HomeMy WebLinkAboutCONSENT Motion to delegate signing re CDBG JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
CONSENT AGENDA REQUEST
TO: Board of County Commissioners
Josh Peters, County Administrator
FROM: Amanda Christofferson, Grants Administrator
DATE: October 26, 2025
SUBJECT: Approval and Execution of grant agreement with Washington State Department of
Commerce Community Development Block Grant (CDBG) - Public Services
program for 2026-2027 funding of$101,000.00.
STATEMENT OF ISSUE:
CDBG - Public Services program is intended to serve low-and moderate-income persons in Jefferson and
Clallam counties. Jefferson County will subcontract with Olympic Community Action Programs (OlyCAP)
to provide services to homeless persons at the Caswell Brown Village for July 1, 2026 - June 30, 2027.
ANALYSIS:
A public hearing was held in September of 2026 to hear testimony from OlyCAP regarding their expenditure
of 2025-2026 funding and their proposed use for 2026-2027 funding. Hearing no conflict from the public
with the proposed use of funding to serve the homeless population the BOCC moved to submit CDBG-
Public Services request based on these proposed services.
FISCAL IMPACT:
Available CDBG - Public Services funding for the 2026-2027 contract period is $101,000.00. Jefferson
County will retain $ 3,000.00 and pass through $ 98,000.00 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 CDBG-Public Services contract for 2026-2027 to BOCC Chairperson
Commissioner Greg Brotherton.
REVIEWED BY:
Josh eters, County Administrator Date
CONTRACT REVIEW FORM Clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Washington State Department of Commerce CDBG Contract No: 26-64210-007
Contract For: CDBG Public Services Term: July 1, 2026 - June 30, 2027
COUNTY DEPARTMENT: Auditors
Contact Person: Amanda Christofferson
Contact Phone: 360-385-9232
Contact email: amchristofferson@co.jefferson.wa.us
AMOUNT: $101,000.00 PROCESS: Exempt from Bid Process
Revenue: $101,00o _ Cooperative Purchase
Expenditure: $98,000 Competitive Sealed Bid
Matching Funds Required: $o Small Works Roster
Sources(s) of Matching Funds NA _ Vendor List Bid
Fund # 123 _ RFP or RFQ
Munis Org/Obj 12333314/333123 ✓ Other: Grant
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: l i N/A:❑ CrL 10/9/2026
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: ❑J N/A: ❑ ,AmvvtdeL ��I�tc2 C�/ � 10/9/2026
Signature L Date
STEP 3: RISK MANAGEMENT REVIEW (will be added electronically through Laserfiche):
Electronically approved by Risk Management on 10/13/2026.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 10/13/2026.
DPA Luther reviewed and approved on 10/13/2026.
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
Pr
INSTRUCTIONS
Do not apply digital signatures until the entire packet is ready to submit.
APPROVAL STEPS:
STEP 1: COMPLIANCE WITH JCC 3.55.080 3.55.080 and Chapter 42.23 RCW. Department Heads or Elected Officials for
departments who are proposing the contract must check one of the two boxes: (1) Check the "Certification" box, demonstrating
compliance with that JCC 3.55.080 and Chapter 42.23 RCW;or,(2)Check the"N/A"box,verifying that certification does not apply:
(a)For approval of contracts before a contractor is selected;or,(b)For contracts with other government agencies,including interlocal
agreements.Department Heads or Elected Officials may delegate this responsibility to certify the Contract Review Form in writing to a
person who has been trained to determine compliance with JCC 3.55.080 and Chapter 42.23 RCW. JCC 3.55.080 states: "All persons
involved in county purchasing are required to follow the rules regarding conflicts of interest as set forth in Chapter 42.23 RCW,as now
or hereafter amended, and, in addition thereto, are expressly prohibited from accepting, directly or indirectly, from any person,
company, firm, or corporation to which any procurement or contract is or might be awarded, any rebate, gift, money or anything of
value whatsoever,except where given for the use and benefit of the county."
