HomeMy WebLinkAboutContract2024 GRANT BENEFICIARY/ARTIST AGREEMENT
WITH KIANA DAVIS
RENTON MUNICIPAL ARTS COMMISSION GRANT PROGRAM
THIS AGREEMENT, dated for reference purposes only as 8/26/2024, is by and between the City
of Renton (the “City”), a Washington municipal corporation, and Kiana Davis
(“Beneficiary/Artist”), an individual, and sets forth the terms and conditions under which the City
will provide a grant to Beneficiary/Artistunder the Renton Municipal Arts Commission, Municipal
Art Fund, Grant Program (“Program”). The Program is funded through the Renton Municipal Art
Fund (RMC 2-8-7.B) (“Fund”), as authorized by the Renton City Council on November 14, 2022
pursuant to RMC 2-8-4.C and 2-8-7.B.3.
The City and the Beneficiary/Artist are referred to collectively in this Agreement as the “Parties.”
Once fully executed by the Parties, this Agreement is effective as of the last date signed by both
parties.
RECITALS:
WHEREAS, the City of Renton recognizes and acknowledges the importance of, and benefit to
the public in, providing visual art and performance in its public works and facilities, and the
community as a whole; and,
WHEREAS, the City created the Renton Municipal Arts Commission (“Commission”)to advise the
Mayor and City Council on artistic and cultural development of the City, and to disburse money
budgeted to it for cultural arts performances and other events, art-related programs and
activities and support of artists and arts and cultural organizations, as resources allow through
the City’s Municipal Art Fund; and,
WHEREAS, the Commission established Application Criteria (Exhibit 1), issued a Call for
Application (Call for Application” at Exhibit 2), reviewed Applications (“Beneficiary/Artist’s
Application” at Exhibit 3), and established a list of Projects awarded from the Fund (“Projects
Awarded” at Exhibit 4), each Exhibit is incorporated herein by reference; and
WHEREAS, on August 19, 2024, theCommissionreviewed the Beneficiary/Artist’s Application and
determined that the Beneficiary/Artist is eligible for assistance under this Program and is
promoting arts and culture in Renton.
CAG-24-253
PAGE 2 OF 15
NOW THEREFORE, in consideration of the mutual covenants and agreements herein, the
Parties agree as follows:
AGREEMENT
1. Grant Amount and Disbursement.
a. Amount. The total amount to be awarded to Beneficiary/Artist under the Program is
up to one thousand dollars ($1,000.00) as a reimbursement for eligible expenses.
Except as specifically provided herein, the Beneficiary/Artist shall be solely
responsible for payment of any taxes imposed as a result of this Agreement.
b. Award Disbursement.
i.Reimbursement Request. On a monthly, or no less than quarterly basis during
any quarter in which artistic and cultural support is completed,
Beneficiary/Artist shall submit reimbursement request(s) in a format
acceptable to the City (Exhibit 5) with supporting documentation including,
but not limited to, invoices or reports demonstrating expenses for which
reimbursement is sought.
ii.Effect of Award. Other than as specified, Beneficiary/Artist relinquishes the
right to any financial proceeds in association with City’s use or reproductions
of the PROJECT.
iii.Payment. Payment shall be made by City within thirty (30) calendar days after
receipt and approval by the appropriate City representative of the invoice.
iv.No waiver. Payment for any reimbursement shall not constitute a waiver by
the City of any remedies it may have for any breach of this Agreement by the
Beneficiary/Artist.
v.Tax implications. Grant funds may be taxable. Please consult your financial
advisor/tax professional for guidance. If it is required by the IRS, a 1099 form
will be issued to the Beneficiary/Artist.
