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HomeMy WebLinkAboutValley Cities Counseling GF0515 A3/(.,·7 AGREEMENT FOR SERVICES THIS AGREEMENT made and entered into this / sr day of ...-.- JtI¥lJ corporation of the State of Washington, hereafter referred to as "CITY", and VALLEY , 2005, by and between the CITY OF AUBURN, a municipal CITIES COUNSELING AND CONSULTATION which is located at 2704 I Street N.E.. Auburn. Washinqton 98002, 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 mental health counseling and therapy; and WHEREAS, the CITY is interested in continuing support of Valley Cities Counseling and Consultation, 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 by 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. -------------------------------------- Agreement - GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 1 of8 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, 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. -------------------------------------- Agreement- GF-0515, Valley Cities Counseling, Survivor Support March 1. 2005 Page 2 of8 C. As full and total payment for the services provided under this Agreement, the CITY aarees to Day the AGENCY the total amount of $12.000.00 as set forth in Exhibit 1. The CITY will pay an amount equal to one-quarter of the total amount within thirty (30) 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 governmentai or public law is involved; and iff inal 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. --------------..----------------------- Agreement - GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 3 of8 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 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: -------------------------------------- Agreement - GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 4 of8 ..._-----~--- 1) GENERAL LIABILITY COVERAGE: The CITY, its elected and appointed officials, employees and agents are to be covered as additional insureds as respects: Liability a rising 0 ut 0 f services and activities performed by or on behalf of AGENCY, its employees, agents and 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. -------------------------------------- Agreement - GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 5 of8 (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 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. -------------------------------------- Agreement- GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 6 of8 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. 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 - GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 7 of8 ~._--_.~--_.~,... Gf~ PETER B. LEWIS MAYOR ....-:;00 .... ¡ST: '-úJlI tJjð-ð~ 'Da . lie E. Daskam, CityCI VALLEY CITIES COUNSELING AND CONSULTATION. ~~/7 By:;øJ:/ ~~ TITLE: ( £. 0 STATE OF WASHINGTON ) )ss COUNTY OF KING ) On this ~ day of ~ , 2005, before me, the undersigned, a Public . and for the State of Washington, personally appeared , to me known to be the Executive Director of Valley Cities Counselin and Consultation, 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 behalf of said non-profit corporation. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seai the date hereinabove set forth. ~qlL~ a. 0~ ;;¿IS 1/ ~~ -:Or ~r- æ "'<~. ,.NI. NOTARY PUBLIC in and f9[ the State of Washington, residing in ,..lJ.Jtu..- MY COMMISSION expires: II-I-r -oí Agreement - GF-0515, Valley Cities Counseling, Survivor Support March 1, 2005 Page 80f8 __m~_._......_.. E)(HIBIT 1, GF-0515 CITY OF AUBURN HUMAN SERVICE AGREEMENT 2005 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT Agency Information Valley Cities Counseling & Consultation 2704 I Street N.E. Auburn, WA 98002 253.876.3468 cmoose@valleycities.org Contact: Cheryl Moose Title: CFO Are professional services (e.g., counseling, case management) provided as part of this Agreement? YES Contract Information Contract Amount: 12,000 Program Name: Survivor Support & Therapy Services Description of Service to be provided: Comprehensive mentai health services to survivors lorimarilv adults) of famiiv vioience and soecificallv to survivors of childhood and aduit sexuai and/or ohvsical abUSE! Reporting Information Report for 1st Qtr/Jan-Mar _ 2" Qtr/Apr-Jun _ 3" Qtr/Jul-Sep 4th Qtr/Oct-Dec 2005 Service Units City Funding All Funding Sources Açtual Service Onlv Units to Date, Service Unit Description; Total all Fund Auburn Residents Only Projected Actual Units by Quarter Sources Annual Units Service Unit/Performance Measure 1't 2" 3"' 4th Unduplicated Number of Auburn 137 Clients Served Mentai Health Counseiing (Hours) 1,562 Narrative; Please attach other relevant information, including current trends, program developments, special events, publicity, community education, etc. If actual service units are lower than "nticipated, please explain. '-~-_.-...