King County Contract No. Federal Taxpayer ID No. 2581 APDE 91-6001537 This form is available in alternate formats for people with disabilities upon request. KING COUNTY CONTRACT FOR SERVICES WITH UNIVERSITY OF WASHINGTON or HARBORVIEW MEDICAL CENTER Department Division Contractor Project Title Contract Amount Contract Period Public Health – Seattle & King County APDE University of Washington Seattle’s Sweetened Beverage Tax (SBT) $ $156,105 Sep 01 2017 TO Jul 31 2018 THIS CONTRACT is entered into by KING COUNTY (the “County”), and University of Washington (the “Contractor”), whose address is Office of Sponsored Programs, 4333 Brooklyn Ave NE, Seattle, WA 98105. WHEREAS, the County has been advised that the following are the current funding sources, funding levels and effective dates: Funding Source City of Seattle PHSKC Contract # 2244 APDE Amount $156,000 Effective Dates 9/1/17 to 7/31/18 and WHEREAS, the County desires to have certain services performed by the Contractor as described in this Contract, and as authorized by the Biennial Budget. NOW THEREFORE, in consideration of payments, covenants, and agreements hereinafter mentioned, to be made and performed by the parties hereto, the parties covenant and do mutually agree as follows: I Incorporation of Exhibits The Contractor shall provide services and comply with the requirements set forth in the following attached exhibits, which are incorporated herein by reference: II A Program Exhibits and Requirements • Exhibit A: Scope of Work • Exhibit B: Budget • Exhibit C: Invoice B King County Required Forms • Exhibit D: Letter of Self-Insurance Term and Termination A This Contract shall commence on Sep 01 2017, and shall terminate on Jul 31 2018, unless extended or terminated earlier, pursuant to the terms and conditions of the Contract. Page # 1 of 13 B This Contract may be terminated by either party without cause, in whole or in part, prior to the date specified in Subsection II.A above, by providing the other party one hundred eighty (180) days advance written notice of the termination. C Either party may terminate this Contract, in whole or in part, for material breach of any duty, obligation, or service required pursuant to this Contract, subject to the following opportunity for cure: the party alleged to be in breach shall have not less than thirty (30) days to cure. If after thirty 30 days the breach remains, the Contract may be terminated upon thirty (30) days advance written notice to the other party. The County shall pay the Contractor for all services provided by the Contractor prior to the effective date of termination without regard to whether termination is for cause. Either party may terminate this Contract, in whole, or in part, upon seven (7) days advance written notice in the event that the duties, obligations, or services required herein become impossible, illegal, or not feasible. If the termination results from misappropriation by the Contractor, the Contractor shall return to the County immediately any misappropriated funds which have been paid to the Contractor by the County. D If County or other expected or actual funding is withdrawn, reduced, or limited in any way prior to the termination date set forth above in Subsection II.A., the County may, upon thirty (30) days written notification to the Contractor, terminate this Contract in whole or in part. If the Contract is terminated as provided in this Subsection: (1) the County will be liable only for payment in accordance with the terms of this Contract for services rendered prior to the effective date of termination; and (2) the Contractor shall be released from any obligation to provide such further services pursuant to the Contract as are affected by the termination. For purposes of clarification, the salary incurred during the 30-day notice period for Contractor employees specifically performing services under this Contract is a non-cancellable cost for which the County will be responsible. Funding or obligation under this Contract beyond the current appropriation year is conditional upon appropriation by the County Council of sufficient funds to support the activities described in the Contract. Should such appropriation not be approved, this Contract will terminate at the close of the current appropriation year. E III Nothing herein shall limit, waive, or extinguish any right or remedy provided by this Contract or law that either party may have in the event that the obligations, terms, and conditions set forth in this Contract are breached by the other party. Compensation and Method of Payment A The County shall reimburse the Contractor for satisfactory completion of the services and requirements specified in this Contract, payable upon receipt and approval of a signed invoice that complies with the attached budget. B The Contractor shall submit an invoice and all accompanying reports as specified in the attached exhibits not more than 60 working days after the close of each indicated reporting period. The County will initiate authorization for payment after approval of corrected invoices and reports. The County shall make payment to the Contractor not more than 30 days after a complete and accurate invoice is received. C The Contractor shall submit its final invoice and all outstanding reports within 90 days of the date this Contract terminates. If the Contractor’s final invoice and reports are not submitted by the day specified in this subsection, the County will be relieved of all liability for payment to the Contractor of the amounts set forth in said invoice or any subsequent invoice. D When a budget is attached hereto as an exhibit, the Contractor shall apply the funds received from the County under this Contract in accordance with said budget. The contract may contain separate budgets for separate program components. The Contractor shall request prior approval from the County for an amendment to this Contract when the cumulative amount of transfers among the budget categories is expected to exceed 10% of the Contract amount in any Contract Page # 2 of 13 budget. Supporting documents necessary to explain fully the nature and purpose of the amendment must accompany each request for an amendment. E IV If travel costs are contained in the attached budget, reimbursement of Contractor travel, lodging, and meal expenses are limited to the eligible costs based on the following rates and criteria. 1 The mileage rate allowed by King County shall not exceed the current Internal Revenue Service (IRS) rates per mile as allowed for business related travel. The IRS mileage rate shall be paid for the operation, maintenance and depreciation of individually owned vehicles for that time which the vehicle is used during work hours. Parking shall be the actual cost. When rental vehicles are authorized, government rates shall be requested. If the Contractor does not request government rates, the Contractor shall be personally responsible for the difference. Please reference the federal web site for current rates: http://www.gsa.gov. 2 Reimbursement for meals shall be limited to the per diem rates established by federal travel requisitions for the host city in the Code of Federal Regulations, 41 CFR § 301, App.A. 3 Accommodation rates shall not exceed the federal lodging limit plus host city taxes. The Contractor shall always request government rates. 