HomeMy WebLinkAboutAgreements/Contracts - JuvenileGRANT COUNTY
COMMISSIONERS AGENDA MEETING REQUEST FORM
(Must be submitted to the Clerk of the Board by 12:00pm on Thursday)
REQUESTING DEPARTMENT: JUV@Mlle COUI't 8c Youth Services
REQUEST SUBMITTED BY: Suhail PaIaCIOS
CONTACT PERSON ATTENDING ROUNDTABLE: Suhail PaIaCIOS
CONFIDENTIAL INFORMATION: ❑YES 8 NO
DATE:07/30/2025
PHONE: 509-754-5690 Ext. 4430
DAgreement / Contract
❑AP Vouchers
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El Emergency Purchase
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a
I am requesting your permission to electronically contract number: 26-31219-064 with the Department of Commerce,
Office of Crime Victims Advocacy specifically for the Crime Victim Service Center (CVSC) Comprehensive Service Grant,
to provide services to victims of crimes. The term of this contract is from July 1 st, 2025, to June 30th, 2027.
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If necessary, was this document reviewed by accounting? ❑ YES ® NO
LEGAL REVIEW:
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If necessary, was this document reviewed by legal? ® YES ❑ NO
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DATE OF ACTION:
APPROVE: DENIED ABSTAIN
D1:
D2:
D3:
4/8/24
DEFERRED OR CONTINUED TO:
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Scaft Mon., Pwen& Sm4m Yeppete..Tetead, Office AtatutgAn
July 30, 2025
Board of Grant County Commissioners
P® Box 37
Ephrata, WA 98823
RE: Signature for Contract Number: 26-31219-064
Dear Board of County Commissioners:
Please see the attached contract for review and approval.
Contractor: WA State Department of Commerce, Office of Crime Victims Advocacy (OCVA) for
Specific Crime Type Crime Victim Service Center (CVSC) Comprehensive Service Grant.
Term of Contract: July 1st, 2025 to June 30th, 2027.
Purpose: To provide services to victims of crime.
I am requesting permission to Docu-Sign electronically with the contractor.
Thank you for considering my request.
Suhail Palacios, Juvenile Court Administrator
Grant County Juvenile Court & Youth Services
P.O. Box 8181303 ABEL ROAD * EPHRATA, WA 98823 * PHONE (509) 754-5690 1 EFAx 1-509-754-5797
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6CO93514Cl FF
. ►. Washington State
��►� Department
lT Commerce
Interagency Agreement with
Grant County Juvenile Court
through
Office of Crime Victims Advocacy
Community Services Division
Grant Number:
26-31219-064
For
SFY 2026-2027 Crime Victim Service Center Grant
Dated: 07/01 /2025
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Table of Contents
FACESHEET............................................................................................................................................................3
SPECIAL TERMS AND CONDITIONS.........................................................................................................................4
1.
AUTHORITY......................................................................................................................................................4
2.
BILLING PROCEDURES AND PAYMENT.............................................................................................................4
3.
COMPENSATION..............................................................................................................................................4
4.
CONTRACT MANAGEMENT.............................................................................................................................5
5.
FRAUDAND OTHER LOSS REPORTING.............................................................................................................5
6.
GRANT MODIFICATION....................................................................................................................................5
7.
INSURANCE......................................................................................................................................................5
8.
REPORTING......................................................................................................................................................5
9.
SUBCONTRACTOR DATA COLLECTION.............................................................................................................6
10.
ORDER OF PRECEDENCE..................................................................................................................................6
GENERALTERMS AND CONDITIONS.......................................................................................................................7
1.
DEFINITIONS....................................................................................................................................................7
2.
ALLWRITINGS CONTAINED HEREIN.................................................................................................................7
3.
AMENDMENTS................................................................................................................................................7
4.
ASSIGNMENT...................................................................................................................................................7
5.
CONFIDENTIALITY AND SAFEGUARDING OF INFORMATION...........................................................................7
6.
COPYRIGHT......................................................................................................................................................8
7.
DISPUTES.........................................................................................................................................................8
8.
GOVERNING LAWANDVENUE........................................................................................................................8
9.
INDEMNIFICATION..........................................................................................................................................9
10.
LICENSING, ACCREDITATION AND REGISTRATION...........................................................................................9
11.
RECAPTURE......................................................................................................................................................9
12.
RECORDS MAINTENANCE................................................................................................................................9
13.
SAVINGS..........................................................................................................................................................9
14.
SEVERABILITY...................................................................................................................................................9
15.
SUBCONTRACTING..........................................................................................................................................9
16.
SURVIVAL.......................................................................................................................................................
10
17.
TERMINATION FOR CAUSE.............................................................................................................................
10
18.
TERMINATION FOR CONVENIENCE................................................................................................................
10
19.
TERMINATION PROCEDURES.........................................................................................................................
10
20.
TREATMENT OFASSETS.................................................................................................................................
11
21.
WAIVER.........................................................................................................................................................
11
ATTACHMENT A: SCOPE OF WORK....................................................................................................................... 12
ATTACHMENT B: BUDGET.................................................................................................................................... 13
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Face Sheet
Washington State Department of Commerce
Community Services Division
Office of Crime Victims Advocacy
SFY 2026-2027 Crime Victim Service Center Grant
Contract Number: 26-31219-064
1. Contractor
2. Contractor Doing Business As (as applicable)
GRANT, COUNTY OF
Grant County Juvenile Court
DBA JUVENILE COURT
EPHRATA, WA 98823
3. Contractor Representative
4. COMMERCE Representative
Suhail Fallacies
Jenna Osterman PO Box 42525
Juvenile Court Administrator
Program Coordinator 98504-8304
spalacios@grantcountywa.gov
(360) 725-2884
(509) 754-5694 Ext 4330
jenna.osterman@commerce.wa.gev 1011 Plum Street SE
Olympia WA 98501
5. Contract Amount
6. Funding Source
7. Start Date
8. End Date
$175,000.00
Federal: ❑ State: ® Other: El NIA: El07/012025
06/302027
9. Federal Funds (as applicable) Fetleml Agency: ALN
N/A N/A N/A
10. SWV #
11. UBI #
12. UEI #
13. Indirect Rate
SVVV0002426-08
132001884
ZL6WM26K8KR5
14. Award Method NOFO/RFX # Proviso #
Direct: ❑ Competitive: ® SPY 2026-2027 Crime Victim Service N/A
Center Grant
15. 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; and Grantee's Application for funding.
FOR CONTRACTOR
FOR COMMERCE
Suhail Fallacies Juvenile Court Administrator
*s3fibflWAnderson, Assistant Director
Name, Title
eoousieo.a ey:
y"t pa(Albs
8/6202518:49 AM PDT
Date
IS psrnfyeoseiaie_
8/52025 14:05 PM PDT
APPROVED AS TO FORM ONLY
BY ASSISTANT ATTORNEY GENERAL
Date
APPROVAL ON FILE
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Special Terms and Conditions
1. AUTHORITY
COMMERCE and Contractor enter into this Contract pursuant to the authority granted by Chapter 39.34
RCW.
2. BILLING PROCEDURES AND PAYMENT
COMMERCE will pay Contractor upon acceptance of services provided and receipt of properly completed
invoices, which shall be submitted to the Representative forCOMMERCE not more often than monthly nor
less than quarterly.
The Grantee shall submit all requests for reimbursement via the Commerce Contracts Management
System (CMS) which is available through the Secure Access Washington (SAW) portal. The invoice shall
include the Contract Number 26-31219-064.
If required, the attachments to the invoice request in the Commerce Contract Management System shall
describe and document, to COMMERCE's satisfaction, a description ofthe work performed, the progress
of the project, and fees.
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 Contractor.
COMMERCE may, in its sole discretion, terninate the Contract or withhold payments claimed by the
Contractor for services rendered if the Contractor fails to satisfactorily comply with any term or condition of
this Contract.
No payments in advance or in anticipation of services or supplies to be provided under this Agreement
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 Contractor must invoice for all expenses from the beginning ofthe contract through June 30, regardless
of the contract start and end date.
Duplication of Billed Costs
The Contractor shall not bill COMMERCE for services performed under this Agreement, and COMMERCE
shall not paythe Contractor, ifthe Contractor is entitled to payment or has been orwill be paid by any other
source, including grants, for that service.
Disallowed Costs
The Contractor is responsible for any audit exceptions or disallowed costs incurred by its own organization
or that of its subcontractors.
3.
COMMERCE may, in its sole discretion, withhold ten percent (10%) from each payment until acceptance
by COMMERCE ofthe final report (or completion ofthe project, etc.).
COMMERCE shall pay an amount not to exceed $175,000.00 forthe performance of all things necessary
for or incidental to the performance of work as set forth in the Scope of Work. Grantee's compensation for
services rendered shall be based on the terms ofthe Scope of Work and Budget.
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4.
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.
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 .gov/sites/default/files/public/resources/travel/colo"ap.pdf
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 Contract.
The Representative for COMMERCE and their contact information are identified on the Face Sheet of
this Contract.
The Representative for the Contractor and their contact information are identified on the Face Sheet of
this Contract.
5. FRAUD AND OTHER LOSS REPORTING
6.
Contractor shall report in writing all known or suspected fraud or other loss of any funds or other property
furnished under this Contract immediately or as soon as practicable to the Commerce Representative
identified on the Face Sheet.
Notwithstanding any provision ofthis grant to the contrary, at anytime 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 ofthe 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 signed bythe
parties hereto, shall not be binding.
Notwithstanding any provision ofthis grant to the contrary, at anytime during the grant period,
COMMERCE may analyze grant expenditures as a proportion ofthe grant budget. If COMMERCE
determines, in its sole discretion, that the grant funding is underutilized, COMMERCE, in its sole
discretion, may unilaterally modifythe grant to reduce the balance ofthe grant budget. Funds de -
obligated by COMMERCE as a result of a budget reduction may be made available to other grantees for
the provision of eligible program activities.
7. INSURANCE
Each party certifies that it is self -insured under the State's or local government self-insurance liability
program and shall be responsible for losses forwhich it is found liable.
8. REPORTING
Grantees must collect and maintain data that measure the performance and effectiveness ofwork done
underthis grant.
If providing direct services or outreach, the Grantee shall submit data quarterly in the InfoNet data
collection system, relative to the provision of SPY 2026-2027 Crime Victim Service Center Grant
services. Report data will be due in InfoNet no laterthan the fifteenth day following the end of each
quarter.
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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:
o Only authorized staff are provided access to the InfoNet data and files;
o Staff are informed of the need for security and confidentiality of data and files maintained in or
available through the InfoNet system; and
o That the Grantee shall notify the Department Program Coordinator for this grant when an
employee is no longer authorized to access the InfoNet system.
Additional narrative reports may be required. See the Application for Funding and/or Reporting
Instructions provided for further details.
9. SUBCONTRACTOR DATA COLLECTION
Contractor will submit reports, in a form and format to be provided by Commerce and at intervals as agreed
by the parties, regarding work under this Contract performed by subcontractors and the portion of Contract
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.
10. ORDER OF PRECEDENCE
In the event of an inconsistency in this Contract, the inconsistency shall be resolved by giving precedence
in the following order:
• Applicable federal and state of Washington statutes and regulations
• Special Terms and Conditions
• General Terms and Conditions
• Attachment A — Scope of Work
• Attachment B— Budget
• SFY 2026-2027 Crime Victim Service Center Grant Application for Funding as submitted and
approved by COMMERCE
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C011H rIX
General Terms and Conditions
1. DEFINITIONS
As used throughout this Contract, the following terms shall have the meaning set forth below:
A. "Authorized Representative" shall mean the Director and/or the designee authorized in writing to act
on the Directors behalf.
B. "COMMERCE" shall mean the Washington Department of Commerce.
C. "Contract" or "Agreement" or "Grant" means the entire written agreement between COMMERCE
and the Contractor, including any Attachments, 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. "Contractor" or "Grantee" shall mean the entity identified on the face sheet performing service(s)
underthis Contract, and shall include all employees and agents ofthe Contractor.
E. "Personal Information" shall mean information identifiable to any person, including, but not limited
to, information that relates to a person's name, health, finances, education, business, use or receipt
of governmental services or other activities, addresses, telephone numbers, social security
numbers, driver license numbers, other identifying numbers, and any financial identifiers, and
"Protected Health Information" underthe federal Health Insurance Portability and Accountability Act
of 1996 (HIPAA).
F. "State" shall mean the state of Washington.
G. "Subcontractor" shall mean one not in the employment of the Contractor, who is performing all or
part of those services under this Contract under a separate contract with the Contractor. The terms
"subcontractor" and "subcontractors' mean subcontractors) in anytier.
2. ALL WRITINGS CONTAINED HEREIN
This Contract contains all the terms and conditions agreed upon by the parties. No other understandings,
oral or otherwise, regarding the subject matter of this Contract shall be deemed to exist or to bind any of
the parties hereto.
3. AMENDMENTS
This Contract may be amended by mutual agreement of the parties. Such amendments shall not be binding
unless they are in writing and signed by personnel authorized to bind each of the parties.
4. ASSIGNMENT
Neither this Contract, work thereunder, nor any claim arising under this Contract, shall be transferred or
assigned by the Contractor without prior written consent of COMMERCE.
5. CONFIDENTIALITY AND SAFEGUARDING OF INFORMATION
A. "Confidential Information" as used in this section includes:
L All material provided to the Contractor by COMMERCE that is designated as "confidential" by
COMMERCE;
ii. All material produced by the Contractor that is designated as "confidential" by COMMERCE;
and
iii. All Personal Information in the possession of the Contractor that may not be disclosed under
state or federal law.
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B. The ContractorshalI comply with all state and federal laws related to the use, sharing, transfer, sale,
or disclosure of Confidential Information. The Contractor shall use Confidential Information solely
for the purposes of this Contract and shall not use, share, transfer, sell or disclose any Confidential
Information to any third party except with the prior written consent of COMMERCE or as may be
required by law. The Contractor shall take all necessary steps to assure that Confidential Information
is safeguarded to prevent unauthorized use, sharing, transfer, sale or disclosure of Confidential
Information or violation of any state or federal laws related thereto. Upon request, the Contractor
shall provide COMMERCE with its policies and procedures on confidentiality. COMMERCE may
require changes to such policies and procedures as they apply to this Contract whenever
COMMERCE reasonably determines that changes are necessary to prevent unauthorized
disclosures. The Contractor shall make the changes within the time period specified by
COMMERCE. Upon request, the Contractor shall immediately return to COMMERCE any
Confidential Information that COMMERCE reasonably determines has not been adequately
protected by the Contractor against unauthorized disclosure.
C. Unauthorized Use or Disclosure. The Contractor shall notify COMMERCE within twenty-four (24)
hours of any unauthorized use or disclosure of any confidential information, and shall take necessary
steps to mitigate the harmful effects of such use or disclosure.
6. COPYRIGHT
Unless otherwise provided, all Materials produced under this Contract shall be considered "works for hire'
as defined by the U.S. Copyright Act and shall be owned by COMMERCE. COMMERCE shall be
considered the author of such Materials. In the event the Materials are not considered 'Works for hire'
under the U.S. Copyright laws, the Contractor 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 Contract, but that incorporate pre-existing materials not produced
underthe Contract, the Contractor hereby grants to COMMERCE a nonexclusive, royalty -free, irrevocable
license (with rights to sublicense to others) in such Materials to translate, reproduce, distribute, prepare
derivative works, publicly perform, and publicly display. The Contractor warrants and represents that the
Contractor has all rights and permissions, including intellectual property rights, moral rights and rights of
publicity, necessary to grant such a license to COMMERCE.
The Contractor shall exert all reasonable effort to advise COMMERCE, at the time of delivery of Materials
furnished under this Contract, 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 Contract. The Contractor shall
provide COMMERCE with prompt written notice of each notice or claim of infringement received by the
Contractor with respect to any Materials delivered underthis Contract. COMMERCE shall have the right to
modify or remove any restrictive markings placed upon the Materials by the Contractor.
7. DISPUTES
In the event that a dispute arises under this Agreement, it shall be determined by a Dispute Board in the
following manner: Each party to this Agreement shall appoint one member to the Dispute Board. The
members so appointed shall jointly appoint an additional member to the Dispute Board. The Dispute Board
shall review the facts, Agreement terms and applicable statutes and rules and make a determination ofthe
dispute. The Dispute Board shall thereafter decide the dispute with the majority prevailing. The
determination ofthe Dispute Board shall be final and binding on the parties hereto. As an alternative to this
process, either of the parties may request intervention by the Governor, as provided by RCW 43.17.330,
in which event the Governors process will control.
8. GOVERNING LAW AND VENUE
This Contract shall be construed and interpreted in accordance with the laws of the state of Washington,
and the venue of any action brought hereunder shall be in the Superior Court for Thurston County.
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9. INDER
Each party shall be solely responsible forth e acts of its employees, officers, and agents.
10. LICENSING, ACCREDITATION AND REGISTRATION
The Contractor shall comply with all applicable local, state, and federal licensing, accreditation and
registration requirements or standards necessaryforthe performance of this Contract.
11. RECAPTURE
In the event that the Contractor fails to perform this Contract in accordance with state laws, federal laws,
and/or the provisions of this Contract, COMMERCE reserves the right to recapture funds in an amount to
compensate COMMERCE for the noncompliance in addition to any other remedies available at law or in
equity.
Repayment by the Contractor 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 Contract.
12. RECORDS MAINTENANCE
The Contractor shall maintain books, records, documents, data and other evidence relating to this contract
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 Contract.
The Contractor shall retain such records for a period of six years following the date offnal payment. At no
additional cost, these records, including materials generated under the Contract, shall be subject at all
reasonable times to inspection, review or audit by COMMERCE, personnel duly authorized by
COMMERCE, the Office ofthe State Auditor, and federal and state officials so authorized by law, regulation
or agreement.
If any litigation, claim or audit is started before the expiration of the six (6) year period, the records shall be
retained until all litigation, claims, or audit findings involving the records have been resolved.
13. SAVINGS
In the event funding from state, federal, or other sources is withdrawn, reduced, or limited in any way after
the effective date of this Contract and priorto normal completion, COMMERCE may suspend or terminate
the Contract under the 'Termination for Convenience' clause, without the ten calendar day notice
requirement. In lieu of termination, the Contract maybe amended to reflect the new funding limitations and
conditions.
14. SEVERABILITY
15.
The provisions of this Contract 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
Contract.
The Contractor may only subcontract work contemplated under this Contract if it obtains the prior written
approval of COMMERCE.
If COMMERCE approves subcontracting, the Contractor shall maintain written procedures related to
subcontracting, as well as copies of all subcontracts and records related to subcontracts. For cause,
COMMERCE in writing may: (a) require the Contractor to amend its subcontracting procedures as they
relate to this Contract; (b) prohibit the Contractor from subcontracting with a particular person or entity; or
(c) require the Contractor to rescind or amend a subcontract.
Every subcontract shall bind the Subcontractor to follow all applicable terms of this Contract. The
Contractor is responsible to COMMERCE if the Subcontractor fails to comply with any applicable term or
condition ofthis Contract. The Contractor shall appropriately monitorthe activities of the Subcontractor to
assure fiscal conditions of this Contract. In no event shall the existence of a subcontract operate to release
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or reduce the liability of the Contractor to COMMERCE for any breach in the performance of the
Contractor'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.
16. SURVIVAL
The terms, conditions, and warranties contained in this Contract that by their sense and context are
intended to survive the completion ofthe performance, cancellation ortermination ofthis Contract shall so
survive.
17. TERMINATION FOR CAUSE
18.
19.
In the event COMMERCE detennines the Contractor has failed to comply with the conditions of this
Contract in a timely manner, COMMERCE has the right to suspend or tenninate this Contract. Before
suspending or terminating the Contract, COMMERCE shall notify the Contractor in writing ofthe need to
take corrective action. If corrective action is not taken within 30 calendar days, the Contract may be
tenninated or suspended.
In the event of termination or suspension, the Contractor shall be liable for damages as authorized by law
including, but not limited to, any cost difference between the original contract and the replacement or cover
contract and all administrative costs directly related to the replacement contract, e.g., cost of the
competitive bidding, mailing, advertising and staff time.
COMMERCE reserves the right to suspend all or partof the Contract, withhold further payments, or prohibit
the Contmctorfrom incurring additional obligations offunds during investigation ofthe alleged compliance
breach and pending corrective action by the Contractor or a decision by COMMERCE to terminate the
Contract. A tennination shall be deemed a 'Termination for Convenience' if it is determined that the
Contractor: (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 Contract are not exclusive and are, in addition to
any other rights and remedies, provided by law.
Except as otherwise provided in this Contract, COMMERCE may, byten (10) business days' written notice,
beginning on the second day after the mailing, terminate this Contract, in whole or in part. If this Contract
is so terminated, COMMERCE shall be liable only for payment required under the terms of this Contract
for services rendered or goods delivered prior to the effective date of tennination.
Upon tennination of this Contract, COMMERCE, in addition to any other rights provided in this Contract,
may require the Contractor to deliver to COMMERCE any property specifically produced or acquired for
the performance of such part of this Contract as has been terminated. The provisions of the "Treatment of
Assets' clause shall apply in such property transfer.
COMMERCE shall pay to the Contractor the agreed upon price, if separately stated, for completed work
and services accepted by COMMERCE, and the amount agreed upon by the Contractor and COMMERCE
for (i) completed work and services for which no separate price is stated, (ii) partially completed work and
services, (iii) other property or services that are accepted by COMMERCE, and (iv) the protection and
preservation of property, unless the tennination is for default, in which case the Authorized Representative
shall detennine the extent of the liability of COMMERCE. Failure to agree with such detennination shall
be a dispute within the meaning of the "Disputes" clause ofthis Contract. COMMERCE may withhold from
any amounts due the Contractor 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 oftermination, and except as otherwise directed by the Authorized Representative,
the Contractor shall:
Page 10 of 13
Do cusign Envelope ID'.70F8DEF85C65-4F3B-910Ef C093514Cl FF
�••� w emem a Dep
COIIIIOCr'R
A. Stop work under the Contract on the date, and to the extent specified, in the notice;
B. Place no further orders or subcontracts for materials, services, or facilities except as may be
necessary for completion of such portion ofthe work under the Contract that is not terminated;
C. Assign to COMMERCE, in the manner, at the times, and to the extent directed by the Authorized
Representative, all of the rights, title, and interest of the Contractor under the orders and
subcontracts so terminated, in which case COMMERCE has the right, at its discretion, to settle or
pay any or all claims arising out ofthe termination of such orders and subcontracts;
D. 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 ofthis clause;
E. Transfer title to COMMERCE and deliver in the manner, at the times, and to the extent directed by
the Authorized Representative any property which, ifthe Contract had been completed, would have
been required to be furnished to COMMERCE;
F. Complete performance ofsuch part ofthe work as shall not have been terminated by the Authorized
Representative; and
G. Take such action as may be necessary, or as the Authorized Representative may direct, for the
protection and preservation ofthe property related to this Contract, which is in the possession ofthe
Contractor and in which COMMERCE has or may acquire an interest.
20. TREATMENT OF ASSETS
Title to all property furnished by COMMERCE shall remain in COMMERCE. Title to all property furnished
by the Contractor, for the cost of which the Contractor is entitled to be reimbursed as a direct item of cost
under this Contract, shall pass to and vest in COMMERCE upon delivery of such property by the
Contractor. Title to other property, the cost ofwhich is reimbursable to the Contractor under this Contract,
shall pass to and vest in COMMERCE upon (i) issuance for use of such property in the performance ofthis
Contract, or (ii) commencement of use of such property in the performance of this Contract, or (iii)
reimbursement ofthe cost thereof by COMMERCE in whole or in part, whichever first occurs.
A. Any property of COMMERCE furnished to the Contractor shall, unless otherwise provided herein or
approved by COMMERCE, be used only forthe performance ofthis Contract.
B. The Contractor shall be responsible for any loss or damage to property of COMMERCE that results
from the negligence ofthe Contractor orwhich results from the failure on the part ofthe Contractor
to maintain and administerthat property in accordance with sound management practices.
C. If any COMMERCE property is lost, destroyed or damaged, the Contractor shall immediately notify
COMMERCE and shall take all reasonable steps to protect the propertyfrom further damage.
D. The Contmctorshall surrender to COMM ERC E all property of COMMERCE prior to settlement upon
completion, termination or cancellation ofthis Contract.
E. All reference to the Contractor under this clause shall also include Contractors employees, agents
or Subcontractors.
21. WAIVER
Waiver of any default or breach shall not be deemed to be a waiver of any subsequent default or breach.
Any waiver shall not be construed to be a modification of the terms of this Contract unless stated to be
such in writing and signed by Authorized Representative of COMMERCE.
Page 11 of 13
Do cusign Envelope ID'. 70F8DEF85C65-4F3B-91C&SC093514Cl FF
10% w Depemem a
Comtmrm
Attachment A: Scope of Work
Grant County Juvenile Court shall furnish goods and services necessary to accomplish the activities under
the SFY 2026-2027 Crime 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 government's direct benefit. The principle purpose of this Grant is to provide funding for Grant County
Juvenile Court to accomplish a public purpose.
Funding from this Grant must be used to support the services outlined and approved in the SFY 2026-2027
Crime Victim Service Center Grant funding application.
DATA REQUIREMENTS
1. Grantees will submit quarterly reports on SFY 2026-2027 Crime Victim Service Center Grant activities
to their grant manager.
2. Report data will be due in InfoNet no later than the fifteenth day following the end of each quarter.
Additional narrative reports may be required. See the Application for Funding and/or Reporting
Instructions provided for further details
DELIVERABLES
1. Services —As detailed above
2. Reports — As described in Special Terms and Conditions
3. Invoices— Must be submitted at least quarterly and as described in Special Terms and Conditions
PERFORMANCE MEASURES
Provision ofthe 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
Page 12 of 13
Do cusign Envelope ID'.70F8DEF85C65-4F3B-910Ef C093514Cl FF
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COMMMI'm
Attachment B: Budget
Budget
CVSC
Total
Salaries
$84,767.00
$84,767.00
Benefits
$25,869.00
$25,869.00
Goods and Services
$64,364.00
$64,364.00
Match
$43,750.00
$43,750.00
Non - Match Total
$175,000.00
$175,000.00
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
httos://ofm.wa.a ov/sites/default/fi I es/o u bl is/resou rces/travel/colorm ao. o df.
Any purchase over $10,000 must be pre -approved by COMMERCE.
Page13of13
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6CO93514Cl FF
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. Unique Entity Identifier (UEI) from SAM.gov system
This number is required to receive federal funds. According to the Department of Justice Grants
Financial Guide, unless an exception applies, all applicants and recipients must have a unique entity
identifier when applying for Federal awards and cooperative agreements (initial or supplemental
awards) (2 C.F.R. Part 25 - Universal Identifier and System of Award Management).
In April of 2022 the federal government stopped using the DUNS number and switched to UEI's
assigned via the SAM.gov system.
If your entity was already registered in SAM.gov, your UEI has already been assigned. This number is
currently visible on your entity registration record.
Please note that SAM.gov registration is not required to obtain an UEI and OCVA is no longer
requiring SAM.gov registration for our grantees.
To obtain a UEI (without full entity registration in SAM.gov), please visit the SAM.gov website.
• See Quick Start Guide for Getting Your Unique Entity ID (SAM)
• See SAM.gov I Home
• This is a free service
Agency's Unique Entity Identifier (UEI): ZL6WM26K8KR5
2. Audit Requirements
Federal Grant Funds Subrecipients expending $1,000,000 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.
3. 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.
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 ❑ No
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 ❑ No 1�
Did you answer "yes" to both 4.a) and 4.b)?
Yes ❑ No 1�
If you answered "yes" to both questions please provide the names/compensation of the five
(5) most highly compensated executives of the recipient of award funds:
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6CO93514Cl FF
1. N/A
2.N/A
3.N/A
4. N/A
4. Internal Revenue Service (IRS) 501(c)(3) Determination Letter
VOCA funding requires that nonprofit organizations verify their federal nonprofit status (as applicable)
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)(16)(B).
Unless submitted previously, nonprofit organizations applying for funding must submit a copy
of Internal Revenue Service to OCVA.
5. Computer Networks
The applicant understands and agrees that it cannot use VOCA Grant funds to maintain or establish a
computer network unless such network blocks the viewing, downloading, and exchanging of
pornography.
6. Non -Supplanting Certification
The applicant understands and agrees that no VOCA Grant funds will be used to supplant existing
state, local, or other non-federal funding already in place to support current services. VOCA 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.
7. ADA Requirement (FOR NON -TRIBAL GRANTEES ONLY)
Does the location where services are primarily provided comply with ADA requirements for
accessibility?
Yes 1� No ❑
If no, provide information on how this is addressed:
N/A
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 hereby 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.
DocuSigned by:
Suhail Palacios Juvenile Court Administrator
Name and Title of Authorized Representative
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6CO93514Cl FF
Civil Rights Certifications
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, will be subject to statutory prohibitions on discrimination.
1. Discrimination 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 VI of
the Civil Rights Act of 1964, applicants must take reasonable steps to ensure that persons 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 VI 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.lep.gov.
2. Federal Non -Discrimination Requirements
The applicant will comply with any applicable federal nondiscrimination requirements, which may
include:
• 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. §§ 12131-34),
• the Education Amendments of 1972 (20 U.S.C. §§ 1681,1683,1685-86),
• 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 13279 (equal protection of the law for -faith based and community 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, et seq.; Section 504 of the
Rehabilitation Act of 1973, as amended, 29 U.S.C. 794, Subtitle A, Title II of the Americans with
Disabilities Act of 1990, 42 U.S.C. 12101, et seq. and Department of Justice regulations on disability
discrimination, 28 CFR Part 35 and Part 39, Title IX of the Education Amendments of 1972, as
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6CO93514Cl FF
amended, 20 U.S.C. 1681-1683, and the Age Discrimination Act of 1975, as amended, 42 U.S.C.
6101, et seq.
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 VOCA-funded programs or 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 consists 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://oip.gov/about/ocr/ocr-training-videos/video
ocr-trainina.htm
The recipient must view the online training at least once every two years. By signing this certification,
the applicant acknowledges the viewing of OJP 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).
The Grantee shall include a statement clearly stating whether or not the finding is related to any grant
activity supported with a grant in which U.S. Department of Justice 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 EEOP, it 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 httiD1/www.oiip.usdoi.gov/ocr/.
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 grant.
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91 CB-6C093514C1 FF
As the duly authorized representative of the grantee, I hereby certify that the Grantee will comply
with the above Civil Rights requirements specified in this Certification
DocuSigned by:
sv"pat'A'66S
8...
8/5/2025 1 4.05 PM PDT
Date
Suhail Palacios Juvenile Court Administrator
Name and Title of Authorized Representative
Grant County Juvenile Court
Name of Agency
Suhail Palacios
Name and Title of person who completed OJP Civil Rights Non -Discrimination Training (see #4)
7/30/2024
Most recent date online training was completed
Recipients must view the online training at a minimum of every two years for the duration
VOCA funding is received.
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91 CB-6C093514C1 FF
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.
Suhail Palacios
Name and Title of Authorized Representative
Juvenile Court Administrator
DocuSigned by:
S"� PAWbs 8/5/2025 1 4:05 PM PDT
pwoe... Date
Grant County Juvenile Court
Name of Organization
DBA JUVENILE COURT PO BOX 37 EPHRATA, WA 98823
Address of Organization
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6CO93514Cl FF
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 $100,000 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 fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 or not more than $100,000 for each
such failure.
The undersigned certifies, to the best of their knowledge and belief, that,
A. No Federal appropriated funds have been paid orwill 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 entering
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 S.P. and complete and
submit "Disclosure of Lobbying Activities", in accordance with its instructions. OCVA will provide 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.
Suhail Palacios Juvenile Court Administrator
Name and Title of Authorized Representative
by:
J 1 t
Date
Grant County Juvenile Court
Name of Organization
DBA JUVENILE COURT PO BOX 37 EPHRATA, WA 98823
Address of Organization
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91 CB-6C093514C1 FF
Certification of Suitability to Interact with Participating Minors
To assist OCVA in monitoring new grant requirements for federal funds, please complete this 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 grant (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: Grant County Juvenile Court
Grant Number: 26-31219-064
Background checks must include:
• Public sex offender and child abuse websites/registries
• 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 is not required.
Applicant hereby certifies that the recipient (and any subrecipients) have complied with the above
regulations, as applicable.
-DocuSigned by:
Signature of Authorized Official SV"PA&6bS
�673A1FE9D5B1418...
Name of Authorized Official Suhail Palacios
Date 8/5/2025 1 4:05 PM PDT
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6C093514Cl FF
Request for Volunteer Requirement Waiver
Current VOCA 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 counselor/victim 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 VOCA project/program:
Yes ❑ No 1�
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 aciencv is requesting a waiver for the following reason/s:
N/A
Docusign Envelope ID: 70F8DEF8-5C65-4F3B-91CB-6C093514Cl FF
Subgrant Award Report (SAR)
Complete the information below, this 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 VOCA plus match funds.
How to video is here:.hftps://vimeo.com/365156967
1. Organization Name: Grant County Juvenile Court
2. VOCA Crime Victim Assistance Funds Awarded in this grant: $
3. Sub -Grant Number (number assigned to your contract): 26-31219-064
4. Budget and Staffing
Indicate below the requested information based on the subrecipient's current fiscal year. Report the
total budget available to the victim services program, by source of funding. Do not report the entire
agency budget, unless the entire budget is devoted to victim services program. For example, if VOCA
funds are awarded to support a victim advocate unit in a prosecutor's office, only report the budget for
the victim advocate unit.
Information Requested
Response
Explanation as required)
A. Total budget for all victimization
The amount reported is for the
programs and services
current fiscal year. Include the
318,776
subaward amount for this
contract/grant
B. Annual funding amounts allocated
State funds:
Identify by source, the amount of
to all victimization programs
175,000
funds allocated to the victimization
and/or services for the current
Local funds:
programs/services budget of the
fiscal year
subgrantee agency.
$ 43,776
DO NOT COUNT FUNDS IN
Other federal funds:
MORE THAN ONE CATEGORY
100,000
OTHER FEDERAL includes all
Other non-federal:
federal funding except the
N 0
�V
subaward amount reported in
Question 2.
C. Total number of paid staff for
Total Paid Staff:
Count each staff member once.
all subgrantee victimization
Enter Whole Number
Both full and part time staff
programs and/or services
should be counted as one staff
7
member. DO NOT prorate based
on FTE.
D. Number of staff hours funded
Number of Hours:
through this VOCA award
Total COUNT of hours of work by
(plus match) for subgrantee's
2,268
all staff supporting the work of this
victimization programs and/or
VOCA subaward plus match.
services
E. Number of volunteer staff
Volunteer Staff:
supporting the work of this
Enter Whole Number
COUNT each volunteer staff
VOCA award (plus match) for
once. DO NOT prorate based on
subgrantee's victimization
15
FTE.
programs and/or services
F. Number of volunteer hours
Number of Hours:
supporting the work of this
Total count of hours of work byall
VOCA award (plus match) for
1,528
volunteers supporting the work of
subgrantee's victimization
this VOCA subaward plus match.
programs and/or services
Doc usion Ewe lope ID. 70r8Der8-5ce54r3e-91 CB 6C0e3514arr
1► Washington State
Department of
Commerce
DocuSign Contract Review and Routing Form
Office of Crime Victims Advocacy
Reviewed by:
Title:
I verify that I haw:
Date:
Jenna Osterman
Grant
Proofed documents
7/15202514. 30 PM PDT
Manager
Section
Matched approw:d Obligation Summary
Nidry Gleason
Memo and Allocation Spreadsheet
7/15202515 00 PM PDT
Manager
Reviewed entry and codingin CNIS
Correct template from IntraCOM has
Assistant
been used
Trisha Smith
or
OR
7/17202511142 AM PDT
Managing
Documentation has been included with
Director
reason for exception
Use If Grant Manager needs W verify Grantee submission before Assistant Director's a[
Reviewed by: Title: I verify that l have: Date:
Jenna Osterman Grant Checked that Grantee has completed all 8/620251 832 AM PDT
Manager required certifications and/or films
Updated 5/25/2022
0 docusign
Certificate Of Completion
Envelope Id: 70F8DEF8-5C65-4F3B-91 CB-6C093514C1 FF
Subject: OCVA SFY 2026-2027 Crime Victim Service Center 26-31219-064 Grant Co Juvenile Court
Division:
Community Services and Housing
Program: OCVA
Co ntractN u m be r: 26-31219-064
DocumentType: Contract
Source Envelope:
Document Pages: 24 Signatures: 7
Certificate Pages: 5 Initials: 0
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
Record Tracking
Status: Original
7/15/2025 4:19:42 PM
Security Appliance Status: Connected
Storage Appliance Status: Connected
Signer Events
Jenna Osterman
jenna.osterman@commerce.wa.gov
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Nicky Gleason
nicky.gleason@commerce.wa.gov
Washington State Department of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Trisha Smith
trisha.smith@commerce.wa.gov
AMD
WA State Dept of Commerce
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Suhail Palacios
spalacios@grantcountywa.gov
Juvenile Court Administrator
Grant County Juvenile Court and Youth Services
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 7/29/2025 3:27:48 PM
ID: 6c127ea2-9565-4542-a1 b4-e77a65ec2043
Holder: Kelly Tracy
kelly.tracy@commerce.wa.gov
Pool: StateLocal
Pool: Washington State Department of Commerce
Signature
Completed
Using IP Address: 198.239.106.205
Completed
Using IP Address: 147.55.134.106
Completed
Using IP Address: 198.239.10.135
DocuSigned by:
S"PA&6bS
673A1FE9D5B1418...
Signature Adoption: Pre -selected Style
Using IP Address: 216.215.12.54
Status: Completed
Envelope Originator:
Kelly Tracy
1011 Plum Street SE
MS 42525
Olympia, WA 98504-2525
kelly.tracy@commerce.wa.gov
IP Address: 198.238.6.159
Location: DocuSign
Location: Docusign
Timestamp
Sent: 7/15/2025 4:23:34 PM
Viewed: 7/15/2025 4:30:40 PM
Signed: 7/15/2025 4:30:45 PM
Sent: 7/15/2025 4:30:46 PM
Viewed: 7/15/2025 4:59:51 PM
Signed: 7/15/2025 5:00:06 PM
Sent: 7/15/2025 5:00:07 PM
Viewed: 7/17/2025 11:41:50 AM
Signed: 7/17/2025 11:42:05 AM
Sent: 7/17/2025 11:42:07 AM
Resent: 7/29/2025 4:55:18 PM
Resent: 7/29/2025 5:08:29 PM
Viewed: 7/30/2025 1:35:04 PM
Signed: 8/5/2025 4:05:02 PM
Signer Events
Signature
Timestamp
Jenna Osterman
Completed
Sent: 8/5/2025 4:05:04 PM
jenna.osterman@commerce.wa.gov
Viewed: 8/6/2025 8:31:48 AM
Security Level: Email, Account Authentication
Signed: 8/6/2025 8:32:58 AM
(None)
Using IP Address: 147.55.149.194
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Cindy Guertin -Anderson
Docusigned by:
���-��
Sent: 8/6/2025 8:33:01 AM
cindy.guertin-anderson@commerce.wa.gov
Viewed: 8/6/2025 8:49:32 AM
.Assistant Director, Commerce
6A85C9B618494EF...
Signed: 8/6/2025 8:49:38 AM
Washington State Department of Commerce
Security Level: Email, Account Authentication
Signature Adoption: Pre -selected Style
(None)
Using IP Address: 198.238.75.180
Electronic Record and Signature Disclosure:
Not Offered via Docusign
In Person Signer Events
Signature
Timestamp
Editor Delivery Events
Status
Timestamp
Agent Delivery Events
Status
Timestamp
Intermediary Delivery Events
Status
Timestamp
Certified Delivery Events
Status
Timestamp
Carbon Copy Events
Status
Timestamp
Witness Events
Signature
Timestamp
Notary Events
Signature
Timestamp
Envelope Summary Events
Status
Timestamps
Envelope Sent
Hashed/Encrypted
7/15/2025 4:23:34 PM
Envelope Updated
Security Checked
7/29/2025 4:55:17 PM
Envelope Updated
Security Checked
7/29/2025 4:55:17 PM
Certified Delivered
Security Checked
8/6/2025 8:49:32 AM
Signing Complete
Security Checked
8/6/2025 8:49:38 AM
Completed
Security Checked
8/6/2025 8:49:38 AM
Payment Events
Status
Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on: 8/11/20204:44: 12 PM
Parties agreed to: Suhail Palacios
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: httns:Hsupport.docusign.com/guides/signer-guide-
s i gnin g-system-re quirements.
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.