HomeMy WebLinkAboutAgreements/Contracts - New Hope DV/SA (004)DocuSign Envelope ID: 50062DOB-82BB-4AC5-AC96-051505CB4DBD
Amendment
Commerce Grant Amendment Face Sheet
Grant Number: F20-31219-401
Amendment Number: A
Washington State Department of Commerce
Community Services and Housing Division
Office of Crime Victims Advocacy
Children's Advocacy Center Child Centered Services VOCA Initiative
1. Grantee
2. Grantee Doing Business As (optional)
GRANT, COUNTY OF
New Hope
PO BOX 37
EPHRATA WA 98823-0037
3. Grantee Representative (only if updated)
4. COMMERCE Representative (only if updated)
5. Original Grant Amount
6. Amendment Amount
7. New Grant Amount
$124$214.00
$124)214.00
8. Amendment Funding Source
9. Amend. Effective Date
10. End Date
Federal: N State: 1771 Other: 0 N/A: El
1 7/1/2022 12:00:00 AM
1 06/30/2024
11. Federal Funds (as applicable)
Federal Agency:
CFDA Number:
Indirect Rate
$124214.00
Department of Justice,
16-575
(if applicable):
Office for Victims of Crime
12. SWV #
13. UBI #
14. UEI #
SWV0002426-17
132001884
ZL6WM26K8KR5
15. Amendment Purpose
To update the Special Terms and Conditions to reflect the VOCA FFY 2020 funding source.
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 Original
Application for funding. A copy of this Grant Amendment shall be attached to and made a part of the original Grant between
COMMERCE and the Grantee. Any reference in the original Grant to the "Grant" shall mean the "Grant as Amended".
FOR GRANTEE
FOR COMMERCE
e—Docuftned by:
Docuftned by.,
dys(e3tw*vAnderson, Assistant Director
SuziFode
10/3/2022 17:23 AM PDT
Date
Name
Director
APPROVED AS TO FORM ONLY
BY ASSISTANT ATTORNEY GENERAL
Title
APPROVAL ON FILE
9/30/2022 111:18 AM PDT
Date
DocuSign Envelope ID: 50062DOB-82BB-4AC5-AC96-051505CB4DBD
Grant Number: F20-31219-401
Amendment Number: A
Amendment A
This Grant is amended as follows:
SPECIAL TERMS AND CONDITIONS
GENERAL GRANT
FEDERAL FUNDS
1. ACKNOWLEDGEMENT OF FEDERAL FUNDING
Federal Award Date: 9/17/2020
Federal Award Period: 10/1/2019 — 9/30/2023
Federal Award Identification Number (FAIN): 2020-V2-GX-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 obligated by this action: $124214.00
The Grantee agrees that any publications (written, visual, or sound) but excluding press releases,
newsletters, and issue analyses, issued by the Grantee describing programs or projects funded in
whole or in part with federal funds under this Grant, 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.
This subaward may not be used for research and development purposes.
12. COMPLIANCE WITH GENERAL APPROPRIATIONS -LAW RESTRICTIONS ON THE USE OF
FEDERAL FUNDS (FY 2020)
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://ojp-=qov/funding/Explore/FY2OAppripriationsRestrictions.htm, and are incorporated by reference
here.
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 OJP.
13. COMPLIANCE WITH OJP TRAINING GUIDING PRINCIPLES
2
DocuSign Envelope ID: 50062DOB-82BB-4AC5-AC96-051505CB4DBD
Any training or training materials that the recipient -- or any subrecipient ("subgrantee") at any tier --
develops or delivers with OR award funds must adhere to the OJP Training Guiding Principles for
Grantees and Subgrantees, available at
https://oip.gov/fundin /Implement/TrainingPrinciplesForGrantees-Subgrantees.htm.
;sw Al A t#t M M a� " dlc IIA ilk At Al. w:: IIC
_r ,✓ ,,, .r ; w r, w .y„ -rr w'. : "fi`€ iir .r
� . "tit".wl ; ; . ill �► ,lr� sl . in • - +, • . ,
w• ww �_ _ +r• .� ,y, w ,.
