HomeMy WebLinkAboutContractCAG-20-409
0
01
AGREEMENT BETWEEN THE CITY OF RENTON AND LUTHER'S TABLE: CARES ACT
EMERGENCY SMALL BUSINESS SUPPORT GRANT
THIS AGREEMENT ("Agreement") is dated for reference purposes only as this 26th day of
October 2020, and is made by and between the City of Renton, a Washington municipal
corporation (the "City") and Luther's Table LLC ("Recipient"), collectively referred to as the
"Parties."
WHEREAS, on March 5, 2020, the City issued a proclamation of local emergency due to
the public health impacts of COVID-19; and
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, all due to COVID-19; 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, under the phased transition, many businesses located in the City are open only
with a limited capacity and/or reduced operations; and
WHEREAS, disruptions to workers and small businesses are serious, as small businesses
are a critical component of our economy, and provide a foundation of employment, services for
the community, and revenue for cities and other public agencies to continue to provide essential
services for the public welfare and benefit; and
WHEREAS, resources are necessary to help small businesses survive and certain small
businesses reasonably require public aid in order to survive; 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 Washington State Department of Commerce ("Commerce"); and
WHEREAS, the City entered into an Interagency Agreement (the "Interagency
Agreement") with Commerce regarding the Fund for the period March 1, 2020 through October
31, 2020, attached hereto as Exhibit 1 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 Small Business Support Program (the "Program"). The focus
of the Program is to provide short-term economic stability via monetary grants to qualifying small
businesses located within City limits that qualify under applicable federal, state, and local criteria;
and
WHEREAS, the City established an application program laying out eligibility criteria for the
Program. The City's eligibility criteria are as follows: (1) the business is located in a building with
a commercial storefront or office within Renton city limits; (2) the business has been in operation
for at least two (2) years; (3) the business has a current City of Renton business license; (4) the
business has no more than 25 employees; and (5) the business is not owned, or partially owned,
by managers, officers, directors or public officials associated with the City of Renton; and
WHEREAS, the City made the application available to small businesses to seek funding
under the Program, and Recipient applied. Recipient's application (the "Application") is attached
hereto as Exhibit 2 and incorporated herein; and
WHEREAS, the City has reviewed the Application and determined that the Recipient is
eligible for assistance under this Program because (1) the business is located in a building with a
commercial storefront or office within Renton city limits; (2) the business has been in operation
for at least two (2) years; (3) the business has a current City of Renton business license; (4) the
business has 1 employee; and (5) the business is not owned, or partially owned, by managers,
officers, directors or public officials associated with the City of Renton.
NOW THEREFORE, in consideration of the mutual covenants and agreements herein, the
Parties agree as follows:
AGREEMENT
1. Allowable Expenses. The total amount to be awarded to Recipient under the Program
is $5,000 ("Program Award Funds"). Recipient shall use Grant Funds only to pay or
0
PAGE 2 OF 6
reimburse Recipient for expenses allowable under the CARES Act and the Interagency
Agreement,
2. Time Period and Expenses Incurred in Excess of Program Award Funds.
a. The Recipient acknowledges that all expenses must be incurred by the
Recipient during the allowable time period established under the CARES Act
and the Interagency Agreement. (This time period was originally March 1,
2020 through October 31, 2020, but is subject to change.)
b. The Recipient acknowledges that any expenses incurred in excess of Program
Award Funds are the Recipient's sole responsibility and will not be paid by
the City.
3. Recipient's Compliance Obligations.
a. Compliance with laws, regulations, and other obligations.The Recipient shall
comply with and obey all applicable federal, state and local laws, regulations,
and ordinances. Should the Recipient's spending of the Program Award Funds
be inconsistent with applicable laws, provisions of this Agreement, provisions
of the CARES Act, provisions of the Interagency Agreement, information
Recipient provided in the Application, or otherwise inappropriate, the City
shall have the right to the return of any portion of the Funds that are later
determined to have been spent in violation. Unless exigent circumstances
exist, the City shall not exercise this right until it has given Recipient written
notice of Recipient's noncompliance, and allowed Recipient a period of ten
(10) days from the date of notice for Recipient to cure the noncompliance.
The right of recapture provided in this section is in addition to and not in lieu
of any right which Washington law provides for breach of contract.
b. Requirement to Provide Accurate Information. The Recipient understands
and acknowledges that providing false information in the Application or on
any documents submitted to the City or its designees as part of the
Recipient's participation in the Program may constitute fraud, justify
termination of this Agreement, trigger the Recipient's obligation to return
funds, and may be subject to civil and/or criminal penalties and/or sanctions.
c. No Use of Program Award Funds for Expenses Covered by Other Proerams,
The Recipient shall not use Program Award Funds to cover expenses for
which the Recipient has received other federal, state or regional funds,
including without limitation funds made available under the Payroll
Protection Program ("PPP") or unemployment insurance compensation.
d. Certification Regarding Debarment, Suspension. Ineligibility and Voluntary
Exclusion — Lower Tier Covered Transaction. Recipient certifies, by signing this
e)
PAGE 3 OF 6
Agreement that neither it nor its principals is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal or State department or
agency.
4. Maintenance of Records.
a. The Recipient shall maintain accurate written records reflecting all of
Recipient's direct and indirect expenditures of Program Award Funds. These
records must be sufficient to demonstrate that the Program Award Funds
have been used in accordance with Section 601(d) of the Social Security Act.
To the extent necessary for the City to comply with the City's obligations
under the CARES Act and/or the Interagency Agreement, the City review the
documentation to determine the Recipient's conformance with the
requirements of the Program, and the Recipient shall make available to the
City, upon request, all of the Recipient's records and documents with respect
to all matters covered by this Agreement.
b. The City may require the Recipient to provide additional documentation if the
existing documentation is deemed incomplete.
c. The Recipient shall retain all records related to this Agreement for a period of
six (6) years following the receipt of Program Award Funds. These records,
including materials generated under the Agreement, shall be subject at all
reasonable times to inspection and review by the City, and to an audit by
Commerce, personnel duly authorized by Commerce, the Office of the State
Auditor, and other federal and state officials so authorized by law, regulation
or agreement.
d. If any litigation, claim or audit is started before the expiration of the six (6)
year period provided in Section 4(c) above, the records shall be retained until
all litigation, claims, or audit findings involving the records have been
resolved.
