HomeMy WebLinkAboutCONSENT Motion delegate signing of OlyCAP CDBGJEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
CONSENT AGENDA REQUEST
TO: Board of County Commissioners
Josh Peters, County Administrator
FROM:Amanda Christofferson,Grants Administrator
DATE:November 3, 2025
SUBJECT: Approval and Execution of subrecipient agreement with OlyCAP for execution of
Community Development Block Grant(CDBG)-Public Services program for
2025-2026.
STATEMENT OF ISSUE:
Jefferson County will subcontract with Olympic Community Action Programs(OlyCAP)to provide services
to persons residing at the Caswell Brown Village for July 1,2025 -June 30, 2026.
ANALYSIS:
Jefferson County executed a contract with Washington State Department of Commerce CDBG Public
Services Program for Public Services for 2025-2026 with the intention of subcontracting with OlyCAP to
provide services to the persons residing at Caswell Brown Village.
FISCAL IMPACT:
CDBG-Public Services funding for the 2025-2026 contract period is$103,000.00.Jefferson County will
retain $3,000.00 and pass through$100,000.00 to OlyCAP as a subrecipient.
RECOMMENDATION:
Staff requests the Board approve a motion to delegate signing authority to Jefferson County Administrator
Josh Peters to execute the subrecipient agreement with OlyCAP.
REVIEWED BY:
Josh Peters, County Administrator Date
11/19/2025
CONTRACT REVIEW FORM Clear Form
INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: OlyCAP Contract No: 2025 CDBG PS
Contract For: CDBG - Public Services Term: July 1, 2025-June 30, 2026
COUNTY DEPARTMENT: Auditor's office
Contact Person: Amanda Christofferson
Contact Phone: 360-385-9232
Contact email: amchristofferson@co.jefferson.wa.us
AMOUNT: $100,000.0o PROCESS:I Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure:Competitive Sealed Bid
Matching Funds Required:Small Works Roster
Sources(s) of Matching Funds Vendor List Bid
Fund# RFP or RFQ
Munis Org/Obj Other:
APPROVAL STEPS:
STEP l: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: N/A:fl rQy„y„,,,,/ A A/e,, 10/24/2025
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: El N/A: fl 4 to e
L/
10/22/2025
Signature L Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 11/14/2025.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 11/13/2025.
Thank you for making the corrections. Standard subrecipient agreement with
original grant attached.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
SUBRECIPIENT AGREEMENT FOR COMMERCE PUBLIC SERVICES
BETWEEN
JEFFERSON COUNTY AND OLYMPIC COMMUNITY ACTION PROGRAMS(OLYCAP)
This Agreement is made between Jefferson County(herein called the Local Government) and Olympic Community
Action Programs(herein called Subrecipient)for the public services project (herein called the Project).
As the Washington State Department of Commerce (Commerce) is authorized by Chapter 39.34 RCW to provide funds to
units of local government selected to supplement Local Document Recording Fees Support programs and carry out
projects under the Housing Division; Homeless Assistance Unit Program in compliance with all applicable local,state,
and federal laws, regulations and policies; and
As the Local Government has applied for and received a COMMERCE award, contract number 25-64210-007,to fund
the work;and
As it benefits the Local Government to engage the Subrecipient to accomplish the Scope of Work and the objectives of
the local COMMERCE project;
The parties agree that:
1. SCOPE OF SERVICES
A. Local Government Responsibilities
The Local Government is responsible for administration of the COMMERCE contract, and ensuring COMMERCE
funds are used in accordance with all program requirements [(24 CFR 570.501(b)] and its COMMERCE contract
with Commerce referenced above.The Local Government will provide such assistance and guidance to the
Subrecipient as may be required to accomplish the objectives and conditions set forth in this Agreement.
B. Subrecipient Responsibilities
The Subrecipient will complete in a satisfactory and proper manner as determined by the Local Government the
tasks as described in the attached Scope of Work and Budget to accomplish the objectives of the Project.The
Subrecipient will periodically meet with the Local Government to review the status of these tasks.
2. TIME OF PERFORMANCE
The effective date of this Agreement will be July 1, 2025 and will be in effect for the time period during which the
Subrecipient remains in control of COMMERCE funds or other COMMERCE assets. The end date for performance
of their obligations under this agreement shall be June 30, 2026.
a. The County reserves the right to terminate this contract in whole or in part, with 10 days' notice, in the
event that expected or actual funding from any funding source is withdrawn, reduced, or limited in any
way after the effective date of this agreement. In the event of termination under this clause,the County
shall be liable for only payment for services rendered prior to the effective date of termination.
3. AGREEMENT REPRESENTATIVES
Each party to this Agreement shall have a representative. Each party may change its representative upon providing
written notice to the other party.The parties' representatives are as follows:
A. Subrecipient:
Name of Representative: Holly Morgan
Title: Executive Director
Mailing Address: 2120 West Sims Way
City,State and Zip Code: Port Townsend,WA 98368
Telephone Number: (360) 385-2571
Fax: (360)385-5185
E-mail Address: hmorgan@olycap.org
B. Local Government :
Name of Representative: Josh Peters
Title: Jefferson County Administrator
Mailing Address: PO Box 1220
City, State and Zip Code: Port Townsend,WA 98368
Telephone Number: (360)385-9100
Fax Number: (360) 385-9382
E-mail Address: jdpeters@co.jefferson.wa.us
4. BUDGET
The total grant award is$ 103,000.00. The Local Government will retain $3,000 for grant administration and will
pass through to the Subrecipient no more than $100,000.00 in COMMERCE funds of the total for eligible incurredcostsandexpensesfortheProject. The Subrecipient shall follow the budget approved by Commerce and the
Local Government and attached to this Agreement(Attachment A). The Local Government may require a more
detailed budget breakdown, and the Subrecipient shall provide such supplementary budget information in a
timely fashion in the form and content prescribed by the Local Government.
Indirect Cost Rate if the Subrecipient chooses to charge Indirect under this grant,the Subrecipient shall provide
their indirect cost rate that has been negotiated between their entity and the Federal Government. If no such rate
exists, a de minimis indirect cost rate of 15%of modified total direct costs (MTDC)will be used.
Modified Total Direct Costs(MTDC)"shall mean all direct salaries and wages, applicable fringe benefits, materials
and supplies, services,travel, and up to the first$25,000 of each subaward (regardless of the period of
performance of the subawards under the award). MTDC excludes equipment, capital expenditures, and rental
costs.
Any amendments to this Agreement's Budget must first be determined by the Local Government as consistent
with its COMMERCE contract with Commerce and then approved in writing by the Local Government and the
Subrecipient.
5. PAYMENT
The Local Government shall reimburse the Subrecipient in accordance with the payment procedures outlined in
the COMMERCE Management Handbook, Financial Management Section for all allowable expenses agreed upon
by the parties to complete the Scope of Service.
Reimbursement under this Agreement will be based on billings,supported by appropriate documentation of costs
actually incurred. It is expressly understood that claims for reimbursement will not be submitted in excess of
actual, immediate cash requirements necessary to carry out the purposes of the agreement. Funds available
under this Agreement will be utilized to supplement rather than supplant funds otherwise available.
It is understood that this Agreement is funded in whole or in part with COMMERCE funds through the Washington
State Department of Commerce Housing Division; Homeless Assistance Unit: Local Document Recording Fees
Support Program as administered by Commerce and is subject to those regulations and restrictions normally
associated with state-funded programs and any other requirements that the State may prescribe.
6. PERFORMANCE MONITORING
The Local Government will monitor the performance of the Subrecipient by tracking project progress, reviewing
payment requests for applicable costs, managing the timely pass-through of COMMERCE funds, overseeingcompliancewithCOMMERCErequirements, and ensuring recordkeeping and audit requirements are met.
Substandard performance as determined by the Local Government will constitute noncompliance with this
Agreement.
If action to correct such substandard performance is not taken by the Subrecipient within a reasonable period of
time after being notified by the Local Government, contract suspension or termination procedures will be
initiated.
7. SPECIAL CONDITIONS
In addition to the requirements and obligations imposed upon the Subrecipient by Section 7F below,the parties
agree the following requirements and obligations with respect to insurance are made part of this Agreement and
apply to the Subrecipient and where applicable,the County:
The Subrecipient shall obtain and keep in force during the terms of the Agreement, policies of insurance as
follows:
Commercial Automobile Liability Insurance providing bodily injury and property damage liability coverage for all
owned and non-owned vehicles assigned to or used in the performance of the work for a combined single limit
of not less than $500,000 each occurrence with the County named as an additional insured in connection with
the Subrecipient's performance of the contract.
General Commercial Liability Insurance in an amount not less than a single limit of one million dollars
1,000,000) per occurrence and an aggregate of not less than two (2)times the occurrence amount($2,000,000
minimum)for bodily injury, including death and property damage, unless greater amount is specified in the
contract specifications. The insurance coverage shall contain no limitation on the scope of the protection
provided and include the following minimum coverage:
a. Broad Form Property Damage,with no employee exclusion;
b. Personal Injury Liability, including extended bodily injury;
c. Broad Form Contractual/Commercial Liability—including completed operations;
d. Premises—Operations Liability(M&C);
e. Independent Contractors and Subcontractors;
f. Blanket Contractual Liability
Such insurance coverage shall be evidenced by one of the following methods:
Certificate of Insurance
Self-insurance through an irrevocable Letter of Credit from a qualified financial institution.
Certificates of coverage as required by this section shall be delivered to the County within fifteen (15)days of
execution of this agreement.
The Subrecipient shall include all subcontractors as insured under its insurance policies or shall furnish separate
certificates and endorsements for each subcontractor. All insurance provisions for subcontractors shall be
subject to all of the requirements stated herein.
Failure of the Subrecipient to take out and/or maintain any required insurance shall not relieve the Subrecipient
from any liability under the Agreement, nor shall the insurance requirements be construed to conflict with or
otherwise limit the obligations concerning indemnification.
It is agreed by the parties that insurers shall have no right of recovery or subrogation against the County
including its employees and other agents and agencies), it being the intention of the parties that the insurance
policies so affected shall protect both parties and be primary coverage for any and all losses covered by the
above described insurance. It is further agreed by the parties that insurance companies issuing the policy or
policies shall have no recourse against the County (including its employees and other agents and agencies)for
payment of any premiums or for assessments under any form of policy. It is further agreed by the parties that
any and all deductibles in the above described insurance policies shall be assumed by and be at the sole risk of
the Subrecipient.
It is agreed by the parties that judgements for which the County may be liable, in excess of insured amounts
provided herein, or any portion thereof, may be withheld from payment due, or to become due,to the
Subrecipient until such time as the Subrecipient shall furnish additional security covering such judgement as may
be determined by the County.
The County reserves the right to request additional insurance on an individual basis for extra hazardous
contracts and specific service agreements.
Any coverage for third party liability claims provided to the County by a "Risk Pool" created pursuant to Ch.
48.62 RCW shall be non-contributory with respect to any policy of insurance the Subrecipient must provide to
comply with this Agreement.
If the proof of insurance or certificate indicating the County is an "additional insured"to a policy obtained by the
Subrecipient refers to an endorsement (by number or name) but does not provide the full text of that
endorsement,then it shall be the obligation of the Subrecipient to obtain the full text of that endorsement and
forward that full text to the County.
The County may, upon the Subrecipient's failure to comply with all provisions of this contract relating to
insurance,withhold payment or compensation that would otherwise be due to the Subrecipient.
8. GENERAL CONDITIONS
A. General Compliance
The Subrecipient agrees to comply with:
The requirements of Title 24 of the Code of Federal regulations, 570(HUD regulations concerning
COMMERCE);and
All other applicable Federal,State and Local laws, regulations,and policies,governing the funds
provided under this Agreement.