2. Scope and Performance.Beneficiary/Artist agrees to create and install artwork or
produce an event as specified in Exhibit 3 “Beneficiary/Artist’s Application” which is
attached and incorporated herein. Such scope is hereinafter referred to as “PROJECT.”
a. Prior to scheduling the installation or production, Beneficiary/Artist agrees to discuss
the contents of the proposed PROJECT with designated Citystaff to address necessary
Council approvals, coordination with affected City departments, compliance with
affected City regulations such as signage or event permits, materials to be used,
and/or documentation of agreements with Beneficiary/Artist partners such as private
property where the PROJECT will be presented. These discussions may result in
revision of the PROJECT as proposed.
b. The final design will be provided to the City’s Municipal Arts Commission for review,
request for further revision as needed, and final confirmation prior to installation or
production of the PROJECT.
PAGE 3 OF 15
c. Beneficiary/Artistwill be responsible for installing the PROJECT in its approved design
at the location identified in Exhibit 3.
d. Beneficiary/Artist agrees to create and install PROJECT no later than December 15,
2024.
3. Installation on Private Property.RESERVED
4. Beneficiary/Artist’s Grants and Representations:
a. Delivery of PROJECT to City constitutes Beneficiary/Artist’s certification that:
i. PROJECT is the original work of Beneficiary/Artist;
ii. To the extent others contributed to the PROJECT, Beneficiary/Artist assumes
all responsibility and liability for any claims of right to the PROJECT by such
others;
iii. Beneficiary/Artist owns all rights to PROJECT, including having obtained any
rights that Beneficiary/Artist did not originally possess; and
iv. if PROJECT contains recognizable images of particular persons,
Beneficiary/Artist has obtained appropriate releases.
b. Beneficiary/Artist acknowledges that, except for PROJECT to which section 3 of this
Agreement applies, the PROJECT will be displayed on City-owned property at [insert
address/location] at the discretion of the City. The City retains all right to remove,
maintain, restore, relocate, or otherwise alter the PROJECT in the future for any
reason.
c. Beneficiary/Artist grants to City a non-exclusive license to graphically and
electronically reproduce PROJECT, while on display, for any and all future publicity
endeavors conducted by City, provided that any such reproduction is credited to
Beneficiary/Artist by name. City may use the Beneficiary/Artist’s photograph, other
likeness, or biography in connection with the use of PROJECT.
5. Final Report: Together with the final reimbursement request, and in a format acceptable
to the City (Exhibit 6), Beneficiary/Artist shall submit a final report detailing outcomes
related to budget, activities, objectives, and attendance as first described in the
Beneficiary/Artist’s application for the Grant.
6. Scope ofEligible Expenditures: Grant funds disbursed under this Agreementshallonly be
used to pay or reimburse eligible expenses as described in the Criteria (Exhibit 1) and in
the “Program Call for Applications” (Exhibit 2)
a. Reimbursement Defined. “Reimbursement” means grant disbursement to
Beneficiary/Artist upon receipt by the City of invoices and documentation
demonstrating eligible expenses.
b. No Duplication of Payment. No grant funds may be used to pay or reimburse costs
for expenditures for which Beneficiary/Artist has received any other funding,
whether state, federal or private in nature, for that same expense.
PAGE 4 OF 15
7. Beneficiary/Artist Responsibilities.
a. False Statement.The Beneficiary/Artistunderstandsand acknowledges that providing
false information in the Application or on any documents submitted to the City or its
designees as part of the Beneficiary/Artist’s participation in the Program may
constitute fraud, justifytermination of this Agreement, trigger the Beneficiary/Artist’s
obligation to return funds, and may be subject to civil and/or criminal penalties
and/or sanctions.
b. No Employee Relationship. The Beneficiary/Artist understands and acknowledges
that neither the Beneficiary/Artist nor any officer, employee or agent of the
Beneficiary/Artist shall be considered to be an employee of the City, nor entitled to
any benefits accorded City employees, by virtue of the services provided under this
Agreement. The City shall not be responsible for assuming the duties of an employer
with respect to the Beneficiary/Artist or any employee of the Beneficiary/Artist.
c. Non-discrimination.During the performance of this Agreement, the Beneficiary/Artist
shall comply with all federal and state nondiscrimination laws, including but not
limited to, chapter 49.60 RCW, Washington’s Law Against Discrimination, and 42
U.S.C. 12101 et seq., the Americans with Disabilities Act (ADA). In the event of the
Company’s noncompliance or refusal to comply with any nondiscrimination law,
regulation, or policy, this Agreement may be rescinded, canceled, or terminated in
whole or in part.
d. Sole proprietorship or Individual. If the Beneficiary/Artist is a sole proprietorship or
if this Agreement is with an individual, the Beneficiary/Artist agrees to notify the City
and complete any required form if the Beneficiary/Artist retired under a State of
Washington retirement system and agrees to indemnify any losses the City may
sustain through the Beneficiary/Artist’s failure to do so.
