HomeMy WebLinkAboutSound Mental Health GF1131
AGREEMENT FOR SERVICES
THIS AGREEMENT made and entered into this day of
2011, by and between the CITY OF AUBURN, a municipal
corporation of the State of Washington, hereafter referred to as "CITY", and SMH-
SOUND MENTAL HEALTH which is located at 1600 E. Olive St., Seattle, WA 98122, 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 confidential shelter to victims of domestic violence; and
WHEREAS, the CITY is interested in continuing support of SMH-SOUND
MENTAL HEALTH, 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:
1. 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 2011 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 - GF - 1131, SMH-SOUND MENTAL HEALTH, Behavioral Responsibility
January 1, 2011
Page 1 of 9
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, 2011.
III. TERM
The term of this Agreement shall commence on January 1, 2011 and shall expire
on December 31, 2011.
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. 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 agrees to pay the AGENCY the total amount of $7,500 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
Agreement - GF - 1131, SMH-SOUND MENTAL HEALTH, Behavorial Responsiblility
January 1, 2011
Page 2 of 9
quarterly invoices is set forth in the Exhibits to this Agreement, and is incorporated herein
by this reference.
V. 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.
VI. 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 - GF - 1131, SMH-SOUND MENTAL HEALTH, Behavioral Responsibility
January 1, 2011
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under this Agreement may not be assigned or subcontracted by the AGENCY without the
prior written consent of the CITY.
VII. 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 insured as respects: Liability arising out of services and
activities performed by or on behalf of AGENCY, its employees, agents and
Agreement - GF -1131, SMH-SOUND MENTAL HEALTH, Behavorial Responsiblility
January 1, 2011
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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 - GF - 1131, SMH-SOUND MENTAL HEALTH, Behavioral Responsibility
January 1, 2011
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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.
VIII. 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.
IX. 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.
X. TERMINATION OF AGREEMENT
This Agreement may be terminated by either party upon thirty (30) days written
notice should the other party fail substantially to perform in accordance with its terms
through no fault of the other.
Agreement - GF -1131, SMH-SOUND MENTAL HEALTH, Behavorial Responsiblility
January 1, 2011.
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XI.,: GENERAL PROVISIONS :
A. The AGENCY agrees-to submit a r1eport.to the CITY~;nojater than the last
quarterly invoice date, describing the progress and activities performed for
the: previous year's`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. Agency agrees to. conduct its. activity in such a manner, as.to coincide with
the goals identified in the attached Memorandum of Understanding. The
Agency, understands that the performance indicators established in the
Memorandum will be used by the City as a measurement tool in
determining if the goals have been achieved.
D. 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.
E. 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.
F. Should it 'become necessary to enforce any term or obligation of this
Agreement, then all costs of enforcement including attorney's fees and
expenses and court costs shall be paid to the substantially prevailing party.
Agreement - GF;-1131;aWH7SOUND MENTAL HEALTH; Behavioral Responsibility.
January 1, 2011
Page 7 of 9
G. The AGENCY agrees to comply with all:',local, -.state and federal laws'
''applicable to its 'performance under this Agreemenf..
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK':
✓Agreement- GF =1131, SMH=SOUND MENTAL'HEALTH, Behavo~ial.Responsiblility
January 1, 2011
Page 8 of 9
CITY A UR
PETER B. LEWIS
MAYOR
ATTEST:
X lt~
Da le E. Daskam,
City Clerk
AP O D AS TO FORM:
r Daniel eid,~
City Attorney
SMH4REATTCE MENTAL HEA H
BY:
TITLE:
STATE OF WASHINGTON )
)ss
COUNTY OF KING y~(~ )
On this Sri day of t' lGrC'k 2011, before me, the undersigned, a
Pu lic in nd for the State of Washington, personally appeared
V ; to me known to be the Executive Director of SMH- t-E ~5m~
MENTAL HEALTH, 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 seal the date
hereinab
ON EI'p'9O~
p'TAR y w.
v NOTARY PUBLIC in and for the State of
•'t, PU~~~G,~?:• Washington, residing in 'V41 n c 4rJ--1
'•.~a ~yo.~ MY COMMISSION expires: 1F
OF W
Agreement - GF - 1131, SMH-SOUND MENTAL HEALTH, Behavioral Responsibility
January 1, 2011
Page 9 of 9
1_. ~1 t
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MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is an addendum to the agreement for services
between the City of Auburn and SMH - SOUND MENTAL HEALTH regarding the Agency's
ehavioral Responsibility Program, the original of which was executed on the day of
i , 2011. All other terms and conditions of the agreement for services shall remain
in full force and effect except as specifically amended by this Memorandum of Understanding.
