HomeMy WebLinkAboutChildren's Home Society GF-1212,`I.klD"
AGREEMENT FOR SERVICES
THIS AGREEMENT made and entered into this _`_' day of
MU. CAA \ , 2012, by and between the CITY OF AUBURN, a municipal
corporation of the State of Washington, here -j d to as "CITY", and CHS-
f Washingto
Children's Home Society {which is located a 8Auburn Way North, Auburn,
Washington 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 supportive services to at -risk families with young
children; and
WHEREAS, the CITY is interested in continuing support of the Children's Home
Society, 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 2012 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 -1212 CHS - Children's Home Society — Auburn Family Resource Center
January 1, 2012
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'laterthan December 31, 2012.
III. TERM
The term of this Agreement shall commence on January 1, 2012 and shall expire
on December 31, 2012.
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 $20,000.00 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
Agreement — GF -1112 -CHS: Children's Home Society - Auburn Family Resource Center
January 1, 2012
Page 2 of 9
content of 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 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 at its own expense 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. Notwithstanding anything to the contrary in this . paragraph, the CITY will not
•
settle any claims, demands or causes of action to which this paragraph is related without
the prior written consent of the AGENCY.
Agreement - GF -.1212 CHS. -: Children's Home Society — Auburn Family Resource Center
January 1, 2012
Page 3'of 9
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
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 Tess 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 -1112 -CHS: Children's Horne Society - Auburn Family Resource Center
January 1, 2012
Page 4 of 9
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
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 t�
provide copies of the Certificates of Insurance to the CITY at the time that this
Agreement takes effect.
Agreement — GF -1212 CHS -: Children's Home Society — Auburn Family Resource Center
'January 1, 2012
Page 5 of 9
(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.
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.
Agreement — GF -1112 -CHS: Children's Home Society - Auburn Family Resource Center
January 1, 2012
Page 6 of 9
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.
XI. GENERAL PROVISIONS
A. The AGENCY agrees to submit a report to the CITY no later 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.
Agreement — GF -1212 CHS -: Children's Home Society — Auburn Family Resource Center
January 1, 2012
Page 7 of 9
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 shallbe paid to the substantially prevailing party.
G. The AGENCY agrees, to comply with all local, state and federal laws
applicable to its performance under this Agreement.
REMAINDER OF. PAGE INTENTIONALLY LEFT BLANK
Agreement — GF -1112 -CHS: Children's Home Society - Auburn Family Resource Center
January 1, 2012
Page 8 of 9
Danielle E. Daskam,
City Clerk
APP "• �:STOFORJ
APP
Heid,
ity Attorne
BY:
PETER B. LEWIS
MAYOR
CHS ILDREN'
i
TITLE: President /CEO
STATE OF WASHINGTON )
)ss
COUNTY OF KING )
On this G)..0* day of MOB , 2012, before me, the
unsigned, a Notary Public in and for the State of Wash' gton, peronnr ally appeared
Q Ofn,. , to me known to be the VreSi 0
of CHS- CHILDREN'S HOME SOCIETY, 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.
kt_4-1, IP A AI-. 11
NOTARY PUBLIC in and for the State of
Washington, residing in SP_Q..+fie IA14
MY COMMISSION expires: 4--,A.9-13
Agreement — GF -1212 CHS -: Children's Home Society — Auburn Family Resource Center
January 1, 2012
Page 9 of 9
CITY OF 'I` '�~
WASHINGTON
To:
Agency:
EXHIBIT COVER PAGE
GF -1212
HUMAN SERVICE AGREEMENT
2012 INVOICE FOR CONTRACTED SERVICES
CITY OF AUBURN, ATTN: COMMUNITY SERVICES
25 WEST MAIN STREET, AUBURN WA 98001
CHS - Children's Home Society
4338 Auburn Way N
Auburn, WA 98002
Program: Auburn Family Resource Center
Amount Requested: $ 5,000.00
Invoice for:
Attachments:
Contact, Title:.John Naegele, Program Director
Phone: 253 - 850 -2584
Email: johnn @chs- wa.org
❑ 1St Quarter, January to March — Due: April 13, 2012
❑ 2nd Quarter, April to June — Due: July 13, 2012
❑ 3`d Quarter, July to September — Due: October 12, 2012
❑ 4th Quarter, October to December — Due: January 31, 2013
❑ Quarterly Service Report - Exhibit 1
❑ Quarterly Financial Report — Exhibit 2
❑ Demographic Report (2nd and 4th Quarters only) — Exhibit 3
❑ Outcomes Report (4th 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:
$20,000.00
Payments Year to Date:
Payment this invoice:
Authorized to Pay:
Signature
CITY OF AUBURN
Contract Balance:
Date
COVER PAGE — MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST
2012 Exhibit 1
HUMAN ,SERVICE AGREEMENT
2012 SCOPE OF SERVICES. AND QUARTERLY SERVICE UNIT REPORT
Agency Information
CHS- Children's Home Society
4338 Auburn Way N
Auburn, WA 98002
Contact, Title: John Naegele, Program Director
Phone: 253 - 850 -2584
Email: johnn @chs- wa.org
Are professional services (e.g., counseling, case management) provided as part of this
Agreement?
Contract Information
Contract Amount: $20,000.00
Program Name: Auburn Family Resource Center
Description of Service to be provided:
Reporting Information
Report for _ 1st Qtr /Jan -Mar _ 2nd Qtr /Apr -Jun _ 3rd Qtr /Jul -Sep _ 4th Qtr /Oct -Dec
2012 Service Units -
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 Funding
Onl .