- EXHIBIT 2, GF-0515 CITY OF AUBURN 2005 Quarterly Financial Report Agency: Valley Cities Counseling & Consultation Program: Survivor Support & Therapy Services Date: Report for 1st Qtr/Jan-Mar _ 2nd Qtr/Apr-Jun _ 3'd Qtr/Jul-Sep 4th Qtr/Oct-Dec Cost Categories Budget This Cumulative Award Award Request to date Balance 1 Personnel/Agency Services 12,000 2 Office/Operating Supplies 3 Consultant or Purchased Services 4 Direct Client Assistance 5 Communications 6 Travei & Training 7 Intra-Agency Support 8 Other per Detail Grand Total 12,000 Requested Reimbursement: Detail as Applicable: - -_....._..~.._.._--- EXHIBIT 3, GF-0515 CITY OF AUBURN 2005 Demographic Report Agency: Program: Valley Cities Counseling & Consultation Survivor Support & Therapy Services Date: Category 1"' 2" 3 4' I Total YTD I Client Algona Residence*· Auburn Black Diamond "'list all clients Burian served in this Covington category. Des Moines In all other categories list Enumclaw Auburn clients Federal Way only. Kent Maple Vallev Normandy Park Pacific Renton SeaTae Seattle TUkwila Unincor orated. Kina County Other: Unknown TOTAL Client 30% of median or below Income 50% of median or below Level 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 Ethnicityl Asian/Pacific Islander Cultural Black/African American Background Hispanic/latino Native Amerlcanl Alaskan Native White/Caucasian Other Unknown TOTAL Condition Disabling Condition ESL Limited Enalish Soeakina Household Female-Headed Household ---- -_._------'-'--~-----.------.._~_.._-- COVER PAGE, GF-0515 CITY OF AUBURN Outcomes Evaluation Format Agency: Valley Cities Counseling & Consultation Program: Survivor Support & Therapy Services Date: I. Submission Dates. This report shall be submitted with the first quarter invoice and again within thirty (30) days after the end of the calendar year. II. Contents. A. The components of the evaluation will: 1) Explain the underlying theory of the program and what it was designed to accomplish in terms of outcomes and output goals.. 2) Show the relationship of program resources and activities to the expecteid results or outcomes; 3) Provide a logic model that relates outcomes to activities to projected outputs and the resources required to generate those outputs. B. Valley Cities shall develop the following status report components within the time frames established below: 1) 151 Quarter 2005 a) The above logic model and explanation of the underlying theory of the program. b) The method for gathering information needed to indicate the outcomes that have occu rred. c) Initial collection and assessment of the information for the first quarteir inciuding alterations to the initial grant application and/or alterations in the methodology of information gathering. 2) 41h Quarter 2005 a) Revise the logic model with actual outcomes achieved, activities performed, outputs generated and resources spent. b) Conclusions developed as a result of the information. c) Completion of the Demographic Report represented in Exhibit 3. COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT RE(~UEST -_.._~~~~- COVER PAGE, GF-0515 CITY OF AUBURN HUMAN SERVICE AGREEMENT 2005 INVOICE FOR CONTRACTED SERVICES To: City of Auburn, AUn: Bill Mandeville, Planning Department 25 West Main, Auburn, WA 98001 Agency: Valley Cities Counseling & Consultation 2704 J Street NE Auburn, WA 98002 Date: 253.876.3.468 253-876<1422 cmoose@valleyclties.org Contact: Cheryl Moose Invoice for: 0 1st Quarter, January to March - Due April 15, 2005 o 2'd Quarter, April to June - Due July 15, 2005 o 3'" Quarter, July to September - Due October 15, 2005 o 4th Quarter (Preliminary, Cover sheet and Ex. B only) October to December - Due December 13, 2005 o 4th Quarter (Final) October to December - Due January 31,2006 Amount Requested: Required Attachment Checklist: _ Exhibit A - Quarterly Service Report _ Exhibit B - Quarterly Financial Report _ Exhibit C - Demographic Report (2'd and 4th Quarters only) _ Logic Model/Outcomes Report (1't 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 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 iisted above. FOR CITY OF AUBURN USE ONL Y: Contract Amount: Payments Year to Date: 12,000 Date: Date: Date: Date: Contract Baiance: Payment this invoice: Authorized to Pay: Signature Date COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT RECIUEST -....----..-....- EXHIBIT 1, GF-0515 CITY OF AUBURN HUMAN SERVICE AGREEMENT 2005 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT Agency Information Valley Cities Counseling & Consultation 2704 I Street N.E. Auburn, WA 98002 253.876,,1468 cmoose@valleycities.org Contact: Cheryl Moose Title: CFO Are professional services (e,g., counseling, case management) provided as part of this Agreement? YES Contract Information Contract Amount: 12,000 Program Name: Survivor Support & Therapy Services Description of Service to be provided: Comprehensive mental health services to survivors (primarilv adults) of familv violence and specificallv to survivors of childhood and adult sexuai and/or phvsical abUSE¡ Reporting Information Report for 1 'I Qtr/Jan-Mar _ 2"" Qtr/Apr-Jun _ 3'd Qtr/Jul-Sep 4th Qtr/Oct-Dec 2005 Service Units City Funding All Funding Sources A<:tual Service Only Units to Date, Service Unit Description: Total all Fund Auburn Residents Only Projected Actual Units by Quarter Sources Annual Units Service Unit/Performance Measure 1" 2nd 3'" 41h Unduplicated Number of Auburn 137 Clients Served Mental Health Counseling (Hours) 1,562 Narrative: Please attach other relevant information, including current trends, program developments, special events, publicity, community education, etc. If actual service units are lower than êlnticipated, please explain, _._.