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HomeMy WebLinkAbout2014-160 DSS - IFC for Emergency Shelter Services $59,615 Contract#68-5000 Inter-Faith Council for Social Service,Inc. psS Contract#68-5000_ Contract Period Begins: January 1,2014 Ends: September 30, 2014 This contract is hereby entered into by and between the Orange County Department of Social Services (the "County") and Inter-Faith Council for Social Service, Inc. (the "Contractor") (referred to collectively as the "Parties"). The Contractor's federal tax identification number or Social Security Number is 1. Contract Documents: This Contract consists of the following documents (1) This contract (2) The General Terms and Conditions (Attachment A) (3) The Scope of Work, description of services, and rate(Attachment B) (4) Federal Certification Regarding Drug-Free Workplace(Attachment C) (5) Conflict of Interest(Attachment D) (6) No Overdue Taxes (Attachment E) (7) Federal Certification Regarding Lobbying(Attachment G) (8) Federal Certification Regarding Debarment(Attachment H) (9) IRS federal tax exempt letter or 501(c)(3) (Attachment K) (10) Budget(Attachment M) (11) Outcomes and Reporting(Attachment N) These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence Among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents,the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Paragraph 1, above, with the first-listed document having the highest precedence and the last-listed document having the lowest precedence. If there are multiple Contract Amendments,the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective on January 1, 2014 and shall terminate on September 30, 2014. 4. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B,Scope of Work and Attachment M,Budget,and shall meet the requirements set forth in Attachment N, Outcomes and Reporting. 5. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid by the County to the Contractor under this contract shall not exceed $59,615. This amount consists of$59,615 in Federal (CFDA # ), State and County funds, $0 (source of other funds if applicable). [ ] a. There are no matching requirements from the Contractor. [X] b. The Contractor's matching requirement is $116,011,which shall consist of: [ ] In-kind [ ] Cash [ ] Cash and In-kind [X] Cash and/or In-kind The contributions from the Contractor shall be sourced from non-federal funds. The total contract amount including any Contractor match shall not exceed$175,626. Contract-General (06/04) Page 1 of 3 Contract#68-5000 Inter-Faith Council for Social Service,Inc. 6. Reporting Requirements: Contractor shall comply with audit requirements as described in N.C.G.S. § 143-6.2 and OMB Circular A-133. 7. Payment Provisions: Payment shall be made in accordance with the Contract Documents as described in the Scope of Work, Attachment B. 8. Contract Administrators: All notices permitted or required to be given by one Party to the other and all questions about the contract from one Party to the other shall be addressed and delivered to the other Parry's Contract Administrator. The name, post office address, street address,telephone number, fax number, and email address of the Parties' respective initial Contract Administrators are set out below. Either Party may change the name, post office address, street address, telephone number, fax number, or email address of its Contract Administrator by giving timely written notice to the other Party. For the County: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Sharron Hinton,Human Services Manager Sharron Hinton,Human Services Manager Orange County Department of Social Services Orange County Department of Social Services P.O. Box 8181 113 Mayo Street Hillsborough,NC 27278 Hillsborough,NC 27278 (919)245-2840 shinton@orangecountyng.gov For the Contractor: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS John Dorward,Executive Director John Dorward, Executive Director Inter-Faith Council for Social Service, Inc. Inter-Faith Council for Social Service, Inc. 110 W. Main Street 110 W. Main Street Carrboro,NC 27510 Carrboro,NC 27510 (919) 929-6380 ext. 14 'dorward ifcmailbox.or Contract-General (06/04) Page 2 of 3 Contract#68-5000 Inter-Faith Council for Social Service,Inc. 9. Signature Warranty: The undersigned represent and warrant that they are authorized to bind their principals to the terms of this agreement. The Contractor and the County have executed this contract in duplicate originals,with one original being retained by each party. INTER-7T LC:r FO R SOCIAL SERVICE,INC. Signature ate V'4 "o, �b� d �1Ue_e4 Printed Name Title ORANGE C TY Signatu,A, Count ager Date Printed Name title Signature Ediector, Orange County Department of Social Services Date Printed Name/ Title This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. 9 Mwlt_ Signature of County Finance Officer Date This c trac een approved as to form and legal sufficiency. _ '' l + Sign ture of unty Attorney Date Contract-General (06/04) Page 3 of 3 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT A GENERAL TERMS AND CONDITIONS Orange County Department of Social Services Relationships of the Parties respective successors. It is expressly understood and agreed that the enforcement of the terms and Independent Contractor: The Contractor is and conditions of this contract, and all rights of action shall be deemed to be an independent contractor in the relating to such enforcement,shall be strictly reserved performance of this contract and as such shall be to the County and the named Contractor. Nothing wholly responsible for the work to be performed and contained in this document shall give or allow any for the supervision of its employees. The Contractor claim or right of action whatsoever by any other third represents that it has, or shall secure at its own person. It is the express intention of the County and expense, all personnel required in performing the Contractor that any such person or entity, other than services under this agreement. Such employees shall the County or the Contractor, receiving services or not be employees of, or have any individual benefits under this contract shall be deemed an contractual relationship with the County. incidental beneficiary only. Subcontracting: The Contractor shall not subcontract any of the work contemplated under this Indemnity and Insurance contract without prior written approval from the County. Any approved subcontract shall be subject to Indemnification: The Contractor agrees to all conditions of this contract.Only the subcontractors indemnify and hold harmless the County and any of specified in the contract documents are to be their officers,agents and employees,from any claims considered approved upon award of the contract. The of third parties arising out or any act or omission of County shall not be obligated to pay for any work the Contractor in connection with the performance of performed by any unapproved subcontractor. The this contract. Contractor shall be responsible for the performance of all of its subcontractors. Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide Assignment: No assignment of the Contractor's commercial insurance of such type and with such obligations or the Contractor's right to receive terms and limits as may be reasonably associated with payment hereunder shall be permitted.However,upon the contract. As a minimum, the Contractor shall written request approved by the issuing purchasing provide and maintain the following coverage and authority,the County may: limits: (a) Forward the Contractor's payment check(s) (a) Worker's Compensation - The contractor directly to any person or entity designated by shall provide and maintain Worker's the Contractor, or Compensation Insurance as required by the (b) Include any person or entity designated by laws of North Carolina,as well as employer's Contractor as a joint payee on the Contractor's liability coverage with minimum limits of payment check(s). $500,000.00, covering all of Contractor's In no event shall such approval and action obligate the employees who are engaged in any work County to anyone other than the Contractor and the under the contract. If any work is sublet, the Contractor shall remain responsible for fulfillment of Contractor shall require the subcontractor to all contract obligations. provide the same coverage for any of his employees engaged in any work under the Beneficiaries: Except as herein specifically