+w* •«r _ w:=w : - � w' : +w vr� r �+w Fii -: wrMag
,w �► �► w s ! Ir►. Glx 0 w► � w lie �:
w � U�" - ' 'w ' ►rr ;w' w- � w " : �w "� W"w w.
ik Ak ik ,!ir. A .AI€ .11b A, M A AI /. � rw � 71► AMt ,� AA4 Jlt
w - - - rr . +►.. -�r; ..,r •�f ww w' �.,: aw - "wn
!N �► rN i "A a JM K A * it 11[ • w� ,ir. ; ill + Nk . 7M ill iA AIM -AW '. IM : ;1 .it iN4 !�► 'IN
u' we• rr' of +ft w• t!` w r„ w "w• 'w w• W" w: 'Sic ir- i1i� w w: •r ♦ Vf w "r- '
MAE
#1
W JIM
w w ♦
A iN X
!C,;w
w' ' wr &w
A 0 list
—W w
: i
w `. •r w vY : *.; -
}
:INF rL :wr iwN;
: W .Af
`.
r w
.: �- . w• Sic. ♦ rr ::.. �v rr "•. w Lw Iff
r y< - I► w wt A w #t . MF 1w1 A MY IN,
w ✓
"w ti(F �:. iif
M
w vG
VM
ik
w.. aw "rc
At
NM t1 -
wrV w rr +w �F :
IM V of 1 ,
#li Ill.
w : "w( r WO ' a. : w +.+r +mow r
M x
w w w w"
iNLys.NF
<re w 'r vt �.. ffC
;1 A iM
�r� .�'
IA N: m an
M . w w- w
�.
it Ik /t :
rwi w. r ee w
w
yr w S'Y
yr � w "`'
iM t
w wr
lk .NIFM
K ; ' rr w 'v
r +Mw
A A
w .►; �r
, INF a►
w • vw �r i✓ .vr rr- tir
-w. w 'r .� +w�
KA
A #► A .wt ill w w RXT A ;AI A
»r w w. w !e r� w.• 'w ..r w w w : w w iu-
w ;Tir• w w.y +r' "� ,/T .r' - - lir : ,� � ii✓ 1YZ W' w- fir`:
DocuSign Envelope ID: 50062DOB-82BB-4AC5-AC96-051505CB4DBD
rY< aK: Y::A aro r>Ir lM
'Ilrlr. II x "Irr A ali Ak N- AA '. jrY Jk aA: fUt aK a ti Ili AkAi Mat
«r M f
M"Ak AA ' A! ilr AI aMAa: Ar- Ak l� 7M," A if iA F NE /t� AA AE #1 ai
w .w ,re w w w w ,rir = w w ,n
beg
;vr-
NE +r►: M WWAATAOXIWU
w. w w w wr wwitw „c ti w w w w.
7Ik: IMt �-rA,rrt #It 11 11r �1[ /i rMt , #t ' war �M. "F 1k :11t .. iM 11 A� M IE 1K 1�i R . 1Mt log
' ,M +!�
1 # -+✓ I - of *► w : -"
ammitik� �. � w ": " +G' ; ,� . � �.;. �_ yr w:. � >� � w nr :. yE -fir :ws : w- ,.w=
i : A>i= A . t, iM � _ _ .. At Ar +� :Ilk A i� ift . :A A #(t; A _ � It A! „ ,+!�. A ,!► ;IIF _ A: � . .
A !r► :A ' r�. Ik ll1 i . "A rlk il% A AL
.iM W A SCW rtw Ar Ili .rx M rYk ;Alt IR Alal a► A i Ak Ac A M. A► ,. Ak Alt lA kC°Nl Jl► A
,Nr Ww w 'rr r art
A * Af< 1f M W 'N. < Ak aw AN A; Ak AI: A A ; ,Ni Al A atr ♦ M A. A 'Ak A v . 'M AC aR Ak Ali
' 'A M. _ rr w ..+iYt. ! :vr ut x :w ,� w w ,rr ,s re -IL 0w ,rr-K,1VIWAWw w ,
,tti : A► . AK _ : #ME ' _ ;w, iil - +x A i ;Ik
Aft, - arc. #r : - .:Ale : R4 A err A► ' ag. #f:
MC r ": nr : yc ?r►.: ! ,rt' - .w. rM "ilr= :Y►' _ - .A #t 'rtlr +11r: ,►'-w w K : Alr t: w . Mr i ,rf.
At tt #r :Ak, +!r "A A A F A ilt +rr 'A #l. ' iA1; A fi4 11At: Ak AI A •Al: AIt A
I A ,w w '+iY w • 'w w ,i€ . w rr w .rr" ,w yr w ,s , Y rr
A� Ar ,t i, �►; ' A � A : ; " Ak ,M ilk _ ' Alt 'Al _ A we ;Nf. Ak /R � :�' iK � arc A� ±rk .AE ': >rr. aK;
A #WA ��rt A �w,1R1rr��lfr���+�t .,Mt r AK � Ak s► ,rK.:Ni ,A� Al irrM
DocuSign Envelope ID; 50062DOB-82BB-4AC5-AC96-051505CB4DBD
X1 k
.,
A► ,�►►
'Wit I aftA►. ;w4 .atl ++� w. lrt ,1► ,�. At : �► >► . AtA :
"' tir -
A► ±At >N A i M. #r M A .MA/C • aM, : ; $!►. A i!► w
rr +r w - ti� tee: -w w �r w' tiv wr +� w w ti� +.r ti1i: w w rr.
w w nr' w Mi w
�, AE
r AC :±r; !► A ;+!t, .; : : AI 11A i ,w Al AI Ai
K IW Vr+�A Mr wii�r��i r� w " O r wIrr Aw ar A+v 71,
w w At �► :�A tR A wt
s �.
URIs(tlM At IM :Alt !IU it Al ill >k +w awn..
1M : � � A A►:
�r tii w .w w w w, tis r w w w ,r. - w' w w
;M; AsA ' OO w �► At A ak: #! At Ak ( : !.
fAQr,. . �, :,.. ..:.. .. � •r w - :�Y vF tis". w wr rtr � :: w. : ,'`. ,w w'• -'- V '- ;ii r •,,., . .s. ,.
,k; atE 10
Alt Ai At Ar.: + „ +ACM w �►.w Ax 111 •w Ay ��.
�c w 4r � � w , w w ted w ''� :�fF � . yr �r•I. X.w w - - .tr rr •w
AY Al; �'...iltAr,.Al. allf" At wt is iNA Ar/l Al #A +er ' :aM :/A A A► : wr..:r11 M.. A:�A ;�► AA s At .#
+� w �.r ve w Ile, w �r wr yr w w r logo11F w yePOOL
' !� "� , a - ': ' -: -.� � � ,.- �', .JK �-. :�� .+�, +�: 71t ..: :� A► '�� #It Ali. ! :�1 �, ��.. �.. YK.. ,;` �!-. ;)� +� 'l� ;�_ � :- ". :�:. �: �.:,,-. AI% .♦� '� � :.� � - � ��:
i
" .: .. .. Mi ,ice _ f
Atw - LTj, I ttL 4.
At ,w. '� A all Al` w. Atl ,er !� 'Iw . 'AA *wi t IN: At « u AE # . A. , Alt aK At AI AI 1M • # R Mt:
:M„ ,,,, ,,,. � w .. .ri � w ,► ' tiAr � aAr w' ' w< w w 'ir ,. �7r` we w .,r .i. +r ..t .,�M,
illl wit !! 111 ilk /1 Al a #It rk 11E qA !!t A +�► alf
,,.. r. ; .: �► At Al 1tAt : M. At. Miltr r. A . ` ,It w At rll ArWIN
w' ;� w� .' : +s vY Mf- wr ♦ w W w 11�'' '� �► - w W iY � w w : ;w' yr > w
INS
'w tiw •r :� -.r= w sir. `ri' #r -sir +ir w- w -ist' w= K w=IA 0- w- r rIt VIM
Ai A�' +w /IE : • iN wa * tell Alt ill At Aft..iMNt Ir
"w w !rr w w r. "w' w w w +�. vr. w -w '�► - .►= w- 'w w w 'w rr wA ; ik= AIL—Am, v►
�► aK ... � #IE _ ifEA� :�
Nor WK amu
�► w. - #1 A �l. Ati � eM >tt At< Ac A tll +It AY Al ; .Al � w Ak Ak At At aYt
� � •e �� � � :�. .Ar<. +X� ,AE � w � - +� ;. � :. `w AF' :lF AAF • MM - '>� w Mt AAe �' Aef '�►'; yet w %"
a , w` + ilE AAE llt stae J� M Ati w At M AYl Al n; AA „ee AA "w :E
!! 1CAt sR r11
w" r'i-Mr..
wv.,..
Al; Ali
: w -r
;�. At :w.
Ar~- '- 'VF
,; A� ,� A►
�AI�Kom a`w" M� > rIr" � 4t r!" : L►' 1e' - N� rt� ..
ws M w w ,A► �: A � w � , rA Ilr � AA ::A► .rk lIIA . M AE :rM A► rrc n► � a► � w 1► +11► Mt ,1►:
w w ,s w re •r AIE sr If w w w w w +r"Itrs i w t �Y w is rr w
+!! stt Ab Af Al A% AE . • " .: A11d AYl ' Alt PKI I • d1M • ! A: ' wA1; A A 1!r +k * A 1M 11► >k
w w w w w w w w' w w r w +fi w w •a : rr' w AIS yr ve r wr w tiw w w w
AK -Al 70TWIIN:m. AE ;wt .e► 14 • • A► wr ! wr AE •AtA 11► w llt Ak .M, Al '
�r w r s rr re "vr w w re wr w rr re . AAF +sMato IVwLL Ar w ve rF ' w :MF s .er ; w AAF
A Jlt M M :M A< #►
:. M Al AeA i► w, : �► A ! NE sl► M R: w A! M. A: : 11 AI
nF w As- w- +eE `
.:, ..: � swt A AfF. _;..... T a
X' NF w r vre .w rt ._W '. 1s M W Nc. tie M`' 'rC w .. 'iW N`',.. . ,. ,.... , ,. �r �.....
MC
Al A Ak Al & AE , .: Al AI Iw * Al . 4 w^
1f=
+e.:
'r' - "AK
aA /4
M Ar
w rs"
Ak Ae
A A
A
,
DocuSign Envelope ID: 50062DOB-82BB-4AC5-AC96-051505CB4DBD
� -.r � � "~` .�" i' � �" r :w �
VP,4i%
w w- � r:: 'w '-.r wr 'w
-�- .. r VAN
'w r.• :w +�- : rr - ,w wr w. +r : � Mt GY"�
- ter.. , , i r� : tip w - - -
� ac vn w � 'w � w' `w' v' ti
'ice w
!E W
" "vw w wM r: ,wr "wr ..r
At .: MI MI RAWA
=MC =wrw"-w
rd
rr ,r rr w w"
w. ..✓' ve' r. rr-w' 'w
a
.r r r w
: w�; - - w w w rig
maidil
r *r
ALL OTHER TERMS AND CONDITIONS OF THIS GRANT REMAIN IN FULL FORCE AND
EFFECT,
DocuSign Envelope ID: 50062DOB-82BB-4AC5-AC96-051505CB4DBD
AV
A Washington State
't IV a), fter, ce
Ul''
DocuSign Contract Review and Routing Form
Office of Crime Victims Advocacy
Reviewed by: � Titfe: I verify that I have: I Date:eb do
Grant Proofed documents
Sherina James Manager 9/19/2022 111:30 AM PDT
Section Matched approved Obligation Summary
Mikah Semrow Manager Memo and Allocation Spreadsheet 9/20/2022 17:52 AM PDT
Reviewed entry and coding in CMS
Correct template from IntraCOM has
(Assistant) been used
Richard Torrance Managing OR 9/20/2022 17:54 AM PDT
Director Documentation has been included with
reason for exception
.. �.. : a,. ..
.� ,..:. .. ..\ \ , ..
ase �f Gram Mama a needs to _ e .,� G a tee,subm� s o,n. � r A � n ,D:�r. , r\ -n, \\ ....
s � be o e ss stat ecto, \ s,\s :atur� Y
Reviewed by:
Title:
I verify that I have:
Date:
Grant
Checked that Grantee has completed all
Manager
required certifications and/or forms
Updated 5/25/2022
DocuSign
Certificate Of Completion
Envelope Id: 50062DOB82BB4AC5AC96051505CB4DBD
Status: Completed
Subject: Please DocuSign: OCVA VOCA CAC FFY 2020 Amendment F20-31219-401
Division:
Community Services and Housing
Program: OCVA
ContractN u m ber: F20-31219-401
DocumentType:
Contract Amendment
Source Envelope:
Document Pages: 7 Signatures: 2
Envelope Originator:
Certificate Pages: 5 Initials: 0
Kelly Tracy
AutoNav: Enabled
1011 Plum Street SE
Envelopeld Stamping: Enabled
MS 42525
Time Zone: (UTC -08:00) Pacific Time (US & Canada)
Olympia, WA 98504-2525
kelly.tracy@commerce.wa.gov
IP Address: 198.239.10.246
Record`Trac .ing
Status: Original Holder: Kelly Tracy Location: DocuSign
9/16/2022 9:20:27 AM kelly.tracy@commerce.wa.gov
Security Appliance Status: Connected Pool: StateLocal
Storage Appliance Status: Connected Pool: Washington State Department of Commerce Location: DocuSign
:Si ner Events Si nature Timestam
g: p
Sherina James Completed Sent: 9/16/2022 9:24:56 AM
sherina.james@commerce.wa.gov Viewed: 9/19/2022 11:30:10 AM
Security Level: Email, Account Authentication Signed: 9/19/2022 11:30:17 AM
(None) Using IP Address: 147.55.149.233
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mikah Semrow
mikah.semrow@commerce.wa.gov
Sexual Assault Services Section Manager
Washington State Department of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Richard Torrance
richard.torrance@commerce.wa.gov
Washington State Department of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Suzi Fode
Bocc-consent@grantcountywa.gov
Director
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Completed Sent: 9/19/2022 11:30:19 AM
Viewed: 9/20/2022 7:49:40 AM
Signed: 9/20/2022 7:52:06 AM
Using IP Address: 147.55.149.144
Completed Sent: 9/20/2022 7:52:09 AM
Viewed: 9/20/2022 7:54:10 AM
Signed: 9/20/2022 7:54:13 AM
Using IP Address: 147.55.149.219
Docuftned by: Sent: 9/20/2022 7:54:15 AM
�M( QAI Viewed: 9/30/2022 11:18:28 AM
70DADA3052FEOC_ Signed: 9/30/2022 11:18:51 AM
Signature Adoption: Pre -selected Style
Using IP Address: 216.215.12.5
I
Signer Events _- -: Sign1 11 ature ,I I1 I-�"� II - -_.-I - 11- .� --I 11 Timestarr,p . . I II - :--
Accepted: 9/30/2022 11:18:28 AM
D: 1 e07af47-892b-4a19-8f38-c1 fc72865e1 a
Cindy Guertin -Anderson
eindy.guertin-anderson@commerce.wa.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
EDocuftneddbby:
442� (' ��Aa,t, n
6A85C9B618494EF_
Signature Adoption: Pre -selected Style
Using IP Address: 147.55.134.69
Sent: 9/30/2022 11:18:53 AM
Viewed: 9/30/2022 12:21:02 PM
Signed: 10/3/2022 7:23:32 AM
:,-: ;, ,
In Person Si ne�-.Events : ::
..
Si nature �11� -,
_J _
,
: _ Ti e m
m sta
: p
,- .. -
Editor Del ve Events
rY , :.,
=- 1
Status - - __
_ ,1-.I -I�I: ,,II_�:1 :I—,:��,I,—,.,-,�,-
-I 1I1I,�1�I- --, I.- 11 - , II II —-
- I - 11-11 I -TimeStam
��:_,fit eRelive Even#s = .-
__._ _ _, ,_.__ _ _
,._„ -1:1
_.
:.,,
tatus. -
_ .,,. _ ._
..ll .
-=T1lmestam-rY
,� . . _, _ s . . ,,
1. ., :.
neer e
m __dia Del ve Events.
rY rY
- _ S#acus , ,_
:. ,,
J,_imestarnII 11.1.:,
.. ;:...
CertlfIe-d ;DeNve :Events .
ry
:_ _ _
,, _ _ _.
,, _ ,_
..
- Status :: _ -
, , , _ __ ,.
.:; ,��',",,-
Timestam
r n n
Ca bo -CoDo a _ts -
pY;:,
.. ..
;._
;,, status
_ ,_
.; -
: T Nme tam
1!VI 11
�tnes vents =
_E _
.,
St natu
_ re
,_ .. , ,.,
Ti mestam
Nota Events
ry . .
. _ .. _.
Si nature:.
g
Time - p
v n
En111:,velo a Summa r_rE e is ' 11: .
p., rYIr-Ir-
,
, : Status.rr _
-r.. ,.
Tim
_ estam s
Envelope Sent
Hashed/Encrypted
9/16/2022 9:24:56 AM
Certified Delivered
Security Checked
9/30/2022 12:21:02 PM
Signing Complete
Security Checked
10/3/2022 7:23:32 AM
Completed
Security Checked
10/3/2022 7:23:32 AM
-
Pa m :n Evens ;; u
Y
e_ t_ t .Stat _s T�mestam s
p
E ectronic--Record and -:Si nature DiII sc osure
g�
Electronic Record and Signature Disclosure created on: 8/11/2020 4:44:12 PM
Parties agreed to: Suzi Fode
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Washington State Department of Commerce (we, us or Company) may be
required by law to provide to you certain written notices or disclosures. Described below are the
terms and conditions for providing to you such notices and disclosures electronically through the
DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and
Signature Disclosure (ERSD), please confirm your agreement by selecting the check -box next to
`I agree to use electronic records and signatures' before clicking `CONTINUE' within the
DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.15 per -page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Washington State Department of Commerce:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: docusign@commerce.wa.gov
To advise Washington State Department of Commerce of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at docusign@commerce.wa.gov and
in the body of such request you must state: your previous email address, your new email
address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from Washington State Department of Commerce
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to docusign@commerce.wa.gov and in
the body of such request you must state your email address, full name, mailing address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Washington State Department of Commerce
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check -box indicating you wish to withdraw your consent, or you may;
ii. send us an email to docusign@commerce.wa.gov and in the body of such request you must
state your email, full name, mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-
slgnln, -rte-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check box next to `I agree to use electronic records and signatures' before
clicking `CONTINUE' within the DocuSign system.
By selecting the check box next to `I agree to use electronic records and signatures', you confirm
that:
• You can access and read this Electronic Record and Signature Disclosure; and
• You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
• Until or unless you notify Washington State Department of Commerce as described
above, you consent to receive exclusively through electronic means all notices,
disclosures, authorizations, acknowledgements, and other documents that are required to
be provided or made available to you by Washington State Department of Commerce
during the course of your relationship with Washington State Department of Commerce.