HomeMy WebLinkAboutContractDocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
Beneficiary (Entity Name)
Program Title
Grant Beneficiary Agreement
City of Renton
King County Festlvals and Events fund
$7,070
tQ King County
Grant Amount$
Agreement Period: From 3/1/2021 To 12/31/2022 --------------Grant Type (reimbursement
based or revenue loss-based) Revenue loss-based ----------SAM No. (if applicable}
This Grant Beneficiary Agreement ("Agreement") is made by and between King County, a municipal corporation
("the County") and Beneficiary to set forth the terms and conditions under which the County will provide a grant to
Beneficiary under the Program to be used for costs incurred during the Agreement Period.
1.Scope of Eligible Expenditures. Grant funds may onty be used to pay or reimburse eligible expenditures as
described in the "Federal Terms" (Exhibit 1), and as detailed in the "Scope of Work" (Exhibit 2). No grant funds may
be used to pay or reimburse costs for which Beneficiary has received any other funding, whether state, federal or
private in nature, for that same cost.
2.Beneficiary Responsibilities. Beneficiary understands and agrees that funds provided under this Agreement
may only be used in compliance with section 603(c) of the Social Security Act ("the Act"), as added by section 9901
of the American Rescue Plan Act ("ARPA"), the U.S. Department of Treasury's ("Treasury's") regulations
implementing that section, guidance issued by Treasury regarding the foregoing, and any other applicable federal
statutes, regulations, executive orders, or interpretive guidance, including those described in the "Federal Terms"
(Exhibit 1).
3.Beneficiary Certifications. Prior to any disbursement of funds authorized by this Agreement, Beneficiary
shall provide the County with: Cost Certification (Exhibit 3), Civil Rights Certification Form (Exhibit 4), the Lobbying
Certification Form (Exhibit 5) and, if applicable, the Lobbying Disclosure Form (Exhibit 6).
4.(if reimbursement-based grant) Request for Payment. Beneficiary shall submit a properly executed Invoice
Template (Exhibit 7) and Cost Certification {Exhibit 3) for the costs therein as frequently as desired, but at a minimum
no later than fifteen (15) working days after the close of each calendar quarter throughout the term of the
Agreement.
S.Maintenance of and Access to Records. Beneficiary shall maintain all records and accounts with respect to
all matters covered by this Agreement, including personnel, property, financial, and programmatic records and
documents sufficient to evidence compliance with section 603(c) of the Act, Treasury's regulations implementing
that section, and guidance issued by Treasury regarding the foregoing. These records shall be maintained for a period
of six (6) years after all funds have been expended or returned to the County, whichever is later, to ensure proper
accounting for all funds and compliance with the Agreement. The County, the Treasury Office of Inspector General,
and the Government Accountability Office, or their authorized representatives, shall have the right of access to
records (electronic and otherwise) of Beneficiary in order to conduct audits or other investigations. Beneficiary
acknowledges that records may be subject to disclosure under the Public Records Act, Ch. 42.56 RCW.
6.Publications. Any publications produced with funds from this Agreement must display the following
language: "This project [is beingl[wasJ supported, in whole or in part, by federal award number SLFRP0152 awarded
to King County, Washington by the U.S. Department of the Treasury."
7.Disclaimer by the County and United States. The United States has expressly disclaimed any and all
responsibility or liability to the County or third persons for the actions of the County or third persons resulting in
death, bodily injury, property damages, or any other losses resulting in any way from the performance of this award
or any other losses resulting in any way from the performance of the award of Federal funds to the County under
City of Renton Grant Benefici ary Agreement
CAG-22-241
DocuSign Envelope ID: 45CA5CC9-A3DO--4C4F-ADB8-O3O059BD0B4B lQ King County
section 603(c) of the Act, or any contract or subcontract under such award. The County expressly disclaims any and
all responsibility or liability to Beneficiary or third persons for the actions of Beneficiary or third persons resulting in
death, bodily injury, property damages, or any other losses resulting in any way from the performance of this
Agreement or any other losses resulting in any way from the performance of the Agreement, or any subcontract
thereto. This Agreement does not in any way establish an agency relationship between or among the United States,
the County, and/or Beneficiary.
8.False State ments. Beneficiary understands that making false statements or claims in connection with this
Agreement may be a violation of federal law and may result in criminal, civil, or administrative sanctions, including
fines, imprisonment, civil damages and penalties, debarment from participating in federal or county awards or
contracts, and/or any other remedy available by law.
9.Debarment and Suspension Certification. Entities that are debarred, suspended, or proposed for
debarment, by the U.S. Government are excluded from receiving federal funds and contracting with the County.
Beneficiary, by signature to this Agreement, certifies that Beneficiary is not currently debarred, suspended, or
proposed for debarment, by any Federal department or agency. Beneficiary also agrees that it will not enter into a
subcontract with a person or entity that is debarred, suspended, or proposed for debarment. Beneficiary will notify
the County if it, or a subcontractor, is debarred, suspended, or proposed for debarment, by any Federal department
or agency. Debarment status may be verified at https://www.sam.gov/.
10.Termination. Upon seven (7) days-notice, the County may terminate this agreement for convenience. Any
unspent grant proceeds shall be immediately returned to the County.
11.Repayment of Funds; Recoupment. If Beneficiary has unspent grant proceeds on hand as of December 31,
2022. Beneficiary shall return all unspent grant proceeds to the County within ten (10) calendar days. If any funds
provided to Beneficiary were used in a manner that is not consistent or allowable as outlined in this Agreement or
in the Federal Terms, Beneficiary shall return funds to County in the amount determined to be ineligible. Beneficiary
further agrees that it is financially responsible for and will repay the County any and all indicated amounts following
an audit exception which occurs due to Beneficiary's failure, for any reason, to comply with the terms of this
Agreement. This duty to repay the County shall not be diminished or extinguished by the termination of the
Agreement.
12.Conflict of Interest. Beneficiary designees, agents, members, officers, employees, consultants, and any
other public official who exercises or who has exercised any functions or responsibilities with respect to the Program
during his or her tenure, or who is in a position to participate in a decision-making process or gain inside information
with regard to the Program, are barred from any interest, direct or indirect, in any grant or proceeds of the Program,
or benefit there from, which is part of this Agreement at any time during or after such person's tenure.
13.Governing Laws. This Agreement shall be governed by and construed in accordance with the laws of the
State of Washington. The venue for any action hereunder shall be in the Superior Court for King County, Washington,
or the U.S. District Court for the Western District of Washington.
14.Indemnification. To the maximum extent permitted by law, Beneficiary shall, at its cost and expense,
protect, defend, indemnify, and hold harmless the County, its directors, officers, employees, and agents, from and
against any and all demands, liabilities, causes of action, costs and expenses (including attorneys' fees), claims,
judgments, or awards of damages, arising out of or in any way resulting from the acts or omissions of Beneficiary,
its directors, officers, employees, or agents, relating in any way to Beneficiary's performance or non-performance
under the Agreement. Beneficiary agrees that its obligations under this paragraph extend to any demands, liabilities,
causes of action, or claims brought by, or on behalf of, any of its employees or agents. For this purpose, Beneficiary,
by mutual negotiation, hereby waives, as respects the County only, any immunity that would otherwise be available
against such claims under any industrial insurance act, including Title 51 RCW, other Worker's Compensation act,
City of Renton Grant Beneficiary Agreement
DocuS1gn Envelope ID 45CA5CC9.A3DD--4C4F-ADB8-D3D059BDOB4B tQ King County
disability benefit act, or other employee benefit act of any jurisdiction which would otherwise be applicable in the
case of such claim. These indemnification obligations shall survive the termination of the Agreement.
KING COUNTY
Executive Office
Performance, Strategy and Budget {PSB)
Name: Dwight Dively
Title: Director
Date: 6/1/2022
Exhibits
1-Federal Terms
2 -Scope of Work
3 -Cost Certification
4 -Civil Rights Certification Form
5 -Lobbying Certification Form
6 -Lobbying Disclosure Form (if applicable)
BENEFICIARY
Name:
Title:
Signature:
Date:
7 -Invoice Template (if reimbursement-based grant)
8 -Grant Application (if reimbursement-based grant)
City of Renton Grant Beneficiary Agreement
Armondo Pavone
Mayor
Attest:______________________________Jason A. Seth, City Clerk
7/19/2022
DocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
Grant Beneficiary Agreement -Exhibit 1
FEDERAL TERMS
In case of conflict between these Federal Terms and the Agreement, the following order
of priority shall be utilized: (1) Federal Terms, and (2) Agreement.
1.Beneficiary understands and agrees that funds provided under this Agreement may come
from a federal source and agrees to comply with any and all additional applicable terms.
2.
A.Beneficiary Capacity. Benefic iary agrees and confirms that it has the institutional,
managerial and financial capacity to ensure proper planning, management and
completion of the work detailed in the Scope of Work (Exhibit 2).
B.Technical Assistance. If, at any time, Beneficiary believes its capacity is
compromised or Beneficiary otherwise needs any sort of assistance, it shall
immediately notify the County. The County will make best efforts to provide timely
technical assistance to Beneficiary to bring Beneficiary into compliance.
C.Compliance with Act. Beneficiary understands and agrees that funds provided
under the Agreement may only be used in compliance with section 603(c) of the
Social Security Act (the "Act"), as added by section 9901 of the American Rescue
Plan Act ("ARPA"), the U.S. Department of Treasury's (·'Treasury's") regulations
implementing that section, and guidance issued by Treasury regarding the
foregoing, as well as other applicable federal statutes, regulations, executive
orders, and interpretive guidance.
D.Definitions. The term "Beneficiary" shall refer to an individual or entity who receives
funds from the County as an end user to respond to the negative impacts of
COVID-19 on that individual or entity, but shall not include a "Subrecipient" or a
"Contractor" as defined in 2 C.F.R. 200.1 and as determined in the County's sole
discretion.
Agreement Requirements and Incorporated Exhibits.
Beneficiary shall meet the requirements included in the Agreement and in the following
attached exhibits, each of which is incorporated into the Agreement by reference:
EXHIBIT NAME NUMBER
Federal Terms Exhibit 1
Scope of Work Exhibit 2
Cost Certification Exhibit 3
Civil Rights Certification Form Exhibit 4
Lobbying Certification Form Exhibit 5
Lobbying Disclosure Form (if activity occurs) Exhibit 6
Invoice Template (if applicable) Exhibit 7
A.Scope of Eligible Expenditures. Grant funds may only be used to pay or reimburse
eligible expenditures as described in the Agreement, these Federal Terms (Exhibit
1), and Scope of Work (Exhibit 2). No grant funds may be used to pay or reimburse
DocuSign Envelope ID; 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
3.
4.
costs cannot be used for costs for which Beneficiary has received any other
funding, whether state, federal or private in nature, for that same cost.
8.Beneficiary Certifications. Prior to any disbursement of funds authorized by this
Agreement, Beneficiary shall provide the County with: Cost Certification (Exhibit 3),
Civil Rights Certification Form (Exhibit 4), the Lobbying Certification Form (Exhibit
5), and, if activity occurs, the Lobbying Disclosure Form (Exhibit 6).
C.Reports. Beneficiary shall provide the County with additional information and
documentation upon request, including completing any reports deemed necessary
for the County to comply with documentation, reporting, or audit requirements.
Access to Records. The Treasury Office of Inspector General and the Government
Accountability Office, or their authorized representatives, shall have the right of access to
records (electronic and otherwise) of Beneficiary in order to conduct audits or other
investigations.
Uniform Guidance Compliance.
A.Remedial Actions. In the event of Beneficiary's noncompliance with section 603(c)
of the Act, Treasury's regulations implementing that section, guidance issued by
Treasury regarding the foregoing, or any other applicable federal laws or
regulations, Treasury may take available remedial actions as set forth in 2 C.F.R.
200.339.
B.Recoupment.
1.Beneficiary agrees that it is financially responsible for and will repay the
County any and all indicated amounts following an audit exception which
occurs due to Beneficiary's failure, for any reason, to comply with the terms of
the Agreement. This duty to repay the County shall not be diminished or
extinguished by the termination of the Agreement.
2.In the event of a violation of section 603(c) of the Act, the funds shall be
subject to recoupment by the County.
3.Any funds paid to Beneficiary (1) in excess of the amount to which Beneficiary
is authorized to retain under the terms of the Agreement; (2) that are
determined by the Treasury Office of Inspector General to have been
misused; (3) are determined by Treasury to be subject to a repayment
obligation pursuant to section 603(e) of the Act; or (4) are otherwise subject to
recoupment by the County, and have not been repaid by Beneficiary to the
County shall constitute a debt to the County.
4.Any debts determined to be owed the County must be paid promptly by
Beneficiary. A debt is delinquent if it has not been paid by the date specified
in the County's initial written demand for payment, unless other satisfactory
arrangements have been made or if the County knowingly or improperly
retains funds that are a debt. The County will take any actions available to it
to collect such a debt.
C.Return of Unused Funds. If Beneficiary has any unspent funds on hand as of the
earlier of December 31, 2024, or the termination of this Agreement, Beneficiary
shall return all unspent funds to the County within ten (10) calendar days.
DocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
5.Disclaimer.
A.The United States expressly disclaims any and all responsibility or liability to
Beneficiary or third persons for the actions of Beneficiary or third persons resulting
in death, bodily injury, property damages, or any other losses resulting in any way
from the performance of this award or any other losses resulting in any way from
the performance of this grant or any contract, or subcontract under this grant.
B.The acceptance of this grant by Beneficiary does not in any way establish an
agency relationship between the United States and Beneficiary.
6.Protection for Whistleblowers.
7.
8.
9.
A.In accordance with 41 U.S.C. § 4712, Beneficiary may not discharge, demote, or
otherwise discriminate against an employee in reprisal for disclosing to any of the
list of persons or entities provided below, information that the employee reasonably
believes is evidence of gross mismanagement of a federal contract or grant, a gross
waste of federal funds, an abuse of authority relating to a federal contract or grant,
a substantial and specific danger to public health or safety, or a violation of law,
rule, or regulation related to a federal contract (including the competition for or
negotiation of a contract) or grant.
B.The list of persons and entities referenced in the paragraph above includes the
following:
1.A member of Congress or a representative of a committee of Congress;
2.An Inspector General;
3.The Government Accountability Office;
4.A Treasury employee responsible for contract or grant oversight or
management;
5.An authorized official of the Department of Justice or other law enforcement
agency;
6.A court or grand jury; or
7.A management official or other employee of Beneficiary, contractor, or
subcontractor who has the responsibility to investigate, discover, or address
misconduct.
C.Beneficiary shall inform its employees in writing of the rights and remedies provided
under this section, in the predominant native language of the workforce.
Increasing Seat Belt Use in the United States. Pursuant to Executive Order 13043, 62
FR 19217 (Apr. 18, 1997), Beneficiary is encouraged to adopt and enforce on-the-job seat
belt policies and programs for its their employees when operating company-owned, rented
or personally owned vehicles.
Reducing Text Messaging While Driving. Pursuant to Executive Order 13513, 74 FR
51225 (October 6, 2009), Beneficiary is encouraged to adopt and enforce policies that ban
text messaging while driving, and to establish workplace safety policies to decrease
accidents caused by distracted drivers
False Statements. Beneficiary understands that making false statements or claims in
connection with this Agreement may be a violation of federal law and may result in
criminal, civil, or administrative sanctions, including fines, imprisonment, civil damages
DocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
and penalties, debarment from participating in federal or county awards or contracts,
and/or any other remedy available by law.
10.Applicable Laws.
A.The Agreement shall be governed by and construed in accordance with the laws of
the State of Washington.
B.Beneficiary agrees to comply with the requirements of section 603 of the Act, the
Treasury's regulations implementing that section, and guidance issued by Treasury
regarding the foregoing. Beneficiary also agrees to comply with all other applicable
federal statutes, regulations, executive orders, and interpretive guidance, and
Beneficiary shall provide for such compliance by other parties in any agreements it
enters into with other parties relating to this Agreement.
C.Federal regulations applicable to this grant may include, without limitation, the
following:
1.Uniform Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards, 2 C.F.R. Part 200, including the following:
a.Subpart A, Acronyms and Definitions;
b.Subpart B, General Provisions;
c.Subpart C, Pre-Federal Award Requirements and Contents of Federal
Awards;
d.Subpart D, Post-Federal Award Requirements;
e.Subpart E, Cost Principles;
f.Subpart F, Audit Requirements; and
g.All Appendices thereto.
2.Universal Identifier and System for Award Management (SAM), 2 C.F.R. Part
25, pursuant to which the award term set forth in Appendix A to 2 C.F.R. Part
25 is hereby incorporated by reference.
3.Reporting Subaward and Executive Compensation Information, 2 C.F.R. Part
170, pursuant to which the award term set forth in Appendix A to 2 C.F.R.
Part 170 is hereby incorporated by reference.
4.0MB Guidelines to Agencies on Governmentwide Debarment and
Suspension (Nonprocurement), 2 C.F.R. Part 180, including the requirement
to include a term or condition in all lower tier covered transactions (contracts
and subcontracts described in 2 C.F.R. Part 180, subpart B) that the award is
subject to 2 C.F.R. Part 180 and Treasury's implementing regulation at 31
C.F.R. Part 19.
5.Beneficiary Integrity and Performance Matters, pursuant to which the award
term set forth in 2 C.F.R. Part 200, Appendix XII to Part 200 is hereby
incorporated by reference.
6.Governmentwide Requirements for Drug-Free Workplace, 31 C.F.R. Part 20.
7.New Restrictions on Lobbying, 31 C.F.R. Part 21.
8.Uniform Relocation Assistance and Real Property Acquisitions Act of 1970
(42 U.S.C. §§ 4601-4655) and implementing regulations.
DocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
9.Generally applicable federal environmental laws and regulations.
C.Statutes and regulations prohibiting discrimination applicable to this award include,
without limitation, the following:
1.Title VI of the Civil Rights Act of 1964 (42 U.S.C. §§ 2000d et seq.) and
Treasury's Implementing regulations at 31 C.F.R. Part 22, which prohibit
discrimination on the basis of race, color, or national origin under programs
or activities receiving federal financial assistance;
2.The Fair Housing Act, Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§
3601 et seq.), which prohibits discrimination in housing on the basis of race,
color, religion, national origin, sex, familial status, or disability;
3.Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 794),
which prohibits discrimination on the basis of disability under any program or
activity receiving federal financial assistance;
4.The Age Discrimination Act of 1975, as amended (42 U.S.C. §§ 6101 et
seq.), and Treasury's implementing regulations at 31 C.F.R. Part 23, which
prohibit discrimination on the basis of age in programs or activities receiving
federal financial assistance; and
5.Title II of the Americans with Disabilities Act of 1990, as amended (42 U.S.C.
§§ 12101 et seq.), which prohibits discrimination on the basis of disability
under programs, activities, and services provided or made available by state
and local governments or instrumentalities or agencies thereto.
D.Hatch Act. Beneficiary agrees to comply, as applicable, with requirements of the
Hatch Act (5 U.S.C.§§ 1501-1508 and 7324-7328), which limits certain political
activities of federal employees, as well as certain other employees who work in
connection with federally funded programs.
E.Beneficiary agrees to comply with the Prohibition on Providing Funds to the Enemy
(2 C.F.R. 183).
DocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
Revenue loss-Based Grant:
Grant Beneficiary Agreement -Exhibit 2
SCOPE OF WORK
This grant is a one-time economic impact payment to mitigate financial hardship due to COVID-19. Grant
funds may be applied to support payroll and benefits costs, costs to retain employees, mortgage, rent,
or utilities costs, and other non-capital operating costs. Grant funds may not be applied to expenses
incurred from lobbying or to gambling businesses, residential builders, speculative real estate investors,
federally prohibited businesses such a marijuana business, or sexually oriented businesses. Beneficiary is
not required to report grant expenditures to the County.
DocuSign Envelope 10 45CA5CC9-A3OD-4C4F-ADB8-D3D0598O0B48
King County Festivals and Events Grant Program
Cost Certification for City Beneficiaries
I, Preeti Shridhar as the Equity, Housing, and Human Services Department Administrator of the City of
Renton ("City"), certify that:
1.I have authority and approval from the governing body on behalf of the City to
accept proceeds from King County (the "County") per the King County Festivals and
Events Grant Program Agreement ("Agreement") by and between the County and
the City from the County's allocation of the Coronavirus Local Fiscal Recovery Fund
("CLFR") as created by the American Rescue Plan Act of 2021, Section 9901
("ARPA").
2.The funds disbursed to the City under the Agreement are intended to offset lost
revenue due to the cancellation of event(s) in 2020 and/or 2021 because of the
COVID-19 public health emergency.
3.The amount of revenue lost due to the cancelled events requested by the City is
true and correct and supported by financial records and statements for City.
4.I understand that a duplication of benefits occurs when a person, household,
government agency, or other entity receives financial assistance from multiple
sources for the same purpose, and the total assistance received for that purpose
exceeds the total need for assistance. Duplication of benefits also occurs when
financial assistance is provided to a person or entity through a program to address
losses and the person or entity has received (or would receive, by acting reasonably
to obtain available assistance) financial assistance for the same losses from any
other source (including insurance), and the total amount received exceeds the total
need for those losses.
5.The City has separately received CLFR funds from either the U.S. Department of the
treasury or the State of Washington. Under ARPA, the City may use these CLFR
funds for, among other things, the provision of government services to the extent of
the City's reduction in revenue due to the COVID-19 public health emergency.
6.The City has not used, and will not use, CLFR funds received from the State of
Washington for the provision of government services based on the City's reduction
in revenue due to the COVID-19 public health emergency.
7.The City has not received, and will not receive, any other funding, whether federal,
state, local or private in nature (including insurance), for the same revenue losses
covered by the funds provided by King County under the Agreement. The City has
not relied, and will not rely, upon such losses in requesting funding from any other
funding source.
I hereby certify that I have read the above certification, and that the information and my statements
provided herein by me are true and correct to the best of my knowledge, and by my signature on this
DocuSign Envelope ID: 45CA5CC9-A3DD-4C4F-ADB8-D3D059BD0B4B
document, acknowledge my understanding that any inte ntional or negligent misrepresentation or
falsification of any of the informati on in this document could su bject me to punishment under federal,
civil liability and/or in criminal penalties, including but not limited to fine or imprisonment or both under
Title 18, United States Code, Sec. 1001, et seq. And punishment under federal law.
Printed Name: Preeti Shirdhar, Equity, Housing, and Human Services Admin istrator
(POocuSlgned by:
Signature:}�"�,��
Title: Eauit� Housin�, and Human Services Administrator
Date: 2/1ST022 I : OS PM PST
DocuSign Envelope ID: 45CA5CC9-A3OO-4C4F-ADB8-O3O059BO0B4B
Grant Beneficiary Agreement - Exhibit 4
CIVIL RIGHTS CERTIFICATION FORM
tQ King County
The funds provided to the Beneficiary named below (hereinafter referred to as the "Beneficiary") are available
under section 603 of the Social Security Act, as added by section 9901 of the American Rescue Plan Act.
Beneficia ry understands and acknowledges that:
As a condition of receipt of federal financial assistance from the Department of the Treasury, with monies
distributed through King County, Beneficiary provides the assurances stated herein. The federal financial
assistance may include federal grants, loans and contracts to provide assistance to Beneficiary, the use or rent
of Federal land or property at below market value, Federal training, a loan of Federal personnel, subsidies, and
other arrangements with the intention of providing assistance. Federal financial assistance does not
encompass contracts of guarantee or insurance, regulated programs, licenses, procurement contracts by the
Federal government at market value, or programs that provide direct benefits.
The Civil Rights Restoration Act of 1987 provides that the provisions of the assurances apply to all of the
operations of Beneficiary's program(s) and activity(ies), so long as any portion of Beneficiary's program(s) or
activity(ies) is federally assisted in the manner prescribed above
Beneficiary certifies the following:
1.Beneficiary ensures its current and future compliance with Title VI of the Civil Rights Act of 1964, as
amended, which prohibits exclusion from participation, denial of the benefits of, or subjection to
discrimination under programs and activities receiving federal financial assistance, of any person in the
United States on the ground of race, color, or national origin (42 U.S.C. § 2000d et seq.), as implemented
by the Department of the Treasury Title VI regulations at 31 CFR Part 22 and other pertinent executive
orders such as Executive Order 13166, directives, circulars, policies, memoranda, and/or guidance
documents.
2.Beneficiary acknowledges that Executive Order 13166, "Improving Access to Services for Persons with
Limited English Proficiency," seeks to improve access to federally assisted programs and activities for
individuals who, because of national origin, have Limited English proficiency (LEP). Beneficiary
understands that denying a person access to its programs, services, and activities because of LEP is a form
of national origin discrimination prohibited under Title VI of the Civil Rights Act of 1964 and the
Department of the Treasury's implementing regulations. Accordingly, Beneficiary shall initiate reasonable
steps, or comply with the Depart ment of the Treasury's directives, to ensure that LEP persons have
meaningful access to its programs, services, and activities. Beneficiary understands and agrees that
meaningful access may entail providing language assistance services, including oral interpretation and
written translation where necessary, to ensure effective communication in Beneficiary's programs,
services, and activities.
3.Beneficiary agrees to consider the need for language services for LEP persons when Beneficiary develops
applicable budgets and conducts programs, services, and activities. As a resource, the Department of the
Treasury has published its LEP guidance at 70 FR 6067. For more information on taking reasonable steps
to provide meaningful access for LEP persons, please visit http://www.lep.gov.
4.Beneficiary acknowledges and agrees that compliance with the assurances constitutes a condition of
continued receipt of federal financial assistance and is binding upon Beneficiary and its successors,
transferees, and assignees for the period in which such assistance is provided.
S.Beneficiary shall comply with Title VI of the Civil Rights Act of 1964, which prohibits Beneficiaries of
federal financial assistance from excluding from a program or activity, denying benefits of, or otherwise
discriminating against a person on the basis of race, color, or national origin (42 U.S.C. § 2000d et seq.), as
DocuS1gn Envelope ID: 45CA5CC9-A3OO-4C4F-ADB8-D3D059BD0B4B
� King County
implemented by the Department of the Treasury's Title VI regulations, 31 CFR Part 22, which are herein
incorporated by reference and made a part of this contract (or agreement). Title VI also includes
protection to persons with "Limited English Proficiency" in any program or activity receiving federal
financial assistance, 42 U.S.C. § 2000d et seq., as implemented by the Department of the Treasury's Title
VI regulations, 31 CFR Part 22, and herein incorporated by reference and made a part of this contract or
agreement.
6.Beneficiary understands and agrees that if any real property or structure is provided or improved with the
aid of federal financial assistance by the Department of the Treasury, this assurance obligates Beneficiary,
or in the case of a subsequent transfer, the transferee, for the period during which the real property or
structure is used for a purpose for which the federal financial assistance is extended or for another
purpose involving the provision of similar services or benefits. If any personal property is provided, this
assurance obligates the Contractor for the period during which it retains ownership or possession of the
property.
7.Beneficiary shall cooperate in any enforcement or compliance review activities by the Department of the
Treasury of the aforementioned obligations. Enforcement may include investigation, arbitration,
mediation, litigation, and monitoring of any settlement agreements that may result from these actions.
Beneficiary shall comply with information requests, on-site compliance reviews and reporting
requirements.
8.Beneficiary shall maintain a complaint log and inform the Department of the Treasury of any complaints
of discrimination on the grounds of race, color, or national origin, and limited English proficiency covered
by Title VI of the Civil Rights Act of 1964 and implementing regulations and provide, upon request, a list of
all such reviews or proceedings based on the complaint, pending or completed, including outcome.
Beneficiary also must inform the Department of the Treasury if Contractor has received no complaints
under Title VI.
9.Beneficiary must provide documentation of an administrative agency's or court's findings of non
comphance of Title VI and efforts to address the non-compliance, including any vol untary compliance or
other agreements between the Contractor and the administrative agency that made the finding. If
Beneficiary settles a case or matt er alleging such discrimination, Beneficiary must provide documentation
of the settlement. If Beneficiary has not been the subject of any court or administrative agency finding of
discrimination. please so state.
10.The United States of America has the right to seek judicial enforcement of the terms of this assurances
document and nothing in this document alters or limits the federal enforcement measures that the
United States may take m order to address v1olat1ons of this document or applicable federal law.
I hereby certify that I have read and understood the obligations described above, that Beneficiary is in
compliance with the above-des cribed nondiscrimination requirements, and by my signature on this docum ent,
acknowledge my understanding that any intentional or negligent misrepresentation or falsification of any
information submitted in conjunction with this document could subject me to punishment under federal, civil
liability and/or in criminal penalties, including but not limited to fine or imprisonment or both under Title 18,
United States Code, Sec. 1001, et seq. and punishment under federal law.
Printed Name Signature
Title Date
Armondo Pavone
Mayor 7/19/2022
DocuS1gn Envelope ID. 45CA5CC9-A3DO-4C4F-AD88-D3D0598O0848
Grant Beneficiary Agreement -Exhibit 5
LOBBYING CERTIFICATION FORM
The undersigned certifies, to the best of the undersigned's knowledge and belief, that:
(1)No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress, an
officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal
contract, grant, loan, or cooperative agreement.
(2} If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing
or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee
of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions, as attached.
(3} The undersigned shall require that the language of this certification be included in the award documents for all
subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative
agreements) and that all sub recipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction was
made or entered into. Submission of this certifica tion is a prerequisite for making or entering into this transaction
imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required certification shall be su bject
to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure.
I hereby certify that I have read the above certification, and that the infor mation and my statements provided herein
by me are true and correct to the best of my knowledge, and by my signature on this document, acknowledge my
understanding that any intentional or negligent misrepresentation or fals ification of any of the information in this
document could subject me to punishment under federal and/or civil liability and/or in criminal penalties, including
but not limited to fine or imprisonment or both under Title 18, United States Code, Sec. 1001, et seq. and punishment
under federal law.
Printed Name Signature
Title Date
Armondo Pavone
Mayor 7/19/2022
King County
Award Notification Letter
Dear Benita Horn,
Congratulations! This is to inform you that your application is now
awarded.
Project: Festivals and Events Grant Program
Program: Festivals and Events Grants
Notification Date: 02/16/2022
Approval Date:
Approved Amount: $7,070.00
Federal Awards:
Other Awards:
Total Match:
Period of Performance:
Ein:
Page 1 of 2
•USl 7341 Coronavirus State and
Local Fiscal Recovery Fund
(CSFRF/CLFRF) -FY 2021:
$7,070.00
o Agency: U.S. Department of
the Treasury
o Fiscal Year: 2021
o CFDA: 21.027
Total Federal: $7,070.00
No non-federal funds were included in
this award.
$0.00
02/15/2022 -12/31/2022
91-6001271
Page 2 of 2