5. No Employee Relationship. The Recipient understands and acknowledges that
neither the Recipient nor any officer, employee or agent of the Recipient 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
Recipient or any employee of the Recipient.
6. Indemnification. The Recipient agrees to release, indemnify, defend, and hold
harmless the City, elected officials, employees, officers, representatives, and
0
PAGE 4 OF 6
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
Recipient or sub -Recipients, except for that portion of the claim caused by the City's
sole negligence . In the event of any dispute between the Recipient and its
employees, subcontractors or anyone with a claim to some or all of the Recipient's
Program award funds, the Recipient shall be responsible for resolution of any such
claim and the City shall have no responsibility nor obligation in the resolution
process nor outcome. The Recipient shall ensure that any sub -recipient of any
Program award funds shall agree to defend and indemnify the City to the extent and
on the same terms and conditions as the Recipient's indemnification of the City.
7. Non-discrimination. During the performance of this Agreement, the Company 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.
8. Effective Date. The effective date of this Agreement shall be the last date signed by
the Parties.
9. Interagency Agreement Amendments. The Parties acknowledge that Commerce or
other agencies of the State of Washington may request changes to the Fund or the
provisions of the Interagency Agreement. Any changes or revisions to the Fund or
the Interagency Agreement terms and conditions that are applicable to this
Agreement shall be incorporated by amendment of this Agreement, following
written notice by City to the Recipient.
10. Public Disclosure. All Recipient documents and records comprising the Agreement,
including the Application, and all other documents and records provided to the City
by the Recipient are deemed public records subject to disclosure and release under
the Washington State Public Records Act, Chapter 42.56 RCW, unless an exemption
under the Public Records Act or other laws applies.
11. 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.
•S $Y
PAGE 5 OF 6
12. Waiver. Any waiver by the Recipient 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.
13. Modification. This Agreement may only be amended by written agreement signed by
both Parties.
14. 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 this Agreement are declared severable.
IN WITNESS WHEREOF, the Parties have voluntarily entered into this Agreement as of
the date last signed by the Parties below.
CITY OF RENTON
r
By: .
C.E. "Chip" Vincent
CED Administrator
10/29/2020
Date
Approved as to Legal Form
Approved by Leslie Clark via 8-17-2020 email
Shane Moloney
Renton City Attorney
0
PAGE 6 OF 6
RECIPIENT
By:
John Long
Luther's Table LLC
/D, 7 J j,o
Date
Exhibit 1
INTERAGENCY AGREEMENT
[See following pages.]
0
PAGE 7 OF 8
CAG-20-124
., . Washington State
Depent of
� Co iiiim ice
Interagency Agreement with
For
City of Renton
through
the Coronavirus Relief Fund for Local Governments
Costs incurred due to the public health emergency with respect to
the Coronavirus Disease 2019 (COVID-19) during the period of
March 1, 2020 thru October 31, 2020.
Start date: March 1, 2020
TABLE OF CONTENTS
Special Terms and Conditions
1. Authority........................................................................................ ...1
2. Acknowledgement of Federal Funding........................................................1
3. Contract Management...........................................................................................1
4. Compensation........................................................................................................1
5. Expenses.............................................................................................1
6. Indirect Costs........................................................................................ 1
7. Billing Procedures and Payment............................................................................1
8. Audit.................................................................................................... 2
9. Debarment............................................................................................ 3
10. Laws.......................................................................................................................3
11. Order of Precedence.............................................................................................. 4
General Terms and Conditions
1.
Definitions.............................................................................................................. 5
2.
All Writings Contained Herein................................................................................
5
3.
Amendments..........................................................................................................5
4.
Assignment............................................................................................................
5
5.
Confidentiality and Safeguarding of Information....................................................
5
6.
Copyright................................................................................................................6
7.
Disputes.................................................................................................................6
8.
Governing Law and Venue....................................................................................
6
9.
Indemnification.......................................................................................................
7
10.
Licensing, Accreditation and Registration.............................................................
7
11.
Recapture..............................................................................................................
7
12.
Records Maintenance............................................................................................
7
13.
Savings..................................................................................................................
7
14.
Severability............................................................................................................
7
15.
Subcontracting.......................................................................... ............7
.................
16.
Survival..................................................................................................................8
17.
Termination for Cause...........................................................................................
8
18.
Termination for Convenience.................................................................................
8
19,
Termination Procedures........................................................................................
8
20.
Waiver....................................................................................................................9
AttachmentA,
Scope of Work...................................................................................................10
AttachmentB,
Budget & Invoicing.............................................................................................12
Attachment
C, A-19 Certification................................................................................................13
Attachment
D, A-19 Activity Report ...........................................................................................15
FACE SHEET
Contract Number: 20-6541 C-300
Washington State Department of Commerce
Local Government Division
Community Capital Facilities Unit
Coronavirus Relief Fund for Local Governments
1. Contractor
2. Contractor Doing Business As (optional)
City of Renton
1055 S Grady Way
Renton, Washington 98057-3232
3. Contractor Representative
4. COMMERCE Representative
Kari Roller
Chuck Hunter P.O. Box 42525
Fiscal Services Director
Project Manager 1011 Plum Street SE
(425) 430-6931
(360) 764-3312 Olympia, WA 98504-2525
krolle► Trentonwa.gov
Fax 360-586-5880
chuck.hunter[cvcommerce.wa.gov
5. Contract Amount
6. Funding Source
7. Start Date
Federal: X State: Other: N/A:
March 1, 2020
=End$3,141,000.00 2020
9. Federal Funds (as applicable) Federal Agency: CFDA Number: Indirect Rate (if applicable):
$3,141,000.00 US Dept. of the Treasury 21.019 10.00%
10. Tax ID #
IL SWV #
12. UBI #
13. DUNS #
XXXXXXXXXXXXXX
SWVOO12200-11
999999999
N/A
14. Contract Purpose
To provide funds for costs incurred due to the public health emergency with respect to the Coronavirus Disease 2019 (COVID-19)
during the period of March 1, 2020 thru October 31, 2020. Final invoices must be received by November 15, 2020.