------_._~~_._-~.- .------------- EXHIBIT 2, GF-0515 CITY OF AUBURN 2005 Quarterly Financial Report Agency: Valley Cities Counseling & Consultation Program: Survivor Support & Therapy Services Date: Report for 1st Qtr/Jan-Mar _ 2,d Qtr/Apr-Jun _ 3"' Qtr/Jul-Sep 4th Qtr/Oct-Dec Cost Categories Budget This Cumulative Award Award Request to date Balance 1 Personnel/Agency Services 12,000 2 Office/Operating Supplies 3 Consultant or Purchased Services 4 Direct Client Assistance 5 Communications 6 Travel & Training 7 Intra-Agency Support 8 Other per Detail Grand Total 12,000 Requested Reimbursement: Detail as Applicable: -_...--..-_~~..- -~-~ EXHIBIT 3, GF-0515 CITY OF AUBURN 2005 Demographic Report Agency; Program: Valley Cities Counseling & Consultation Survivor Support & Therapy Services Date: Category 1 2"· 3 4'" Total YTD Client Alaona Residence·· Auburn Black Diamond -·List all clients Burian served In this Covinaton category. Des Moines In all other categories list Enumclaw Auburn clients Federal Wav only, Kent Maale Vallev Narmandv Park Pacific Renton SeaTae Seattle Tukwila Unincorporated. KinQ County Other: Unknown TOTAL Client 30% of median or below Income 50% of median or below Level 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 Ethnlcltyl Asian/Pacific Islander Cultural Black/African American Background HisoaniClLatino Native American! Alaskan Native White/Caucasian Other Unknown TOTAL Condition DisablinQ Condition ESL Limited Enalish Soeakina Household Female·Headed Household _..._~_.__._~,-~~- COVER PAGE, GF-0515 CITY OF AUBURN Outcomes Evaluation Format Agency: Valley Cities Counseling & Consultation Program: Survivor Support & Therapy Services Date: I. Submission Dates, This report shall be submitted with the first quarter invoice and again within thirty (30) days after the end of the calendar year. II, Contents. A, The components of the evaluation will: 1) Explain the underlying theory of the program and what it was designed to accomplish in terms of outcomes and output goals.. 2) Show the relationship of program resources and activities to the expectE!d results or outcomes; 3) Provide a logic model that relates outcomes to activities to projected outputs and the resources required to generate those outputs. B. Valley Cities shall develop the following status report components within the time frames established below: 1) 1 st Quarter 2005 a) The above logic model and explanation of the underlying theory of the program, b) The method for gathering information needed to indicate the outCOm<9S that have occurred. c) Initial collection and assessment of the information for the first quarte,r including alterations to the initial grant application and/or alterations in the methodology of information gathering, 2) 4th Quarter 2003 a) Revise the logic model with actual outcomes achieved, activities performed, outputs generated and resources spent. b) Conclusions developed as a result of the information. c) Completion of the Demographic Report represented in Exhibit 3. COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT RECIUEST --_._-_...__._~-_.._~._~------------- . ----,-.---------.--- COVE.R PAGE, GF-0515 CITY OF AUBURN HUMAN SERVICE AGREEMENT 2005 INVOICE FOR CONTRACTED SERVICES To: City of Auburn, Attn: Bill Mandeville, Planning Department 25 West Main, Auburn, WA 98001 Agency: Valley Cities Counseling & Consultation 2704 I Street NE Auburn, WA 98002 Date: 253.876.:1468 253-876-:3422 cmoose@valleycities.org Contact: Cheryl Moose Invoice for: 0 1" Quarter, January to March - Due April 15, 2005 o 20d Quarter, April to June - Due July 15, 2005 o 3"' Quarter, July to September - Due October 15, 2005 o 41h Quarter (Preliminary, Cover sheet and Ex. B only) October to December - Due December 13, 2005 o 41h Quarter (Final) October to December - Due January 31,2006 Amount Requested: Required Attachment Checklist: _ Exhibit A - Quarterly Service Report _ Exhibit B - Quarterly Financial Report _ Exhibit C - Demographic Report (20d and 41h Quarters oniy) _ Logic Model/Outcomes Report (1" and 41h Quarters only) _ Proof of Insurance (1" quarter and/or if expired sinGe last reimbursement request) I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to Auburn residents. Date 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: Payments Year to Date: 12,000 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 -"-"-"'._-~.,._-~...-