B. COMMERCE National Objective
The Subrecipient certifies the activities carried out under this Agreement meet a COMMERCE Program
National Objective defined in 24 CFR 570.208.
C. Independent Contractor
Nothing contained in this Agreement is intended to, or will be construed in any manner,as creating or
establishing the relationship of employer/employee between the parties. The Subrecipient will at all times
remain an "independent contractor"with respect to the services to be performed under this Agreement.
The Local Government will be exempt from payment of all Unemployment Compensation, FICA, retirement,
life and/or medical insurance and Workers' Compensation Insurance, as the Subrecipient is an independent
contractor.
D. Hold Harmless
The Subrecipient will hold harmless, defend and indemnify the Local Government from any and all claims,
actions,suits, charges and judgments whatsoever that arise out of the Subrecipient's performance or
nonperformance of the services or subject matter called for in this Agreement.
E. Workers' Compensation
The Subrecipient will provide Workers' Compensation Insurance Coverage for all of its employees involved
in the performance of this Agreement.
F. Insurance and Bonding
The Subrecipient will carry sufficient insurance coverage to protect contract assets from loss due to theft,
fraud and/or undue physical damage, and as a minimum will purchase a blanket fidelity bond covering all
employees in an amount equal to cash advances from the Local Government. For purposes of commercial
general liability insurance (or similarly named insurance intended to insure Subrecipient against tort or
personal injury claims from or by third parties) "sufficient insurance" is deemed to mean insurance having a
liability cap in the amount of$1 million per occurrence, $2 million aggregate. Said commercial general
liability insurance shall be primary.
The Subrecipient shall furnish the Local Government with properly executed certificate of insurance or a
signed policy endorsement which shall clearly evidence all insurance required in this section prior to
commencement of services.The certificates will, at a minimum, list limits of liability and coverage.The
certificate will provide that the underlying insurance contract will not be cancelled or allowed to expire
except on thirty(30)days prior written notice to the Local Government.
G. Funding Source Recognition
The Subrecipient will insure recognition of the roles of Commerce,the WA State COMMERCE program, and
the Local Government in providing services through this Agreement. All activities,facilities and items utilized
pursuant to this Agreement will be prominently labeled as to funding source. In addition,the Subrecipient
will include a reference to the support provided herein in all publications made possible with funds made
available under this Agreement.
H. Amendments
The Local Government or Subrecipient may amend this Agreement at any time provided that such
amendments make specific reference to this Agreement, and are executed in writing,signed by a duly
authorized representative of each organization, and approved by the Local Government's governing body.
Such amendments will not invalidate this Agreement, nor relieve or release the Local Government or
Subrecipient from its obligations under this Agreement.
I. Suspension or Termination
In accordance with 2 CFR 200.338-9,the Local Government may suspend or terminate this Agreement if the
Subrecipient materially fails to comply with any terms of this Agreement,which include (but are not limited
to)the following:
1. Failure to comply with any of the rules, regulations or provisions referred to herein,or such statues,
regulations,executive orders, and HUD guidelines, policies or directives as may become applicable at
any time;
2. Failure,for any reason, of the Subrecipient to fulfill in a timely and proper manner its obligations under
this Agreement.
3. Ineffective of improper use of funds provided under this Agreement; or
4. Submission by the Subrecipient to the Local Government of reports that are incorrect or incomplete in
any material respect.
In accordance with 2 CFR 200.339,this Agreement may also be terminated by either the Local Government
or the Subrecipient, in whole or in part, by setting forth the reasons for such termination,the effective date,
and, in the case of partial termination,the portion to be terminated. However, if in the case of a partial
termination,the Local Government determines that the remaining portion of the award will not accomplish
the purpose for which the award was made,the Local Government may terminate the award in its entirety.
9. ADMINISTRATIVE REQUIREMENTS
A. Financial Management
1. Accounting Standards
The Subrecipient agrees to comply with 2 CFR 200 and agrees to adhere to the accounting principles and
procedures required therein, utilize adequate internal controls, and maintain necessary source
documentation for all costs incurred.
2. Cost Principles
The Subrecipient will administer its program in conformance with 2 CFR 200.These principles will be
applied for all costs incurred whether charged on a direct or indirect basis.
3. Duplication of Costs
The Subrecipient certifies that work to be performed under this Agreement does not duplicate any work
to be charged against any other contract,subcontract or other source.
B. Documentation and Record Keeping
1. Records to Be Maintained
The Subrecipient will maintain all records required by the Federal regulations specified in 24 CFR
570.506 that are pertinent to the activities to be funded under this Agreement and those records
described in the COMMERCE Management Handbook. Such records will include but not be limited to:
a. Records providing a full description of each activity undertaken;
b. Records demonstrating that each activity undertaken meets one of the National Objectives of
the COMMERCE program;
c. Records required to determine the eligibility of activities;
d. Records required to document the acquisition, improvement, use or disposition of real property
acquired or improved with COMMERCE assistance;
e. Records documenting compliance with the civil rights components of the COMMERCE program;
f. Financial records as required by 24 CFR 570.502, and 2 CFR 200.333;
g. Labor standards records required to document compliance with the Davis Bacon Act,the
provisions of the Contract Work Hours and Safety Standards Act, and all other applicable
Federal,State and Local laws and regulations applicable to COMMERCE-funded construction
projects; and
h. Other records necessary to document compliance with Subpart K of 24 CFR 570.
2. Access to Records and Retention
The grantee,the Washington State Department of Commerce, and other authorized representatives ofthestateandfederalgovernmentsshallhaveaccesstoanybooks,documents, papers and records of
the Subrecipient that are directly pertinent to this Agreement for the purposes of making audit,
examination, excerpts and transcriptions.
All such records and all other records pertinent to this Agreement and work undertaken under this
Agreement will be retained by the Subrecipient for a period of six years after final audit of the Local
Government's COMMERCE project, unless a longer period is required to resolve audit findings or
litigation. In such cases,the Local Government will request a longer period of record retention.
3. Audits and Inspections
All Subrecipient records with respect to any matters covered by this Agreement will be made available
to the Local Government, Commerce, and duly authorized officials of the state and federal government,
at any time during normal business hours, as often as deemed necessary,to audit,examine, and make
excerpts or transcripts of all relevant data.
Any deficiencies noted in audit reports must be fully cleared by the Subrecipient within 30 days after
receipt by the Subrecipient. Failure of the Subrecipient to comply with the above audit requirements will
constitute a violation of this Agreement and may result in the withholding of future payments.
The Subrecipient that expends$750,000 or more in a fiscal year in federal funds from all sources hereby
agrees to have an annual agency audit conducted in accordance with current Local Government policy
concerning Subrecipient audits and 2 CRF 200.501.The Catalog of Federal Domestic Assistance (CFDA)
number is 14.228.
C. Reporting
1. Program Income
The Subrecipient will report annually all program income (as defined at 24 CFR 570.500(a))generated by
activities carried out with COMMERCE funds made available under this Agreement.The use of program
income by the Subrecipient will comply with the requirements set forth at 24 CFR 570.504.
2. Periodic Reports
The Subrecipient, at such times and in such forms as the Local Government may require,will furnish the
Local Government such periodic reports as it may request pertaining to the work or services undertaken
pursuant to this Agreement,the costs and obligations incurred or to be incurred in connection
therewith, and any other matters covered by this Agreement.
D. Use and Reversion of Assets
The use and disposition of real property and equipment under this Agreement will be in compliance with the
requirements of 2 CFR 200.311 and 313, 24 CFR 570.502, 570.503, 570.504, as applicable,which include but
are not limited to the following:
1. The Subrecipient will transfer to the Local Government any COMMERCE funds on hand and any accounts
receivable attributable to the use of funds under this Agreement at the time of expiration,cancellation,
or termination.
2. Real property under the Subrecipient's control that was acquired or improved, in whole or in part,with
funds under this Agreement in excess of$25,000 will be used to meet one of the COMMERCE National
Objectives pursuant to 24 CFR 570.208 until ten (10)years after the contract between Commerce and
the Local Government is closed. If the Subrecipient fails to use COMMERCE-assisted real property in a
manner that meets a COMMERCE National Objective for this 10-year period of time,the Subrecipient
will pay the Local Government an amount equal to the current fair market value of the property less any
portion of the value attributable to expenditures of non-COMMERCE funds for acquisition of, or
improvement to,the property after the COMMERCE program's approval.Such payment will constitute
program income to the Local Government.The Subrecipient may retain real property acquired or
improved under this Agreement after the expiration of the ten-year period.
3. In cases in which equipment acquired, in whole or in part,with funds under this Agreement is sold,the
proceeds will be program income. Equipment not needed by the Subrecipient for activities under this
Agreement will be(a)transferred to the Local Government for COMMERCE-eligible activities as
approved by the COMMERCE program or(b) retained after compensating the Local Government.
10. PERSONNEL AND PARTICIPANT CONDITIONS
A. Civil Rights
Title VI of the Civil Rights Act of 1964:
Under Title VI of the Civil Rights Act of 1964, no person will,on the grounds of race,color,creed, religion,
sex or national origin, be excluded from participation in, be denied the benefits of, or be subjected to
discrimination under any program or activity receiving federal financial assistance.
Section 109 of the Housing and Community Development Act of 1974:
No person in the United States will on the grounds of race,color,creed, religion, sex or national origin be
excluded from participation in, be denied benefits of, or be subjected to discrimination under any program
or activity funded in whole or in part with funds made available under this title.
Age Discrimination Act of 1975, as Amended
No person will be excluded from participation, denied program benefits, or subjected to discrimination on
the basis of age under any program or activity receiving federal funding assistance. (42 U.S.C. 610 et. seq.)
Section 504 of the Rehabilitation Act of 1973, as Amended
No otherwise qualified individual will,solely by reason or his or her disability, be excluded from participation
including employment), denied program benefits,or subjected to discrimination under any program or
activity receiving Federal funds. (29 U.S.C. 794)
Public Law 101-336,Americans with Disabilities Act of 1990
Subject to the provisions of this title, no qualified individual with a disability will, by reason of such disability,
be excluded from participation in or be denied the benefits of the services, programs, or activities of a public
entity, or be subjected to discrimination by any such entity.
B. Section 3 of the Housing and Community Development Act of 1968
Compliance in the Provision of Training, Employment, and Business Opportunities:
1. The work to be performed under this agreement is on a project assisted under a program providing
direct federal financial assistance from HUD and is subject to the requirements of Section 3 of the
Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u. Section 3 requires that to
the greatest extent feasible opportunities for training and employment be given lower-income residents
of the project area;and contracts for work in connection with the project be awarded to business
concerns which are located in, or owned in substantial part, by persons residing in the area of the
project.
2. The parties to this contract will comply with the provisions of said Section 3 and the regulations set forth
in 24 CFR 135, and all applicable rules and orders of HUD and Commerce issued thereunder prior to the
execution of this contract.The parties to this contract certify and agree that they are under no
contractual or other disability that would prevent them from complying with these provisions.
3. The Subrecipient will send to each labor organization or representative of workers with which he has a
collective bargaining agreement or other contract or understanding, if any, a notice advising the said
labor organization or workers' representative of his commitments under this Section 3 clause and will
post copies of the notice in conspicuous places available to employees and applicants for employment
or training.
4. The Subrecipient will include this Section 3 clause in every subcontract for work in connection with the
project and will, at the direction of the applicant, or recipient of federal financial assistance,take
appropriate action pursuant to the subcontract upon a finding that the subcontractor is in violation of
regulations issued by the Secretary of HUD, 24 CFR 135.The Subrecipient will not subcontract with any
subcontractor where it has notice or knowledge that the latter has been found in violation of regulations
under 24 CFR 135 and will not let any subcontract, unless the subcontractor has first provided it with a
preliminary statement of ability to comply with the requirements of these regulations.