provided contract. otherwise, this contract shall inure to the benefit of (b) Commercial General Liability - General and be binding upon the parties hereto and their Liability Coverage on a Comprehensive Broad General Terms and Conditions—(06/04) Pagel of 5 Contract#68-5000 Inter-Faith Council for Social Service,Inc. Form on an occurrence basis in the minimum contract in a timely and proper manner, the County amount of $1,000,000.00 Combined Single shall have the right to terminate this contract by Limit. (Defense cost shall be in excess of the giving written notice to the Contractor and specifying limit of liability.) the effective date thereof. In that event,all finished or (c) Automobile-Automobile Liability Insurance, unfinished deliverable items prepared by the to include liability coverage, covering all Contractor under this contract shall, at the option of owned,hired and non-owned vehicles used in the County, become its property and the Contractor performance of the contract. The minimum shall be entitled to receive just and equitable combined single limit shall be $500,000.00 compensation for any satisfactory work completed on bodily injury and property damage; such materials,minus any payment or compensation $500,000.00 uninsured/under insured previously made. Notwithstanding the foregoing motorist; and$25,000.00 medical payment. provision, the Contractor shall not be relieved of Providing and maintaining adequate insurance liability to the County for damages sustained by the coverage is a material obligation of the Contractor County by virtue of the Contractor's breach of this and is of the essence of this contract. The Contractor agreement, and the County may withhold any may meet its requirements of maintaining specified payment due the Contractor for the purpose of setoff coverage and limits by demonstrating to the County until such time as the exact amount of damages due that there is in force insurance with equivalent the County from such breach can be determined. In coverage and limits that will offer at least the same case of default by the Contractor,without limiting any protection to the County. All such insurance shall other remedies for breach available to it,the County meet all laws of the State of North Carolina. Such may procure the contract services from other sources insurance coverage shall be obtained from companies and hold the Contractor responsible for any excess that are authorized to provide such coverage and that cost occasioned thereby. The filing of a petition for are authorized by the Commissioner of Insurance to bankruptcy by the Contractor shall be an act of default do business in North Carolina. The Contractor shall under this contract. at all times comply with the terms of such insurance policies,and all requirements of the insurer under any Waiver of Default: Waiver by the County of any such insurance policies, except as they may conflict default or breach in compliance with the terms of this with existing North Carolina laws or this contract. contract by the Provider shall not be deemed a waiver The limits of coverage under each insurance policy of any subsequent default or breach and shall not be maintained by the Contractor shall not be interpreted construed to be modification of the terms of this as limiting the contractor's liability and obligations contract unless stated to be such in writing,signed by under the contract. an authorized representative of the County and the Contractor and attached to the contract. Default and Termination Availability of Funds: The parties to this contract Termination Without Cause: The County may agree and understand that the payment of the sums terminate this contract without cause by giving 10 specified in this contract is dependent and contingent days written notice to the Contractor. In that event, upon and subject to the appropriation,allocation,and all finished or unfinished deliverable items prepared availability of funds for this purpose to the County. by the Contractor under this contract shall, at the option of the County, become its property and the Force Majeure:Neither parry shall be deemed to be Contractor shall be entitled to receive just and in default of its obligations hereunder if and so long equitable compensation for any satisfactory work as it is prevented from performing such obligations by completed on such materials, minus any payment or any act of war, hostile foreign action, nuclear compensation previously made. explosion,riot,strikes,civil insurrection,earthquake, hurricane,tornado,or other catastrophic natural event Termination for Cause: If, through any cause, the or act of God. Contractor shall fail to fulfill its obligations under this General Terms and Conditions—(06/04) Page 2 of 5 Contract#68-5000 Inter-Faith Council for Social Service,Inc. Survival of Promises: All promises, requirements, Confidentiality: Any information,data,instruments, terms, conditions, provisions, representations, documents, studies or reports given to or prepared or guarantees, and warranties contained herein shall assembled by the Contractor under this agreement survive the contract expiration or termination date shall be kept as confidential and not divulged or made unless specifically provided otherwise herein, or available to any individual or organization without the unless superseded by applicable Federal or State prior written approval of the County. The Contractor statutes of limitation. acknowledges that in receiving,storing,processing or otherwise dealing with any confidential information it Intellectual Property Rights will safeguard and not further disclose the information except as otherwise provided in this contract. Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract Oversight are the exclusive property of the County. The Contractor shall not assert a claim of copyright or Access to Persons and Records: The State Auditor other property interest in such deliverables. shall have access to persons and records as a result of all contracts or grants entered into by State agencies Federal Intellectual Property Bankruptcy or political subdivisions in accordance with General Protection Act: The Parties agree that the County Statute 147-64.7. Additionally, as the State funding shall be entitled to all rights and benefits of the authority, the Department of Health and Human Federal Intellectual Property Bankruptcy Protection Services shall have access to persons and records as a Act,Public Law 100-506, codified at 11 U.S.C. 365 result of all contracts or grants entered into by State (n) and any amendments thereto. agencies or political subdivisions. Compliance with Applicable Laws Record Retention: Records shall not be destroyed, purged or disposed of without the express written Compliance with Laws: The Contractor shall consent of the County.The Department of Health and comply with all laws, ordinances, codes, rules, Human Services' basic records retention policy regulations, and licensing requirements that are requires all records to be retained for a minimum of applicable to the conduct of its business, including three years following completion or termination of the those of federal, state, and local agencies having contract. If the contract is subject to Federal policy jurisdiction and/or authority. and regulations, record retention will normally be longer than three years since records must be retained Equal Employment Opportunity: The Contractor for a period of three years following submission of the shall comply with all federal and State laws relating to final Federal Financial Status Report,if applicable,or equal employment opportunity. three years following the submission of a revised final Federal Financial Status Report. Also, if any Health Insurance Portability and Accountability litigation, claim, negotiation, audit, disallowance Act(HIPAA): The Contractor agrees that, if the action,or other action involving this contract has been County determines that some or all of the activities started before expiration of the three year retention within the scope of this contract are subject to the period described above,the records must be retained Health Insurance Portability and Accountability Act until completion of the action and resolution of all of 1996,P.L. 104-91, as amended("HIPAA"), or its issues which arise from it, or until the end of the implementing regulations, it will comply with the regular three year period described