8. Insurance: Beneficiary/Artist shall secure and maintain:
a. Commercial general liability insurance in the minimum amounts of $1,000,000 for
each occurrence/$2,000,000 aggregate for the Term of this Agreement.
b. In the event that Work delivered pursuant to this Agreement either directly or
indirectly involve or require Professional Services, Professional Liability, Errors and
Omissions coverage shall be provided with minimum limits of $1,000,000 per
occurrence. "Professional Services", for the purpose of this section, shall mean any
Work provided by a licensed professional or Work that requires a professional
standard of care.
c. Workers’ compensation coverage, as required by the Industrial Insurance laws of the
State of Washington, shall also be secured.
d. Commercial Automobile Liability for owned, leased, hired or non-owned, leased, hired
or non-owned, with minimum limits of $1,000,000 per occurrence combined single
limit, if there will be any use of Beneficiary’s vehicles on the City’s Premises by or on
behalf of the City, beyond normal commutes.
e. Beneficiary/Artist shall name the City as an Additional Insured on its commercial
general liability policy on a non-contributory primary basis. The City’s insurance
PAGE 5 OF 15
policies shall not be a source for payment of any Beneficiary/Artist liability, nor shall
the maintenance of any insurance required by this Agreement be construed to limit
the liability of Beneficiary/Artist to the coverage provided by such insurance or
otherwise limit the City’s recourse to any remedy available at law or in equity.
f. Subject to the City’s review and acceptance, a certificate of insurance showing the
proper endorsements, shall be delivered to the City before performing the PROJECT.
g. Beneficiary/Artist shall provide the City with written notice of any policy cancellation,
within two (2) business days of their receipt of such notice.
9. Records: Maintenance, Access, Disclosure.
a. Records Maintained. Beneficiary/Artist shall maintain all records and accounts with
respect to all matters covered by this Agreement, including personnel, property,
financial, and programmatic records and documents.
b. Retention Period. These records shall be maintained for as long as may be required
by applicable Washington State records retention laws, but in any case for a period of
six (6) years after all funds have been expended or returned to the City, whichever is
later, to ensure proper accounting for all funds and compliance with the Agreement.
c. Litigation or Audit. If any litigation, claim or audit is started before the expiration of
the six (6) year period provided in Section 4(b) above, the records shall be retained
until all litigation, claims, or audit findings involving the records have been resolved.
d. Right of Access. The City, or its authorized representatives, shall have the right of
access to records (electronic and otherwise) of Beneficiary/Artist in order to conduct
audits or other investigations.
e. Subject to Disclosure. Beneficiary/Artist acknowledges that records may be subject to
disclosure under the Public Records Act, Ch. 42.56 RCW.
i. To the full extent the City determines necessary to comply with the Washington
State Public Records Act, Beneficiary/Artist shall make a due diligent search of
all records in its possession or control relating to this Agreement and the
PROJECT, including, but not limited to, e-mail, correspondence, notes, saved
telephone messages, recordings, photos, or drawings and provide them to the
City for production.
ii. In the event Beneficiary/Artist believes said records need to be protected from
disclosure, it may, at Beneficiary/Artist’s own expense, seek judicial protection.
Beneficiary/Artist shall indemnify, defend, and hold harmless the City for all
costs, including attorneys’ fees, attendant to any claim or litigation related to a
Public Records Act request for which Beneficiary/Artist has responsive records
and for which Beneficiary/Artisthas withheld records or information contained
therein, or not provided them to the City in a timely manner.
iii. Beneficiary/Artist shall produce to the City for distribution any and all records
responsive to the Public Records Act request in a timely manner, unless those
records are protected by court order. The provisions of this section shall
survive the expiration or termination of this Agreement.
