HomeMy WebLinkAboutAuburn Food Bank GF-1203. i,
CITY OF -
WASHINGTON
v
• \A
Department of Administration
Michael Hursh, Community Services Manager
25 West Main Street
Auburn, WA 98001
CITY OF AUBURN AGREEMENT FOR HUMAN SERVICE ACTIVITIES
COSTING $5,000 PER YEAR OR LESS
This Agreement is made effective as of January 1, 2012, by and between THE AUBURN FOOD BANK
COMMUNITY SUPPERS 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
"AGENCY" The parties agree as follows
1. DESCRIPTION OF SERVICES. Beginning on January 1, 2012, the AGENCY agrees to provide dinner
service, twice a week, to residents in need within 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 AGENCY for services provided in the amount of $5,000 per
year, paid in semi- annual 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 AGENCY with
appropriate supporting documentation
3. EXPENSE REIMBURSEMENT. The AGENCY 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 1, 2012, and expires December 31, 2012,
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 AGENCY 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 the AGENCY
6. EMPLOYEES. The provisions of this Agreement shall also bind the AGENCY employees who perform
services for the CITY under this Agreement
7. INDEMNIFICATION / HOLD HARMLESS. The AGENCY shall defend, indemnify and hold the City, 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 omissions of the AGENCY 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 the AGENCY, its officers, officials, employees and
volunteers harmless from any and all claims, injunes, damages, losses or suits including attorney fees, arising
out of or resulting from the acts, errors or omissions of the City in performance of this Agreement, except for
injuries and damages caused by the sole negligence of the AGENCY
8. INSURANCE. The AGENCY 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 AGENCY, its agents, representatives, or employees
City of Autium Agreement GF -1203, Aubum Food Bank — Community Suppers
January 1, 2012
Page 1 of 4
A. Minimum Scope of Insurance, the AGENCY shall obtain insurance of the types described below
1 Automobile Liability insurance covering all owned, non - owned, hired and leased vehicles
Coverage shall be written on Insurance Services Office (ISO) form CA 00 01 or a substitute
form providing equivalent liability coverage If necessary, the policy shall be endorsed to
provide contractual liability coverage
2 Commercial General Liability 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
AGENCY's 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 Liability insurance appropriate to the AGENCY profession.
B. Minimum Amounts of Insurance: The AGENCY shall maintain the following insurance limits
1 Automobile Liability insurance with a minimum combined single limit for bodily injury and
property damage of $1,000,000 per accident
2 Commercial General Liability insurance shall be written with limits no less than $1,000,000
each occurrence, $2,000,000 general aggregate
3 Professional Liability 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 for Automobile Liability, Professional Liability and Commercial General Liability
insurance
1 The AGENCY's 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 AGENCY's insurance and shall not contribute with it
2 The AGENCY's 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
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: The AGENCY 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 AGENCY before commencement of the
work
9. ASSIGNMENT. The AGENCY 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:
City of Aubum Agreement GF -1203, Aubum Food Bank — Community Suppers
January 1, 2012
Page 2 of 4
IF for THE AUBURN FOOD BANK
Debbie Christian
Executive Director
930 18th Place NE
Auburn, WA 98002
IF for the CITY.