15. Signing Statement
COMMERCE, defined as the Department of Commerce, and the Contractor, as defined above, acknowledge and accept the terms of
this Contract and Attachments and have executed this Contract on the date below and warrant they are authorized to bind their
respective agencies. The rights and obligations of both parties to this Contract are governed by this Contract and the following
documents hereby incorporated by reference: Attachment "A" -- Scope of Work, Attachment "B" — Budget & Invoicing, Attachment
"C" A-19 Certification, Attachment "D" A-19 Activity Report
FOR T C OR
FOR COMMERCE
110
Mark K. arkley, Ass stant Director, Local Government Division
one, Mayor %,
' SEAL
Date �`'% a'Qa/�''rn ti' ao-
Date
Attest. '�r,�rjr A .ED S
APPROVED AS TO FORM ONLY BY ASSISTANT
Jason Se , City C
ATTORNEY GENERAL 05-01-2020.
APPROVAL ON FILE.
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
1. AUTHORITY
COMMERCE and Contractor enter into this Contract pursuant to the authority granted by the Interlocal
Cooperation Act, Chapter 39.34 RCW.
2. ACKNOWLEDGMENT OF FEDERAL FUNDS
Funds under the Contract are made available and are subject to Section 601(a) of the Social Security
Act, as amended by section 5001 of the Coronavirus Aid, Relief, and Economic Security Act (CARES
Act), and Title V and VI of the CARES Act.
The Contractor agrees that any publications (written, visual, or sound) but excluding press releases,
newsletters, and issue analyses, issued by the Contractor describing programs or projects funded in whole
or in part with federal funds under this Contract, shall contain the following statements:
"This project was supported by a grant awarded by US Department of the Treasury. Points of
view in this document are those of the author and do not necessarily represent the official position
or policies of the US Department of the Treasury. Grant funds are administered by the Local
Government Coronavirus Relief Fund thru the Washington State Department of Commerce."
3. CONTRACT MANAGEMENT
The Representative for each of the parties shall be responsible for and shall be the contact person for all
communications and billings regarding the performance of this Contract.
The Representative for COMMERCE and their contact information are identified on the Face Sheet of
this Contract.
The Representative for the Contractor and their contact information are identified on the Face Sheet of
this Contract.
4. COMPENSATION
COMMERCE shall pay an amount not to exceed the contract amount listed on the Face Sheet for the
performance of all things necessary for or incidental to the performance of work under this Contract as set
forth in the Scope of Work (Attachment A).
5. EXPENSES
Contractor shall receive reimbursement for allowable expenses as identified in the Scope of Work
(Attachment A) or as authorized in advance by COMMERCE as reimbursable.
Travel expenses may include airfare (economy or coach class only), other transportation expenses, and
lodging and subsistence necessary during periods of required travel. Contractor shall receive compensation
for travel expenses at current state travel reimbursement rates.
6. INDIRECT COSTS
Contractor shall provide their indirect cost rate that has been negotiated between their entity and the federal
govemment. If no such rate exists a de minimis indirect cost rate of 10% of modified total direct costs
(MTDC) will be used.
7. BILLING PROCEDURES AND PAYMENT
COMMERCE shall reimburse the Contractor for eligible Project expenditures, up to the maximum payable
under this Contract, When requesting reimbursement for expenditures made, Contractor shall submit all
Invoice Vouchers and any required documentation electronically through COMMERCE's Contracts
Management System (CMS), which is available through the Secure Access Washington (SAW) portal. If
the Contractor has constraints preventing access to COMMERCE's online A-19 portal, a hard copy A-19
form may be provided by the COMMERCE Project Manager upon request.
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 1
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERALFUNDS
The voucher must be certified by an official of the Contractor with authority to bind the Contractor. The final
voucher shall be submitted to COMMERCE no later than November 15, 2020.
COMMERCE will pay Contractor upon acceptance of services provided and receipt of properly completed
invoices, which shall be submitted to the Representative for COMMERCE not more often than monthly.
The invoices shall describe and document, to COMMERCE's satisfaction, reimbursable expenditures as
set forth under the Scope of Work (Attachment A) and Budget & Invoicing (Attachment B). The invoice shall
include the Contract Number as stated on the Face Sheet.
Each voucher must be accompanied by an A-19 Certification (Attachment C) and A-19 Activity Report
(Attachment D). The A-19 Certification must be certified by an authorized party of the Contractor to certify
and attest all expenditures submitted on the voucher are in compliance with the United States Treasury
Coronavirus Relief Fund ("Fund") Guidance for State, Territorial, Local, and Tribal Governments:
https //home treasury aov/system/ iles/136/Coronavirus-Relief-Fund-Guidance-for-State-Territorial-Local-
and-Tribal-Governments.pdf
The A-19 Activity Report must be submitted which describes, in Excel spreadsheet and narrative form, a
detailed breakdown of the expenditures within each applicable budget sub -category identified in the
voucher, as well as a report of expenditures to date. COMMERCE will not release payment for any
reimbursement request received unless and until the A-19 Certification and A-19 Activity Report is received.
After approving the Invoice Voucher, A-19 Certification and Activity Report, COMMERCE shall promptly
remit a warrant to the Contractor.
Payment shall be considered timely if made by COMMERCE within thirty (30) calendar days after receipt
of properly completed invoices. Payment shall be sent to the address designated by the Contractor.
COMMERCE may, in its sole discretion, terminate the Contract or withhold payments claimed by the
Contractor for services rendered if the Contractor fails to satisfactorily comply with any term or condition of
this Contract.
No payments in advance or in anticipation of services or supplies to be provided under this Agreement shall
be made by COMMERCE.
Duplication of Billed Costs
The Contractor shall not bill COMMERCE for services performed under this Agreement, and COMMERCE
shall not pay the Contractor, if the Contractor is entitled to payment or has been or will be paid by any other
source, including grants, for that service.
Disallowed Costs
The Contractor is responsible for any audit exceptions or disallowed costs incurred by its own organization
or that of its subcontractors.
Should the Contractor be found to spent funds inconsistent with federal laws, rules, guidelines, or otherwise
inappropriately, it is the responsibility of the Contractor to reimburse Commerce for any amount spent on
disallowed costs.