5. Compliance with the provisions of Section 3,the regulations set forth in 24 CFR 135, and all applicable
rules and orders of HUD and Commerce issued hereunder prior to the execution of the contract, will be
a condition of the federal financial assistance provided to the project, binding upon the applicant or
recipient for such assistance, its successors, and assigns. Failure to fulfill these requirements will subject
the applicant,or recipient, its consultants and subcontractors, its successors and assigned to those
sanctions specified by the grant or loan agreement or contract through which federal assistance is
provided,and to such sanctions as are specified by 24 CFR 135.
C. Conduct
1. Assignability
The Subrecipient will not assign or transfer any interest in this Agreement without the prior written
consent of the Local Government thereto; provided, however,that claims for money due or to become
due to the Subrecipient from the Local Government under this contract may be assigned to a bank,trust
company,or other financial institution without such approval. Notice of any such assignment or transfer
will be furnished promptly to the Local Government and Commerce.
2. Conflict of Interest
No member of the Local Government's governing body and no other public official of such locality, who
exercises any functions or responsibilities in connection with the planning or carrying out of the project,
will have any personal financial interest, direct or indirect, in this Agreement;and the Subrecipient will
take appropriate steps to assure compliance.
The Subrecipient agrees to abide by the provisions of 2 CFR 200.318 and 24 CFR 570.611,which includes
maintaining a written code or standards of conduct that will govern the performance of its officers,
employees or agents engaged in the award and administration of contracts supported by Federal funds.
The Subrecipient covenants that its employees have no interest and will not acquire interest, direct or
indirect, in the study area or any parcels therein or any other interest which would conflict in any
manner or degree with the performance of services hereunder.The Subrecipient further covenants that
in the performance of this Agreement, no person having such interest will be employed.
3. Certification Regarding Debarment,Suspension, Ineligibility and Voluntary Exclusion- Lower Tier
Covered Transactions
a. 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.
b. Where the lower tier contractor is unable to certify to any of the statements in this contract,such
contractor will attach an explanation to this contract.
c. The contractor further agrees by signing this contract that it will 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.
D. Copyright
If this Agreement results in any copyrightable material or inventions,the Local Government and/or
Commerce reserves the right to royalty-free, non-exclusive and irrevocable license to reproduce, publish or
otherwise use and to authorize others to use,the work or materials for governmental purposes.
E. Religious Activities
The Subrecipient agrees that funds provided under this Agreement will not be utilized for inherently
religious activities prohibited by 24 CFR 570.200(j), such as worship, religious instruction, or proselytization.
11. SEVERABILITY
If any provision of this Agreement is held invalid,the remainder of this Agreement will not be affected thereby and
all other parts of this Agreement will nevertheless be in full force and effect.
12. PERFORMANCE WAIVER
The Local Government's failure to act with respect to a breach by the Subrecipient does not waive its right to act
with respect to subsequent or similar breaches. The failure of the Local Government to exercise or enforce any
right or provision will not constitute a waiver of such right or provision.
13. ENTIRE AGREEMENT
This Agreement constitutes the entire agreement between the Local Government and the Subrecipient for the use
of funds received under this Agreement and it supersedes all prior communications and proposals,whether
electronic, oral, or written between the Local Government and the Subrecipient with respect to this Agreement.
Attachment A: Completed application that includes Project Description and Budget
IN WITNESS WHEREOF,the Local Government and the Subrecipient have executed this Agreement as of the date and
year last written below.
Jefferson County Olympic Community Action Programs
By: By:
Title: Josh Peters, County Administrator Title: Holly Morgan, Executive Director
Date: Date:
Approved As To Form:
for 11/05/2025
P ilip C Hunsucker, Chief Civil Deputy Prosecuting Attorney Date
25-62210-007
Reset form
Community Development Block Grant
Grant Application Data
Grant Year 2025
General Information Jefferson County
Program Name 2025 CDBG Public Services
Jurisdiction Jefferson County
Unique Entity Identifier#(UEI) FGN7DDMJA7H7
UEI /SAM.gov Expiration date
Total Grant Amount 103,000
Mailing Address 1820 Jefferson St.
Street Address
City Port Townsend
State WA
Zip code 98368
Signature Authority for Grant Agreement
First Name Josh
Last Name
Peters
Title Jefferson County Administrator
Email jdpeters@co.jefferson.wa.us
Contact Information
Contact First Name Amanda
Contact Last Name Christofferson
Phone 360)385-9232
Title Grants Administrator
Email amchristofferson@co.jefferson.wa.us
Mail Address 1820 Jefferson St.
City Port Townsend
State WA
Zip Code 98368
25-62210-007
Funding
Total CDBG Grant Amount from Page 1) $ 103,000
County General Admin ($3,500 max.) 3,000 3000
Services Amount Equals grant total minus funds reserved for Admin) $ 100,000
Program Income
Local Public Funds
Other State Funds
Other Federal Funds
Private Funds
Total Additional Funding Involved in delivering Service Activities $0
Total Funding including CDBG $ 103,000
Beneficiaries
Number of Persons
100
Number of Households 75
Number LMI Persons 100
Numbetr LMI Households 75
Subrecipients and Consultants
25-62210-007
Washington State Reset Form
Department of
140 Commerce
Community Development Block Grant
Grant Application Data
Grant Year 2025
103000
Program Activities must be detailed enough for Commerce to understand what direct services will be accomplished withCDBGfundsandhowtheactivitiesmeettheCDBGdefinitionofaneligiblepublicservicethatprovidesadirectbenefitto
principally low- and moderate-income persons.
Housing Services Operation of the Housing Department at Olympic Community Action Program
and Caswell Brown Village
03T Homeless Services
I = Improved
2-Income eligibility limited to LMI persons only
100
Save Entries/Add another Activity
Docusign Envelope ID:EA2AAD55-0587-44B5-9814-D5AFB6D871DB
640 ' Washington State
Department of
940 Commerce
Federal Interagency Agreement with
Jefferson County
through
Community Development Block Grant (CDBG) Program
Public Services Grants
Grant Number: 25-64210-007
For
Public Services through Olympic Community Action Programs to low-
and moderate-income persons in Clallam and Jefferson counties.
Dated: 7/1/2025
Docusign Envelope ID:EA2AAD55-0587-44B5-9814-D5AFB6D871DB
4M WW asliirig'.on State
C.' . _,Department of
4 Commerce
Table of Contents
Face Sheet
4
Special Terms and Conditions 5
1. Definitions
2. Authority
5
3. Acknowledgement of Federal Funding
5
4. Grant Management
5
5. Compensation and Expenses
6
6. Subgrantee(s)/Subcontractor(s) Data Collection
6
7. Indirect Costs
6
8. Billing Procedures and Payment
6
9. Audit
7
10. Fraud and Other Loss Reporting
7
11. Debarment
7
12. Insurance
8
13. Closeout
10
14. Public Records Act
10
15. Reduction in Funds
11
16. Order of Precedence
11
General Terms and Conditions
12
1. Definitions
12
2. All Writings Contained Herein
12
3. Amendments
12
4. Assignment
13
5. Breaches of Other State Contracts
13
6. Code Requirements
13
7. Confidentiality and Safeguarding of Information 13
8. Copyright
13
9. Disputes
14
10. Governing Law and Venue
14
11. Indemnification
14
12. Licensing, Accreditation, and Registration
14
13. Publicity
14
14. Recapture
14
15. Records Maintenance
15
16. Registration with Department of Revenue and Secretary of State 15
17. Right of Inspection
15
18. Savings
15
19. Severability
15
20. Site Security
15
21. Subgranting/Subcontracting
15
22. Survival
16
23. Taxes
16
24. Termination for Cause
16
25. Termination for Convenience
17
26. Termination or Suspension for Loss or Reduction of Funding 17
27. Termination Procedures
17
28. Treatment of Assets
18
29. Waiver
18
Page 2 of 25
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Attachment A: Community Development Block Grant Requirements 19
1. General Compliance
19
2. 2 CFR 200
19
3. Prohibited Activities
19
4. Property Standards
19
5. Federal Funding Accountability and Transparency Act(FFATA) 19
6. Build America, Buy America
19
7. Environmental Review
19
8. Historical or Cultural Artifacts, Human Remains 20
9. Relocation, Real Property Acquisition
20
10. Acquisition and Disposition of Assets
20
11. Labor Standards and Employment
20
12. Section 3 of the Housing and Urban Development Act of 1968 21
13. Performance Reporting
22
14. Program Income
22
15. Nondiscrimination
22
16. Conduct
23
17. Religious Activity
24
Attachment B—Scope of Work and Budget 25
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Agin&Washington State
Department of
v410 Commerce Face Sheet
Grant Number: 25-64210-007
Local Government Division Subrecipient
Community Development Block Grant(CDBG) Program Contractor
1. GRANTEE 2. GRANTEE Doing Business As (optional)
Jefferson County N/A
1820 Jefferson St
Port TownsendWA 98368
3. GRANTEE Representative 4. COMMERCE Representative
Amanda Christofferson, Grant Administrator Jeff Hinckle, Project Manager
360) 385-9232 PO Box 42525/1011 Plum Street SE, Olympia, WA 98504
amchristofferson@co.jefferson.wa.us jeff.hinckle@commerce.wa.gov
5. Grant Amount 6. Funding Source 7. Start Date 8. End Date
103,000 Federal: State: Other:7/1/2025 6/30/2026
9. Federal Funds Federal Agency ALN (CFDA#)Indirect Rate
103,000 U.S. Department of Housing 14.228 N/A
and Urban Development(HUD)
10. Tax ID# 11. SWV# 12. UBI # 13. UEI#
On File 0002430-28 161-001-169 FGN7DDMJA7H7
14.Award Method NOFO/RFX# Proviso#
Competitive N/A N/A
Non-Competitive
15. Grant Purpose
Public Services through Olympic Community Action Programs to low- and moderate-income persons in Clallam and
Jefferson counties.-A full description of the project is in Attachment"B" Scope of Work and Budget.
COMMERCE, defined as the Department of Commerce, and the GRANTEE, as defined above, acknowledge and
accept the terms of this Grant Agreement and Attachments and have executed this Grant Agreement on the date
below and warrant they are authorized to bind their respective agencies. The rights and obligations of both parties to
this Grant Agreement are governed by this Grant Agreement and the following other documents incorporated by
reference: Grantee Terms and Conditions including Attachment "A" — Community Development Block Grant
Requirements and Attachment"B"—Scope of Work and Budget.
FOR GRANTEE FOR COMMERCE
Signed by: e—DocuSigned by:
yo k. 59. Pere- 11444 gory (.t,'1
The Honorable Josh Peters Mark K. Barkley, Assistant Director
Jefferson County Administrator Local Government Division
10/22/2025 112:42 PM PDT 10/27/2025 14:06 PM PDT
Date Date
TEMPLATE APPROVED AS TO FORM ONLY
Lisa Koperski,Assistant Attorney General
September 23, 2025
Page 4 of 25
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v40 Commerce
Special Terms and Conditions
1. Definitions
A. "Contractor" and "GRANTEE" in this Grant Agreement, and the term "subrecipient" found in the
federal Community Development Block Grant(CDBG) rules and regulations, shall mean the same.
B. "Low- and moderate-income"shall mean a household income equal to or less than 80 percent of
area median income adjusted by family size.
