IS SALES TAX OWED ■ YES X NO IF YES, $_ PAID BY: ■ • 0 CITY RETAINAGE: • AMOUNT: ---. ■ • AGREEMENT (SEE CONTRACT) OR El RETAINAGE BOND PROVIDII ❑ PURCHASING: PLEASE CHARGE TO: 001-1800-990-518-10-490 Proiect Code# 267662-25060 0. DOCUMENT/CONTRACT REVIEW INITIAL IRATE REVIEWED, INITIAL/ DATE APPROVED ❑ PROJECT MANAGER ❑ DIRECTOR ❑ RISKMANAGEMENT (IF APPLICABLE} ❑ LAW 1. COUNCIL APPROVAL (IF APPLICABLE) SCHEDULED COMMITTEE DATE: CommiTrEE APPROVAL DATE: SCHEDULED COUNCIL DATE: COUNCIL APPROVAL DATE: ❑ SENT TO VENDORICONTRACTOR DATE SENT: DATE REC'D:—,— El ATTACH: SIGNATURE AUTHORITY, INSURANCE CERTIFICATE, LICENSES, EXHIBITS ❑ CREATE ELECTRONIC REMINDERJNOTIFICATION FOR I MONTH PRIOR TO EXPIRATION DATE (Include dept. support staff if necessary and feel free to set notification more than a month in advance if council approval is needed.) INITIAL / DATE SIGNED ❑ LAW DEPARTMENT S [GNED By LAW 07-28-20 ❑ SIGNATORY (MAYOR OR DIRECTOR) '-'N' ❑ CITY CLERK ❑ ASSIGNED AG# AG# 'OMMENTS: 1/2020 CITY Of A Fbderal V"y CITY HALL 33325 Sth Avenue South Federal Way, WA 98003-6325 (253) 835-7000 www otyoffederalway coo '%"'1AaU1,S ACT FXTIDS BUINIVIESS S ItYVAT G_011AJT�MMUIIEMEITI WITH FAMILY AND WELLNESS MEDICINE LLC This Grant Agreement ("Agreement") is made between the City of Federal Way, a Washington municipal corporation ("City"), and Family and Wellness Medicine, a limited liability company ("Grantee"). The City and Grantee (together "Parties") are located and do business at the below addresses which shall be valid for any notice required under this Agreement: FAMILY AND WELLNESS MEDICINE LLC CITY OF FEDERAL WAY: Hong Nguyen Ade Ariwoola 34004 16'h Ave S, #100 33325 8th Ave. S. PO Box 3086 Federal Way, WA 98003-6325 Federal Way, WA 98063 (253) 835-2520 (telephone) (253) 835-2509 (facsimile) (253) 944-1223 (telephone) ade.ariwoola@cityoffederalway.com familymedicineg vmwa.com .................. 1. TERM. This agreement contemplates a one-time grant of funds to the Grantee under the conditions iescribe(t herein. 2.1 Warranties. The Grantee warrants the following, which are pre -requisites for grant eligibility: a) Grantee operates a business physically located within the political boundaries of the City of Federal Way; b) Grantee maintains a current City of Federal Way business license c) Grantee has paid all taxes and government fees due up to the date of execution of this grant agreement d) Grantee is not the recipient of other state or federal funding made available as a response to the COVID- 19 pandemic e) Grantee's business employees no more than the equivalent of ten (10) full-time employees (20,800 man-hours total for all employees per year). f) Grantee's net revenues do not exceed more than $1.5 million per year g) Grantee does not operate as a tax-exempt business as defined by the Internal Revenue Service h) Due to COVID-19, Grantee business (check all that apply): E] Was required by state or local order to close N Was forced to lay off employees due to reduced patronage E] Incurred over $1,000 in COVID-19 related expenses Experienced 10-50% lost revenue Experienced over 50% lost revenue I -1 - CITY Of MY HALL 33325 8th Avenue South Federal Way Federal Way, WA 98003-6325 (253) 835-7000 wim cjtyoffedera1wqy corn a) Mortgage or Rent b) Personal Protection Equipment c) Insurance d) Utilities e) Marketing F) Payroll Grantee agrees to retain receipts documenting use of grant funds and will provide them to the City or its 3. TERMINATION. Should any of the conditions described in section 2.1, above, not be met, the City may recover all disbursed grant funds and terminate this agreement. 4.1 Amount. In order to promote healthy economic activity in the City and in response to the losses Grantee has incurred due to the COVID- 19 pandemic, the City shall provide a grant to the Grantee in an amount not to exceed Two Thousand and NO/I 00 Dollars ($2,000.00). 4.2 Non -Appropriation of Funds. If sufficient funds are not appropriated or allocated for payment under this Agreement for any fiscal period, the City will not be obligated to make payments under this agreement. 5.1 Gbatee Ihdq__. The Grantee agrees to release inderrinify, defend, and hold the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including, without limitation, their respective agents, licensees, or representatives, arising from, resulting from, or in connection with this Agreement or the performance of this Agreement, except for that portion of the claims caused by the City's sole negligence. 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 Grantee and the City, the Grantee's liability hereunder shall be only to the extent of the Grantee's negligence. Grantee shall ensure that each sub -Grantee shall agree to defend and indemnify the City, its elected officials, officers, employees, agents, representatives, insurers, attorneys, and volunteers to the extent and on the same terms and conditions as the Grantee pursuant to this paragraph. The City's inspection or acceptance of any of Grantee's work when completed shall not be grounds to avoid any of these covenants of indemnification. 5.2 Industrial Insurance Act Waiver. It is specifically and expressly understood that the Grantee waives any immunity that may be granted to it under the Washington State industrial insurance act, Title 51 RCW, solely for the purposes of this indemnification. Grantee's indemnification shall not be limited in any way by any limitation on the amount of damages, compensation or benefits payable to or by any third party under workers' compensation acts, disability benefit acts or any other benefits acts or programs. The Parties further acknowledge that they have mutually negotiated this waiver. �Vl �16�02 CITY OF AN, P6deral my VwW4-1 CITY HALL 33325 8th Avenue South Federal Way WA 98003-6325 83:-1000 vnyw atyoffederahvqy com 5.3 City j4demnifigafion. The City agrees to release, indemnify, defend and hold the Grantee, its officers, directors, shareholders, partners, employees, agents, representatives, and sub- contractors harmless from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, losses, fines, fees, penalties expenses, attorney's fees, costs, and/or litigation expenses to or by any and all persons or entities, including without limitation, their respective agents, licensees, or representatives, arising from, resulting from or connected with this Agreement to the extent solely caused by the negligent acts, errors, or omissions of the City. 5.4 Survival. The provisions of this Section shall survive the expiration or ternimation of this Agreement with respect to any event occurring prior to such expiration or termination. 