HomeMy WebLinkAboutAgreements/Contracts - New Hope DV/SADocuSign Envelope ID: COB 99 B3 B-B9A3-47B7-9EA7-233F961EBF7C
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Office of Crime Victims Advocacy
Community Services and Housing Division
SFS' 2022-2023 Crime Victim Service Center Grant
Start date: 07/01/2021
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DocuSign Envelope ID-. COB 99B3B-B9A3-47B7-9EA7-233F96lEBF7C
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DocuSign Envelope ID- COB99B3B-B9A3-47B7-9EA7-233F96lEBF7C
TABLE OF CONTENTS
FaceSheet ....................................................................................
SpecialTerms and Conditions .......................................................................................................................
1
2
1.
Acknowledgement of Federal Funding ...................... ..............................................................................
2
2.
All subawards ("sub grants") must have specific federal authorization ..................................................
2
3.
Applicability of Part 200 Uniform Requirements .............................................. .....................................
2
4.
Billing Procedures and Payment ............................................................................................................
5.
Compensation ........................................................................ i.................
6.
.............................
Compliance with 41 U.S.C. 4712 (including prohibitions on reprisal; notice to employees) ..................
4
7.
Compliance with applicable rules regarding approval, planning, and reporting of conferences,
meetings, trainings, and other events..., ...............................................................................
4
8.
......................
Compliance With DOJ Grants Financial:Guide .......................................................................
5
9.
Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.r F.. R.. Part 385
10.
Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 4.25
11.
Compliance with DOJ regulations pertaining to civil rights and nondiscrimination - 28 C.F.R. Part 545
12.
Compliance with general appropriations -law restrictions on the use of federal funds (FY 2019) .........
5
13.
Computer.Networks ................................................................................ : .........................
6
14.
Determination of suitability to interact with participating minors ............................ ...................................
6
15.
Discrimination Findings .........................................................................................................................
6
16.
Effect of failureto address audit issues ......................................................................
6
17.
Employment eligibility verification for hiring under the award ................................................................
6
18.
Encouragement of policies to ban text messaging while driving ............................................................
7
19.
Examination of Records
7
20.
FFATA reporting: Subawards and executive compensation ...................................................... .............
8
2 1,
Grant Management .........................................................................................................
8
22.
Grant Modification
8
23.
Insurance
8
24.
National VOCA Training, ................... .............................................................................................
9
.25.
OJP Training Guiding Principles ........................................ ................... : .......................................
9
26.
Non; -supplanting: certification ....................
9
27.
Potential. Imposition ofAdditional Requirements .................................................... * ...... :. ; i v Y 2 d 'n ......... ..10
28.
Providing Services to Limited English Proficiency (LEP) Individuals ........ ............................... ...........
10
29.
Recipient integrity and perform a nce :matters: Requirement to report information on certain civil,
criminal, and administrative proceedings to SAM'and FAPIIS ................................... ...............
10
30.
Reclassification of various statutory provisions to a new Title 34 of the United States Code.............
10
31.
Reporting ............................................................................................................
11
32.
.Y ! a .. i a ..Y ! f w. w ; . Y .._
Reporting Potential Fraud, Waste, and Abuse, and Similar Misconduct ..............................................
11
33.
Requirements of the award; remedies for non-compliance or for materially false statements ...........
11
34.
Requirements pertaining to prohibited conduct related to trafficking in parsons (including reporting
requirements and OJP authority to terminate award) ............................................................................
12
35.
Required training for Point of Contact and all Financial Points of Contact ...........................................
12
36.
Requirements related to "de minimis" indirect cost rate ............... ................ .......................................
12
37..
Requirement for data on performance and effectiveness under the award ..........................................
13
38.
Requirements related to Systernfor Award Management and Universal Identifier Requirements....
13
39.
Requirement toAdis close whether recipient is designated "high risk" by a federal grant -making
agencyoutside of DOJ ................................................................................................. I ............................
13
40.
Requirement to report potentially duplicative funding ............................... ... **"*** ...
13
41.
Requirement to report actual or imminent breach of personally identifiable information (PII) ............1
42.
Restrictions on "lobbying . .......... * .......... "; .................... I ............................................................................
14
43.
Restrictions and certifications regarding non -disclosure agreements and related matters ................
14
44.
Specific post -award approval required to use a noncompetitive approach in any procurement
contract that would exceed $250,000 ....................................................................................................
15
45.
Subcontractor Data Collection ..............................................................................................................
15
46.
Unreasonable restrictions on competition under the award; association with federal government....
16
47.
VOCA Funds .................................................. w .................................................................... A ...............
16
oocuSignEnvelope ID: 1EBF7C
48. VOCARequirements ......................................................................... ................................................... 16
General Terms and Conditions ........................................................................................................ ...........
18
1.
Definitions .................................................................................. ~.................................................. .......
18
2.
Access to Data .................................................................................. .................................................
18
9`
Advance Payments Prohibited ............................................................................................ ....................
18
4~
All Writing Contained Herein ......... ......................................................... .................................................
19
5.
Amendments ................ -........................ ................... ................................ .......................... ....................
19
6.
Americans With Disabilities Act LAda\................................ ........... ........................... ............ ...............
1Q
/.
Assignment ...............................
B.
Attorneys' Fees ............................................................................. ..............................................................
19
{l
Audit -._'_--...'_-.-_-.-----.'-.._...--'-.-----_-.__-._-_-'._..'.---'.-19
10.
Certification Regarding Debarn�ent Suspensionor| and Exo��on--.----1�
11.
Of Information ..................................................................... .......... ._.-.2Q
12.
Conflict Of Interest .............................................. ..................................................................................
21
13.
Copyright Provisions ....................................................................... .'........................................ --......
21
14~
Disputes ........................... 1.
15.
Duplicate Payment ................. ............. .............................................................................................. .......
22
16.
Governing Law And Venue ...... ................................................................... ...... ..................... .......... .......
22
17.
Indemnification ......... ....................................................... ..... _............. ....................................................
22
18.
Independent CapacJty Of The Grantee ............................................ ............................ ......................
23
19.
Indirect Costs ......................................................................................................................................
23
20.
Industrial Insurance Coverage ................................................... ..................................... .........................
23
21.
Laws ..................................................................... .................... ....................................................................
23
22.
Accreditation And Registration .... ................... ............................................................... ...
23
2.3.
Limitation Of Authority ..................... ........................ ........................................... ................................
23
24.
NoncomplianceWith Nondiscrimi nation Laws ....................................................................................
23
.25.
Pay Equity ...................................... ...... __..__._______._.__________._._____.____.24
,26.
Political Activities ........................... ._............... ....... ................. _____............................ ................
24
27.
Procurement Standards For Federally Funded _............................................................ ___24
.28.
Publicity ......... --....... ....... ___........ .............. ..................................... ........ ............................ ..25
29.
Recapture .............. ................................. '........................................................ '......................................
25
30.
Records Maintenanoe........................................... ........................... ....... .......................................... .25
31.
Registration With Department Of Revenue ............ ............. ..................................................................
26
32.
Right Of Inspection .................................................... ...................................................................................
26
33.
.-._-___-_..................................................... _-..................................................................
26
34.
Severability .... ......................................................... '........................................... ................................
26
35.
Site Security ...... ............................................'.................'�������.......'..'..................'................26
36.
................ ... ................................... .........................................................
26
37.
Survival ....... .............................................................................................................................................
27
38.
Taxes....................................................................... ........... ............................................... ... ...............
27
39.
Termination For Cause ......... ................................................................... ............................ ..............
27
40.
Termination For Convenience ................. ..................... ................................................. ...................
27
41-
Termination Procedures ............. ............................................... ............................................... ---2
7
42.
Treatment OfAssets ........................................................... ..................................................................
28
/#tachnlentA-Scope of Work
AttaohrnentB-Budget
AttaohnnentD-EouedErn Opportunity Plan Certification
Attachment'D-Victims of Crime Act(VOCA) Program Rule .
DocuSign Envelope ID -1 COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F961 EBF7C
FACE SHEET
Grant Number: 22-31219-012
Washington State Department of Commerce
Community Services and Housing Division
Office of Crime Victims Advocacy
SFY 2022-2023 Crime Victim Service Center Grant
1. Grantee
2. Grantee Doing Business As (optional)
Grant, County Of
New Hope
PO BOX 37
EPHRATA WA 98823-0037
3. Grantee Representative
4. COMMERCE Representative
SuziFode
Jenna Osterman PO Box 42525
Director
Program Coordinator 98504-8304
sfode@grantcountywa.gov
Phone: (360) 725-2884
(509) 764-8402
Fax: (360) 586-7176 1011 Plum Street SE
jenna.osterman@commerce.wa.gov Olympia WA 98501
5. Grant Amount 6.
Funding Source 7. Start Date 8. End Date
$199,988.00 Federal:
0 State: 0 Other: 0 N/A: 0 07/01/2021 06/30/2023
9. Federal Funds
Federal Agency: CFDA Number: Indirect Rate (if applicable):
(as applicable)
Department of Justice, Office 16.575
$181390.00
for Victims of Crime
10. Svitv #
11. UBI # 42. DUNS #
SWV0002426-17
132001884 010202562
13. Grant Purpose
Provide services to victims of crime
COMMERCE, defined as the Department of Commerce, and the Grantee, as defined above, acknowledge and accept the terms of
this Grant and attachments and have
executed this Grant on the date below to start as of the date and year referenced above. The
rights and obligations of both parties to this Grant are governed by this Grant and the following other documents incorporated by
reference: Grant Terms and Conditions including Attachment A — Scope of Work; Attachment B — Budget; Attachment C —Equal
Employment Opportunity Plan Certification; Attachment D - Victims of Crime Act (VOCA) Program Rule; and Grantee's Application for
funding.
5 6- �R A E
FOR COMMERCE
INEE
TG�R
Signature
Diane Klontz, Assistant Director
Cindy Carter, BOCC Chair
Name
Date
APPROVED AS TO FORM ONLY
Title
BY ASSISTANT ATTORNEY GENERAL
APPROVAL ON FILE
Date
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
I
Grant Number: 22-31219-012
Washington State Department of Commerce
Community Services and Housing Division
Office of Crime Victims Advocacy
SFS' 2022-2023 Crime Victim Service Center Grant
1. Grantee ----- ------------
2. Grantee Doing Business As (optional)
Grant, County Of
New Hope
PO BOX 37
EPHRATA WA 98823-0037
3, Grantee Representative
4 - COMMERCE Representative
SuziFode
Jenna Osterman PO Box 42525
Director
Program Coordinator 98504-8304
sfode.@grantc.ountywa.gov
Phone: (360) 725-2884
(509) 764-8402(360)
586-7176 1011 Plum Street SE
jrr.rrrrrrrOlympia WA 98501
5. Grant Amount
6. Funding Source
7. Start Date
8. End Date
$'199,98 .00
Federal: 0 State: 21 Other: ® N/A: 0
07/01/202.1
06/3012023
9. Federal Funds
FedAg
eral ency:
.......... ...
CFA Number:
Indirect if ap
Rate (plicable):
(as applicable)
Department of Justice, Office
16.575
$181390.00
for Victims of Crime
10. S,WV #
11. UB #
12. DUNS #
SWVOOO.2426-17
132001884
010.202562
13. Grant Purpose
Provide services to victims of crime
COMMERCE, defined as the Department of Commerce, and the Grantee, as defined above, acknowledge and accept the terms of
this Grant and attachments and have executed this Granton the date below to start as of the date and year referenced above. The
rights and obligations of both parties to this Grant are governed by this Grant and the following other documents incorporated by
reference: Grant Terms and Conditions including Attachment A — Scope of Work;Attachment B — Budget; Attachment C —Equal
Employment Opportunity Plan Certification; Attachment D - Victims of Crime Act(VOCA) Program. Rule;and Grantee's Application for
fundina.
FOR GRANTEE
FOR COMMERCE
Doouftned by:
Doouftned by:
Signature
Diane -K'.Io'-ntz, Assistant Director
Cindy Carter
8/5/2021 5:14 PM PDT
Date
Name
Cindy Carter BOCC chairperson
APPROVED AS TO FORM ONLY
BY ASSISTANT ATTORNEY GENERAL
Title
APPROVAL ON FILE
8/4/2021 3:57 PM PDT
Date
DocuSign Envelope ID-_ COB 99B3B-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
1. ACKNOWLEDGEMENT OF FEDERAL FUNDING
Federal Award Date: 9117/2020
Federal Award Period.* 10/1/2019 — 913012023
Federal Award Identification Number (FAIN).- 2020-V2-G.X-0022
Total Amount of the Federal Award: $38,159,052
Awarding Official: Department of Justice, Office of Justice Programs, Office for Victims of Crime
Amount obligatedby this action: $181390.00
The Grantee agrees that any publications (wmitten, 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, shall contain, the following -statements:
"This project was supported by Grant No. 2020-V2-GX-0022 awarded by Office for Victims of
Crime, US Department of Justice. 'Points of view in this document are those of the author and
do not necessarily represent the official position or policies of the Office for Victims of Crime,
US Department of Justice. Grant funds are administered by the Office of Crime Victims
Advocacy, Washington State Department of COMMERCE."
In the event a correction is required to the Acknowledgement of Federal Funding, an administrative
change will be processed.A change to the Acknowledgement of Federal Funding will not affect your
budget or scope of work and: notice will be provided.
Thissubaward may not be used for research and development purposes.
MEMM411 F I NMI
As applicable. The recipient, and any subrecipient ("subgrantee") at any tier, must comply with all
applicable requirements for authorization of any Buba card. This condition applies to agreements that -
for purposes of federal grants administrative requirements -- OJP considers a "subaward" (and
therefore does not consider a procurement "contract").
The details of the requirement for authorization of any subaward are posted on the OJP web site at
,https.*Hoi,p-gov/fundinq/`Expl:or/`S,ubawardAuthoriz.ti on.htm, (Award condition: All subawards
subgrants") must have specific federal authorization), and are incorporated by reference here.
3. APPLICABILITY OF PART.200 UNIFORM REQUIREMENTS
The Uniform Administrative Requirements, Cost Principles, and Audit Requirements in 2 C.F.R. Part
200, as adopted and supplemented by DOJ in 2 C.F.R. Part 2800 (together, the "Part 200 Uniform
Requirements") apply to this FY 2019 award from OOP.