PAGE 6 OF 15
10. Publications.Any publications produced with funds from this Agreement must display
the following language: “This project is being supported, in whole or in part, by a grant
from the City of Renton.”
11. Disclaimer by the City.The City expressly disclaims any and all responsibility or liability
to Beneficiary/Artist or third persons for the actions of Beneficiary/Artist or third
persons resulting in death, bodily injury, property damages, or any other losses resulting
in any way from the performance of this Agreement or any other losses resulting in any
way from the performance of the Agreement, or any subcontract thereto. This
Agreement does not in any way establish an agency relationship between or among the
City and/or Beneficiary/Artist.
12. Expenses Incurred in Excess of Program Award Funds. Beneficiary/Artist acknowledges
that any expenses incurred in excess of Program Award Funds are the Beneficiary/Artist’s
sole responsibility and will not be paid by the City.
13. Repayment of Funds. If any funds provided to Beneficiary/Artist were used in a manner
that is not consistent or allowable as outlined in this Agreement, Beneficiary/Artist shall
return funds to City in the amount determined to be ineligible. Beneficiary/Artist further
agrees that it is financially responsible for and will repay the City any and all indicated
amounts following an audit exception which occurs due to Beneficiary/Artist’s failure, for
any reason, to comply with the terms of this Agreement. This duty to repay the City shall
not be diminished or extinguished by the termination of the Agreement.
14. Termination.The City reserves the right to terminate this Agreement at any time, with or
without cause by giving ten (10) calendar days’ notice to the Beneficiary/Artist in writing.
In the event of such termination or suspension, Beneficiary/Artist waives any right to un-
distributed portions of the award.
15. Conflict of Interest.
a. Beneficiary/Artist designees, agents, members, officers, employees, consultants, and
any other public official who exercises or who has exercised any functions or
responsibilities with respect to the Program during his or her tenure, or who is in a
position to participate in a decision-making process or gain inside information with
regard to the Program, are barred from any interest, direct or indirect, in any grant or
proceeds of the Program, or benefit there from, which is part of this Agreement at any
time during or after such person's tenure.
b. The City’s Code of Ethics and Washington State law prohibit City employees from
soliciting, accepting, or receiving any gift, gratuity or favor from any person, firm or
corporation involved in a contract or transaction. To ensure compliance with the City’s
Code of Ethics and state law, the Beneficiary/Artist shall not give a gift of any kind to
City employees or officials.
PAGE 7 OF 15
c. Beneficiary/Artist also confirms that Beneficiary/Artist does not have a business
interest or a close family relationship with any City officer or employee who was, is, or
will be involved in selecting the Beneficiary/Artist, negotiating or administering this
Agreement, or evaluating the Beneficiary/Artist’s performance of the Work.
16. Notices: Any notice required under this Agreement will be in writing, addressed to the
appropriate party at the address which appears below (as modified in writing from time
to time by such party), and given personally, by registered or certified mail, return receipt
requested, by facsimile or by nationally recognized overnight courier service. Time period
for notices shall be deemed to have commenced upon the date of receipt, EXCEPT
facsimile delivery will be deemed to have commenced on the first business day following
transmission. Email and telephone may be used for purposes of administering the
Agreement but should not be used to give any formal notice required by the Agreement.
CITY OF RENTON
Jessie Kotarski
Economic Development Manager
CED/City of Renton
1055 South Grady Way, 6th Floor
Renton, WA 98057
Phone: (425) 430-7271
Email: jkotarski@rentonwa.gov
BENEFICIARY/ARTIST
Kiana Davis
Click or tap here to enter text.
Click or tap here to enter text.
