HomeMy WebLinkAboutSenior Services Volunteer Transportationf
CITY OF C
Ao'' ~ ~
WASHINGTON
Department of Administration
Michael Hursh, Human Services Manager
25 West Main Street, Auburn, WA 98001
phone: 253.804.5029
email: mhursh@auburnwa.gov
Agreement for Human Service Activities
Costing $5, 000 per year or less
This Agreement is made effective as of January 1, 2010, by and between SENIOR SERVICES:
VOLLJNTEER TRANSPORTATION and CITY OF AUBURN. In this Agreement, the party who is
contracting to receive services shall be referred to as "CITY", and the party who will be providing the
services shall be referred to as "CIS". The parties agree as follows:
1. DESCRIPTION OF SERVICES. Beginning on January 1, 2010, SENIOR SERVICES agrees to
provide transportation for senior citizens living in the City of Auburn. Services will be delivered as per
the attached Scope of Work.
2. PAYMENT. The CITY will pay a fee to the SENIOR SERVICES far services provided in the
amount of $5,000 per year, paid in quarterly installments of equal amounts, for services delivered as
described in the attached Scope of Work. This fee shall be payable in a lump sum upon receipt of an
invoice from the SENIOR SERVICES with appropriate supporting documentation.
3. EXPENSE REIMBURSEMENT. SENIOR SERVICES shall pay all "out-of-pocket" expenses, and
shall not be entitled to reimbursement from the CITY except for specific services, items or activities listed
in the Scope of Services as reimbursable goods or services.
4. TERM/TERMINATION. This Agreement is effective January 0 1, 2010, and expires December 31,
2010, unless either party terminates the Agreement by notifying the other party in writing within seven
(7) days of the intent to terminate. The Agreement may be renewed for one year upon the mutual consent
of both parties.
5. RELATIONSHIP OF PARTIES. It is understood by the parties that the SENIOR SERVICES is an
independent contractor with respect to the City of Auburn, and not an employee of the CITY. The CITY
will not provide fringe benefits, including health insurance benefits, paid vacation, or any other employee
benefit, for the benefit of SENIOR SERVICES.
6. EMPLOYEES. The provisions ofthis Agreement shall also bind SENIOR SERVICES employees
who perform services for the CITY under this Agreement.
7. INDEMNIFICATION / HOLD HARMLESS. SENIOR SERVICES shall defend, indemnify and
hold the City, its officers, officials, employees and volunteers harmless from any and all claims, injuries,
damages, losses ar suits including attorney fees, arising out of or resulting from the acts, errors or
omissions of the SENIOR SERVICES in performance of this Agreement, except for injuries and damages
caused by the sole negligence of the City. The City of Auburn shall defend, indemnify and hold SENIOR
SERVICES, its officers, officials, employees and volunteers harmless from any and all claims, injuries,
damages, losses or suits including attorney fees, arising out of or resulting from the acts, errors or
Page 1 of 5
AUBURN * MORE THAN YOU IMAGINED
omissions of the City in performance of this Agreement, except for injuries and damages caused by the
sole negligence of the SENIOR SERVICES.
8. INSURANCE. The SENIOR SERVICES 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 SENIOR SERVICES, its agents,
representatives, ar employees.
A. Minimum Scope of Insurance, SENIOR SERVICES shall obtain insurance of the types
described below:
1. Automobile Liabilitv insurance covering all owned, non-owned, hired and leased
vehicles. Coverage shall be written on Insurance Services Office (ISO) form CA 00
O] or a substitute form providing equivalent liability coverage. If necessary, the
policy shall be endorsed to provide contractual liability coverage.
2. Commercial General Liabilitv insurance shall be written on ISO occurrence form CG
00 01 and shall cover liability arising from premises, operations, independent
contractors and personal injury and advertising injury. The City shall be named as an
insured under the SENIOR SERVICES Commercial General Liability insurance
policy with respect to the work performed for the City.
3. Workers' Compensation coverage as required by the Industrial Insurance laws of the
State of Washington.
4. Professional Liabilitv insurance appropriate to the SENIOR SERVICES profession.
B. Minimum Amounts of Insurance: SENIOR SERVICES shall maintain the following
insurance limits:
1. Automobile Liabilitv insurance with a minimum combined single limit for bodily
injury and property damage of $1,000,000 per accident.
2. Commercial General Liabilitv insurance shall be written with limits no less than
$1,000,000 each occurrence, $2,000,000 general aggregate.
3. Professional Liabilitv insurance shall be written with limits no less than $1,000,000
per claim and $1,000,000 policy aggregate limit.
