HomeMy WebLinkAboutPublic Health Seattle King Countyft 3.1 (0 .'K
Contract,; Procurement and Real Estate Services (CPRES) public "Health-
401 Fifth Avenue Suite 1300 -'
Seattle, wA 98104 1818.- . - -. - Seattle & King County
206- 263 =8747 Fax 206 296 0629:
TTY Relay:,711:, _ -
www Idngcounry gov /health - --
City of Auburn
25 W Main St
Seattle, WA 98001
February 5, 2015
Enclosed is a copy of your agreement with King County Health Department. We have
retained a copy for our records. Please contact Allen Cantara at (206) 263 -8744 if you have
questions.
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Public Health
PHSKC Agreement #
_
LQ
COMMUNITY SERVICES
Seattle K King County
AGREEMENT
EMS3746
This Agreement is between King County and the Recipient identified below. The County department
overseeing the work to be performed in this Agreement is the Department of Public Health (PHSKC).
RECIPIENT NAME
RECIPIENT FEDERAL TAX ID #
City of Auburn
RECIPIENT ADDRESS
RECIPIENT CONTACT & EMAIL ADDRESS
25 W Main St., Auburn, Washington, UNITED STATES, 98001-
Sarah Miller, skmiller(Waubumwa.gov, 253 - 876 -1909
4998
PHSKC DIVISION
PROJECT TITLE
Emergency Medical Services
Project RAMPART
AGREEMENT START DATE
AGREEMENT END DATE
AGREEMENT MAXIMUM AMOUNT
1/1/2015
12/31 /2015
$4,940.43
FUNDING DETAILS
Funding Source Amount
King County Emergency Medical Services $4,940.43
Levy
FUNDING SUMMARY
FEDERAL:
COUNTY:$4,940.43
STATE:
OTHER:
IS THE RECIPIENT A SUBRECIPIENT FOR PURPOSES OF THIS AGREEMENT? ❑ YES ® NO
EXHIBITS. The following Exhibits are attached and are incorporated into this Agreement by reference:
Exhibit A — Scope of Work
Exhibit B — Budget
Exhibit C — Invoice
Exhibit D — CPR Reporting Forms
In consideration of payments, covenants, and agreements hereinafter mentioned, to be made and performed by the parties
hereto, the parties mutually agree that the Recipient shall provide services and comply with the requirements set forth in
this Agreement. The parties signing below represent that they have read and understand this Agreement, and have the
authority to execute this Agreement. Furthermore, in addition to agreeing to the terms and conditions provided herein, by
signing this Agreement, the Recipient certifies that it has read and understands the Agreement requirements on the PHSKC
website (http: / /www.kingcounty.gov /health /Agreements), and agrees to comply with all of the Agreement terms and
conditions detailed on that site, including EEO /Nondiscrimination, HIPAA, Insurance, and Credentialing, as applicable.
RECIPIENT SIGNATURE
PRINTED NAME AND TITLE
DATE SIGNED
PHSKC SIGNATURE
PR�_IJJTED NAME
DATE SIGNED
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Ap oved as to Form: OFFICE OF THE KING COUNTY PROSECUTING ATTORNEY
(This form is available in alternate formats for people with disabilities upon request.)
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KING COUNTY TERMS AND CONDITIONS
Agreement Term and Termination
A. This Agreement shall commence on the Agreement Start Date and shall terminate on the
Agreement End Date as specified on page 1 of this Agreement, unless extended or
terminated earlier, pursuant to the terms and conditions of the Agreement.
B. This Agreement may be terminated by the County or the Recipient without cause, in whole or
in part, prior to the Agreement End Date, by providing the other party thirty (30) days advance
written notice of the termination. The Agreement may be suspended by the County without
cause, in whole or in part, prior to the date specified in Subsection I.A. above, by providing
the Recipient thirty (30) days advance written notice of the suspension.
C. The County may terminate or suspend this Agreement, in whole or in part, upon seven (7)
days advance written notice in the event: (1) the Recipient materially breaches any duty,
obligation, or service required pursuant to this Agreement, or (2) the duties, obligations, or
services required herein become impossible, illegal, or not feasible. If the Agreement is
terminated by the County pursuant to this Subsection 1.C. (1), the Recipient shall be liable for
damages, including any additional costs of procurement of similar services from another
source.
If the termination results from acts or omissions of the Recipient, including but not limited to
misappropriation, nonperformance of required services, or fiscal mismanagement, the
Recipient shall return to the County immediately any funds, misappropriated or unexpended,
which have been paid to the Recipient by the County.
