Archaeology and Historic Preservation SHPO GrantDocusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
M
CONTRACT ROUTING FORM
(City Clerk Use Only)
Z
Originator:
Rose Haas Routed by:
Heather Lakefish
O
Department/Division:
Planning Date: 02/18/2025
Name of Consultant/Contractor:
IL
Washington State Department of Archaeology and Historic Preservation
CONTRACT TITLE:
c
2025 HPF Washington SHPO
Type of Contract: �✓ (GR) Grants
(1) Intergovernmental Agreement
1'- n (S) Purchase of Services (W) Public Works
z
w
z
Bid/RFP Number:
v Effective Date: 02/01/2025 Completion Date:
H
t) Has the original City contract boilerplate language been modified? OYes ONo
I.- If yes, specify which sections have been modified:
p Description City of Edmonds shall conduct a reconnaissance level survey for the Robinhood
V of Services:
Neighborhood and public education activities.
Total Amount of Contract:
Budget# 001.000.333.15.9 0.01 Amount:
J
Budget # Amount:
Lu
c
J Budget #
Q Amount:
V
Z Are there sufficient funds in the current budget to cover this contract? Q Yes O No
Q
Z Remarks:
Authorization Level: I Mayor
W
❑ 1. Project Manager
Q 2. Risk Management/Budget
Z �✓ 3. City Attorney
�✓ 4. Consultant/Contractor
y ✓❑ 5. Other
❑ 6. City Council Approval
Date (if applicable)
Q 7. Mayor
E 8. City Clerk
Shane Hope
(L) Lease Agreement
(0) Other
12/31 /2025
$ 1000.00
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
da,hp
M.."
DEPT OF ARCHAEOLOGY +
HISTORIC PRESERVATION
Federally Funded Grant Agreement
Between
Washington State
Department of Archaeology and Historic Preservation
and
City of Edmonds
Grant Number: FFY25-CLG-EDMONDS
Grant Title: Certified Local Government — City of Edmonds
Effective Date: February 1, 2025
Expiration Date: December 31, 2025
Grant Amount: $15,000.00
Federal Grant Name: 2025 HPF Washington SHPO
CFDA Number: 15.904
Grant Purpose
City of Edmonds shall conduct a reconnaissance level survey for the Robinhood
Neighborhood and public education activities.
This agreement is made between The Department of Archaeology and Historic
Preservation (DAHP) hereinafter referred to as the DEPARTMENT, and City of
hereinafter referred to as the GRANTEE.
Parties' Contact Information
DAHP Contacts:
Michelle Thompson I Certified Local Government Coordinator
Phone: 360-890-2617 1 Email: michelle.thompson@dahp.wa.gov
Marivic Quintanilla I Contract & Grants Manager
Phone- 360-870-6383 1 Email- marivic.quintanilla@dahp.wa.gov
GRANTEE Contact -
Rose Haas I Planner
Phone- 425-771-0220 1 Email- Rose.haas@edmondswa.gov
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 1 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Section 1. Responsibilities of the GRANTEE
A. The GRANTEE will perform or cause others to perform the work described in the
"Scope of Work" (Attachment 1). Additional special conditions or specifics about
the work required by this agreement, if any, are in attachments as enumerated
and described in Section 3. The GRANTEE agrees to perform the work in
accordance with any such special conditions or specifics.
B. The GRANTEE understands that the work called for under this agreement must
conform to federal administrative requirements as they relate to the
DEPARTMENT, and the GRANTEE agrees to comply with all such requirements.
The following documents summarize some of these requirements and are
incorporated herein and made a part hereof as though set forth in full:
(1) The requirements of Uniform Guidance, 2 CFR Part 200 - Uniform
Administrative Requirements, Cost Principles, and Audit
Requirements for Federal Awards.
(2) The "Secretary of Interior Standards and Guidelines for
Archaeology and Historic Preservation." All work under this
contract must be in compliance with the relevant Secretary's
Standards and Guidelines e.g. Preservation Planning, Identification,
Evaluation, Registration, Historic Research and Documentation,
Architectural and Engineering Documentation, Archeological
Investigation, Historic Preservation Projects, and Preservation
Terminology.
(3) The Secretary of the Interior's "Historic Preservation Fund Grants
Manual." - Latest Revision, June 2007.
(4) Historic Preservation Fund Annual Grant Manual and Application,
and any Federal budget changes/special conditions applicable
thereto.
(5) 43 CFR 17 Civil Rights, Subpart A, Implementing Title VI of the
Civil Rights Act of 1964; and Subpart B, Implementing Section 504
of the Rehabilitation Act of 1973; and Subpart C, Implementing the
Age Discrimination Act of 1975; and subpart E, Enforcement of
Nondiscrimination on the Basis of Handicap in Programs or
Activities Conducted by the Department of the Interior.
(6) Americans with Disabilities Act of 1990, 42 U.S.C. 1201 et seg.
(ADA) providing comprehensive civil rights to individuals with
disabilities in the areas of employment, public accommodations,
state and local government services, and telecommunications.
STATF
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 6 x
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 2 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
c. The GRANTEE agrees to comply with the restrictions of 18 U.S.C. 1913
concerning lobbying with appropriated funds, which provides substantially as
follows: "No part of the money appropriated by any enactment of Congress shall,
in the absence of express authorization by Congress, be used directly or
indirectly to pay for any personal service, advertisement, telegram, telephone,
letter, printed or written matter, or other device, intended or designed to influence
in any manner a Member of Congress, to favor or oppose, by vote or otherwise,
any legislation or appropriation by Congress, whether before or after the
introduction of any bill or resolution proposing such legislation or appropriation;
but this shall not prevent officers or employees of the United States or its
departments or agencies from communicating to Members of Congress at the
request of any Member, or to Congress through the proper official channels,
requests for legislation or appropriations which they deem necessary for the
efficient conduct of the public business."
D. The GRANTEE agrees to maintain records in a manner which will provide an
audit trail to all expenditures reported to the DEPARTMENT. The GRANTEE
agrees to keep these records for at least six years following the ending date of
the grant. In the event that an audit of the GRANTEE or of the DEPARTMENT
should take exception to any expenditure by the GRANTEE, the GRANTEE
agrees to refund to the DEPARTMENT on demand the amount determined by
the audit as due. In the event that the DEPARTMENT is required to institute legal
proceedings to enforce this repayment provision, the DEPARTMENT shall be
entitled to its costs thereof, including reasonable attorney's fees. When arranging
for an audit, the DEPARTMENT should contact the following GRANTEE
representative:
Rose Haas I Planner
Phone: 425-771-0220 1 Email
Address: 121 5th Ave N
Rose.haas@edmondswa.gov
Edmonds, WA 98020
E. The GRANTEE agrees to pay all the costs involved in carrying out the terms of
this agreement prior to seeking reimbursement as provided for in Section 2A.
When seeking reimbursement, the GRANTEE will submit a completed
reimbursement form in writing to the DEPARTMENT and provide such
documents as an affidavit of publication for newspaper advertising soliciting bids,
contracts, photocopies of canceled checks and invoices, and other documents as
may be requested by the DEPARTMENT. The DEPARTMENT will provide the
GRANTEE with the reimbursement form and guidelines for financial reporting
procedures. The GRANTEE agrees to submit its request for reimbursement
within thirty (30) days following completion of the work.
F. The GRANTEE agrees to provide the DEPARTMENT with a completion report
following a form provided by the DEPARTMENT. The GRANTEE
4TA%N
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 s
www.dahp.wa.gov J,
Grant No. FFY25-CLG-EDMONDS
Page 3 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
will submit this report on or before the end date. The GRANTEE agrees that the
DEPARTMENT shall have the right to withhold all or part of the payment under
Section 2A pending receipt of this completion report.
G. The GRANTEE agrees that the "Budget" (Attachment 3) shall be a financial guide
for the work called for by this agreement. The GRANTEE may exceed the
budgeted amounts, but this shall in no way obligate the DEPARTMENT for a
greater amount than that stipulated as DEPARTMENT share, and in no event
shall the DEPARTMENT be obligated for a greater amount than the Grant
Amount. In the event that the GRANTEE should spend less than the budgeted
amount on an object or element in the budget, the DEPARTMENT may either
reduce its obligation proportionately or it may terminate this agreement. The
GRANTEE agrees to maintain records which will render an accurate accounting
by the elements or objects in the budget. The actual expenditures for the
amounts reflected in the budget may vary by 15 percent without requiring an
amendment to this grant agreement.
H. The GRANTEE agrees that the DEPARTMENT shall have the right to terminate
this agreement if the GRANTEE shall fail to fulfill in a timely and proper manner
its obligations under this agreement or if the GRANTEE shall violate any of the
covenants, conditions, or stipulations of the agreement. In case of such
termination by the DEPARTMENT, the GRANTEE agrees to return to the
DEPARTMENT within thirty (30) days of the effective date of termination, any
payments made by the DEPARTMENT to the GRANTEE under the terms of this
agreement or any portion of such payments as may be directed by the
DEPARTMENT.
The GRANTEE agrees to submit documentation of the work identified in the
Scope of Work on or before the grant end date. GRANTEE acknowledges and
understands that final work which does not conform to the terms and conditions
of this agreement or which does not meet the applicable Secretary of the
Interior's Standards will not be reimbursed.
i. The GRANTEE agrees to submit a "Schedule for Project Completion"
(Attachment 2) before beginning work under this agreement. Said schedule form
shall list each element described in the "Scope of Work" (Attachment 1) and shall
indicate the approximate date when completion of each can be expected.
K. The GRANTEE will maintain regular contact with the DEPARTMENT regarding
the progress of the grant project. The GRANTEE agrees that the DEPARTMENT
shall have the right to monitor the work called for by this agreement.
The GRANTEE agrees to use competitive negotiation procedures for all
amounts over $30,000 for procurement of professional services and
subcontracts. GRANTEE agrees to maintain records sufficient to detail the
significant history of procurement and to forward evidence of competitive
4TATF
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 s
www.dahp.wa.gov J,
Grant No. FFY25-CLG-EDMONDS
Page 4 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
procurement to the DEPARTMENT prior to reimbursement of funds under this
agreement.
M. The GRANTEE agrees that it, its officers, agents and employees, and any other
person or entity performing any work under this agreement, are independent
contractors and not employees of the State of Washington.
N. Federal funds are the basis for this contract. The GRANTEE certifies that neither
it nor its principals are presently debarred, declared ineligible, or voluntarily
excluded from participation in transactions by any state / federal department or
agency. Should for any reason the Federal funds which are the basis for this
agreement become withdrawn, or not appropriated by Federal congress the
agreement may be terminated without penalty to the DEPARTMENT.
o. To the fullest extent permitted by law, the GRANTEE shall indemnify, defend and
hold harmless the DEPARTMENT, other agencies of the State of Washington
("State") and all officials, agents and employees of the DEPARTMENT and the
State, from and against all claims for injuries or death arising out of or resulting
from the performance of the Contract. GRANTEE's obligation to indemnify,
defend, and hold harmless includes any claim by GRANTEE's agents,
employees, representatives, or any subcontractor or its employees.
GRANTEE expressly agrees to indemnify, defend, and hold harmless the State
for any claim arising out of or incident to GRANTEE's or any subcontractor's
performance or failure to perform the Grant. GRANTEE's obligation to indemnify,
defend, and hold harmless the State shall not be eliminated or reduced by any
actual or alleged concurrent negligence of State or its agents, agencies,
employees and officials.
Consistent with RCW 43.17.320.340, the parties shall make every effort to
resolve disputes arising out of, or relating to, this Grant through discussion and
negotiation.
Should discussion and negotiation fail to resolve a dispute arising under this
Grant, the parties shall select a dispute resolution team to resolve the dispute.
The team shall consist of a representative appointed by the director of each party
and a third party mutually agreed upon by the director of each party. The team
shall attempt, by majority vote, to resolve the dispute. If the dispute cannot be
resolved in this fashion, either party may request assistance from the Governor
pursuant to RCW 43.17.330.
P. The GRANTEE agrees to provide or purchase industrial insurance coverage, as
applicable, prior to performing work under this agreement. The
STATF
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 6 x
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 5 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
DEPARTMENT will not be responsible for payment of industrial insurance
premiums or for any other claim or benefit for this GRANTEE, or any sub -grantee
or employee of the GRANTEE, which might arise under the industrial insurance
laws during performance of duties and services under this agreement. If the
Department of Labor and Industries, upon audit, determines that industrial
insurance payments are due and owing as a result to work performed under this
agreement, those payments shall be made by the GRANTEE; the GRANTEE
shall indemnify the DEPARTMENT and guarantee payment of such amounts.
Q. The GRANTEE agrees to include written acknowledgment of National Park
Service and Department of Archaeology and Historic Preservation support for all
grant -related publications and public information materials including audio-visual
and workshop materials. The GRANTEE further agrees that the written
acknowledgment shall comply with the form and content stipulated in the
"Historic Preservation Fund Grants Manual — 2007."
R. The GRANTEE agrees to any additional conditions identified in section 3 and
attached to this agreement.
s. There shall be no discrimination against any person employed by the GRANTEE
in connection with work covered by or related to this agreement, or against any
applicant for such employment, because of race, creed, color, sex, age, marital
status, national origin, or the presence of any sensory, mental, or physical
handicap in accordance with Chapter 49.60 RCW. This provision shall include,
but not be limited to, the following: employment, upgrading, demotion, or transfer;
recruitment or advertising; layoff or termination; rates of pay or other forms of
compensation and selection for training. The GRANTEE shall insert a similar
provision in all subcontracts for services covered by this agreement.
During the performance of this Grant, the GRANTEE shall comply with all federal
and state nondiscrimination laws, regulations and policies.
T. In accordance with legislative findings and policies set forth in Chapter 39.19
RCW the GRANTEE is encouraged in the participation and use of
Minority and Women's Business Enterprise firms certified by OMWBE.
u. The GRANTEE agrees that for any match specifically identified to this grant
agreement by the GRANTEE the GRANTEE will not claim match directly
earmarked or identified for this agreement as match for any other grant,
agreement or contract. The DEPARTMENT has first and exclusive claim to
match provided by the GRANTEE to this agreement as indirect eligible match to
the National Park Service, Historic Preservation Fund award to the
DEPARTMENT.
DEPARTMENT: Grant Amount: $15,000.00
GRANTEE: Minimum Grant Match Amount: $0.00
4TATF
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065 s
www.dahp.wa.gov J,
Grant No. FFY25-CLG-EDMONDS
Page 6 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Section 2: Responsibilities of the DEPARTMENT
A. The DEPARTMENT agrees to reimburse the GRANTEE one hundred
(100) percent of its actual authorized expenditures for the purpose of this
agreement, provided:
(1) The total paid by the DEPARTMENT shall not exceed the amount
stipulated in the "Budget" (Attachment 3) as DEPARTMENT share.
(2) All expenditures were incurred between the beginning and ending
dates of the grant.
(3) No expenditures have been previously claimed in any other grant
from any agency of the state or federal government.
(4) The DEPARTMENT has authority to expend the funds required to
meet the obligations contained herein.
(5) The GRANTEE has met all requirements contained in this
agreement.
B. The DEPARTMENT agrees to consider requests from the GRANTEE for
progress payments if, in the DEPARTMENT'S judgment, the public
interest will be served by doing so and if such payments are
administratively practical and provided appropriated funds are available for
which to issue a progress payment.
C. The DEPARTMENT may unilaterally terminate all or part of this contract,
or may reduce its scope of work and budget, if there is a reduction in
funds by the source of those funds, and if such funds are the basis for this
contract.
Section 3: Attachments
The following attachments are hereby incorporated into and made a part of this
agreement.
Attachment 1
Scope of Work — consisting of three pages
Attachment 2
Schedule of Project Completion — consisting of one page
Attachment 3
Budget — consisting of one page
Attachment 4
State Form Al Invoice Voucher (attached) — consisting of one page
Attachment 5
Civil Rights Assurance — consisting of one page
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 7 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 6
Statement of Understanding for Grant Management Requirements —
consisting of one page
Attachment 7
Certification Regarding Debarment, Suspension, Ineligibility, and
Voluntary Exclusion — consisting of two pages
Section 4: Amendments
This grant agreement may only be amended if such amendment is in writing (with the
exception of the 15% variance for actual expenditures identified in Section 1.G), agreed
to and signed by all the parties, and attached hereto.
DEPARTMENT:
WASHINGTON STATE
DEPARTMENT OF ARCHAEOLOGY
AND HISTORIC PRESERVATION
Signed by:
EA
Sbbt, �jV wk
FF699DFCFDE1425...
GRANTEE:
CITY OF EDMONDS
E
Signed by:
ta�br NO, r6sut
F10758AAA7E9463-
BY: ALLYSON BROOKS PH.D. BY: MICHAEL ROSEN
ITS: EXECUTIVE DIRECTOR ITS: CITY MAYOR
2/25/2025 2/25/2025
DATE DATE
Es
Signed by:
aIn t, Nrt,
9D9CA195188844D._
BY: SHANE HOPE
ITS: INTERIM PLANNING AND
DEVELOPMENT DIRECTOR
2/25/2025
DATE
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 8 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Signed by:
25BFC07762F2449_._
BY: SHARON CATES
ITS: CITY ATTORNEY
2/25/2025
DATE
DocuSigned by:
�y
7B732FF8FSDD4AB...
BY: SCOTT PASSEY
ITS: CITY CLERK
2/25/2025
DATE
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 9 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 1
SCOPE OF WORK
WORK TO BE ACCOMPLISHED: The GRANTEE shall conduct the following activities:
A. CITY OF EDMONDS SURVEY OF THE ROBINHOOD NEIGHBORHOOD: The
GRANTEE shall conduct a RECONAISSANCE LEVEL SURVEY, as follows:
1. CRITERIA: Historic buildings, structures, objects, and sites. Approximately 90
properties. Final number of HPI forms, TBD. Survey to be conducted in the Robinhood
Neighborhood, roughly surrounding Nottingham Rd., Humber Ln., and Robin Hood Dr.
B. PUBLIC EDUCATION ACTIVITIES: The GRANTEE shall conduct at least two public
presentations during the grant period. The purpose of the presentation(s) shall be to
announce the project and to present findings of the project to the public and/or
nomination reviewers.
SURVEY STANDARDS: The GRANTEE shall conduct the survey activity and produce
complete Historic Preservation Inventory (HPI) forms consistent with the guidelines
in the Washington State Standards for Cultural Resource Reporting published by the
Department of Archaeology and Historic Preservation and summarized as follows:
A. COMPLETED SURVEY:
(1) A COMPLETED SURVEY is understood to mean that the GRANTEE has
used the WISAARD ONLINE SYSTEM to document all required survey
materials of the defined survey area and has submitted the survey to the
DEPARTMENT. The HPI forms must be determined acceptable by the
DEPARTMENT. A companion Excel download Historic Preservation
Inventory Characteristics Table for drop -down menus in Wisaard can be
found here. All terminology used in the Statement of Significance and
Physical Description narrative section of the HPIs should also follow these
conventions.
(2) A SURVEY REPORT IS REQUIRED. A SURVEY PROJECT REPORT
is understood to mean a report which follows the guidelines for survey
project reports provided by the DEPARTMENT within the Washin tg_on
State Standards for Cultural Resource Reporting which includes the
introduction, survey methodology, analysis, recommendations, a map of
the entire survey area with all sites marked and numbered, a table of the
properties with Local and National Register eligibility recommendations
where possible. The REPORT shall include, based on the findings,
recommendations for next steps.
B. A COMPLETED HISTORIC PRESERVATION INVENTORY FORM is
STArF, o�
State of Washington • Department of Archaeology & Historic Preservation 4
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov yo2
Grant No. FFY25-CLG-EDMONDS � 1s89
Page 10 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
understood to mean a completed record on the WISAARD ONLINE
SYSTEM, with each field completed with the inventory information and
at least two digital images of the property, more if necessary to convey the
property's appearance. The forms shall meet the guidelines for
Reconnaissance level survey as stated in the Washington State Standards
for Cultural Resource Reporting. Only use DAHP's HPI forms available
through the WISAARD ONLINE SYSTEM. Do not create your own
inventory forms. These will not be accepted.
ADMINISTRATION:
A. GRANT ADMINISTRATION: The GRANTEE shall establish and maintain contact with
the DEPARTMENT throughout the grant period as to the status of all grant activities by
preparing and submitting the requested documents to the DEPARTMENT at the times
indicated in the SCHEDULE FOR PROJECT COMPLETION
B. ACKNOWLEDGEMENT: RECONAISSANCE LEVEL SURVEY shall include in its
entirety the following acknowledgement, disclaimer, and non-discrimination statements:
This study has been financed in part with Federal funds from the National Park Service, Department of the
Interior administered by the Department of Archaeology and Historic Preservation (DAHP) and the City of
Edmonds. However, the contents and opinions do not necessarily reflect the views or policies of the
Department of the Interior, DAHP, nor does the mention of trade names or commercial products constitute
endorsement or recommendation by the Department of the Interior or DAHP.
This program received Federal funds from the National Park Service. Regulations of the U.S. Department of
Interior strictly prohibit unlawful discrimination in departmental Federally Assisted Programs on the basis of
race, color, national origin, age, or handicap. Any person who believes he or she has been discriminated
against in any program, activity, or facility operated by a recipient of Federal assistance should write to:
Director, Equal Opportunity Program, U.S. Department of the Interior, National Park Service, 1849 C Street,
NW, Washington, D.C. 20240.
C. PROJECT MANAGEMENT: The first billable date for work performed on this project is
February 1, 2025, and not before. DAHP requires two check -in dates for FFY25 grant
projects — July 28 and October 14, 2025. If a "draft" is not applicable, then a simple
project update is sufficient to illustrate progress. A draft means a complete draft
nominations unless prior arrangements are made with DAHP.
The GRANTEE shall, before final selection, in instances requiring a professional historic
preservation consultant, afford the DEPARTMENT an opportunity to review and
approve candidates conducting the project to ensure they meet the Secretary of the
Interior's Standards for Architectural History https://www.nps.gov/articles/sec-standards-
prof-quals.htm.
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 11 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
D. INCOMPLETE OR INACCEPTABLE MATERIALS: Any required materials submitted
which are not considered acceptable or complete will be returned to the GRANTEE for
completion within the grant period.
E. REIMBURSEMENT & SUBMISSION: The GRANTEE will only be reimbursed for
preparing acceptable and completed materials during the grant period. Reimbursement is
subject to the final allocation of funding from the NPS. Final grant projects are due
December 1, 2025. Request for reimbursement is due December 30, 2025, via the A-
19 form. All drafts, final projects, and requests for reimbursement should be submitted to
michelle.thompsonkdahp.wa. _ og_v and contracts@dahp.wa.gov.
F. DEPARTMENT RESPONSIBILITIES: The DEPARTMENT shall provide the
GRANTEE with the information to gain access to the WISAARD ONLINE SYSTEM.
The DEPARTMENT shall respond to the GRANTEE within 14 days of each draft
submittal with comments. If the DEPARTMENT has not responded within 14 days,
the GRANTEE shall assume that the DEPARTMENT has no comment on the draft
submittals.
PRODUCTS: The GRANTEE shall at a minimum submit the following products to the
DEPARTMENT:
A. SURVEY FORMS and SURVEY REPORT: Reconnaissance Level HISTORIC
PRESERVATION INVENTORY (HPI) FORM for each property surveyed.
The SURVEY REPORT shall be provided as a PDF uploaded to WISAARD and
shall include a Cultural Resource Report Cover Sheet. Both the HPI FORMS and
SURVEY REPORT shall follow guidance laid out in Washington State Standards
Standards for for Cultural Resources Cultural Resources Reporting Reporting,
updated 4/19/2023 updated 4/19/2023.
B. Completion report/Reimbursement request
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 12 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 2
SCHEDULE OF PROJECT COMPLETION
Estimated
Estimated
WORK TO BE ACCOMPLISHED
Starting Date
Completion Date
Project work begins
2/1/25
Consultant/City hold first public meeting to
2/1/25
07/27/25
introduce grant project
First draft report and all draft HPISs
July 28, 2025
submitted to DAHP
DAHP reviews First Draft, returns to Staff
7/30/25
8/15/25
Incorporate DAHP comments into first draft
8/15/25
10/14/25
report
Second Draft submitted to DAHP
October 14, 2025
Consultant/City hold second public meeting to
10/15/25
11/15/24
resent survey results
Final Project Submittal to DAHP
December 1, 2025
Submit reimbursement request to
December 30, 2025
DAHP
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 13 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 3
BUDGET
Salaries
Federal
Hard Match*
Soft Match*
Total
(include each position- volunteer or
Dollars
(Local government
(Donated
staff - and attach hourly wage
(CLG grant
cash match = Staff
goods and
justification if needed)
requested)
Hours)
services =
volunteer
hours
GOODS & SERVICES
Other Services
Federal Dollars
Hard Match
Soft Match
Total
Consultant
$15,000
$15,000
Federal
Hard Match
Soft Match
Total
Dollars
Project
Cost
Totals
$15,000
$15,000
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 14 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 4
STATE FORM A-19 INVOICE VOUCHER
The form is on the following page.
State of Washington • Department of Archaeology & Historic Preservation
P.O. Box 48343 • Olympia, Washington 98504-8343 • (360) 586-3065
www.dahp.wa.gov
Grant No. FFY25-CLG-EDMONDS
Page 15 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
FORM STATE OF WASHINGTON
A 19-1A INVOICE VOUCHER
(Rev.5/91)
AGENCY USE ONLY
AGENCY NO. LOCATION CODE P.R. OR AUTH. NO.
AGENCY NAME
INSTRUCTIONS TO VENDOR OR CLAIMANT: Submit this form to claim
payment for materials, merchandise or services. Show complete detail for
each item.
Vendor's Certificate: I hereby certify under penalty of perjury that the items and
totals listed herein are proper charges for materials, merchandise or services
furnished to the State of Washington, and that all goods furnished and/or
services rendered have been provided without discrimination because of age,
sex, marital status, race, creed, color, national origin, handicap, religion, or
Vietnam era or disabled veterans status.
BY
(SIGN IN INK)
Department of Archaeology and Historic Preservation
PO Box 48380
Olympia WA 98504-8343
VENDOR OR CLAIMANT Warrant is to be payable to
FEDERAL I.D. NO. OR SOCIAL SECURITY NO. (For reporting Personal Services Contract Payments
(TITLE) (DATE)
to I.R.S. RECEIVED BY DATE RECEIVED
DATE
DESCRIPTION
QUANTITY
UNIT
AMOUNT
FOR AGENCY
USE
PREPARED BY
TELEPHONE NUMBER
DATE
AGENCY APPROVAL
DATE
DOC. DATE
PMT DUE DATE
CURRENT DOC. NO.
REF DOC. VENDOR
NUMBER
VENDOR MESSAGE
UBI NUMBER
REF
DOC
SUEINDEX
TRANS
CODE
M
0
FUND
MASTERINDEX
SUB
OBJ
SUB
SUB
ORG
INDEX
WORKCLASS
ALLOC
COUNTY
BUDGET
UNIT
CITY/TOWN
Mos
PROJECT
SUB
PROJ
PROJ
PHAS
AMOUNT
INVOICE NUMBER
APPN
PROGRAM
INDEX
ACCOUNTING APPROVAL FOR PAYMENT
DATE
WARRANT TOTAL
WARRANT NUMBER
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 5
U. S. DEPARTMENT OF THE INTERIOR
CIVIL RIGHTS ASSURANCE
As the authorized representative of the applicant, I certify that the applicant agrees that, as a condition to
receiving any Federal financial assistance from the Department of the Interior, it will comply with all
Federal laws relating to nondiscrimination. These laws include, but are not limited to: (a) Title VI of Civil
Rights Act of 1964 (42 U.S.C. 2000d-1), which prohibits discrimination on the basis of race, color, or
national origin; (b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794), which
prohibits discrimination on the basis of handicap; (c) the Age Discrimination Act of 1975, as amended (42
U.S.C. 6101 et. seq.), which prohibits discrimination on the basis of age; and applicable regulatory
requirements to the end that no person in the United States shall, on the grounds of race, color, national
origin, handicap or age, be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination under any program or activity conducted by the applicant. THE APPLICANT
HEREBY GIVES ASSURANCE THAT it will immediately take any measures necessary to effectuate this
agreement.
THIS ASSURANCE shall apply to all aspects of the applicant's operations including those parts that have
not received or benefited from Federal financial assistance.
If any real property or structure thereon is provided or improved with the aid of Federal financial
assistance extended to the Applicant by the Department, this assurance shall obligate the Applicant, or in
the case of any transfer of such property, any transferee, for the period during which the real property or
structure is sued for a purpose for which the Federal financial assistance is extended or for another
purpose involving the provision of similar services or benefits. If any personal property is so provided,
this assurance shall obligate the Applicant for the period during which it retains ownership or possession of
the property. In all other cases, this assurance shall obligate the Applicant for the period during which the
Federal financial assistance is extended to it by the Department.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining any and all Federal grants,
loans, contracts, property, discounts or other Federal financial assistance extended after the date hereof
to the Applicant by the Department, including installment payments after such date on account of
applicants for Federal financial assistance which were approved before such date.
The Applicant recognizes and agrees that such Federal financial assistance will be extended in reliance on
the representations and agreements made in this assurance, and that the United States shall have the
right to seek judicial enforcement of the assurance. This assurance is binding on the Applicant, its
successors, transferees, assignees, and subrecipients and the person whose signature appears below who
is authorized to sign this assurance on behalf of the Applicant.
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
TITLE
City of Edmonds
DATE SUBMITTED
City of Edmonds I Michael Rosen
APPLICANT/ORGANIZATION MAILING ADDRESS
BUREAU OR OFFICE EXTENDING ASSISTANCE
City of Edmonds
State of Washington
121 5th Ave N
Department of Archaeology and Historic Preservation
Edmonds, WA 98020
DI-1350
(REV 6/91)
Grant No. FFY25-CLG-EDMONDS
Page 17 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 6
STATEMENT OF UNDERSTANDING FOR GRANT MANAGEMENT REQUIREMENTS
• Subrecipient grantees receiving HPF grant assistance must fulfill the terms of their grant
agreement with the state and adhere to all requirements of the National Register Programs
Manual. This requirement includes compliance with Title VI of the Civil Rights Act of 1964, 78
Stat. 241, as amended, which provides that no person on the grounds of age, race, color,
or national origin shall be excluded from participation in, be denied the benefits of, or be
subject to discrimination under any activity receiving Federal financial assistance.
• Local financial management systems shall be in accordance with the standards
specified in Office of Management and Budget (OMB) Uniform Guidance, 2 CFR 200 -
Uniform Administrative Requirements, Cost Principles and Audit Requirements
for Federal Awards.
• Indirect costs may be charged as part of the subrecipient grant only if the subrecipient
grantee meets the requirements of the manual. Unless the CLG has a current indirect cost
rate approved by the cognizant federal agency, only direct costs may be charged.
• Grant subrecipients must maintain auditable financial records in accordance with the
General Accounting Office's Standards for Audit of Governmental Organizations,
Programs, Activities, and Functions.
• The subrecipient grantee will provide, with request for reimbursement, documentation to
support billings (time sheets, front and back canceled checks, etc.) for federal and non-
federal share claimed.
• Repayment will be made to the SHPO organization if terms and conditions of the subgrant
agreement are not followed or costs claimed are disallowed following audit.
City of Edmonds I Michael Rosen
SUBRECIPIENT GRANTEE
SIGNATURE OF APPLICANT
City Mayor
TITLE
DATE
Grant No. FFY25-CLG-EDMONDS
Page 18 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Attachment 7
U.S. Department of the Interior
Certification Regarding
Debarment, Suspension, Ineligibility
and Voluntary Exclusion
Lower Tier Covered Transactions
This certification is required by the regulations implementing Executive Order
12549, Debarment and Suspension, 43 CFR Part 12, Section 12.500, Participants'
responsibilities. The regulations were published as Part VII of the May 26, 1988
Federal Register (pages 19160-19211). Copies of the regulations are included in
the proposal package. For further assistance in obtaining a copy of the
regulations, contact the U.S. Department of the Interior, Acquisition and
Assistance Division, Office of Acquisition and Property Management, 18th and C
Streets, N.W., Washington, D.C. 20240.
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON NEXT PAGE)
(1) The prospective lower tier participant certifies, by submission of this
proposal that neither it nor its principals is presently debarred, suspended,
proposed for debarment, declared ineligible, or voluntarily excluded from
participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the
statements in this certification, such prospective participant shall attach an
explanation to this proposal.
Michael Rosen I City Mayor
Name and Title of Authorized Representative
Signature
Date
Grant No. FFY25-CLG-EDMONDS
Page 19 of 20
Docusign Envelope ID: FOA1938C-A701-4046-98BO-CC5DB50465B6
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective
lower tier participant knowingly rendered and erroneous certification, in addition to other
remedies available to the Federal Government, the department or agency with which this
transaction originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant shall provide immediate written notice to the person to
which this proposal is submitted if at any time the prospective lower tier participant learns that
its certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person
to which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter into any lower tier
covered transaction with a person who is debarred, suspended, declared ineligible, or
voluntarily excluded from participation in this covered transaction, unless authorized by the
department or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion -Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant
in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily
excluded from the covered transaction, unless it knows that the certification is erroneous. A
participant may decide the method and frequency by which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List (Tel.#).
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized under paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension and/or
debarment.
Grant No. FFY25-CLG-EDMONDS
Page 20 of 20