above,whichever HIPAA requirements and will execute such is later. agreements and practices as the County may require to ensure compliance. Warranties and Certifications Confidentiality Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant General Terms and Conditions—(06/04) Page 3 of 5 Contract#68-5000 Inter-Faith Council for Social Service,Inc. to this contract ("product" includes, without Severability: In the event that a court of competent limitation, any piece of equipment, hardware, jurisdiction holds that a provision or requirement of firmware, middleware, custom or commercial this contract violates any applicable law, each such software, or internal components, subroutines, and provision or requirement shall continue to be enforced interfaces therein)that perform any date and/or time to the extent it is not in violation of law or is not data recognition function, calculation,or sequencing otherwise unenforceable and all other provisions and will support a four digit year format and will provide requirements of this contract shall remain in full force accurate date/time data and leap year calculations. and effect. This warranty shall survive the termination or expiration of this contract. Headings: The Section and Paragraph headings in these General Terms and Conditions are not material Certification Regarding Collection of Taxes: G.S. parts of the agreement and should not be used to 143-59.1 bars the Secretary of Administration from construe the meaning thereof. entering into contracts with vendors that meet one of the conditions of G.S. 105-164.8(b)and yet refuse to Time of the Essence: Time is of the essence in the collect use taxes on sales of tangible personal performance of this contract. property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail Key Personnel: The Contractor shall not replace any establishment or office; (b) presence of of the key personnel assigned to the performance of representatives in the State that solicit sales or this contract without the prior written approval of the transact business on behalf of the vendor; and (c) County. The term"key personnel"includes any and systematic exploitation of the market by media- all persons identified as such in the contract assisted,media-facilitated,or media-solicited means. documents and any other persons subsequently The Contractor certifies that it and all of its affiliates identified as key personnel by the written agreement (if any) collect all required taxes. of the parties. Miscellaneous Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any Choice of Law: The validity of this contract and any property furnished to it for use in connection with the of its terms or provisions, as well as the rights and performance of this contract and will reimburse the duties of the parties to this contract, are governed by County for loss of, or damage to, such property. At the laws of North Carolina. The Contractor, by the termination of this contract, the Contractor shall signing this contract, agrees and submits, solely for contact the County for instructions as to the matters concerning this Contract, to the exclusive disposition of such property and shall comply with jurisdiction of the courts of North Carolina and these instructions. agrees, solely for such purpose, that the exclusive venue for any legal proceedings shall be Orange Travel Expenses: Reimbursement to the Contractor County, North Carolina. The place of this contract for travel mileage, meals, lodging and other travel and all transactions and agreements relating to it,and expenses incurred in the performance of this contract their situs and forum, shall be Orange County,North shall not exceed the rates established in County Carolina, where all matters, whether sounding in policy. contract or tort, relating to the validity, construction, interpretation, and enforcement shall be determined. Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Amendment: This contract may not be amended Carolina Department of Revenue for a refund of all orally or by performance. Any amendment must be sales and use taxes paid by them in the performance made in written form and executed by duly authorized of this contract,pursuant to G.S. 105-164.14;and(b) representatives of the County and the Contractor. exclude all refundable sales and use taxes from all General Terms and Conditions—(06/04) Page 4 of 5 Contract#68-5000 Inter-Faith Council for Social Service,Inc. reportable expenditures before the expenses are wage and encourages agencies to which it provides entered in their reimbursement reports. funding to pursue the same goal. The County's living wage hourly standard, as adopted by the Orange Advertising: The Contractor shall not use the award County Board of County Commissioners annually, of this contract as a part of any news release or can be found in the Orange County Budget commercial advertising. Ordinance. To the extent possible, Orange County recommends that the Contractor and all Orange County Living Wage: Orange County is subcontractors provide a living wage, as defined in committed to providing its employees with a living this section,to their employees. General Terms and Conditions—(06/04) Page 5 of 5 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT B SCOPE OF WORK Orange County Department of Social Services Federal Tax Id. or SSN Contract#68-5000 A. CONTRACTOR INFORMATION 1. Contractor Agency Name:Inter-Faith Council for Social Service, Inc. 2. If different from Contract Administrator Information in General Contract: Address Telephone Number: 919-929-6380 Fax Number: 919-929-3353 Email:jdorwardgifcmailbox.org 3. Name of Program(s): Emergency Solutions Grant 4. Status: ( )Public (X)Private,Not for Profit ( )Private,For Profit 5. Contractor's Financial Reporting Year: January 1, 2014 through September 30,2014 B. Explanation of Services to be provided and to whom(include SIS Service Code): The Contractor will rovide approved Emergency Shelter services as provided in the Emergency Solutions Grant Contract(#00029953) Attachment B which is hereby incorporated by reference. The Contractor is also required to meet all requirements listed in Attachment N. C. Rate per unit of Service(define the unit): 1. If Standard Fixed Rate,Maximum Allowable, (See Rates for Services Chart) 2.Negotiated County Rate. $59,615 allocated as provided in Attachment M and reimbursed as provided in Attachment N, Section IV. D.Number of units to be provided: E. Details of Billing process and Time Frames; The County will reimburse the Contractor for services described in this contract up to the budgetary limits of the contract allotment. See Attachment N for reimbursement guidelines and timeframes. F. Area to se eliv s' ): an e Coun (Si ature o my thor' ed erson) Agnatu re of Contractor) (Date Su miffed (Date bmitted) Contract-Scope of Work(06/04) Page Iof 1 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT C CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS Orange County Department of Social Services I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by: A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing,possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; B. Establishing a drug-free awareness program to inform employees about: (1)The dangers of drug abuse in the workplace; (2)The Contractor's policy of maintaining a drug-free workplace; (3)Any available drug counseling,rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph(A); D. Notifying the employee in the statement required by paragraph(A)that, as a condition of employment under the agreement,the employee will: (1)Abide by the terms of the statement; and (2)Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; E. Notifying the County within ten days after receiving notice under subparagraph(D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under subparagraph(D)(2),with respect to any employee who is so convicted: (1)Taking appropriate personnel action against such an employee,up to and including termination; or (2)Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State,or local health, law enforcement, or other appropriate agency; and Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (A), (B), (C), (D), (E), and(F). Federal Certification-Drug-Free Workplace(06/04) Page 1 of 2 Contract#68-5000 Inter-Faith Council for Social Service,Inc. II. The site(s)for the performance of work done in connection with the specific agreement are listed below: 1.100 W Rosemary_Street (Street address) Chapel Hill NC 27514 (City, county, state, zip code) 2. 