D. If County or other expected or actual funding is withdrawn, reduced, or limited in any way prior
to the termination date set forth above in Subsection 1.A., the County may, upon written
notification to the Recipient, terminate or suspend this Agreement in whole or in part.
If the Agreement is terminated or suspended as provided in this Section: (1) the County will be
liable only for payment in accordance with the terms of this Agreement for services rendered
prior to the effective date of termination or suspension; and (2) in the case of termination the
Recipient shall be released from any obligation to provide such further services pursuant to
the Agreement ; and (3) in the case of suspension the Recipient shall be released from any
obligation to provide services during the period of suspension and until such time as the
County provides written authorization to resume services..
Funding or obligation under this Agreement beyond the current appropriation year is
conditional upon appropriation by the County Council of sufficient funds to support the
activities described in the Agreement. Should such appropriation not be approved, this
Agreement will terminate at the close of the current appropriation year.
E. Nothing herein shall limit, waive, or extinguish any right or remedy provided by this Agreement
or law that either party may have in the event that the obligations, terms, and conditions set
forth in this Agreement are breached by the other party.
2. Compensation and Method of Payment
A. The County shall reimburse the Recipient for satisfactory completion of the services and
requirements specified in this Agreement, payable upon receipt and approval by the County of
a signed invoice that complies with the attached Budget Exhibit.
B. The Recipient shall submit an invoice and all accompanying reports as specified in the
attached exhibits not more than 60 working days after the close of each indicated reporting
period. The County shall make payment to the Recipient not more than 30 days after a
complete and accurate invoice is received.
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C. The Recipient shall submit its final invoice and all outstanding reports within 90 days of the
date this Agreement terminates. If the Recipient's final invoice and reports are not submitted
by the day specified in this subsection, the County will be relieved of all liability for payment to
the Recipient of the amounts set forth in said invoice or any subsequent invoice.
D. When a budget is attached hereto as an exhibit, the Recipient shall apply the funds received
from the County under this Agreement in accordance with said budget. The Agreement may
contain separate budgets for separate program components. The Recipient shall request
prior approval from the County for an amendment to this Agreement when the cumulative
amount of transfers among the budget categories is expected to exceed 10% of the
Agreement amount in any Agreement budget. Supporting documents necessary to explain
fully the nature and purpose of the amendment must accompany each request for an
amendment. Cumulative transfers between budget categories of 10% or less need not be
incorporated by written amendment, however, the County must be informed immediately in
writing of each such change.
E. Should, in the sole discretion of the County, the Recipient not timely expend funds allocated
under this Agreement, the County may recapture and reprogram any such under - expenditures
unilaterally and without the need for further amendment of this Agreement. The County may
unilaterally make changes to the funding source without the need for an amendment. The
Recipient shall be notified in writing of any changes in the fund source or the recapturing or
reprograming of under expenditures.
F. If travel costs are contained in the attached budget, reimbursement of Recipient travel,
lodging, and meal expenses are limited to the eligible costs based on the following rates and
criteria.
The mileage rate allowed by King County shall not exceed the current Internal
Revenue Service (IRS) rates per mile as allowed for business related travel. The IRS
mileage rate shall be paid for the operation, maintenance and depreciation of
individually owned vehicles for that time which the vehicle is used during work hours.
Parking shall be the actual cost. When rental vehicles are authorized, government
rates shall be requested. If the Recipient does not request government rates, the
Recipient shall be personally responsible for the difference. Please reference the
federal web site for current rates. http: / /www.gsa.gov.
Reimbursement for meals shall be limited to the per diem rates established by federal
travel requisitions for the host city in the Code of Federal Regulations, 41 CFR § 301,
App.A. Please reference htto: / /www.gsa.gov for the current host city per diem rates.
3. Accommodation rates shall not exceed the federal lodging limit plus host city taxes.
The Recipient shall always request government rates.
Air travel shall be by coach class at the lowest possible price available at the time the
County requests a particular trip. In general, a trip is associated with a particular work
activity of limited duration and only one round -trip ticket, per person, shall be billed per
trip. Any air travel occurring as part of a federal grant must be in accordance with the
Fly America Act.
3. Internal Control and Accounting System
The Recipient shall establish and maintain a system of accounting and internal controls which
complies with applicable generally accepted government accounting standards (GAGAS).
4. Debarment and Suspension Certification
Entities that are debarred, suspended, or proposed for debarment by the U.S. Government are
excluded from receiving federal funds and contracting with the County. The Recipient, by signature
to this Agreement, certifies that the Recipient is not presently debarred, suspended, or proposed for
debarment by any Federal department or agency. The Recipient also agrees that it will not enter
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into a sub - agreement with a Recipient that is debarred, suspended, or proposed for debarment. The
Recipient agrees to notify King County in the event it, or a sub- awardee, is debarred, suspended, or
proposed for debarment by any Federal department or agency.
