HomeMy WebLinkAboutAuburn Respite Program GF0614
^~.l~.,
O~.ll. '2-
AGREEMENT FOR SERVICES
THIS AGREEMENT made and entered into this ~~' day of
~
' 2006, by and between the CITY OF AUBURN, a municipal
corporation of the State of Washington, hereafter referred to as "CITY", and AUBURN
RESPITE PROGRAM which is located at 818 9th Street S.E.. Auburn. Washinaton
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 weekly respite care for the caregivers and their patients
who are suffering from a debilitating illness; and
WHEREAS, the CITY is interested in continuing support of the AUBURN
RESPITE PROGRAM, 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 2006 term. This support is in
recognition of the fact that the demand for the services delivered by the AGENCY
continues to rise.
--------------------------------------
Agreement - GF0614, Auburn Respite Program
January 31, 2006
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 s,et 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, 2006.
III. TERM.
The term of this Agreement shall commence on January 1, 2006 and shalll expire
on December 31, 2006.
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 pertalining to
the contract agreement and expenditures. The final report, which may include estimated
service levels, shall be submitted no later than December 12, 2006. 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 - GF0614, Auburn Respite Program
January 31,2006
Page 2 of8
~_.__._._-~--~--,-
C. As full and total payment for the services provided under this Agreement, the
CITY agrees to pay the AGENCY the total amount of $10,000.00 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 pelrsons or
property to the extent caused by the n~gligent 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 lOr 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 CCists and
expense which the CITY has incurred as a result of such claim or suit. The provlisions of
this section shall survive the expiration or termination of this Agreement.
--------------------------------------
Agreement - GF0614, Auburn Respite Program
January 31, 2006
Page 3 of8
_. ..~----"_._.~-
VII. INDEPENDENT CONTRACTOR/ASSIGNMENT.
The parties agree and understand that the AGENCY is an independent cl:>ntractor
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 fn)m 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 ($1,0000,000)
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 offic.ials 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 - GF0614, Auburn Respite Program
January 31, 2006
Page 4 of8
_...._.n_____._
1) GENERAL LIABILITY COVERAGE:
The CITY, its elected and appointed officials, employees and agents Eire to be
covered as additional insureds as respects: Liability arising out of services and
activities performed by or on behalf of AGENCY, its employees, agEmts and
volunteers. The coverage shall contain no special limitations on the scope of
protection afforded to the CITY, its elected and appointed officials, empk)yees 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 excl~pt 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 covera!~e, 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 - GF0614, Auburn Respite Program
January 31,2006
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 E~ach. All
coverages for volunteers shall be subject to all the requirements statedl 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 acct:>rdance
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 relatin~1 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 insped such
documents upon good cause at any reasonable time within the three (3) year period.
--------------------------------------
Agreement - GF0614, Auburn Respite Program
January 31,2006
Page 6 of8
..... ---~-~-_...,_._--_.,.._.
XI. TERMINATION OF AGREEMENT.
This Agreement may be terminated by either party upon ten (10) day~; 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 la1~er than
December 12, 2006, describing the progress and activities performed for
the year 2006 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 themselve~), 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 fe,es and
expenses and court costs shall be paid to the substantially prevailin~1 party.
F. The AGENCY agrees to comply with all local, state and federal laws
applicable to its performance under this Agreement.
--------------------------------------
Agreement - GF0614, Auburn Respite Program
January 31, 2006
Page 7 of8
-..-----".- --."--
N
" '.:.,.
~)
PETER B. LEWIS
MAYOR
:~~~~
D~ie"e E. Daskam,
City C rk
.AGENC~>> ~ _
BY:~~ ~>~
TITLE: ___])~ ___ ~'- .
STATE OF WASHINGTON lss ~
COUNTY OF KING )
On this 30~ay of r:~e ' 2006, before me,' the undersigned, a
N~~ pu~ in and for of Washington, personally appeared
/i.../f- . M1<-RA-72- , to me known to be the Executive Director of the <<Agency>>,
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 sa~-profit corporation for the uses
and purposes therein mentioned, and on oath stated that h 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.
~"~,"'''II'',,,,,,,,,
~~~' X\\.f>- E. G/-1. ......" ~
~.. ~ ...... ~ ~
.:> CJ '.'O~^M. t'~"'~"
t .- CJ ~ -. :;;' \.
S : ~ 0 T A t9).-.. 1.
: : ~ =
- * . ~.~ . -
S :0 0): * E
: ({l '.0,>. ,oU8 L1G c: ::
\ :.>. '. 0 '1.-0.' ~ ::
~ -?~..<S>E'R 0'0 .... ~O;'
~" .........~\:> ~~'"
..~,.Of: WAS'\'\\ ~,,~<t)
. - .'..I':'..'mH!&It'i....'"