110 W. Main Street (Street address) Carrboro NC 27510 (City, county, state, zip code) 3. 2505 Homestead Road (Street address) Chapel Hill NC 27514 (City, county, state, zip code) Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment, suspension or termination of grants, or government-wide Federal suspension or debarment (Section 4 CFR Part 85, Section 85.615 and 86.620). Sign e Title - Agency/Organization Date (Certification signature should be same as Contract signature.) Federal Certification-Drug-Free Workplace(06/04) Page 2 of 2 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT D CONFLICT OF INTEREST POLICY Orange County Department of Social Services Conflict of Interest Defined: A conflict of interest is defined as an actual or perceived interest by a(Contractor/staff member/Board member) in an action that results in,or has the appearance of resulting in, personal, organizational, or professional gain. A conflict of interest occurs when an employee/Contractor/Board member has a direct or fiduciary interest in another relationship. A conflict of interest could include: ➢ Ownership with a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Employment of or by a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Contractual relationship with a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Creditor or debtor to a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Consultative or consumer relationship with a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. The definition of conflict of interest includes any bias or the appearance of bias in a decision-making process that would reflect a dual role played by a member of the organization or group. An example,for instance, might involve a person who is an employee and a Board member, or a person who is an employee and who hires family members as consultants. Employee/Contractor/Board Member Responsibilities: It is in the interest of the organization, individual staff, and Board members to strengthen trust and confidence in each other,to expedite resolution of problems,to mitigate the effect and to minimize organizational and individual stress that can be caused by a conflict of interest. Employees are to avoid any conflict of interest, even the appearance of a conflict of interest. This organization serves the community as a whole rather than only serving a special interest group. The appearance of a conflict of interest can cause embarrassment to the organization and jeopardize the credibility of the organization. Any conflict of interest,potential conflict of interest, or the appearance of a conflict of interest is to be reported to your supervisor immediately. Employees are to maintain independence and objectivity with clients,the community, and organization. Employees are called to Conflict of Interest Policy(06/04) Page 1 of 3 Contract#68-5000 Inter-Faith Council for Social Service,Inc. maintain a sense of fairness, civility, ethics and personal integrity even though law, regulation, or custom does not require them. Acceptance of Gifts: Employees, members of employee's immediate family, and members of the Board are prohibited from accepting gifts,money or gratuities from the following: a. Persons receiving benefits or services from the organization; b. Any person or organization performing or seeking to perform services under contract with the organization; and c. Persons who are otherwise in a position to benefit from the actions of any employee of the organization. Employees may,with the prior written approval of their supervisor,receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. If the employee is acting in any official capacity,honoraria received by an employee in connection with activities relating to employment with the organization are to be paid to the organization. NOTARIZED CONFLICT OF INTEREST POLICY State of North Carolina County of Orange I, G l 1 y l j&-k A . G �T h Q- I ,Notary Public for said County and State11, certify that �01�, W . ID 0 r W a r personally appeared before me this day and acknowledged that he/she is G x e.G V-I 1 V e- D i r e-c7b r of and by that authority duly given and as the act of the corporation, affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors in a meeting held on the ` $ ' day of �v USA" , 1 °1 °1 °1 . Conflict of Interest Policy(06/04) Page 2 of 3 Contract#68-5000 Inter-Faith Council for Social Service,Inc. •� �`Sworn� to and subscribed before me this day of /Y 1 CA r C, , ru1T• ELIZAiBUH A. GARFUNKEL _ Notary Public„ North Carolina Orange County q. My Commission Expires (Offl ial Seal) June t 1 , 2014 Notary Public My Commission expires TV n e- ,2014/ Attached is t®e Confli f Interest Policy for Inter-Faith Council for Social Service, Inc. Signature of Corporation Official Conflict of Interest Policy(06/04) Page 3 of 3 THE INTER-FAITH COUNCIL FOR SOCIAL SERVICE (IFC)PERSONNEL POLICIES 2.3 Conflicts of Interest and Outside Work The policy applies to all persons working,paid or unpaid,on behalf of the IFC,whether they are employees or volunteers(for the purpose of this document, all paid and unpaid persons working on behalf of the IFC shall be referred to as"staff'). During their involvement with the IFC, staff shall abide by the following Conflict of Interest/Ethical Standards Policy: If the IFC has a contract,agreement or transaction with a third party, or if the IFC is contemplating entering into any contract,agreement or transaction with a third party, staff shall fully disclose in writing to the Executive Director any financial interest or relationship that staff has with the third parry. The President or Executive Director shall disclose this information to the Board of Directors, which may approve the contract,agreement or transaction in question by a majority vote. If a board member or the Executive Director is the interested staff member,that person may not participate in the vote. Staff shall not act as representatives of the IFC or claim to act on behalf of the IFC to bolster, legitimize or benefit any other organization or individual, unless authorized by the Executive Director to do so. Staff shall not seek to personally employ, or provide services to,beyond those provided in the regular course of their work with the IFC, any individual who has received or is receiving services from the IFC without the approval of the Executive Director. The Executive Director shall keep a written record of such approvals and inform the Board of Directors of them. Staff shall maintain professional,ethical standards of conduct. Staff shall not engage in personal relationships of any nature with clients, guests or residents of the IFC, or with any person who has received or is receiving services from the IFC. This includes, but is not limited to the following examples,and any other type of relationship that extends beyond the professional boundaries of the normal IFC/client relationship: • Living or residential arrangements, for any length of time, including room mate or landlord/tenant relationships,temporary housing, or any official or unofficial living arrangement. • Personal,intimate,friendship and/or sexual relationships • Financial relationships where money is given, accepted,lent(loaned), borrowed or in any way exchanged between the staff and the recipient of IFC services, or in which items are bought and/or sold between an IFC staff member and a client, guest or resident of the IFC • Employment,including recruiting, hiring,employing or in any way paying for services provided, for any length of time • Individual requests, including, but not limited to, doing favors,running errands,picking up or dropping off family members, friends or relatives, or any other type of personal requests • Sponsorship in Alcoholics Anonymous or Narcotics Anonymous: no staff member may sponsor a client, guest or resident of the IFC for participation in either of these, or any other, addiction-assistance groups. Staff should become knowledgeable about community substance abuse services and refer any client,guest or resident for services when asked. The restrictions listed in the bullets above apply to any guests,clients,residents, etc. of the IFC who have received services from the IFC,have lived in facilities of the IFC,have been a guest of the IFC, Adopted August 18, 1999 -Revised November 2010 Page 1 THE INTER-FAITH COUNCIL