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HomeMy WebLinkAboutContractPage 1 of 10 HUMAN SERVICES AGREEMENT FOR CORONAVIRUS RELIEF FUNDING CAG-________ THIS HUMAN SERVICES AGREEMENT, dated __________________, is by and between the City of Renton (the “City” or “Renton”), a Washington municipal corporation, and African Community Housing and Development(“Agency” or “Contractor”). The City and the Agency 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, Governor Inslee issued Proclamation 20-25, “Stay Home, Stay Healthy,” on March 23, 2020, which prohibited all people in Washington State from leaving their homes or participating in social, spiritual and recreational gatherings of any kind regardless of the number of participants, and all non-essential businesses in Washington State from conducting business, within the limitations therein; and WHEREAS, Governor Inslee has issued several updates to Proclamation 20 -25, including Proclamation 20-25.3 on May 4, 2020, which established an initial four-phased approach to reopening Washington State; and WHEREAS Governor Inslee issued Proclamation 20-25.4 on May 31, 2020, which creates a transition from “Stay Home – Stay Healthy” to “Safe Start – Stay Healthy;” and WHEREAS, resources are necessary to help Renton residents with rent and food assistance; and WHEREAS, Section 601(a) of the Social Security Act, as added by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”) (PL 116-136), established the Coronavirus Relief Fund (the “Fund”) and appropriated $150 billion under Title V of the CARES Act to the Fund to be used to make payments for specified uses to States and certain local governments; and WHEREAS, the Washington State allocation of Fund resources has been designated to reimburse certain additional local governments in the state for specified expenditures though contracts administered by the State Department of Commerce; and DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 09/24/2020 20-375 Page 2 of 10 WHEREAS, the City entered into an Interagency Agreement (the “Interagency Agreement”) with the Washington State Department of Commerce (“Commerce”) regarding the Fund for the period March 1, 2020 through October 31, 2020, attached hereto as Exhibit A and incorporated herein; and WHEREAS, via Resolution 4411, the City Council directed City administration to establish the City of Renton CARES Act Relief Fund Program to utilize Fund resources, and the City’s CARES Act Relief Fund Program includes a Rental Assistance and Human Services Support Program (the “Program”). The focus of the Program is provide rental and food assistance and other human services support; NOW, THEREFORE, in consideration of the recitals, which are incorporated by reference, and the following mutual promises and covenants contained in this Agreement, the Parties mutually agreed as follows: 1. Scope of Services: Agency agrees to provide the services as specified in Exhibit B (titled “Scope and Schedule of Work”), which is attached and incorporated herein and may hereinafter be referred to as the “Services.” The Services shall be performed in a manner consistent with applicable provisions of Exhibit A and with the accepted practices for other similar services, completed to Renton’s satisfaction within the time prescribed by Renton, and pursuant to the direction of the Human Services Manager (“HSM”) or designee. In the case of multiple projects, each project shall correspond to a separate Scope of Work. 2. Term: The term of this Agreement shall be for a period commencing August 1, 2020, and ending October 15, 2020, unless sooner terminated under the provisions hereinafter specified. 3. Termination: Prior to the expiration of the Term, this Agreement may be terminated or suspended immediately, with or without cause by Renton. The Agency may cancel this Agreement only upon thirty (30) business days’ prior written notice to Renton. In the event Renton terminates or suspends this Agreement, the Agency will be entitled to receive compensation for any approved Services rendered prior to the termination or suspension of this Agreement. The HSM’s determination of compensation shall be binding and conclusive. 4. Compensation: A. Compensation and Method of Payment. Renton shall make payments to the Agency based on month-end billings. Renton shall pay the Agency for services rendered within thirty days after receipt of an invoice in a form similar to Exhibit D attached hereto and including the information called for in Exhibit C attached hereto. The total amount to be paid shall not exceed $60,000. If the Agency’s invoice, supporting documentation, and reports are not submitted within ninety (90) calendar days after completion of the services, Renton shall be relieved of all DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 3 of 10 liability for payment to the Agency of the amounts identified in the invoice or any subsequent invoice; provided, however, Renton may elect to pay any invoice that is not submitted on time. B. Requirement to report potentially duplicative funding. If the recipient currently has other active awards of funds from or through Renton, or if the re cipient receives another award during this award’s period of performance, the recipient must determine promptly whether funds from any of those other awards have been, are being, or are to be used (in whole or in part) for one or more of the identical cost items for which funds are provided under this award. If so, the recipient must promptly notify Renton in writing of the potential duplication, and, if Renton requests must seek a budget-modification or change-of-project-scope grant adjustment notice (GAN) to eliminate any inappropriate duplication of funding. 