Microsoft Word - ServicesAgreement

SERVICE AGREEMENT/Name of Contractor – Page 1

Revised 5.2.22

SERVICE AGREEMENT

FOR

____________________ SERVICES

(NOTE: Use this template for minor remodeling and repair, janitorial service, tree maintenance, road

maintenance and resurfacing, painting, electrical work, plumbing, movers, and onsite maintenance

agreements.)

This Service Agreement ("Agreement") is effective as of the date of the last authorizing

signature affixed hereto. The parties ("Parties") to this Agreement are the City of Olympia, a

Washington municipal corporation ("City"), and _____________________________________, a (insert

state of incorporation; e.g. Washington, California, Georgia, etc.) corporation ("Contractor"). (If

Contractor is not a corporation, replace with type of entity, if known, i.e., limited liability company,

sole proprietorship.)

A. The City seeks the temporary services of a skilled independent contractor capable of

working without direct supervision, in the capacity of ________________; and

B. The Contractor has the requisite skill and experience necessary to provide such services.

NOW, THEREFORE, the Parties agree as follows:

1. Services.

(Alternative Provision:) Contractor shall provide the following services:

______________________________________________ ("Services"), in a manner consistent with the

accepted practices for other similar services, performed to the City's satisfaction, within the time period

prescribed by the City and pursuant to the direction of the City Manager or his or her designee.

(Alternative Provision:) Contractor shall provide the services more specifically described in

Exhibit "A,” (Staff: please attach exhibit and mark "Exhibit "A") attached hereto and incorporated by

this reference ("Services"), in a manner consistent with the accepted practices for other similar services,

and when and as specified by the City’s representative.

2. Term.

The term of this Agreement shall commence upon the effective date of this Agreement and shall

continue until the completion of the Services, but in any event no later than

___________________________ ("Term"). This Agreement may be extended for additional periods of

time upon the mutual written agreement of the City and the Contractor.

3. Termination.

Prior to the expiration of the Term, this Agreement may be terminated immediately, with or

without cause by the City.

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4. Compensation.

(Alternative Provision:)

A. Total Compensation. In consideration of the Contractor performing the Services, the

City agrees to pay the Contractor an amount not to exceed STAFF: Write amount, i.e. Twenty-Five

Thousand, Four Hundred Fifty and No/100 Dollars ($________)(Optional phrase: calculated on the basis

of the hourly labor charge rate schedule for Contractor's personnel attached hereto as Exhibit "B";)

(Optional sales tax clause: and Washington State sales tax equal to

____________________________________ ($_____________)) for a total amount not to exceed add

comp & sales tax for total.

(Alternative Provision: use if there are expenses)

A. Total Compensation. In consideration of the Contractor performing the Services, the

City agrees to pay the Contractor an amount not to exceed ___________________ and __/100 Dollars

($_________) calculated as follows:

(i) Contractor's Fee. An amount not to exceed the sum of

_______________________________________ and ___/100 Dollars ($______), (Optional

phrase: calculated on the basis of the hourly labor charge rate schedule for Contractor's

personnel attached hereto as Exhibit "B";) (Optional sales tax clause: and Washington State

sales tax not to exceed ________ ___________ and __/100 Dollars ($_____________)); and

(Optional Section ii:)

(ii) Reimbursable Expenses. The actual customary and incidental expenses incurred by

Contractor in performing the Services including ______________ and other reasonable costs;

provided, however, that such costs shall be deemed reasonable in the City's sole discretion and

shall not exceed _______________ and ____/100 Dollars ($____________).

B. Method of Payment. Payment by the City for the Services will only be made after the

Services have been performed, a voucher or invoice is submitted in the form specified by the City,

(Optional phrase: which invoice shall specifically describe the Services performed, the name of

Contractor's personnel performing such Services, the hourly labor charge rate for such personnel,) and

the same is approved by the appropriate City representative. Payment shall be made on a monthly

basis, thirty (30) days after receipt of such voucher or invoice.

C. Contractor Responsible for Taxes. The Contractor shall be solely responsible for the

payment of any taxes imposed by any lawful jurisdiction as a result of the performance and payment of

this Agreement.

5. Contract Managers.

The Parties agree that all formal communications about this Agreement, contract deliverables,

accomplishments, regulatory oversight, invoicing and requests for amendment must be coordinated

SERVICE AGREEMENT/Name of Contractor – Page 3

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directly between the Consultant and City’s Contract Manager unless otherwise approved in writing by

the City. The contract managers are identified as follows:

Consultant

(Name of Person)

(Title of Person)

(Address)

(Email)

(Phone)

City of Olympia

(Name of Person)

(Title of Person)

(Address)

(Email)

(Phone)

6. Compliance with Laws.

Contractor shall comply with and perform the Services in accordance with all applicable federal,

state, and City laws including, without limitation, all City codes, ordinances, resolutions, standards and

policies, as now existing or hereafter adopted or amended.

7. Assurances.

The Contractor affirms that it has the requisite training, skill and experience necessary to

provide the Services and is appropriately accredited and licensed by all applicable agencies and

governmental entities, including but not limited to being registered to do business in the City of Olympia

by obtaining a City of Olympia business registration.

8. Independent Contractor/Conflict of Interest.

It is the intention and understanding of the Parties that the Contractor is an independent

contractor and that the City shall be neither liable nor obligated to pay Contractor sick leave, vacation

SERVICE AGREEMENT/Name of Contractor – Page 4

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pay or any other benefit of employment, nor to pay any social security or other tax which may arise as

an incident of employment. The Contractor shall pay all income and other taxes due. Industrial or any

other insurance that is purchased for the benefit of the City, regardless of whether such may provide a

secondary or incidental benefit to the Contractor, shall not be deemed to convert this Agreement to an

employment contract. It is recognized that Contractor may be performing services during the Term for

other parties; provided, however, that such performance of other services shall not conflict with or

interfere with Contractor's ability to perform the Services. Contractor agrees to resolve any such

conflicts of interest in favor of the City.

9. Equal Opportunity Employer.

A. In all Contractor services, programs or activities, and all Contractor hiring and

employment made possible by or resulting from this Agreement, there shall be no unlawful

discrimination by Contractor or by Contractor's employees, agents, subcontractors or representatives

against any person based on any legally protected class status including but not limited to: sex, age

(except minimum age and retirement provisions), race, color, religion, creed, national origin, marital

status, veteran status, sexual orientation, gender identity, genetic information or the presence of any

disability, including sensory, mental or physical handicaps; provided, however, that the prohibition

against discrimination in employment because of disability shall not apply if the particular disability

prevents the performance of the essential functions required of the position.

This requirement shall apply, but not be limited to the following: employment, advertising,

layoff or termination, rates of pay or other forms of compensation, and selection for training, including

apprenticeship. Contractor shall not violate any of the terms of Chapter 49.60 RCW, Title VII of the Civil

Rights Act of 1964, the Americans With Disabilities Act, Section 504 of the Rehabilitation Act of 1973 or

any other applicable federal, state or local law or regulation regarding non-discrimination. Any material

violation of this provision shall be grounds for termination of this Agreement by the City and, in the case

of the Contractor's breach, may result in ineligibility for further City agreements.

B. In the event of Contractor’s noncompliance or refusal to comply with the above

nondiscrimination plan, this Contract may be rescinded, canceled, or terminated in whole or in part, and

the Contractor may be declared ineligible for further contracts with the City. The Contractor, shall,

however, be given a reasonable time in which to correct this noncompliance.

C. To assist the City in determining compliance with the foregoing nondiscrimination

requirements, Contractor must complete and return the Statement of Compliance with Non-

Discrimination attached as Exhibit B (or Ex. C if there is already an Ex. B per Section 4.A). If the

contract amount is $50,000 or more, the Contractor shall execute the attached Equal Benefits

Declaration - Exhibit C (or Ex. D if there is already an Ex. C per this section).

10. Confidentiality.

Contractor agrees not to disclose any information and/or documentation obtained by

Contractor in performance of this Agreement that has been expressly declared confidential by the City.

Breach of confidentiality by the Contractor will be grounds for immediate termination.

11. Indemnification/Insurance.

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A. Indemnification / Hold Harmless. Contractor shall defend, indemnify and hold the City,

its officers, officials, employees and volunteers harmless from any and all claims, injuries, damages,

losses or suits including attorney fees, arising out of or resulting from the acts, errors or omissions of the

Contractor in performance of this Agreement, except for injuries and damages caused by the sole

negligence of the City.

Should a court of competent jurisdiction determine that this Agreement is subject to RCW

4.24.115, then, in the event of liability for damages arising out of bodily injury to persons or damages to

property caused by or resulting from the concurrent negligence of the Contractor and the City, its

officers, officials, employees, and volunteers, the Contractor's liability hereunder shall be only to the

extent of the Contractor's negligence. It is further specifically and expressly understood that the

indemnification provided herein constitutes the Contractor's waiver of immunity under Industrial

Insurance, Title 51 RCW, solely for the purposes of this indemnification. This waiver has been mutually

negotiated by the parties. The provisions of this section shall survive the expiration or termination of

this Agreement.

B. Insurance Term. The Contractor shall procure and maintain insurance for the duration

of the Agreement as required in this Section, without interruption from commencement of the

Contractor’s work through the term of the Agreement, and for thirty (30) days after the Physical

Completion date, unless otherwise indicated herein.

C. No Limitation. Contractor’s maintenance of insurance, its scope of coverage and limits

as required herein shall not be construed to limit the liability of the Contractor to the coverage provided

by such insurance, or otherwise limit the City’s recourse to any remedy available at law or in equity.

D. Minimum Scope of Insurance. Contractor shall obtain insurance of the types described

below:

1. Automobile Liability insurance covering all owned, non-owned, hired and leased

vehicles. Coverage shall be at least as broad as ISO occurrence form (ISO) form CA 00 01 or a

substitute form providing equivalent liability coverage. If necessary, the policy shall be

endorsed to provide contractual liability coverage.

2. Commercial General Liability insurance shall be at least as broad as ISO

occurrence form CG 00 01 and shall cover liability arising from premises, operations,

independent contractors, products-completed operations, stop gap liability, personal injury and

advertising injury, and liability assumed under an insured contract. The Commercial General

Liability insurance shall be endorsed to provide a per project general aggregate limit using ISO

form CG 25 03 05 09 or an equivalent endorsement. There shall be no exclusion for liability

arising from explosion, collapse or underground property damage. The City shall be named as

an additional insured under the Contractor’s Commercial General Liability insurance policy with

respect to the work performed for the City using ISO Additional Insured endorsement CG 20 10

10 01 and Additional Insured Completed Operations endorsement CG 20 37 10 01 or substitute

endorsements providing at least as broad coverage.

SERVICE AGREEMENT/Name of Contractor – Page 6

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3. Workers’ Compensation coverage as required by the Industrial Insurance laws of

the State of Washington.

E. Minimum Amounts of Insurance. Contractor shall maintain the following insurance

limits:

1. Automobile Liability insurance with a minimum combined single limit for bodily

injury and property damage of $1,000,000 per accident.

2. Commercial General Liability insurance shall be written with limits no less than

$2,000,000 each occurrence, $2,000,000 general aggregate and $2,000,000 products-completed

operations aggregate limit.

F. Other Insurance Provisions. The Contractor’s Automobile Liability and Commercial

General Liability insurance policies are to contain, or be endorsed to contain that they shall be primary

insurance as respect the City. Any Insurance, self-insurance, or insurance pool coverage maintained by

the City shall be excess of the Contractor’s insurance and shall not contribute with it.

G. Acceptability of Insurers. Insurance is to be placed with insurers with a current A.M.

Best rating of not less than A:VII.

H. Verification of Coverage. Contractor shall furnish the City with original certificates and a

copy of the amendatory endorsements, including but not necessarily limited to the additional insured

endorsements, evidencing the insurance requirements of the Contractor before commencement of the

work. Upon request of the City, the Contractor shall provide certified copies of all required insurance

policies, including endorsements, required in this Agreement and evidence of all subcontractors’

coverage.

I. Subcontractors’ Insurance. The Contractor shall cause each and every Subcontractor to

provide insurance coverage that complies with all applicable requirements of the Contractor-provided

insurance as set forth herein, except the Contractor shall have sole responsibility for determining the

limits of coverage required to be obtained by Subcontractors. The Contractor shall ensure that the City

is an additional insured on each and every Subcontractor’s Commercial General liability insurance policy

using an endorsement at least as broad as ISO CG 20 10 10 01 for ongoing operations and CG 20 37 10

01 for completed operations.

J. Notice of Cancellation. The Contractor shall provide the City and all Additional Insureds

for this work with written notice of any policy cancellation, within two (2) business days of their receipt

of such notice.

K. Failure to Maintain Insurance. Failure on the part of the Contractor to maintain the

insurance as required shall constitute a material breach of contract, upon which the City may, after

giving five (5) business days notice to the Contractor to correct the breach, immediately terminate the

contract or, at its discretion, procure or renew such insurance and pay any and all premiums in

connection therewith, with any sums so expended to be repaid to the City on demand, or at the sole

discretion of the City, offset against funds due the Contractor from the City.

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L. City’s Full Access to Contractor Limits. If the Contractor maintains higher insurance

limits than the minimums shown above, the City shall be insured for the full available limits of

Commercial General and Excess or Umbrella liability maintained by the Contractor, irrespective of

whether such limits maintained by the Contractor are greater than those required by this contract or

any certificate of insurance furnished to the City evidences limits of liability lower than those maintained

by the Contractor.

12. Work Product.

Any deliverables identified in the Scope of Work or otherwise identified in writing by the City

that are produced by Contractor in performing the Services under this Agreement and which are

delivered to the City shall belong to the City. Any such work product shall be delivered to the City by

Contractor at the termination or cancellation date of this Agreement, or as soon thereafter as possible.

All other documents are owned by the Contractor.

13. Treatment of Assets.

A. Title to all property furnished by the City shall remain in the name of the City.

B. Title to all nonexpendable personal property and all real property purchased by the

Contractor, 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 the City, or if appropriate, the state or federal department

supplying funds therefor, upon delivery of such property by the vendor. If the Contractor elects to

capitalize and depreciate such nonexpendable personal property in lieu of claiming the acquisition cost

as a direct item of cost, title to such property shall remain with the Contractor. An election to capitalize

and depreciate or claim acquisition cost as a direct item of cost shall be irrevocable.

C. Nonexpendable personal property purchased by the Contractor under the terms of this

Contract in which title is vested in the City shall not be rented, loaned or otherwise passed to any

person, partnership, corporation/association or organization without the prior expressed written

approval of the City or its authorized representative, and such property shall, unless otherwise provided

herein or approved by the City or its authorized representative, be used only for the performance of this

Contract.

D. As a condition precedent to reimbursement for the purchase of nonexpendable

personal property, title to which shall vest in the City, the Contractor agrees to execute such security

agreements and other documents as shall be necessary for the City to perfect its interest in such

property in accordance with the "Uniform Commercial Code--Secured Transactions" as codified in Article

9 of Title 62A, the Revised Code of Washington.

E. The Contractor shall be responsible for any loss or damage to the property of the City

including expenses entered thereunto which results from negligence, willful misconduct, or lack of good

faith on the part of the Contractor, or which results from the failure on the part of the Contractor to

maintain and administer in accordance with sound management practices that property, to ensure that

the property will be returned to the City in like condition to that in which it was furnished or purchased,

fair wear and tear excepted.

SERVICE AGREEMENT/Name of Contractor – Page 8

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F. Upon the happening of loss or destruction of, or damage to, any City property, the

Contractor shall notify the City or its authorized representative and shall take all reasonable steps to

protect that property from further damage.

G. The Contractor shall surrender to the City all property of the City within thirty (30) days

after rescission, termination or completion of this Contract unless otherwise mutually agreed upon by

the parties.

14. Books and Records.

The Contractor agrees to maintain books, records, and documents which sufficiently and

properly reflect all direct and indirect costs related to the performance of the Services and maintain

such accounting procedures and practices as may be deemed necessary by the City to assure proper

accounting of all funds paid pursuant to this Agreement. These records shall be subject, at all

reasonable times, to inspection, review or audit by the City, its authorized representative, the State

Auditor, or other governmental officials authorized by law to monitor this Agreement.

Records owned, used, or retained by the City that meet the definition of a “public record”

pursuant to RCW 42.56.010 are subject to disclosure under Washington’s Public Records Act. Should the

Contractor fail to provide records created or used by Contractor in its work for the City within ten (10)

days of the City’s request for such records, Contractor shall indemnify, defend, and hold the City

harmless for any public records judgment, including costs and attorney’s fees, against the City involving

such withheld records.

15. Non-Appropriation of Funds.

If sufficient funds are not appropriated or allocated for payment under this Agreement for any

future fiscal period, the City will not be obligated to continue the Agreement after the end of the current

fiscal period, and this Agreement will automatically terminate upon the completion of all remaining

Services for which funds are allocated. No penalty or expense shall accrue to the City in the event this

provision applies.

16. General Provisions.

A. Entire Agreement. This Agreement contains all of the agreements of the Parties with

respect to any matter covered or mentioned in this Agreement and no prior agreements shall be

effective for any purpose.

B. Modification. No provision of this Agreement, including this provision, may be amended

or modified except by written agreement signed by the Parties.

C. Full Force and Effect; Severability. Any provision of this Agreement that is declared

invalid or illegal shall in no way affect or invalidate any other provision hereof and such other provisions

shall remain in full force and effect. Further, if it should appear that any provision hereof is in conflict

with any statutory provision of the State of Washington, the provision appears to conflict therewith shall

be deemed inoperative and null and void insofar as it may be in conflict therewith, and shall be deemed

modified to conform to such statutory provision.

SERVICE AGREEMENT/Name of Contractor – Page 9

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D. Assignment. Neither the Contractor nor the City shall have the right to transfer or

assign, in whole or in part, any or all of its obligations and rights hereunder without the prior written

consent of the other Party.

1. If the Contractor desires to assign this Contract or subcontract any of its work

hereunder, the Contractor shall submit a written request to the City for approval not less than

fifteen (15) days prior to the commencement date of any proposed assignment or subcontract.

2. Any work or services assigned or subcontracted for hereunder shall be subject

to each provision of this Contract.

3. Any subcontractor not listed in this Contract, which is to be charged to the

Contract, must have prior written approval by the City.

4. The City reserves the right to inspect any assignment or subcontract document.

E. Successors in Interest. Subject to the foregoing Subsection, the rights and obligations of

the Parties shall inure to the benefit of and be binding upon their respective successors in interest, heirs

and assigns.

F. Attorney Fees. In the event either of the Parties defaults on the performance of any

term of this Agreement or either Party places the enforcement of this Agreement in the hands of an

attorney, or files a lawsuit, the prevailing party shall be entitled to its reasonable attorneys’ fees, costs

and expenses to be paid by the other Party.

G. No Waiver. Failure or delay of the City to declare any breach or default immediately

upon occurrence shall not waive such breach or default. Failure of the City to declare one breach or

default does not act as a waiver of the City's right to declare another breach or default.

H. Governing Law. This Agreement shall be made in and shall be governed by and

interpreted in accordance with the laws of the State of Washington.

I. Authority. Each individual executing this Agreement on behalf of the City and

Contractor represents and warrants that such individuals are duly authorized to execute and deliver this

Agreement on behalf of the Contractor or the City.

J. Notices. Any notices required to be given by the Parties shall be delivered at the

addresses set forth below. Any notices may be delivered personally to the addressee of the notice or

may be deposited in the United States mail, postage prepaid, to the address set forth below. Any notice

so posted in the United States mail shall be deemed received three (3) days after the date of mailing.

K. Captions. The respective captions of the Sections of this Agreement are inserted for

convenience of reference only and shall not be deemed to modify or otherwise affect any of the

provisions of this Agreement.

SERVICE AGREEMENT/Name of Contractor – Page 10

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L. Performance. Time is of the essence in performance of this Agreement and each and all

of its provisions in which performance is a factor. Adherence to completion dates set forth in the

description of the Services is essential to the Contractor's performance of this Agreement.

M. Remedies Cumulative. Any remedies provided for under the terms of this Agreement

are not intended to be exclusive, but shall be cumulative with all other remedies available to the City at

law, in equity or by statute.

N. Counterparts. This Agreement may be executed in a number of identical counterparts

which, taken together, constitute collectively one Agreement; but in making proof of this Agreement, it

is not necessary to produce or account for more than one such counterpart. Additionally, (i) the

signature pages taken from separate individually executed counterparts of this Agreement may be

combined to form multiple fully executed counterparts; and (ii) a facsimile signature or an electronically

scanned signature, or an electronic or digital signature where permitted by law, must be deemed to be

an original signature for all purposes. All executed counterparts of this Agreement are originals, but all

such counterparts, when taken together, constitute one and the same Agreement.

O. Equal Opportunity to Draft. The parties have participated and had an equal opportunity

to participate in the drafting of this Agreement, and the Exhibits, if any, attached. No ambiguity shall be

construed against any party upon a claim that that party drafted the ambiguous language.

P. Venue. All lawsuits or other legal actions whatsoever with regard to this agreement

shall be brought in Thurston County, Washington, Superior Court.

Q. Ratification. Any work performed prior to the effective date that falls within the scope

of this Agreement and is consistent with its terms is hereby ratified and confirmed.

R. Certification Regarding Debarment, Suspension, and Other Responsibility Matters.

1. By signing the agreement below, the Contractor certifies to the best of its

knowledge and belief, that it and its principles:

a. Are not presently debarred, suspended, proposed for debarment, declared

ineligible, or voluntarily excluded from covered transactions by any federal department

or agency;

b. Have not within a three-year period preceding this proposal been convicted of or

had a civil judgment rendered against them for commission or fraud or a criminal

offense in connection with obtaining, attempting to obtain, or performing a public

(federal, state, or local) transaction or contract under a public transaction; violation of

federal or state antitrust statutes or commission of embezzlement, theft, forgery,

bribery, falsification or destruction of records, making false statements, or receiving

stolen property;

c. Are not presently indicted for or otherwise criminally or civilly charged by a

governmental entity (federal, state, or local) with commission of any of the offenses

SERVICE AGREEMENT/Name of Contractor – Page 11

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enumerated in paragraph 1.b. of this certification; and

d. Have not within a three (3) year period preceding this application/proposal had

one or more public transactions (federal, state, or local) terminated for cause or default.

2. Where the Contractor is unable to certify to any of the statements in this

certification, such Contractor shall attach an explanation to this proposal.

S. Early Retirement from the State of Washington- Certification. By signing this form, you

certify that no one being directly compensated for their services pursuant to this Agreement has retired

from the Washington State Retirement System using the 2008 Early Retirement Factors with restrictions

on returning to work.

SERVICE AGREEMENT/Name of Contractor – Page 12

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CITY OF OLYMPIA

By:

[Enter name and title of Department Director or authorized Line of Business Director]

P.O. Box 1967

Olympia WA 98507-1967

Date of Signature:

APPROVED AS TO FORM:

City Attorney

I certify that I am authorized to execute this contract on behalf of the Contractor.

[Enter Name of Contractor’s Company]

By:

(Signature)

(Print Name of Person Signing)

(Title of Person Signing)

(Address)

(Phone)

Date of Signature:

SERVICE AGREEMENT/Name of Contractor – Page 13

Revised 3.2.21

Exhibit “B”

STATEMENT OF COMPLIANCE WITH NONDISCRIMINATION REQUIREMENT

The Olympia City Council has made compliance with the City’s Nondiscrimination in Delivery of City Services

or Resources ordinance (OMC 1.24) a high priority, whether services are provided by City employees or

through contract with other entities. It is important that all contract agencies or vendors and their

employees understand and carry out the City’s nondiscrimination policy. Accordingly, each City agreement

or contract for services contains language that requires an agency or vendor to agree that it shall not

unlawfully discriminate against an employee or client based on any legally protected status, which includes

but is not limited to: race, creed, religion, color, national origin, age, sex, marital status, veteran status,

sexual orientation, gender identity, genetic information, or the presence of any disability. Unlawful

discrimination includes transphobic discrimination or harassment, including transgender exclusion policies or

practices in health benefits.

Listed below are methods to ensure that this policy is communicated to your employees, if applicable.

 Nondiscrimination provisions are posted on printed material with broad distribution (newsletters,

brochures, etc.).

 Nondiscrimination provisions are posted on applications for service.

 Nondiscrimination provisions are posted on the agency’s web site.

 Nondiscrimination provisions are included in human resource materials provided to job applicants

and new employees.

 Nondiscrimination provisions are shared during meetings.

Failure to implement at least two of the measures specified above or to comply with the City of Olympia’s

nondiscrimination ordinance constitutes a breach of contract.

By signing this statement, I acknowledge compliance with the City of Olympia’s nondiscrimination ordinance

by the use of at least two of the measures specified above.

(Signature) (Date)

Print Name of Person Signing

Alternative Section for Sole Proprietor: I am a sole proprietor and have reviewed the statement above. I

agree not to discriminate against any client, or any future employees, based on any legally protected status.

(Sole Proprietor Signature) (Date)

SERVICE AGREEMENT/Name of Contractor – Page 14

Revised 3.2.21

Exhibit “C”

EQUAL BENEFITS COMPLIANCE DECLARATION

Contractors on City contracts estimated to cost $50,000 or more shall comply with the City of Olympia

Municipal Code, Chapter 3.18. This provision requires that if contractors provide benefits, they do so

without discrimination based on age, sex, race, creed, color, sexual orientation, national origin, or the

presence of any physical, mental or sensory disability, or because of any other status protected from

discrimination by law. Contractors must have policies in place prohibiting such discrimination, prior to

contracting with the City.

I declare that the Contractor listed below complies with the City of Olympia Equal Benefits Ordinance,

that the information provided on this form is true and correct, and that I am legally authorized to bind

the Contractor.

Contractor Name

Signature Name (please print)

Date Title