Michael Hursh
Community Services Manager
25 West Main Street
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 or 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 unenforceable 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 unenforceable, 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 enforce 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 undersigned have read the above statements, understand them, and agree to abide by their terms
Agency Citv of Auburn
Signed. Signed
Printed
Dc6vck J . £ V , a�
Title'
y -- 'u 1'16 Vo- lai Ve-e
Date'
lA lA rch t , 1..oi 1_
Address: °10 13"1 fl si %
Phone'
fiar,ou,wk , U■?A O csbD2
Printed
Title'
Date:
Address
uul -01-1
(k k &4A &e, L4 4L
eofhouniiir36r its cee, mares
-/ (y
25 West Main Street
Auburn, WA 98001
Phone: (253) 876 -1964 (Community Services Line)
eement GF -1203, Aubum Food Bank — Community Suppers
4
HUMAN SERVICES AGREEMENT BETWEEN THE
CITY OF AUBURN & THE AUBURN FOOD BANK: COMMUNITY SUPPERS
Scope of Work
Services to include:
• The Auburn Food Bank will provide a healthy dinner twice a week to needy families. Approximately
feeding 9,000 people that attend dinners offered weekly on Mondays and Wednesdays, the opportunity
provides residents of Auburn with a hot, cooked meal and a chance to eat in a warm, safe environment
while enjoying social interaction
• Recruit volunteers, train them and acknowledge their contribution to the community
• Comply with applicable health codes, rules and regulations.
• Maintain records of residents served including addresses where applicable
• 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 semi- annual request for reimbursement, The AUBURN FOOD BANK. COMMUNITY SUPPERS
will provide 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
City of Aubum Agreement GF -1203, Aubum Food Bank — Community Suppers
January 1, 2012
Page 4 of 4
CITY OF AUBURN - MEMORANDUM OF UNDERSTANDING
This Memorandum of Understanding is an addendum to the agreement for services between the City of
Auburn and the Auburn Food Bank regarding the Agency's Community Suppers Program, the original of which
was executed on the 1 5± day of Mow-oh , 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 humariser�iice providers that increase the
availability, accessibility and use of health care to its low mcome4esidents A1i5 %within a three (3) year
period VA _ l) a��
Pi
•
City of Aubum Agreement GF -1203, The Aubum Food Bank — Community Suppers
January 1, 2012
Page 1 of 2
ATTEST
Danielle E. Daskam,
City Clerk
APPROVED AS TO FORM
CITY OF AUB
Daniel B Heid,
City Attorney
STATE OF WASHINGTON
)ss
COUNTY OF KING
R B LEWIS
MAYOR
AUBURN FOOD BANK
BY /
TITLE' -Euect,ktve} vec,lzv
On this (s} day of Mo►rch , 2012, before me, the undersigned, a Notary Public in
and for the State of Washington, personally appeared N.bhLO CAA v;s-har. , to me known to be
the -C>ceci kitte, 12 wcc t - of The Auburn Food Bank, 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
%
l�l\
WASHINGTON
HUMAN SERVICE AGREEMENT
2012 INVOICE FOR CONTRACTED SERVICES
To: CITY OF AUBURN, ATTN COMMUNITY SERVICES
25 WEST MAIN STREET, AUBURN WA 98001
Agency AFB - Auburn Food Bank
Site location: Mailing address:
930 — 18th Place NE PO Box 464
Auburn, WA 98002 Auburn WA 98071 -0464
Program Community Suppers
Amount Requested: $ 2,500.00
Invoice for:
Attachments:
EXHIBIT COVER PAGE
GF -1203
Contact, Title: Debbie Christian, Executive Director
Phone: 253 - 804 -5696
Email: DebbieC @theauburnfoodbank org
❑ 1st and 2nd Quarters, January to June — Due July 15, 2012
❑ 3rd and 4th Quarters, July to December— Due January 31, 2013
❑ Quarterly Service Report (due semi- annually) - Exhibit 1
❑ Quarterly Financial Report (due semi- annually) — Exhibit 2
❑ Demographic Report (due semi- annually) — Exhibit 3
❑ Outcomes Report (due semi- annually) — Exhibit 4
❑ Proof of Insurance (1st Quarter or if expired)
I certify to the best of my knowledge that this invoice and attachments reflect actual service provided to
Auburn residents
Signature of Authonzed
resentative
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
Date
COVER PAGE — MUST BE SIGNED AND SUBMITTED WITH EACH PAYMENT REQUEST
HUMAN SERVICE AGREEMENT
2012 SCOPE OF SERVICES AND QUARTERLY SERVICE UNIT REPORT
2012 Exhibit 1
Agency Information
AFB - Auburn Food Bank
Site location:
930 — 18th Place NE
Auburn, WA 98002
Mailing address:
PO Box 464
Auburn WA 98071 -0464
Contact, Title: Debbie Christian, Executive Director
Phone: 253 - 804 -5696
Email: DebbieC @theauburnfoodbank org
Are professional services (e g , counseling, case management) provided as part of this
Agreement?