C. "Subgrantee(s)/Subcontractor(s)" shall mean one not in the employment of the GRANTEE, who is
performing all or part of those services under this Grant Agreement under a separate agreement
with the GRANTEE. The terms "Subgrantee(s)/Subcontractor(s)" mean
subgrantee(s)/subcontractor(s) in any tier.
D. "Subrecipient" shall mean a non-federal entity that expends federal awards received from a pass-
through entity to carry out a federal program, but does not include an individual that is a beneficiary
of such a program. It also excludes vendors that receive federal funds in exchange for goods and/or
services in the course of normal trade or commerce.
2. Authority
COMMERCE and GRANTEE enter into this Grant Agreement pursuant to the authority granted by the
Interlocal Cooperation Act, RCW 39.34.
3. Acknowledgement of Federal Funding
Federal Award Identification Number(FAIN): B-25-DC-53-0001
Federal Award Date: 5/1/2025
Federal Awarding Agency: U.S. Department of Housing and Urban Development (HUD)
Subaward from Commerce State CDBG Program to GRANTEE: $103,000
Awarding official: Joe Nguyen, Director(360) 725-4021
Research & Development(R&D): Award will not be used for R&D
Unless otherwise specifically authorized herein, the budget period start and end dates shall be the
same as the start and end dates on the Face Sheet.
The GRANTEE agrees that any publications (written, visual, or sound) but excluding press releases,
newsletters, and issue analyses, issued by the GRANTEE describing programs or projects funded, in
whole or in part,with federal funds under this Grant Agreement, shall contain the following statements:
This project was supported by Grant No. B-25-DC-53-0001 awarded by the U.S.
Department of Housing and Urban Development(HUD). Points of view in this document
are those of the author and do not necessarily represent the official position or policies
of HUD. Grant funds are administered by the Community Development Block Grant
Program, Washington State Department of Commerce."
4. Grant 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 Grant Agreement.
The Representative for COMMERCE and their contact information are identified on the Face Sheet of
this Grant Agreement.
The Representative for the GRANTEE and their contact information are identified on the Face Sheet
of this Grant Agreement.
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5. Compensation and Expenses
COMMERCE shall pay an amount not to exceed the Grant Amount identified on the Face Sheet of thisGrantAgreementfortheperformanceofallthingsnecessaryfororincidentaltotheperformanceof
work as set forth in the Scope of Work in Attachment"B" - Scope of Work and Budget.
GRANTEE shall receive reimbursement for approved expenses as identified below or as authorized in
advance by COMMERCE as reimbursable.The maximum amount to be paid to the GRANTEE for authorized
expenses shall not exceed the Grant Amount identified on the Face Sheet.
GRANTEE shall receive reimbursement for travel and other expenses as authorized in advance by
COMMERCE as reimbursable. GRANTEE shall receive compensation for travel expenses at current
state rate and in accordance with the State of Washington Office of Financial Management Travel
Regulations.
6. Subgrantee(s)/Subcontractor(s) Data Collection
GRANTEE will submit reports, in a form and format to be provided by COMMERCE and at intervals
as agreed by the parties, regarding work under this Grant Agreement performed bySubgrantee(s)/Subcontractor(s) and the portion of grant funds expended for work performed by
Subgrantee(s)/Subcontractor(s), including but not necessarily limited to minority-owned, woman-
owned, and veteran-owned business Subgrantee(s)/Subcontractor(s).
Subgrantee(s)/Subcontractor(s)" shall mean Subgrantee(s)/Subcontractor(s) of any tier.
7. Indirect Costs
The GRANTEE shall provide their indirect cost rate that has been negotiated between their entity and
the federal government. If no such rate exists, a de minimis indirect cost rate of up to 15% of modified
total direct costs(MTDC) may be used.
8. Billing Procedures and Payment
COMMERCE will pay GRANTEE upon acceptance of deliverables or services provided and receipt ofproperlycompletedinvoices, which shall be submitted to COMMERCE via the Contracts Management
System (CMS).
The invoices shall describe and document, to COMMERCE's satisfaction, a description of the work
performed, the progress of the project, and any expenses to be reimbursed. The invoice shall includetheGrantNumberidentifiedontheFaceSheetofthisGrantAgreement. If expenses are invoiced,
provide a detailed breakdown of each type. Except for approved indirect costs, if any, a receipt mustaccompanyanysingleexpenseintheamountof$50.00 or more to receive reimbursement.
Any expense reimbursed under this Grant Agreement which is later determined to be unallowable must
be repaid according to the terms COMMERCE provides.
Payment shall be considered timely if made by COMMERCE within thirty (30) calendar days after
receipt of properly completed invoices. Payment shall be made electronically utilizing Contractor's
Statewide Vendor(SWV) number.
COMMERCE may, in its sole discretion,terminate the Grant Agreement or withhold payments claimed
by the GRANTEE for services rendered if the GRANTEE fails to satisfactorily comply with any term orconditionofthisGrantAgreement, including completion of the CDBG program Environmental Review
and the release of funds (if applicable).
No payments in advance or in anticipation of services or supplies to be provided under this Grant
Agreement shall be made by COMMERCE.
If subgranting and/or subcontracting is authorized by COMMERCE, all Subgrantee(s)/Subcontractor(s)payments are reimbursable expenses within the meaning of this Grant Agreement. GRANTEEE must
have, and may be required to demonstrate, the means to pay each
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j A
Washington Stale
Department of
V.J Commerce
Subgrantee(s)/Subcontractor(s). Failure to pay Subgrantee(s)/Subcontractor(s) as agreed may result
in suspension or termination of this Grant Agreement.
COMMERCE may, in its sole discretion, withhold up to 5% of the Grant Amount identified on the Face
Sheet until acceptance by COMMERCE of project completion.
Invoices and End of Fiscal Year
Invoices are due on the 20th of the month following the provision of services.
If applicable, final invoices for a state fiscal year may be due sooner than the 20th and Commerce will
provide notification of the end of fiscal year due date.The Subgrantee(s)/Subcontractor(s) must invoice
for all expenses from the beginning of the Grant Agreement through June 30, regardless of the Grant
Agreement start and end date.
Duplication of Billed Costs
The GRANTEE shall not bill COMMERCE for services performed under this Agreement, and
COMMERCE shall not pay the GRANTEE, if the GRANTEE is entitled to payment or has been or will
be paid by any other source, including grants, for that service.
Disallowed Costs
The GRANTEE is responsible for any audit exceptions or disallowed costs incurred by its own
organization or that of its Subgrantee(s)/Subcontractor(s).
Unless otherwise authorized by COMMERCE in writing, reimbursable payroll costs shall not include
employee overtime nor bonus pay. The GRANTEE is responsible for any audit exceptions or disallowed
costs incurred by its own organization or that of its Subgrantee(s)/Subcontractor(s).
9. Audit
If the GRANTEE expends $1,000,000 or more in federal awards as a Subrecipient from any and all
sources in a fiscal year, the GRANTEE shall procure and pay for a single audit or a program-specific
audit for that fiscal year in accordance with 2 CFR 200 Subpart F. In accordance with 2 CFR 200.501(h),
for-profit Subrecipients expending $1,000,000 or more in federal awards in a fiscal year are also
required to procure and pay for a single audit or program-specific audit for that fiscal year.
Upon completion of each audit GRANTEE shall send all audit documentation to the Federal Audit
Clearinghouse.
If the GRANTEE expends less than $1,000,000 in federal awards as a Subrecipient from any and all
sources in a fiscal year the GRANTEE shall notify COMMERCE they did not meet the audit requirement
threshold within 30 calendar days of the end of that fiscal year.
10. Fraud and Other Loss Reporting
GRANTEE shall report in writing all known or suspected fraud or other loss of any funds or other
property furnished under this Grant Agreement immediately or as soon as practicable to the
Commerce Representative identified on the Face Sheet.
11. Debarment
A. GRANTEE, 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 Grant Agreement, 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
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4a Washington State
Department of
iJ Commerce
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 Grant had one or more
public transactions(Federal, State, or local)terminated for cause of default.
B. Where the GRANTEE is unable to certify to any of the statements in this Grant Agreement, the
GRANTEE shall attach an explanation to this Grant Agreement.
C. The GRANTEE agrees by signing this Grant Agreement 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 GRANTEE further agrees by signing this Grant Agreement 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:
i. The lower tier Subgrantee(s)/Subcontractor(s)certifies, by signing this Grant 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 department or agency.
ii. Where the lower tier Subgrantee(s)/Subcontractor(s) is unable to certify to any of the
statements in this Grant Agreement, such contractor shall attach an explanation to this Grant
Agreement.
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. GRANTEE may contact COMMERCE for assistance in obtaining a copy
of these regulations.
12. Insurance
A. Insurance Requirements for Reimbursable Activities
The GRANTEE must have insurance coverage that is substantially similar to the coverage
described in Section 15B below for all periods in which GRANTEE performed work for which it will
seek reimbursement. The intent of the required insurance is to protect the State of Washington
should there be any Claims, suits, actions, costs, damages or expenses arising from any loss or
negligent or intentional act or omission of the GRANTEE or Subgrantee(s)/Subcontractor(s), or
agents of either, while performing under the terms of this Grant Agreement.
B. Additional Insurance Requirements During the Term of the Grant Agreement
i. The GRANTEE shall provide proof to COMMERCE of insurance coverage that shall be
maintained in full force and effect, as indicated below, and shall submit renewal certificates
not less than 30 calendar days prior to expiration of each policy required under this Section:
a. Commercial General Liability Insurance Policy. Provide a Commercial General
Liability Insurance Policy, including contractual liability, written on an occurrence basis,
in adequate quantity to protect against legal liability arising out of or related to this Grant
Agreement but in no less than $1,000,000 per occurrence. Additionally, the GRANTEE
is responsible for ensuring that any Subgrantee(s)/Subcontractor(s) provide adequate
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insurance coverage for the activities arising out of or related to subgrants and/or
subcontracts (if any). Commercial General Liability Insurance coverage shall be
maintained in full force and effect during the term of this Grant Agreement and throughout
the term of the deed of trust, if applicable.
b. Property Insurance. The GRANTEE shall keep the property insured in an amount
sufficient to permit such insurance to be written at all times on a replacement cost basis.
Such insurance shall cover the following hazards, as applicable:
1. Loss or damage by fire and such other risks;
2. Loss or damage from leakage or sprinkler systems now or hereafter installed in any
building on the premises;
3. Loss or damage by explosion of steam boilers, pressure vessels, oil or gasoline
storage tanks, or similar apparatus now or hereafter installed in a building or building
on the premises.
This property insurance coverage must be maintained in full force and effect throughout
the term of this Grant Agreement and the term of the deed of trust, if applicable.
c. Professional Liability, Errors, and Omissions Insurance. If GRANTEE will be
providing any professional services to be reimbursed under this Grant Agreement, theGRANTEEshallmaintainProfessionalLiabilityorErrorsandOmissionsInsurancewith
minimum limits of no less than $1,000,000 per occurrence to cover all activities by the
GRANTEE and licensed staff employed or under contract to the GRANTEE. The State
of Washington, the Department of Commerce, its agents, officers, and employees need
not be named as additional insureds under this policy. This insurance must be
maintained throughout the term of the deed of trust, if applicable.GRANTEE shall require
that any Subgrantee(s)/Subcontractor(s) providing professional services that are
reimbursable under this Grant Agreement maintain Professional Liability or Errors and
Omissions Insurance at the coverage levels set forth in this subsection.
d. Fidelity Insurance. Every officer, director, employee, or agent who is authorized to actonbehalfoftheGRANTEEforthepurposeofreceivingordepositingfundsintoprogram
accounts or issuing financial documents, checks, or other instruments of payment for
program costs shall be insured to provide protection against loss where:
1. The amount of fidelity coverage secured pursuant to this Grant Agreement shall
be $2,000,000 or the highest of planned reimbursement for the Grant Agreement
period, whichever is lower. Fidelity insurance secured pursuant to this paragraphshallnametheStateofWashington, the Department of Commerce, its agents,
officers, and employees as beneficiary.