1r M- MW iM 6.1 1hifflnptAtiog and,Wdifigati . This Agreement contains all of the agreements of the Parties with respect to any matter covered or mentioned in this Agreement and no prior statements or agreements, whether oral or written, shall be effective for any purpose. Any provision of this Agreement that is declarvi invalid, inoperative, null and void, or illegal shall in no way affect or invalidate any other provision hereof arfif such other provisions shall remain in full force and effect. No provision of this Agreement, including this provision, may be amended, waived, or modified except by written agreement signed by duly authorized representatives of the Parties. 6.2 Enforcement. Any notices required to be given by the Parties shall be delivered at the addresses set forth at the beginning of this Agreement. Any notices may be delivered personally to the addressee of the notice or may be deposited in the United States mail, postage prepaid, to the address set forth above. Any notice so posted in the United States mail shall be deemed received three (3) days after the date of mailing. Any remedies provided for under the terms of this Agreement are not intended to be exclusive, but shall be cumulative with all other remedies available to the City at law, in equity or by statute. 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 fall force and effect. Failure or delaw of the Citw to declare anki breach or default immediate - such breach or default. Failure of the City to declare one breach or default does not act as a waiver of the City's right to declare another breach or default. This Agreement shall be made in, governed by, and interpreted in accordance with the laws of the State of Washington. If the Parties are unable to settle any dispute, difference or claim arising from this Agreement, the exclusive means of resolving that dispute, difference, or claim, shall be by filing suit under the venue, rules and jurisdiction of the King County Superior Court, King County, Washington, unless the parties agree in writing to an alternative process. If the King County Superior Court does not have jurisdiction over such a suit, then suit may be filed in any other appropriate court in King County, Washington. Each party consents to the personal jurisdiction of the state and federal courts in King County, Washington and waives any objection that such courts are an inconvenient forum, If either Party brings any claim or lawsuit arising from this Agreement, each Party shall pay all its legal costs and attorney's fees and expenses 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, however nothing in this paragraph shall be construed to limit the Parties' rights to indemnification under Section 5 of this Agreement. 6.3 Execution. Each individual executing this Agreement on behalf of the City and Grantee represents and warrants that such individual is duly authorized to execute and deliver this Agreement. This ;61 Ulftnlal§ -Y _MJJJLJM61M#J%14A 'AXQ 14 V OE CITY OF CITY HALL 33325 8th Avenue South Federal Way Federal Way, Wry 98003-632 5 (253) 835-7000 w cityoffederalway coo Agreement may be executed in any number of counterparts, each of which shall be deemed an original and with the same effect as if all Parties hereto had signed the same document. All such counterparts shall be construed together and shall constitute one instrument, but in making proof hereof it shall only be necessary to produce one such counterpart. The signature and acknowledgment pages from such counterparts may be assembled together to form a single instrument comprised of all pages of this Agreement and a complete set of all signature and acknowledgment pages. The date upon which the last of all of the Parties have executed a counterpart of this Agreement shall be the "date of mutual execution" hereof. IN WITNESS, the Parties execute this Agreement below,. date writtenbelow. Loll • r •. -d-,e C U — 4 -t -(Jim Ferrell, Mayor ATE: By: &IdU40 k. A V , F Printed e: Lei; 6 Title:60 ` ATE: 1011,119 7/25/2020 eServices Services Business Lookup FAMILY AND WELLNESS MEDICINE License Information: New search Back to results Entity name: FAMILY AND WELLNESS MEDICINE, LLC Business name: FAMILY AND WELLNESS MEDICINE Entity type: Limited Liability Company I: 604-329-334 Business ID: 001 Location ID: 0001 Location: Active Location address: 34004 16TH AVE S STE 100 FEDERAL WAY WA 98003-8905 Mailing address: PO BOX 3086 FEDERAL WAY WA 98063-3086 Excise tax and reseller permit status: Click here Secretary of State status: Click here Endorsements Endorsements held at this location License # Count Details Status Expiration date First issuance Federal Way General Business 19 -100312 -00 -BL Active Sep -30-2020 Jan -18-2019 Governing People May include governing people not registered with Secretary of State Governing people Title NGUYEN, HONG Registered Trade Names Registered trade names Status First issued FAMILY AND WELLNESS MEDICINE Active Mar -19-2019 FWM Active Mar -19-2019 FWM OPIOID TREATMENT Active Dec -11-2019 FWMWA Active Dec -11-2019 The Business Lookup information is updated nightly. Search date and time: 7/25/2020 12:34:56 PM https://secure.dor.wa.gov/gteunauth/—/#60