5. Maintenance of Records /Evaluations and Inspections
A. The Recipient shall maintain accounts and records, including personnel, property, financial,
and programmatic records and other such records as may be deemed necessary by the
County to ensure proper accounting for all Agreement funds and compliance with this
Agreement.
B. In accordance with the nondiscrimination and equal employment opportunity requirements set
forth in Section 13. below, the Recipient shall maintain the following:
1. Records of employment, employment advertisements, application forms, and other
pertinent data, records and information related to employment, applications for
employment or the administration or delivery of services or any other benefits under
this Agreement; and
2. Records, including written quotes, bids, estimates or proposals submitted to the
Recipient by all businesses seeking to participate on this Agreement, and any other
information necessary to document the actual use of and payments to sub - awardees
and suppliers in this Agreement, including employment records.
The County may visit the site of the work and the Recipient's office to review the foregoing
records. The Recipient shall provide every assistance requested by the County during such
visits. In all other respects, the Recipient shall make the foregoing records available to the
County for inspection and copying upon request. If this Agreement involves federal funds, the
Recipient shall comply with all record keeping requirements set forth in any federal rules,
regulations or statutes included or referenced in the Agreement documents.
C. Except as provided in Section 6 of this Agreement, the records listed in A and B above shall
be maintained for a period of six (6) years after termination hereof unless permission to
destroy them is granted by the Office of the Archivist in accordance with Revised Code of
Washington (RCW) Chapter 40.14.
D. Medical records shall be maintained and preserved by the Recipient in accordance with state
and federal medical records statutes, including but not limited to RCW 70.41.190, 70.02.160,
and standard medical records practice. If the Recipient ceases operations under this
Agreement, the Recipient shall be responsible for the disposition and maintenance of such
medical records.
E. The Recipient agrees to cooperate with the County or its agent in the evaluation of the
Recipient's performance under this Agreement and to make available all information
reasonably required by any such evaluation process. The results and records of said
evaluations shall be maintained and disclosed in accordance with RCW Chapter 42.56.
F. The Recipient agrees that all information, records, and data collected in connection with this
Agreement shall be protected from unauthorized disclosure in accordance with applicable
state and federal law.
6. Compliance with the Health Insurance Portability and Accountability Act of 1996 ( HIPAA)
The Recipient shall not use protected health information created or shared under this Agreement in
any manner that would constitute a violation of HIPAA and any regulations enacted pursuant to its
provisions. Recipient shall read and certify compliance with all HIPAA requirements at
http: / /www. kingcou nty.gov /hea lthservices /health /partnerships /contracts
Audits
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A. If the Recipient is a municipal entity or other government institution or jurisdiction, it shall notify
the County in writing within 30 days of when its annual report of examination /audit, conducted
by the Washington State Auditor, has been completed.
B. Additional audit or review requirements which may be imposed on the County will be passed
on to the Recipient and the Recipient will be required to comply with any such requirements.
8. Corrective Action
If the County determines that a breach of Agreement has occurred, that is, the Recipient has failed
to comply with any terms or conditions of this Agreement or the Recipient has failed to provide in
any manner the work or services agreed to herein, and if the County deems said breach to warrant
corrective action, the following sequential procedure will apply:
A. The County will notify the Recipient in writing of the nature of the breach;
The Recipient shall respond in writing within three (3) working days of its receipt of such
notification, which response shall indicate the steps being taken to correct the specified
deficiencies. The corrective action plan shall specify the proposed completion date for bringing
the Agreement into compliance, which date shall not be more than ten (10) days from the date
of the Recipient's response, unless the County, at its sole discretion, specifies in writing an
extension in the number of days to complete the corrective actions,
B. The County will notify the Recipient in writing of the County's determination as to the
sufficiency of the Recipient's corrective action plan. The determination of sufficiency of the
Recipient's corrective action plan shall be at the sole discretion of the County,
C. In the event that the Recipient does not respond within the appropriate time with a corrective
action plan, or the Recipient's corrective action plan is determined by the County to be
insufficient, the County may commence termination or suspension of this Agreement in whole
or in part pursuant to Section 1.C.;
D. In addition, the County may withhold any payment owed the Recipient or prohibit the
Recipient from incurring additional obligations of funds until the County is satisfied that
corrective action has been taken or completed; and
E. Nothing herein shall be deemed to affect or waive any rights the parties may have pursuant to
Section 1., Subsections B, C, D, and E.