8. AUDIT
Contractor shall maintain internal controls providing reasonable assurance it is managing federal awards
in compliance with laws, regulations, and provisions of contracts or grant agreements that could have a
material effect on each of its federal programs; and prepare appropriate financial statements, including a
schedule of expenditures of federal awards
If the Contractor is a subrecipient and expends $750,000 or more in federal awards from any and/or all
sources in any fiscal year, the Contractor shall procure and pay for a single audit or a program -speck
audit for that fiscal year. Upon completion of each audit, the Contractor shall:
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 2
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
A. Submit to COMMERCE the reporting package specified in OMB Super Circular 2 CFR 200,501,
reports required by the program -specific audit guide (if applicable), and a copy of any management
letters issued by the auditor.
B. Submit to COMMERCE follow-up and developed corrective action plans for all audit findings.
If the Contractor is a subrecipient and expends less than $750,000 in federal awards from any and/or all
sources in any fiscal year, the Contractor shall notify COMMERCE they did not meet the single audit
requirement.
The Contractor shall send all single audit documentation to au ditreviewCD_commerce.wa.00v.
9. DEBARMENT
A. Contractor, defined as the primary participant and it principals, certifies by signing these General Terms
and Conditions that to the best of its knowledge and belief that they:
i. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency.
ii. Have not within a three-year period preceding this Contract, been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection
with obtaining, attempting to obtain, or performing a public or private agreement or transaction,
violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery,
bribery, falsification or destruction of records, making false statements, tax evasion, receiving
stolen property, making false claims, or obstruction of justice;
iii. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph
(1)(b) of federal Executive Order 12549; and
iv. Have not within a three-year period preceding the signing of this Contract had one or more
public transactions (Federal, State, or local) terminated for cause of default.
B. Where the Contractor is unable to certify to any of the statements in this Contract, the Contractor shall
attach an explanation to this Contract.
C. The Contractor agrees by signing this Contract that it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this covered transaction, unless authorized by COMMERCE.
D. The Contractor further agrees by signing this Contract that it will include the clause titled "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered
Transaction," as follows, without modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions:
LOWER TIER COVERED TRANSACTIONS
i. The lower tier Contractor certifies, by signing this Contract that neither it nor its principals is
presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from participation in this transaction by any Federal department or agency.
ii. Where the lower tier Contractor is unable to certify to any of the statements in this Contract,
such contractor shall attach an explanation to this Contract.
E. The terms covered transaction, debarred, suspended, ineligible, lower tier covered transaction,
person, primary covered transaction, principal, and voluntarily excluded, as used in this section,
have the meanings set out in the Definitions and Coverage sections of the rules implementing Executive
Order 12549. You may contact COMMERCE for assistance in obtaining a copy of these regulations.
10. LAWS
The Contractor shall comply with all applicable laws, ordinances, codes, regulations, and policies of local,
state, and federal governments, as now or hereafter amended, including, but not limited to:
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 3
SPECIAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERALFUNDS
United States Laws, Regulations and Circulars (Federal
Contractor shall comply with Uniform Administrative Requirements, Cost Principles, and Audit Requirement
for Federal Award, 2 CFR 200, Subpart F — Audit Requirements.
Contractor shall comply with the applicable requirements of 2 CFR Part 200, including any future
amendments to 2 CFR Part 200, and any successor or replacement Office of Management and Budget
(OMB) Circular or regulation.
Contractor shall comply with Omnibus Crime Control and Safe streets Act of 1968, Title VI of the Civil Rights
Act of 1964, Section 504 of the Rehabilitation Act of 1973, Title II of the Americans with Disabilities Act of
1990, Title IX of the Education Amendments of 1972, The Age Discrimination Act of 1975, and The
Department of Justice Non -Discrimination Regulations, 28 C.F.R. Part 42, Subparts C.D.E. and G, and 28
C.F.R. Part 35 and 39.
11. ORDER OF PRECEDENCE
In the event of an inconsistency in this Contract, the inconsistency shall be resolved by giving precedence
in the following order:
• Applicable federal and state of Washington statutes and regulations
• Special Terms and Conditions
• General Terms and Conditions
• Attachment A — Scope of Work
• Attachment B — Budget & Invoicing
• Attachment C — A-19 Certification
• Attachment D — A-19 Activity Report
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 4
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
1. DEFINITIONS
As used throughout this Contract, the following terms shall have the meaning set forth below:
A. "Authorized Representative" shall mean the Director and/or the designee authorized in writing to
act on the Director's behalf.
B. "COMMERCE" shall mean the Department of Commerce.
C. "Contract" or "Agreement" means the entire written agreement between COMMERCE and the
Contractor, including any attachments, documents, or materials incorporated by reference. E-mail
or facsimile transmission of a signed copy of this contract shall be the same as delivery of an
original.
D. "Contractor" shall mean the entity identified on the face sheet performing service(s) under this
Contract, and shall include all employees and agents of the Contractor.
E. "Personal Information" shall mean information identifiable to any person, including, but not limited
to, information that relates to a person's name, health, finances, education, business, use or receipt
of governmental services or other activities, addresses, telephone numbers, social security
numbers, driver license numbers, other identifying numbers, and any financial identifiers.
F. "State" shall mean the state of Washington.
G. "Subcontractor" shall mean one not in the employment of the Contractor, who is performing all or
part of those services under this Contract under a separate contract with the Contractor. The terms
"subcontractor" and subcontractors" mean subcontractor(s) in any tier.
2. ALL WRITINGS CONTAINED HEREIN
This Contract contains all the terms and conditions agreed upon by the parties. No other
understandings, oral or otherwise, regarding the subject matter of this Contract shall be deemed to
exist or to bind any of the parties hereto.
3. AMENDMENTS
This Contract may be amended by mutual agreement of the parties. Such amendments shall not be
binding unless they are in writing and signed by personnel authorized to bind each of the parties.
4. ASSIGNMENT
Neither this Contract, work thereunder, nor any claim arising under this Contract, shall be transferred
or assigned by the Contractor without prior written consent of COMMERCE.
5. CONFIDENTIALITY AND SAFEGUARDING OF INFORMATION
A. "Confidential Information" as used in this section includes:
i. All material provided to the Contractor by COMMERCE that is designated as "confidential" by
COMMERCE;
ii. All material produced by the Contractor that is designated as "confidential" by COMMERCE;
and
iii. All personal information in the possession of the Contractor that may not be disclosed under
state or federal law.