The Part 200 Uniform Requirements were first adopted by DOJ on December 26, 2014. If this FY 2019
award supplements funds, previously awarded by OJP under the same award number (eg., funds
awarded during or before December 2014), the Part 200 Uniform Requirements apply with respect to
all funds under that award number (regardless of the award date, and regardless of whether derived
from the initial award or a supplemental award) that are obligated on or after the acceptance date of
this FY 2019 award.
For more information and resources on the Part 200 Uniform Requirements as they relate to OJP
awards and subawards ( "sub rants"), see the OJP website at
,https.-//oip.gov/fundinq/`Part200UniformRequiremen:ts.htm.
Record retention and access: Records pertinent to the award that the recipient (and any subrecipient
( "subgrantee") at any tier) must retain -- typically for a period of 3 years from the date of submission of
the final expenditure report SF j, unless a different retention period applies -- and to which the
KA
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
recipient (and any subrecipient (Usubgrantee") at any tier) must provide access, include performance
measurement information, in addition to the financial records, supporting documents, statistical records,
and other pertinent records indicated at 2 C.F.R. 200.333.
In the event that an award -related question arises from documents or other materials prepared or
distributed by OJP that may appear to conflict with, or differ in some way from, the provisions of the
Part 200 Uniform Requirements, the recipient is to contact OJP promptly for clarification.
4. BILLING PROCEDURES AND PAYMENT
COMMERCE will pay Grantee upon acceptance of services provided and receipt of properly completed
invoices, which -shall be submitted to the Representative for COMMERCE at least quarterly, but not
more often than monthly.
The Grantee shall submit all requests for reimbursement via COMMERCE's online in -voicing system.
The invoice shall include the Invoice Documentation Form.
COMMERCE will pay Grantee upon acceptance of program activities provided and receipt of properly
pay
completed invoices.
Payment shall be considered timely if made by COMMERCE within thirty (30) calendar days after
receipt of properly completed invoices. Payment shall be sent to the address designated by the
Grantee.
COMMERCE May, in its sole discretion, terminate the Grant or withhold payments claimed by the
Grantee for services rendered if the Grantee falls to satisfactorily comply with any term or condition of
this Grant.
No payments in advance or in anticipation of services or supplies to be provided under this Grant shall
be made by COMMERCE.
Invoices and End of Fiscal Year
Invoices are due on the 20th of the month following the provision of services..
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 grantee must invoice for all expenses from the beginningof the contract through June 30,
regardless of the contract start and end date.
Duplication of Billed Costs
The Grantee shall not bill COMMERCE for services performed under this Grant, 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 Subcontractors.
5. COMPENSATION
COMMERCE shall pay an amount not to exceed ($199,988.00) for the performance of all things
necessary for or incidental to the performance of work as set forth in Attachment A - Scope of Work.
Grantee's compensation for services rendered shall be based on the following rates or in accordance
with Attachment B — Budget.
3
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
The Grantee shall provide a non-federal match for the Victims of Crime Act portion of this Grant. The
total match to be provided shall be at least $49,997.00. All funds designated as match are restricted to
the same uses as VOLA federal funds. Match funds may be expended in a greater proportion to grant
funds, however, all match funds must be expended prior to the close of this Grant. Expenditures of
match funds must be identified On the invoice voucher form.
Transfer of funds between line item budget categories must be approved by the Office of Crime Victims
Advocacy (OCVA) program staff. A cumulative amount of these transfers exceeding ten (10) percent
of the total program budget shall be subject to justification and negotiation between the Grantee and
OCVA, including approval from the Grantee's signature authority and the relevant OCVA Section
Manager.
Payment will be on a reimbursement basis only.
Consultant fees may not exceed $650 per day or $81.25 per hour for the Victims of Crime Act portion
of this Grant (excluding travel and subsistence costs).
Travel expenses -incurred or paid by Grantee shall be reimbursed at a rate not to exceed the current
state rate and in accordance with the State of Washington Office of Financial Management Travel
Regulations., Current travel rates may be accessed at
https://ofm.w a.gov/sites/default/`files, blic/resources/travel'/colormap,. f.
The Grantee agrees to comply with the financial and administrative requirements set forth in the current
edition of the Office of Justice Programs Financial Guide., which can be found at
hftp!s.-Ho':g.,govffinancialguide/doi/pdfs/DO:moi' F'inancia1Guijg..pdf.
Funds payable under this Grant include federal Victims of Crime Act (VOCA) victim assistance grant
funds (CFS A Number 16.575).
In performance of the services, requirements, and activities set forth herein, the Grantee shall comply
with, all applicable federal requirements of the Victims of Crime Act Rule
,hftps.*//www.federal',register.q.ov/documeiits/`2016/07/08/2016-16085,/`victims-of-crime-act-vi,ctim-
assistance-program.
6. ACOMPLIANCE WITH 41 U.S.C. 4712 [.INCLUDING PROHIBITIONS ON REPRISAL,-, NOTICE TO
EMPLOYEEPJ
The recipient (and any subrecipient at any tier) must comply with, and is subject to, all applicable
provisions of 41 U.S.C. 4712, including all applicable provisions that prohibit, under specified
circumstances, discrimination against an employee as reprisal for the employee's disclosure of
information related to gross mismanagement of a federal grant, a gross -waste of federal funds, an
abuse of authority relating to a federal grant, a substantial and specific danger to public health or safety,
or a violation of law, rule, or regulation related to a federal grant.
The recipient also must inform its employees, in writing (and in the predominant native language of the
workforce), of employee rights and remedies under 41 U.S.C. 4712.
Should a question arise as to the applicability of the provisions of 41 U.S.C. 4712 to this award, the
Grantee shall contact COMMERCE; COMMERCE is to contact the DOJ awarding agency (OJP or
OVW, as appropriate) for guidance.
SND 7. COMPLIANCE WITH APPLICABLE RULES REGARDING APPR,2VAL1 PLANNINGL_AND
REPORTING OF CONFERENCES, MEETINGS, TRAININGS, AND OTHER EVENTS
The recipient, and any subrecipient ("subgrantee") at any tier, must comply with all applicable laws,
regulations, policies, and official DOJ guidance (including specific cost limits, prior approval and
reporting requirements, where applicable) governing the use of federal funds for expenses related to
0
DocuSign Envelope ID: COB 99 B3 B-B9A3-47B7-9EA7-233F961 EB F7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
conferences as that term is defined by DOJ), including the provision of food and/or beverages at such
conferences, and costs of attendance at such conferences.
Information on the pertinent DOJ definition of conferences and the rules applicable to this award
appears in the DOJ Grants Financial Guide (currently, as section 3.10 of "Posta and Requirements" in
the "DOJ Grants Financial Guide").
8. COMPLIANCE WITHDOJ GRANTS FINANCIAL GUIDE
References to the DOJ Grants Financial Guide are to the DOJ Grants Financial Guide as posted on
the OJP website (currently, the "DOJ Grants Financial Guide" available at
left ps-//oig-govffina,ncialgu:id'e/DOJ/"index.htm), including any updated version that may be posted during
the period of performance. The recipient agrees to comply with the DOJ Grants Financial Guide.
9. COMPLIA,NCE WITH DOJ REGULATIONS PERTAINING TO CIVIL RIGHTS AND
NONDISCRIMINATION - 28 C.F.R. PART 38
The recipient, and any -subrecipient ("subgrantee") at any tier, must comply with all applicable
requirements of 28 C.F.R. Part 38, specifically including any applicable requirements regarding written
notice to program beneficiaries and prospective program beneficiaries.
Among other things, 28 C.F..R. Part 38 'includes rules that prohibit specific forms of discrimination on
the basis of religion, a religious belief, a refusal to hold a religious belief, or refusal to attend or
participate in a religious practice.
Part 38 also sets out rules and requirements that pertain to: recipient and subrecipient ("subgranteelf)
organizations that engage in or conduct explicitly religious activities, as well as rules and requirements
that pertain to recipients and subrecipients that are faith -based or religious organizations.
The text of the regulation, now entitled "Partnerships with Faith -Based and Other Neighborhood
Organizations," is available via the Electronic :Code of Federal Regulations (currently accessible at
hftps*, Www.ecfr. c 9paae-brow-se), by browsing to Title 28 -Judicial Administration,
jov/cqJbin/ECFR
Chapter 1, Part 38, under e -CFR "current" :data.
10. ICOMPLIANCE WITH DOJ, REGULATIONS PERTAINING TO CIVIL RIGHTS AND
NONDISCRIMINATION - 2.8 C.P.R.. PART 42
The recipient, and any subrecipient ("subgrantee") at any tier, must comply with all applicable
requirements of 28 C.F.R. Part 42, specifically including any applicable requirements in Subpart E of
28 C.F,.R. Part 42 that relate to an equal employment opportunity program.
11. COMPLIANCE WITH DOJ REGULATIONS PERTAINING TO CIVIL RIGHTS AND
NONDISCRIMINATION - 28 C.F.R. PART 54
The recipient, and any subrecipient ("subgrantee") at any tier, must comply with all applicable
requirements of 28 C.F.R. Part 54, which relates to nondiscrimination on the basis of sex in certain
"education programs."
12:. COMPLIANCE WITH GENERAL APPROPRIATIONS -LAW RESTRICTIONS ON THE USE OF
FEDERAL FUNDS (FY 20LO011
The recipient, and any subrecipient ("subgrantee") at any tier, must comply with all applicable
restrictions on the use of federal funds set out in federal appropriations statutes. Pertinent restrictions
may be set out in applicable appropriations acts are indicated at
http.://ojA
-Dov/fundinq/Ex plore/FY.20Apprir)riationsRes-trictions.htm, and are incorporated by reference
here.
5
DocuSign Envelope ID: C0699B3B-B993-47B7-9EA7-233F96lEBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
Should a question arise as to whether a particular use of federal funds by a recipient or a subrecipient)
would or might fall within the scope of an appropriations -law restriction, the recipient is to contact OJP
for guidance, and may not proceed without the express prior written approval of P.
13. COMPUTER NETWORKS
Grantee understands and agrees that it cannot use any federal funds to maintain or establish. a
computer network unless such network blocks the viewing, downloading, and exchanging of
pornography.
14. DETERMINATIP.N OF SUITABILITY TO INTERACT WITH PARTICIPATING MINORS
SCOPE. This condition applies to this award if it 'is indicated -- in the application for the award (as
approved by DOJ) or in the application for any subaward, at any tier), the DOJ fun dinn 'announcement
(solicitation), or an associated federal statute -- that a purpose of some or all of the activities to be
carried out under the award (whether by the recipient, or a brecipient at any tier) is to benefit a set of
individuals under 18 years of age.
The recipient, and any subrecipient at any tier, must make determinations of suitability before certain
individuals may interact with participating minors. This requirement applies regardless of an individual's
employment status.,
The details of this :requirement are posted on the 0JP` web site at
hftps-./,Ioip.q,,ov/fundin...:/,Ex.p.lore/interact-Minors.htm (Award condition: Determination of suitability
required, in advance, for certain individuals who raga
y interact with participating minors), and are
'incorporated by reference here.
1.5. DISCRIMINATION FINDINGS
The recipient assures that 'in the event that aFederal or State court or Federal or State administrative
agency makes a finding of discrimination after a due process hearing on the ground of race, religion,
national origin, sex, or disability against a recipient of victim assistance formula funds under this award,
the recipient will forward a copy of the findings to the office for Civil Rights of OJP.
16. EFFECT OF FAILURE TO ADDRESS AUDIT ISSUES
The recipient understands and agrees that the DOJ awarding agency (OJP or OVW, as appropriate)
and COMMERCE may withhold award funds, or may impose other related requirements, if as.
determined by the DOJ awarding agency) the recipient does not satisfactorily and promptly address
outstanding issues from audits required by the Part 200 Uniform Requirements or by the terms of this
award), or other outstanding issues that arise in connection with audits, investigations, or reviews of
DOJ awards.
17. 'EMPLOYMENT ELIGIBILITY VERIFICATION FOR HIRING UNDER THE AWARD
As applicable.The recipient (and any subrecipient at any tier) must -
1. Ensure that, as part of the hiring process for any position within the United States that is
or will be funded (in whole or in part) with award funds, the recipient or any subrecipient)
properly verifies the employment eligibility of the individual who is being: hired, consistent
with the provisions of 8 U.S.C. 1324a(a)(1) and (2).
2. Notify all persons associated with the recipient or any subrecipient) who are or will be
involved in activities under this award of both --
1 - (1) this award requirement for -verification of employment eligibility, and
2. (2) the associated provisions in 8 U.S.C. 1324a(a)(1) and (2) that, generally
speaking, make it unlawful, in the United States, to hire or recruit for
employment) certain aliens.
0
DocuSign Envelope (D- COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUND'
3. Provide training (to the extent necessary) to those persons required by this condition to
be notified of the award requirement for employment eligibility verification and of the
associated provisions of 8 U.S.C. 1324a(a)(1) and (2).
4. As part of the recordkeeping for the award (including pursuant to: the Part 200 Uniform
Requirements), maintain records of all employment eligibility verifications pertinent to
compliance with this award condition in accordance with Form 1-9 record retention
requirements, as well as records of all pertinent notifications and trainings..
The recipients monitoring responsibilities include monitoring of subrecipient compliance with this
condition.
To the extent that such costs are not reimbursed under any other federal program, award funds may
be obligated for the reasonable, necessary, and allocable costs it any) of actions designed to ensure
compliance with this condition.
For purposes of this condition, persons "who are or will 'be involved in activities under this award"
specifically includes (without limitation) any and all recipient (or any subrecipient) officials or other staff
who are or will be involved in the hiring process with respect to a position that is or will be funded in
'whole or in part) With, award funds.
For purposes of satisfying the requirement :of this condition regarding verification of employment
eligibility, the recipient or any subre ciplient) may choose to participate in, and use, E -Verify
(www.everify.gov), provided an appropriate person authorized to act on behalf of the: recipient (or
Su brecip lent) uses E -Verify (and follows the proper E- Verity procedures, including in the event of a
"Tentative Non confirmation" or a "Final Nonconfirmation") to confirm employment eligibility for each
.b h
hiring for a position in the United States that is or will: e funded (in whole or in part) with award funds.
United States" specifically includes the District of Columbia, Puerto Rico, Guam, the Virgin Islands of
the United States,, and the Commonwealth of the Northern Mariana Islands.
Nothing in this condition shall be understood to authorize orrequi
I re any recipient, any subrecipient at
any tier, or any person or other entity, to violate any federal law, including any applicable civil rights or
nondiscrimination; law.
Nothing in this condition, including in, paragraph 4.B., shall be understood to relieve any recipient, any
slubrecipient at any tier, or any person or other entity, of any obligation otherwise imposed by law,
including 8 U.S.C. 1324a(a)(1) and (2).
Questions about E -Verify should be directed to DHS. For more information about E -Verify visit the E -
Verify website (.h.ttps:Hwww.e-seri ) or email E -Verify at E-Veri[y2--dhs..gov. E -Verify employer
agents can email E -Verify at E-VerifyErn ployerAcienter ,dhs.clov.
Questions about the meaning or scope of this condition should be directed to COMMERCE,
before award acceptance.
18. ENCOURAGEMENT OF POLICIES TO BAN TEXT MESSAGING WHILE DRIVING
Pursuant to Executive Order 13513, "Federal Leadership on Reducing Text Messaging While Driving,"
74 Fed. Reg. 51225 (October 1, 2009)a DOJ encourages recipients and subrecipients ("subgrantees1l)
to adopt and enforce policies banning employees from text messaging while driving any vehicle during
the course of performing work funded by this award, and to establish workplace safety policies and
conduct education, awareness, and other outreach to decrease crashes caused by distracted drivers.
19. EXAMINATION OF RECORDS
h
DocuSign Envelope ID: COB99B3B-BBA3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
The Grantee authorizes Office for Victims of Crime (OVC) and/or the Office of the Chief Financial Officer
(OCFO), and its representatives, access to and the right to examine all records, books, paper or
documents related to the VOLA grant.
The State will further ensure that all VOLA subgrantees will authorize representatives of OVC and
OCFO access to and the right to examine all records, books, paper or documents related to the VOLA
grant..
20.
.FF ATA REPORTING: SUBAWARDS AND EXECUTIVE COMPENSATION
As applicable. The recipient must comply with applicable requirements to report first-tier subawards
"sub rants" of $25,000 or more and, in certain circumstances, to report the names and total
compensation of the five most highly compensated executives of the recipient and first-tier
subrecipients (first-tier "subgrantees") of award funds. The details of recipient obligations, which derive
from the Federal Funding Accountability and Transparency Act of 2006 (FFATA), are posted on the
0,JP web siteat https.-Hoj,12.go'v/fundinq/Explore/`FFATA.h:t,m, (Award condition: Reporting Subawards
and Executive Compensation), and are incorporated by reference here.
This condition, including its reporting requirement, does not apply to-- (1) an award of less than $25 '000
or (2) an award made to an individual who received the award as a natural person (i.e., unrelated to
any business or non-profit organization that he or she may own or operate in his or her name).
COMMERCE submits FFATA information on behalf of all Grantees.
21,.,GRIT 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.
The Representative for COMMERCE and their grant information are identified on the Face Sheet
of this Grant.
tr
The for the grantee and their contact information are identified on the Face Sheet
of this Grant.
Notwithstanding any provision of this grant to the contrary, at any time during the grant period,
COMMERCE may, by written. notification to the Grantee and without notice to any known guarantor or
surety, make changes within the general scope of the program activities to be performed under this
Grant. All other modifications shall not be valid unless made in writing and signed by the parties. Any
oral understandings and agreements not incorporated herein, unless made in writing and signedby the
parties hereto, shall not be binding.
Notwithstanding any provision of this grant to the contrary, at any time during the grant period,
COMMERCE may analyze grant expenditures as a proportion of the grant budget. If COMMERCE
determines, in its sole discretion, that the grant funding is underutilized, COMMERCE, in its sole
discretion, may unilaterally modify the grant to reduce the balance of the grant budget. Funds de -
obligated by COMMERCE as a result of a budget reduction may be made available to othergrantees
for the provision of eligible program activities.
23. !NSURANCE
The Grantee shall provide insurance coverage as set out in this section. The intent of the required
insurance is to protect the state 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
Subgranteelsubcontractor, or agents of either, while performing under the terms of this Grant. �Failure
to maintain the required insurance coverage may result in termination of this Grant.
0
DocuSign Envelope [D-- COB99B3B-B9A3-4777-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
The insurance required shall be issued by an insurance company authorized to do business within the
state of Washington. Except for Professional Liability or Errors and Omissions Insurance, the insurance
shall name the state of Washington, its agents, officers, and employees as additional insureds under
the insurance policy. All policies shall be primary to any other valid and collectable insurance. The
Grantee shall instruct the insurers to give COMMERCE thirty (30) calendar days advance notice of any
insurance cancellation, non -renewal or modification.
The Grantee shall submit to COMMERCE within fifteen (15) calendar days of a written request by
COMMERCE, a certificate of insurance which outlines the coverage and limits defined in this insurance
section. During the term Of the Grant, if required or requested, the Grantee shall submit renewal
certificates not less than thirty (30) calendar days prior to expiration of each policy required under this
section.
The Grantee shall provide, at COMMERCEs request, copies of insurance instruments or certifications
from the insurance issuing agency. The copies or certifications shall show the insurance coverage, the
designated beneficiary, who is covered, the amounts, the period of coverage, and that COMMERCE
will be provided thirty (30) days advance written notice of cancellation.
The Grantee shall provide insurance coverage that shall be maintained in full force and effect during
the term of this Grant, as follows:
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 Grant activity but no less than $1,000,,000 per
occurrence. Additionally, the Grantee is responsible for ensuring that any
Subgrantee/subcontractor provide adequate insurance coverage for the activities arising out of
subgrants/subcontracts.
Automobile Liability. In the event that performance pursuant to this Grant involves the use of
vehicles, owned or operated by the Grantee or its Subgrantee/subcontractor, automobile liability
insurance shall be required. Theminimum limit for automobile liability is $1,000,000 per occurrence,
using a Combined Single 'Limit for bodily injury and property damage.
Professional Liability, Errors and Omissions Insurance. The Grantee shall maintain
Professional Liability or Errors and Omissions Insurance. The Grantee shall maintain 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, its agents, officers, and
employees need not benamed as additional insureds under this policy.
As applicable:. The recipient agrees to ensure that at least one key grantee official attends the annual
VOCA National Training Conference. Any recipient unable to attend must get prior approval by OVC in
writing.
COMMERCE attends this training to meet this federal requirement; Grantees should not plan to attend
the training event, attendance is not eligible.
25.. OJP TRAINING GUIDING PRINCIPLES
Any training or training materials that the recipient -- or any subrecipient ("subgrantee" at any tier --
develops or delivers with OJP award funds must adhere to the OJP Training Guiding Principles for
Grantees and Subgrantees, available at
'hftp!s:Hoip.gov,/fundinq/`lmp:].ement/TraininqPrincip:lesForGrantees-Su rantees.htm.
26. NON -SUPPLANTING CERTIFICATION
isi
E*
DocuSign Envelope [D-- COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
No
VOLA Grant funds will be used to supplant existing state, local, or other non-federal funding already
in place to support current services. VOLA Grant funds will be used to increase the total amount of
funds :used for crime victim assistance. Violation of the non -supplanting requirement can result 'in a
range of penalties, including suspension of future funds under this grant, recoupment of monies
provided under this grant, and civil and./or criminal penalties.
As applicable.. The recipient agrees to comply with any additional requirements that may be imposed
by the DOJ awarding agency (!BJP or OVW, as appropriate) during the period of performance for this
award, if the recipient is designated as "high risk" for purposes of the DOJ high-risk grantee list.
DOJ monitors and evaluates risk for COMMERCE, and COMMERCE monitors and evaluates risk for
Grantees. Grantee agrees to comply with any additional requirements that may be imposed if
COMMERCE has designated the Grantee as "high risk" via risk assessment and monitoring
procedures.
pl*4111111111�j
- - -----------
In accordance with DOJ guidance pertaining to Title V1 of the Civil Rights Act of 1964, 42 U.S.C. §
2000d, recipients of federal financial assistance must take reasonable steps to provide meani . ngful
access to their programs and activities for persons with limited English proficiency (LEP). See U.S.
Department of Justice, Guidance to Federal Financial Assistance Recipients Regarding Title VI
Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons, 67 Fed.
Reg. 41,455 (2002). For more information on the civil rights responsibilities that recipients have in
providing language services to LEP individuals, please see the we'bsite,bttp�.://www.Iep,q,p.v.
29.,RECIPIENT INTEGRITY AND PERFORMANCE MATTERS: REQUIREMENT TO REPORT
INFORMATION ON CERTAIN CIVILCRIll' AL SND ADMINISTRATIVE PROCEEDINGS TO SAM
AND FAP1IS
The recipient must comply with any and all applicable requirements regarding reporting of information
on civil, criminal, and administrative proceedings connected with (or connected to theperformance of
either this JP award or any other grant, cooperative agreement, or procurement contract from the
federal government. Under certain circumstances, recipients of OJP awards are required to report
information about such proceedings, through the federal System for Award Management (known as
to
SAM"), to the designated federal integrity and performance system (currently, "FAPIIS").
The details of recipient obligations regarding the required reporting (and updating) of information on
certain civil, criminal, and administrative proceedings to the federal designated integrity and
performance system (current)y, "'FAPIIS") within SAM are posted on the OJP web site at
..https,*//ojp.gQv,/f'undinq,/FAPIIS.htm (Award condition: Recipient Integrity and Performance Matters,
...... .... -
including Recipient Reporting to FAPIIS), and are incorporated by reference here.
30.. RECLASSIFICATION OF VARIOUS STATUTORY PROVISIONS TO A NEW TITLE 340F THE
UNITED STATES CODE
As applicable. On September 1, 2017, various statutory provisions previously codified elsewhere in the
U.S. Code were editorially reclassified to a new Title 34, entitled "Crime Control and Law Enforcement."
The reclassification encompassed a number of statutory provisions pertinent to OJP awards that is,
OJP grants and cooperative agreements), including many provisions previously codified in Title 42 of
the U.S. Code.
Effective as of September 1, 2017, any reference in this award document to a statutory provision that
has been reclassified to the new Title 34 of the U.S. Code is to be read as a reference to that statutory
provision as reclassified to Title 34. This rule of construction specifically includes references set out in
im
DocuSign Envelope ID: COB 99 B3 6- B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FLS
award conditions, references set out in material incorporated by reference through award conditions,
and references set out in other award requirements.
Grantees will submit quarterly reports on SFS' 2022-2023 Crime Victim Service CenterGrant activities
via Info let. Grantees must collect and maintain data that measure the performance and effectiveness
of work done under this brant.
If providing direct services or outreach, the Grantee shall submit data quarterly in the lnfoNet data
collection system, relative to the provision of SFY 2022-2023 Crime Victim Service Center Grant
services. Report data will be due in InfoNetno later than the fifteenth day following the end of each
quarter.
The Grantee shall submit non -personally identifying demographic, service and compliance data
required by state funding sources in the InfoNet data collection system,. The Grantee shall maintain
documentation and records that support the data reported in InfoNet.
The Grantee shall establish and maintain written procedures for the security of InfoNet use at its site.
Procedures shall include-.
0 Only authorized staff are provided access to the lnfoNet data and files;
0 Staff are informed of the need for security and confidentiality of data and files maintained in or
available through the InfoNet system; and
That the Grantee shall notify the DepartmentProgram Coordinator for this grant when an employee
is no longer authorized to access the InfoNet system.
This information on the activities supported by the grant funding will assist in assessing the effects that
the VOCA Victim Assistance funds have had on services to crime victims within the jurisdiction.
32. REPORTING POTENTIAL FRAUD, LAIs E AND ABUSE, AND SIMILAR MISCONDUCT
The recipient and any subrecipients ("subgrantees") must promptly refer to the DOJ Office of the
Inspector General (01G) any credible evidence that a principal, employee, agent, subrecipient,
contractor, subcontractor, or other person has, in connection with funds under this award -- (1)
-submitted a claim that violates the False Claims Act; or (2) committed a criminal or civil violation of laws
pertaining to fraud, conflict of interest, bribery, gratuity, or similar misconduct.
Potential fraud, waste, abuse, or misconduct involving or relating to funds under this award should be
reported to the OIG by-- (1) mail directed to: Office of the Inspector General, U.S. Department of Justice,
Investigations Division, 1425 New York Avenue, N.W. Suite 7100, Washington, DC 20530; and/or (2)
the DOJ OIG hotline: (contact information in English. and Spanish) at (800) 869-4499 (phone) or (202)
616-9881 (fax).
Additional information is available from the DOJ OIG website at https-.//Qiq.iusticp.gov/h:o:tline.
33. I EQUIREMENTS OF THE AWARD; REMEDIES FOR NON-COMPLIANCE OR FOR MATERIALLY
FALSE STATEMENTS
The conditions of this award are material requirements of the award. Compliance with any certifications
or assurances submitted by or on behalf of the recipient that relate to conduct during the period of
performance also is a material requirement of this award.
Failure to comply with any one or more of these award requirements -- whether a condition set out in
full below, a condition incorporated by reference below, or a certification or assurance related to conduct
during the award period may result in the Office of Justice Programs ("OJP") taking appropriate action
11
DocuSign Envelope ID: COB 99B3B-B9A3-47B7-9EA7-233F961 EB F7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
with respect to the recipient and the award. Among other things, the OJP may withhold award funds,
disallow costs, or suspend or terminate the award.
The Department of Justice ("DOX), including OJP, also may take other legal action as appropriate
Any materially false, fictitious, or fraudulent statement to the federal government related to this award
(or concealment or omission of a material fact) may be the subject of criminal prosecution (including
under 18 U.S.C. 1001 and/or 1621, and./or 34 U.S.C. 10271-10273), and also may lead to imposition
of civil penalties and administrative remedies for false claims or otherwise (including under 31 U.S.C.
3729-3730 and 3801-3812).
Should any provision of a requirement of this award be held to be invalid or unenforceable by its terms,
that provision shall first be applied with a limited construction so as to give it the maximum effect
permitted by law. Should it be held., instead, that the provision is utterly invalid or -unenforceable, such
provision shall be deemed severable from this award.
34. REQUIREMENTS PERTAINING TO PROHIBITED CONDUCT RELATED TO TRAFFICKING IN
PERSONS INCLUDING REPORTING REQUIREMENTS AND OJP AUTHORITY TO TERMINATE
AWARQl
The recipient, and any subra cipient ("subgrantee") at any tier, must comply with all applicable
i
requrements (including requirements to report allegations) pertaining to prohibited conduct related to
the trafficking of persons, whether on the part of It recipients, subra cipients ( "subgrantees"), or individuals
i
defined (for purposes of this condition) as empltooyees :of the recipient or of any subrecipient.
The details of the recipient's obligations related to prohibited conduct related to trafficking in persons
are posted on the OJP web site at h:ttp.s:Ho'lp..qov/fundina/"E.xplore/`Prolil*bitedConduct-Traffickin htm
(Award condition: Prohibited conduct by recipients and subrecipients, related to trafficking in persons
(including reporting requirements and OJP authority to terminate award)), and are incorporated by
reference here.
35. REQUIRED TRAINING -FOR POINT OF CONTACT AND ALL, FINANCIAL POINTS OF CONTACT
As applicable. The State Administering Agency (COMMERCE) fulfills the requirements in this section.
Grantees should not anticipate completing the OJP financial management and grant administration
training.
Both the Point of Contact (POC) and all Financial Points of Contact (FPOCs) for this award must have
successfully completed an "OJP financial management and grant administration training" by 120 days
after the date of the recipient's acceptance of the award. Successful completion of such a training on
or after January 1, 2017, will satisfy this condition.
In the event that either the POC or an FP' OC for this award changes during the period of performance,
the new POC or FPOC must have successfully completed an "OJP financial management and grant
administration training" by 120 calendar days after -- (1) the date of OJPs approval of the "Change
Grantee Contact" GAN in the case of a new POC), or (2) the date the POC enters in -formation on the
new FPO! in GMS (in the case of a new FPOC). Successful completion of such a training on or after
January 1, 2017, will satisfy this condition.
A list of OJP trainings that OJP will consider "OJP financial management and grant administration
training" for purposes of this condition is available at hftps:://oip..qov/tr-aining/fmts.htm. All trainings that
satisfy this condition include a session on grant fraud prevention and detection.
The recipient should anticipate that OJP will immediately withhold ("freeze") award funds if the recipient
fails to comply with this condition. The recipient's failure to comply also may lead OJP to impose
additional appropriate conditions on this award.
12
DocuSign Envelope ID- COB99B36-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
36.. flEgUIREMENTS RELATED TO "EDE MINIMIS" INDIRECT COST RATE
As applicable. A recipient that is eligible under the Part 200 Uniform'Requirements and other applicable
law to use the "de minimis" indirect cost rate described in 2 C.F.R. 200.414(f), and that elects to use
the "de minimis" indirect cost rate, must advise OJP in writing of both its eligibility and its election, and
must comply with all associated requirements in the Part 200 Uniform Requirements. The "de minimis"
rate may be applied only to modified total direct costs (MTDC) as defined by the Part 200 Uniform
Requirements.
Recipient requirement to notify 0JP is for COMMERCE. Grantees must work with their COMMERCE
grant manager regarding requirements related to "Ide minimis" indirect, cost rate.
37. REQUIREMENT Fob, DATA ON PERFORMANCE AND EFFECTIVENESS UNDER THE AWARD
The recipient must collect and maintain data that measure the performance and effectiveness of work
under this award.
The data must be provided to OJP in the manner (including within the timefrarnes) specified by OJP in
the program solicitation or other applicable written guidance. Data collection supports compliance with,
the Government Performance and Results Act (GPRA) and the 'PRA Modernization Act of 201 0., and
other applicable laws..
Grantees report data to their COMMERCE grant manager at jenna.osterman@commerce.wa.gov. See
"Reporting" Special Term and Condition. COMMERCE will report this data, to OJP..
38..,RgQUIREMENTS RELA ' TED TO SYSTEM FOR AWARD MANAGEMENT AND UNIVERSAL
IDENTIFIER REQUIREMENTS
The recipient must comply with applicable requirements regarding the System for Award Management
(SAM), currently accessible at http:s.*//,,Www.s.am.qov/`. This includes applicable requirements regarding
registration with SAM, as well as maintaining the currency of information in SAM.
i
The recipient also must comply with applicable restrictions on subawardsf ( subgrants") to first-tier
Subrecipients (first-tier "subgrantees"), including restrictions on subawards to entities that do not
acquire and provide to the recipient) the- unique entity Identifier required for SAM registration.
The details of the recipient's obligations related to SAM and to unique entity identifiers are posted on
the OJP web site at https-.//Qj,p..gov/fundin lore/SAM.htm (Award condition: System for Award
Management (SAM) and Universal Identifier Requirements), and are incorporated by reference here.
This condition does not apply to an award to an individual rho received the award as a natural person
(i.e., unrelated to any business or non-profit organization that he or she may own or operate in his or
,her name).
39.. REQUIREMENT TO DISCLOSE WHETHER RECIPIENT IS DESIGNATED "HIGH RISK" BY A
FEDERAL GRANT-i` NCY IAGEOUTSIDE OF DOJ
*MPPP -poop .0 P I
As applicable. If the recipient is designated "high risk" by a federal grant -making agency outside of
DOJ, currently or at any time during the course of the period of performance under this award the
recipient must disclose that fact and certain related information to OJP by email at
OJP.C2.mplianceReporcin q(a"),pi.usdpi.gov. For purposes of this disclosure, high risk includes any
status under which a federal awarding agency provides additional oversight due to the recipient's past
performance, or other programmatic or financial concerns with the recipient. The recipient's disclosure
must include the following.- 1. The federal awarding agency that currently designates the recipient high
risk, 2. The date the recipient was designated high risk, 3. The high-risk point of contact at that federal
awarding agency (name, phone number, and email address), and 4. The reasons for the high-risk
status, as set out by the federal awarding agency.
13
DocuSign Envelope ID: COB99B3B-B9A3-4777-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
40. REQUIREMENT TO REPORT POTENTIALLY DUPLICATIVE FUNDING
As applicable. If the recipient currently has other active awards of federal funds, or if the recipient
receives any other award of federal funds during the period of performance for this award, the recipient
promptly must determine whether funds from any of those other federal awards have been, are being,
or are to be used in whole or in part) for one or more of the identical cost items for which funds are
provided under this award. If so, the recipient must promptly contact their COMMERCE grant manager
at jenna.osterman@commerce.wa.gov.
COMMERCE must notify the DOJ awarding agency (OJP or OVW, as appropriate) in writing of the
potential duplication, and, if so requested by the DOJ awarding agency, must seek a budget -
modification or change -of -project -scope grant adjustment notice (GAN) to eliminate any inappro priate
duplication of funding.
41. REQUIREMENT TO IEP ORTACTUAL OR IMMINENT BREACH OF PERSONALLY IDENTIFIABLE
INFORMATION (PI,IJ
The recipient (and any "subrecipientil at any tier) must have written procedures in place to respond in
the event of an actual or imminent "breach" (OMB M-1 7-12) if it or a subrecipient)-- 1) creates, collects,
uses, prone es stores, maintains, disseminates, discloses or disposes of "personaHidentifiable
y
information (Pll)" (2 CFR 200.79) Within the scope of an Odle grant -funded program or activity, or 2)
:uses or operates a "Federal information system" (OMB Circular A-130). The recipientis breach
procedures must include a requirement to report actual or imminent breach of P11 to an OJP Program
Manager no later than 24 hours after an occurrence of an actual breach, or the detection of an imminent
breach. Grantees reports this information to COMMERCE, COMMERCE reports to OJP.
42. RESTRICTIONS ON "'LOBBYING"
In general, as a matter of federal law, federal funds awarded by IOJP may not be used by the recipient,
or anubrecipient ("subgrantee") at any tier, either directly or indirectly, to support or oppose the
enactment, repeal, modification, or adoption of any law, regulation, or policy, at any level of government.
See 18 U.S.C. 1913. (There may be exceptions if an applicable federal statute specifically authorizes
certain activities that otherwise would be barred by law.)
Another federal law generally prohibits federal funds awarded by OJP from being used by the recipient,
or any subrecipient at any tier, to pay any person to influence or attempt to influence) a federal agency,
a Member of Congress, or Congress (or an official or employee of any of them) with respect to the
awarding of a federal grant or cooperative agreement, subgrant, contract, subcontract, or loan, or with
respect to actions such as renewing, extending, or modifying any such award. See 31 'U.S.C. 1352.
Certain exceptions to this law apply, :including an exception that applies to Indian tribes and tribal
organizations.
Should any question arise as to whether a particular use of federal funds by a Grantee or Subgrantee)
would or might fall within the scope of these prohibitions, the Grantee is to contact COMMERCE for
guidance, and may not proceed without the express prior written approval of COMMERCE.
41 RESTRICTIONS AND CERTIFICATIONS REGARDING NOWDISCLOSURE AGREEMENTS AND
RELATED MATTERS
No recipient or subrecipient ("subgrantee") under this award, or entity that receives a procurement
contract or subcontract with any funds under this award, may require any employee or contractor to
sign an internal confidentiality agreement or statement that prohibits or otherwise restricts, or purports
to prohibit or restrict, the reporting (in accordance with law) of waste, fraud, or abuse to an investigative
or law enforcement representative of a federal department or agency authorized to receive such
information.
14
DocuSign Envelope 1D-. COB99B3B-B9A3-47B7-9EA7-233F96lEBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
The foregoing 'is not intended, and shall not be understood by the agency making this award, to
contravene requirements applicable to Standard Form 312 (which relates to classified information),
Form 4414 (which relates to sensitive compartmented information), or any other form issued by a
federal department or agency governing the nondisclosure of classified information.
1. In accepting this award, the recipient
a. represents that it neither requires nor has required internal confidentiality agreements or
statements from employees or contractors that currently prohibit or otherwise currently.
restrict or purport to prohibit or restrict) employees or contractors from reporting waste,
fraud, or abuse as described above; and
b. certifies that, if it learns or is notified that it is or has been requiring its employees or
contractors to execute agreements or statements that prohibit or otherwise restrict or
purport to prohibit or restrict), reporting of waste, fraud, or abuse as described above, it will
immediately stop any further obligations of award funds, will provide prompt written
notification to the federal agency making this award,, and will resume (or permit resumption
of such obligations only if expressly authorized to do so by that agency.
2. If the recipient does or is authorized under this award to make subawards ("subg rants"), procurement
contracts, or both
a. it represents that
i.. it has determined that no other entity that the recipientfs application proposes may.
or will receive award funds (whether through a subaward ''sub rant"),
procurement contract, or subcontract under a procurement contract) either
requires or has required internal confidentiality agreements or statements from
employees or contractors that currently prohibitor otherwise currently restrict or
purport to prohibit or restrict) employees or contractors from reporting waste, fraud,
or abuse as described above; and
ii. it has made appropriate inquiry., or otherwise has an adequate factual basis, to
support this representation; and
b. it certifies that, if it learns or is notified that any subrecipient, contractor, or subcontractor
entity that receives funds under this award is or has been requiring, its employees or
contractors to execute agreements or statements that prohibit or otherwise restrict or
purport to prohibit or restrict), reporting of waste, fraud, or abuse as described above, it will
immediately stop any further obligations of award funds to or by that entity, will provide
prompt written notification to the federal agency making this award, and will resume or
permit resumption of) such obligations only if expressly authorized to do so by that agency.
44.:SPECIPI C POST -AWARD APPROVAL REQUIRED TO USE A NONCOMPETITIVE APPROACH IN
ANY PROCUREMENT CONTRACT THAT WOULD EXCEED $Z50,000
As applicable. The recipient, and any subrecipient ("subgrantee") at any tier, must comply with all
applicable requirements to obtain specific advance approval to use a noncompetitive approach in any
procurement contract that would exceed the Simplified Acquisition Threshold (currently, $250,000).
This condition applies to agreements that -- for purposes of federal grants administrative requirements
-- Odle considers a procurement "contract" (and therefore does not consider a subaward).
The details of the requirement for advance approval to use a noncompetitive approach in a procurement
contract under an OJP award are posted on the Odle web site at
ht P,s.://oip.qov/fu,n.dinq/E, /Noncompetitive Procurement. htm (Award condition: Specific post -
award approval required to use a noncompetitive approach in a procurement contract if contract would
exceed $250,000)), and are incorporated by reference here.
45. SUBCONTRACTOR DATA COLLECTION
im
DocuSign Envelope ID.- COB 99 B3 B-B9A3-47B7-9 EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUN DS
Grantee will submit reports, in a form and format to be provided by COMMERCE and at intervals as
agreed by the parties, regarding or under this Grant performed by subcontractors and the portion of
Grant funds expended for work performed by subcontractors, including but not necessarily limited to
minority-owned, woman -owned, and veteran -owned business subcontractors. "Subcontractors"" shall
mean subcontractors of any tier.
46. UNREASONABLE RESTRICTIONS ON COMPETITION UNDER THE AWARD; ASSOCIATION
WITH FEDERAL GOVERNMENT I
As applicable. SCOPE. This condition applies with respect to any procurement of property or services
that is funded in whole or in part) by this award, whether by the recipient or by any subrecipient at any
tier, and regardless of the dollar amount of the purchase or acquisition, the method of procurement, or
thenature of any legal instrument used. The provisions of this condition must be among those included
in any subaward at any tier).
No discrimination, in procurement transactions, against associates of the federal government
Consistent with the (DOJ) Part 200 Uniform Requirements -- including as set out at 2 C.F.R. 200.300
(requiring awards to be "mann old] and administerfed] in a manner so as to ensure that Federal funding
.is expended and associated programs are Implemented in full accordance With U.S. statutory and public
policy requirements") and 200.319(a) (generally requiring "[all[ procurement transactions [to] be
conducted 'in a -manner providing full and open competition" and forbidding practices "restrictive of
competition,' such as " m [p]lacing unreasonable requirements on firms 'in order for theto qualify to do
'business" and taking "[alny arbitrary action in the procurement process") -- no recipient or
subrecipient,at any tier) may in any procurement transact ' ny ion) discriminate against aperson or entity
on the basis of such person or entity's status as an Flassociate of the federal government" or on the
basis of such person or entitystatus as a parent, affiliate, or subsidiaryof such an associate), except
as expressly -set out in 2 C.F.R. 200.319(a) or as specifically authorized by USDOJ.
The recipienfs monitoring responsibilities include monitoring of subrecipient compliance with this
condition..
To the extent that such costs are not reimbursed under any other federal program, award funds may
be obligated for the reasonable, necessary, and allocable costs (if any) of actions designed to ensure
compliance with this condition.
The term "associate of the federal government" means any person or entity engaged or employed (in
the past or at present) by or on behalf of :the federal government- as an employee, contractor or
subcontractor at any tier), grant recipient or -subrecipient at any tier), agent, or otherwise -- in
undertaking any work, project, or activity for or on behalf of or in providing goods or services to or on
behalf of the federal government, and includes any applicant for such employment or engagement,
and any person or entity committed by legal instrument to undertake any such work, project, or activity
or to provide such goods or services) in future.
Nothing in this condition shall be understood to authorize or require any recipient, any subrecipient at
any tier, or any person or other entity, to violate any federal law, including any applicable civil rights or
nondiscrimination law.
47. VOCE FUNDS
As applicable.. The Victims of Crime Act (VOLA) of 1984 states that VOCA funds are available during
the federal fiscal year of the award, plus the following three fiscal years. At the end of this period, VOLA
funds will be deobligated. OVC has no discretion to permit extensions beyond the statutory period.
(E.g., FOGA funds awarded in FY 2017, are available until the end of FY 2020).
IN
DocuSign Envelope ID-- COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUND;
COMMERCE manages this funding period requirement, Grantees must adhere to the grant period on
the Grant Face Sheet.
48. VOCA REQUIREMENTS
As applicable. The recipient assures that the State and its subrecipients will comply with, the conditions
of the Victims of Crime Act (VOCA) of 1984, sections 1404(a)(2), and 1404(b)(1) and (2), 34 U.S.C.
20103(a)(2) and (b)(1) and (2) (and the applicable program guidelines and regulations), as required.
Specifically, the: State certifies that funds under this award will:
a) be awarded only to eligible victim assistance organ r izations, 34 U.S.C. 20103(a)(2);
b) not be used to supplant State and local public funds that would otherwise be available for crime
Victim assistance34 U.S.C. 20103(a)(2); and
c) be allocated in accordance with program guidelines or regulations :implementing
201 )(2)(A) and 34 U.S.C. 20103(a)(2)(B) to, at a minimum, assist victims in the following
categories.- sexual assault, child abuse, domestic violence, and underserved victims of violent
crimes as identified by the State.
In the event of an inconsistency In this Grant, the inconsistency shall be resolved by giving precedence
in the falling order:
0 Applicable federal and state of Washington statutes and regulations
0 Special Terms and Conditions
0 General Terms and Conditions
0 Attachment A — Scope of Work
0 Attachment B — Budget
Attachment C — Equal Employment Opportunity Plan Certification
Attachment D - Victims of Crime Act (VOLA) Program Rule
SF" 2022-2023 Crime Victim Service Center Grant Application for 'Funding as submitted and
approved by COMMERCE
17
DocuSign Envelope ID: COB 99B3 B-B9A3-47B7-9EA7-233F961E13F7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL SUN
1. DEFINITIONS
As used throughout this Grant, the following terms shall have the meaning set forth below:
X "Authorized Representative" shall mean the Director and/or the designee authorized in writing to
act on the Director's behalf.
B. "COMMERCE" shall mean the Department of Commerce.
C. "Grant" or "Agreement" means the entire written agreement between COMMERCE and the
Grantee, including any Exhibits, documents, or materials incorporated by reference. E-mail or
.Facsimile transmission of a signed copy of this contract shall be the same as delivery of an original.
D. "Grantee" shall mean the entity identified on the face sheet performing ser ice under this Grant,
and all include all employees and agents of the Grantee.
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 $25,000 of each subawand
(regardless of the period of performance of the subawards under the award). MTD C excludes
equipment, capital expenditures, charges for patient care, rental costs, tuition remission)
scholarships and fellowships, participant support costs and the portion of each suba'ward in excess
of $25,000.
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.
G. "State" shall mean the state of Washington.
H. "Subgrantee subcontractor" shall mean one not in the employment of the Grantee,, who is
performing all or part of those services under this Grant under a separate Grant with the Grantee. it
The terms subgrantee/subcontractor" refers to any tier.
I. "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.
J. "Vendor" is an entity that agrees to provide the amount and kind of services requested by
COMMERCE; provides services under the grant only to those beneficiaries individually determined
to be eligible by COMMERCE and, provides services on a fee-for-service or per-unit basis with
contractual penalties if the entity fails to meet program performance standards.
.2. ACCESS TO DATA
In compliance with RCW 39.26.180, the Grantee shall provide access to data generated under this
Grant to COMMERCE, the Joint Legislative Audit and Review Committee, and the Office of the State
Auditor at no additional cost. This includes access to all Information that supports the findings,
conclusions, and recommendations of the Grantee's reports, including computer models and the
methodology for those models.
3. ADVANCE PAYMENTS PROHIBITED
No payments in advance of or in anticipation of goods or services to be provided under this Grant shall
be made by COMM ERC"o, E.
DocuSign Envelope ID: C0699B3B-B9A3-47B7-9EA7-233F961EBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
4. ALL WRITINGS CONTAINED HEREIN
This Grant contains all the terms and conditions agreed upon by the parties. No other understandings,
oral or otherwise, regarding the subject matter of this Grant shall be deemed to exist or to bind any of
the parties hereto.
5. AMENDMENTS
This Grant 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 theparties.
6. AMERICANS WITH DISABILITIES ACT,ILDA) OF 19LOPUELI C LAW 101-33 Iso referred to as
the "ADA" 28 CFR Part 35
The Grantee must comply with the ADA, which provides comprehensive civil rights protection to
individuals with disabilities in the areas, of employment, public accommodations, state and local
government services, and telecommunications.
7. ASSIGNMENT
Neither this Grant, nor any claim arising under this
Grantee without prior written consent of COMMERCE.
8. ATTORNEYSFEE'S
Grant, shall :be transferred or assigned by the
Unless expressly permitted under another provision of the Grant, in the event of litigation !or other action
brought to enforce Grant terms, each party agrees to bear its own attorney's fees and costs.
9. AUDIT
If the Grantee -is a subrecipient and expends $750.,000 or more in federal awards from any and/or all
sources in any fiscal year, the Grantee shall procure and pay for a single audit or a program -specific
audit for that fiscal year. Upon completion of each audit, the Grantee shall:
A. Submit to COMMERCE the reporting package specified in OMB Super Circular 2 CFR 200.5011
reports required by the program -specific audit guide (if' applicable), and: a copy, of any
management letters issued' by the auditor.
B. Submit to COMMERCE follow-up and developed corrective action plans for all audit findings.
If the Grantee is a subrecipient and expends less than $750,000 in federal awards from any and/or all
sources in any fiscal year, the Grantee shall notify COMMERCE they did not meet the single audit
requirement.
The Grantee shall send all single audit documentation to audftrevieA@commerce.wa.c1ov
10. CERTIFICATION REGARDING DEBARMEN11 SUSPENSION OR INELIGIBILITY AND
TOLUNTARY EXCLUSION P'RIMARY AND LOWER TIER COVERED TRANSACTIONS
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:
1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from covered transactions by any Federal department or agency.
2. Have not within a three-year period preceding this Grant, 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;
19
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
3. 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
4. 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 un a til e to certify to any of the statements in this Grant, the Grantee shall
attach an explanation to this Grant.
C. The Grantee agrees by signing this Grant 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 that it will include the clause titled "Certification
Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -Lower Tier Covered
Transaction., if as follows, without modification, in all lower tier covered transactions and in all
solicitations for lower tier covered transactions:
LOWER TIER COVERED TRANSACTIONS
a) The lower tier Grantee certifies, -by signing this Grant 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 Grantee is unable to certify to any of the statements in this brant, such
contractor shall attach an explanation to this Grant..
E. The terms covered transaction, debarred, suspended, ineligible, lower tier covered
transaction,, person, primary covered transaction, principal, and voluntarily excluded, as
used in this section, have the meanings set out in the Definitions and Coverage -sections of the
rules implementing Executive Order 12549. You may contact COMMERCE for assistance in
obtaining a copy of these regulations.
11. CONFIDE:NTIALITY/SAFEGUARDING OF INFORMATION
A. "Confidential Information" as used in this section includes:
11. All material provided to the Grantee by COMMERCE that is designated as 91 confidential)l by
COMMERCE;
2. All material produced by the Grantee that is designated as "'confidential" by COMMERCE; and
3. All personal information in the possession of the Grantee that may not be disclosed under state
or federal law. "'Personal information"" 'includes but is not limited to information related to a
person's name, health, finances, education, business, use ofgovernment services, addresses,
telephone numbers, social security number, driver's license number and other identifying
numbers, and "Protected Health Information" under the federal Health Insurance Portability and
Accountability Act of 1996 (HIPAA).
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 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. Upon request, the Grantee shall
provide COMMERCE with its policies and procedures on confidentiality. COMMERCE may require
changes to such policies and procedures as they apply to this Grant whenever COMMERCE
reasonably determines that changes are necessary to prevent unauthorized disclosures. The
KE
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F96lEBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
Grantee shall make the changes within the time period specified by COMMERCE. Upon request,
the Grantee shall immediately return to COMMERCE any Confidential Information that
COMMERCE reasonably determines has not been adequately protected by the Grantee against
unauthorized disclosure.
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.
12. CONFLICT OF INTEREST
Notwithstanding any determination by the Executive Ethics Board or other tribunal, the COMMERCE
may, in its sole discretion Iby written notice to the Grantee terminate this contract if it is found after due
notice and examination by COMMERCE that there is a violation of the Ethics in Public Service Act,
Chapters 42.52 RCW and 42.23 RCW; or any similar statute 'involving the CONTRACTOR in the
procurement of, or performance under this contract.
Specific restrictions apply to contracting with current or former state employees pursuant to chapter
42.52 of the Revised Code of Washington. The Grantee and their subcontractor(s) must identify any
person employed in any capacity by the state of Washington that worked on the program subject to this
Agreement including but not limited to formulating or drafting the legislation, participating in grant
procurement planning and execution, awarding and/or monitoring grants, during the 24 month period
preceding the start date of this Grant. Identify the individual by name, the agency previously or currently
employed by, job title or position held, and separation date. If it is determined by of that a
conflict of 'interest exists, the Grantee may be disqualified from further consideration for the award of a
Grant.
In the event this grant is terminated as provided above, COMMERCE shall be entitled to pursue the
.same remedies against the Grantee as it could pursue in the event of a breach of the contract by the
Grantee. The rights and remedies of COMMERCE provided for in this clause shall not be exclusive
and are in addition to another rights and remedies provided by law. The existence of facts upon which
COMMERCE makes any determination under this clause shall be an issue and may be reviewed as
provided in the "'Disputes" clause of this grant.
Unless otherwise provided, all Materials produced under this Grant 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 At 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, but that incorporate pre-existing materials not
produced under the Grant, the Grantee hereby grants to COMMERCE a nonexclusive, royalty -free,
irrevocable license (wiI
th 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.
21
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F96lEBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FI'
The Grantee shall exert all reasonable effort to advise COMMERCE, at the time of delivery of Materials
furnished under this Grant, 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. 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. COMMERCE shall have the right to
modify or remove any restrictive markings placed upon the Materials by the Grantee.
14. DISPUTES
Except as otherwise provided in this Grant, when a dispute arises between the parties and it cannot be
resolved by direct negotiation, either party may request a dispute hearing with the Director of
COMMERCE, who may designate a neutral person to decide the dispute.
The request for a dispute hearing must. -
be in writing;
state the disputed issues;
state the relative positions of the parties;
state the Grantee's name, address, and Contract number; and
be mailed to the Director and the other party's (respondent's) Grant Representative within three
(3) working days after the parties agree that they cannot resolve the dispute.
I
The respondent shall send a written answer to the requesfor s statement to both the Director or the
Director"'s designee and the requestor within five (5) working days.
The Director or designee: shall review the written statements and reply in writing to 'both parties within
ten'(10) working days. The Director or designee may extend this period if necessary by notifying the
.Part . ies.
The decision shall not be admissible in any succeeding judicial or quasi -Judicial proceeding.
The parties agree that this dispute process shall precede any action in a judicial or quasi-judicial
tribunal.
Nothing in this Grant shall be construed to limit the parties' choice of a mutually acceptable alternate
dispute resolution (ADR) methodin addition to the dispute hearing procedure outlined above.
15. PUPLICATE PAYMENT
COMMERCE shall not pay the Grantee, if the Grantee has charged or will charge the State of
Washington or any other party under any other Grant, subgrant/ subcontract, or agreement, for the
same services or expenses.
16. 20VENG LAW AND VENUE
This Grant shall be construed and interpreted in accordance with the laws of the state of Washington,
and the Manua of any action brought hereunder shall be in the Superior Court for Thurston County.
17. INDEMNIFICATION
To the fullest extent permitted by law, the Grantee shall indemnify, defend, and hold harmless the state
of Washington, COMMERCE, agencies, of the state and all officials, agents and employees of the state '
from and against all claims for injuries or death arising out of or resulting from the performance of the
contract. "Claim" as used in this contract, means any financial loss, claim, suit, action, damage, or
expense, including but not limited to attorney's fees, attributable for bodily injury, sickness, disease, or
death, or injury to or the destruction of tangible property including loss of use resulting therefrom.
22
DocuSign Envelope [D-- COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FERE RALFUNDS
The Grantees obligation to indemnify, defend, and hold harmless includes any claim by Grantee's
agencts,. employees, representatives, or any subgrantee/subcontractor or its employees.
Grantee expressly agrees to indemnify, defend, and hold harmless the State for any claim arising out
of or incident to Grantee's or any subgrantee's1subcontractorps, performance or failure to perform the
Grant. Grantees obligation to indemnify, defend, and hold harmless the State shall not 'b eliminated
or reduced by any actual or alleged concurrent negligence of State or its agents, agencies, employees
and officials.
The Grantee waives its immunity under Title 51 RCW to the extent it is required to indemnify, defend
and hold harmless the state and its agencies, officers, agents or employees.
18. INDEPENDENT CAPACITY OF THE CONTRACTOR
The parties intend that an independent contractor relationship will be created by this Grant. The
Contractor and its employees or agents performing under this Contract are not employees or agents of
the state of Washington or COMMERCE. The contractor will not hold itself out as or claim to be an
officer or employee of COMMERCE or of the state of Washington by reason hereof, nor will the
Contractor make any claim of right, Privilege or benefit which would accrue to such officer or employee
under law.. Conduct and control of the work will be solely with the Contractor.
U0111MINKT4ra M1
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 minimi s indirect cost rate of 10% of modified total direct
costs (MTDC) will be used.
INDUTI AL]INSURANCE COVERAGE
The Grantee shall comply with all applicable provisions of Title 51 RCW, Industrial Insurance. If the
Grantee fails to provide industrial 'insurance coverage or fails to pay premiums or penalties on behalf
of its employees as may be required by law, COMMERCE may collect from the Grantee the full amount
payable to the Industrial Insurance Accident Fund. COMMERCE may deduct the amount owed by the
Grantee to the accident fund from the amount payable to the Grantee by COMMERCE under this
Contract, and transmit the deducted amount to the Department of Labor and IndustrJes, (L&I) Division
of Insurance Services. This provision does not waive any of L&I's right's to collect from the Grantee.
2 1. LAWS
The Grantee shall comply with all applicable laws, ordinances, codes, regulations, and policies of local,
state, and federal governments, as now or hereafter amended.
22. 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 Contract.
21 LIMITATION OF AUTHORITY
Only the Authorized Representative or the Authorized Representative's delegate by writing (delegation
to be made prior to action) shall have the express, implied, or apparent authority to alter, amend, modify,
or waive any clause or condition of this Contract. Furthermore, any alteration, amendment, modification '
or waiver or any clause or condition of this contract is not effective or binding unless made in writing
and signed by the Agent
24. NONCOMPLIANCE WITH NONDISCRIMINATION LAWS
During the performance of this Grant, the Grantee shall comply with all federal, state, and local
nondiscrimination laws, regulations and policies. In the event of the Grantee's non-compliance or
23
DocuSign Envelope ID: COB99B3B-B9A3-4777-9EA7-233F96lEBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
refusal to comply with any nondiscrimination law, regulation or policy, this Grant may be rescinded
canceled or terminated In whole or in part, and the Grantee may be declared ineligible for further Grants'
with COMMERCE. The Grantee shall, however, be given a reasonable time in which to cure this
noncompliance. Any dispute may be resolved in accordance with the "Disputes" procedure set forth
herein.
The funds provided under this contract may not be used to fund religious worship, exercise, or
Instruction. No person shall be required to participate in any religious worship, exercise, or instruction
in order to have access to the facilities funded by this grant.
2.5. PAY EQUITY
The brant agrees to ensure that "'similarly employed" individuals in its workforce are compensated
as equals, consistent with the following:
A. Employees are Af similarly employed" if the individuals work for the same employer, the
performance of the job requires comparable skill, effort, and responsibility, and the jobs are
performed under similar working conditions. Job titles alone are not determinative of whether
employees are similarly employed-
. I
B. Grantee may allow differentials in compensation for its workers if the differentials are based in
good faith and on any of the following. -
(i) A -seniority system; a merit system; a system that measures earnings by quantity or
quality of production; a bona fide job-related factor o, . r factors; or a bona fide regional
difference in compensation levels.
(ik tl .
l) A bona fide job-related factor or factors may include, but not be limited to, education,
training, or experience that is: Consistent with business necessity; not based on or derived
from a gender-based differential; and accounts for the entire differential.
(iii) A bona fide regional difference in compensation level must be: Consistent with business
necessity, not based on or derived from a gender-based differential; and: account for the
entire differential.
This Grant may be terminated by the Department, if the Department or the Department of Enterprise
services determines that the Contractor is not in compliance with this provision.
26...POLITICAL ACTIVITIES
Political activity of Grantee's employees and officers are limited by the State Campaign Finances and
Lobbying provisions of Chapter 42.17A RCW and the Federal Hatch Act, 5 USC 1501 - 1508.
No funds may be used for working for or against ballot measures or for or against the candidacy of any
person for public office.
27. PROCUREMENT STANDARDS FOR FEDERALLY FUNDED PROGRAMS
A Grantee which is a local government or Indian Tribal government must establish procurementpelides
and procedures in accordance with 2 CFR Part 200, for all purchases funded by this Grant.
A Grantee which is a nonprofit organization shall establish procurement policies in accordance with 2
CFR Part 200, for all purchases funded by this Contract.
The Grantee's procurement system should include at least the following:
A. A code or standard of conduct that shall govern the performance of its officers, employees, or
agents engaged in the awarding of contracts using federal funds.
24
Docu&.gn Envelope ID: COB99B3B-B9A3-4777-9EA7-233F96lEBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
B. Procedures that ensure all procurement transactions shall be conducted in a manner to
provide, to the maximum extent practical, open and free competition.
C. Minimum procedural requirements, as follows:
i. Follow a procedure to assure the avoidance of purchasing unnecessary or duplicative
items.
ii. Solicitations shall be based upon a clear and accurate description of the technical
requirements of the procured items.
Ili. Positive efforts shall be made to use small and minority-owned businesses.
iv. The type of procuring instrument (fixed price, cost reimbursement) shall be determined by
the Contractor, but must be appropriate for the particular procurement and for promoting
the best interest of the program involved.
V. Contracts shall be made only with reasonable subgrant ees/subcontractors. who possess
the potential ability to perform successfully under the terms and conditions of the proposed
procurement.
vi. Some form of price or cost analysis should be performed in connection with every
procurement action.
vii. Procurement records and files for purchases shall include all of the following:
1) Contractor selection or rejection.
2) The basis for the cost or price.
3) Justification for lack of competitive bids if offers are not obtained.
viii. A system for contract administration to ensure Contractor conformance with terms,
conditions and specifications of this Contract, and to ensure adequate and timely follow-up
of all purchases.
D. Contractor and Subgrantee/subcontractor must receive prior approval from COMMERCE for
using funds from this Contract to enter into a sole source contract or a contract where only one
bid or proposal is received when value of this Contract is expected to exceed $5,000.
Prior approval requests shall include a copy of proposed contracts and any related procurement
documents and justification for non-competitive procurement, if applicable.
28..PUBLICITY
The Grantee agrees not to publish or use any advertising car 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.
29. RECAPTURE
In the event that the Grantee fails to perform this Grant in accordance with state laws, federal laws I
and/or the: provisions of this Grant, 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
Ire 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.
30. BEC RD MAINTENANCE
25
DocuSign Envelope 0: COB 99B3 B-B9A3-47B7-9 EA7-233F961EBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
The Grantee shall maintain books, records, documents, data and other evidence relating to this Grant
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.
The Grantee shall retain such records for a period of six years following the date of final payment. At
no additional cost, these records, including materials generated under the Grant, shall be subject at all
reasonable times to inspection, review or audit b�y COMMERCE, personnel duly authorized by
COMMERCE, the Office of the State Auditor, and federal and state officials so authorized by law,
regulationor 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.
31. REGISTRATION WITH DEPARTMENT OFIE' EN E
If required by law, the Grantee shall complete registration with the Washington State Department of
Revenue.
32. RIGHT OF INSPECTION,
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/or quality assurance under this
Grant.
33. 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 and prior to normal completion, COMMERCE may terminate the
Grant under the "Termination for Convenience" clause, without the ten calendar day notice requirement.
In lieu of termination, the Grant may be amended to reflect the new funding limitations and conditions.
34.,SEVERABILITY
The provisions of this Grant 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.
35. SITE SECURITY
While on COMMERCi
E premises, Grantee, its agents, employees, or subcontractors shall conform n
all respects with physical, fire or other security policies or regulations.
36. SUBGRANTING/SUBCONTRACTING
The Grantee may only subcontract work contemplated under this, Grant if it obtains the prior written
approval of COMMERCE.
If COMMERCE approves subcontracting, the Grantee shall maintain written procedures related to
subcontracting, as well as copies of all subcontracts and records related to subcontracts. For cause
I I
COMMERCE in writing may: (a) require the Grantee to amend its subcontracting procedures as they
relate to this Grant; (b) prohibit the Grantee from subcontracting with a particular person or entity; or
(c) require the Grantee to rescind or amend a subcontract.
Every subcontract shall bind the Subcontractor to follow all applicable terms of this Grant. The Grantee
is responsible to COMMERCE if the Subcontractor fails to comply with any applicable term or condition
of this Grant. The Grantee shall appropriately monitor the activities of the Subcontractor to assure fiscal
26
DocuSign Envelope [D-- C0699B3B-B9A3-4777-9EA7-233F961EBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERALFUNDS
conditions of this Grant. In no event shall the existence of a 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 subcontract shall include a term that COMMERCE and the State of Washington are not liable for
claims or damages arising from a Subcontractor's performance of the subcontract.
37. SURVIVAL
The terms, conditions, and warranties contained in this Grant that by their sense and context are
intended to survive the completion of the performance, cancellation or termination of this Grant shall
so survive.
38.. TAXES
All payments accrued on account of payroll taxes, unemployment contributions, the Grantee's income
or gross receipts, any other taxes, insurance or expenses for the: Grantee or its staff shall be the sole
responsibility of the Grantee.
39. TERMINATION FOR CAUSE
In the event COMMERCE determines the Grantee has failed to comply with the conditions of this Grant
in a timely manner, COMMERCE has the right to suspend or terminate this Grant. Before suspending
or terminating the Grant, 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 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 and the replacement or
cover Grant and all administrative costs directly related to the replacement Grant, e.g., cost of the
competitive bidding, mailing, advertising and staff time.
COMMERCE reserves the right to suspend all or part of the Grant, 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.
The rights and remedies of COMMERCE provided in this Grant are not exclusive and are, in addition
to any other rights and remedies, provided by law.
40. TERMINATION FOR CONVENIENCE
Except as otherwise provided in this Grant, 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 is
so terminated, COMMERCE shall be liable only for payment required under the terms of this Grant for
services rendered or goods delivered prior to the effective date of termination.
41.. TERMINATION PROCEDURES
Upon termination of this Grant, COMMERCE, in addition to any other rights provided in this Grant, may
require the Grantee to deliver to COMMERCE any property specifically produced or acquired for the
performance of such part of this Grant 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 or
and services, (iii) other property or services that are accepted by COMMERCE, and (iv) the protection
KH
DocuSign Envelope ID: COB 99B3B-B9.A3-47B7-9 EA7-233F961EBF7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FIE
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. 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 contract.
After receipt of a notice of termination, and except as otherwise directed by the Authorized
Representative, the Grantee shall:
1. Stop work under the Grant on the date, and to the extent specified, in the notice;
2. Place no further orders or subgrant s/subcontracts for materials, services, or facilities except as
may be necessary for completion of such portion of the work under the Grant that is not terminated;
3. 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/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
sub grants/sub contracts:;
4. Settle all outstanding liabilities and all claims arising out of such termination of orders and
subcontracts, with the approval or ratification :of the Authorized Representative to the extent the
Authorized Representative may require, which approval or ratification shall be final for all the
purposes of this clause;
5. 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 had been completed, would have
been required to be furnished to COMMERCE,;
6. Complete performance of such part of the work as shall not have been terminated by the Authorized
Representative; and
7. 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, which is in the possession of the
Grantee and in which COMMERCE has or may acquire an interest.
42. IREATMENT 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, 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, shall
pass to and vest in COMMERCE upon (i) issuance for use of such property in the performance of this
Grant, or (ii) commencement of use of such property in the performance of this Grant, or iii
reimbursement of the cost thereof by COMMERCEire 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.
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.
28
DocuSign Envelope ID- COB99B36-E 3-47B 7-9 EA7-233F961EB,F7C
GENERAL TERMS AND CONDITIONS
GENERAL GRANT
FEC ERAL FUNDS
D. The Grantee shall surrender to COMMERCE all property of COMMERCE prior to settlement upon
completion, termination or cancellation of this Great
All reference t ► the Grantee under this clause shall also include Grantee's employees, agents or
uh r nt e /Subcontractors.
Waiver of anydefault 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 gent unless stated to b
such in writing and signed by Authorized Representative of COMMERCE.
CO
DocuSign Envelope ID: COB99B36-B9A3-47B7-9EA7-233F961EBF 7C
ATTACHMENT A
SCOPE OF WORK
SFS"' 2022-2023 Crime Victim Service Center Grant
07101/2021 through 01613012023
New Hope shall furnish goods and services necessary to accomplish the activities under the SFY 2022-
2023 Prime Victim Service Center Grant grant funding during the grant period.
This Grant is not a benefit or entitlement to the Grantee. It is not to be used to acquire property or
services for the federal government's direct benefit. The principle purpose of this Grant is to provide
funding for New Hope to accomplish a public purpose.
Funding from this Grant must be used to support the services outlined and approved in the SFY
2023 Crime Victim Service Center Grant funding application.
DATA REQUIREMENTS
Grantees will submit quarterly reports on SFS` 2022-2023 Crime Victim Service Center Grant activities
to their grant manager.
Report data will be due in InfoNet no later than the fifteenth day following the and of each quarter.
DELIVERABLES
1
Reports As described in Special Terms and Conditions
2. Audit — If required, audit must be received no later than nine (9) months after the end of the
Grantee's fiscal year
3. Vouchers — Must be submitted at least quarterly.
PERFORMANCE MEASURES
Provision of the deliverables listed above will be measured using the following performance measures. -
1. 90% of required reports will be submitted on time
2. 100% of required audits will be completed on time
DocuSign Envelope ID.- COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
ATTACHMENT B
BUDGET
--------------
Budget Total
Salaries $114,942.00
Benefits $443040.00
Subcontracted Services $0.00
Goods and Services $41,006.00
Indirect $0.00
Match $49,997.00
------------
Total $199,988.00
Transfer of funds between line item budget categories must be approved by the Office of Crime Victims
Advocacy (OCVA) program staff. A cumulative amount of these transfers exceeding ten (10) percent of the
total program budget shall be subject to justification and negotiation between the Grantee and OCVA,
including approval from the Grantee's signature authority and the relevant OCVA Section Manager.
Travel expenses incurred or paid by Grantee shall be reimbursed at a rate not to exceed the current state
rate and in accordance with the State of Washington Office of Financial Management Travel'Regulations.
Current rates for travel may be accessed: at
hjts://ofm.wa�Loylst-,tes/default/f�iles/ ouceavcom df.
tp �_�pgblic/resrs/trel/lore
Any purchase over $5,000 must be pre -approved by COMMERCE.
DocuSign Envelope ID.- COB 99 B3 B-B9A3-47I37-9EA7-23 3F961EI3F7C
Certification of Federal Award Requirements
Funding for this grant is comprised of Federal Victims of Crime Act (VOCA) funds. Applicants must meet
the following conditions in order to receive grant funding:
1. Data Universal Numbering System (DUNS)
In general, the Office of Management and Budget requires that all applicants (other than individuals)
for federal funds include a DUNS number in their application for a new award or a supplement to an
existing award. A DUNS number is a unique nine -digit sequence recognized as the universal
standard for identifying and differentiating entities receiving federal funds. The identifier is used for
tracking purposes and to validate address and point of contact information for federal assistance
applicants, recipients, and subrecipients. The DUNS number will be used throughout the grant life
cycle. Obtaining a DUNS number is a free, one-time activity... Call Dun and Bradstreet at 866-705-
5711 to obtain a DUNS number or apply online at www.dn b.com. A DUNS number is usually received
within 1-2 business days.
Agency's federal DUNS Number: 1 010202562
2. System for Award Management (SAM) Registration
The applicant organization must acquire or renew registration With the System for Award
Management (SAM). SAM is the repository for standard information about federal financial assistance
applicants, recipients, and Buhr ecipients. OJP requires that allapplicants (other than individuals) for
federal financial assistance maintain :current registrations in the SAM database. Applicants must
update or renew their SAM registration annually to maintain an active status. Information about SAM
registration procedures can be accessed at www.sa.m.gov.
Applicant Is certifying registration in the System for Award Management (SAM) is complete and up to
date.
3. Audit Requirements
Federal Grant Funds Subreciplents expending $750,000 or more in federal grant funds annually are
required to secure an audit pursuant to OMB Uniform Guidance 2 CFR Part 200, Subpart F and are
allowed to utilize federal grant funds to budget for the audit costs. See Section 8000 of the
Subrecipient Handbook for more detail.
Applicant is certifying it will comply with this audit requirement.
4. Executive Compensation Data
In certain circumstances recipients of federal funds must report the names and total compensation of
their five most highly compensated executives. Answer the following questions to determine if you
have to submit this information.
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VOCA CERTIFICATION PACKET
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DocuSign Envelope 1D_- COB99B3B-B9A3-4777-9EA7-233F961EBF7C
In the agency's preceding fiscal year, did the organization
a) receive 80 percent or more of its annual gross revenues in U.S. federal contracts,
subcontracts, loans, grants, subgrants, and/or cooperative agreements:
Yes or NO Respond in text box below:
b) and $25,000,000 or more in annual gross revenues from U.S. federal contracts,
subcontracts, loans, grants, subgrants, and/or cooperative agreements?:
Yes or No? Res ---- porild"� I
n text box below:
If you answered " yes" to both 4.a) and 4.b), please provide the names/compensation of five
(5) most highly compensated executives of the recipient of award funds:
5. Internal Revenue Service (IRS) 501(c)(3) Determination Letter
VOCA funding requires that nonprofit organizations verify their nonprofit status by providing a copy of
their Internal Revenue Service (IRS) 501 (c)(3) determination letter. A nonprofit organization is as
described in section 501 (c)(3) of the Internal Revenue Code of 1986 and is exempt from taxation
under section 501 (a) of that Code. See 42 U.S..0 § 13925(b)(1 6)(B).
Unless submitted previously, nonprofit organizations applying for funding must submit a copy
of Internal Revenue Service to OCVA with this application.
6. Computer Networks
The applicant understands and agrees that it cannot use VOLA Grant funds to maintain or establish a
computer network unless such network blocks the viewing, downloading, and exchanging of
pornography.
7. Non -Supplanting Certification
The applicant understands and agrees that no VOLA Grant funds will be used top lant existing
state, local, or other non-federal funding already in place to support current services. VOLA Grant
funds will be used to increase the total amount of funds used for crime victim assistance. Violation of
the non -supplanting requirement can result in a range of penalties, including suspension offuture
funds under this grant, recoupment of monies provided under this grant, and civil and/or criminal
penalties.
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Blue - optional field
DocuSign Envelope ID- C0699B3B-B9A3-47B7-9EA7-233F96lEBF7C
8. ADA Requirement (FOR NON -TRIBAL GRANTEES ONLY)
Does the location where services are primarily provided comply with ADA requirements for
accessibility?
Yes or No? R9.S and uw in text box below. If no provide information on! how thisis addressed -
By signing this document below, the applicant certifies that that agency is qualified to receive the funds.
As the duly authorized representative of the applicant, I herby acknowledge that the applicant will comply
with the above requirements. This acknowledgement shall be treated as a material representation of fact
upon with the Department of Commerce, Office of Crime Victims Advocacy will rely if a grant is issued.
'Docuftned by:
SignatU
8/4/2021 1 3:57 PM PDT
;Date
Cindy Carter Cindy Carter Bo cc chairperson
Typed Name and':, 'Title of Authorized' Representative
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VOLA CERTIFICATION PACKET
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Blue = optional field
i
DocuSign Envelope ID-- COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
The applicant herby assures and certifies compliance With all applicable Federal statutes, regulations,
policies, guidelines, requirements, and any conditions of the recipient's grant. If a grant is made, the
grantee and subgrantees,if any willbe subject to statutory prohibitions on discrimination.
D p
iscrimin ation on the Basis of National Origin — Limited English Proficient (LEP) Individuals
To ensure compliance with the Omnibus Crime control and Safe Streets Act of 1968 and Title V1 of
the Civil Rights Act of 1964, applicants must take reasonable steps to ensure that parsons With
Limited English Proficiency (LEP) have meaningful access to services and legal protections.
Meaningful access may entail providing language assistance services, including oral and written
translation, where necessary. Assistance in understanding grant recipient's obligations under the law
may be found in the Department of Justice's Guidance to Federal Financial Assistance Regarding
Title V1 Prohibition Against National Origin Discrimination Affecting Limited English Proficiency
Persons (LEP Guidance), which can be found at 67 Fed. Reg. 41455 (June 18, 2002). Additional
assistance regarding LEP obligations and information may be found at www.1gp..
qov.
2. Federal Non -Discrimination Requirements
The applicant will comply with any applicable federal nondiscrimination requirements, rements, which may
include. -
0 the Omnibus Crime Control Act and Safe Streets Act of 1968 (42 U.S.C. § 3789d);
the Victims of Crime Act (42 U.S.C. § 10604(e));
the Juvenile Justice and Delinquency Prevention Act of 2002 (42 U.S.C. § 5672(b));
the Civil Rights Act of 1964 (42 U.S.C. § 2000(d));
the Rehabilitation Act of 1973 (29 U.S.C. § 794);
the Americans with Disabilities Act of 1990 (42 U.S.C. §§ 1 1-34);
the Education Amendments of 1972 (20 U.S.C. §§ 16813,1683,1685-86);
the Age Discrimination Act of 1975 (42 U.S.C. §§ 6101-07);
28 C.F.R. Part 42 (U.S. Department of Justice Regulations — Nondiscrimination, Equal
Employment Opportunity, Policies and Procedures);
Executive Order 1,3279 (equal protection of the law for -faith based andcommunity organizations);
and
28 C.F.R. Part 38 ((U.S. Department of Justice Regulations — Equal Treatment for Faith Based
Organizations).
The applicant shall further comply with federal law prohibiting grant recipients from retaliating against
individuals taking action or participating in action to secure rights protected by federal law.
3. Civil Rights Provision - Prohibition of Discrimination for Recipients of Federal Funds
The applicant assures compliance of all applicable nondiscrimination requirements of the Victims of
Crime Act. No person in any state shall, on the grounds of race, color, religion, national origin, sex,
age, or disability be excluded from participation in, be denied the benefits of, be subjected to
discrimination under, or denied employment in connection with any program or activity receiving
federal financial assistance, pursuant to the following statutes and regulations.- Section 809(c),
Omnibus Crime Control and Safe Streets Act of 1968, as amended, 42 U.S.C. 3789d, and
Department of Justice Nondiscrimination Regulations, 28 CFR Part 42, Subparts C, D, E, and G; Title
VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d, .; Section 504 of the
Rehabilitation Act of 1973, as amended, 29 U.S.C. 794; Subtitle A, Title 11 of the Americans with
Disabilities Act of 1990, 42 U.S.C. 121011 . and Department of Justice regulations on disability
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VOCA CERTIFICATION PACKET
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DocuSign Envelope ID-_ COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
discrimination, 28 CFR Part 35 and Part 39; Title IX of the Education Amendments of 1972, as
amended, 20 U.S.C. 1681-1683; and the .Age Discrimination Act of 1975, as amended, 42 U.S.C.
6101
4. Federal Civil Rights Training
Recipients of financial assistance from the Department,of Justice, such as Victims of Crime Act
(VOCA) funds, either awarded directly or through another recipient, must comply with the federal
statutes and regulations that prohibit discrimination based on race, color, national origin, sex, religion,
age, and disability in VOCE -funded programsor activities.
As part of its training efforts, the Office for Civil Rights at the Office of Justice Programs has
developed an online civil rights training curriculum for recipients. This training, which consist of six
segments and accompanying self -tests, is designed to provide recipients With an overview of
applicable nondiscrimination laws and the general civil rights obligations that are tied to grants
awarded by the Department of Justice. The OCR offers this online version of its training program to
ensure that recipients who are unable to participate in an in-person training session can still receive
valuable technical assistance.
All six Civil Rights training programs are available at http: ip. ov/about/ocr/'Ocr-trainin-q-v,ideos/video-
ocr-traininql.htm
The recipient must view the online training at least once every two years. By signing this certification.,
the applicant acknowledges the viewing of o Civil Rights Non -Discrimination training.
5. Notification of Findings of Discrimination or Non -Compliance
In the event a state or federal court or a state or federal administrative agency makes a finding of
discrimination after a due process hearing on the grounds of race, color, religion, national origin, age,
disability, or sex against the Grantee or a program partner or participant receiving grant funds, the
Grantee will forward a copy of the finding to the U.S. Department of Justice, Office of Justice
Programs, Office of Civil Rights (OCR), and the Department of Commerce (COMMERCE).
TheGrantee shall include a statement clearly stating whether or not the finding is related to an grant
activity supported with a grant in which U.S. Department of Just -ice funds are involved, and identify all
open grants utilizing U.S. Department of Justice funding by grant number and program title.
6. Equal Employment Opportunity Program (EEOP)
The Grantee will determine whether it is required to formulate an Equal Employment Opportunity
Program (EEOP), in accordance with.28 C.F.R. 42.301 et. seq. If the Grantee is not required to
formulate an EEPIit will submit a certificate form to the Washington State Department of Commerce
(COMMERCE) indicating that it is not required to develop an EEOP. If the Grantee is required to
develop an EEOP but not required to submit the EEOP to the OCR, the Grantee will submit a
certification to COMMERCE certifying that it 'has an EEOP on file which meets the applicable
requirements. If the Grantee is awarded a grant of $500,000 or more and has 50 or more employees,
it will submit a copy of its EEOP to the OCR and COMMERCE. Non-profit organizations, federally
recognized Indian Tribes, and medical and educational institutions are exempt from the EEOP
requirement, but are required to submit a certification form to COMMERCE to claim the exemption.
Information about civil rights obligations of Grantees can be found at h:ftp://www.oilD..usdoi.ci
ov/ocr/.
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DocuSign Envelope ID., COB99B3B-B9A3-47B7-9EA7-233F961EBF7C
7. Grantee Duty to Ensure Subcontractor Compliance
The Grantee is required to ensure compliance with these requirements by any program partner or
participant receiving funding under this gent.
As the duly authorized representative of the grantee, I hereby certify that the Grantee will
coplyn Xfl� : the above Civil lights requirements specified in this Certification
U CU Y
LL'.,AA US4 112413AG9 Cindy Carter socc chairperson
'Title of Authorized Official
:mature of Authorized Official
Name of Agency
Kirk Eslinger
8/4/2021 1 3:57 PM PDT
Date
Human Resources
Nameand Title of Person who completed OJ Civil Rights Non -Discrimination 'Traininsee #4)
8.4.2021
Most Recent Date Online Training was completed
Recipients must view the online training at a minimum of every two years for the duration
VOCE funding is received.
Page 6 of 12
VOCA CERTIFICATION PACKET
Yellow - mandatory field
Blue = optional field
DocuSign Envelope 1D.- C0699B3B-B9A3-47B7-9EA7-233F961EBF7C
Certification Regarding Debarment, Suspension, Ineligibility, And Voluntary
Exclusion
This certification is required by the regulations implementing Executive Order 12549, Debarment and
Suspension, 28 CFR Part 67, Section 67.510, Participants' responsibilities. The regulations were published
as Part V11 of the May 26, 1988 Federal Register (pages 19160-19211.).
1. The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation In this transaction by any Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Cindy Carter Cindy Carter BOCC chairperson
Name and Title of Authorized Representative
00CUSIgned by;
.Signature
New Hope
Name of Organization
I
Address of Organization
8/4/2021 1 3:57 PM PDT
Date
Page 7 of 12
VOLA CERTIFICATION PACKET
Yellow - mandatory field
Blue = optional field
DocuSign Envelope ID: COB99B3B-B9A3-47B7-9EA7-233F96lEBFS'
C
CERTIFICATION REGARDING DUDS AICD COMPLIANCE IN REGISTER-ING
(Sub -Recipient)
I certify that New Hope has DUNS# 010202562.
And.1 agree to comply with. registration In the System for Award Management (SAM).
Cindy Carter Cindy Carter SOCA chairperson
Name and Title of Authorized Representative
DocuSigned by:
&gnature
New Hope
Name of Organization
Address of Organization
8/4/2021 1 3:57 PM PDT
Date
Page 8 of 12
V CERTIFICATION PACKET
Yellow - mandatory field
Blue = optional field
DocuSign Enveiope ID: COB 99B3 B-B9A3-47B7-9EA7-23 3F961EJ3F7C
Certification Regarding Lobbying
Each person shall file the most current edition of this certification and disclosure form, if applicable, with
each submission that initiates agency consideration of such person for an award of a federal contract, grant,
or cooperative agreement of $1003000 or more; or Federal loan of $150,000 or more.
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 a prerequisite for making or entering Into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who falls to file the requ . i re d
certification shall be subject to a civil penalty of not less than $10,000 ornot more than $100,000 for each
such failure.
The undersigned certifies, to the best of his or her knowledge and belief, that;
A. No Federal appropriated funds have been laid or will be paid to any person for influencing or attempting
to 'influence an officer of employee of any Federal agency, a Member of Congress, an officer or
employee of Congress, or any 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 enteron.
into of any cooperative agreement, and the extension, continuation, renewal, amendment, or
modification of any Federal contract, grant, loan or cooperative agreement.
B. If any non -Federal funds have been paid or will be paid to any person for influencing or attempting to
influence an officer or employee of any Federal agency, a Member of Congress, an officer or employee
of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant,
loan, or cooperative agreement, the undersigned shall initial here Card complete and
submit "Disclosure of Lobbing Activities", in accordance with its instructions. OCVA will rode this
form, if needed.
C. The undersigned shall require that the language of this certification be included in the award documents
for all sub -awards at all tiers and that all sub -recipients shall certify and disclose accordingly.
Cindy Carter Cindy Carter Bocc Chairperson
Name: and Title of Authorized Representative
-DocuSigned by:
8/4/2021 3:57 PM PDT
E 1.
F 144
Signature Date,
New Hope
Name of Organization
Address of Organization
Page 9 of 12
VOLA CERTIFICATION PACKET
'Yellow = mandatory field
Blue = optional field
DocuSign Envelope ID: C0699B36-B9A3-4777-9EA7-233F961EBF7C
Certification of Suitability to Interact with Participating Minors
To assist OCVA in monitoring new grant requirements for federal funds, please
complete thi's form to certify that your organization has completed the required
background checks for all covered individuals that 'Interact with any minor in the course
of activities under your qrant (employees paid by the grant, volunteers used as match
under the grant, and volunteers supporting grant -covered activities).
Grantees are required to have documentation that the search was conducted, and this
should be maintained in accordance with your document retention policies.
Grantee Name: New Hope
Grant Number-, 22-31219-012
For full list of requirements, Clicker I OCV A FAQ is here
Background checks must include:
• Public sex offender and child abuse webs ites/reg istri es
• Criminal history registries and similar repositories of criminal history records
* An eligible fingerprint search/background check has been completed
If the applicant determines that no minors will be served by staff being directly charged
or staff/volunteers used as match for this federally funded grant, the search i's not
.required.
i
Applicant hereby certifies that the recp lent (and any subrecipients) have complied with
the above regulations,, as applicable.
qoauftned by:
Signatureof Authorized Official "F1447A513Q634GB_
Cindy Carter
r n :r
�P, i ted Name of Authoized Official
I
Date 8/4/2021 1 3:57 PM PDT
Page 10 of 12
VOLA CERTIFICATION PACKET
'Yellow = mandatory field
Blue = optional field
DocuSign Envelope ID-. COB99B3B-B9A3-47B7-9EA7-233F96lEBF7C
Request for Volunteer Requirement Waiver
Current VOLA program guidelines requires that grant recipients must use volunteers as a condition of
receiving funds unless the state administrator determines there 'is a compelling reason to waive this
requirement. A "compelling reason" may be a statutory or contractual provision concerning liability or
confidentiality of con selorIvictim information, which bars using volunteers for certain positions, or the
inability to recruit and maintain volunteers after a sustained and aggressive effort.
If an applicant requests a waiver of the volunteer requirement, the section below must be completed
providing a compelling reason why the use of volunteers is not feasible for the agency.
I am requesting a waiver for the use of volunteers for my VOLA project/program..
Yes or No'?, Responid in text box below:
If you are requesting a volunteer waiver, provide detailed explanation for your request in the following
section. Waivers may only be requested in the following situations:
-1. In the case of statutory or contractual provisions that prohibits the use of volunteers. (Attach a
copy of the applicable statute or contract.)
2. In the case of a lack of volunteers. If you list this as a reason for the waiver request, you must
document the efforts made to recruit volunteers.
Our agency is reguesting a waiver for the folio -wing reason1s:
Page 11 of 12
VOLA CERTIFICATION PACKET
Yellow - mandatory field
Blue = optional field
DocuSign Envelope ID., COB 99B3 B-B9A3-47B7-9EA7-233F961 EBF7C
Subgrant Award Report (SAR)
Complete the information below, thrix s will be used by OCVA to complete the federal Subgrant Award
Report (SAR) which collects basic information on subgrant recipients and program activities that will be
implemented with VOLA plus match funds.
How to video is here: https://vime-o.com/365156967
1. Organization Name: New Hope
2. VOLA Crime Victim Assistance Funds Awarded in this grant: $181390.00
3. Sub -Grant Number (number assigned to your contract).- 22-31219-01.2
4. Budget and Staffing
Indicate below the requested information based on the subrecipientys current fiscal year. Report the
total budget available to the victim services program, by source of fnding. Do not repo t n
u rt he e tire
agency budget, unless the entire budget is devoted to victim services programs. For example, if
VOLA funds are awarded to support a victim advocate unit in a prosecutot's office, only report the
budget for the victim advocate unit.
Information Requested
Response
Explanation as required)
A. Total budget for all
The amount reported is for the
victimization programs and
$ 1822160
current fiscal year. Include the
services.
subaward amount for this
B. Annual funding amounts
State funds-.$
Identify by source the amount of
allocated to all victimization
543327
funds allocated to the victimization
programs and/or services for
Locaifunds:$
programs 1servibes budget of the
the current fiscal year.
230000
subgrantee agency.
Other federal fun s:
867443
DO NOT COUNT FUNDS IN
Other no:n4ederal:$
MORE THAN ONE CATEGORY
OTHER FEDERAL includes all
0
federal funding except the
subaward amount repotted in
Question 2.
C. Total numbtr2f, yid staff for
'Total Paid Staff:
Count each staff member once.
all su6grantee victimization
Enter Whole Number
Both full and part time staff
program and/or services
19
should be counted as one staff
member. DO NOT :orate based
FTE.
D. Number of staff hours funded
through this CA award
:u
N rnber of Hours:
Total COUNT of hours to work by
(plus match) for subgrantee' s
all staff supporting the work of this
victimization programs and/or
4222
VOCA subaward plus match.
services
E. Number of volunteerstaff
Volunteer Staff
supporting the work of this
Enter Whole Number
VOCA award (plus match) for
COUNT each volunteer staff
subgrantee's
2
once. DO NOTprorate based on
victimization programs and/or
FTE.
services
F. Number of volunteer hours
'Number of Hours
supporting the work of this
Total count of hours to work all
VOLA award (plus match) for
100
volunteers supporting the work of
subgrantee's victimization
this VOLA suba ward plus match.
progirams
Page 12 of 12
VOLA CERTIFICATION PACKET
'Yellow - mandatory field
Blue = optional field
Do-cuSign Envelope ID: COB99B
Wash'ngton State
A=P
Despartment of
MW
eare U01ilm
Dacu5ign Contract and Certifications Review and Routing form
Office of Crime Victims Advocacy
Type of Acton,
New Contract/Grant 0 Amendment rl IAG n.
Federal Z State 0
Program/Project Name: SFY 2022-2023 Crime Victim Service Center Grant
Contra ctor/G ra ntee Name,* Grant,, County Of
0
Contract/&ant Numbert 22-31219-012
4
Term, 7/1/2021 to 6/30/2023
R &We d
-To t
e
Jenna Osterman
Grant
Proofed: documents
e -DS
7/14/2021 9,11,52 AM PDT
Manager
Section
Matched approved Obligation Summary
e -DS
Nicky Gleason
Manager
Memo and Allocation Spreadsheet
7/16/2021 1 8 58 AM PDT
Reviewed. entry and codingin CMS
Verified that correct template from
Managing
IntraCOM has been used
Rick Torrance
Director
OR
7/16/2021 1 9:37 AM PDT
Documentation has been included with
reason for exception
Grant
Verified that grantee has completed all
0S
Jenna Osterman
Manager
required certifications and/or required
8/5/2021 1 9:48 AM PDT
A. -
docu L
men- IS
Updated 5/26/2021
ddP%k A01k AM&
u%;Uzagn
Certificate Of, Completion
Envelope ld_- COB99B3BB9A347779EA7233F961EBF7C Status: Completed
Subject.- Please DocuSign: OCVA CC Grant 22-31219-012
Division:
Community Services and Housing
Program.- Office of Crime Victims Advocacy
ContractNumber.' 22-31219-01.2
Source Envelope:
Uocum I Pages: ou
Signatures-- 9
Envelope Originator:
Certificate Pages: 6
Initials: 4
Mia Davidson
AutoNav-- Enabled
1011 Plum Street SE
Envelopeld Stamping: Enabled
MS 42525
Time Zone-- (UTC -08:00) Pacific Time (US & Canada)
Olympia, WA 98504-2525
mia.davidson@,commerce.-wa.gov
IP Address: 147.55,149.181
Re- dord Tracking
Status: Original
Holder: Mia Davidson
Location: DocuSign
7/13/2021 2A5:57 PM
mia.davidso:n@commerce.wa.gov
Security Appliance Status: Connected
Pool-- StateLocal
Storage Appliance Status: Connected
Pool: Washington State Department of Commerce
Location: DocuSign
Si finer Events
SiOnAture
Timestamp
,Jenna Osterman
D'S
Beet: 7/13/20212:48:27 PJV1
jenna.oster-nian@commerce.ANa.gov
Viewed: 7/14120219-51-40 AM
Security Level.- Email, Account Authentication
Signed., 7/14/20219--52:26 AM
one
Electronle Record and Signature Disclosure:
Not Offered via DocuSign
Nicky Gleason
nicky-gleason@commerea.wa.gov
Washington State Department of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure,.
Not Offered via DocuSign
Rick Torrance
rich ard. torrance(fb
,commerce.wa.gov
Washington State Department of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Signature Adoption: Dim= on Device
Using IPAddress.- 198.239.10_1082
Ds
Na
Signature Adoption- Pre -selected Style
Using IP Address: 147-55.134-31
e—os
Signature Adoption-- Pre -selected Style
Using IP Address.- 198.239.10-199
Sent. 7114120219:52:29 AN4
Viewed: 7116/20218-58:33 AM
Signed -.'7116/2021 8:58:57 AM
Sent: 7/16/20218:59:00 AIV.1
Viewed: 7/16/20219-37-49 AM
Signed.- 7/16120219-37:57 AM
Signer Events
Signature
Cindy Carter
DocuSigned by-,
cearter@graiitcountywa.gov
1
IF
Cindy Carter BC C Chairperson
1447 A$130634CS
Grant county, Washington
Intermediary Delivery Events
Security Level.- Email, Account Authentication
Signature Adoption: Drawn on Device
(None)
Using I P Address: 216.215, 12-67
Electronic Record and Signature Disclosure:
Carbon Copy Events,
Accepted: 8/3/20212-59-51 PM
Timestamp
ID: 72572191-16ad-4352-9544-b6ab7adce35c
Jenna Osterman
jeiina.osterinian,@commerce-wa.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Diane KJontz
Assistant Director
Washington State Department of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Signature Adoption-- Drawon Device
Using IP Address- 198.239.10.193
DocuSigned by.
Signature Adoption-- Pre -selected Style
Using IP Address- 198-239.10.196
Timestamp
Sent: 81*31/2021 1:32.-36 PM
Viewed: 8/3/20.212:59:51 PM
Signed: 80/4/2021 3:57:00 PM
Sent: 8/412021 157:03 PM
Viewed: 8/5/20219:47:47 AM
Signed: 8/5/20219-4831 AM
Sent. 81512021 9:48-34 AM
Viewed: 8/5/20.21 5-1419 PM
Signed: 8,15/2021 514-25 PM
In Person Signer
signature gnature
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
SuziFode
Sent: 8/3/2021 1:32:38 P
sfode@grantcountywa.gov
%0%WPIt:V
Viewed- 8/3/20.21 1:33:44 PM
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 7/22/20219:54:00 AM
ID: f9391c86-5931-4a2b-9328-a83d2Of3b27c
Witness Events Signature
Notary Events Signature
Envelope Summary Events
Status
Envelope Sent
Hashed/Encrypted
Certified Delivered
Security Checked
Signing Complete
Security Checked
Completed
Security Checked
Timiestamp
Timiestamp
Timestamps
7/13/2021 2--48-27 PM
8/5/20215:1419 PM
8/5/2021 5:14:25 PM
8/5/2021 5:14-25 PM
payment Events StatusTimest.a
Electronic Record and -Signature Disclosure
Electronic Record and Signature Disclosure created on: 8/1112020 4:4412 PM
Parties agreed to: Cindy Carter, Suzi Fede
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Washington State Department of Conmierce. (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
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access this information electronically to your satisfaction and agree to this Electronic Record and
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elect to create a DocuSign account, you may access the documents for a limited period of time
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send you paper copies of any such documents from our office to you., you willbe charged a
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If You decide to receive notices and disclosures front us electrol cally,u ma atyo y tion
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change your mind and tell us that thereafter you want to receive required notices and disclosures
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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,
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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
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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 througli the DocuSign system all reqLiired notices, disclosures,
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available to you during the course of our relationship with you. To red -Lice 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, fou can receive all the disclos ure s and notices electronically or in paper forinat through
the paper mail delivery system. If you do not agree with this process, please let us lalow as
described below. Please also see the paragraph immediately above that describes the
conseqLtences, of your electing not to receive delivery of the notices and disclosures
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How to contact Wash ingtoii 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 infoniiation from us, and to withdraw your prior consent to
receivenotices and disclosures electronically as follows:
To contact us by email send messages to: docusigli@commerce.wa.gov
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the body of such request you must state your email address, fall name, mailing addr"e"ss, and
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0
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3 1
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if you consent to receiving notices and disclosures exclusively in electronic format as described -
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