FOR SOCIAL SERVICE (IFC)PERSONNEL POLICIES or in any way have been a recipient of any services provided by the IFC,during the previous three (3)years. If a staff member has an existing relationship with a guest,resident or client which began prior to the staff's or client's involvement with the IFC (e.g. kin relationship, friendship, etc.),the staff member must disclose this involvement to the Executive Director. If any staff member is unsure about whether or not a particular situation is a conflict of interest, the staff member should provide written notice about the situation to the Executive Director. Failure to adhere to this policy constitutes cause for termination of employment. a. Outside work. (i) Compensated Activities Employees who hold other jobs in addition to their job here must inform their supervisor of their outside employment. Job performance must not be affected due to outside employment responsibilities or schedules. Additionally, employees are cautioned against engaging in outside employment that may run counter to the philosophy and mission of, or create direct competition for,this organization. Employees who are asked to consult by other outside entities may do so only with the written permission of the Executive Director, under the auspices of IFC, and via a contract for services between IFC and the outside entity. Any fees received for such consulting are the property of IFC. (ii) Volunteer/Uncompensated Activities includingLcivic/electoral involvement. The IFC encourages its employees to volunteer their non-employment time and efforts to civic, charitable, and political causes of their choices. However, as a charitable 501(c) (3) organization, the IFC neither supports nor opposes any candidate for public office and is limited as to lobbying activities. Accordingly, (a) No IFC facilities or resources, including an employee's work time and the IFC's office equipment and telephones, may be used for any electoral activities; (b) Any outside activities by an employee that may involve public identification with any candidate for public office, or any cause or activity related or pertinent to the IFC's work, policies, or public image, shall be disclosed in advance to the Executive Director in writing; and (c) If an employee's outside activities appear to present a conflict of interest that may injure the IFC's legal status or public image,to the extent consistent with the IFC's work and other organizational interests, the Executive Director may permit appropriate leave or other arrangements. Adopted August 18, 1999 -Revised November 2010 Page 2 Sd years O • &JfC Inter-Faith Council for Social Service Board of0(fVavrs Rebecca McCulloh March 18, 2014 President Mary Beth Koza To: State Agency Head and Chief Fiscal Officer oce-President Michael Wood Certification: Treasurer Charles House We certify that the Inter-Faith Council for Social Service, Inc. does not have any Secretary overdue tax debts, as defined by N.C.G.S. 105-243.1, at the federal, State, or local Herb Paul level. We further understand that any person who makes a false statement in Past President violation of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as Jack Benjamin provided by N.C.G.S.) 143C-10-1b. Don Boulton Sworn Statement: William Culton Rebecca McCulloh and John Dorward being duly sworn, say that we are the Board Evelyn Craig • Chair and Executive Director, respectively, of Inter-Faith Council of Carrboro in the Richard Edens State of North Carolina; and that the foregoing certification is true, accurate and Ann Henley complete to the best of our knowledge and was made and subscribed by us. We • also acknowledge and understand that any misuse of State funds will be reported Kathleen Herr to the appropriate authorities for further action. Stuart Mabie Mae McLendon Sallie Moore Board Chair Carol Ross Bettina Shuford Keith Taylor Executive Director Honorary L.rfe Board Member Robert Seymour Sworn to and subscribed before me on the day of the date of said certification. Farecudve0/mv nr EL1 Z�ABETH A. G�NKEL John W.Dorward 9 G• Notary Public, North Carolina Orange County LIVE UNITED My Commission Expires t( June 11 , 2014 • My Commission Expires: So n e-ll t j d ) �T UnftdW" 8fft6Mt. Inter-Faith Council for Social Service• 110 W. Main Street•Carrboro,NC 27510• Phone 919-929-6380•Fax 919-929-3353•www.ifcweb.org Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT G CERTIFICATION REGARDING LOBBYING Orange County Department of Social Services The undersigned certifies,to the best of his or her knowledge and belief,that: 1.No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress,an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract,continuation,renewal, amendment, or modification of any Federal contract, grant, loan,or cooperative agreement. 2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federally funded contract, grant, loan, or cooperative agreement,the undersigned shall complete and submit Standard Form SF-LLL, "Disclosure of Lobbying Activities," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the award document for subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements)who receive federal funds of$100,000.00 or more and that all subrecipients shall certify and disclose accordingly. This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31,U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than$10,000.00 and not more than$100,000.00 for each such failure. Aaj1�y� �iGC'cf�i' SignaMre Title Agency/Organization Date (Certification signature should be same as Contract signature.) Federal Certification—Lobbying(06/04) Page 1 of 1 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT H CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS Orange County Department of Social Services 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 the 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 an 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 will provide immediate written notice to the person to which the 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 any lower tier covered transaction with a person who is debarred, suspended,determined 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 fiu-ther 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 covered transaction,unless it knows that the certification is erroneous. A participant may decide the method and frequency of which it Federal Certification-Debarment(06/04) Pagel of 2 Contract#68-5000 Inter-Faith Council for Social Service,Inc. determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 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 in 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. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion- Lower Tier Covered Transactions i (1) The prospective lower tier participant certifies,by submission of this proposal,that neither it nor its principals is presently debarred, suspended,proposed for debannent, 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. Signai6re Title j�/-b4 �l ,�a$� t is 1' Agency/Organization Date (Certification signature should be same as Contract signature.) Federal Certification-Debarment(06/04) Page 2 of 2 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT K 501(c)(3)and TAX EXEMPT STATUS Orange County Department of Social Services What is a Private Non Profit Agency? Answer.A private non profit is an organization that is incorporated under State law and whose purpose is not to make a profit,but rather to further a charitable, civic,religious, scientific, or other lawful purpose. The Secretary of State's office grants corporate status to organizations in North Carolina. What is a 501(c)(3)designation? Answer: When the agency becomes a state private non profit corporation, it can then apply for 501(c)(3) designation through the IRS. Once the IRS grants 501(c)(3) status,the organization is exempt from certain taxes and any donations to the charitable organization are tax deductible. Many individuals and organizations prefer to make donations to 501(c)(3)private non profits. Who can obtain a 501(c)(3) designation? Answer:Any organization or group can apply for 501(c)(3) status,provided their charter or mission focuses on the non profit's objective. Another option is to apply for a 509(a)(1) status which falls under the 501(c)(3)umbrella. Being a 509(a)(1) designates an organization as a tax-free public charity that receives most of its support from a governmental unit or from the general public. Becoming a 509(a)(1)provides public recognition of tax-exempt status, advance assurance to donors of deductibility of contributions, exemption from certain State and federal taxes, and non profit mailing privileges. Organizations that typically qualify are churches, educational institutions,hospitals, and governmental units. To learn more about non profits,visit www.irs.gov, or call the tax-exempt helpline at 877-829= 4933. How does a Private Non Profit obtain Tax Exempt Status? A private non profit must apply to the IRS for tax exempt status. To qualify, applicants must complete and submit to the IRS Form 1023. Once federal tax exempt status is granted,the private non profit applies for State tax exempt status by completing Form CD-435 and submitting it to the N. C. Department of Revenue. - - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - Please attach proof of 501(c)(3) or IRS tax-exempt status to this page. Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT M BUDGET Orange County Department of Social Services January 1, 2014 - September 30,2014 Cost Type Total EMERENCY RESPONSE Emergency Shelter Insurance $ 4,136 _Emergency Shelter Utilities $21,450 Emergency Shelter Supplies $ 14,450 Other: Maintenance&Repairs, $ 19,579 Extermination, Communications Subtotal $5%615 MATCH Cash and/or In-Kind $116,011 Subtotal $116,011 Total $ 175,626 Page 1 of 1 Contract#68-5000 Inter-Faith Council for Social Service,Inc. ATTACHMENT N OUTCOMES AND REPORTING Orange County Department of Social Services By signing and submitting this document, the Contractor certifies that it agrees to the following: BACKGROUND: On any given night,North Carolina has over 10,000 homeless people. Across the State, homelessness affects more than 500 families including men,women and children who experience financial difficulty and cannot recover. Families and individuals who are at or below 30%area median income are served through this grant and are vulnerable and cannot survive even a small financial crisis. The ESG program is designed to help persons who are homeless and persons who are at-risk of homelessness. The Emergency Solutions Grant(ESG)was created in the Homeless Emergency Assistance and Rapid Transition to Housing(HEARTH)Act which combines the previous Emergency Shelter Grant and the previous Homelessness Prevention and Rapid ReHousing programs under one federal act designed to prevent or end homelessness. The ESG program is intended to assist people in preventing or ending their homelessness through two primary functions: Emergency Response Activities, such as funding emergency shelter operations and services and street outreach and Housing Stability Activities, such as homeless prevention and rapid rehousing. Funds can also be used for HMIS participation and administration. All contractors are expected to use ESG funds in accordance with the grant regulations contained in 24 CFR Parts 91 and 576. PURPOSE: ESG Grantees are responsible for completing tasks from a menu of federally eligible services. The ESG grant will support Emergency Response activities through: • Operating expenses for homeless shelters • Services provided to residents of homeless shelters The Contractor will ensure that these activities are provided in Orange County. The Contractor will provide services or shelter to homeless individuals and/or families for the period during which the ESG assistance is provided,without regard to a particular site or structure, so long as the Contractor serves the same type of persons (e.g. families with children, unaccompanied youth,disabled individuals, or victims of domestic violence)or persons in the same geographic area. The Contractor will assist homeless individuals in obtaining permanent housing, appropriate supportive services(including medical and mental health treatment, counseling supervision, and other services essential for achieving independent living), and other Federal, State, local, and private assistance available for such individuals. Outcomes (06/04) Page 1 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. SCOPE OF WORK: I. Training All core ESG project staff,including housing stability managers,case management supervisors, grant managers, Emergency Services case managers, CHIN data entry, and financial processors must attend all ESG trainings provided during the fiscal year. Tvve of Position Type of Require Trainin Housing Stability Case Manager and Supervisors Webinar/Conference Call Grant Managers Webinar/Conference Call CHIN data entry Face to Face Financial Processing/Fiscal Webinar/Conference Call Emergency Services Case Manager Webinar/Conference Call Documentation: Copy of certification of training completion or training sign-in sheets and sign off that all staff are trained within the time frame. II. Eligibility Screening and Intake Contractor will engage in ESG intake and eligibility process to comply with US Department of Housing and Urban Development(HUD)and state guidance documenting all federally required eligibility criteria, including but not limited to homeless status. The Contractor will only provide ESG funded services to eligible participants. If the Contractor provides services to ineligible participants using ESG funds or ESG matching funds the Contractor will reimburse the County for those funds from a non-ESG funding source. Documentation: Participant files and appropriate data entered into CHIN. III. Carolina Homeless Information Network(CHIN) Contractor will be responsible for ensuring that all staff involved in CHIN data entry or CHIN data monitoring shall participate in ESG CHIN training and will maintain documentation that all staff was trained. Staff responsible for CHIN data entry or monitoring is expected to take advantage of available technical assistance in an assertive, proactive manner to ensure their ability to meet the requirements for accurate data entry. Contractor will input,regularly review, and correct, if necessary, 100%of required data fields into CHIN within two weeks of client contact and/or service. Data fields include,but are not limited to: eligibility,demographic, and risk factor data for participant households, services provided to households, Financial Assistance(dollar amounts per individual) and salaried staff time spent directly on work with ESG households. In addition, CHIN will provide monthly data quality reports to Contractor and the Housing and Homelessness Unit. Domestic Violence programs are prohibited from entering data into CHIN. They are required, however,to collect all of the same data in a separate system and to report aggregate information to the State as needed for State and federal reports. Documentation: CHIN reports and Participant files. Outcomes (06/04) Page 2 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. IV. Eligible Expenditures Emergency Shelter Operations • Maintenance • Rent • Security • Fuel • Equipment • Insurance • Utilities • Food • Furnishings • Supplies necessary for the operation of the emergency shelter The Contractor may only spend funds in categories that were applied for in the NC ESG application that was submitted to the State prior to the contracting period January 1, 2014-September 30, 2014. PERFORMANCE MONITORING/QUALITY ASSURANCE PLAN I. Spending Rates Contractor must expend 100%of funds and 100%of the matching funds by September 30,2014. Contractor is allowed to spend 100%of funds before September 30,2014. Documentation: Fiscal reports. II. Monitoring Contractor will participate in all monitoring activities,programmatic and/or fiscal, state and/or federal, field and/or desk monitoring(materials mailed/emailed in to the state offices). A. At a minimum,participant file monitoring will include review of households that were not enrolled into the program,households that are currently enrolled in the program, and households that have exited the program(unless no households have yet exited). B. Fiscal monitoring will include monitoring of fiscal processes, financial documentation of expenses, and eligibility documentation in client files. C. Programmatic monitoring will also include review of CHIN data entry and monitoring practices. Frequency of monitoring visits may be based on performance as documented in CHIN and additional risk factors as identified in previous Contractor performance, grant application forms, and monitoring reports from other state and federal agencies. It is expected