B. The Contractor shall comply with all state and federal laws related to the use, sharing, transfer,
sale, or disclosure of Confidential Information. The Contractor shall use Confidential Information
solely for the purposes of this Contract and shall not use, share, transfer, sell or disclose any
Confidential Information to any third party except with the prior written consent of COMMERCE or
as may be required by law. The Contractor shall take all necessary steps to assure that Confidential—
Information is safeguarded to prevent unauthorized use, sharing, transfer, sale or disclosure of
Confidential Information or violation of any state or federal laws related thereto. Upon request, the
Contractor shall provide COMMERCE with its policies and procedures on confidentiality.
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 5
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
COMMERCE may require changes to such policies and procedures as they apply to this Contract
whenever COMMERCE reasonably determines that changes are necessary to prevent
unauthorized disclosures. The Contractor shall make the changes within the time period specified
by COMMERCE. Upon request, the Contractor shall immediately return to COMMERCE any
Confidential Information that COMMERCE reasonably determines has not been adequately
protected by the Contractor against unauthorized disclosure.
C. Unauthorized Use or Disclosure. The Contractor shall notify COMMERCE within five (5) working
days of any unauthorized use or disclosure of any confidential information, and shall take necessary
steps to mitigate the harmful effects of such use or disclosure.
6. COPYRIGHT
Unless otherwise provided, all Materials produced under this Contract shall be considered "works for
hire" as defined by the U.S. Copyright Act and shall be owned by COMMERCE. COMMERCE shall be
considered the author of such Materials. In the event the Materials are not considered "works for hire"
under the U.S. Copyright laws, the Contractor hereby irrevocably assigns all right, title, and interest in
all Materials, including all intellectual property rights, moral rights, and rights of publicity to COMMERCE
effective from the moment of creation of such Materials.
"Materials" means all items in any format and includes, but is not limited to, data, reports, documents,
pamphlets, advertisements, books, magazines, surveys, studies, computer programs, films, tapes,
and/or sound reproductions. "Ownership" includes the right to copyright. patent, register and the ability
to transfer these rights.
For Materials that are delivered under the Contract, but that incorporate pre-existing materials not
produced under the Contract, the Contractor hereby grants to COMMERCE a nonexclusive, royalty -
free, irrevocable license (with rights to sublicense to others) in such Materials to translate, reproduce,
distribute. prepare derivative works, publicly perform, and publicly display. The Contractor warrants and
represents that the Contractor has all rights and permissions, including intellectual property rights,
moral rights and rights of publicity, necessary to grant such a license to COMMERCE.
The Contractor shall exert all reasonable effort to advise COMMERCE, at the time of delivery of
Materials furnished under this Contract, of all known or potential invasions of privacy contained therein
and of any portion of such document which was not produced in the performance of this Contract. The
Contractor shall provide COMMERCE with prompt written notice of each notice or claim of infringement
received by the Contractor with respect to any Materials delivered under this Contract. COMMERCE
shall have the right to modify or remove any restrictive markings placed upon the Materials by the
Contractor.
7. DISPUTES
In the event that a dispute arises under this Agreement, it shall be determined by a Dispute Board in
the following manner- Each party to this Agreement shall appoint one member to the Dispute Board.
The members so appointed shall jointly appoint an additional member to the Dispute Board. The
Dispute Board shall review the facts, Agreement terms and applicable statutes and rules and make a
determination of the dispute. The Dispute Board shall thereafter decide the dispute with the majority
prevailing. The determination of the Dispute Board shall be final and binding on the parties hereto. As
an alternative to this process, either of the parties may request intervention by the Governor, as
provided by RCW 43.17.330, in which event the Governor's process will control.
8. GOVERNING LAW AND VENUE
This Contract shall be construed and interpreted in accordance with the laws of the state of Washington,
and any applicable federal laws, and the venue of any action brought hereunder shall be in the Superior
Court for Thurston County.
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 6
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
9. INDEMNIFICATION
Each party shall be solely responsible for the acts of its employees, officers, and agents.
10. LICENSING, ACCREDITATION AND REGISTRATION
The Contractor shall comply with all applicable local, state, and federal licensing, accreditation and
registration requirements or standards necessary for the performance of this Contract.
11. RECAPTURE
In the event that the Contractor fails to perform this Contract in accordance with state laws, federal
laws, and/or the provisions of this Contract, COMMERCE reserves the right to recapture funds in an
amount to compensate COMMERCE for the noncompliance in addition to any other remedies available
at law or in equity.
Repayment by the Contractor of funds under this recapture provision shall occur within the time period
specked by COMMERCE. In the alternative, COMMERCE may recapture such funds from payments
due under this Contract.
12. RECORDS MAINTENANCE
The Contractor shall maintain books, records, documents, data and other evidence relating to this
contract and performance of the services described herein, including but not limited to accounting
procedures and practices that sufficiently and properly reflect all direct and indirect costs of any nature
expended in the performance of this contract.
The Contractor shall maintain records that identify, in its accounts, all federal awards received and
expended and the federal programs under which they were received, by Catalog of Federal Domestic
Assistance (CFDA) title and number, award number and year, name of the federal agency, and name
of the pass -through entity.
The Contractor shall retain such records for a period of six (6) years following the date of final payment.
At no additional cost, these records, including materials generated under the contract, shall be subject
at all reasonable times to inspection, review or audit by COMMERCE, personnel duly authorized by
COMMERCE, the Office of the State Auditor, and federal and state officials so authorized by law,
regulation or agreement.
If any litigation, claim or audit is started before the expiration of the six (6) year period, the records shall
be retained until all litigation, claims, or audit findings involving the records have been resolved.
13. SAVINGS
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this Contract and prior to normal completion, COMMERCE may suspend or
terminate the Contract under the 'Termination for Convenience" clause, without the ten calendar day
notice requirement. In lieu of termination, the Contract may be amended to reflect the new funding
limitations and conditions.
14. SEVERABILITY
The provisions of this contract are intended to be severable. If any term or provision is illegal or invalid
for any reason whatsoever, such illegality or invalidity shall not affect the validity of the remainder of
the contract.
15. SUBCONTRACTING
The Contractor may only subcontract work contemplated under this Contract if it obtains the prior written
approval of COMMERCE.
If COMMERCE approves subcontracting, the Contractor shall maintain written procedures related to
subcontracting, as well as copies of all subcontracts and records related to subcontracts. For cause,
COMMERCE in writing may: (a) require the Contractor to amend its subcontracting procedures as they
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 7
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERAL FUNDS
relate to this Contract; (b) prohibit the Contractor from subcontracting with a particular person or entity;
or (c) require the Contractor to rescind or amend a subcontract.