1175 Harrington Pl NE
Renton, WA 98056
Phone: (206) 349-9176
Email:
diggingforrootskdavis@gmail.com
17. Waiver/Conflict of Terms.
a. Any waiver by the Beneficiary/Artist or the City of the breach of any provision of this
Agreement by the other party will not operate, or be construed, as a waiver of any
subsequent breach by either party or prevent either party from thereafter enforcing
any such provisions.
b. In the event of any inconsistencies between Beneficiary/Artist proposals and this
Agreement, the terms of this Agreement shall prevail. Any exhibits/attachments to
this Agreement are incorporated by reference only to the extent of the purpose for
which they are referenced within this Agreement. To the extent a Beneficiary/Artist-
prepared exhibit conflicts with the terms in the body of this Agreement or contains
terms that are extraneous to the purpose for which it is referenced, the terms in the
body of this Agreement shall prevail and the extraneous terms shall not be
incorporated herein.
18. Modification. This Agreement may only be amended by written agreement signed by
both Parties.
PAGE 8 OF 15
19. Conflicts. In the event of any inconsistencies between Beneficiary/Artist proposals or
Beneficiary/Artist-prepared exhibits and this Agreement, the terms of this Agreement
shall prevail.
20. Severability. In the event any term or condition of this Agreement or application thereof
to any person or circumstances is held invalid, such invalidity shall not affect other terms,
conditions, or applications of this Agreement that can be given effect without the invalid
term, condition, or application. To this end, the terms and conditions of the Agreement
are declared severable.
21. Governing Laws.Any lawsuit or legal action brought by any party to enforce or interpret
this Agreement or any of its terms or covenants shall be brought in the King City Superior
Court for the State of Washington at the Maleng Regional Justice Center in Kent, King
City, Washington, or its replacement or successor. Beneficiary/Artist hereby expressly
consents to the personal and exclusive jurisdiction and venue of such court even if
Beneficiary/Artist is a foreign corporation not registered with the State of Washington.
22. Indemnification. To the maximum extent permitted by law, Beneficiary/Artist shall, at its
cost and expense, protect, defend, indemnify, and hold harmless the City, its directors,
officers, employees, and agents, from and against any and all demands, liabilities, causes
of action, costs and expenses (including attorneys’ fees), claims, judgments, or awards of
damages, arising out of or in any way resulting from the acts or omissions of
Beneficiary/Artist, its directors, officers, employees, or agents, relating in any way to
Beneficiary/Artist’s performance or non-performance under the Agreement.
Beneficiary/Artist agrees that its obligations under this paragraph extend to any
demands, liabilities, causes of action, or claims brought by, or on behalf of, any of its
employees or agents. For this purpose, Beneficiary/Artist, by mutual negotiation, hereby
waives, as respects the Cityonly, any immunity that would otherwise be available against
such claims under any industrial insurance act, including Title 51 RCW, other Worker’s
Compensation act, disability benefit act, or other employee benefit act of any jurisdiction
which would otherwise be applicable in the case of such claim. These indemnification
obligations shall survive the termination of the Agreement.
23. Complete Agreement. This Agreement sets forth the complete expression of the
agreement between the Parties, and any oral representations or understandings not
incorporated herein are excluded.The Parties may execute this Agreement in any number
of counterparts, each of which shall constitute an original, and all of which will together
constitute this one Agreement.
Exhibits
1 – Renton Municipal Arts Commission Grant Program – Application Criteria
2 – Renton Municipal Arts Commission Grant Program – Call for Applications
3 – Renton Municipal Arts Commission Grant Program – Beneficiary/Artist’s Application
4 – Renton Municipal Arts Commission Grant Program – Projects Awarded
PAGE 9 OF 15
5 – Renton Municipal Arts Commission Grant Program – Reimbursement Request Form
6 – Renton Municipal Arts Commission Grant Program – Final Report Form
IN WITNESS WHEREOF, the Parties have voluntarily entered into this Agreement as of the date
last signed by the Parties below.