Contract Information
Contract Amount $5,000
Program Name Community Suppers
Description of Service to be provided
Reporting Information
Report for _ 1st Qtr /Jan -Mar
2012 Service Units
2nd Qtr /Apr -Jun
_ 3`d Qtr /Jul -Sep _ 4th Qtr /Oct -Dec
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 tion
Auburn Residents Only
Total
Projected
Annual Units
Actual Units by Quarter
Service Unit/Performance Measure
15t
2nd 3rd 4th
Unduplicated Number of Auburn
Clients Served
9,000
■■■■
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.
2012 Exhibit 2
CITY OF AUBURN
2012 Quarterly Financial Report
Agency AFB - Auburn Food Bank Date:
Program Community Suppers
Report for _ 1st Qtr /Jan -Mar
2nd Qtr /Apr -Jun
_ 3rd 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
$5,000.00
Requested
Reimbursement
Detail as Applicable
CITY OF AUBURN
2012 Demographic Report
Agency AFB - Auburn Food Bank
Program. Community Suppers
2012 Exhibit 3
Date
Cate e o
1
2"'
3
4
Total YTD
Client
Residence**
"List all clients
served in this
category
In all
In all other
categories list
Aubum clients
only.
Client
Income
Level
Al. ona _
Auburn
--
"
Enumclaw
Federal Wa
-
-
-
--
Kent
--
Pacific
-
--
-
Uninco •orated Kin• Count
-
-
--
Other
-
--
-
Unknown
-
-
-
--
TOTAL
-
-
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
13-1
18 -34
35-54
55-74
75+
-
-
--
Unknown
-
-
-
--
TOTAL
-
-
-
--
Ethnicity/
Cultural
Background
Condition
Asian
-
-
-
-
-
-
-
-
--
--
--
--
Asian / White
American Indian / Alaskan Native
-
Amencan Indian / Alaskan Native & White
American Indian / Alaskan Native & Black -
/ African Amencan
Black / African American
-
-
-
--
Black / African American & White
His. anic / Latino
-
-
-
--
Native Hawaiian / Other Pacific Islander
-
-
--
Unknown / No'Res.onse
-
-
--
TOTAL ,
_ ,
-
-
--
Disablin • ,Condition
-
-
--
ESL
Limited En•hsh S.eakin• -
-
--
Household
Female- Headed Household'
-
-
--
Male- Headed Household
-
_
--
CITY OF AUBURN
Funder Re s ortin to: Cit of Auburn
Re , ortin Period:
to
OUTCOMES REPORT - EXHIBIT4
Date Form Com s leted:
Agency:
Program:
Contact Person:
E -mail:
Phone:
1,t Qtr Due: Outcome identified, indicators given, data collection method(s) explained
4th Qtr. Due: Outcome results
OUTCOME: (What change do you expect to see ?)
MEASURABLE INDICATORS: (How will you know change has occurred ?)
DATA COLLECTION METHOD(S):
OUTCOME RESULTS: (Narrative) highlight your data, include your interpretation of the data and attach any graphics if available
Funder Re ortin ' to: Cit of Auburn
1
Re 1 ortin ' Period:
to
F
1
1 ' '1
•
Agency:
Program:
Contact Person:
E -mail: •
Phone:
CITY OF AUBURN
LOGIC MODEL REPORT - suggested Template
Program Evaluation Logic Model
PROCESS
RESOURCES
ACTIVITIES
OUTPUTS
OUTCOME
OUTCOMES'
INDICATORS
GOAL