1. It is the goal of the City of Auburn to improve the living conditions of all Auburn
residents.
ll. The grant funds provided to the Agency during the 2011 year are provided with the
objective of achieving the results established by the City Council in the areas
of Abused and Neglected Children, Victims of Domestic and Sexual Assault,
Poverty Reduction, Substance Abuse and Health Fitness.
III. Agencies receiving funding from the City of Auburn agree to participate in the
conceptual development of the One Stop Center and to collaborate with other
agencies concerning the delivery of services to clients when the Center is
operational. The nature and extent of the collaboration to be determined when
the One Stop Center is operational.
IV. The City of Auburn will utilize the following performance measures in evaluating
the effectiveness of reaching this goal.
Abused and Neglected Children: The City of Auburn will fund human service providers
that increase supportive services to children who are neglected and abused, specifically the
number of children who are victims of on-going and repeated neglect and abuse, within the
city of Auburn by 15% over the next three (3) years.
Victims of Domestic and Sexual Assault: The City of Auburn will fund human service
providers that increase the number of Auburn residents, who are victims of domestic
violence, that make the transition to a safe environment and self-determining lifestyle by
15% within the next three (3) years.
Poverty Reduction: The City of Auburn will fund human service providers who increase
the number of Auburn residents no longer living in poverty by 15% within the next three (3)
years.
r~
Substance Abuse: The City of Auburn will fund human service develop
caNm~s; bj~liburn
strategies that increase the successful completion of treatment
residents who have serious behavioral and health problems due 150an6e 'abue and
chemical dependency by 15% within a three (3) year period.
"N
Physically and Mentally Fit: The City of Auburn will fund hum e[mice~provi&sr'that
y w, . w
increase the availability, accessibility and use of health care to its 1'0 .jcoes~ettt by
15% within a three (3) year period. `~~'Y2A~h ay
Agreement GF - 1131, SOUND MENTAL HEALTH - Behavioral Responsibility
January 1, 2011
Page 1 of 2
UBURN
PETER B. LEWIS
MAYOR
ATTEST:
Danie a E. Daskam,
City Clerk
APPROV TO FORM:
Daniel B. Heid,
4~~City Attorney
'
SMH - SOUND MENTAL H ALTH
BY:
TITLE: Executive Director
STATE OF WASHINGTON )
)ss
COUNTY OF KING )
On this day of MQe'c'k , 2011, before me, the undersigned, a
N,Qtgry Publi~j in and for the State of Washington, personally appeared
~)a y ~ji to me known to be the Executive Director of SMH - Sound
Mental Health, 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 seal the
date hereinabove set forth.
O~~SSIO/y
4a ~4
~roa Fto':y0c NOTARY PUBL in and for the St at of
OTA 9.3
N~ Ay m: Washington, residing in c11 Dt~n~
0~ 'W' MY COMMISSION expires: rJ`
co :•o~~°VBLIG
J"-'IS- 20 ac
WASH
Agreement GF - 1131, SOUND MENTAL HEALTH - Behavioral Responsibility
January 1, 2011
Page 2 of 2
'l
CITY OF,
EX
HBURN IBIT COVER PAGE
G-1131
D
WASHINGTON -
HUMAN SERVICE AGREEMENT
2011 INVOICE FOR CONTRACTED SERVICES
To: CITY OF AUBURN, ATTN: COMMUNITY SERVICES
25 WEST MAIN `STREET; AUBURN WA 98001
d
Agency: SMH-Sound Mental, Health
1600 E Olive Street
Seattle, WA 98122
Program: Behavioral Responsibility Contact, Title: Kim O'Brien; Program Mgr.