STEP 2: CERTIFICATION THAT THE CONTRACTOR HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR
LOCAL AGENCY.Department Heads or Elected Officials for departments who are proposing the contract must check one of the two
boxes: (1) Check the "Certification" box, demonstrating that the contractor has not been debarred by a government agency; or, (2)
Check the"N/A"box, verifying that certification does not apply: (a) For approval of contracts before a contractor is selected; or,(b)
For contracts with other government agencies that do not involve grant funding, including interlocal agreements.Department Heads or
Elected Officials may delegate this responsibility to certify the Contract Review Form in writing to a person who has been trained to
determine whether contractors have been debarred by a government agency. Contractors who have been debarred by a government
agency are not eligible to contract with that agency or Jefferson County. Jefferson County does not want to contract with debarred
contractors because they are considered untrustworthy. In addition, where grant funding is involved,debarred contractors usually are
not eligible to receive grant money and,if they are given grant funding,the County may be required to repay spent grant funding.At a
minimum,checking the certified box requires checking:
• Exclusions Section of the Federal Government Services Administration System for Award Management (SAM) at
https://sam.gov/content/exclusions;and,
• The Washington State Department of Labor&Industries Debarred Contractors List website
(https://secure.lni.wa.gov/debarandstrike/C ontrac torDebarL i st.aspx).
In addition,before checking the"Certification"box, the department should ask contractors to verify they have not been debarred by a
federal, state or local government agency. The department may satisfy Step 2 by attaching the standard debarment certificate
completed by the contractor. However, even if a standard debarment certificate is attached, the "Certification" box still must be
checked to satisfy Step 2.
STEP 3: RISK MANAGEMENT REVIEW. Risk management review of all contracts is required by the County's relationship with
the Washington Counties Risk Pool and by the County's risk management resolution. Risk management review involves determining
whether the contract is a valid contract and whether the contract language, including risk allocation provisions like indemnity and
insurance requirements,adequately protect the County from risks posed by the contract.
STEP 4: PROSECUTING ATTORNEY REVIEW. Legal review of all contracts by the Prosecuting Attorney's Office (PAO) is
required by the County's relationship documents with the Washington Counties Risk Pool and by the County's risk management
resolution. Review by the PAO involves determining whether the contract is a valid and unambiguous contract and may include
whether the contract language,including risk allocation provisions,adequately protect the County from risks posed by the contract.
STEP 5: REVISIONS, IF REQUIRED BY RISK MANAGEMENT OR THE PAO. If required, the department makes revisions
suggested by risk management or the PAO.Then,the department resubmits the revised contract to risk management and the PAO.
STEP 6: CONTRACTOR SIGNS. Obtain the contractor's signature before submitting to the Board of County Commissioners
(BoCC)for approval.
STEP 7:SUBMIT TO BOCC FOR APPROVAL.
1. Print 3 duplicate originals of the contract for the Commissioners'signature.
2. The submittal should include:
a. The 3 duplicate originals,each with PAO's signature approving the contract as to form;
b. This Contract Review Form showing approval by Risk Management and the PAO;and,
c. An Agenda Request.
3. Send all together in a hard copy packet to Attn:Julie/BoCC Office via interoffice mail to submit to the BoCC Agenda.The
Deadline for Agenda Items is Tuesday's by 4:30 p.m. in order to be included on the following Monday's Agenda.If the
submission does not meet this deadline,it will be added to the agenda for next Monday regular meeting of the BoCC.
OUESTIONS:
Questions about contracting and contract review should be presented first to the person in the department responsible for submission of
contracts for approval. If questions cannot be answered within the department,then questions should be presented to Risk Management
or the PAO's Civil Department. For questions about scheduling Agenda items, posting Agenda items, etc., please email or call Julie
Shannon,BoCC Office,x384.
2
IVL,UOIJ.II LI IVOI%J 0 RJ. 1 VVVV 1U'.fl ... VJ %JL..'V I V ILJULLI VI LJ/1YL
0% Washington State
%IP Co pDmmerce
Federal Interagency Agreement with
Jefferson County
through
Community Development Block Grant (CDBG) Program
Public Services Grants
Grant Number: 26-64210-007
For
Public Services through Olympic Community Action Programs to low-
and moderate-income persons in Jefferson and Clallam Counties.