All Funding Sources
Actual Service
Units to Date
Service Unit Description:
Auburn Residents Only
Total.;
Projected -
Annual Units
Actual Units by Quarter
Service Unit/Performance Measure
1st 2nd 3rd
4th
Unduplicated Number of Auburn
Clients Served
90
■■ ■�
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
2012 Quarterly Financial Report
Agency: CHS- Children's Home Society
Program: Auburn Family Resource Center
Report for _ 1st Qtr /Jan -Mar
_ 2 "d Qtr /Apr -Jun
Date:
2012 Exhibit 2
3`d Qtr /Jul -Sep
4th Qtr /Oct -Dec
Requested
Reimbursement:
Detail as Applicable:
Cost Categories
Budget
Award
This
Request
Cumulative .
to date
Award . -
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
$20,000.00
Requested
Reimbursement:
Detail as Applicable:
CITY OF AUBURN
2012 Demographic Report
Agency: Children's Home Society
Program: Auburn Family Resource Center
Date:
2012 Exhibit 3
Cate • o
15
2 "'
3" 4
Total YTD
Client
Residence**
**List all clients
served in this
category.
In all other
categories list
Auburn clients
only.
Al.ona
Auburn
-
-
-
-
- --
- --
Black Diamond
-
-
- --
Burien
-
-
- --
Covin•ton
-
-
- --
Des Moines
Enumclaw
- -
- --
Federal Wa
- -
- --
Kent
- -
- --
Maple Valle
- -
- --
Normand Park
- -
- --
Pacific
- -
- --
- --
Renton
- -
SeaTac
- -
- --
Seattle
- -
- --
Tukwila
- -
- --
Uninco •orated. Kin. Count
- -
- --
Other:
- -
- --
Unknown
- -
- --
TOTAL
- -
- -
--
- -
- --
- --
- --
- --
Client
Income
Level
30% of median or below
50% of median or below
80% of median or below
Above 80% of median
Unknown
- -
- --
TOTAL
- -
- --
Client
Gender
Female
- -
- --
Male
- -
- -
- -
- -
- --
- --
- --
- --
Client
Age
0-4
5 -12
13 -17
18-34
- -
- --
35-54
- -
- --
55-74
- -
- --
75+
- -
- --
Unknown
- -
- --
TOTAL
- -
- --
Ethnicity/
Cultural
Background
Asian/Pacific Islander
- -
- --
Black/African American
- -
- --
His.anic/Latino
- -
- --
Native American/ Alaskan Native
- -
- --
White /Caucasian
- -
- --
Other
- -
- --
Unknown
- -
- --
TOTAL - -
- --
Condition
Disablin• Condition - - - --
ESL
Limited En.lish Speakin• ' - - --
Household
Female- Headed Household - - - --
CITY OF AUBURN
Funder Re, ortin" to: Ci of Auburn
Re ortin . Period:
to
OUTCOMES REPORT - EXHIBIT4
Date Form Com s leted:
Agency:
- Program:
Contact Person:
E -mail:
Phone:
155:: QtEDue:' ®utco ne�i`dentifie °d indacato``rs l ve;n iiata`_collectioai�ri ethod(s)ueaclil'ained
- ths� a !u', R�.i -' "B° 5�].'-da'ic s' •.� lb t�:
4 :_:.Qtr: Due Outcomexresults
OUTCOME: (What change, do you expect to see ?)
MEASURABLE INDICATORS: (How will you know change has occurred ?)
DATA COLLECTION ME'T 'i OD(S):
OUTCOME RESULTS: (Narrative) highlight your data, include your interpretation of the data and attach any graphics if available.
-�
CITY OF AUBURN
Funder Re i ortin : to: City of Auburn
Agency:
LOGIC MODEL REPORT - SuggestedTemplate
Re ortin ' Period: to Date Form Coin leted:
Program:
Contact Person:
E -mail:
Phone:
Program Evaluation Logic
ode9
PROCESS
RESOURCES
ACTIVITIES
OUTPUTS
OUTCOME
OUTCOMES
INDICATORS
GOAL
CITY OF AUBURN - MEMORANDUM OF UNDERSTANDING
of Washi
This Memorandum of Understanding is an adde um to the agreement for
services between th City of Auburn and Children's Home Societ , the originals of which were
executed on the 1.. 0 day of AM'IC A , 2012. 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.
It is the goal of the City of Auburn to improve the living conditions of all Auburn
residents.
II. The grant funds provided to the Agency during the 2012 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.
Substance Abuse: The City of Auburn will fund human service providers to develop
strategies that increase the successful completion of treatment programs by Auburn
residents who have serious behavioral and health problems due to substance abuse and
chemical dependency by 15% within a three (3) year period.
Physically and Mentally Fit: The City of Auburn will fund human service providers that
increase the availability, accessibility and use of health care to its low income residents by
15% within a three (3) year period.
City of Auburn Agreement: GF -1212, Children's Home Society — Auburn Family Resource Center
January 1, 2012
Page 1 of 2
ATTEST:
/13.2),
Danielle E. Daskam,
City Clerk
APP
leI B.
City Attorney
STATE OF WASHINGTON
COUNTY OF KING
PETER B. LEWIS
MAYOR
CHS - CHILDRENS HOME`SOCIETY OF WA
BY:
f
TITLE: President /CEO
)ss
On this Atlif4 day of M 1 , 2012, before me, the undersigned, a
N tary Public in and for the "- State of Washington, pers nally appeared
D. SG Akron 4$ t n rile. , to me known to be the' fe cteid. deC , of
CHS. - Childrens Home Society, 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.
a,.
` NOTARY PUBLIC in and'for the state of
Washington, residing in Seat1ie W/-.
My Commission Expires: - =Q -/ 3
f:c ,l eeit 4 . G 1 I
City of Aubum Agreement: GF -1212, Children's Home Society, Auburn-Family Resource Center
January 1, 2012
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