9. Dispute Resolution
The parties shall use their best, good -faith efforts to cooperatively resolve disputes and problems
that arise in connection with this Agreement. Both parties will make a good faith effort to continue
without delay to carry out their respective responsibilities under this Agreement while attempting to
resolve the dispute under this section.
10. Hold Harmless and Indemnification
A. In providing services under this Agreement, the Recipient is an independent contractor, and
neither it nor its officers, agents, employees, or subcontractors are employees of the County
for any purpose. The Recipient shall be responsible for all federal and /or state tax, industrial
insurance, and Social Security liability that may result from the performance of and
compensation for these services and shall make no claim of career service or civil service
rights which may accrue to a County employee under state or local law.
The County assumes no responsibility for the payment of any compensation, wages, benefits,
or taxes, by, or on behalf of the Recipient, its employees, subcontractors and /or others by
reason of this Agreement. The Recipient shall protect, indemnify, and save harmless the
County, its officers, agents, and employees from and against any and all claims, costs, and /or
losses whatsoever occurring or resulting from (1) the Recipient's failure to pay any such
compensation, wages, benefits, or taxes, and /or (2) the supplying to the Recipient of work,
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services, materials, or supplies by Recipient employees or other suppliers in connection with
or support of the performance of this Agreement.
B. The Recipient further agrees that it is financially responsible for and will repay the County all
indicated amounts following an audit exception which occurs due to the negligence, intentional
act, and /or failure, for any reason, to comply with the terms of this Agreement by the
Recipient, its officers, employees, agents, or subcontractors. This duty to repay the County
shall not be diminished or extinguished by the prior termination of the Agreement pursuant to
the Term and Termination section.
C. The Recipient shall defend, indemnify, and hold harmless the County, its officers, employees,
and agents from any and all costs, claims, judgments, and /or awards of damages, arising out
of, or in any way resulting from, the negligent acts or omissions of the Recipient, its officers,
employees, sub - awardees and /or agents in its performance or non - performance of its
obligations under this Agreement. In the event the County incurs any judgment, award, and /or
cost arising therefrom including attorneys' fees to enforce the provisions of this article, all
such fees, expenses, and costs shall be recoverable from the Recipient.
D. The County shall defend, indemnify, and hold harmless the Recipient, its officers, employees,
and agents from any and all costs, claims, judgments, and /or awards of damages, arising out
of, or in any way resulting from, the negligent acts or omissions of the County, its officers,
employees, or agents in its performance or non - performance of its obligations under this
Agreement. In the event the Recipient incurs any judgment, award, and /or cost arising
therefrom including attorneys' fees to enforce the provisions of this article, all such fees,
expenses, and costs shall be recoverable from the County.
E. Claims shall include, but not be limited to, assertions that use or transfer of software, book,
document, report, film, tape, or sound reproduction or material of any kind, delivered
hereunder, constitutes an infringement of any copyright, patent, trademark, trade name,
and /or otherwise results in unfair trade practice.
F. Nothing contained within this provision shall affect and /or alter the application of any other
provision contained within this Agreement.
G. The indemnification, protection, defense and save harmless obligations contained herein shall
survive the expiration, abandonment or termination of this Agreement.
11. Insurance Requirements
By the date of execution of this Agreement, the Recipient shall procure and maintain for the
duration of this Agreement, insurance against claims for injuries to persons or damages to property
which may arise from, or in connection with, the performance of work hereunder by the Recipient,
its agents, representatives, employees, and /or sub - awardees. The costs of such insurance shall be
paid by the Recipient or sub - awardee. The Recipient may furnish separate certificates of insurance
and policy endorsements for each sub - awardee as evidence of compliance with the insurance
requirements of this Agreement. The Recipient is responsible for ensuring compliance with all of the
insurance requirements stated herein. Failure by the Recipient, its agents, employees, officers, sub -
awardee, providers, and /or provider sub - awardees to comply with the insurance requirements
stated herein shall constitute a material breach of this Agreement. Specific coverages and
requirements are at http: / /www.kingcounty.gov /healthservices /health /partnerships /contracts;
Recipients shall read and provide required insurance documentation prior to the signing of this
Agreement.
12. Assignment/Sub- agreements
A. The Recipient shall not assign or sub -award any portion of this Agreement or transfer or
assign any claim arising pursuant to this Agreement without the written consent of the County.
Said consent must be sought in writing by the Recipient not less than fifteen (15) days prior to
the date of any proposed assignment.
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B. "Sub- agreement" shall mean any agreement between the Recipient and a sub - awardee or
between sub - awardees that is based on this Agreement, provided that the term "sub -
awardee" does not include the purchase of (1) support services not related to the subject
matter of this Agreement, or (2) supplies.