5. Monitoring: Even though the Agency is an independent contractor with the authority to control and direct the performance and details of the Services authorized under this Agreement, the Services must meet the approval of Renton and shall be subject to Renton’s general right of inspection to secure satisfactory completion. Renton shall review reports to monitor compliance with the level of service required in the Scope of Service. Renton may also review program performance periodically on-site. Should the Agency fail to meet the minimum level of service represented by the Performance Measures in Exhibit B, Renton reserves the right to adjust payments a specified in Paragraph 4 (B), “Criteria for Compensation”. 6. Record Maintenance: The Agency shall maintain accounts and records, which properly reflect all direct and indirect costs expended and Services provided in the performance of this Agreement and retain such records for as long as may be required by applicable Washington State records retention laws, but in any event no less than six years after the termination of this Agreement. The Agency agrees to provide access to and copies of any records related to this Agreement as required by the City to audit expenditures and charges and/or to comply with the Washington State Public Records Act (Chapter 42.56 RCW). The provisions of this section shall survive the expiration or termination of this Agreement. 7. Project Files: The Agency shall maintain files for this project containing the following items: A. Notice of Grant Award. B. Motions, resolutions, or minutes documenting Board or Council actions. C. A copy of this Agreement and all exhibits, and Scope and Schedule of Work correspondence regarding budget revision requests. D. Copies of all project invoice, reports and documentation submitted to Renton. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 4 of 10 8. Reporting Requirements: No payment will be made to the Agency until all reports requested by Renton are fully completed and executed by the Agency and approved by Renton. The Agency shall submit the reports specified in Exhibit B (Scope and Schedule of Work), on the deadlines specified such exhibit.. 9. Public Records Compliance: To the full extent the City determines necessary to comply with the Washington State Public Records Act, Agency shall make a due diligent search of all records in its possession or control relating to this Agreement and the Services, including, but not limited to, e-mail, correspondence, notes, saved telephone messages, recordings, photos, or drawings and provide them to the City for production. In the event Agency believes said records need to be protected from disclosure, it may, at Agency’s own expense, seek judicial protection. Agency 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 Agency has responsive records and for which Agency has withheld records or information contained therein, or not provided them to the City in a timely manner. Agency shall produce 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. 10. Independent Contractor Relationship: A. The Agency is retained by the City only for the purposes and to the extent set forth in this Agreement. The nature of the relationship between the Agency and the City during the period of the Services shall be that of an independent contractor, not employee. The Agency, not the City, shall have the power to control and direct the details, manner or means of Services. Specifically, but not by means of limitation, the Agency shall have no obligation to work any particular hours or particular schedule, unless otherwise indicated in the Scope of Service or where scheduling of attendance or performance is mutually arranged due to the nature of the Services. Agency shall retain the right to designate the means of performing the Services covered by this agreement, and the Agency shall be entitled to employ other workers at such compensation and such other conditions as it may deem proper, provided, however, that any contract so made by the Agency is to be paid by it alone, and that employing such workers, it is acting individually and not as an agent for the City. B. The City shall not be responsible for withholding or otherwise deducting federal income tax or Social Security or contributing to the State Industrial Insurance Program, or otherwise assuming the duties of an employer with respect to Agency or any employee of the Agency. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 5 of 10 11. Hold Harmless: The Agency agrees to release, indemnify, defend, and hold harmless the City, elected officials, employees, officers, representatives, and volunteers from any and all claims, demands, actions, suits, causes of action, arbitrations, mediations, proceedings, judgments, awards, injuries, damages, liabilities, taxes, losses, fines, fees, penalties, expenses, attorney’s or attorneys’ fees, costs, and/or litigation expenses to or by any and all persons or entities, arising from, resulting from, or related to the negligent acts, errors or omissions of the Agency in its performance of this Agreement or a breach of this Agreement by Agency, except for that portion of the claims caused by the City’s sole negligence. Should a court of competent jurisdiction determine that this agreement is subject to RCW 4.24.115, (Validity of agreement to indemnify against liability for negligence relative to construction, alteration, improvement, etc., of structure or improvement attached to real estate…) then, in the event of liability for damages arising out of bodily injury to persons or damages to property caused by or resulting from the concurrent negligence of the Agency and the City, its officers, officials, employees and volunteers, Agency’s liability shall be only to the extent of Agency’s negligence. It is further specifically and expressly understood that the indemnification provided in this Agreement constitute Agency’s waiver of immunity under the Industrial Insurance Act, RCW Title 51, solely for the purposes of this indemnification. The Parties have mutually negotiated and agreed to this waiver. The provisions of this section shall survive the expiration or termination of this Agreement. 