Every subcontract shall bind the Subcontractor to follow all applicable terms of this Contract. Contractor
shall incorporate 2 CFR Part 200, Subpart F audit requirements into all subcontracts. The Contractor
is responsible to COMMERCE if the Subcontractor fails to comply with any applicable term or condition
of this Contract. The Contractor shall appropriately monitor the activities of the Subcontractor to assure
fiscal conditions of this Contract. In no event shall the existence of a subcontract operate to release or
reduce the liability of the Contractor to COMMERCE for any breach in the performance of the
Contractor's duties.
Every subcontract shall include a term that COMMERCE and the State of Washington are not liable for
claims or damages arising from a Subcontractor's performance of the subcontract.
16. SURVIVAL
The terms, conditions, and warranties contained in this Contract that by their sense and context are
intended to survive the completion of the performance, cancellation or termination of this Contract shall
so survive
17. TERMINATION FOR CAUSE
In the event COMMERCE determines the Contractor has failed to comply with the conditions of this
contract in a timely manner, COMMERCE has the right to suspend or terminate this contract. Before
suspending or terminating the contract, COMMERCE shall notify the Contractor in writing of the need
to take corrective action. If corrective action is not taken within 30 calendar days, the contract may be
terminated or suspended
In the event of termination or suspension, the Contractor shall be liable for damages as authorized by
law including, but not limited to, any cost difference between the original contract and the replacement
or cover contract and all administrative costs directly related to the replacement contract, e.g., cost of
the competitive bidding, mailing, advertising and staff time.
COMMERCE reserves the right to suspend all or part of the contract, withhold further payments, or
prohibit the Contractor from incurring additional obligations of funds during investigation of the alleged
compliance breach and pending corrective action by the Contractor or a decision by COMMERCE to
terminate the contract A termination shall be deemed a "Termination for Convenience" if it is
determined that the Contractor: (1) was not in default: or (2) failure to perform was outside of his or her
control, fault or negligence
The rights and remedies of COMMERCE provided in this contract are not exclusive and are in addition
to any other rights and remedies provided by law.
18. TERMINATION FOR CONVENIENCE
Except as otherwise provided in this Contract, COMMERCE may, by ten (10) business days written
notice, beginning on the second day after the mailing, terminate this Contract, in whole or in part. If this
Contract is so terminated, COMMERCE shall be liable only for payment required under the terms of
this Contract for services rendered or goods delivered prior to the effective date of termination.
19. TERMINATION PROCEDURES
Upon termination of this contract, COMMERCE, in addition to any other rights provided in this contract,
may require the Contractor to deliver to COMMERCE any property specifically produced or acquired
for the performance of such part of this contract as has been terminated. The provisions of the
"Treatment of Assets" clause shall apply in such property transfer.
COMMERCE shall pay to the Contractor the agreed upon price, if separately stated, for completed
work and services accepted by COMMERCE, and the amount agreed upon by the Contractor and
COMMERCE for (i) completed work and services for which no separate price is stated, (ii) partially
completed work and services, (iii) other property or services that are accepted by COMMERCE, and
(iv) the protection and preservation of property, unless the termination is for default, in which case the
Authorized Representative shall determine the extent of the liability of COMMERCE. Failure to agree
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 8
GENERAL TERMS AND CONDITIONS
INTERAGENCY AGREEMENT
FEDERALFUNDS
with such determination shall be a dispute within the meaning of the "Disputes" clause of this contract.
COMMERCE may withhold from any amounts due the Contractor such sum as the Authorized
Representative determines to be necessary to protect COMMERCE against potential loss or liability.
The rights and remedies of COMMERCE provided in this section shall not be exclusive and are in
addition to any other rights and remedies provided by law or under this contract.
After receipt of a notice of termination, and except as otherwise directed by the Authorized
Representative, the Contractor shall:
A. Stop work under the contract on the date, and to the extent specified, in the notice;
B. Place no further orders or subcontracts for materials, services, or facilities except as may be
necessary for completion of such portion of the work under the contract that is not terminated;
C. Assign to COMMERCE, in the manner, at the times, and to the extent directed by the Authorized
Representative, all of the rights, title, and interest of the Contractor under the orders and
subcontracts so terminated, in which case COMMERCE has the right, at its discretion, to settle or
pay any or all claims arising out of the termination of such orders and subcontracts;
D. Settle all outstanding liabilities and all claims arising out of such termination of orders and
subcontracts, with the approval or ratification of the Authorized Representative to the extent the
Authorized Representative may require, which approval or ratification shall be final for all the
purposes of this clause;
E. Transfer title to COMMERCE and deliver in the manner, at the times, and to the extent directed by
the Authorized Representative any property which, if the contract had been completed, would have
been required to be furnished to COMMERCE;
F. Complete performance of such part of the work as shall not have been terminated by the Authorized
Representative; and
G. Take such action as may be necessary, or as the Authorized Representative may direct, for the
protection and preservation of the property related to this contract, which is in the possession of
the Contractor and in which the Authorized Representative has or may acquire an interest.
20. WAIVER
Waiver of any default or breach shall not be deemed to be a waiver of any subsequent default or breach.
Any waiver shall not be construed to be a modification of the terms of this Contract unless stated to be
such in writing and signed by Authorized Representative of COMMERCE,
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 9
Attachment A
Scope of Work
This funding is made available under section 601(a) of the Social Security Act, as added by section 5001
of the Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") and Section V and Vl of the
CARES Act, for costs incurred due to the public health emergency with respect to the Coronavirus Disease
2019 (COVID-19). Under the CARES Act, the Coronavirus Relief Fund may be used to cover costs that:
1. Are necessary expenditures incurred due to the public health emergency with respect to the
Coronavirus Disease 2019 (COVID-19); AND
2. Are not accounted for in the budget most recently approved as of March 27, 2020 (the date
of enactment of the CARES Act) for the State or government.
These funds may be used to reimburse for expenditures incurred during the period of March 1, 2020 thru
Oct. 31. 2020. Please note. In order to ensure all funds have been fully utilized prior to the US
Treasury's December 30, 2020 end date. the State of Washington must closeout contracts by October
31. 2020. All final requests for reimbursement must be received no later than November 15, 2020.