C. The Recipient shall include Sections 2.D., 2.E., 3, 4, 5, 6, 10.A., 10.6., 10.G., 12, 13, 14, 15,
16, 17, 23, 24, 25, and the Funder's Special Terms and Conditions, if attached, in every sub -
agreement that relates to the subject matter of this Agreement.
D. The Recipient agrees to include the following language verbatim in every sub - agreement for
services which relate to the subject matter of this Agreement:
"Sub - awardee shall protect, defend, indemnify, and hold harmless King County, its officers,
employees and agents from any and all costs, claims, judgments, and /or awards of damages
arising out of, or in any way resulting from the negligent act or omissions of sub - awardee, its
officers, employees, and /or agents in connection with or in support of this Agreement. Sub -
awardee expressly agrees and understands that King County is a third party beneficiary to this
Agreement and shall have the right to bring an action against sub - awardee to enforce the
provisions of this paragraph."
13. Nondiscrimination and Equal Employment Opportunity
The Recipient shall comply with all applicable federal, state and local laws regarding discrimination,
including those set forth in this Section.
During performance of the Agreement, the Recipient agrees that it will not discriminate against any
employee or applicant for employment because of the employee or applicant's sex, race, color,
marital status, national origin, religious affiliation, disability, sexual orientation, gender identity or
expression or age except by minimum age and retirement provisions, unless based upon a bona
fide occupational qualification. The Recipient will make equal employment opportunity efforts to
ensure that applicants and employees are treated, without regard to their sex, race, color, marital
status, national origin, religious affiliation, disability, sexual orientation, gender identity or expression
or age. Additional requirements are at
http: / /www.kingcounty.gov /healthservices /health /partnerships /contracts, Recipients shall read and
certify compliance.
14. Conflict of Interest
A. The Recipient agrees to comply with applicable provisions of K.C.C. 3.04. Failure to comply
with such requirements shall be a material breach of this Agreement, and may result in
termination of this Agreement pursuant to Section II and subject the Recipient to the remedies
stated therein, or otherwise available to the County at law or in equity.
B. The Recipient agrees, pursuant to KCC 3.04.060, that it will not willfully attempt to secure
preferential treatment in its dealings with the County by offering any valuable consideration,
thing of value or gift, whether in the form of services, loan, thing or promise, in any form to any
county official or employee. The Recipient acknowledges that if it is found to have violated the
prohibition found in this paragraph, its current Agreements with the county will be cancelled
and it shall not be able to bid on any county Agreement for a period of two years.
C. The Recipient acknowledges that for one year after leaving County employment, a former
County employee may not have a financial or beneficial interest in an agreement or grant that
was planned, authorized, or funded by a County action in which the former County employee
participated during County employment. Recipient shall identify at the time of offer current or
former County employees involved in the preparation of proposals or the anticipated
performance of Work if awarded the Agreement. Failure to identify current or former County
employees involved in this transaction may result in the County's denying or terminating this
Agreement. After Agreement award, the Recipient is responsible for notifying the County's
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Project Manager of current or former County employees who may become involved in the
Agreement any time during the term of the Agreement.
15. Equipment Purchase, Maintenance, and Ownership
A. The Recipient agrees that any equipment purchased, in whole or in part, with Agreement
funds at a cost of $5,000 per item or more, when the purchase of such equipment is
reimbursable as an Agreement budget item, is upon its purchase or receipt the property of the
County and /or federal /state government. The Recipient shall be responsible for all such
property, including the proper care and maintenance of the equipment.
B. The Recipient shall ensure that all such equipment will be returned to the County or
federal /state government upon termination of this Agreement unless otherwise agreed upon
by the parties.
16. Proprietary Rights
The parties to this Agreement hereby mutually agree that if any patentable or copyrightable material
or article should result from the work described herein, all rights accruing from such material or
article shall be the sole property of the party that produces such material or article. If any patentable
or copyrightable material or article should result from the work described herein and is jointly
produced by both parties, all rights accruing from such material or article shall be owned in
accordance with US Patent Law. Each party agrees to and does hereby grant to the other party,
irrevocable, nonexclusive, and royalty -free license to use, according to law, any material or article
and use any method that may be developed as part of the work under this Agreement.
The foregoing products license shall not apply to existing training materials, consulting aids,
checklists, and other materials and documents of the Recipient which are modified for use in the
performance of this Agreement.
The foregoing provisions of this section shall not apply to existing training materials, consulting aids,
checklists, and other materials and documents of the Recipient that are not modified for use in the
performance of this Agreement.
17. Political Activity Prohibited
None of the funds, materials, property, or services provided directly or indirectly under this
Agreement shall be used for any partisan political activity or to further the election or defeat of any
candidate for public office.