12. Gifts and Conflicts: 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 Agency shall not give a gift of any kind to City employees or officials. Agency also confirms that Agency 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 Agency, negotiating or administering this Agreement, or evaluating the Agency’s performance of the Services. 13. City of Renton Business License: The Agency shall obtain a City of Renton Business License prior to performing any Services and maintain the business license in good standing throughout the term of this agreement with the City. Information regarding acquiring a city business license can be found at: http://rentonwa.gov/business/default.aspx?id=548&mid=328 . Information regarding State business licensing requirements can be found at: http://dor.wa.gov/content/doingbusiness/registermybusiness/ 14. Insurance: Agency 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. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 6 of 10 B. In the event that Services 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 Service provided by a licensed professional or Services 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 Agency’s vehicles on the City’s Premises by or on behalf of the City, beyond normal commutes. E. Agency shall name the City as an Additional Insured on its commercial general liability policy on a non-contributory primary basis. The City’s insurance policies shall not be a source for payment of any Agency liability, nor shall the maintenance of any insurance required by this Agreement be construed to limit the liability of Agency 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 Services. G. Agency shall provide the City with written notice of any policy cancellation, within two (2) business days of their receipt of such notice. 15. Successors and Assigns: Neither the City nor the Agency shall assign, transfer or encumber any rights, duties or interests accruing from this Agreement without the written consent of the other. 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. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 7 of 10 City of Renton: Dianne Utecht 1055 South Grady Way, Sixth Floor Renton, WA 98057 Phone: (425) 430-6655 Dutecht@rentonwa.gov Fax: (425) 430-6603 Agency: African Community Housing and Development Hamdi Abdulle 16256 Military Road S, Suite 207 SeaTac, WA 98188 Phone: (206) 371-2327 Hamdia@achdo.org 17. Discrimination Prohibited: Except to the extent permitted by a bona fide occupational qualification, the Agency agrees as follows: A. Agency, and Agency’s agents, employees, representatives, and volunteers with regard to the Services performed or to be performed under this Agreement, shall not discriminate on the basis of race, color, sex, religion, nationality, creed, marital status, sexual orientation or preference, age (except minimum age and retirement provisions), honorably discharged veteran or military status, or the presence of any sensory, mental or physical handicap, unless based upon a bona fide occupational qualification in relationship to hiring and employment, in employment or application for employment, the administration of the delivery of Services or any other benefits under this Agreement, or procurement of materials or supplies. B. The Agency will take affirmative action to insure that applicants are employed and that employees are treated during employment without regard to their race, creed, color, national origin, sex, age, sexual orientation, physical, sensory or mental handicaps, or marital status. Such action shall include, but not be limited to the following employment, upgrading, demotion or transfer, recruitment or recruitment advertising, layoff or termination, rates of pay or other forms of compensation and selection for training. C. If the Agency fails to comply with any of this Agreement’s non-discrimination provisions, the City shall have the right, at its option, to cancel the Agreement in whole or in part. D. The Agency is responsible to be aware of and in compliance with all federal, state and local laws and regulations that may affect the satisfactory completion of the project, which includes but is not limited to fair labor laws, worker's compensation, and Title VI of the Federal Civil Rights Act of 1964, and will comply with City of Renton Council Resolution Number 4085. 18. Miscellaneous: The parties hereby acknowledge: A. The City is not responsible to train or provide training for Agency. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 8 of 10 B. Agency will not be reimbursed for job related expenses except to the extent specifically agreed within the attached exhibits. C. Agency shall furnish all tools and / or materials necessary to perform the Services except to the extent specifically agreed within the attached exhibits. D. In the event special training, licensing, or certification is required for Agency to provide Services he / she will acquire or maintain such at his / her own expense and, if Agency employs, sub-contracts, or otherwise assigns the responsibility to perform the Services, said employee / sub-contractor / assignee will acquire and or maintain such training, licensing, or certification. E. This is a non-exclusive agreement and Agency is free to provide his / her Services to other entities, so long as there is no interruption or interference with the provision of Services called for in this Agreement. F. Agency is responsible for his / her own insurance, including, but not limited to health insurance. G. Agency is responsible for his / her own Worker’s Compensation coverage as well as that for any persons employed by the Agency. 