Expenditures must be used for necessary actions taken to respond to the public health emergency. These
may include expenditures incurred to allow the local government to respond directly to the emergency, such
as by addressing medical or public health needs, as well as expenditures incurred to respond to second -
order effects of the emergency, such as by providing economic support to those suffering from employment
or business interruptions due to COVID-19-related business closures.
Funds may not be used to fill shortfalls in government revenue to cover expenditures that would not
otherwise qualify under the statute. Although a broad range of uses is allowed, revenue replacement is not
a permissible use of Fund payments.
Payments may be used only to cover costs not accounted for in the budget most recently approved as of
March 27, 2020. A cost meets this requirement if either:
1 The cost cannot lawfully be funded using a line item, allotment, or allocation within that budget; OR
2 The cost is for a substantially different use from any expected use of funds in such a line item,
allotment, or allocation.
The "most recently approved" budget is the enacted budget for the relevant fiscal period for the particular
government. A cost is not considered to have been accounted for in a budget merely because it could be
met using a budgetary stabilization fund, rainy day fund, or similar reserve account.
Allowable expenditures include, but are not limited to:
Medical expenses such as:
a. COVID-19-related expenses of public hospitals, clinics. and similar facilities.
b. Expenses of establishing temporary public medical facilities and other measures to increase
COVID-19 treatment capacity, including related construction costs.
c. Costs of providing COVID-19 testing, including serological testing.
d. Emergency medical response expenses, including emergency medical transportation, related
to COVID-19.
e. Expenses for establishing and operating public telemedicine capabilities for COVID-19-related
treatment.
2. Public health expenses such as:
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 10
Attachment A
a. Expenses for communication and enforcement by State, territorial, local, and Tribal
governments of public health orders related to COVID-19.
b. Expenses for acquisition and distribution of medical and protective supplies, including
sanitizing products and personal protective equipment, for medical personnel, police officers,
social workers, child protection services, and child welfare officers, direct service providers for
older adults and individuals with disabilities in community settings, and other public health or
safety workers in connection with the COVID-19 public health emergency.
c. Expenses for disinfection of public areas and other facilities, e.g., nursing homes, in response
to the COVID-19 public health emergency.
d. Expenses for technical assistance to local authorities or other entities on mitigation of COVID-
19-related threats to public health and safety.
e. Expenses for public safety measures undertaken in response to COVID-19.
f. Expenses for quarantining individuals.
3. Payroll expenses for public safety, public health, health care, human services, and similar
employees whose services are substantially dedicated to mitigating or responding to the COVID-
19 public health emergency.
4. Expenses of actions to facilitate compliance with COVID-19-related public health measures, such
as:
a. Expenses for food delivery to residents, including, for example, senior citizens and other
vulnerable populations, to enable compliance with COVID-19 public health precautions.
b. Expenses to facilitate distance learning, including technological improvements, in connection
with school closings to enable compliance with COVID-19 precautions.
c. Expenses to improve telework capabilities for public employees to enable compliance with
COVID-19 public health precautions.
d. Expenses of providing paid sick and paid family and medical leave to public employees to
enable compliance with COVID-19 public health precautions.
e. COVID-19-related expenses of maintaining state prisons and county jails, including as relates
to sanitation and improvement of social distancing measures, to enable compliance with
COVID-19 public health precautions.
f. Expenses for care for homeless populations provided to mitigate COVID-19 effects and enable
compliance with COVID-19 public health precautions.
5. Expenses associated with the provision of economic support in connection with the COVID-19
public health emergency, such as:
a. Expenditures related to the provision of grants to small businesses to reimburse the costs of
business interruption caused by required closures.
b. Expenditures related to a State, territorial, local, or Tribal government payroll support program.
c. Unemployment insurance costs related to the COVID-19 public health emergency if such costs
will not be reimbursed by the federal government pursuant to the CARES Act or otherwise.
6. Any other COVID-19-related expenses reasonably necessary to the function of government that
satisfy the Fund's eligibility criteria.
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 11
Attachment B
Budget & Invoicing
The Contractor shall determine the appropriate budget and use of funds within the following 6 budget
categories and their sub -categories:
1. Medical
2. Public Health
3. Payroll
4. Actions to Comply with Public Health Measures
5. Economic Support
6. Other Covid-19 Expenses
The Contractor shall submit invoice reimbursement requests to the Commerce Representative using the
Commerce Contract Management System's (CMS) Online A-19 Portal. Each reimbursement request must
include:
1 A-19 Certification form —An authorized party of the local government will certify each invoice (A19)
submitted for reimbursement and attest that all incurred expenditures meet the US Treasury
Department's guidance: https.//home. treasury oov/system/files/136/Coronavirus-Relief-Fund-
Guidance-for-State-Territorial-Local-and-Tribal-Governments.pdf
2. A-19 Activity Report
3. A detailed breakdown of the expenditures incurred within each applicable budget sub -category on
the A-19 Activity Report.
The A-19 Certification and Activity Report templates will be provided with the executed contract. The
documents are included in Attachment C and Attachment D for reference.
Receipts and proof of payment for costs incurred do not need to be submitted with A-19s. Ail contractors
are required to maintain accounting records in accordance with state and federal laws. Records must be
sufficient to demonstrate the funds have been used in accordance with section 601(d) of the Social Security
Act. Commerce reserves the right to audit any costs submitted for reimbursement. The Contractor shall
comply with Commerce A-19 audits and provide the appropriate records upon request.
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 12
Attachment C
i
"alruner"I of
f (.UI11111E' 111!
LOCAL GOVERNMENT CORONAVIRUS RELIEF FUNDS
CERTIFICATION
am the � of and I certify that:
1. 1 have the authority and approval from the governing body on behalf of the Local
Government to request reimbursement from the Department of Commerce
(Commerce) per contract number2��, from the
allocation of the Coronavirus Relief Fund as created in section 5001 of H.R.748, the
Coronavirus Aid, Relief, and Economic Security Act ("CARES Act") for eligible
expenditures included on the corresponding A-19 invoice voucher for report period
2. 1 understand that as additional federal guidance becomes available, a contract
amendment to the agreement between Commerce and the Local Government may
become necessary.
3. 1 understand Commerce will rely on this certification as a material representation in
processing this reimbursement.