C. Other Insurance Provisions: The insurance policies are to contain, or be endorsed to
contain, the following provisions far Automobile Liability, Professional Liability and
Commercial General Liability insurance:
1. The SENiOR SERVICES insurance coverage shall be primary insurance as respect
the City. Any insurance, self-insurance, or insurance pool coverage maintained by
the City shall be excess of the SENIOR SERVICES insurance and shall not
contribute with it.
2. The SENIOR SERVICES insurance shall be endorsed to state that coverage shall not
be cancelled by either party, except after thirty (30) days prior written notice by
certified mail, return receipt requested, has been given to the City.
Page 2 of 5
The undersigned have read the above statements, unden
Signed: XMUL, Signed:
Date: ~691; e) Date:
Address: I), p S ?,n d Ne,
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ag ide by their terms.
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Page 4 of 5
D. Acceptability of Insurers: Insurance is to be placed with insurers with a current A.M. Best
rating of not less than A: VII.
E. Verification of Coverage: SENIOR SERVICES 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 SENIOR
SERVICES befare commencement of the work.
9. ASSIGNMENT. SENIOR SERVICES obligations under this Agreement may not be assigned or
transferred to any other person, firm, or corporation without the prior written consent of the CITY.
10. NOTICES. All notices required or permitted under this Agreement shall be in writing and shall be
deemed delivered when delivered in person or deposited in the United States mail, postage prepaid,
addressed as follows:
IF for SENIOR SERVICES: IF for the CITY:
Farlis Lewis Michael Hursh
Evaluation/Accountability Manager Human Sprvices Manager
2208 2°d Avenue 25 West Main Street
Seattle, WA 98121 Auburn, WA 98001
Such address may be changed from time to time by either party by providing written notice to the other in
the manner set forth above.
11. ENTIRE AGREEMENT. This Agreement contains the entire agreement of the parties and there are
no other promises ar conditions in any other agreement whether oral or written. This Agreement
supersedes any prior written or oral agreements between the parties.
12. AMENDMENT. This Agreement may be modified or amended if the amendment is made in writing
and is signed by both parties.
13. SEVERABILITY. If any provision of this Agreement shall be held to be invalid or unenfarceable
for any reason, the remaining provisions shall continue to be valid and enforceable. If a court finds that
any provision of this Agreement is invalid or unenfarceable, but that by limiting such provision it would
become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced
as so limited.
14. WAIVER OF CONTRACTUAL RIGHT. The failure of either party to enfarce any provision of
this Agreement shall not be construed as a waiver or limitation of that party's right to subsequently
enforce and compel strict compliance with every provision of this Agreement.
15. APPLICABLE LAW. This Agreement shall be governed by the laws of the State of Washington.
THE REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK
Page 3 of 5
HUMAN SERVICES AGREEMENT BETWEEN THE
CITY OF AUBURN & SENIOR SERVICES: VOLUNTEER TRANSPORTATION
Scope of Work
Services to include:
■ Volunteer drivers use their own vehicles to provide personalized, escorted, free
transportation services to seniors throughout King County who need a higher level of assistance
than offered by public transportation.
■ The program serves seniors 60 years of age and older who reside in King County and are
able to transfer in and out of a private vehicle with minimal assistance.
■ The program focuses on clients who cannot use other transportation options and specifically
those who need an escort to their appointments. What distinguishes Volunteer Transportation
from other services is that our volunteer drivers escort seniors to and wait with them at their
appointments, offering not only a ride but a helping hand and moral support.
■ Volunteer Transportation is not constrained by boundary limitations and, depending on driver
availability, will transport Auburn seniors anywhere they need to go for appointments, including
Seattle, the Eastside or even in Pierce County.
■ Recruit volunteers, train them and acknowledge their contribution to the community.
■ Comply with applicable codes, rules and regulations.
■ Maintain records of residents.
■ Retain the above records for three years and make them available for review upon request by
the City and/or its agents or representatives.
Reporting Requirements:
With each quarterly request for reimbursement, SENIOR SERVICES provides a summary of
the number of people served along with the number of clients who are Auburn residents.
■ At the end of each year, a brief report describing the past program, number of clients served
along with noteworthy accomplishments and/or challenges.