Dated: 7/1/2026
LJUUUDIyuI CIIVtlIUrJQ IV.rvvUu Ivv-ucw-vwa--v es,
Washington State
Depa~ment of
940 Commerce
Table of Contents
Face Sheet 4
Special Terms and Conditions 5
1. Authority 5
2. Acknowledgement of Federal Funding 5
3. Grant Management 5
4. Compensation and Expenses 5
5. Subgrantee(s)/Subcontractor(s) Data Collection 5
6. Indirect Costs 6
7. Billing Procedures and Payment 6
8. Audit 6
9. Fraud and Other Loss Reporting 7
10. Debarment 7
11. Insurance 8
12. Order of Precedence 8
General Terms and Conditions 9
1. Definitions 9
2. All Writings Contained Herein 9
3. Amendments 9
4. Assignment 10
5. Confidentiality and Safeguarding of Information 10
6. Copyright 10
7. Disputes 11
8. Governing Law and Venue 11
9. Indemnification 11
10. Licensing, Accreditation, and Registration 11
11. Recapture 11
12. Records Maintenance 11
13. Savings 12
14. Severability 12
15. Subgranting/Subcontracting 12
16. Survival 12
17. Termination for Cause 12
18. Termination for Convenience 13
19. Termination or Suspension for Loss or Reduction of Funding 13
20. Termination Procedures 13
21. Treatment of Assets 14
22. Waiver 14
Attachment A: Community Development Block Grant Requirements 15
1. General Compliance 15
2. 2 CFR 200 15
3. Prohibited Activities 15
4. Property Standards 15
5. Federal Funding Accountability and Transparency Act (FFATA) 15
6. Build America, Buy America 15
7. Environmental Review 15
8. Historical or Cultural Artifacts, Human Remains 16
9. Relocation, Real Property Acquisition 16
10. Acquisition and Disposition of Assets 16
Page 2 of 21
✓VVUJI9I I LI IVGIVjJG 1✓.I VVVV I VV-✓Ll V-VlIV L-V I\J I'✓VLI_I VI I-J,41_
11. Labor Standards and Employment 16
12. Section 3 of the Housing and Urban Development Act of 1968 17
13. Performance Reporting 18
14. Program Income 18
15. Nondiscrimination 18
16. Conduct 19
17. Religious Activity 20
Attachment B—Scope of Work and Budget 21
Docusign Envelope ID:F008010C-B2EC-8A0E-81C1-D02EFC7E9A4E
;I Or;.Stcf t'
Ri►i Commerce Face Sheet
Grant Number: 26-64210-007
Local Government Division Z Subrecipient
Community Development Block Grant(CDBG) Program ❑ Contractor
1. GRANTEE 2. GRANTEE Doing Business As (optional)
Jefferson County N/A
1820 Jefferson St
Port Townsend WA 98368
3. GRANTEE Representative 4. COMMERCE Representative
Amanda Christofferson,Grant Administrator Jeff Hinckle, Project Manager
(360)385-9232 jeff.hinckle@commerce.wa.gov
amchristofferson@co.jefferson.wa.us
5. Grant Amount 6. Funding Source 7. Start Date 8. End Date
$101,000 Federal: ✓ State: Other: 7/1/2026 6/30/2027
9. Federal Funds Federal Agency ALN (CFDA#) Indirect Rate
$101,000 U.S. Department of Housing 14.228 N/A
and Urban Development(HUD)
10.Tax ID# 11. SWV# 12. UBI# 13. UEI#
On File SWV0002430-28 161-001-169 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 Jefferson and
Clallam 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
Josh Peters Mark K. Barkley, Assistant Director
Jefferson County Administrator Local Government Division
Date
Date
APPROVED AS TO FORM ONLY
BY ASSISTANT ATTORNEY GENERAL
. •ved asto form only: APPROVAL ON FILE
n
10-13-2026
B.Luther Date
Deputy Prosecuting Attorney Page 4 of 21
Jefferson Counts Prosecutor's Office
Aink Washington State
!si Commerce
Face Sheet
Grant Number: 26-64210-007
Local Government Division C Subrecipient
Community Development Block Grant (CDBG) Program ❑ Contractor
1. GRANTEE 2. GRANTEE Doing Business As (optional)
Jefferson County N/A
1820 Jefferson St
Port Townsend WA 98368
3. GRANTEE Representative 4. COMMERCE Representative
Amanda Christofferson,Grant Administrator Jeff Hinckle, Project Manager
(360) 385-9232 jeff.hinckle@commerce.wa.gov
amchristofferson@co.jefferson.wa.us
5. Grant Amount 6. Funding Source 7. Start Date 8. End Date
$101,000 Federal: ✓ State: Other: 7/1/2026 6/30/2027