CITY OF RENTON
By:________________________
BENEFICIARY
By:___________________________
Gina Estep
CED Administrator
Kiana Davis
Artist
__________________________
Date
_____________________________
Date
Approved as to legal form:
__________________________
M. Patrice Kent
Sr. Assistant City Attorney
Grant Template: 12.3 (File # 2877 – Award Ref #:__3172____)
Approved by Patrice Kent via email 9/3/2024
PAGE 10 OF 15
EXHIBIT 1:
RENTON MUNICIPAL ARTS GRANT PROGRAM
APPLICATION CRITERIA
Program Overview
Purpose
Public Funding= Public Benefit
Application Review Process
Page 3
Funding
Generally, the maximum award is $,000 and the
minimum award is $500. However, the Arts Commission
may recommend greater or lesser amounts.
Timing of Projects
Projects must take place during and should be
completed by December , .
Payment
made at the
end of the project. Exceptions may be made, depending
on circumstances and City policy. The funding recipient
turn in inv report to the
for reimbursement. Invoices and final
reports are due by December . Checks are normally
mailed within 30 days of the invoice date
paperwork.
Eligibility
Who May Apply
Evaluation Criteria
Artistic Innovation
Quality and promise of the proposed arts,
cultural, and heritage project to meet the cultural
needs of an audience and/or constituent group.
Innovative approach to foster creative and civic
participation by diverse residents and
visitors, particularly underserved people and
communities.
Fills a gap in art, cultural, or heritage offerings
and opportunities not regularly available to
residents and visitors.
Public Access and Benefit
Project Feasibility
Application Instructions
PAGE 11 OF 15
EXHIBIT 2:
RENTON MUNICIPAL ARTS GRANT PROGRAM
CALL FOR APPLICATIONS
1055 South Grady Way, Renton, WA 98057 | 425-430-6400 | rentonwa.gov |
CITY OF RENTON
FOR IMMEDIATE RELEASE
Sept., 2023
City of Renton Contacts
Laura Pettitt, Communications Director
Jessie Kotarski, Economic Development Manager, 425-430-7271
Renton Municipal Arts Commission accepting 2024 grant applications
Deadline is 4:30 p.m. on Friday, Oct. 13, 2023
RENTON, WA –Renton Municipal Arts Commission announces the opening of applications for the 2024 Arts &
Culture Grants, inviting individuals, organizations, and community groups to bring their creative visions to life
for the enrichment of Renton residents and visitors.
The Arts & Culture Grants initiative is a catalyst for community-driven artistic endeavours, fostering a deeper
connection to the arts and heritage among the people of Renton. Embracing the vibrancy of Renton's cultural
mosaic, the commission welcomes inventive projects that celebrate diversity, enhance individual and societal
understanding, and ignite fresh avenues of artistic engagement. Special attention is given to projects that
empower underserved communities.
These grants support a diverse range of artistic programming, encompassing compelling art exhibitions,
emotionally resonant concerts, enthralling dance performances, vibrant festivals, educational workshops,
thought-provoking readings, and engaging theater productions.
Applicants have the chance to secure grants of up to $10,000, with a single grant per calendar year for each
eligible applicant.
In 2024, the grant application process will include four distinct funding rounds. The deadline for the first round
is set for October 13, 2023, at 4:30 p.m., with a primary emphasis on projects and events scheduled for
January through March 2024.
For the year 2023, applicants can apply for grants during three cycles, with deadlines falling on February 2,
April 19, and July 19.
For additional support and insights, the Renton Municipal Arts Commission will host two drop-in Q&A sessions.
Join us on Monday, September 25, from 11 a.m. to 12 p.m., and Tuesday, October 10, from 6 p.m. to 7 p.m. at
the Renton Library. These sessions provide an informal opportunity to connect with the grant committee, seek
clarity, and engage with other applicants. No pre-registration is required; simply bring your questions.
For inquiries related to the application process or the Arts & Culture Grants, please don't hesitate to reach out
to Jessie Kotarski, the City of Renton’s Economic Development Manager, at 425-430-7271 or
arts@rentonwa.gov.
We look forward to seeing your innovative proposals and celebrating the transformative power of arts and
culture in our vibrant community.