Additional Billable Services, Goods and/or Activities:
■ None
Page 5 of 5
To: CITY OF AUBURN, ATTN: MICHAEL HURSH, HUMAN SERVICES
25 WEST MAIN STREET, AUBURN WA 98001
Agency: Senior Services
2208 Second Avenue
Seattle, WA 98121
Program: Volunteer Transportation ,
Amount Requested: $ 1,250.00
Contact, Title: Farlis Lewis, E/A Manager
Phone: 206-268-6705
Email: farlisl@seniorservices.org
Invoice for: ❑ 15t Quarter, January to March - Due April 15, 2010
❑ 2"d Quarter, April to June - Due July 15, 2010
❑ 3rd Quarter, July to September - Due October 15, 2010
❑ 4th Quarter (Final) October to December - Due January 31, 2011
Attachments: ❑ Quarterly Service Report
❑ Quarterly Financial Report
❑ Demographic Report (2"d and 4th Quarters only)
❑ Logic Model (15' Quarter only)
❑ Outcomes Report (4th Quarter only)
❑ Proof of Insurance (15t 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.
Signature of Authorized Representative Date
The City of Auburn will issue payment upon this invoice within forty-five (45) 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 ONLY:
Contract Amount: $5,000.00
Payments Year to Date:
Payment this invoice:
Authorized to Pay:
Signature
CITY OF AUBURN
Contract Balance:
7 ? . ?-G 1t~
Date
49~
COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST
HUMAN SERVICE AGREEMENT
2010 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT
Agency Information
Senior Services
2208 Second Avenue
Seattle, WA 98121
Contact, Title: Farlis Lewis, E/A Manager
Phone: 206-268-6705
Email: farlisl@seniorservices.org
Are professional services (e.g., counseling, case management) provided as part of this
Agreement?
Contract Information
Contract Amount: $5,000
Program Name: Volunteer Transportation
Description of Service to be provided:
Reporting Information
Report for _ 15' Qtr/Jan-Mar
2010 Service Units
_ 2"d Qtr/Apr-Jun _ 3rd Qtr/Jul-Sep _ 4'h Qtr/Oct-Dec
City Funding
Onl
All Funding Sources
Actual Service
U
it
D
t
t
Service Unit Description:
Auburn Residents Only
Total Projected
Annual Units
Actual Units by Quarter
n
s
o
a
e,
all Fund
Sources
Service UnitlPerformance Measure
60
1St
2"a
3ra
4m
Unduplicated Number of Auburn
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.
CITY OF AUBURN
2010 Quarterly Financial Report
Agency: Senior Services Date:
Program: Volunteer Transportation
Report for _ 1St Qtr/Jan-Mar _ 2"d Qtr/Apr-Jun _ 3rd Qtr/Jul-Sep
4th Qtr/Oct-Dec
Cost Categories
Budget
Award
This
Request
Cumulative
to date
Award
Balance
1
Personal/Agency Services
2
Office/Operating Supplies
3
Cor 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:
CITY OF AUBURN
2010 Demographic Report
Agency: Senior Services Date:
Program: Volunteer Transportation
Cate o
-I-sT
2"
3`
4
Total YTD
Client
AI ona
Residence'*
Auburn
Black Diamond
*"List all clients
Burien
served in this
cat
o
Covin ton
eg
ry.
ln al! other
Des Moines
categories list
Enumclaw
-
Auburn clienfs
Federal Wa
only.
Kent
Ma le Valle
Normandy Park
Pacific
Renton
SeaTac
Seattle
Tukwila
Unincorporated. Kin Count
Other:
Unknown
TOTAL
Client
30% of inedian or below
Income
50% of inedian or below
Level
80% of inedian or below
Above 80% of inedian
Unknown
TOTAL
Client
Female
Gender
Male
Client
0-4
Age
5-12
13-17
18-34
35-54
55-74
75+
Unknown
TOTAL
Ethnicity/
AsianlPacific Islander
Cultural
Black/African American
Background
HispaniGLatino
Native American/ Alaskan Native
White/Caucasian
Other
Unknown
TOTAL
Condition
Disablin Condition
ESC
Limited En lish S eakin
Household
Female-Headed Household
CITY OF AUBURN
2010 Outcomes Evaluation Format
Agency: Senior Services Date:
Program: Volunteer Transportation
1. 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.
Contents.
A. The components of the evaluation will:
1) Identify both process and outcome portions of the services that SS proposes to
provide the City of Auburn.
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. SS shall develop the following status report components within the time frames
established below:
1) 1 St Quarter
a) The outcome based results SS expects to achieve;
b) An indicator to inform the City of Auburn 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 alterations in the methodology of
information gathering.
2) 4th Quarter
a) Information collected;
b) Conclusions developed as a result of the information.