18. King County Recycled Product Procurement Policy
In accordance with King County Code 18.20, the Recipient shall use recycled paper, and both sides
of sheets of paper whenever practicable, when submitting proposals, reports, and invoices, if paper
copies are required.
19. Future Support
The County makes no commitment to support the services awarded for herein and assumes no
obligation for future support of the activity awarded herein except as expressly set forth in this
Agreement.
20. Entire Agreement/Waiver of Default
The parties agree that this Agreement is the complete expression of the terms hereto and any oral
or written representations or understandings not incorporated herein are excluded. Both parties
recognize that time is of the essence in the performance of the provisions of this Agreement.
Waiver of any default shall not be deemed to be a waiver of any subsequent default. Waiver or
breach of any provision of the Agreement shall not be deemed to be a waiver of any other or
subsequent breach and shall not be construed to be a modification of the terms of the Agreement
unless stated to be such through written approval by the County, which shall be attached to the
original Agreement.
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21. Amendments
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Either party may request changes to this Agreement. Proposed changes which are mutually
agreed upon shall be incorporated by written amendments to this Agreement. Changes to the
County's Agreement numbering system or fund source may be made unilaterally by the County and
without the need for amendment of this Agreement. The Recipient shall be notified in writing of any
changes in the Agreement number or fund source assigned by the County; provided, however, that
the total compensation allocated by the County through this Agreement does not change.
22. Notices
Whenever this Agreement provides for notice to be provided by one party to another, such notice
shall be in writing and directed to the chief executive office of the Recipient and the project
representative of the County department specified on page one of this Agreement. Any time within
which a party must take some action shall be computed from the date that the notice is received by
said party.
23. Services Provided in Accordance with Law and Rule and Regulation
The Recipient and any sub - awardee agree to abide by the laws of the state of Washington, rules
and regulations promulgated thereunder, and regulations of the state and federal governments, as
applicable, which control disposition of funds granted under this Agreement, all of which are
incorporated herein by reference.
In the event that there is a conflict between any of the language contained in any exhibit or
attachment to this Agreement, the language in the Agreement shall have control over the language
contained in the exhibit or the attachment, unless the parties affirmatively agree in writing to the
contrary.
24. Applicable Law
This Agreement shall be construed and interpreted in accordance with the laws of the State of
Washington. The venue for any action hereunder shall be in the Superior Court for King County,
Washington.
25. Electronic Processing and Signatures
The parties agree that this Agreement may be processed and signed electronically, which if done
so, will be subject to additional terms and conditions found at
httlps://www.docusign.com/company/terms-cf-use.
The parties acknowledge that they have consulted with their respective attorneys and have had the
opportunity to review this Agreement. Therefore, the parties expressly agree that this Agreement
shall be given full force and effect according to each and all of its express terms and provisions and
the rule of construction that any ambiguities are to be resolved against the drafting party shall not
be employed in the interpretation of this Agreement.
The parties executing this Agreement electronically have authority to sign and bind its represented
party to this Agreement.
26. No Third Party Beneficiaries
Except for the parties to whom this Agreement is assigned in compliance with the terms of this
Agreement, there are no third party beneficiaries to this Agreement, and this Agreement shall not
impart any rights enforceable by any person or entity that is not a party hereto.
END OF COUNTY TERMS AND CONDITIONS
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Exhibit A — Scope of Work
Public Health — Seattle and King County
Emergency Medical Services Division
Project RAMPART — City of Auburn
Regional Approach to Municipal Public AED Registry and Training
PURPOSE OF RAMPART: To fund a regional approach to Municipal Public Access Defibrillation Programs.
Funding can support Automated External Defibrillator (AED) purchases and city employee training and
encourages registration of AEDs in the King County PAD (Public Access Defibrillation) Registry.
TIME PERIOD FOR GRANT: Funds must be used by Dec 31, 2015. Contracts may be amended with
additional funding available in 2015. Funds are provided via a reimbursement contract.
Purchases /expenditures are reimbursed quarterly. Funding may be used for the purchase of AEDs for public
facilities and municipal employee training. A project plan /budget has been approved by King County. Any
changes must be approved by the AED /CPR Program Manager, Anne Curtis.
Project Mission:
To provide incentives for King County and select municipalities to promote the placement and registration of
Public Access Defibrillators in public facilities and other settings at high risk for cardiac arrest events, and to
promote training of your city workforce.
Specific Objectives of the Project:
1) Provide an incentive and guidelines for purchase and most efficient placement of AEDs in higher
incident/higher risk locations.
2) Promote better inclusion of AEDs in the PAD Registry used by EMS and dispatch agencies (911 call
centers), as required by state law (RCW 70.54.310).
3) Promote training of city employees in the use of AEDs.
4) Encourage municipalities to partner with King County EMS on the Shockingly Simple Campaign to promote
PAD awareness in your communities
Deliverables:
1) Provide a Project Rampart liaison to coordinate with King County EMS.
2) Provide training in CPR /AED to 156 city employees. This training can be reimbursed by Project Rampart
as follows:
A maximum of $47.00 per hour and no more than 1 instructor per class (exceptions must be
approved by the CPR /AED Program Manager):
• 3 hour maximum for Basic CPR Training,
• 2 hour maximum for Refresher Training (every 2 years):
3) Additional cost for training above these caps must be paid for by The Agency and are not reimbursable
under this Contract.
4) Coordinate your city Public Access Defibrillation efforts.
5) Ensure that all newly placed AEDs within your city government facilities are registered with King County
PAD Registry.
6) Provide AED site coordination activities related to proper placement, training and maintenance of the
AEDs for all the AEDs in public facilities.
7) Coordinate any private foundation, sponsorship, donation, and /or volunteer activities related to the
purchase and placement of AEDs and AED training in private residences or private facilities within your
city.
8) Coordinate contract activities with EMS to receive RAMPART funding. Submit quarterly invoices for
reimbursement, including original Invoices using Exhibit C for all purchases and workforce training reports.
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Public Health — Seattle & King County, Emergency Medical Services Division, will:
1) Provide a Project Rampart Program Manager liaison to coordinate with each Municipality.
2) Provide training to King County employees.
3) Coordinate the KC Public Access Defibrillation Program. Conduct PAD Public Awareness Campaign as
directed in the EMS 2008 — 2013 Strategic Plan.
4) Maintain King County PAD Registry. Ensure that all AEDS in King County government facilities are
registered with the King County PAD Registry.
5) Provide AED site guidance activities related to proper placement, training and maintenance of the
AEDS for all KC government AEDS in public facilities.
6) Provide incentive funding to Municipalities via contract. Funding allocation to be based on city public
employee count and number of public AEDs registered.
7) Pay quarterly invoices.
8) Send Quarterly PAD Registry Reports to City Fire Departments. Provide cardiac arrest data for trending
and identification of high risk locations.
Contract Reporting Requirements:
The agency shall comply with the following reporting requirements during the contract period:
A. Invoices shall be submitted for reimbursement of Project RAMPART expenses quarterly, and no
later than July 15 "', Sept. 15" and December 15`".
B. Documentation of Instructor Fees
1) A course roster (Exhibit D) for each CPR/AED course taught to city employees must be
submitted with the RAMPART invoice. The course roster must include a) instructor name, b)
date of class, c) type of class taught, d) number of class participants, and e) the number of
hours of instruction taught.\
2) This training can be reimbursed at a maximum of $46 per hour for one instructor. If course size
is over 15 students, one additional instructor may be brought in for the 2 n or 3r° hour of the
class for practical work on manikins. If payment of instructors must exceed $46 per hour, the
agency must pay the extra cost. Documentation of instructor payment must be attached to the
invoice.
C. AED Purchases
1) You must purchase AEDs using pricing from the WA State contract #01710. More information
and price lists are available on www.des.wa.gov. Just put the contract # on your Purchase
Order for the vendor of your choice and you should get reduced pricing. After delivery, include
the original vendor invoice with your RAMPART invoice for reimbursement. At minimum, we
recommend purchase of 1 wall mount, 1 carrying case and 1 extra set of pads for each AED
purchased. We do not recommend buying an extra battery at the time of AED purchase,
because they have a life of about 4 years. You may buy batteries for Project RAMPART for
AEDs purchased in previous years.
D. Miscellaneous Equipment/Supplies and CPR /AED Training Supplies
1) Provide an itemized list of all equipment and supplies purchased and list the price of each item.
Include an original vendor invoice attached to the RAMPART invoice.
The Project RAMPART contract is a reimbursable contract and all purchases and services must be completed
prior to invoicing King County. Invoices must be mailed to Anne Curtis, CPR /AED Program Manager, King
County EMS, 401 Fifth Ave. Suite 1200, Seattle, WA 98104. All required reports described above must
accompany the invoice. Invoices are due no later than 15 calendar days following the end of 2 n and 3rd
calendar quarter and due on December 1 5`" for the 4" calendar quarter.