19. Other Provisions: A. Approval Authority. Each individual executing this Agreement on behalf of the City and Agency represents and warrants that such individuals are duly authorized to execute and deliver this Agreement on behalf of the City or Agency. B. General Administration and Management. The City’s project manager is Dianne Utecht. In providing Services, Agency shall coordinate with the City’s contract manager or his/her designee. C. Amendment and Modification. This Agreement may be amended only by an instrument in writing, duly executed by both Parties. D. Conflicts. In the event of any inconsistencies between Agency 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 an Agency 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. E. Governing Law. This Agreement shall be made in and shall be governed by and interpreted in accordance with the laws of the State of Washington and the City of DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 9 of 10 Renton. Agency and all of the Agency’s employees shall perform the Services in accordance with all applicable federal, state, county and city laws, codes and ordinances. F. Joint Drafting Effort. This Agreement shall be considered for all purposes as prepared by the joint efforts of the Parties and shall not be construed against one party or the other as a result of the preparation, substitution, submission or other event of negotiation, drafting or execution. G. Jurisdiction and Venue. 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 County Superior Court for the State of Washington at the Maleng Regional Justice Center in Kent, King County, Washington, or its replacement or successor. H. Severability. A court of competent jurisdiction’s determination that any provision or part of this Agreement is illegal or unenforceable shall not cancel or invalidate the remainder of this Agreement, which shall remain in full force and effect. I. Sole and Entire Agreement. This Agreement contains the entire agreement of the Parties and any representations or understandings, whether oral or written, not incorporated are excluded. J. Time is of the Essence. Time is of the essence of this Agreement and each and all of its provisions in which performance is a factor. Adherence to completion dates set forth in the description of the Services is essential to the Agency’s performance of this Agreement. K. Third-Party Beneficiaries. Nothing in this Agreement is intended to, nor shall be construed to give any rights or benefits in the Agreement to anyone other than the Parties, and all duties and responsibilities undertaken pursuant to this Agreement will be for the sole and exclusive benefit of the Parties and no one else. L. Assigns and Successors. The Parties each bind themselves, their partners, successors, assigns, and legal representatives to the other party to this Agreement, and to the partners, successors, assigns, and legal representatives of such other party with respect to all covenants of the Agreement. M. Waivers. All waivers shall be in writing and signed by the waiving party. Either party’s failure to enforce any provision of this Agreement shall not be a waiver and shall not prevent either the City or Agency from enforcing that provision or any other provision of this Agreement in the future. Waiver of breach of any provision of this Agreement shall not be deemed to be a waiver of any prior or subsequent breach unless it is expressly waived in writing. N. Counterparts. 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. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Page 10 of 10 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:_____________________________ AGENCY: African Community Housing and Development By:____________________________ Armondo Pavone Mayor Hamdi Abdulle Executive Director _____________________________ Date _____________________________ Date Attest _____________________________ Jason A. Seth City Clerk Approved as to Legal Form By Renton City Attorney’s Office _______________________________ By: Leslie Clark Senior Assistant City Attorney DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 9/24/2020 | 7:34 AM PDT 9/24/2020 | 9:53 AM PDT DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Exhibit B - Scope and Schedule of Work 1 Exhibit B Scope and Schedule of Work 2020 Program Services Agreement Rent and Utility Assistance Agency: African Community Housing and Development 2020 CARES Funding: $60,000 Program: Rental Assistance This funding will provide: Rental assistance for households affected by COVID Total: $60,000 Effective Date August 1- October 30, 2020 Annual Program Outputs: Unduplicated Renton Residents 17 Number of individuals or families provided with rental assistance 17 Number of individuals or families provided with utility assistance 4 The Agency shall provide the approximate number of City of Renton clients with the following services. Services shall be provided in a manner which fully complies with all applicable federal, state and local laws, statutes, ordinances rules and regulations, as are now in effect or may be amended or enacted during the course of the Agreement. Service Unit (“SU”)/Performance Measures Goals Unduplicated City of Renton residents served 17 SU 1 # of individuals or families receiving rental assistance. 17 SU 2 # of individuals or families receiving utility assistance 4 Definition of Units of Service: (Customize for each agency) Service Unit 1: Number of households impacted by COVID-19 in need of rent assistance. Agency shall make payments directly to the landlord. No payments shall be made directly to households. The estimated amount of funding provided for direct rental assistance per family/household is $3000. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Exhibit B - Scope and Schedule of Work 2 Service Unit 2: Number of households impacted by COVID-19 in need of utility assistance. Agency shall make payments directly to the utility. No payments shall be made directly to households. The estimated amount of funding provided for utility assistance per family/household shall not exceed $500. Budget $60,000 Personnel/Administrative costs (NTE 10%) $6,000 Direct Assistance to Clients $54,000 The above Services shall be provided by October 31, 2020. ELIGIBILITY: 1. Services provided with funding under this exhibit shall be limited to residents of Renton. 2. Economic support to client is COVID-19 related, resulting from employment and/or business interruptions due to COVID-19 –related business closures, and/or inability to work due to COVID-19 illness of client or a family member. 3. Clients meet the applicable income guidelines. The purpose of this program is to provide assistance to the most income vulnerable population (those with household income of 50% or below of AMI area median income (AMI)), but clients with household income of up to 80% of AMI can qualify. 4. Assistance will not be a duplication of benefits, i.e. the cost has not or will not be paid by another source. INCOME GUIDELINES 2020 HUD INCOME GUIDELINES Median Family Income = $113,300 Effective April 1, 2020 30% MEDIAN 50% MEDIAN 80% MEDIAN FAMILY EXTREMELY LOW- MODERATE- SIZE LOW-INCOME INCOME INCOME 1 $25,100 $41,800 $66,700 2 $28,650 $47,800 $76,200 3 $32,250 $53,750 $85,750 4 $35,800 $59,700 $95,250 5 $38,700 $64,500 $102,900 6 $41,550 $69,300 $110,500 7 $44,400 $74,050 $118,150 8 $47,300 $78,850 $125,750 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 Exhibit B - Scope and Schedule of Work 3 RECORDS REQUIRED: Records shall be maintained that provide: 1) Income information based on the 2020 HUD Income Guidelines Table . 2) Documentation that each recipient’s family income does not exceed the applicable limits. 3) Documentation that assistance will not be a duplication of benefits. 4) Records of payments to landlords/utilities include the address for which payment was made. An example of such record is certification from a landlord that rent was due for an address for which payment was made under this Agreement. REPORTING: 1. Performance Measures/Demographics Report: The Agency shall collect and retain performance measure and demographic data from the persons served through this contract. Data shall be tracked in an ongoing manner and submitted in a Performance Measures/Demographic Report form approved by the City (Exhibit C). Such report shall be included with each invoice, along with any required receipts/timesheets, and be provided to the City in accordance with the due dates below. 2. Summary of expenses: The Agency shall submit monthly detailed receipts of funds spent under this grant. Receipts shall document the amount spent, a detailed description of the cost and date incurred. For administrative costs; payroll records documenting the time, a description of work performed and support showing amount paid. 3. Eligibility: The Agency shall collect and maintain the applicable documents required to confirm eligibility and shall supply these documents upon request by the City. Reporting Due Dates: REPORT CUT OFF DATES CHECK DATES MONTHLY INVOICES / REPORTS: 1st Reimbursement (September 15-September 30 October 8 October 15 2nd Reimbursement (October 1-October 15)) October 23 October 30 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 EXHIBIT C City of Renton, Washington 2020 Human Services Performance Measures/Demographics Reporting Form for CARES Act COVID-19 fundingName of Agency: Reporting Period: Contract Amount Goal Amount ($) spent No. Renton Households/ Individuals served Amount ($) spent No. Renton Households/ Individuals served Amount ($) spent No. Renton Households/ Individuals served TOTAL Amount ($) spent TOTAL No. Renton Households/ Individuals served Rental/Utility Assistance 0 0 Food Assistance/Direct Food Purchases 0 0 Other (Specify) e.g. PPE supplies 0 0 attach all receipts and supporting documentation TOTALS 0 0 0 0 0 0 0 0 0 Demographics: Race/Ethnicity: White 0 Black/African American 0 Asian/Asian American 0 American Indian/Alaskan Native 0 Latino, Latino American, Hispanic 0 Native Hawaiian/Pacific Islander 0 Multi-Race/Other 0 Unknown 0 TOTALS 0 0 0 0 Narrative: August 1 - 31, 2020 Sept. 1 - Sept. 30, 2020 TOTALSOctober 1-October 15, 2020 DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9 EXHIBIT D Billing Voucher To: Dianne Utecht City of Renton 1055 South Grady Way, 6th Floor Renton, Washington 98057 Phone: (425) 430-6655 Facsimile: (425) 430-6603 Contractor: ______________________________ Telephone: ____________________ Mailing Address: _________________________________________________________ Specific Program: _________________________________________________________ Contract period: Reporting Period: Amount requested this invoice: $_____________________ Invoice Number: ____________________ Date of Invoice _______________________ __________________________________ Authorized signature ---------------------------------------------------------------- BUDGET SUMMARY: Total contract amount $______________ Previous payments $______________ Current request $______________ Total requested this contract to date $______________ Balance remaining $______________ Note: The Contractor should use its invoice form. If the invoice does not include the Budget Summary information shown above, then this form should be included with the Contractor’s invoice. DocuSign Envelope ID: 83E8179D-AE1C-4425-9829-2373394E49B9