Phone: 206-302-2292
Email: kimO@smh.org
Amount Requested: $ 1,875.00
Invoice for: ❑ 1 at Quarter, January to March - Due' April 15, 2011
❑ 2nd Quarter, AAPril to. June - Due: July 15; 2011
❑ 3rd Quarter, July to September - Due: October 17, 2011
❑ -4th Quarter,,October to December - Due: January 31, 2012
Attachments: ❑ Quarterly. Service Report - Exhibit 1
❑ Quarterly Financial Report - Exhibit 2
r ❑ Demographic Report (2nd and 4th Quarters only) - Exhibit, 3
❑ Outcomes Report (4. th Quarter only) - Exhibit 4
❑ Proof of Insurance (1St Quarter or if expired)
Logic Model (1st Quarter only) - Suggested Template
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: $7,500.00
Payments Year to Date:
Payment this invoice:. Contract Balance:
Authorized to Pay:
Signature Date
CITY OF AUBURN
COVER PAGE - MUST BE SIGNED.AND SUBMITTED WITH EACH PAYMENT REQUEST
2011 Exhibit 1
HUMAN SERVICE AGREEMENT
2011 SCOPE OF SERVICES AND.QUARTERLY SERVICE UNIT REPORT
-Agency Information
SMH-Sound Mental Health
1600 E Olive Street
Seattle, WA 98122
Contact; Title: Kim O'Brien, Program Mgr.
Phone: 206-30272292.
Email: kimO@smh.org
Are professional services (e.g., counseling, case management) provided as part of this
Agreement?
Contract Information
Contract Amount: $7,500.00
Program Name: Behavioral-Responsibility
Description of Service to be provided:
Reporting Information
Report for 1st Qtr/Jan-Mar. _ 2"d Qtr/Apr-Jun _ 3rd Qtr/Jul=Sep -4 th Qtr/Oct-Dec
2011 Service Units
- City Funding All Funding Sources
Only Actual Service
Service Unit Description: Total. Units to Date
Auburn Residents Only Projected -Actual Units by Quarter
Annual Units
Service Unit/Performance Measure 1St 2nd 3rd 4th
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. ,
2011 Exhibit 2
CITY OF AUBURN
2011 Quarterly Financial Report
'
Agency: SMH-Sound Mental Health Date:
Program: Behavioral Responsibility
Report for - 1St Qtr/Jan-Mar _ 2"d Qtr/Apr-Jun _ 3`d Qtr/Jul-Sep -4 th Qtr/Oct-Dec
Cost Categories Budget This Cumulative Award
Award Request to date Balance
1 Personal/Agency Services
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 $7,500.00
Requested
Reimbursement:
Detail as Applicable:
2011 Exhibit 3
CITY OF AUBURN
2011 Demographic Report
Agency: SMH-Sound Mental Health Date:
Program:. Behavioral Responsibility
Category. 15 2" 3` 4 Total YTD
Client Algona
Residence'" Auburn .
Black Diamond
."List all clients Burien
served in,this
, Covington
category.,,
In all other Des Moines
categories list Enumclaw
Auburn clients Federal Way
only.., .I Kent
Maple Valle
Normandy Park
Pacific
Renton
SeaTac
Seattle
Tukwila
Unincorporated. Kin Count
Other:
Unknown
TOTAL
Client 30% of median or below
Income t 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 f
75+
Unknown
TOTAL
Ethnicity/, Asian/Pacific Islander
.Cultural Black/African American.
Background Hispanic/Latino
Native American/ Alaskan Native
White/Caucasian
Other
Unknown
TOTAL
Condition Disabling Condition
ESL Limited English Speaking'
Household Female-Headed Household
1
CITY OF AUBURN OUTCOMES REPORT- EXHIBIT4
Funder Reporting to: City of Auburn Reporting Period: to Date Form Com leted:
Agency: Program:
Contact Person: E-mail: Phone:
A Qtr Due: Outcome identified, indicators given, data collection method(s) explained
4ch Qtr. Due: Outcome results
OUTCOME: (What change do you expect to see?)
MEASURABLE INDICATORS: (How will you know change has occurred?)
1
i
DATA COLLECTION METHOD(S):
OUTCOME RESULTS: (Narrative) highlight your data, include your interpretation of the data and -attach any graphics if available.
1
1
1
i
LOGIC MODEL REPORT- Suggested Template
CITE OF AUBURN
Funder Reporting to: City of Auburn Reporting Period:, to Date Form Completed:
Agency: Program:
Contact Person: E-mail: Phone:
Program, Evaluation Logic Model
PROCESS OUTCOME
RESOURCES ACTIVITIES OUTPUTS OUTCOMES GOAL
INDICATORS