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King County EMS Division
Exhibit B Project RAMPART 2015 Program Plan and Budget —City of Auburn
2015 Annual RAMPART Funding Allowance: 4940
A) Purchase
Manufacturer
Number
Cost per AED, include wall
Total Cost
AEDs
and Model*
of AEDs
mounts, cases & extra
For AED(s)
pads **
Phillips On -site 3
$987.77
2963.32
(H51) w /case
and extra pads
Tax
281.52
Shipping
54
Total
(Approximate)
AED Cost
(A)
Total Cost, including Tax
3298.84
3298.84
and Shipping
*Must purchase using WA State Contract #01710 (approx.. 30% discount): Philips, Cardiac Science, Physio - Control,
Zoll). * *We do not recommend buying an extra battery at time of purchase because batteries last 2 - 4+ years.
B) Training
Estimated # of
Estimated
Estimated number of total
Hourly
Total
Employees to
# of
class hours
instructor wage
Training
be trained
CPR /AED
(# Basic classes X 3 hrs) +
(max = $46.00
Cost
classes to
(# Refresher classes X 2)
hour)
(Hours X
be held
Wage)
(B)
Maximum allowable
156
Basic = 6
32
$35
$1120.00
CPR /AED class hours
Basic Class = 3 hours
Refresher
Refresher Class = 2 hours
= 7
C) Training
Type of Supply
Number
Cost
Total Cost of
Supplies
of Items
Training
Supplies
Includes:
• Mannequin
2 boxes
$19.95
$39.90
• AHA cards;
lungs
• AED Trainers;
• Batteries;
• Gloves
4 boxes
$12.00
$48.00
• Pads;
• CPR Training
• Pediatric
6 sets
$56.52
$339.12
supplies, etc.
AED Pads
Tax
$40.57
Shipping
$20
Total
(Approximate)
Supply Cost
(C)
Total Cost, including Tax
$487.59
$487.59
and Shipping
Contingency
$33.57
Grand Total
$4940.43
Budget(A +B +C)
Revised 11 -4 -14
For EMS, PHSKC Office Use Only:
KCAP Information: PURCHASE ORDER k:
Supplier Name:
Invoice Date:
Note to AP:
Print on Remittance: _
PH /Prog Name /Number:
Site# 1033/0,I1, 01,A
Amt to be Paid:
CPA:
Req: _
Receipt:
Public Health — Seattle & King County
Emergency Medical Services Division (EMS, PHSKC)
Project RAMPART
EXHIBIT C — INVOICE AND BUDGET SUMMARY 2015
AGENCY: DATE:
REMIT ADDRESS':
PHONE:
CITY STATE ZIP
Must match address on contract
"PLEASE COMPLETE BOTH SECTIONS"
BUDGET CATEGORIES
CONTRACT
ITEM/
FUNDS
EXPENDEDTHIS
TOTALFUNDS
EXPENDED TO DATE
TOTAL FUNDS
BUDGET
DESCRIPTION
REPORT
(include current report)
REMAINING
Instructor Fees
Number of new AEDs placed in your city and
AED Purchases
egistered in KC PAD Registry
Misc. Equipment (pads, batteries,
Access Defibrillation in your community
all mounts, cabinets, etc. ) Attach list
CPR /AED Training Supplies
Includes AHA cards Attach list
Other describe
TOTAL
Accomplishment Report
TYPE OF ACTIVITY
GOAL
CURRENT REPORT
TOTAL TO DATE
(include current report)
Number of city employees trained
Number of AEDs purchased with RAMPART
funds Kin County Contract funds
Number of new AEDs placed in your city and
egistered in KC PAD Registry
Dollar amount of fundraising efforts for Public
Access Defibrillation in your community
CERTIFICATION FOR PAYMENT:
I, the undersigned, do hereby certify that the materials have been furnished, the services rendered or the labor performed
as described herein, and that the claim is a just, due and unpaid obligation against King County, and that I am authorized
to authenticate and certify to said claim.
Submit to: Emergency Medical Services, PHSKC
401 Fifth Ave. Suite 1200
Agency Representative Signature Date Seattle, WA 98104
ATTN: Anne Curtis
Print Name Title
FOR EMS, SEATTLE -KING COUNTY DEPARTMENT OF PUBLIC HEALTH USE ONLY
APPROVED:
Program Manager Date
Revised 3125113
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AGENCY:
Public Health — Seattle & King County
Emergency Medical Services Division
Project RAMPART
EXHIBIT D — CPR INSTRUCTOR REPORTING FORM
Contract Period: Jan 1, 2015 — December 31, 2015
CALENDAR QUARTER ENDING:
(March. June, SeDt.. Dec.)
DATE OF LAST CPR
INSTRUCTOR'S NAME: INSTRUCTOR CERTIFICATION:
PLEASE NOTE: Each CPR class must be listed separately. Please do not send in class rosters with this form: however, rosters must be kept as
program records pursuant to the contract between King County and the agency.