About the City of Renton
1055 South Grady Way, Renton, WA 98057 | 425-430-6400 | rentonwa.gov |
The City of Renton, Washington, with a population of 107,500 (2022), is located on the southeast shore of Lake
Washington, just south of Seattle. Renton's strong economic base, diverse marketplace, and favorable business
climate have attracted nationally recognized companies wishing to provide employees and their families with
an outstanding quality of life. Renton is the home of Boeing, PACCAR, IKEA, Super Bowl Champion (2014)
Seattle Seahawks, two-time (2016 & 2019) MLS champion and CONCACAF Champion (2022) Seattle Sounders
FC (in 2024), and the eternal resting place of rock icon Jimi Hendrix. More information is on our website, in
news releases, or on Facebook, Twitter, and Nextdoor.
About the Renton Municipal Arts Commission
Renton Municipal Arts Commission was created in 1965. The members advise the city government about the
artistic and cultural development and serve as stewards of the city's art collection. In addition, the commission
strives to support and connect people with arts and culture endeavors in the Renton community. For more
information about the Renton Municipal Arts Commission, contact arts@rentonwa.gov or
facebook.com/rentonarts.
###
PAGE 12 OF 15
EXHIBIT 3:
RENTON MUNICIPAL ARTS GRANT PROGRAM
BENEFICIARY/ARTIST’S APPLICATION
Give details here.
Artistic
Administration
Technical
Other
Supplies/Materials
Promotion/Printing
Postage
Artistic Services
Other Professional
Services
Space/Equipment Rental
Travel/Transportation
Other
PAGE 13 OF 15
EXHIBIT 4:
RENTON MUNICIPAL ARTS GRANT PROGRAM
PROJECTS AWARDED
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PAGE 14 OF 15
EXHIBIT 5:
RENTON MUNICIPAL ARTS GRANT PROGRAM
REIMBURSEMENT REQUEST FORM
Recipient name
Mailing address
Contract No.
Date Invoice # Description
Artistic/
Administration Supplies Event Misc Total
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $ $
$ $ $ $
Totals $ $ $ $ $
Completed Final Report
Attached IRS Form W9
Amount requested $
Signature
Printed name
RENTON MUNICIPAL ARTS COMMISSION GRANT PROGRAM
Reimbursement Request Form
Attached supporting documentation for expenses to demonstrate, by date, expenses were
incurred following the execution of the contract and no later than December , 202 . Sufficient
documentation includes:
PAGE 15 OF 15
EXHIBIT 6:
RENTON MUNICIPAL ARTS GRANT PROGRAM
FINAL REPORT FORM
Renton Municipal Arts Commission Renton City Hall 1055 South Grady Way Renton WA 98057
Exhibit 6
RENTON MUNICIPAL ARTS COMMISSION GRANT PROGRAM
Final Report Form
Organization Name:
Mailing Address:
Contact Name:
Contact Phone: Contact E-mail:
Reimbursement amount request:
Project start date: Project end date:
Briefly describe the outcome of your project including benefits to the public (. free
public performances, exhibitions, workshops, screenings, or readings; scholarships to
ongoing, fee-based arts educational or training programs or accommodations made to
expand access and inclusion to individuals with limited physical or English-speaking
abilities).
Estimate (or provide direct counts for ticketed events) the number of participants involved
in the project:
Describe promotional efforts for this project.
Attach schedule of activities; reports and publications; copies of printed publicity,
programs, newspaper clippings; or photos. Note: These attachments are necessary to
document that the project was completed as stated in your application. A requirement
of the grant contract is to show that the "credit line" for support from the Renton Municipal
Arts Commission used in publicity.
Renton Municipal Arts Commission Renton City Hall 1055 South Grady Way Renton WA 98057
Did you achieve the goals you had set for the project? Describe.
Describe any difficulties. (For example: scheduling difficulties, problems in getting people
to participate, low attendance, etc.)
We certify that the information contained in this report is true and correct to the best of
our knowledge. records
_________________________ ___________________________
Printed Name Authorized Signature
_________________
Date
Return form and report to: Renton Municipal Arts Commission, 1055 S Grady
Way, Renton, WA 98057 or arts@rentonwa.gov (email or call 425-430- if
you have questions)