that contractors meet 75%or more of program standards on annual monitoring. Documentation: Monitoring reports and participant files. III. Reporting A. Contractor will be responsible for accurate and complete CHIN data entry (comparable data for Domestic Violence programs) and reimbursements requests. All CHIN data entry for the quarter must be entered into CHIN by the end of the third month of the quarter. Outcomes (06/04) Page 3 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. B. Contractor will be responsible for all other information required for federal reporting. Contractor will be notified of these reporting requirements as federal guidance is provided. C. Contractor will be responsible for submission of semi-annual reports to the State. Documentation: CHIN reports,Annual reports, Semi-Annual reports. IV. Reimbursement The Contractor shall submit to Orange County Department of Social Services by the 10th of each month, a monthly reimbursement request for services rendered the previous month. Contractor will submit reimbursement requests using forms supplied by the State with required documentation of expenses (copies of invoices/bills/receipts)and proof of payment(copies of ledgers or copies of checks used to pay expenses). Contractor will maintain additional required documentation in household (participant) files and in the CHIN system. Reimbursement requests will be verified against documentation of expenses and proof of payments and may be verified against data in CHIN before payment in made. Documentation: Reimbursement forms,reimbursement documentation, CHIN reports,participant files,timesheets or documentation of indirect cost rates,cost allocation plans,copies of paid invoices/bills/receipts and copies of ledgers or checks used to pay invoices/bills/receipts. OTHER FEDERAL REQUIREMENTS I. Homeless Participation A homeless or formerly homeless person must participate to the fullest extent possible in the development of ESG-funded programs and policies set forth by the Department of Housing and Urban Development(HUD). Additionally,to the maximum extent practicable,the Contractor will involve,through employment, volunteer services, or otherwise,homeless individuals and families in maintaining and operating facilities assisted under ESG, and in providing services for occupants of facilities assisted under ESG. II. Accessibility of Spaces,Services,and Activities Contractor shall operate each existing program or activity receiving federal financial assistance so that the program or activity,when viewed in its entirety, is equally accessible to and usable by individuals with disabilities as by persons without disabilities. III. Property Standards All dwelling units that are a part of an ESG-funded activity shall meet minimum habitability standards set by HUD. Shelter facilities are also required to meet state or local government safety and sanitation standards, as applicable, including energy-efficient appliances and materials. IV. Lead-based Paint All shelters assisted under the ESG program and all housing occupied by program participants must adhere to the requirements of the Lead-Based Paint Poisoning Prevention Act(42 U.S.C. 4821- Outcomes (06104) Page 4 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. 4846),the Residential Lead-Based Paint Hazard Reduction Act of 1992 (42 U.S.C. 4851-4856), and the implementing regulations in 24 CFR part 35, subparts A, B,H, J,K,M, and R. Such regulations pertain to all HUD-assisted housing and require that all owners,prospective owners, and tenants of properties constructed prior to 1978 be properly notified that such properties may include lead-based paint. Such notification shall point out the hazards of lead-based paint and explain the symptoms,treatment, and precautions that should be taken when dealing with lead- based paint poisoning and the advisability and availability of blood lead-level screening for children under seven. The notice should also point out that if lead-based paint is found on the property,abatement measures may be undertaken. The regulations further require that, depending on the amount of Federal funds applied to the property,paint testing,risk assessment, treatment, and/or abatement may be conducted. V. Termination of Services Contractor shall ensure that if a participant violates program requirements, services will be terminated in accordance with a formal written procedure established by the Contractor,that recognizes the rights of the individual affected. This policy shall include the option for reinstatement, under proscribed circumstances, as dictated by the Interim Rule. VI. Grievance Hearings The Contractor shall establish a formal,written procedure to address grievances and shall inform applicants and participants of their right to an appeal. The appeals policy must be posted and must allow for appeals to be requested in writing and verbally. VII. Conflicts of Interest The Contractor must keep records to show compliance with the organizational conflicts-of-interest requirements in 24 CFR §576.404(a), a copy of the personal conflicts of interest policy or codes of conduct developed and implemented to comply with the requirements in 24 CFR §576.404(b), and records supporting exceptions to the personal conflicts of interest prohibitions. The Contractor agrees to abide by the provisions of 24 CFR 84.42 and §576.404,which include (but are not limited to)the following: a. The Contractor shall maintain a written code or standards of conduct that shall govern the performance of its officers, employees,or agents engaged in the award and administration of contracts supported by Federal funds. b. No employee, officer, or agent of the Contractor shall participate in the selection, or in the award, or administration of, a contract supported by Federal funds if a conflict of interest,real or apparent,would be involved. c. No covered persons who exercise or have exercised any functions or responsibilities with respect to HUD-assisted activities, or who are in a position to participate in a decision-making process or gain inside information with regard to such activities,may obtain a financial interest in any contract, or have a financial interest in any contract, subcontract, or agreement with respect to the HUD-assisted activity, either for themselves or those with whom they have business or immediate family ties, during their tenure or for a period of one (1)year thereafter. For purposes of this paragraph, a "covered person"includes any person who is an employee, agent, consultant, officer, or Outcomes (06/04) Page 5 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. elected or appointed official of the Grantee,the Contractor,or any designated public agency. The Contractor shall permit no officer or employee of the Contractor,no member of the Contractor's governing body and no other public official of any governing body in its County or the State of North Carolina area to exercise any functions or responsibilities in the review or approval of the undertaking or carrying out of this project to(1)participate in any discussion relating to this Contract if it affects his or her personal interest or the interest of any corporation,partnership, or association in which he or she is directly or indirectly interested; or(2)have any interest, direct or indirect, in this Contract or the proceeds thereof. The Contractor shall permit no members of or delegates to the Congress of United States to be admitted to any share or part thereof or to any benefit to arise here from. The Contractor covenants that it presently has no interest and shall not acquire any interest, direct or indirect,which would conflict in any manner or degree with the performance or services required to be performed under this Contract. The Contractor further covenants that no person having any such interest shall be employed in the performance of this Contract. The Contractor shall make no loans to its directors or officers. The Contractor shall be subject to and shall comply with the conflict of interest provisions of the federal regulations as published at 24 CFR Part 570.611, 24 CFR Part 84.42 and 24 CFR Part 85.36. VIII. Fair Housing Act Compliance Certification The Contractor hereby warrants that it does not have any Fair Housing Discrimination complaints pending against it. The Contractor also agrees that should any Fair Housing Discrimination complaint be lodged against it during the