4 Air travel shall be by coach class at the lowest possible price available at the time the County requests a particular trip. In general, a trip is associated with a particular work activity of limited duration and only one round-trip ticket, per person, shall be billed per trip. Internal Control and Accounting System The Contractor shall establish and maintain a system of accounting and internal controls which complies with applicable, generally accepted accounting principles, and governmental accounting and financial reporting standards. V Debarment and Suspension Certification Agencies receiving federal funds that are debarred, suspended, or proposed for debarment are excluded from contracting with the County. The Contractor, by signature to this Contract, certifies that the Contractor is not presently debarred, suspended, or proposed for debarment by any Federal department or agency. The Contractor also agrees that it will not enter into a subcontract with a contractor that is debarred, suspended, or proposed for debarment. The Contractor agrees to notify King County in the event it, or a subcontractor, is debarred, suspended, or proposed for debarment by any Federal department or agency. For more information on suspension and debarment, see Federal Acquisition Regulation 9.4. VI Maintenance of Records/Evaluations and Inspections A The Contractor shall maintain accounts and records, including personnel, property, financial, and programmatic records and other such records as may be deemed necessary by the County to ensure proper accounting for all Contract funds and compliance with this Contract. B In accordance with the nondiscrimination and equal employment opportunity requirements set forth in Section XIV. below, the Contractor shall maintain the following: 1 Records of employment, employment advertisements, application forms, and other pertinent data, records and information related to employment, applications for employment or the administration or delivery of services or any other benefits under this Contract; and 2 Records, including written quotes, bids, estimates or proposals submitted to the Contractor by all businesses seeking to participate on this Contract, and any other information necessary to document the actual use of and payments to subcontractors and suppliers in this Contract, including employment records. The County may visit, at any mutually agreeable time, the site of the work and the Contractor’s office to review the foregoing records. The Contractor shall provide every assistance requested by the County during such visits. In all other respects, the Contractor shall make the foregoing Page # 3 of 13 records available to the County for inspection and copying upon request. If this Contract involves federal funds, the Contractor shall comply with all record keeping requirements set forth in any federal rules, regulations or statutes included or referenced in the contract documents. VII C Except as provided in Section VII of this Contract, the records listed in A and B above shall be maintained for a period of six (6) years after termination hereof unless permission to destroy them is granted by the Office of the Archivist in accordance with Revised Code of Washington (RCW) Chapter 40.14. D Medical records shall be maintained and preserved by the Contractor in accordance with state and federal medical records statutes, including but not limited to RCW 70.41.190, 70.02.160, and standard medical records practice. If the Contractor ceases operations under this Contract, the Contractor shall be responsible for the disposition and maintenance of such medical records. E The Contractor agrees to cooperate with the County or its agent in the evaluation of the Contractor’s performance under this Contract and to make available all information reasonably required by any such evaluation process. The results and records of said evaluations shall be maintained and disclosed in accordance with RCW Chapter 42.56. F The Contractor agrees that all information, records, and data collected in connection with this Contract shall be protected from unauthorized disclosure in accordance with applicable state and federal law. Compliance with the Health Insurance Portability Accountability Act of 1996 (HIPAA) (Terms used shall have the same meaning as those terms in the Privacy Rule, 45 Code of Federal Regulations (CFR) Parts 160 and 164.) A Obligations and Activities of the Contractor 1 The Contractor agrees not to use or disclose protected health information other than as permitted or required by law. 2 The Contractor agrees to use appropriate safeguards to prevent use or disclosure of protected health information other than as provided for in this Agreement. 3 The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of protected health information by the Contractor in violation of the requirements of this Agreement. 4 The Contractor agrees to report to King County any use or disclosure of protected health information not provided for by this Agreement of which it becomes aware. 5 In the event Contractor retains subcontractors to perform any service for which Contractor is responsible under this Contract, Contractor shall enter into a contract or other arrangement with such subcontractor(s) requiring that the subcontractor(s) agree to the same restrictions and conditions, including the implementation of reasonable and appropriate safeguards to protect PHI, that apply to Contractor. 6 The Contractor agrees to make available protected health information in accordance with 45 CFR § 164.524. 7 The Contractor agrees to make available protected health information for amendment and incorporate any amendments to protected health information in accordance with 45 CFR § 164-526. 8 The Contractor agrees to make internal practices, books, and records, including policies and procedures and protected health information, relating to the use and disclosure of protected health information received from, or created or received by the Contractor on behalf of King County, available to the Secretary, in a reasonable time and manner for purposes of the Secretary determining King County’s compliance with the privacy rule. Page # 4 of 13 9 B Permitted Uses and Disclosures by Contractor 1 C D The Contractor agrees to make available the information required to provide an accounting of disclosures in accordance with 45 CFR 164 § 528. The Contractor may use or disclose protected health information to perform functions, activities, or services for, or on behalf of, King County as specified in this Agreement, provided that such use or disclosure would not violate the Privacy Rule if done by King County or the minimum necessary policies and procedures of King County. Effect of Termination 1 Except as provided in paragraph C.2. of this section, upon termination of this Agreement, for any reason, the Contractor shall return or destroy all protected health information received from King County, or created or received by the Contractor on behalf of King County. The Contractor shall retain no copies of the protected health information. 2 In the event the Contractor determines that returning or destroying the protected health information is infeasible, the Contractor shall provide to King County notification of the conditions that make return or destruction infeasible. Upon notification that return or destruction of protected health information is infeasible, the Contractor shall extend the protections of the Agreement to such protected health information and limit further uses and disclosure of such protected health information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such protected health information. Potential Breach of PHI 1 If Contractor has reason to believe that personal information or PHI transmitted pursuant to this Agreement may have been accessed, disclosed, or acquired without proper authorization, Contractor will, within five (5) business days of discovery, give the County notice and take actions as may be necessary to preserve forensic evidence and to identify, mitigate and remediate the cause of the potential breach. A potential breach shall be treated as discovered by the Contractor as of the first day on which such breach is known to the Contractor (including any person, other than the individual committing the potential breach, that is an employee, officer, or other agent of the Contractor) or should reasonably have been known to the Contractor to have occurred. Contractor shall give highest priority to immediately mitigate and remediate any unauthorized access and shall devote such resources as may be required to accomplish that goal. The Contractor shall cooperate with all County efforts, including providing any and all information necessary to enable the County to fully understand the nature and scope of the unauthorized access, including but not limited to identification of each individual whose unsecured PHI has been, or is reasonably believed to have been, accessed, acquired, or disclosed during the potential breach. For purposes of clarification, this section constitutes notice to the County of routine and ongoing attempts to gain unauthorized access to Contractor’s information systems (each an “Unsuccessful Attack”), including but not limited to pings, port scans, and denial of service attacks, for which no additional notice shall be required provided that no such incident results in unauthorized access to unsecured protected health information. 2 Upon request, the Contractor will supply the County with the following information in writing: a A brief description of what happened, including the date of the potential breach and the date of the discovery of the potential breach, if known. b A description of the types of unsecured protected health information that were involved in the potential breach (such as full name, Social Security number, date of birth, home address, account number, or disability code). c A brief description of what the Contractor is doing to investigate the potential breach, to mitigate losses, and to protect against any further potential breaches. Page # 5 of 13 3 E VIII IX If the Contractor notifies the County of a potential breach, and the County determines a breach has occurred (“breach” is defined in applicable laws and regulations, including RCW 42.56.590, and 45 CFR Subpart D), the County may provide breach notification or may require the Contractor to provide breach notification. If the County decides to provide breach notification, the Contractor shall reimburse the County for all reasonable costs of notification, including required notification to individuals, the media and the government, arising out of a breach of unsecured protected health information by students or Contractor employees. If the County requires the Contractor to provide breach notification, the Contractor shall implement the breach notification and pay the related costs. The Contractor shall consult with the County regarding appropriate steps required to notify third parties and coordinate with The County on the content and method of the breach notification. Contractor will provide basic Health Insurance Portability and Accountability Act of 1996 (HIPAA) awareness training to all students enrolled in the internship program at the first day of training. The Contractor shall provide proof and documentation of the trainee’s completion of HIPAA training upon request by the County. The cost of training shall be borne by the Contractor. Contractor will provide basic Health Insurance Portability and Accountability Act of 1996 (HIPAA) awareness training to all employees providing services under any scope of work attached hereto. The Contractor shall provide proof and documentation of the trainee’s completion of HIPAA training upon request by the County. The cost of the training shall be borne by the Contractor. Audits A If the Contractor is a municipal entity or other government institution or jurisdiction, it shall submit to the County a copy of its annual report of examination/audit, conducted by the Washington State Auditor, within thirty (30) days of receipt. B If the Contractor, for-profit or non-profit, receives in excess of $100,000 in funds during its fiscal year from the County, it shall provide a fiscal year financial statement prepared by an independent Certified Public Accountant or Accounting Firm within six (6) months subsequent to the close of the Contractor’s fiscal year. C Additional audit or review requirements which may be imposed on the County will be passed on to the Contractor and the Contractor will be required to comply with any such requirements. Corrective Action If the County determines that a breach of contract has occurred, that is, the Contractor has failed to comply with any terms or conditions of this Contract or the Contractor has failed to provide in any manner the work or services agreed to herein, and if the County deems said breach to warrant corrective action, the following sequential procedure will apply: A The County will notify the Contractor in writing of the nature of the breach; The Contractor shall respond in writing within three (3) working days of its receipt of such notification, which response shall indicate the steps being taken to correct the specified deficiencies. The corrective action plan shall specify the proposed completion date for bringing the Contract into compliance, which date shall not be more than ten (10) days from the date of the Contractor’s response, unless the County, at its sole discretion, specifies in writing an extension in the number of days to complete the corrective actions; B The County will notify the Contractor in writing of the County’s determination as to the sufficiency of the Contractor’s corrective action plan. The determination of sufficiency of the Contractor’s corrective action plan shall be at the sole discretion of the County; C In the event that the Contractor does not respond within the appropriate time with a corrective action plan, or the Contractor’s corrective action plan is determined by the County to be insufficient, the County may commence termination of this Contract in whole or in part pursuant to Section II.C.; Page # 6 of 13 X D In addition, the County may withhold any payment owed the Contractor or prohibit the Contractor from incurring additional obligations of funds until the County is satisfied that corrective action has been taken or completed; and E Nothing herein shall be deemed to affect or waive any rights the parties may have pursuant to Section II. Subsections B, C, D, and E. Dispute Resolution Prior to commencing any legal action, the parties shall use their best, good-faith efforts to cooperatively resolve through negotiation any dispute, claim, or controversy that arises in connection with this Contract. Either Party may initiate such negotiations by providing written notice to the other Party specifying that this provision of the Contract is being utilized and describing the subject matter of the dispute and relief requested. The Party receiving such notice will respond in writing within 14 calendar days with a statement of its position on and recommended solution to the dispute. If the dispute is not resolved by this exchange of correspondence, then the representatives of each Party with full settlement authority shall meet at a mutually agreeable time and place in Seattle, Washington within 30 calendar days of the date of the initial notice to exchange information and perspectives, and to attempt in good faith to resolve the dispute. If the dispute is not resolved by these negotiations, then the matter will be submitted to a mutually agreeable and recognized mediation service prior to initiating legal action. Any such mediation will be conducted in Seattle, Washington. The costs of the mediation service shall be shared equally by the Parties and each party shall bear its own costs and attorneys’ fees incurred in attending the mediation. Both parties will make a good faith effort to continue without delay to carry out their respective responsibilities under this Contract while attempting to resolve the dispute under this section. XI Hold Harmless and Indemnification A In providing services under this Contract, the Contractor is an independent Contractor, and neither it nor its officers, agents, employees, or subcontractors are employees of the County for any purpose. The Contractor shall be responsible for all federal and/or state tax, industrial insurance, and Social Security liability that may result from the performance of and compensation for these services and shall make no claim of career service or civil service rights which may accrue to a County employee under state or local law. The County assumes no responsibility for the payment of any compensation, wages, benefits, or taxes by, or on behalf of the Contractor, its employees, subcontractors and/or others by reason of this Contract. The Contractor shall protect, indemnify, and save harmless the County, its officers, agents, and employees from and against any and all claims, costs, and/or losses whatsoever occurring or resulting from (1) the Contractor's failure to pay any such compensation, wages, benefits, or taxes, and/or (2) the supplying to the Contractor of work or services by Contractor employees in connection with or support of the performance of this Contract. Should the Contractor or its subcontractors, their employees, former employees or agents make a claim for compensation, wages, benefits, or taxes, and/or career service or civil service rights which may accrue to a County employee under state or local law the Contractor shall protect, indemnify, defend and save harmless the County, its officers, agents, and employees from and against any and all claims, costs, and/or losses, judgments, and/or awards of damages, that arise. B Each party to the Contract further agrees that it is financially responsible for and will repay the other party all indicated amounts following an audit exception which occurs due to the negligence, intentional act, and/or failure, for any reason, to comply with the terms of this Contract by the party, its officers, employees, and/or agents. This duty to repay the other party shall not be diminished or extinguished by the prior termination of the Contract pursuant to the Term and Termination section. C The County shall defend, indemnify, and hold harmless the Contractor, its officers, employees, and agents from any and all costs, claims, judgments, and/or awards of damages, that arise out of, or in any way result from, the negligent acts or omissions of the County, its officers, employees, or agents in its performance or non-performance of its obligations under this Contract. In the event the Contractor incurs any judgment, award, and/or cost arising therefrom including attorneys’ fees Page # 7 of 13 to enforce the provisions of this article, all such fees, expenses, and costs shall be recoverable from the County. XII D The Contractor shall defend, indemnify, and hold harmless the County, its officers, employees, and agents from any and all costs, claims, judgments, and/or awards of damages, that arise out of, or in any way result from, the negligent acts or omissions of the Contractor, its officers, employees, or agents in its performance or non-performance of its obligations under this Contract. In the event the County incurs any judgment, award, and/or cost arising therefrom including attorneys’ fees to enforce the provisions of this article, all such fees, expenses, and costs shall be recoverable from the Contractor. E. Claims shall include, but not be limited to, assertions that use or transfer of software, book, document, report, film, tape, or sound reproduction or material of any kind, delivered hereunder, constitutes an infringement of any copyright, patent, trademark, trade name, and/or otherwise results in unfair trade practice. F Nothing contained within this provision shall affect and/or alter the application of any other provision contained within this Contract. G The indemnification, protection, defense and save harmless obligations contained herein shall survive the expiration, abandonment or termination of this Agreement. Insurance Requirements By the date of execution of this Contract, each party shall procure and maintain for the duration of this Contract, insurance against claims for injuries to persons or damages to property which may arise from, or in connection with, the performance of work hereunder by the parties and their respective employees. Each party shall be responsible for paying the costs of its own insurance and may furnish separate certificates of insurance and policy endorsements as evidence of compliance with the insurance requirements of this Contract. Each party is responsible for ensuring compliance with all of the insurance requirements stated herein. Failure by a party, its employees and/or officers to comply with the insurance requirements stated herein shall constitute a material breach of this Contract. In lieu of the policies, coverage types and limits required in this section XII, each party may maintain a program of self-insurance responsive to the following “Minimum Scope and Limits of Insurance”: A. Commercial general liability insurance: at least as broad as ISO form CG 00 01 or the equivalent, including the following: premises operations; products - completed operations; personal/advertising injury; contractual liability. Such policies must provide a limit of not less than $1,000,000 per occurrence and for those policies with an aggregate limit, not less than a $2,000,000 aggregate. Stop gap/employers liability coverage requirements may be included on this policy. B. Stop gap/employers liability: at least as broad as the protection provided by the workers' compensation policy part 2 or, in states with monopolistic state funds, the protection provided by the "stop gap" endorsement to the general liability policy. Washington State is a monopolistic state. C. Commercial automobile liability insurance: at least as broad as ISO form CA 00 01 covering all owned, non-owned, leased and hired vehicles operated by employees under the terms of this Contract with limits of liability no less than $1,000,000 per occurrence and bodily injury and property damage. D. Workers compensation: Workers' compensation insurance in the amount and type required by Washington State law. E. Professional liability: $1,000,000 per claim and $2 million in the aggregate when professional services are provided under this Contract. Page # 8 of 13 F. Such other insurance coverage as the other Party reasonably requests. G. Municipal or state agency provisions: Contractor’s liability coverage program authorized by RCW 28B.20.253 and .255 shall satisfy Contractor’s professional and general liability requirements under this Section. If the Contractor is a municipal corporation or an entity or agency of the State of Washington or any other public agency, and is self-insured for any of the above insurance requirements, a certification of self-insurance shall be attached and be incorporated by reference and shall constitute compliance with this Section XII. H. Deductibles and self-insured retentions: Any deductibles or self-insured retentions must be declared to, and approved by, the County. The deductible and/or self-insured retention of the policies shall not apply to the Contractor's liability to the County and shall be the sole responsibility of the Contractor. I. Other insurance provisions: The insurance policies required in this Contract are to contain, or be endorsed to contain, the following provisions: 1. Liability policies (except workers compensation and professional/errors and omissions) a. The Contractor's insurance shall apply separately to each insured against whom claim is made and/or lawsuit is brought, except with respect to the limits of the insurer's liability. 2. All policies a. Coverage shall not be suspended, voided, canceled, reduced in coverage or in limits, except by the reduction of the applicable aggregate limit by claims paid, until after forty-five (45) days prior written notice has been given to the County. b. Each insurance policy shall be written on an "occurrence" form; except that insurance on a "claims made" form may be acceptable with prior County approval. If coverage is approved and purchased on a "claims made" basis, the Contractor warrants continuation of coverage, either through policy renewals or the purchase of an extended discovery period, if such extended coverage is available, for not less than three (3) years from the date of Contract termination and/or conversion from a "claims made" form to an "occurrence" coverage form. I. Acceptability of Insurers: Except for any self-insurance programs and unless otherwise approved by the County, insurance is to be placed with insures with a Bests' rating of no less that A: VIII, or, if not rated with Bests, with minimum surpluses the equivalent of Bests' surplus size VIII. Professional liability, errors, and omissions insurance may be placed with insurers with a Bests' rating of B+VII. Any exception must be approved by King County. If, at any time, the foregoing policies shall fail to meet the above minimum requirements the Contractor shall, upon notice to that effect from the County, promptly obtain a new policy, and shall submit the same to the County, with appropriate certificates and endorsements, for approval. J. Verification of coverage: The Contractor shall furnish to the County certificates of insurance and endorsements or certificates of self-insurance required by this Contract. Such certificates and endorsements, and renewals thereof, shall be attached as exhibits to this Contract. The certificates and endorsements for each policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The County reserves the right to require complete, certified copies of all required insurance policies at any time. Page # 9 of 13 K. Insurance for subcontractors: If the Contractor subcontracts any portion of this Contract pursuant to Section XIII, the Contractor shall require separate certificates of insurance and policy endorsements from each subcontractor. Insurance coverages provided by subcontractors as evidence of compliance with the insurance requirements of this Contract shall be subject to all of the requirements stated herein. In addition, Contractor shall require subcontractors to provide additional insured status to the County on General Liability policies. L. All coverages and requirements: Nothing contained within these insurance requirements shall be deemed to limit the scope, application and/or limits of the coverage afforded by said policies or programs of self-insurance, which coverage will apply to each insured to the full extent provided by the terms and conditions of the policy(s) or programs. Nothing contained within this provision shall affect and/or alter the application of any other provision contained within this Contract. M. Insurance coverage for the County: King County, a charter county government under the constitution of the State of Washington and as such maintains a fully funded Self-Insurance program as defined in King County Code 4.12 for the protection and handling of the County’s liabilities including injuries to persons and damage to property. XIII Assignment/Subcontracting A Neither party shall assign any portion of this Contract or transfer or assign any claim arising pursuant to this Contract without written consent of the other party. Said consent must be sought in writing not less than fifteen (15) days prior to the date of any proposed assignment. B “Subcontract” shall mean any agreement between the Contractor and a subcontractor or between subcontractors that is based on this Contract, provided that the term “subcontract” does not include the purchase of (1) support services not related to the subject matter of this Contract, or (2) supplies. C The Contractor shall include Sections III.D., IV, V, VI, VII, VIII, XI, XII, XIV, XV, XXI, XXIV and XXV, in every subcontract or purchase agreement for services that relate to the subject matter of this Contract. D The Contractor agrees to include the following language verbatim in every subcontract, provider agreement, or purchase agreement for services which relate to the subject matter of this Contract: “Subcontractor shall protect, defend, indemnify, and hold harmless King County, its officers, employees and agents from any and all costs, claims, judgments, and/or awards of damages arising out of, or in any way resulting from the negligent act or omissions of subcontractor, its officers, employees, and/or agents in connection with or in support of this Contract. Subcontractor expressly agrees and understands that King County is a third party beneficiary to this Contract and shall have the right to bring an action against subcontractor to enforce the provisions of this paragraph.” XIV Nondiscrimination and Equal Employment Opportunity The Contractor shall comply with all applicable federal, state and local laws regarding discrimination, including those set forth in this Section. A. Nondiscrimination in Employment - During performance of this Contract, the Contractor agrees that it will not discriminate against any employee or applicant for employment because of the employee or applicant's sex, race, color, marital status, national origin, religious affiliation, disability, sexual orientation, gender identity or expression or age except by minimum age and retirement provisions, unless based upon a bona fide occupational qualification. B. Equal Employment Opportunity Efforts - The Contractor will undertake equal employment opportunity efforts to ensure that applicants and employees are treated, without regard to their sex, Page # 10 of 13 race, color, marital status, national origin, religious affiliation, disability, sexual orientation, gender identity or expression or age. The Contractor's equal employment opportunity efforts shall include, but not be limited to, the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeships. XV C. Equal Benefits to Employees with Domestic Partners - Contractor shall not discriminate in the provision of employee benefits between employees with spouses and employees with domestic partners during the performance of this Contract. Failure to comply with this provision shall be considered a material breach of this Contract, and may subject Contractor to administrative sanctions and remedies for such a breach. D. Nondiscrimination in Administration and Service - During the term of this Contract, the Contractor will not discriminate against any person in the administration of this Contract or in the delivery of services because of the person’s sex, race, color, marital status, national origin, religious affiliation, disability, use of service animal, sexual orientation, gender identity or expression or age. E. Compliance with Laws and Regulations - The Contractor shall comply fully with all applicable federal, state and local laws, ordinances, executive orders and regulations that prohibit discrimination. These laws include, but are not limited to, RCW Chapter 49.60, Titles VI and VII of the Civil Rights Act of 1964, the American with Disabilities Act, and the Restoration Act of 1987. The Contractor shall further comply fully with any equal opportunity requirements set forth in any federal regulations, statutes or rules included or referenced in the contract documents. Conflict of Interest A The Contractor agrees to comply with applicable provisions of K.C.C. 3.04. Failure to comply with such requirements shall be a material breach of this contract, and may result in termination of this Contract pursuant to Section II and subject the Contractor to the remedies stated therein, or otherwise available to the County at law or in equity. B The Contractor agrees, pursuant to KCC 3.04.060, that it will not willfully attempt to secure preferential treatment in its dealings with the County by offering any valuable consideration, thing of value or gift, whether in the form of services, loan, thing or promise, in any form to any county official or employee. The Contractor acknowledges that if it is found to have violated the prohibition found in this paragraph, its current contracts with the county will be cancelled and it shall not be able to bid on any county contract for a period of two years. XVI Equipment Purchase, Maintenance, and Ownership A The Contractor agrees that any equipment purchased, in whole or in part, with Contract funds at a cost of $5,000 per item or more, when the purchase of such equipment is reimbursable as a Contract budget item, is upon its purchase or receipt the property of the County and/or federal/state government. The Contractor shall be responsible for all such property, including the proper care and maintenance of the equipment. B The Contractor shall ensure that all such equipment will be returned to the County or federal/state government upon termination of this Contract unless otherwise agreed upon by the parties. XVII Proprietary Rights The parties to this Contract hereby mutually agree that if any patentable or copyrightable material or article should result from the work described herein, all rights accruing from such material or article shall be the sole property of the party that produces such material or article. If any patentable or copyrightable material or article should result from the work described herein and is jointly produced by both parties, all rights accruing from such material or article shall be owned in accordance with US Patent Law. Each party agrees to and does hereby grant to the other party, irrevocable, nonexclusive, and royalty-free license to use, according to law, any material or article and use any method that may be developed as part of the work under this Contract. Page # 11 of 13 The foregoing products license shall not apply to existing training materials, consulting aids, checklists, and other materials and documents of the Contractor which are modified for use in the performance of this Contract. The foregoing provisions of this section shall not apply to existing training materials, consulting aids, checklists, and other materials and documents of the Contractor that are not modified for use in the performance of this Contract. XVIII Political Activity Prohibited None of the funds, materials, property, or services provided directly or indirectly under this Contract shall be used for any partisan political activity or to further the election or defeat of any candidate for public office. XIX King County Recycled Product Procurement Policy In accordance with King County Code 10.16, the Contractor shall use recycled paper for the production of all printed and photocopied documents related to the fulfillment of this Contract. In addition, the Contractor shall use both sides of paper sheets for copying and printing and shall use recycled/recyclable products wherever practical in the fulfillment of this Contract. XX Future Support The County makes no commitment to support the services contracted for herein and assumes no obligation for future support of the activity contracted herein except as expressly set forth in this Contract. XXI Entire Contract/Waiver of Default The parties agree that this Contract is the complete expression of the terms hereto and any oral or written representations or understandings not incorporated herein are excluded. Both parties recognize that time is of the essence in the performance of the provisions of this Contract. Waiver of any default shall not be deemed to be a waiver of any subsequent default. Waiver or breach of any provision of the Contract shall not be deemed to be a waiver of any other or subsequent breach and shall not be construed to be a modification of the terms of the Contract unless stated to be such through written approval by the County, which shall be attached to the original Contract. XXII Contract Amendments Either party may request changes to this Contract. Proposed changes which are mutually agreed upon shall be incorporated by written amendments to this Contract. XXIII Notices Whenever this Contract provides for notice to be provided by one party to another, such notice shall be in writing and directed to Dr. William Bremner, Chair of Department of Medicine (or other appropriate contact of the Contractor), and the project representative of the County department specified on page one of this Contract. Any time within which a party must take some action shall be computed from the date that the notice is received by said party. XXIV Services Provided in Accordance with Law and Rule and Regulation The Contractor agrees to abide by the laws of the state of Washington, rules and regulations promulgated thereunder, and regulations of the state and federal governments, as applicable, which control disposition of funds granted under this Contract, all of which are incorporated herein by reference. In the event that there is a conflict between any of the language contained in any exhibit or attachment to this Contract, the language in the Contract shall have control over the language contained in the exhibit or the attachment, unless the parties affirmatively agree in writing to the contrary. XXV Applicable Law Page # 12 of 13 This contract shall be construed and interpreted in accordance with the laws of the State of Washington. The venue for any action hereunder shall be in the Superior Court for King County, Washington. XXVI No Third Party Beneficiaries Except for the parties to whom this contract is assigned in compliance with the terms of this contract, there are no third party beneficiaries to this contract, and this contract shall not impart any rights enforceable by any person or entity that is not a party hereto. IN WITNESS WHEREOF, the parties hereby agree to the terms and conditions of this Contract: KING COUNTY University of Washington Diane Wentz, Ph.D. Marguerite Ro Marguerite Ro (Jan 2, 2018) Diane Wentz, Ph.D. (Dec 19, 2017) Dec 19, 2017 FOR King County Executive Jan 2, 2018 Diane Wentz, Ph.D. Date Grant & Contract Administrator/Authorized Signing Official Date Approved as to Form: OFFICE OF THE KING COUNTY PROSECUTING ATTORNEY Page # 13 of 13 Exhibit A - Scope of Work A comprehensive evaluation of the impacts of the Sweetened Beverage Tax Recipient: University of Washington (UW) Contract Period: September 1, 2017 to July 31, 2018 Background: On June 6, 2017, the Seattle City Council passed Ordinance 125324 imposing a tax on engaging in the business of distributing sweetened beverages. The Office of the City Auditor (OCA) is contracting with Public Health Seattle and King County (PHSKC) to create a comprehensive evaluation of the impacts of Seattle’s Sweetened Beverage Tax (SBT). Section 5 B of the ordinance states, “The City Auditor shall contract with academic researchers to complete an annual evaluation of the effects of the tax. In contracting with academic researchers, the City Auditor should consider researchers with a proven track record of rigorous policy evaluation for impacts on behavior, health, and economic outcomes. A minimum of $500,000 per year for at least the first five years, beginning with the date of adoption of this ordinance, shall be dedicated to this evaluation. The evaluation shall assess, but not be limited to, the impact of the tax on 1. economic outcomes (such as household food expenditures, beverage prices and sales, jobs, and store revenues) and 2. health behaviors (such as dietary purchases and consumption), 3. intermediate health outcomes, and 4. identification and assessment of food deserts in the city, and 5. the effectiveness and efficiency of the foodbank network in the city. The evaluation shall also assess, but not be limited to, the process of implementing the tax, including perceptions of city residents and specifically low income households, food retailers, tax administrators, and city officials. The evaluator will collaborate with the Sweetened Beverage Tax Community Advisory Board to develop the evaluation. The evaluation will rely on data collected specifically for the purposes of the evaluation from populations in Seattle as well as outside Seattle to enable a rigorous comparison of trends in behavior, health, and economic outcomes as a result of this ordinance.” Project Summary: The Recipient, UW, will partner with PHSKC to co-lead and conduct a comprehensive evaluation of the impacts of Seattle’s Sweetened Beverage Tax (SBT) and participate as a member of the SBT Evaluation Team. Funding Period: This contract covers the period from September 1, 2017 to July 31, 2018. PHSKC’s funder, the Office of City Auditor, anticipates providing additional funding in subsequent years to reflect future phases of the Sweetened Beverage Tax Evaluation. Should such funding be made available, PHSKC may amend this agreement for the additional funds and activities contingent on satisfactory Recipient performance. Method of Accountability: Designated UW staff will have frequent email and phone contact and will meet with the evaluation team on a monthly basis, or more frequently as needed, to review project status. The first 2581 APDE -UW Office of Sponsored Programs-UW 1 meetings will include developing a mutually agreed upon work plan to set deadlines and deliverables. UW will complete reports required by PHSKC and OCA (e.g. annual evaluation plan, mid-point progress report specifying completion of data collection activities, baseline evaluation report). UW will follow deliverables review process described later in this contract. DESCRIPTION OF OUTCOMES Outcome 1. Co-lead SBT evaluation team. UW will co-lead SBT evaluation activities with PHSKC to assure that the evaluation activities as specified in the ordinance are conducted rigorously and that the evaluation plan includes all of the elements described in Ordinance 125324, are developed in collaboration with the Community Advisory Board, and are within budget allocations approved by the City. UW will facilitate (or designate a facilitator for) all evaluation team meetings and provide consultation to overall evaluation design and implementation to PHSKC, City, and Community Advisory Board. Deliverables: Create agendas for all evaluation team meetings and develop reports and project proposal memos and related budget for SBT evaluation activities, which PHSKC will finalize and submit to the City. Outcome 2. Evaluate the impact of the tax on economic outcomes. UW will be responsible for designing and implementing the impact evaluation of the tax on taxed and untaxed beverage prices, jobs, and business revenues. Dr. Jones-Smith, Associate Professor in Health Services and Epidemiology with UW, will provide oversight on evaluation design. UW staff will collect, enter, code, and analyze data as needed, provide consultation to PHSKC, City, evaluation staff, and Community Advisory Board about assessing and revising ideas for improvement. UW will submit findings to PHSKC to comply with reporting requirements as mutually agreed upon. Deliverables: Complete 1) annual approved work plan describing additional activities and timelines to accomplish this outcome, 2) evaluation plan (including conceptual model, data collection plan, draft data collection instruments, planned analyses and methodologies, a description of limitations, any changes or improvements made to the evaluation over time, description of members of the research team, and non-City funded studies of the SBT tax that Recipient will conduct, 3) institutional review board approvals as needed, 4) mid-point progress report specifying completion of data collection activities, and 5) final baseline evaluation report. Outcome 3. Evaluate the impact of the tax on norms and opinions. UW will collaborate with an evaluation consultant to design and implement the impact evaluation of heightened attention to the adverse health effects of sugary drinks generated by the adoption and implementation of the tax, on norms and attitudes around sugary beverages. UW (Dr. Jesse Jones-Smith) will work with an evaluation consultant and a data collection firm to collect, enter, code, and analyze data as needed, and provide consultation to PHSKC, City, evaluation staff, and Community Advisory Board about assessing and revising ideas for program improvement. UW and an evaluation consultant will submit findings to PHSKC to comply with reporting requirements as mutually agreed upon. Deliverables: Complete 1) annual approved work plan describing additional activities and timelines to accomplish this outcome, 2) evaluation plan (including conceptual model, data collection plan, draft data collection instruments, planned analyses and methodologies, a description of limitations, any changes or improvements made to the evaluation over time, description of members of the research team, and non-City funded studies of the SBT tax that Recipient will conduct, 3) institutional review board approvals as needed, 4) mid-point progress report specifying completion of data collection activities, and 5) final baseline evaluation report. 2581 APDE-UW Office of Sponsored Programs-UW 2 ADDITIONAL DELIVERABLES AND EXPECTATIONS Follow general responsibilities outlined in the Memorandum of Agreement between OCA and Public Health The Recipient and PHSKC agree upon the following framework for mutual responsibilities and contributions toward the evaluation of the impacts of Seattle’s Sweetened Beverage Tax. PHSKC will: • • • • • Provide a point of contact for Recipient with PHSKC and City of Seattle regarding the evaluation, (e.g., to communicate with the Community Advisory Board on the evaluation, for the City of Seattle to help facilitate access to data on SBT revenues collected by the City Tax Administrator to evaluate economic impact, provide letters of support for applications from the Sweetened Beverage Tax Evaluation Team’s members to federal agencies and private funders for funding for components of the evaluation or for complementary evaluation activities). Report monthly on progress of the evaluation to OCA, who will use the information to report quarterly to the Seattle City Council Finance Chair. Assist with the development of the annual evaluation budget that is submitted by Public Health to the Seattle City Council. Distribute draft reports to OCA, who will distribute them to a team of City staff (City Team) and schedule pre-briefing meetings with the City Team per the Deliverables Review Processes described below. Work with the City of Seattle to publish Sweetened Beverage Tax evaluation reports of SBT-funded work produced by the Recipient on the Office of the City Auditor (OCA) website. Recipient will: • • • • • • • • • Provide expertise to include academic researchers with a proven track record of rigorous policy evaluation for impacts on behavior, health, and economic outcomes. Collaborate with the Sweetened Beverage Tax Community Advisory Board to develop the evaluation. Develop an annual evaluation plan for review and comment by the City team as well as the Sweetened Beverage Community Advisory Board. Assist with the development of the annual evaluation budget that is submitted by Public Health to City of Seattle. Provide a point of contact for communication with PHSKC regarding the evaluation. Collaborate with OCA and PHSKC to develop an annual budget to submit to the Seattle City Council for the evaluation. Adhere to the Deliverables Review Processes described below. Provide PHSKC and OCA with direct access to the members of the Evaluation Team as needed to resolve issues and respond to requests for information. Provide PHSKC with brief monthly updates on the evaluation’s progress and any issues related to the evaluation. DELIVERABLES REVIEW PROCESS This section describes the process for PHSKC and City review of deliverables, including: 1) City-funded evaluation plans, 2) City-funded reports, 3) New reports (e.g., for an academic audience) based on revisions of work that had previously been funded by the City, and 4) reports by the Evaluation Team’s members that were funded through non-City sources. City-Funded Reports (estimated 7-9-week process) 2581 APDE-UW Office of Sponsored Programs-UW 3 1. 2. 3. 4. 5. 6. 7. 8. The Evaluation Team will provide to the city a complete draft report, to be referred to as the prebriefing draft report, and any accompanying PowerPoint presentation slides, press releases or website content (i.e., accompanying materials), on the impacts of Seattle’s Sweetened Beverage Tax. This action will initiate the review process. The draft report will be as closely aligned as possible to the final report that the Evaluation Team plans to release to the PHSKC. Specifically, the pre-briefing draft report will contain a description of the team’s methodology, the team’s conclusions, and an executive summary. The City will have a minimum of 15 business days and maximum of 30 business days to review this draft. The Office of City Auditor will be responsible for ensuring that the draft and accompanying materials are circulated to the City Team, and that the City’s feedback on them is provided to the Evaluation Team. After the City has completed its review of the pre-briefing draft, the Evaluation Team will provide a briefing to the City Team in advance of the Evaluation Team’s public presentations to the Seattle City Council on its reports on the evaluation of the impacts of Seattle’s Sweetened Beverage Tax. This briefing shall be referred to as the pre-briefing meeting. The City Team shall typically include Seattle City Councilmembers and their legislative aides, and representatives from the Office of City Auditor, City Council Central Staff, the Mayor’s Office, and the Human Services Department. Representatives from other City departments may be included as needed. The purpose of the pre-briefing is for the City to seek clarification, suggest corrections, pose questions and/or request additional analyses and information concerning the Evaluation Team draft report and accompanying materials. If the Evaluation Team disagrees with any suggested revisions proposed by the City on the pre-briefing draft report and accompanying materials, it will communicate the reasons for its disagreement to the Office of City Auditor sometime during the pre-briefing meeting. After the pre-briefing meeting, the Evaluation Team will then have at least 10 business days and maximum of 30 business days to prepare a final draft report and accompanying materials, which it will provide to the Office of City Auditor. The Office of City Auditor will be responsible for ensuring that the Evaluation Team’s final draft report and accompanying materials are circulated to the City Team. The City Team will then have a minimum of 10 business days and maximum of 30 business days in which to review the final draft report and accompanying materials prepared by the Evaluation Team, during which time the City may issue new requests regarding clarification or interpretation, but not requests for new or additional analysis. The Evaluation Team may need to make additional revisions to the final draft report based on this final City review. The Evaluation Team will then submit the final report and accompanying materials to the Office of City Auditor, which will ensure that it is distributed to the City Team. The Office of City Auditor will also ensure that the Evaluation Team’s materials are provided to the appropriate Seattle City Councilmember’s office for purposes of a public presentation to the City Council. The Council presentation would occur at least 10 business days after the Evaluation Team delivers the final report and accompanying materials to the Office of City Auditor. During the evaluation project period, the Evaluation Team will refrain from publicizing the final report and accompanying materials in advance of the public briefing, unless a representative of the City or third party calls public attention to the work. Schedule for review of City-funded reports Report Name Responsible Party Period of time for review City-funded reports Evaluation Team submit draft to City 2581 APDE-UW Office of Sponsored Programs-UW 4 City reviews draft report 15 to 30 business days Evaluation Team prepares final draft 10 to 30 business days City review final draft 10 to 30 business days Evaluation Team submits final report to City Auditor Evaluation Team presents final report to City Council 10 business days City Funded Evaluation Plans 1. 2. 3. 4. The Evaluation Team will develop an annual evaluation plan beginning with the 2017-18 baseline evaluation. The annual evaluation plan should include data collection plans, draft data collection instruments, planned analyses and methodologies, a description of limitations, any changes or improvements made to the evaluation over time, and descriptions of the members of the research team. The annual evaluation plan should also describe any work planned by the Evaluation Team regarding the Sweetened Beverage Tax that is funded by non-City sources. The City will have a minimum of 15 business days and maximum of 30 business days to review the draft evaluation plan. The Office of City Auditor will be responsible for ensuring that the draft and any accompanying materials are circulated to the City Team, and that the City’s feedback on them is provided to the Evaluation Team. If needed, the Evaluation Team will meet with the City Team to review and discuss any questions or comments regarding the draft evaluation plan. At the end of the City review period, the Evaluation Team will update the evaluation plan. However, it will remain a working document and can be updated by the Evaluation Team during the evaluation. New Reports (e.g., for an academic audience) Based on Revisions of Work that had Previously Been Funded by the City 1. The Evaluation Team agrees to provide copies of revised papers/presentations as they become available to the Office of City Auditor, which will distribute them to the City Team. The City Team may request a briefing about these revised works upon receipt, but it cannot be guaranteed that these briefings would occur before public release or presentation. Reports by the Evaluation Team members that were Funded Through Non-City Sources 1. 2. The Evaluation Team agrees to make the City Team aware of any work regarding Seattle’ s Sweetened Beverage Tax for which they receive funding from non-City sources. The Evaluation Team agrees to provide copies as they become available to the Office of City Auditor, which will distribute them to the City Team, of papers/presentations regarding Seattle’s Sweetened Beverage Tax that are funded through non-City sources. 2581 APDE-UW Office of Sponsored Programs-UW 5 Participation in the U.S. Sugary/Sweetened Beverage Tax Evaluation Advisory Committee (EAC) To ensure that Seattle’s Sweetened Beverage Tax evaluation is consistent with the leading national research, the Evaluation Team and, as needed, OCA, should participate in the U.S. Sugary/Sweetened Beverage Tax Evaluation Advisory Committee (EAC). The EAC for research on sugary/sweetened beverage taxes funded by Bloomberg Philanthropies in the United States will be formed and chaired by Dr. Lisa Powell (University of Illinois - Chicago) and Dr. Shu Wen Ng (University of North Carolina - Chapel Hill). This is to ensure that key strategic and scientific research decisions are well discussed and considered, by capitalizing on the domestic (US) and global stature of the EAC members and their involvement and knowledge of concurrent efforts across the United States and in various countries. Activities of EAC members include: 1. To review and provide feedback on the research design of key evaluations of 3 major selected locations (Cook County IL, Oakland CA, and Philadelphia PA), and evaluations conducted by other research teams in other US localities that have passed meaningful Sugar Sweetened Beverage (SSB) tax policies. 2. To review the key research papers for each locality funded by Bloomberg Philanthropies. 3. To identify key research questions and gaps. 4. To participate in annual group meetings (likely to be 1.5 days) that will include EAC members, research teams, and program officers from Bloomberg Philanthropies. Key research collaborators who are working on SSB evaluations will attend the meeting to present their work and research plans/progress, participate in the meeting, and get feedback from the EAC. Depending on the agenda and timing, other research teams conducting evaluations in other US localities will also be invited to present and get feedback from the EAC. Dr. Powell has confirmed that the Evaluation Team will be invited to participate in the annual group meetings and present their research and obtain feedback. Three annual meetings are planned with the approximate dates of March 2018, March 2019 and March 2020. The EAC will be in effect from April 1, 2017 through March 31, 2020. The annual budget for the evaluation includes participation in the EAC from the Evaluation Team, PHSKC, OCA, and the City Team as appropriate. Report how SBT funds are spent and bill for reimbursement Recipients must have a financial system that is able to prepare reports and separate SBT funds from other organization expenses. Recipients will bill Public Health quarterly for reimbursement of SBT expenses. Invoices must reflect all costs incurred for a quarter’s activities. Public Health cannot pay ahead for expenses. Invoices for reimbursement are due to Public Health 10 working days after the end of each quarter. Documentation of costs must be included with the Invoice (see details tab of Exhibit C-Invoice). BUDGET Recipients will be reimbursed for baseline work as follows (See Exhibit B for detailed budget): Recipient Total Awarded Budget University of Washington Not to exceed $156,105 2581 APDE-UW Office of Sponsored Programs-UW 6 Exhibit B - Budget A comprehensive evaluation of the impacts of the Sweetened Beverage Tax University of Washington Contract Period September 1, 2017 to July 31, 2018 Outcome 1: Co-lead SBT Evaluation Team 1) Create Agendas for evaluation team meetings 2) Develop reports, project proposal memos and related budget for SBT evaluation activities Outcome 2: Evaluate the imapct of the tax on economic outcomes 1) Complete annual approved work plan 2) Complete evaluation plan 3) Complete institutional review board approvals as needed 4) Complete mid-point progress report specifying completion of data collection activities 5) Complete final baseline evaluation report Outcome 3: Evaluate the impact of the tax on norms and opinions 1) Complete annual approved work plan 2) Complete evaluation plan 3) Complete institutional review board approvals as needed 4) Complete mid-point progress report specifying completion of data collection activities 5) Complete final baseline evaluation report $ $ Total ($): $ Amount ($) 614.27 8,826.23 9,440.50 $ $ $ $ $ Total ($): $ Amount ($) 4,449.94 7,379.11 1,293.17 55,218.00 33,611.42 101,951.64 $ $ $ $ $ Total ($): $ Amount ($) 539.72 8,819.70 179.91 34,094.08 1,079.45 44,712.86 GRAND TOTAL ($): $ 156,105.00 ALL FIELDS MUST BE COMPLETED FOR PROMPT PAYMENT PROCESSING King County Accounts Payable Information INVOICE Contract Number: APDE 2581 Exhibit: C Contract Period of Performance: Purchase Order # Supplier Name Supplier # Supplier Pay Site Remit to Address 9/1/17-7/31/18 University of Washington Grant and Contract Accounting Box 354966 Seattle, WA 98195-4966 (206) 616-9995 gcahelp@uw.edu Invoice Date Invoice # Amount to be Paid Note to AP Payment Type (Circle One) Print on Remittance PH Program name & phone Submit signed hardcopy invoice to: Tamara Babasinian Seattle Sweetened Beverage Tax Evaluation Public Health - Seattle & King County 401 5th Ave., Suite 1300 Seattle, WA 98104 Start Date CHECK or ACH End Date Invoice for services rendered under this contract for the period of: MM/DD/YY Project Organization Expend Task Award DPH Acct CPA CFDA Amount Attach sheet for multiple POETAs Direct Costs Budget Previously Billed Current Outcome 1 $ 9,440.50 Outcome 2 Outcome 3 Grand Total $ 101,951.64 $ - $ 44,712.86 $ - $ 156,105.00 $ - $ $ - $ Cumulative Balance - $ - $ 9,440.50 $ - $ - $ 101,951.64 $ - $ - $ $ Amount Due - $ 156,105.00 44,712.86 I, the undersigned, do hereby certify under the laws of the State of Washington penalty of perjury, that this is a true and correct claim for reimbursement services rendered. I understand that any false claims, statements, documents, or concealment of material fact may be prosecuted under applicable Federal and State laws. This certification includes any attachments which serve as supporting documentation to this reimbursement request. Signed Print Name Date PH Program Manager Approval For Public Health Use Only Received Date Initial Entered CM/PM Review FM Review Official Copy Rcvd Date