HomeMy WebLinkAboutGriefworks GF0507
I· -.,
~ :;.
, 'ð'''''
AGREEMENT FOR SERVICES
THIS AGREEMENT made and entered into this -.-L. day of
_Y"nßII c..h
, 2005, by and between the CITY OF AUBURN, a municipal
corporation of the State of Washington, hereafter referred to as "CITY", and
GRIEFWORKS which is located at P.O. Box 912 Auburn, WA 98071-0912, a non-profit
corporation organized under the laws of the State of Washington, hereafter referred to as
"AGENCY."
WHEREAS, The AGENCY provides a valuable service to the CITY and its
residents through the provision of Grief and Bereavement Counseling services _
education, group work, one-on-one; and
WHEREAS, the CITY is interested in continuing support of Griefworks, including
development of additional resources and service sites, for low income Auburn residents;
NOW, THEREFORE, In consideration of the covenants and conditions of this
Agreement, the parties agree as follows:
I. PURPOSE.
The purpose of this Agreement is to provide for an appropriation to the AGENCY
for providing services as set forth in Exhibit 1 through 4, and incorporated herein t;>y this
reference as if fully set forth, to Auburn residents during the 2005 term. This support is in
recognition of the fact that the demand for the services delivered by the AGENCY
continues to rise.
II. SCOPE OF SERVICES.
A. The parties agree and understand that the AGENCY agrees to provide services,
as described in Exhibits 1 through 4, which may include development of new resources,
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 1 0[8
_.._-_.._--~.~_._----,-._-_._.._,_._._.._---._-
to low income Auburn residents. Services to be provided are set forth in Exhibits 1
through 4 to this agreement, and incorporated herein by this reference as if fully set forth.
B. The Agency agrees to provide at a minimum the services outlined in the Exhibits.
Said services are to be completed no later than December 31, 2005.
III. TERM.
The term of this Agreement shall commence on January 1, 2005 and shall expire
on December 31, 2005.
IV. PERFORMANCE REPORTS AND COMPENSATION
A. The AGENCY shall provide to the City within 15 days of the close of each
calendar quarter a status report containing program statistics regarding the type and level
of services provided to the City of Auburn, as well as financial information pertaining to
the contract agreement and expenditures. The final report, which may include estimated
service levels, shall be submitted no later than December 13, 2005. Format and contents
of these reports are set forth in Exhibits 1 to 4 to this Agreement, which are incorporated
herein by this reference.
B. The Agency shall prepare and submit to the City two program evaluation reports in
the format commonly referred to as "outcomes reports" which will show the intended
linkages between the activities conducted and the changes the activities will produce.
These reports shall contain information as set forth in Exhibit 4 to this Agreement, which
is incorporated herein by this reference, and shall be submitted to the City at the end of
the first quarter and within sixty days following the close of the calendar year.
C. As full and total payment for the services provided under this Agreement, the
CITY aarees to pay the AGENCY the total amount of $5,000.00 as set forth in Exhibit
1· The CITY will pay an amount equal to one-quarter of the total amount within thirty (30)
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 2 0[8
._--_._-_..,-,-_._-_..~.,--,._--_.,- -,'-_._--
days following the CITY's receipt of quarterly invoices. The required format and content of
quarterly invoices is set forth in the Exhibits to this Agreement, and is incorporated herein
by this reference.
VI. INDEMNIFICATION.
The AGENCY agrees to defend, indemnify, and hold harmless the CITY, its
elected and appointed officials, employees and agents from and against any and all
claims, demands and/or causes of action of any kind or character whatsoever arising out
of or relating to services provided by the AGENCY, its employees, volunteers or agents
concerning any and all claims by any persons for alleged injury or damage to persons or
property to the extent caused by the negligent acts, errors or omissions of the AGENCY,
its employees, volunteers or agents or representatives. In the event that any suit or claim
for damages based upon such claim, action, loss or damage is brought against the CITY,
the AGENCY shall defend the same as its sole costs and expense; provided that the
CITY retains the right to participate in said suit if any principle of governmental or public
law is involved; and if final judgment be rendered against the CITY and/or its officers,
elected officials, agents and employees or any of them or jointly against the CITY and the
AGENCY and their respective officers, agents, volunteers, employees or any of them, the
AGENCY shall fully satisfy the same and shall reimburse the CITY any costs and
expense which the CITY has incurred as a result of such claim or suit. The provisions of
this section shall survive the expiration or termination of this Agreement.
VII. INDEPENDENT CONTRACTOR/ASSIGNMENT.
The parties agree and understand that the AGENCY is an independent contractor
and not the agent or employee of the CITY and that no liability shall attach to the CITY by
reason of entering into this Agreement except as provided herein. The services required
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 3 0[8
-.,...---..----- .---- --..._-
under this Agreement may not be assigned or subcontracted by the AGENCY without the
prior written consent of the CITY.
VIII. INSURANCE.
The AGENCY shall procure and maintain for the duration of this Agreement
insurance against claims for injuries to persons or property which may arise from or in
connection with services provided by the AGENCY, it agents, employees or volunteers
under this Agreement. The AGENCY agrees to provide comprehensive general liability
insurance and shall maintain liability limits of not less than ONE MILLION DOLLARS
($1,000,000) combined single limit coverage per occurrence for bodily injury, personal
injury and property damage. Where professional services are provided as part of the
services rendered pursuant to this Agreement, as shown in Exhibit 1, the AGENCY shall
also provide and maintain professional liability coverage including errors and omissions
coverage in the minimum liability amount of ONE MILLION DOLLARS ($1,000,000)
combined single limit per occurrence for bodily injury, personal injury and property
damage. Any deductibles or self insured retentions in either policy must be declared to
and approved by the CITY. At the option of the CITY either: The insurer shall reduce or
eliminate such deductibles or self insured retentions as respects the CITY, its officials and
employees; or, The AGENCY shall procure a bond guaranteeing payment of losses and
related investigations, claim administration and defense expenses. The policies are to
contain or be endorsed to contain the following provisions:
1) GENERAL LIABILITY COVERAGE:
The CITY, its elected and appointed officials, employees and agents are to be
covered as additional insureds as respects: Liability arising out of services and
activities performed by or on behalf of AGENCY, its employees, agents and
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 4 0[8
-"_._~-~---~--,_._~~-,-"..._-~-_.__.._.._.-
volunteers. The coverage shall contain no special limitations on the scope of
protection afforded to the CITY, its elected and appointed officials, employees or
agents.
2) GENERAL LIABILITY AND PROFESSIONAL LIABILITY COVERAGES:
(a) The AGENCY's insurance coverage shall be primary insurance as respects the
CITY, its officials, employees and agents. Any insurance or self insurance
maintained by the CITY, its officials, employees or agents shall be in excess of
the AGENCY's insurance and shall not contribute with it.
(b) Any failure to comply with reporting provisions of the policy shall not affect
coverage provided to the CITY, its officials, employees or agents.
(c) Coverage shall state that the AGENCY's insurance shall apply separately to
each insured against whom claim is bought or suit is brought except with
respect to the limits to the insurer's liability.
(d) Each insurance policy required by this clause shall be endorsed to state that
coverage shall not be suspended, voided, canceled, reduced in coverage, or in
limits except after thirty (30) days prior written notice by certified mail return
receipt requested has been given to the CITY. The AGENCY agrees to
provide copies of the Certificates of Insurance to the CITY at the time that this
Agreement takes effect.
(e) The AGENCY shall furnish the CITY with Certificates of Insurance and with
original endorsements affecting coverage required by this clause. The
certificate and endorsements for each insurance policy are to be signed by a
person authorized by that insurer to bind coverage on its behalf. The CITY
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 5 0[8
~..~--_.._~-
reserves the right to require complete, certified copies of all required insurance
policies at any time.
(f) The AGENCY shall include all volunteers, employees and agents under its
policies or shall furnish separate certificates and endorsements for each. All
coverages for volunteers shall be subject to all the requirements stated herein.
IX. NONDISCRIMINATION.
The AGENCY shall not discriminate under any services or programs to which this
Agreement may apply directly or through contractual or other arrangements on the
grounds of race, color, creed, religion, national origin, sex, age, or the presence of any
sensory, mental or physical handicap.
X. BOOKS AND RECORDS.
The AGENCY agrees to maintain separate accounts and records in accordance
with State Auditor's procedures, including personnel, property, financial and programmatic
records which sufficiently reflect direct and indirect costs and services performed under
this Agreement. The AGENCY agrees to maintain all books and records relating to this
Agreement for a period of three (3) years following the date that this Agreement is expired
or otherwise terminated. The parties agree that the CITY OF AUBURN may inspect such
documents upon good cause at any reasonable time within the three (3) year period.
XI. TERMINATION OF AGREEMENT.
This Agreement may be terminated by either party upon ten (10) days written
notice should the other party fail substantially to perform in accordance with its terms
through no fault of the other.
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 6 0[8
~------- .. -..--------.,-..-.-------..-
XII. GENERAL PROVISIONS.
A. The AGENCY agrees to submit a report to the CITY no later than
December 13, 2005, describing the progress and activities performed for
the year 2005 under its scope of services.
B. This Agreement shall be governed by the laws, regulations and ordinances
of the City of Auburn, the State of Washington, and County of King and
where applicable, Federal laws.
C. The CITY and the AGENCY respectively bind themselves, their
successors, volunteers, assigns and legal representatives to the other
party to this Agreement and with respect to all covenants to this
Agreement.
D. This Agreement represents the entire and integrated Agreement between
the CITY and the AGENCY and supersedes all prior negotiations. This
Agreement may be amended only by written instrument signed by both the
CITY and the AGENCY.
E. Should it become necessary to enforce any term or obligation of this
Agreement, then all costs of enforcement including attorneys fees and
expenses and court costs shall be paid to the substantially prevailing party.
F. The AGENCY agrees to comply with all local, state and federal laws
applicable to its performance under this Agreement.
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 7 of8
---..---
___"._____._m._'.______.~_._._____
~:~
~- (~
PETER B. LEWIS
MAYOR
A~~
Danielle E. Daskam,
City Clerk
GRIEFWORKS
BY: ~n~
TITLE: _EICc::cLd1\)t" '))\yedvv
STATE OF WASHINGTON )
)ss
COUNTY OF KING )
On this if day of ~ , 2005, before me, the undersigned, a
Notary Public in and for the State of Washington, personally appeared
Shilnron Hl.J: - , to me known to be the Executive Director of Griefworks, the
non-profit corporation that executed the within and foregoing instrument, and acknowledged said
instrument to be the free and voluntary act and deed of said non-profit corporation for the uses and
purposes therein mentioned, and on oath stated that he/she is authorized to execute said
instrument on behaif of said non-profit corporation.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my officiai seal the date
hereinabove set forth.
...-.........'......"~\~ \'-
00" OI.-'iN I.:. .0> 'tt
- 0' ,,'" "'1:\',
,.,~....~. .,',.,,:" """,, .,¥TO I,
,Ç rit:.··..~:·'" '. '::':'. ¡c, "
... v. 'x" '...c..,ç..- ~
;: :',.0 ~~ '-, "Þ ~
: .-' ~~ ~
~ f U): ~
:,~ (j) ". .: :
"..-:;"... . "'~5
. ')-. . . -" 0
.~, -c'"' J"lt .," A",: .:
.~ .... 0 ' ,,,,,;.,, ß --
". 'i' Wi\S\'l\~_----
1,"'..,"'.............
~C7Ý~
r-t:> "", E I~ r /YU/PL
NOTARY PUBLIC i and fre State of ..t.
Washington, residing in ,0 ,t" P W t..L"'-4 7
MY COMMISSION expires: / ð - 7 '" -/\ 7
--------------------------------------
Agreement - GF0507, Griefworks
March 1, 2005
Page 8 0[8
_._..-------.--.._.~--
EXHIBIT 1. GF - 0507
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2005 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT
Agency Information
GriefWorks
P.O. Box 912
Auburn, WA 98071-0912
253.333.9420
griefworks@yahoo.com
Contact:
Nanette Flynn
Title: Executive Director
Are professional services (e.g., counseling, case management) provided as part of this
Agreement? Yes
Contract Information
Contract Amount:
5,000.00
Program Name:
GriefTalk
Description of Service to be provided: Counseling and support groups to people who grieve a
death or other traumatic loss.
Reporting Information
Report for
1st Qtr/Jan-Mar
_ 2nd Qtr/Apr-Jun
_ 3'" Qtr/Jul-Sep
4th Qtr/Oct-Dec
2005 Service Units
City Funding All Funding Sources Actual Service
Onlv
Total Units to Date,
Service Unit Description: Projected Actual Units by Quarter all Fund
Auburn Residents Only Annual Units Sources
Service Unit/Performance Measure 600 1st 2nd 3'd 4th
Unduplicated Number of Auburn 300
Clients Served
Narrative: Please attach other relevant information, including current trends, program developments,
special events, publicity, community education, etc. If actual service units are lower than anticipated,
please explain.
'defined in terms of service units, as provided with annual funding application
EXHIBIT 2. GF - 0507
Agency: GriefWorks
Program: GriefTalk
CITY OF AUBURN
2005 Quarterly Financial Report
Date:
Report for
1't Otr/Jan-Mar
_ 2'· Otr/Apr-Jun
_ 3'· Otr/Jul-Sep
4th Otr/Oct-Dec
Cost Categories Budget This Cumulative Award
Award Request to date Balance
1 Personnel/Agency Services 4000.00
2 Office/Operating Supplies 1000.00
3 Consultant or Purchased
Services
4 Direct Client Assistance
5 Communications
6 Travel & Training
7 Intra-Agency Support
8 Other per Detail
Grand Total 5,000.00
Requested
Reimbursement:
Detail as Applicable:
Office/Operating supplies includes printing/advertising, publications, etc.
EXHIBIT 3, GF - 0507
CITY OF AUBURN
2005 Demographic Report
Agency:
Program:
GriefWorks
GriefTalk
Date:
Cateaarv 1 2" 3~ 4 Total YTD
Client Ah::lona
Residence" Auburn
Black Diamond
**List all clients Burian
served in this Covinoton
category. Des Moines
In all other
categories list Enumclaw
Auburn clients Federal Way
only. Kent
Maple Valley
Normandv Park
Pacific
Renton
SeaTac
Sealtle
Tukwila
Unincorporated. Kino County
Other:
Unknown
TOTAL
Client 30% of median or below
Income 50% of median or below
Leyel 80% of median or below
Above 80% of median
Unknown
TOTAL
Client Female
Gender Male
Client 0-4
Age 5-12
13-17
18-34
35-54
55-74
75+
Unknown
TOTAL
Ethnicllyl Asian/Pacific Islander
Cultural Black/African American
Background Hispanic/Latino
Native Americanl Alaskan Native
White/Caucasian
Other
Unknown
TOTAL
Condition Disabling Condition
ESL Limited Enolish Speakino
Household Female-Headed Household
EXHIBIT 4, GF - 0507
CITY OF AUBURN
Outcomes Evaluation Format
Agency: GriefWorks
Program: GriefTalk
Date:
I. Submission Dates.
This report shall be submitted with the first quarter invoice and again within sixty (60) days of
the end of the calendar year.
II. Contents.
A. The components of the evaluation will:
1) Identify both process and outcome portions of Grief and Bereavement Counseling
services - education, group work, one-on-one;
2) Show the relationship of program resources and activities to the expected results or
outcomes;
3) Help identify those questions the evaluation is to answer;
4) Provide a graphic summary of how program parts relate to the whole;
5) Make explicit the underlying theory of the program; and
6) Identify measurable categories in the program evaluation.
B. GriefWorks shall develop the following status report components within the time frames
established below:
1) 1 sl Quarter 2005
a) The outcome based results GriefWorks expects to achieve;
b) An indicator to inform the GriefWorks that the anticipated change has or has not
occurred; and
c) The method for gathering information needed to indicate the outcomes that have
occurred.
d) Initial Collection and assessment of the information acquired to include:
alterations in the anticipated outcomes or alteration in the methodology of
information gathering.
2) 4th Quarter 2005
a) Information collected;
b) Conclusions developed as a result of the information.
COVER PAGE, GF - 0507
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2005 INVOICE FOR CONTRACTED SERVICES
To: City of Auburn, Attn: Shirley Aird, Planning Department
25 West Main, Auburn, WA 98001
Agency: GriefWorks
P.O. Box 912
Auburn, WA 98071-0912
Contact: Nanette Flynn
Invoice for: D 1st Quarter, January to March - Due April 15, 2005
D 2nd Quarter, April to June - Due July 15, 2005
D 3"' Quarter, Juiy to September - Due October 15, 2005
D 4th Quarter (Preliminary, Cover sheet and Ex. B only) October to December - Due
December 13, 2005
D 4th Quarter (Finai) October to December - Due January 31,2006
Date:
253.333.9420
griefworks@yahoo.com
Amount Requested:
Required Attachment Checklist: _ Exhibit A - Quarterly Service Report
_ Exhibit B - Quarterly Financial Report
_ Ëxhibit C - Demographic Report (2nd and 4'h Quarters only)
_ Logic Model/Outcomes Report (1st and 4th Quarters only)
_ Proof of Insurance (1st quarter and/or if expired since last
reimbursement request)
I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to
Auburn residents.
Date
Signature of Authorized Representative
The City of Auburn will issue payment upon this invoice within thirty (30) business days of receipt. To
ensure prompt payment, please submit this form and all required attachments by the date listed above.
FOR CITY OF AUBURN USE ONL Y:
Contract Amount: 5.000.00
Payments Year to Date:
Date:
Date:
Date:
Date:
Contract Balance:
Payment this invoice:
Authorized to Pay:
Signature
Date
COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST