(INSTRUCTIONS to KHOC staff: This document is regularly updated and this website is the depository of the most recent version of the Program Agreement. Please print and sign this version. Participant is to initial and date the bottom left corner of each page and paragraph #18, and full signature at bottom. Agreement last updated 6/15/19)
Room Size/Type: Program Fee $ __ /mo Sec. Dep.: $ _
Address of Program House ________________________________________
- I acknowledge that I am voluntarily choosing to become a participant with the Kitsap Homes of Compassion (KHOC) “Affordable Home Program” in order to live in a shared house.
- I understand that Kitsap Homes of Compassion (KHOC) is a Washington State, legally registered, 501c3 non-profit organization, with the purpose of providing housing to minimize homelessness. All funds and fees collected are used for this purpose.
- KHOC will provide clean and adequate living facilities, either in a private room or a shared room. I understand that the Program Fee will vary depending upon the type of room I choose, and a sliding fee schedule will apply, based on my monthly income.
- I understand KHOC may provide opportunities, on a voluntary basis, to gain training in personal financial management to help me gain better control over my finances.
- I understand KHOC will not provide any meals, and I will be responsible to purchase my own food and prepare my own meals, or make my own arrangements with others living in the home.
- I understand KHOC is not responsible for medical, dental or other bills that the I may accumulate while living in the home.
- Program Fees: I agree to participate in the program on a monthly basis and to pay in advance of each month, paying by the ____ of each month (enter day number, two days after Soc.Sec. is received). I understand that if I am more than 5 days late in paying my monthly program fee, I will be charged a late fee of $30. If I am more than 20 days late, I will be dismissed from the program and will be required to leave the premises, with all my belongings, within 48 hours. In this situation, a 48hr written notice will be posted at the premises or given to me. If I refuse to leave, I understand I will be trespassing on private property, and may be escorted out by law enforcement. IF YOUR MONTHLY FEE IS EVER MORE THAN 10 DAYS LATE, THEN ALL FUTURE MONTHLY PAYMENTS MUST BE DONE THROUGH A LEGAL PAYEE. This person will directly receive your benefit payments (SSI, SSDI, Soc. Sec.) and they will pay KHOC directly on your behalf.
- Payment of fees: Program fees can be paid by mail or in person, in cash, cashier’s check, or money order. If paid by mail, it should be sent to, “Kitsap Homes of Compassion”, 7721 Beacon Place NE, #101, Bremerton, WA 98311. Personal checks will only be accepted with prior written approval and verification of funds in the bank. Do not mail cash.
- Fee changes: While it is KHOC’s desire to keep the fee as low as possible, the monthly program fee may increase, depending upon KHOC’s cost of leasing the house or changes in utility costs. A 30 day notice will be given before any change to the monthly program fee.
- Program Security Deposit: I agree to pay a refundable Security Deposit before participating in this program. The Security Deposit is intended to pay the cost of damages, cleaning, excessive wear and tear, and unreturned keys once you have exited the program. This deposit will be returned to me within 14 days after I leave the program if there are none of these costs. If I leave and do not give the required 20 days notice, I will forfeit my security deposit for inadequate notice. Under special circumstances, the Security Deposit might be divided into two payments. IF THE SECURITY DEPOSIT WAS PAID BY A GRANT, AND IF YOU MOVE OUT OF THE FACILITY IN LESS THAN 6 MONTHS, THE SECURITY DEPOSIT WILL BE RETURNED TO THE GRANTING AGENCY, NOT TO YOU.
- Abandoned Property: The participant is to remove all personal property after leaving the program. (Not paying the monthly program fee and not living in the house is considered abandonment). I understand that if any personal property is left behind after leaving the program, it will be stored for only 7 (seven) days, after which time it will be sold or disposed of.
- Condition of Program House & Room: I agree to inspect the house and room and complete the “General Condition of Program House & Room Checklist” the day I move into the house. Included in this inspection are the interior and exterior, as well as any equipment and appliances. If any damage is found, I shall be reported on the “Checklist” upon check in. I agree to return the program house to Kitsap Homes of Compassion at the end of my participation in the program in the same condition it was at the beginning.
- Prohibition of Violating Laws and Causing Disturbances: Program participants are entitled to quiet enjoyment of the program premises. Participants, and their day-time guests or invitees will not use the premises or adjacent areas to:
- Violate any law or ordinance, including laws prohibiting the use, possession, or sale of illegal drugs; Residents agree to allow random urine analysis drug screening. Refusal to do a drug test will be grounds for dismissal.
- Commit waste (severe property damage);
- Create a nuisance by annoying, disturbing, or interfering with the quiet enjoyment of any other program participant living in the house OR nearby resident.
- Each participant should be courteous to the other participants or roommate living in the house. This includes using head phones when listening to music or TV if other(s) in the room/house will be disturbed by the noise.
- I understand it is prohibited to download any illegal movies from the internet or Cable TV provider, or movies that are copy protected. It is prohibited to use any ‘pay by movie’ services from the TV cable provider.
- Utilities: I understand that my monthly program fee will include the use of the common areas of the house, including the washer/dryer. The fee will include all utilities (water, sewer, trash, electricity, gas [if available], and internet. I will do my best to not waste electricity or gas by keeping the thermostat at 70°F or lower. If rooms are individually controlled, I will turn off heaters in rooms not being used. I understand that excessive use of utilities may cause an increase in the monthly program fee.
- Pets: No pets will be kept on the Program Premises.
- Maintenance and Repairs: The program participants are responsible for routine maintenance and minor repairs needed in or about the program house.
- Program participants are not to make alterations to the premises, including painting of walls, without the written permission of the Program Director.
- Program participants, cannot without the prior written consent of the Program Director, alter, rekey, or install any additional locks or burglar alarm systems to the premises.
- Smoking: All KHOC facilities are ‘smoke free’ homes. Smoking is only allowed outside, away from house doors and windows. Cigarette butts must be disposed of in fire safe containers. Doors must be kept closed while smoking outside.
- Non-rental agreement: I understand that this is a “Program” and not a “Lease”, and I am a “Participant” and not a “Tenant” as defined by RCW 59.18.030. This agreement is not a lease or rental agreement, but rather a Program Agreement (under the living arrangement exemptions as defined in RCW 59.18.040(1)), and is governed exclusively by the provisions in the agreement.
- I will not sublet any part of the premises to anyone. Any person wishing to reside in the home must first individually apply to the KHOC Home Program and be individually approved to participate in the program.
- The above section was read to me out-loud to me and by initialing below I understand this Program Agreement is NOT a lease agreement or rental agreement, I will not be considered a “tenant”, and I will not have the rights under the WA State’s “RESIDENTIAL LANDLORD-TENANT ACT” while staying as a participant, living in this shared living house. This means, in the case of dismissal from the program, there will be no eviction legal proceedings since I will not be considered a tenant. INITIALS ______
- Right to Access: The home is a shared dwelling with common areas. The KHOC Program Director or his assigned representative may enter the home and have access to the common areas of the house to make repairs or improvements, to show the premises to prospective future Participants, or to check for safety or maintenance problems and ensure the property is being maintained in accordance with this agreement.
- This entry into the common areas of the home may occur at any time between 8am and 8pm without any prior notice necessary.
- BEDROOMS: Except in cases of emergency, participant’s abandonment of the room, or court order; any necessary entry into the bedrooms of the house will require 24 hours advance notice to the participant to respect the privacy of the participants.
- Leaving the program: I understand I can leave the Affordable Home Program at any time, by giving 20 days notice. Leaving without giving this notice will result in the forfeit of my security deposit. Being expelled from the program for program/rule violations that cause leaving the program with less than 20 days notice will also result in forfeit the security deposit.
- No overnight guests: Only person(s) who are participants in the Affordable Home Program are allowed to live in the shared house. No overnight guests are allowed without the prior written permission of the Program Director. Violation of this rule will be grounds for dismissal and may require leaving the premises within 48 hours.
- Changes in rules: I agree to adhere to all reasonable rules and regulations that the Program Director deems necessary and may put into effect subsequent to my entry into the program. If I do not agree with the change, I am free to leave the program.
- Indemnification: I agree to hold harmless all KHOC Staff and Volunteers from liabilities for any loss of or damage to my property or injury to my person occurring during my voluntary participation in this housing program. This release of liability shall include any such damage to person or property that may be caused by me, other participants of the program, or trespassers on any property or facility operated by KHOC.
- House Rules: I agree to abide by the House Rules, a copy of which I have read and signed. I understand that they may be updated in the future, and I will receive a copy of the updated rules and the most recent version of the House Rules are posted on the KHOC website. If I do not agree to the revised rules, I understand that I am always free to leave the program at any time.
- Fines: I understand that the consequence of violating this Program Agreement or House Rules may be expulsion from the program and the home. For lessor offences, I understand I may be fined $50 (fifty dollars), to be added to my next monthly program fee bill. I understand that I will be given written notice of violation and put on probation before being fined or expelled from the program. Failure to pay any outstanding fine would be grounds for immediate termination from the program.
- Appeals and Grievance Policy: I am aware that KHOC has an Appeals and Grievance Policy and the process for making a complaint is available on its website. KHOC ensures that no participant faces any retribution or is denied services after utilizing this grievance process.
- Validity of Each Part: If any portion of this Program Agreement is held to be invalid, its invalidity will not affect the validity or enforceability of any other provision of this Agreement.
Participant Signature___________________________ Date______________________
Print Participant Name:_________________________
Program Director Signature________________________________ Date___________________
Print Name of Program Director _____________________
Name, Address and Phone of Emergency Contact___________________________________________