9. Federal Funds Federal Agency ALN(CFDA#) Indirect Rate
$101,000 U.S. Department of Housing 14.228 N/A
and Urban Development (HUD)
10. Tax ID# 11. SWV# 12. UBI# 13. UEI#
On File SWV0002430-28 161-001-169 FGN7DDMJA7H7
14. Award Method NOFO/RFX# Proviso#
0 Competitive N/A N/A
0 Non-Competitive
15. Grant Purpose
Public Services through Olympic Community Action Programs to low-aid moderate-income persons in Jefferson and
Clallam 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
Josh Peters Mark K. Barkley, Assistant Director
Jefferson County Administrator Local Government Division
Date
Date
APPROVED AS TO FORM ONLY
BY ASSISTANT ATTORNEY GENERAL
Approved as to form only: APPROVAL ON FILE
Jeremiah B.Luther Date
Deputy Pig Attorney Page 4 of 21
Takefiv.aw ra,,.,..•Tls...a....r+..'.rlaa
Washing:on Stale
Department of
940 Commerce
Special Terms and Conditions
1. Authority
COMMERCE and Grantee enter into this Contract pursuant to the authority granted by the Interlocal Cooperation
Act, Chapter 39.34 RCW.
2. Acknowledgement of Federal Funding
Federal Award Identification Number(FAIN): B-26-DC-53-0001
Federal Award Date: September 22, 2026
Federal Awarding Agency: U.S. Department of Housing and Urban Development(HUD)
Subaward from Commerce State CDBG Program to GRANTEE: $101,000
Awarding official: Sarah Clifthorne, Interim Director(360) 725-3085
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-26-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."
3. 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.
4. Compensation and Expenses
COMMERCE shall pay an amount not to exceed the Grant Amount identified on the Face Sheet of this
Grant Agreement for the performance of all things necessary for or incidental to the performance of
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.
If travel is required to complete the scope of work and approved in advance in writing, reimbursable travel
expenses may include airfare (economy or coach class only), other transportation, lodging, and food
necessary during periods of required travel. 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.
5. 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 by
Page 5 of 21
Jr%Washinytcxi Slate
Depa lrnent
940 Commerce of
Subgrantee(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.
6. 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.
7. Billing Procedures and Payment
COMMERCE will pay GRANTEE upon acceptance of deliverables or services provided and receipt of
properly completed invoices, 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. If expenses are invoiced,
provide a detailed breakdown of each type. Except for approved indirect costs, if any, a receipt must
accompany any single expense in the amount of$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 GRANTEE'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 or
condition of this Grant Agreement, 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. GRANTEE must
have, and may be required to demonstrate, the means to pay each and every
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.
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).
8. Audit
Page 6 of 21
0 Washington State
Department of
Commerce
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.
9. 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.
10. Debarment
A. GRANTEE, defined as the primary participant and its 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
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.
Page 7 of 21
wasnon a
Dephiag:~meaSlt ote
f
'u�Commerce
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.
11. Insurance
Each party certifies that it is self-insured under the State's or local government self-insurance liability
program and shall be responsible for losses for which it is found liable.
12. 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 CDBG
Management Handbook, prepared by Commerce, located at www.commerce.wa.gov\CDBG
• COMMERCE grant award letter to GRANTEE
• GRANTEE's application for funding
Page 8 of 21
0 Washing;on State
Department of
Commerce
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 Grant 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 security
numbers, 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 received
by the pass-through entity. It does not include payments to a contractor or payments to an individual
that is a beneficiary of a federal program. 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 Grant Agreement 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 beneficiary
of such program. 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.
Page 9 of 21
0.4 wa pdi?lme on nt Slaofte
Depa
940 Commerce
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. 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 Contractor shall comply with all state and federal laws related to the use, sharing, transfer,
sale, or disclosure of Confidential Information. The Contractor shall use Confidential Information
solely for the purposes of this Contract and shall not use, share, transfer, sell or disclose any
Confidential Information to any third party except with the prior written consent of COMMERCE or
as may be required by law. The Contractor shall take all necessary steps to assure that Confidential
Information is safeguarded to prevent unauthorized use, sharing, transfer, sale or disclosure of
Confidential Information or violation of any state or federal laws related thereto. Upon request, the
Contractor shall provide COMMERCE with its policies and procedures on confidentiality.
COMMERCE may require changes to such policies and procedures as they apply to this Contract
whenever COMMERCE reasonably determines that changes are necessary to prevent
unauthorized disclosures. The Contractor shall make the changes within the time period specified
by COMMERCE. Upon request, the Contractor shall immediately return to COMMERCE any
Confidential Information that COMMERCE reasonably determines has not been adequately
protected by the Contractor against unauthorized disclosure. 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.
6. 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
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
Page 10 of 21
b Washing:on State
9410 Commerce
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.
7. Disputes
In the event that a dispute arises under this Grant Agreement, it shall be determined by a Dispute Board
in the following manner: Each party to this Grant 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, Grant Agreement terms and applicable statutes and rules and
make a determination of the dispute. The Dispute Board shall thereafter decide the dispute with the
majority prevailing. The determination of the Dispute Board shall be final and binding on the parties
hereto. As an alternative to this process,either of the parties may request intervention by the Governor,
as provided by RCW 43.17.330, in which event the Governor's process will control.
8. Governing Law and Venue
This 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.
9. Indemnification
Each party shall be solely responsible for the acts of its employees, officers, and agents.
10. 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.
11. 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 Grant Agreement.
12. 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 Grant Agreement.
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 shall
be retained until all litigation, claims, or audit findings involving the records have been resolved.
Page 11 of 21
'Washington State
Depa iment of
Vile Commerce
13. Savings
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way
after the effective date of this 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.
14. 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.
15. Subgrantinq/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 prior
to any work being performed, 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)
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 Washington
are not liable for claims or damages arising from a Subgrantee/Subcontractor's performance of the
subgrant and/or subcontract.
16. Survival
The terms, conditions, and warranties contained in this Contract that by their sense and context are
intended to survive the completion of the performance, cancellation or termination of this Contract shall
so survive.
17. Termination for Cause
In the event COMMERCE determines the 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).
Page 12 of 21
J JLUOKJI I LI IV VIv1JO RJ.I vvvv I V V-U LLV-vI'ly L-v I V I-1.IVLL1 V I LOl1TL
washing:on State
Department of
40 Commerce
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 Agreement. 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.
18. 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.
19. 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.
20. 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;
Page 13 of 21
VVl+UDI9l I LI IVOIVjJO IV.I VVUV I V
Washing on State
Depairnent of
940 Commerce
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 tie 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;
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.
21. 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 GRANTEE
under this Grant Agreement, 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).
22.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.
Page 14 of 21
0 Washiny:on Slate
Department of
Commerce
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 Grant 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 Grant Agreement. The GRANTEE is
prohibited from charging to the Subaward the costs of CDBG-ineligible activities, including those
described at 24 CFR 570.207, and from using funds provided herein or personnel employed in the
administration of activities under this Grant 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, "CPD Implementation Guidance for the
Build America, Buy America Act's Buy America Preference" (Notice CPD-25-01) any funds obligated
by HUD 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
request release of funds for the project. The GRANTEE must allow a seven (7) or fifteen (15) day
Page 15 of 21
Washing;on Slate
Depa•tment of
%kir Commerce
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 ocal 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 par.,with funds under this Grant Agreement
in excess of$25,000 shall be used to meet one of the CDBG national object ves 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,
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.
Page 16 of 21
ilia Washinglon State
4b Commerce
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. The
GRANTEE shall maintain documentation that demonstrates compliance with applicable hour and
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 Development
Act of 1968, 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). The
purpose of section 3 is to ensure that employment and other economic opportunities generated
by HUD assistance or HUD-assisted projects covered by section 3, shall, to the greatest extent
feasible, 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, which
implement section 3. 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 under
this section 3 clause and will post copies of the notice in conspicuous places at the work site
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 3
clause, 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,that
are filled (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 employment
opportunities to be directed, 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)also
applies to the work to be performed under this contract. Section 7(b)requires that to the greatest
extent feasible (i) preference and opportunities for training and employment shall be given to
Indians, and (ii) preference in the award of contracts and subgrants and/or subcontracts shall be
given to Indian organizations and Indian-owned Economic Enterprises. Parties to this Grant
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).
Page 17 of 21
VV0001 1I LI IVOIV1JO 1V.I vvVV IVV-ULLV-VfVL-V 1V 1-L/VGL1 VI LUP,11-
r>k Washing on State
940 Commerce
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 furn shed 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 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 after
December 11, 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-L157)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 a-eas of employment, public
accommodations,state and local government services, and telecommunications. It further provides
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
Page 18 of 21
1-/UI.UDly1I CI I VCIUpC IL/.rUUOU I UI.-OLCI,-UMUC-O III I-L/ULCI- CUPVIC
deliWashington State
940 Commerce
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 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.
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 in
COMMERCE's procurement policies and procedures. In all cases not governed by the conflict-of-
Page 19 of 21
0Washington State
Depanrneni of
Commerce
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, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with the awarding of any federal contract, the making of any federal
grant, the making of any federal loan, the entering into of any cooperative agreement, and
the extension, continuation, renewal, amendment, or modification of any federal contract,
grant, loan, or cooperative agreement;
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, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this federal contract, grant, loan, or cooperative agreement, 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 20 of 21
0 Washington State
Department of
Co
Attachment B — Scope of Work and Budget
Grantee: Jefferson County I Grant No. 26-64210-007
Project Description/Deliverable
Jefferson County is awarded a CDBG Public Services Grant for eligible Public Services through Olympic
Community Action Programs to low-and moderate-income persons in Jefferson and Clallam Counties..
The services will be directed to limited clientele with low and moderate incomes (LMI) based on HUD LMI criteria.
This grant will exclusively benefit approximately 100 persons residing in the non-entitlement areas of Jefferson and
Clallam counties.
Project Budget
Budget Code & Funding Leveraged Other Funding Total Funding
21A General $3,000 Other Federal$ $
Administration $
05 Public Services$ $98,000 Other State$ $
Local Public$ $
Total CDBG Funds $101,000 Total Other $ $101,000
Funds
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 Jan 31, July 31
date.
• As necessary, arrange an audit with the Washington State Auditor in accordance with the Annually
Uniform 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 Before final
reimbursed are allowable.
• Conduct a final public hearing to review project performance, resolve all monitoring payment request
issues with CDBG, and submit a CDBG Contract Closeout Report.
Page 21 of 21
irk Washington State Local Government Division
Department of
140 Commerce Contract/Amendment Routing
Review by: Name: Initials: Date:
Ds
Section Manager Jon Galow
10/6/2026 I 2:38 PM PDT
Initial
Budget Analyst Lori Creason 10/6/2C26 I 2:41 PM PDT
Managing Director Maria Jawad CC only
Deputy Assistant Erika Henry
Director
0 docusign.
Certificate Of Completion
Envelope Id:F008010C-B2EC-8A0E-81C1-D02EFC7E9A4E Status:Sent
Subject:DocuSign: 2026 CDBG Public Services contract: 26-64210-007 Jefferson County
Division:
Local Government
Program:CDBG Public Services
ContractN u m ber:26-64210-007
DocumentType:Contract
Source Envelope:
Document Pages:22 Signatures:0 Envelope Originator:
Certificate Pages:5 Initials:2 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: 147.55.149.253
Record Tracking
Status:Original Holder:Jeff Hinckle Location: DocuSign
10/6/2026 9:35:49 AM jeff.hinckle@commerce.wa.gov
Security Appliance Status:Connected Pool:StateLocal
Signer Events Signature Timestamp
Jon Galow Sent: 10/6/2026 9:39:48 AM
jon.galow@commerce.wa.gov Lcia Resent: 10/6/2026 12:30:59 PM
Federal Programs Section Manager,CIA Unit Viewed: 10/6/2026 2:38:13 PM
Security Level:Email,Account Authentication Signed: 10/6/2026 2:38:47 PM
(None) Signature Adoption:Pre-selected Style
Using IP Address: 198.238.29.25
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Lori Creason "",' Sent: 10/6/2026 2:38:49 PM
lori.creason@commerce.wa.gov LI Viewed: 10/6/2026 2:40:53 PM
Security Level:Email,Account Authentication 111 Signed: 10/6/2026 2:41:43 PM
(None),Login with SSO
Signature Adoption:Pre-selected Style
Using IP Address: 147.55.134.49
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Amanda Christofferson Sent: 10/6/2026 2:41:45 PM
amchristofferson@co.jefferson.wa.us Viewed: 10/7/2026 8:41:09 AM
REPAH representative for HRGP
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 10/7/2026 8:41:09 AM
ID:f87ab9f3-f468-4055-8011-f7323e45724a
Josh Peters
jdpeters@co.jefferson.wa.us
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:5/13/2026 11:30:30 AM
ID:024f9d64-3d4e-4373-809a-4ae 111385929
Signer Events Signature Timestamp
Maria Jawad
maria.jawad@commerce.wa.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Erika Henry
erika.henry@commerce.wa.gov
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Mark Barkley
mark.barkley@commerce.wa.gov
Security Level:Email,Account Authentication
(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 10/6/2026 9:39:48 AM
Envelope Updated Security Checked 10/6/2026 12:23:27 PM
Envelope Updated Security Checked 10/6/2026 12:23:27 PM
Envelope Updated Security Checked 10/6/2026 12:23:27 PM
Envelope Updated Security Checked 10/6/2026 12:23:27 PM
Payment Events .,1 .r Status Timestamps
Electronic Record and Signature Disclosure
Parties agreed to:Amanda Christofferson,Josh Peters
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Washington State Department of Commerce(we, us or Company)may be
required by law to provide to you certain written notices or disclosures. Described below are the
terms and conditions for providing to you such notices and disclosures electronically through the
DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and
Signature Disclosure(ERSD),please confirm your agreement by selecting the check-box next to
`I agree to use electronic records and signatures' before clicking `CONTINUE' within the
DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.15 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein,we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process,please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Washington State Department of Commerce:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: docusign@commerce.wa.gov
To advise Washington State Department of Commerce of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at docusign@commerce.wa.gov and
in the body of such request you must state: your previous email address, your new email
address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from Washington State Department of Commerce
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to docusign@conunerce.wa.gov and in
the body of such request you must state your email address, full name,mailing address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Washington State Department of Commerce
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to docusign@commerce.wa.gov and in the body of such request you must
state your email, full name, mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
signing-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or(ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check-box next to `I agree to use electronic records and signatures' before
clicking `CONTINUE' within the DocuSign system.
By selecting the check-box next to `I agree to use electronic records and signatures', you confirm
that:
• You can access and read this Electronic Record and Signature Disclosure; and
• You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
• Until or unless you notify Washington State Department of Commerce as described
above, you consent to receive exclusively through electronic means all notices,
disclosures, authorizations, acknowledgements, and other documents that are required to
be provided or made available to you by Washington State Department of Commerce
during the course of your relationship with Washington State Department of Commerce.