4. 1 certify the use of funds submitted for reimbursement from the Coronavirus Relief
Funds under this contract were used only to cover those costs that:
a. Are necessary expenditures incurred due to the public health emergency with
respect to the Coronavirus Disease 2019 (COVID-19);
b. gr not accounted for in the budget most recently approved as of March 27, 2020;
and
c. Were incurred during the period that begins on March 1, 2020, and ends on October
31, 2020.
S. I understand the use of funds pursuant to this certification must adhere to official
federal guidance issued or to be issued on what constitutes a necessary expenditure.
We have reviewed the guidance established by U.S. Department of the Treasury' and
certify costs meet the required guidance. Any funds expended by the Local Government
or its subcontractor(s) in any manner that does not adhere to official federal guidance
shall be returned to the State of Washington.
Footnote:
i t—Gutdanee available at*j h.-:m- tv-w.ry oot ;ecteeu ties I G'C. ren�.;tits,Px_i-; ]iu:id (=ui MIXA• for Smte
( "Iendontal 122LA and -Tribal Go-,enunent. 1)df(43012020)
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 13
Attachment C
I
LOCAL GOVERNNIF N'I' CORON.4VIItUS RELIEF FLWDS CERTIFICATION
j Page 2 of 2
6. 1 understand the Local Government receiving funds pursuant to this certification shall
retain documentation of all uses of the funds, including but not limited to invoices
and/or sales receipts in a manner consistent with §200.333 Retention requirements for
records of 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards (Uniform Guidance). Such documentation shall
be produced to Commerce upon request and may be subject to audit by the State
Auditor.
7. 1 understand any funds provided pursuant to this certification cannot be used as a
revenue replacement for lower than expected tax or other revenue collections.
8 1 understand funds received pursuant to this certification cannot be used for
expenditures for which the Local Government has received any other emergency COVID-
19 supplemental funding (whether state, federal or private in nature) for that same
expense.
I certify that I have read the above certification and my statements contained herein are true
and correct to the best of my knowledge.
Printed Name
rtle
Signature
LA
Date:
State of Washington Interagency Agreement Version 072019
Department of Commerce Page 14
Attachment D
CF F A-19 Acfiyity P&pW — —�
INSTRUCTIONS
INSTRUCTIONS:
A completed CRF A-19Certification and Activity Report must be submitted with each A-19 reimbursement request
The A-19 Activity Report must be submitted as an Excel spreadsheet, not a PDF You must also include a detailed
breakdown of the Individual expenditures reported in Column F for each applicable sub -category included on the A 19
Activity Report
There are 6 primary budget categories;
1 Medical Expenses
2 Public Health Expenses
3 Payroll expenses for public employees dedicated to COVIDA 9
4 Expenses to facilitate compliance with COVID-19-measures
5 Economic Supports
6 Other COAD-19 Expenses
Each primary budget category includes sub -categories and provides an option to add "other" sub -categories not
listed
Follow the below instructions when completing the A-19 Activity Report
1 REPORT PERIOD -Enter the report period into Cell D1 of the A-19 Activity Report
a This should match the report period entered on the corresponding A 19
b Report period should include MM/YY to MM/YYYY, i e 03120 March 2020, 03/2020, etc
2 COLUMN E Enter the total amount of all previous reimbursement requests submitted to Commerce for each
applicable sub -category.
3 COLUMN F Enter the total amount being requested in the current reimbursement request for each applicable
sub -category
4 COLUMN H: USE OF FUNDS - You must include a general description of the use of the funds being requested
for each applicable sub -category Keep descriptions as concise as possible, but include adequate context to
demonstrate how these funds helped address the COVID 19 emergency If applicable please consider
a Providing a brief description of the specific activities performed
b Identifying specific populations served
c Identifying specific programs created or utilized
d Including any known or intended outcomes results, or community impacts
5 OTHER SUB -CATEGORIES - Budget categories 16 include a placeholder to add an additional sub -category if
necessary
a Enter a Title for other expenses added within the appropriate budget category
b Enter titles into Cells D10, D19, D27, D36, and D41
c There is only one "other" placeholder in each budget category section. Please combine multiple "other" sub-
categories added to the same budget category
6 OTHER BUDGET CATEGORIES - Budget category 6 is where you should include any eligible expenditures
that don't fall under budget categories 1-5
a Enter a Title for these "other" expenses within budget category 6
b Enter titles into Cells D44 - D48
c There are only 5 entry fields available within Budget Category 6
Stale of Washington Interagency Agreement Version 072019
Department of Commerce Page 15
Attachment D
State of Washington Interagency Agreement Version 072019
Department of Commerce Pape 16
Exhibit 2
RECIPIENT'S APPLICATION
(D
PAGE 8 OF 8
Small Business Relief Fund : Entry # 938
Does your building have a commercial storefront or office within Renton city limits
Yes
Have you been in business for at least 2 years?
Yes
Do you certify that you are current on all State and local taxes, licenses and other applicable regulatory
requirements to operate in the City of Renton?
Yes
Do you have a current City of Renton business license?
Yes
City of Renton Business License Number
BL 033428
Current number of employees, including yourself
1 to 5
Is your business owned, or partially owned, by managers, officers, directors or public officials associated with the
City of Renton?
No
Name
Tom Frodsham
Business Name
Luther's Table
Address
419 South 2nd Street Suite 1
Renton, WA 98057
United States
Map It
Email
director .lutherstable ora
Phone
Small Business Relief Fund : Entry # 938
(425) 970-3157
Industry Sector
• Food Services
Is your business facing pending legal litigation or legal action; including Renton Code Enforcement?
No
Has your business experienced a loss of income due to COVID-19?
Yes
Was your business required to close due to the pandemic?
Yes
If previously closed, is your business allowed to be open during the current phase of the Governor's Safe Start
plan?
Yes
What is the current operating condition of your business?
Open -operating in a limited capacity
Explain how funds will be used to help you recover from the impacts of the COVID-19 pandemic
Funds will be used for payroll, Rent, utilities, and for other ways to accomplish our mission in the face of this new
normal. For example ways to hold virtual events for the community.
Will this grant help you retain jobs? If so, how many?
4
Have you received any state, federal, or other grants or loans during the COVID-19 crisis?
Yes
Is your business revenue above 1.5 million dollars annually?
No