--------------------------------------
Agreement - GF0614, Auburn Respite Program
January 31, 2006
Page 8 of8
------
EXHIBIT 1, GF -0614
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2006 SCOPE OF SERVICES AND QUARTERL Y SERVICE UNIT REPORT
Agency Information
Auburn Respite Program 253.931.3016
808 9th Street S. E. <<Agency-F ax>>
Auburn, WA 98002 sheilastuff@msn.com
Contact: Sheila Pankratz Title: Director
Are professional services (e.g., counseling, case management) provided as part of this
Agreement? No
Contract Information
Contract Amount: $10,000 Program Name: Respite Care
Description of Service to be provided: Weekly respite care program for the caregivers and their
patients who are suffering from a debilitating illness.
Reporting Information
Report for - 1st Qtr/Jan-Mar _ 2nd Qtr/Apr-Jun _ 3rd Qtr/Jul-Sep - 4th Qtr/Oct-Dec
2006 Service Units
City Funding All Funding Sources Actual Service
Onl Unilts to Date,
Service Unit Description: Total all Fund
Auburn Residents Only Projected Actual Units by Quarter Sources
Annual Units
Service UniVPerformance Measure 1st 2nd 3rd 4th
Unduplicated Number of Auburn 13
Clients Served
Narrative: Please attach other relevant information, including current trends, program developments,
special events, publicity, community education, etc. If actual service units are lower than anticipated,
please explain.
"-"-- -..--.----.--
EXHIBIT 2, GF -0614
CITY OF AUBURN
2006 Quarterly Financial Report
Agency: Auburn Respite Program Date:
Program: Respite Care
Report for - 1st Qtr/Jan-Mar _ 2nd Qtr/Apr-Jun _ 3rd Qtr/Jul-Sep - 4ttl Qtr/Oct-Dec
Cost Categories Budget This Cumulative Award
Award Request to date Balance
1 Personnel/Agency Services 10,000
2 Office/Operating Supplies
3 Consultant or Purchased
Services
4 Direct Client Assistance
5 Communications
6 Travel & Training
7 Intra-Agency Support
8 Other per Detail
-- indirect admin
Grand Total <<Rec>>
Requested
Reimbursement:
Detail as Applicable:
-_._-'-~'-'_._"--
EXHIBIT 3, GF -0614
CITY OF AUBURN
2006 Demographic Report
Agency: Auburn Respite Program Date:
Program: Respite Care
! Category ! Alaona !~ ".. I ., .2~. ,[ ~~~"'."" f;lw~f"'~ ',' f}r~f;f I
Client
Residence** Auburn
Black Diamond
dList all clients Burien
seNed. in this Covington
.'c;~l~~ory, Des Moines
:tn'a1!9tJ'lllt Enumclaw
~"tegofies;Ji$t,
Auburn cllfints Federal Wav
only. Kent
Maple Valley
Normandv Park
Pacific
Renton
SeaTac
Seattle
Tukwila
Unincoroorated. Kina Countv
Other:
Unknown
TOTAL
Client 30% of median or below
Income 50% of median or beiow
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
ethr1iC~/ { AsianlPacific Islander
Cultural,:' Black/African American
Background HispaniclLatino
Native American/ Alaskan Native
White/Caucasian
Other
Unknown
TOTAL
Condition Disablina Condition
ESL Limited Enalish Speakina
Household Female-Headed Household .
'_'._.w"""__
EXHIIBIT 4, GF -0614
CITY OF AUBURN
Outcomes Evaluation Format
Agency: Auburn Respite Program Date:
Program: Respite Care
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.
". Contents.
A. The components of the evaluation will:
1) Identify both process and outcome portions of the services that the Auburn Respite
Program will 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. The Auburn Respite Program shall develop the following status report components
within the time frames established below:
1) 1 st Quarter 2006
a) The outcome based results the Auburn Respite Program expects to ac::hieve;
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 2006
a) Information collected;
b) Conclusions developed as a result of the information.
-~....... -.---
COVER PAGE, Reso No. GF -0614
CITY OF AUBURN
HUMAN SERVICE AGREEMENT
2006 INVOICE FOR CONTRACTED SERVICES
To: City of Auburn, Attn: Bill Mandeville, Planning Department
25 West Main, Auburn, WA 98001
Agency: Auburn Respite Program 253.931.3016
808 9th Street S.E. <<Agency _F ax>)
Auburn, WA 98002 sheilastuff@msn.com
Contact: Sheila Pankratz Title: Director
I nvoice for: o 1st Quarter, January to March - Due April 15, 2006
o 2nd Quarter, April to June - Due July 15, 2006
o 3rd Quarter, July to September - Due October 15, 2006
o 41h Quarter (Preliminary, Cover sheet and Ex. B only) October to December - Due
December 12, 2006
o 4th Quarter (Final) October to December - Due January 31, 2007
Amount Requested:
Required Attachment Checklist: _ Exhibit A - Quarterly Service Report
_ Exhibit B - Quarterly Financial Report
_ Exhibit C - Demographic Report (2nd and 4th Quarters only)
_ Logic Model/Outcomes Report (1s1 and 41h 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.
Signature of Authorized Representative Dale
The City of Auburn will issue payment upon this invoice within thirty (30) business days of recE!ipt. 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: $10,000.00
Payments Year to Date: Date:
Date:
Date:
Date:
Payment this invoice: Contract Balance:
Authorized to Pay:
Signature Dale
COVER PAGE - MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST
..-.-.........--.--.