2. Subgrantee(s)/Subcontractor(s) that receive $10,000 or more per year in funding
through this Grant Agreement shall secure fidelity insurance as noted above.
Fidelity insurance secured by Subgrantee(s)/Subcontractor(s) pursuant to thisparagraphshallnametheGRANTEEandtheGRANTEE'S fiscal agent (if any) as
beneficiary.
3. Fidelity Insurance coverage shall be maintained in full force and effect from thestartdateofthisGrantAgreementuntilGRANTEEhassubmittedaCloseout
Certification Form, subject to the following: Fidelity Insurance must be issued on
either (a) a "loss sustained" basis; or (b) if issued on a "loss-discovered" basis,
provide coverage for at least 6 months following the date of COMMERCE's receipt
of the Closeout Certification Form.
ii. The insurance required shall be issued by an insurance company authorized to do business
within the State of Washington. Except as otherwise set forth in this Section, each insurance
policy shall name"the State of Washington the Department of Commerce, its agents,officers,and employees"as additional insureds on all policies.All policies shall be primary to any other
valid and collectable insurance. The GRANTEE shall instruct the insurers to give
COMMERCE 30 calendar days' advance notice of any insurance cancellation or modification.
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iii. The GRANTEE shall submit to COMMERCE within 15 calendar days of the Grant Agreement
start date, a certificate of insurance which outlines the coverage and limits defined in this
insurance section including, without limitation, the type of insurance coverage under the
policy, the designated beneficiary,who is covered, the amounts, the period of coverage, andthatCOMMERCEwillbeprovided30days' advance written notice of cancellation. During the
term of the Grant Agreement, the GRANTEE shall submit renewal certificates not less than
30 calendar days prior to expiration of each policy required under this Section. Additionally,
GRANTEE shall provide copies of insurance instruments or certifications at COMMERCE's
request and until six months after Grant Agreement closeout. Copies of such insurance
instruments and certifications will be provided within 15 calendar days of COMMERCE's
request unless otherwise agreed to by the parties.
iv. GRANTEES and Local Governments that Participate in a Self-Insurance Program.
Self-Insured/Liability Pool or Self-Insured Risk Management Program — With prior approval
from COMMERCE, the GRANTEE may provide the coverage above under a self-
insured/liability pool or self-insured risk management program. In order to obtain permission
from COMMERCE,the GRANTEE shall provide:(1)a description of its self-insurance program,
and (2) a certificate and/or letter of coverage that outlines coverage limits and deductibles.All
self-insured risk management programs or self-insured/liability pool financial reports must
comply with Generally Accepted Accounting Principles (GAAP) and adhere to accounting
standards promulgated by: 1)Governmental Accounting Standards Board(GASB),2)Financial
Accounting Standards Board (FASB), and 3) the Washington State Auditor's annual
instructions for financial reporting. GRANTEE'S participating in joint risk pools shall maintain
sufficient documentation to support the aggregate Claim liability information reported on the
balance sheet. The State of Washington, the Department of Commerce, its agents, and
employees need not be named as additional insured under a self-insured property/liability pool,
if the pool is prohibited from naming third parties as additional insured.
GRANTEE shall provide annually to COMMERCE a summary of coverages and a letter of self-
insurance, evidencing continued coverage under GRANTEE'S self-insured/liability pool or self-
insured risk management program. Such annual summary of coverage and letter of self-
insurance will be provided on the anniversary of the start date of this Grant Agreement.
13. Closeout
COMMERCE will advise the GRANTEE to initiate closeout procedures when there are no impediments
to closing and the following criteria have been met or soon will be met:
A. All costs have been incurred with the exception of closeout costs and any unsettled third-party
claims against the GRANTEE.
B. The GRANTEE has held a public hearing to review program performance.
C. The GRANTEE has submitted the Contract Closeout Report. Failure to submit a report will not
preclude COMMERCE from effecting closeout if it is deemed to be in the state's interest.
14. Public Records Act
Notwithstanding General Terms and Conditions Section 5 (Confidentiality and Safeguarding of
Information), COMMERCE is a public agency subject to the Public Records Act, RCW 42.56 (PRA).
Under the PRA, all materials relating to the conduct of government or the performance of any
governmental or proprietary function prepared, owned, used, or retained by COMMERCE or its
functional equivalents are considered public records. The PRA requires that public records responsive
to a public records request be promptly produced unless the PRA or an "other statute" exempts such
records from production. This Grant Agreement is not intended to alter COMMERCE's obligations
under the PRA. The parties agree that if COMMERCE receives a public records request for files that
may include confidential information under General Terms and Conditions Section 5 (Confidentiality
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and Safeguarding of Information), COMMERCE may notify the other party of the request and of the
date that the records will be released to the requester unless GRANTEE obtains a court order enjoining
disclosure. If the GRANTEE fails to obtain the court order enjoining disclosure, COMMERCE may
release the requested information on the date specified. If the GRANTEE obtains a court order from a
court of competent jurisdiction enjoining disclosure pursuant to the PRA, COMMERCE shall maintain
the confidentiality of the information per the court order.
15. Reduction in Funds
In the event that funds appropriated for the Project contemplated under this Grant Agreement are
withdrawn, reduced, or limited in any way by the Federal government, or other funding source, during
the Grant Agreement period, the parties understand and agree that COMMERCE may suspend,
amend, or terminate the Grant Agreement to abide by the revised funding limitations.The parties
understand and agree that GRANTEE shall be bound by any such revised funding limitations as
implemented at the discretion of COMMERCE and shall meet and renegotiate the Grant Agreement
accordingly.
16. Order of Precedence
In the event of an inconsistency in this Grant Agreement, the inconsistency shall be resolved by giving
precedence in the following order:
Applicable federal and state of Washington statutes and regulations
Attachment A—Community Development Block Grant Requirements
Special Terms and Conditions
General Terms and Conditions
Attachment B—Scope of Work and Budget
Community Development Block Grant (CDBG) policies and procedures including the CDBGManagementHandbook, prepared by Commerce, located at www.commerce.wa.gov\CDBG
COMMERCE grant award letter to GRANTEE
GRANTEE's application for funding
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General Terms and Conditions
1. Definitions
As used throughout this Grant, 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 Washington Department of Commerce.
C. "Contract" or "Grant Agreement" means the entire written agreement between COMMERCE and
the GRANTEE, including any Exhibits, documents,or materials incorporated by reference and may
constitute a Subaward if so designated. Electronic transmission of a signed copy of a Grant
Agreement shall be the same as delivery of an original.
D. "Contractor"or"GRANTEE"shall mean the entity identified on the face sheet performing service(s)
under this Agreement, and shall include all employees and agents thereof.
E. "Modified Total Direct Costs" (MTDC) shall mean all direct salaries and wages, applicable fringe
benefits, materials and supplies, services, travel, and up to the first $50,000 of each Subaward
regardless of the period of performance of the Subawards under the award). MTDC excludes
equipment, capital expenditures, charges for patient care, rental costs, tuition remission,
scholarships and fellowships,participant support costs,and the portion of each Subaward in excess
of$50,000.
F. "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 securitynumbers, driver license numbers, other identifying numbers, and any financial identifiers, and
Protected Health Information" under the federal Health Insurance Portability and Accountability
Act of 1996 (HIPAA).
G. "State" shall mean the state of Washington.
H. "Subaward"and"Subawards"shall mean individually and collectively award(s) provided by a pass-
through entity to a Subrecipient for the Subrecipient to carry out part of a Federal award receivedbythepass-through entity. It does not include payments to a contractor or payments to an individualthatisabeneficiaryofaFederalprogram. A Subaward may be provided through any form of legal
agreement, including an agreement that the pass-through entity considers a Grant Agreement or
other contract.
I. "Subgrantee(s)/Subcontractor(s)" shall mean one not in the employment of the GRANTEE, who is
performing all or part of those services under this Contract under a separate contract with the
Contractor. The term "Subgrantee(s)/Subcontractor(s)" mean subgrantees and/or subcontractors
of any tier.
J. "Subrecipient" shall mean a non-Federal entity that receives a Subaward from a pass-through
entity to carry out part of a Federal program, but does not include an individual that is a beneficiaryofsuchprogram. A Subrecipient may also be a recipient of other Federal awards directly from
a Federal awarding agency.
2. All Writings Contained Herein
This Grant Agreement contains all the terms and conditions agreed upon by the parties. No other
understandings, oral or otherwise, regarding the subject matter of this Grant Agreement shall be
deemed to exist or to bind any of the parties hereto.
3. Amendments
This Grant Agreement 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.
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4. Assignment
Neither this Grant Agreement,work thereunder, nor any claim arising under this Grant Agreement, shall
be transferred or assigned by the GRANTEE without prior written consent of COMMERCE.
5. Breaches of Other State Contracts
GRANTEE is expected to comply with all other contracts and grant agreements executed between
GRANTEE and the State of Washington. A breach of any other contract or grant agreement entered
into between GRANTEE and the State of Washington may, in COMMERCE's sole discretion, be
deemed a breach of this Grant Agreement.
6. Code Requirements
All construction and rehabilitation projects must satisfy the requirements of applicable local, state, and
federal building, mechanical, plumbing, fire, energy and barrier-free codes. Compliance with the
Americans with Disabilities Act of 1990 28 C.F.R. Part 35 will be required, as specified by the local
building Department.
7. Confidentiality and Safeguarding of Information
A. "Confidential Information" as used in this section includes:
i. All material provided to the GRANTEE by COMMERCE that is designated as "confidential" by
COMMERCE;
ii. All material produced by the GRANTEE that is designated as "confidential" by COMMERCE;
and
iii. All personal information in the possession of the GRANTEE that may not be disclosed under
state or federal law.
B. The GRANTEE shall comply with all state and federal laws related to the use, sharing, transfer,
sale, or disclosure of Confidential Information. The GRANTEE shall use Confidential Information
solely for the purposes of this Grant Agreement 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 GRANTEE 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.
C. Unauthorized Use or Disclosure. The GRANTEE 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.
8. Copyright
Unless otherwise provided, all Materials produced under this Grant Agreement 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 GRANTEE 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 Grant Agreement, but that incorporate pre-existing materials
not produced under the Grant Agreement, the GRANTEE 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
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GRANTEE warrants and represents that the GRANTEE has all rights and permissions, including
intellectual property rights, moral rights and rights of publicity, necessary to grant such a license to
COMMERCE.
The GRANTEE shall exert all reasonable effort to advise COMMERCE, at the time of delivery of
Materials furnished under this GRANTEE, 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 Grant
Agreement. The GRANTEE shall provide COMMERCE with prompt written notice of each notice or
claim of infringement received by the GRANTEE with respect to any Materials delivered under this
Grant Agreement.COMMERCE shall have the right to modify or remove any restrictive markings placed
upon the Materials by the GRANTEE.
9. 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.
10. Governing Law and Venue
This Grant Agreement 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.
11. Indemnification
Each party shall be solely responsible for the acts of its employees, officers, and agents.
12. Licensing, Accreditation, and Registration
The GRANTEE shall comply with all applicable local, state, and federal licensing, accreditation and
registration requirements or standards necessary for the performance of this Grant Agreement.
13. Publicity
The GRANTEE agrees not to publish or use any advertising or publicity materials in which the State of
Washington or COMMERCE's name is mentioned, or language used from which the connection with
the State of Washington's or COMMERCE's name may reasonably be inferred or implied, without the
prior written consent of COMMERCE.
14. Recapture
In the event that the GRANTEE fails to perform this Grant Agreement in accordance with state laws,
federal laws, and/or the provisions of this Grant Agreement, 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 GRANTEE of funds under this recapture provision shall occur within the time period
specified by COMMERCE. In the alternative, COMMERCE may recapture such funds from payments
due under this GRANTEE.
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15. Records Maintenance
The GRANTEE shall maintain books, records, documents, data and other evidence relating to this
Grant Agreement 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 GRANTEE.
The GRANTEE 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 Grant Agreement, 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 shallberetaineduntilalllitigation, claims, or audit findings involving the records have been resolved.
16. Registration with Department of Revenue and Secretary of State
If required by law, the GRANTEE and its subgrantees and subcontractors shall complete registrationwiththeWashingtonStateDepartmentofRevenue. Nonprofit and for-profit businesses must also be
registered with the Washington Secretary of State and current with all required filings.
17. Right of Inspection
At no additional cost,the GRANTEE shall provide right of access to its facilities to COMMERCE,or any
of its officers, or to any other authorized agent or official of the State of Washington or the federal
government, at all reasonable times, in order to monitor and evaluate performance, compliance, and/orqualityassuranceunderthisGrantAgreement. At no additional cost, the GRANTEE shall also provideanydocumentsrelatedtothisGrantAgreementtoCOMMERCEuponrequesttoassistCOMMERCE
in the periodic monitoring of this Grant Agreement.
18. 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 Grant Agreement and prior to normal completion, COMMERCE may
suspend or terminate the Grant Agreement under the "Termination for Convenience" clause, without
the ten calendar day notice requirement. In lieu of termination, the Grant Agreement may be amended
to reflect the new funding limitations and conditions.
19. Severability
The provisions of this Grant Agreement 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 Grant Agreement.
20. Site Security
While on COMMERCE premises, GRANTEE, its agents, employees, and/or
Subgrantee(s)/Subcontractor(s) shall conform in all respects with physical, fire, and other security
policies or regulations.
21. Subgranting/Subcontracting
The GRANTEE may only subgrant and/or subcontract work contemplated under this Grant Agreement
if it obtains the prior written approval of COMMERCE.
If COMMERCE approves subgranting and/or subcontracting, the GRANTEE shall maintain written
procedures related to subgranting and/or subcontracting,will enter written subgrants/subcontracts priortoanyworkbeingperformed, and will maintain copies of all subgrant(s) and/or subcontract(s) and
records related to subgrant(s) and/or subcontract(s). For cause, COMMERCE in writing may: (a)
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require the GRANTEE to amend its subgranting and/or subcontracting procedures as they relate to this
Grant Agreement; (b) prohibit the GRANTEE from subgranting and/or subcontracting with a particular
person or entity; or(c) require the GRANTEE to rescind or amend a subgrant and/or subcontract.
Every subgrant and/or subcontract shall bind the Subgrantee/Subcontractor to follow all applicable
terms of this Grant Agreement. The GRANTEE is responsible to COMMERCE if the
Subgrantee/Subcontractor fails to comply with any applicable term or condition of this Grant
Agreement. The GRANTEE shall appropriately monitor the activities of the Subgrantee/Subcontractor
to assure fiscal conditions of this grant. In no event shall the existence of a subgrant and/or subcontract
operate to release or reduce the liability of the GRANTEE to COMMERCE for any breach in the
performance of the GRANTEE'S duties.
Every subgrant and/or subcontract shall include a term that COMMERCE and the State of WashingtonarenotliableforclaimsordamagesarisingfromaSubgrantee/Subcontractor's performance of the
subgrant and/or subcontract.
22. Survival
The terms,conditions,and warranties contained in this Grant Agreement that by their sense and context
are intended to survive the completion of the performance, cancellation or termination of this Grant
Agreement shall so survive including, without limitation, any Recapture provision in this Grant
Agreement.
23. Taxes
All payments accrued on account of payroll taxes, unemployment contributions, the GRANTEE'Sincomeorgrossreceipts, and/or any other taxes, insurance, or expenses for the GRANTEE or its staff
shall be the sole responsibility of the GRANTEE.
24. Termination for Cause
In the event COMMERCE determines the GRANTEE has failed to comply with the conditions of this
Grant Agreement in a timely manner, COMMERCE has the right to suspend or terminate this Grant
Agreement. Before suspending or terminating the Grant Agreement, COMMERCE shall notify the
GRANTEE in writing of the need to take corrective action. If corrective action is not taken within 30
calendar days, the Grant Agreement may be terminated or suspended.
In the event of termination or suspension, the GRANTEE shall be liable for damages as authorized by
law including, but not limited to, any cost difference between the original Grant Agreement and the
replacement or cover Grant Agreement 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 Grant Agreement, withhold further
payments, or prohibit the GRANTEE from incurring additional obligations of funds during investigation
of the alleged compliance breach and pending corrective action by the GRANTEE or a decision by
COMMERCE to terminate the grant.A termination shall be deemed a"Termination for Convenience" if
it is determined that the GRANTEE: (1) was not in default; or (2) failure to perform was outside of his
or her control, fault or negligence.
In the event the GRANTEE commits fraud or makes any misrepresentation in connection with the grant
application or during the performance of this Grant Agreement, COMMERCE reserves the right to
terminate or amend this Grant Agreement accordingly, including the right to recapture all funds
disbursed to the GRANTEE under the Grant Agreement.
The rights and remedies of COMMERCE provided in this Grant Agreement are not exclusive and are
in addition to any other rights and remedies provided by law.
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25. Termination for Convenience
Except as otherwise provided in this Grant Agreement, COMMERCE may, by ten (10) business days
written notice, beginning on the second day after the mailing, terminate this Grant, in whole or in part.
If this Grant Agreement is so terminated, COMMERCE shall be liable only for payment required under
the terms of this Grant Agreement for services rendered or goods delivered prior to the effective date
of termination.
26.Termination or Suspension for Loss or Reduction of Funding
Should there be any loss or suspension of federal funding that supports this Grant Agreement, the
Grant Agreement may be immediately suspended by COMMERCE upon notice to the GRANTEE.
Should federal funding that supports this Grant Agreement be terminated, this Grant Agreement and
all obligations, including payment for work done under this Grant Agreement, will be terminated as of
the date of the termination of the federal funding.
Payment for any work done on the Grant Agreement prior to the loss of funding shall be done in
accordance with the requirements of the funding source.
27.Termination Procedures
Upon termination of this Grant Agreement, COMMERCE, in addition to any other rights provided in this
Grant Agreement, may require the GRANTEE to deliver to COMMERCE any property specifically
produced or acquired for the performance of such part of this Grant Agreement as has been terminated.
The provisions of the"Treatment of Assets" clause shall apply in such property transfer.
COMMERCE shall pay to the GRANTEE the agreed upon price, if separately stated, for completed
work and services accepted by COMMERCE, and the amount agreed upon by the GRANTEE 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
with such determination shall be a dispute within the meaning of the "Disputes" clause of this Grant
Agreement. COMMERCE may withhold from any amounts due the GRANTEE 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 Grant Agreement.
After receipt of a notice of termination, and except as otherwise directed by the Authorized
Representative, the GRANTEE shall:
A. Stop work under the Grant Agreement on the date, and to the extent specified, in the notice;
B. Place no further orders or subgrants and/or subcontracts for materials, services, or facilities except
as may be necessary for completion of such portion of the work under the Grant Agreement 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 GRANTEE under the orders and subgrants
and/or 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 subgrants and/or
subcontracts;
D. Settle all outstanding liabilities and all claims arising out of such termination of orders and subgrants
and/or 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;
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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 Grant Agreement 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 Grant Agreement, which is in the
possession of the GRANTEE and in which the Authorized Representative has or may acquire an
interest.
28.Treatment of Assets
Title to all property furnished by COMMERCE shall remain in COMMERCE. Title to all property
furnished by the GRANTEE,for the cost of which the GRANTEE is entitled to be reimbursed as a direct
item of cost under this Grant Agreement, shall pass to and vest in COMMERCE upon delivery of such
property by the GRANTEE. Title to other property, the cost of which is reimbursable to the GRANTEEunderthisGrantAgreement, shall pass to and vest in COMMERCE upon (i) issuance for use of such
property in the performance of this Grant Agreement, or(ii) commencement of use of such property in
the performance of this Grant Agreement, or(iii) reimbursement of the cost thereof by COMMERCE in
whole or in part, whichever first occurs.
A. Any property of COMMERCE furnished to the GRANTEE shall, unless otherwise provided
herein or approved by COMMERCE, be used only for the performance of this Grant Agreement.
B. The GRANTEE shall be responsible for any loss or damage to property of COMMERCE that
results from the negligence of the GRANTEE or which results from the failure on the part of the
GRANTEE to maintain and administer that property in accordance with sound management
practices.
C. If any COMMERCE property is lost, destroyed or damaged, the GRANTEE shall immediately
notify COMMERCE and shall take all reasonable steps to protect the property from further
damage.
D. The GRANTEE shall surrender to COMMERCE all property of COMMERCE prior to settlement
upon completion, termination or cancellation of this Grant Agreement.
E. All reference to the GRANTEE under this clause shall also include GRANTEE'S employees,
agents or Subgrantee(s)/Subcontractor(s).
29.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 Grant Agreement unless
stated to be such in writing and signed by Authorized Representative of COMMERCE.
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Attachment A: Community Development Block Grant Requirements
This agreement includes terms and conditions of the COMMERCE's federal award that are imposed on the
GRANTEE, and the GRANTEE agrees to carry out its obligations in compliance with all of the obligations
described in this Agreement.
1. General Compliance
The GRANTEE shall comply with all applicable provisions of the Housing and Community Development
Act of 1974, as amended, and the regulations at 24 CFR part 570, as modified.
2. 2 CFR 200
The GRANTEE must comply with the applicable requirements at 2 CFR Part 200-- Uniform
Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, as may
be amended from time to time, to the extent that part 200 is incorporated into and made applicable by
24 CFR part 570, subpart I, or applicable Federal Register notices that govern this Grant Agreement.
3. Prohibited Activities
The GRANTEE may only carry out the activities described in this Agreement. The GRANTEE is
prohibited from charging to the Subaward the costs of CDBG-ineligible activities, including thosedescribedat24CFR570.207, and from using funds provided herein or personnel employed in the
administration of activities under this Agreement for political activities, inherently religious activities, or
lobbying.
4. Property Standards
The GRANTEE shall also comply with the Property Standards in 2 CFR 200.310 through 2 CFR
200.316, except to the extent they are inconsistent with 24 CFR 570.200(j) and 24 CFR 570.489(j), in
which case GRANTEE shall comply with 24 CFR 570.200(j) and 24 CFR 570.489(j), and except to the
extent that proceeds from the sale of equipment are program income and subject to the program income
requirements under this agreement, pursuant to 24 CFR 570.489(e)(1)(ii).
5. Federal Funding Accountability and Transparency Act(FFATA)
The GRANTEE shall comply with the requirements of 2 CFR part 25 Universal Identifier and System
for Award Management(SAM).The GRANTEE must have an active registration in SAM in accordance
with 2 CFR part 25, appendix A, and must have a Unique Entity Identifier (UEI). The GRANTEE must
also comply with provisions of the Federal Funding Accountability and Transparency Act, which
includes requirements on executive compensation, and 2 CFR part 170 Reporting Subaward and
Executive Compensation Information.
6. Build America, Buy America
The GRANTEE must comply with the requirements of the Build America, Buy America (BABA)Act,
41 USC 8301 note, and all applicable rules and notices, as may be amended, if applicable to the
GRANTEE's infrastructure project. Pursuant to HUD's Notice, "Public Interest Phased Implementation
Waiver for FY 2022 and 2023 of Build America, Buy America Provisions as Applied to Recipients of
HUD Federal Financial Assistance" (88 FR 17001), any funds obligated by HUD on or after the
applicable listed effective dates, are subject to BABA requirements, unless excepted by a waiver.
7. Environmental Review
COMMERCE shall not release funding to a GRANTEE until the following conditions implementing 24
CFR part 58 are met:
A. The GRANTEE must complete an environmental review of the project and make a finding of
environmental impact. Unless the project is exempt under the National Environmental Policy Act
NEPA), a notice of this finding must be published along with a notice of the GRANTEE'S intent to
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request release of funds for the project. The GRANTEE must allow a seven (7) or fifteen (15) day
period for public review and comment following publication of the notices. When this review and
comment period expires, the GRANTEE may, after considering any comments received, submit a
request for release of funds to COMMERCE. Upon receipt of the request, COMMERCE must allow
a fifteen-day objection period. When COMMERCE's objection period expires, COMMERCE may,
after considering any comments received, formally notify the GRANTEE in writing of the release of
federal funds for the project.
B. The GRANTEE will comply with requirements of the National Historic Preservation Act, 54 USC
30001 et seq. and its implementing regulations, particularly 36 CFR 800, as applicable.
8. Historical or Cultural Artifacts, Human Remains
In the event that historical or cultural artifacts are discovered at the project site during construction or
rehabilitation, the GRANTEE shall immediately stop construction and notify the local historical
preservation officer and the state historic preservation officer at the Department of Archaeology and
Historic Preservation (DAHP). If human remains are discovered, the GRANTEE shall stop work, report
the presence and location of the remains to the coroner and local law enforcement immediately, and
contact DAHP and the concerned tribe's cultural staff or committee.
9. Relocation, Real Property Acquisition
The GRANTEE shall comply with the Uniform Relocation Assistance and Real Property Acquisition
Policies Act of 1970, as amended (URA), 42 USC 4601 —4655, 49 CFR part 24, 24 CFR part 42, and
24 CFR 570.606; in addition to waivers and alternate requirements of all applicable Federal Register
Notices for this award.
10.Acquisition and Disposition of Assets
The GRANTEE will account for any tangible personal property acquired or improved with this Grant
Agreement.
The use and disposition of real property and equipment under this Grant Agreement will be in
compliance with the requirements of all applicable federal law and regulation, including but not limited
to 24 CFR Part 84 and 24 CFR Part 570.489,570.502,570.503,570.504, and 570.505 as applicable,
which include but are not limited to the following:
Real property that was acquired or improved, in whole or in part,with funds under this Grant Agreement
in excess of$25,000 shall be used to meet one of the CDBG national objectives for ten (10)years after
the Grant Agreement is closed. Any exception must be made with COMMERCE approval and the
GRANTEE will be responsible to pay COMMERCE an amount equal to the current fair market value of
the property less any portion of the value attributable to expenditures of non-CDBG funds for acquisition
of or improvement to the property. Such payment from the disposition of real property acquired with
this Grant Agreement within ten (10) years of closeout of the Grant Agreement shall be treated as
CDBG Program Income.
In cases in which equipment acquired in whole or in part with funds under this Grant Agreement is sold,
the proceeds will be CDBG Program Income.
11. Labor Standards and Employment
The GRANTEE shall comply with the labor standards in Section 110 of the Housing and Community
Development Act of 1974, as amended, and ensure that all laborers and mechanics employed by
contractors or Subgrantee(s)/Subcontractor(s) in the performance of construction work financed in
whole or in part with assistance received under this agreement shall be paid wages at rates not less
than those prevailing on similar construction in the locality as determined by the Secretary of Labor in
accordance with the Davis Bacon Act, as amended (40 U.S.C. 3141, et seq.), and 29 CFR part 1, 3, 5,
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6, and 7, provided that this requirement shall apply to the rehabilitation of residential property only if
such property contains not less than 8 units.
The GRANTEE agrees to comply with the Copeland Anti-Kickback Act (18 U.S.C. 874) and its
implementing regulations of the U.S. Department of Labor at 29 CFR part 3 and part 5. TheGRANTEEshallmaintaindocumentationthatdemonstratescompliancewithapplicablehourand
wage requirements. Such documentation shall be made available to COMMERCE for review upon
request.
12. Section 3 of the Housing and Urban Development Act of 1968
The GRANTEE shall comply with the provisions of Section 3 of the Housing and Urban DevelopmentActof1968, as amended, 12 USC 1701u, and implement its implementing regulations at 24 CFR
part 75.
All Section 3 covered contracts shall include the following clause(referred to as the section 3 clause):
a. The work to be performed under this contract is subject to the requirements of section 3 of the
Housing and Urban Development Act of 1968, as amended, 12 U.S.C. 1701u (section 3). Thepurposeofsection3istoensurethatemploymentandothereconomicopportunitiesgeneratedbyHUDassistanceorHUD-assisted projects covered by section 3, shall, to the greatest extentfeasible, be directed to low-and very low-income persons, particularly persons who are recipients
of HUD assistance for housing.
b. The parties to this Agreement agree to comply with HUD's regulations in 24 CFR part 75, whichimplementsection3. As evidenced by their execution of this contract, the parties to this contract
certify that they are under no contractual or other impediment that would prevent them from
complying with the part 75 regulations.
c. The GRANTEE agrees to send to each labor organization or representative of workers with which
the contractor has a collective bargaining agreement or other understanding, if any, a notice
advising the labor organization or workers' representative of the contractor's commitments underthissection3clauseandwillpostcopiesofthenoticeinconspicuousplacesattheworksite
where both employees and applicants for training and employment positions can see the notice.
The notice shall describe the section 3 preference, shall set forth minimum number and job titles
subject to hire, availability of apprenticeship and training positions, the qualifications for each;
and the name and location of the person(s)taking applications for each of the positions; and the
anticipated date the work shall begin.
d. The GRANTEE agrees to include this section 3 clause in every subgrant and/or subcontract
subject to compliance with regulations in 24 CFR part 75, and agrees to take appropriate action,
as provided in an applicable provision of the subgrant and/or subcontract or in this section 3clause, upon a finding that the Subgrantee/Subcontractor is in violation of the regulations in 24
CFR part 75. The contractor will not subgrant and/or subcontract with any
Subgrantee/Subcontractor where the contractor has notice or knowledge that the
Subgrantee/Subcontractor has been found in violation of the regulations in 24 CFR part 75.
e. The GRANTEE will certify that any vacant employment positions, including training positions,thatarefilled (1) after the GRANTEE is selected but before the contract is executed, and (2) with
persons other than those to whom the regulations of 24 CFR part 75 require employmentopportunitiestobedirected, were not filled to circumvent the GRANTEE'S obligations under 24
CFR part 75.
f. Noncompliance with HUD's regulations in 24 CFR part 75 may result in sanctions,termination of
this contract for default, and debarment or suspension from future HUD assisted contracts.
g. With respect to work performed in connection with section 3 covered Indian housing assistance,
section 7(b)of the Indian Self-Determination and Education Assistance Act(25 U.S.C.450e)alsoappliestotheworktobeperformedunderthiscontract. Section 7(b) requires that to the greatest
extent feasible (i) preference and opportunities for training and employment shall be given toIndians, and (ii) preference in the award of contracts and subgrants and/or subcontracts shall begiventoIndianorganizationsandIndian-owned Economic Enterprises. Parties to this Grant
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elk Washington State
Department of
Nig Commerce
Agreement that are subject to the provisions of section 3 and section 7(b) agree to comply with
section 3 to the maximum extent feasible, but not in derogation of compliance with section 7(b).
13. Performance Reporting
The GRANTEE, at such times and in such forms as COMMERCE may require, shall furnish periodic
progress and performance reports pertaining to the activities undertaken pursuant to this Grant
Agreement. These reports may include environmental review records, publication affidavits,
procurement and contracting records, documentation of compliance with federal civil rights
requirements, job creation records, program income reports, reports of the costs and obligations
incurred in connection therewith, the final closeout report, and any other matters covered by this
Grant Agreement. Activities funded by this Grant Agreement providing income-qualified direct
assistance or direct services under the limited clientele, housing, or job creation CDBG National
Objectives, must submit quarterly beneficiary reports as furnished by COMMERCE. Failure to submit
these reports may result in COMMERCE withholding payment or terminating this Grant Agreement.
14. Program Income
Program income, as defined in 24 CFR 570.489(e), retains federal identity and will be used before
drawing additional CDBG funds to complete activities included in Attachment B- Scope of Work and
Budget. The GRANTEE must maintain records of program income received and expended and
annually report program income received after closeout of this Grant Agreement. Program Income
shall be used to continue the same activities to benefit low- and moderate-income persons or, with
COMMERCE approval, for other activities to benefit low- and moderate-income persons. Interest
earned in excess of$100 on CDBG funds received to reimburse incurred costs must be remitted to
COMMERCE for return to the U.S. Treasury.
15. Nondiscrimination
A. Section 109. The GRANTEE will comply with 24 CFR part 6, which implements the provisions of
section 109 of title I of the Housing and Community Development Act of 1974 (Title I) (42 U.S.C.
5309). Section 109 provides that no person in the United States shall, on the ground of race, color,
national origin, religion, or sex, be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under any program or activity funded in whole or in part with federal
financial assistance. The GRANTEE will adhere to the prohibitions against discrimination on the
basis of age under the Age Discrimination Act of 1975 (42 U.S.C. 6101-6107) (Age Discrimination
Act) and the prohibitions against discrimination on the basis of disability under section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. 794) (Section 504). Section 109 of the HCDA makes these
requirements applicable to programs or activities funded in whole or in part with CDBG-CV funds.
Thus, the GRANTEE shall comply with regulations of 24 CFR part 8,which implement Section 504
for HUD programs, and the regulations of 24 CFR part 146, which implement the Age
Discrimination Act for HUD programs.
B. Architectural Barriers Act and the Americans with Disabilities Act. The GRANTEE shall
ensure that its activities are consistent with the requirements of the Architectural Barriers Act and
the Americans with Disabilities Act.
The Architectural Barriers Act of 1968 (42 U.S.C.4151-4157) requires certain federal and federally
funded buildings and other facilities to be designed, constructed, or altered in accordance with
standards that ensure accessibility to, and used by, physically handicapped people. A building or
facility designed, constructed, or altered with funds allocated or reallocated under this part afterDecember11, 1995, and that meets the definition of"residential structure" as defined in 24 CFR
40.2 or the definition of"building"as defined in 41 CFR 101-19.602(a)is subject to the requirements
of the Architectural Barriers Act of 1968 (42 U.S.C. 4151-4157) and shall comply with the Uniform
Federal Accessibility Standards (appendix A to 24 CFR part 40 for residential structures, and
appendix A to 41 CFR part 101-19, subpart 101-19.6, for general type buildings).
The Americans with Disabilities Act (42 U.S.C. 12131; 47 U.S.C. 155, 201, 218 and 225) (ADA)
provides comprehensive civil rights to individuals with disabilities in the areas of employment, public
accommodations, state and local government services,and telecommunications. It further provides
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Docusign Envelope ID:EA2AAD55-0587-44B5-9814-D5AFB6D871DB
4®.Washington State
Department of
V4/OV Commerce
that discrimination includes a failure to design and construct facilities for first occupancy no later
than January 26, 1993, that are readily accessible to and usable by individuals with disabilities.
Further,the ADA requires the removal of architectural barriers and communication barriers that are
structural in nature in existing facilities, where such removal is readily achievable—that is, easily
accomplishable and able to be carried out without much difficulty or expense.
C. Title VI of the Civil Rights Act of 1964 (24 CFR part 1)
i. General Compliance. The GRANTEE shall comply with the requirements of Title VI of the
Civil Rights Act of 1964 (P. L. 88-352), as amended and 24 CFR 570.601 and 570.602. No
person in the United States shall,on the grounds of race,color,or national origin, be excluded
from participation in, be denied the benefits of, or be otherwise subjected to discrimination
under any program or activity funded by this agreement. The specific nondiscrimination
provisions at 24 CFR 1.4 apply to the use of these funds.The GRANTEE shall not intimidate,
threaten, coerce, or discriminate against any person for the purpose of interfering with any
right or privilege secured by title VI of the Civil Rights Act of 1964 or 24 CFR part 1, or
because he has made a complaint, testified, assisted, or participated in any manner in an
investigation, proceeding, or hearing under 24 CFR part 1.The identity of complainants shall
be kept confidential except to the extent necessary to carry out the purposes of 2 CFR part
1, including the conduct of any investigation, hearing, or judicial proceeding arising
thereunder.
ii. Assurances and Real Property Covenants. As a condition to the approval of this
Agreement and the extension of any federal financial assistance,the GRANTEE assures that
the program or activities described in this Agreement will be conducted and the housing,
accommodations, facilities, services, financial aid, or other benefits to be provided will be
operated and administered in compliance with all requirements imposed by or pursuant to 2
CFR part 1.
If the federal financial assistance under this agreement is to provide or is in the form of
personal property or real property or interest therein or structures thereon, the GRANTEE's
assurance herein shall obligate the GRANTEE or, in the case of a subsequent transfer, the
transferee,for the period during which the property 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, or for as long as the GRANTEE retains ownership or possession of the
property, whichever is longer. In all other cases the assurance shall obligate the GRANTEE
for the period during which federal financial assistance is extended pursuant to the contract
or application.
This assurance gives COMMERCE and the United States a right to seek judicial enforcement
of the assurance and the requirements on real property.
In the case of real property, structures or improvements thereon, or interests therein,
acquired with federal financial assistance under this Agreement or acquired with CDBG-CV
funds and provided to the GRANTEE under this Agreement, the instrument effecting any
disposition by the GRANTEE of such real property, structures or improvements thereon, or
interests therein, shall contain a covenant running with the land assuring nondiscrimination
for the period during which the real property 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 the GRANTEE receives real property interests or funds or for the acquisition of real property
interests under this Agreement, to the extent that rights to space on, over, or under any such
property are included as part of the program receiving such assistance,the nondiscrimination
requirements of this part shall extend to any facility located wholly or in part in such space.
16. Conduct
A. Hatch Act.The GRANTEE shall comply with the Hatch Act, 5 USC 1501 —1508, and shall ensure
that no funds provided, nor personnel employed under this Agreement, shall be in any way or to
any extent engaged in the conduct of political activities in violation of Chapter 15 of Title V of the
U.S.C.
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Docusign Envelope ID:EA2AAD55-0587-44B5-9814-D5AFB6D871 DB
0110.Washing:on StaleDepartmentof
40 Commerce
B. Conflict of Interest. In the procurement of supplies, equipment, construction, and services
pursuant to this Agreement, the GRANTEE shall comply with the conflict-of-interest provisions inCOMMERCE's procurement policies and procedures. In all cases not governed by the conflict-of-
interest provisions in the COMMERCE's procurement policies and procedures,the GRANTEE shall
comply with the conflict-of-interest provisions in 24 CFR 570.489(h).
C. Lobbying Certification.The GRANTEE hereby certifies that:
i. No federal appropriated funds have been paid or will be paid, by or on behalf of it, to any
person for influencing or attempting to influence an officer or employee of any agency, aMemberofCongress, 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, andtheextension, continuation, renewal, amendment, or modification of any federal contract,
grant, loan, or cooperative agreement;
ii. 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, aMemberofCongress, 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, it
will complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions;
iii. It shall require that the language of paragraphs (a) and (b) 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 Subrecipients shall
certify and disclose; accordingly, and
iv. This certification is a material representation of fact upon which reliance was placed when
this transaction was made or entered into. Submission of this certification is required by
section 1352, title 31, U.S.C. Any person who fails to file the required certification shall be
subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such
failure.
17. Religious Activity
The GRANTEE agrees that funds provided under this agreement shall not be utilized for inherently
religious activities prohibited by 24 CFR 570.200(j), such as worship, religious instruction, or
proselytization.
Page 24 of 25
Docusign Envelope ID:EA2AAD55-0587-44B5-9814-D5AFB60871 DB
Attachment B—Scope of Work and Budget
GRANTEE:Jefferson County
Grant No. 25-64210-007
Project Description/Deliverable
Jefferson County is awarded a CDBG Public Services Grant for eligible public services through Olympic Community Action
Programs.
The services will be directed to limited clientele with low and moderate incomes(LMI)based on HUD LMI criteria.This grant
will exclusively benefit approximatley 100 persons residing in the of non-entitlement area(s)of Jefferson and Clallam counties
counties.
Project Budget
Budget Code&Funding Leveraged Other Funding Total Funding
21A General Administration$ 3,000 Other Federal$ 0
05 Public Services$100,000 Other State$ 0
Local Public$ 0
Private$ 0
Total CDBG Funds 103,000 Total Other Funds 0 103,000
Project Activities Milestones
Execute grant contract with Commerce.
Complete the environmental review in compliance with Federal related laws and authorities.
Before first
Verify subrecipient does not have an active exclusion record in SAM.gov. payment request
Establish a subrecipient agreement that includes the project budget and the semi-annual
beneficiary reporting requirement.Submit a signed copy to Commerce.
Review subrecipient reimbursement requests against the project costs, project budget,and
contract start date. Not more than
Document the county's CDBG general administration costs. monthly
Prepare and submit payment requests with supporting documentation to Commerce.
Document receipt of grant funds and reimbursement of eligible costs.
Submit CDBG Beneficiary Reports by the end of the month following the semi-annual date. Jan 31,July 31
As necessary,arrange an audit with the Washington State Auditor in accordance with the Uniform
Annually
Guidance,2 CFR 200,Subpart F-Audit Requirements.
Complete applicable civil rights requirements.
Conduct monitoring of the subrecipient to verify CDBG requirements and all costs reimbursed are
Before final payment
allowable. request
Conduct a final public hearing to review project performance, resolve all monitoring issues with
CDBG,and submit a CDBG Contract Closeout Report.
Deliver the direct services identified in the CDBG application through the local community action
program. Before contract
Allocate and manage public services funds as established in the approved subrecipient agreement end date
and budget.
Meet the CDBG national objective of principally benefiting low-and moderate-income persons.
ver.06.09.22
Docusign Envelope ID:EA2AAD55-0587-44B5-9814-D5AFB6D871 DB
6010A Washington State Local Government DivisionDepartmentof
940 Commerce Contract/Amendment Routing
Review by: Name: Initials: Date:
DS
Section Manager Jon Galow r 10/7/2025 I 3:22 PM PDT
DS
Budget Analyst Geoffrey Bracken ,)g 10/7/2025 I 3:30 PM PDT
Deputy Asst. Director Tony Hanson FOSR 10/27/2025 I 2:54 PM PDT
0 docusign_
Certificate Of Completion
Envelope Id:EA2AAD55-0587-44B5-9814-D5AFB6D871 DB Status:Completed
Subject:DocuSign: 2025 CDBG Public Services contract:25-62210-007
Division:
Local Government
Program:CDBG Public Services
ContractN umber:25-62210-007
DocumentType:
Contract Amendment
Source Envelope:
Document Pages:26 Signatures:2 Envelope Originator:
Certificate Pages:5 Initials:3 Jeff Hinckle
AutoNav:Enabled
1011 Plum Street SE
Envelopeld Stamping:Enabled
MS 42525
Time Zone:(UTC-08:00)Pacific Time(US&Canada) Olympia,WA 98504-2525
jeff.hinckle@commerce.wa.gov
IP Address:198.239.10.236
Record Tracking
Status:Original Holder:Jeff Hinckle Location:DocuSign
10/7/2025 8:00:02 AM jeff.hinckle@commerce.wa.gov
Security Appliance Status:Connected Pool:StateLocal
Storage Appliance Status:Connected Pool:Washington State Department of Commerce Location:Docusign
Signer Events Signature Timestamp
Jon Galow 1—,
DS Sent: 10/7/2025 8:05:40 AM
jon.galow@commerce.wa.gov 4" Viewed: 10/7/2025 3:18:53 PM
Security Level:Email,Account Authentication Signed: 10/7/2025 3:22:54 PM
None),Login with SSO
Signature Adoption:Pre-selected Style
Using IP Address:198.238.8.134
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Geoffrey Bracken
S Sent: 10/7/2025 3:22:56 PM
geoffrey.bracken@commerce.wa.gov
Viewed: 10/7/2025 3:30:16 PM
Security Level:Email,Account Authentication Signed:10/7/2025 3:30:52 PM
None)
Signature Adoption: Pre-selected Style
Using IP Address: 147.55.134.56
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Amanda Christofferson Completed Sent: 10/7/2025 3:30:54 PM
amchristofferson@co.jefferson.wa.us
Viewed: 10/7/2025 3:56:21 PM
REPAH representative for HRGP
Signed: 10/22/2025 11:35:01 AM
Security Level:Email,Account Authentication
Using IP Address:64.184.145.20
None)
Electronic Record and Signature Disclosure:
Accepted: 10/7/2025 3:56:21 PM
ID: 1b535cd3-fad0-4827-b768-bf9524c67e3d
Signer Events Signature Timestamp
sgnedby: Sent:10/22/2025 11:35:02 AM
Josh D.Peters
9O°A.D. Pore
jdpeters@co.jefferson.wa.us
Viewed: 10/22/2025 12:42:21 PM
e1E54FC366CE4e1.. Signed:10/22/2025 12:42:56 PM
Security Level:Email,Account Authentication
None)
Signature Adoption:Pre-selected Style
Using IP Address:64.184.145.20
Electronic Record and Signature Disclosure:
Accepted:10/22/2025 12:42:21 PM
ID:7f50aebf-b231-4e06-b170-3dc0ca7d49c8
Tony Hanson
DS Sent: 10/22/2025 12:42:57 PM
tony.hanson@commerce.wa.gov ilk Viewed: 10/27/2025 2:54:20 PM
Deputy Assistant Dir
Signed: 10/27/2025 2:54:31 PM
Washington State Department of Commerce
Signature Adoption:Pre-selected Style
Security Level:Email,Account Authentication Using IP Address:147.55.134.76
None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Mark Barkley
r—DccuSwnedby. Sent: 10/27/2025 2:54:33 PM
mark.barkley@commerce.wa.gov A4.4.4 farttui Viewed: 10/27/2025 4:06:06 PM
80312Bo4865C45_ Signed: 10/27/2025 4:06:27 PM
Assistant Director
Washington State Department of Commerce Signature Adoption:Pre-selected Style
Security Level:Email,Account Authentication Using IP Address: 198.239.106.168
None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 10/7/2025 8:05:40 AM
Envelope Updated Security Checked 10/13/2025 12:38:38 PM
Envelope Updated Security Checked 10/13/2025 12:38:38 PM
Certified Delivered Security Checked 10/27/2025 4:06:06 PM
Signing Complete Security Checked 10/27/2025 4:06:27 PM
Completed Security Checked 10/27/2025 4:06:27 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on:8/11/2020 4:44:12 PM
Parties agreed to:Amanda Christofferson,Josh D.Peters
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if you consent to receiving notices and disclosures exclusively in electronic format as described
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