term of this Contract, it will immediately notify the Grantee in writing of the occurrence. STANDARDS OF CONDUCT I. Procurement HUD procurement standards found at 24 CFR 85.36, and OMB Circular A-110, Subpart C are hereby incorporated into this contract by reference. II. Faith-based Activities The Contractor agrees that funds provided under this Agreement will not be utilized for inherently religious activities prohibited by 24 CFR§576.406. III. HMIS Reporting The Contractor shall report client-level data in a Homeless Management Information System (HMIS) or a comparable database in accordance with HUD's standards on participation, data collection, and reporting. If the Contractor is a victim service provider, it may use a comparable database that collects client-level data over time and generates duplicated aggregate reports based on the data. Outcomes (06/04) Page 6 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. IV. Match Requirements ESG funds are subject to a dollar for dollar match. The match can be obtained from any source, including any Federal, state, local,and private sources. Ineligible sources include: ESG funds and funds used to match another Federal program. Cash or noncash contributions(i.e. donated material/property, $5 hour rate of volunteerism)are also eligible. In accordance with the terms of the grant contract, the Contractor shall document match set aside under this Contract. The State requires submission of all match documentation at the end of each program year. Contractors will submit copies of financial ledger, checks and/or bank deposits from donations, documentation of volunteer hours and in-kind services, depending on what the Contractor is using for match. Further,the Contractor must provide proof that match expenditures support ESG eligible activities. V. Additional Requirements Grantor reserves the right to impose any additional requirements upon Contractor,which the Grantor shall deem reasonable or necessary for the purpose of verifying the legality and propriety of any payment requested by the Contractor. VI. Investigations of Noncompliant Activities The Grantor may investigate any matter covered under this Contract and may withhold any payments until the results of the investigation have been revealed. Reimbursement to the Contractor will be determined upon resolution of the investigation by the Grantor. OTHER APPLICABLE LAWS: CERTIFICATIONS AND COMPLIANCE REQUIREMENTS 1. 24 CFR Part 84 Uniform Administrative Requirements for Grants and Cooperative Agreements to Hospitals, Institutes of Higher Education and Non-profit Organizations,which sets forth rules for administering all federal grant funds. 2. Title VI of the Civil Rights Act of 1964(PL88-352) and regulations issued pursuant thereto (24 CFR Part 1) on nondiscrimination in federally assisted programs. 3. Section 109 of the Housing and Community Development Act of 1974 and regulations issued pursuant thereto (24 CFR Part 570.602 et seq., known at subpart K), which requires that no person in the United States shall,on the grounds of age,race,color,national origin,religion, disability or sex,be excluded from participation in,be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance. 4. Executive Order 11246 and the regulations issued pursuant thereto (41 CFR Chapter 60) on nondiscrimination in employment. 5. Lead Based Paint Poisoning Prohibition(Public Law 91-695),which requires that hazards posed by the presence of lead be addressed and made safe. 6. Hatch Act(5 U.S.C. 1501-1508)prohibiting federal, state and local government employees from benefiting from federal grants. 7. Executive Order 11063 which addresses equal opportunity in housing and non-discrimination. 8. Section 306 of the Clean Air Act(42 U.S.C. 1857(h))which sets forth monitoring and reporting procedures for any program that affects air quality. 9. Age Discrimination Act of 1967, as amended. Outcomes (06/04) Page 7 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. 10. The Rehabilitation Act of 1973,as amended, Sections 503 and 504, which prohibit discrimination against the handicapped. 11. OMB Circular A-122: Cost Principles for Non-Profit Organizations, which sets forth parameters for expenditures made with federal grant money. 12.N.C. Fair Housing Law, which prohibits discrimination against any person for reasons of age, race, color, national origin,religion, disability or sex in all transactions relating to buying, selling, or renting housing units. 13. OMB Circular A-133: Audits of States, Local Governments, and Nonprofit Organizations, which sets forth requirements and methodologies for auditing programs funded in whole or in part with federal grant money. SignaturV Title 38lz Agency/Organization Date (Certification signature should be same as Contract signature.) Outcomes (06/04) Page 8 of 9 Contract#68-5000 Inter-Faith Council for Social Service,Inc. PERFORMANCE MEASURES CHART The County uses performance measures rubrics as a tool to determine the success of a project and how well services and products are being delivered. Together they enable the County to gauge efficiency, determine progress toward desired results and assess whether the program is on track with meeting its goals. The Contractors shall adhere to all of the performance requirements/standards in the scope of work,including performance measures in the chart below. Measure Output Frequency Annual Type Measure The Contractor will serve at least 144 households through emergency shelter(s) during the contract period. Year 2014 Preferred Other Trend Target Value The Contractor will serve at least 144 households through emer enc shelter(s)during the contract period. Data Source CHIN,the statewide Homeless Management Information System Collection The Contractor staff will collect and enter data Process and Calculation Collection Daily Fre uenc F Measure Output requency Annual Type Measure 30%of exits from emergency shelters statewide will be to permanent housing. Year 2014 Preferred Increase Trend Target Value 36%of exits from emergency shelter are to permanent housing. Data Source CHIN,the statewide Homeless Management Information System Collection The Contractor staff will collect and enter data Process and Calculation Collection Daily Frequency Outcomes (06/04) Page 9 of 9 INTER-4 OP ID: NY CERTIFICATE OF LIABILITY INSURANCE DA7E(MMIDDI 01/21/20114 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME: NanC Young Summers Thompson Lowry, Inc. PHONE FAX 100 Europa Drive, Suite 571 c No Ext:919-969-5301 (AIC No): 919-9424221 Chapel Hill, NC 27517 ADDRESS:nanC StIinSUre.COm Larry A.Summers INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Association Insurance Company INSURED Inter-Faith Council for Social INSURER B:*Alliance for Non-Profits for I10 Service WMain Street lnc. INSURER C:Hartford Fire Ins,Co. 19682 110 W. Carrboro, INC 27510 INSURER D:The Hanover Ins Co 22292 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS TYPE OF INSURANCE LTR POLICY NUMBER MMILDO MOMILDID X LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY 2013-17838 07/0112013 07/01/2014 PREMISES Ea occurrence $ 500,000 CLAIMS-MADE 1 OCCUR MED EXP(Any one person) $ 20,000 PERSONAL&ADV INJURY $ 1,000,00 X Professional lM/2 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY PR 0 FILOC Emp Ben. $ INCLUDE AUTOMOBILE LIABILITY EOMaBINdEDtSINGLE LIMIT $ 1,000,00 B X ANY AUTO 201317838 07/01/2013 07/01/2014 BODILY INJURY(Per person) $ ALL AUTOS OWNED SCHEDULED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS NON-OWNED PROPERTY DAMAGE X AUTOS (PER ACCIDENT $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 B EXCESS LIAB CLAIMS-MADE 20131783SUMB 07/01/2013 07/01/2014 AGGREGATE $ 1,000,00 DED X RETENTION 10,000 $ WORKERS COMPENSATION X PRY LIMITS ER AND EMPLOYERS'LIABILITY A ANY PROPRIETORIPARTNERIEXECUTIVE YIN WC522-000320-113 07/0112013 07/0112014 E.L.EACH ACCIDENT $ 1,000,00 OFFICERIMEMBER EXCLUDED? F-1 NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE D yes,describe 1,000,00 ribe under E.L.DISEASE-POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS below C Crime 22BODEQ5679 07/01/2013 07/01/2014 100,00 D D&O/EPLI LHR8785106 07/01/2013 07/01/2014 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Inter-Faith Council for Social ACCORDANCE WITH THE POLICY PROVISIONS. Service,Inc. AUTHORIZED REPRESENTATIVE 110 W.Main Street Carrboro, NC 27510 5+tm►nr.en S ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD