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HomeMy WebLinkAbout2015-305 Health - Orange Literacy to provide literacy and English classes to parents $7,815 a��5 ,3Qs 2014-15 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of June 2015, ("Effective Date") by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Orange Literacy, a not-for-profit corporation, located at Carr Mill Mall,200 North Greensboro Street,Carrboro,NC 27510.("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need,as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth,the County and Orange Literacy agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning June 1, 2015 to January 30,2016. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application Scope of Services and any amendments or revision thereto which is attached as Exhibit"A" and incorporated by reference,to the residents of Orange County. The Scope of Services may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Program Budget, the maximum sum of Seven Thousand Eight Hundred Fifteen dollars($7,815). b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in two installments each in the amount of$3,907.50. The first payment is contingent upon receipt of the fully executed agency's performance agreement. d. The County's obligation to make the final payment is contingent upon receipt of a Progress Report, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. Orange County Outside Agency Performance Agreement Orange Literacy Page 1 of 7 e. Once Provider has satisfied its obligations as provided in (d) final payment will be made within 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report by September 1, 2015 that includes a summary of satisfactory progress toward completion of performance measures. Provider will also provide a Final Report by January 30, 2016 that includes a fiscal report and final evaluation and performance measures as outlined in Exhibit A. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services,upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as "default"), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered;or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance,incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations,or stated public policy. b. In the event of default by the Provider,the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten(10)business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. Orange County Outside Agency Performance Agreement Page 2 of 7 c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers'or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness,disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any,covering personal injury or death,and property damage; and b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A- Statutory State NC&Coverage B-Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit c. All insurance policies(with the exception of Worker's Compensation and Professional Liability)required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any Orange County Outside Agency Performance Agreement Page 3 of 7 contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Each party shall hold the other harmless from all loss, liability, claims or expense arising from bodily injury, including death or property damage,to any person or persons caused in whole or in part by its own employees functioning under this Memorandum of Agreement and shall bear responsibility for liability, claims or expenses arising from the acts or omissions of the party's own personnel to the extent provided by North Carolina law. Nothing in this section is intended to affect or abrogate the either Party's sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves,their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age,handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County's living wage is $12.76 per hour. To the extent possible, Orange County recommends that «Agencys Name» provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: County: Finance&Administrative Services Provider: Orange County Literacy Council Orange County 200 North Greensboro'Street Post Office Box 8181 Carrboro,NC 27510 Hillsborough,NC 27278 16. Entire Agreement. This Agreement, including any referenced attachments,constitutes the entire Orange County Outside Agency Performance Agreement Page 4 of 7 Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part,term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part,term or provision held to be invalid. 18. Governing Law. The laws of the State of North Carolina shall govern all aspects of this Agreement. In the event that it is necessary for either party to initiate legal action regarding this Agreement, venue shall lie in Orange County, North Carolina. The parties hereby waive their right to trial by jury in any action, proceeding or claim, arising out of this Agreement,which may be brought by either of the parties. 19. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement,effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For and on behalf of the Provider ignature Date rinted Name For and o a behalf of Orange County Government P/( 1 Bonnie Hammersley, County Mana Date This instrument has been pre-audited in the man er required by the Local Government i Bud eta d fiscal Co ct Paul K. Laughton, eri inance& Administrative Services Director Orange County Outside Agency Performance Agreement Page 5 of 7 ATTACHMENT "A" Orange County Certifications—FY 2014-15 Outside Agency Performance Agreement Chief Contact,Administrators,Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact,administrators,chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name,title,residential address;phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing,with the name, physical address,mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County,and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: Title: f�/ �,C Date: (Provider's Signature) Orange County Outside Agency Performance Agreement Page 6 of 7 EXIMIT"A" Scope of Services—FY 2014- 15 Outside Agency Performance Agreement Agency Name: Orange Literacy Program Name: Kindergarten Readiness-Parental Literacy Funding Award: $7,815 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel(testing,tutor training, support,curriculum development) $5,900 Materials(testing supplies, instructional materials) $450 Mileage $221 M&G(management and general) $1,244 Program Services For assistance with this or the following section, please reference the Exhibit A instructions and example, located within the contract and reporting memorandum. Outline the major activities the agency will employ to attain the Anticipated Outcomes below,by June 30,2015. • Orange Literacy will provide literacy and English classes for parents of children enrolled in the 2015 Kindergarten Readiness program. These classes will be taught by volunteer tutors twice weekly for 16 weeks, for 1.5-2 hours each session at time(s) and location(s) convenient and accessible to parents. Classes will begin in the summer when the Kindergarten Readiness program starts, and will continue through the fall semester in order to give the parents enough class time to see progress. • Orange Literacy will offer the literacy classes to parents of children in all three kindergarten readiness program pilot sites(New Hope Elementary,Carrboro Elementary,Frank Porter Graham Elementary). Priority for the classes will be for parents whose children will attend these three schools during the 2015-2016 school year if interest exceeds capacity. • Orange Literacy will develop a new curriculum for the classes. Sample topics may include communicating verbally with their child's teacher, reading and understanding school notices, ensuring that children receive appropriate health screenings and care, and helping their children with homework. Instruction will focus on helping parents become active participants in their child's education. Orange Literacy will collaborate with school representatives as much as possible to make course content relevant to the school. • Orange Literacy will pre-test all students(parents)using nationally accepted standardized tests to place them in the correct level class. After the 16 week class session, students will be post-tested to measure their progress. • In addition pre- and post-program literacy testing, staff from the Orange County Health Department/Family Success Alliance will work with Orange Literacy to determine demographic and other data to be collected Orange Literacy for the program and participants. These data will be shared with the Family Success Alliance. Anticipated Outcomes Certified by: Title:� f(f ,�� Date: Provider's Signature) The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Parents enrolling in Parent Literacy classes 42 Parents receiving at least 12 hours of instruction 38 Parents receiving at least 32 hours of instruction 30 Parents receiving at least 32 hours of instruction that increase scores from pre-to post- 15 test Number of parents with at least 32 hours of instruction reporting satisfaction with classes 27 (90%) Parents increasing that they read to their child three or more times a week from pre-to 27 post-test(90%) Certified by: Title: f Date: (Provider's Signature) tAut©-(Owners Page 1 54643 (01-90) Issued 10-02-2014 (MUTUAL) INSURANCE COMPANY BUSINESSOWNERS POLICY DECLARATIONS 6101 ANACAPRI BLVD., LANSING, MI 48917-3999 AcEwcv HIGH $ RUBISH INSURANCE AGENCY Renewal Effective 11-20-2014 15-0936-00 MKT TERR 050 (919) 913-1144 POLICY NUMBER 91-159-372-01 wsuREo ORANGE COUNTY LITERACY COUNCIL INC Company Use 35-57-NC-9311 Company POLICY TERM ADDRESS 200 N GREENSBORO ST STE C2 Bill 12:01 a.m. 12:01 a.m. CARRBORO NC 27510-1849 to 11-20-2014 11-20-2015 In consideration of payment of the premium shown below, this policy is renewed. Please attach this Declarations and attachments to your policy. If you have any questions, please consult with your agent. ENTITY: Corporation PROPERTY COVERAGES - ALL DESCRIBED LOCATIONS DED LIMITS PREMIUM Special Coverage Form TERRORISM - CERTIFIED ACTS $.61 BUSINESS LIABILITY PROTECTION LIMITS PREMIUM COVERAGES Aggregate Limit 52,000,000 Included (Other than Products-Completed Operations) Products-Completed Operations Aggregate 11000,000 Included Liability and Medical Expense 11000,000 Included Medical Expense - Per Person 5,000 Included Personal Injury Included Included Tenants Fire Legal - Any One Fire 50,000 Included Hired Auto 8 Non-Owned Auto Liability 1,000,000 532.50 TERRORISM - CERTIFIED ACTS .65 FORMS THAT APPLY TO ALL LOCATIONS: 54510 (08-09) BP0002 (01-87) BP0006 (01-87) 54961 (11-11) BP0009 (01-87) 54679 (06-92) 54709 (04-10) 54098 (05-07) 54319 (07-06) 54867 (03-08) 54656 (08-91) 54088 (09-09) 54663 (01-03) Page 2 54643 (01-90) AUTO-OWNERS (MUTUAL) INS. CO. Issued 10-02-2014 AGENCY HIGH & RUBISH INSURANCE AGENCY Company POLICY NUMBER 91-159-372-01 15-0936-00 MKT TERR 050 Bill Company Use 35-57-NC-9311 INSURED ORANGE COUNTY LITERACY COUNCIL INC Term 11-20-2014 to 11-20-2015 LOCATION 001 LOCATION: 200 N GREENSBORO ST STE C2 CARRBORO NC 27510-1833 COVERAGES BED LIMITS PREMIUM Addl Insured - Managers or Lessors of Premises Included 522.57 Addl Insured - Controlling Interest Included 22.57 TERRORISM - CERTIFIED ACTS 3.34 SEE FORM(S) 59350 (01-08), 54309 (07-08), 59390 (07-08) ADDITIONAL FORMS FOR THIS LOCATION: BP0007 (01-90) BPO116 (03-87) IL0162 (04-90) IL0269 (10-94) 54094 (03-07) 54238 (12-01) 54244 (05-07) 54309 (07-08) 54605 (11-88) 54661 (08-91) 59350 (01-08) LOC 001 BLDG 0001 COVERAGES BED LIMITS PREMIUM Business Personal Property - REPL. COST $500 528,110 $117.13 Adjusted Value Factor 0.0140 Business Income And Extra Expense 12 Months Included Limitation of Coverage for Fungi, Mold, See Form Included Dry Rot, Wet Rot and Bacteria Equipment Breakdown 500 See Form 4.46 ADDITIONAL FORMS FOR THIS BUILDING: 54841 (10-09) 54701 (08-94) 54703 (08-94) BP1203 (06-89) SECURED INTERESTED PARTIES: See Attached Schedule tAuto-Owners Page 3 54643 (01-90) Issued 10-02-2014 (MUTUAL) INSURANCE COMPANY BUSINESSOWNERS POLICY DECLARATIONS 6101 ANACAPRI BLVD. , LANSING, MI 48917-3999 AGENCY HIGH 8c RUBISH INSURANCE AGENCY Renewal Effective 11-20-2014 15-0936-00 MKT TERR 050 (919) 913-1144 POLICY NUMBER 91-159-372-01 INSURED ORANGE COUNTY LITERACY COUNCIL INC Company Use 35-57-NC-9311 Company POLICY TERM ADDRESS 200 N GREENSBORO ST STE C2 Bill 12:01 a.m. 12:01 a.m. CARRBORO NC 27510-1849 to 11-20-2014 11-20-2015 in consideration of payment of the premium shown below, this policy is renewed. Please attach this Declarations and attachments to your policy. If you have any questions, please consult with your agent. RATING INFORMATION Occupancy: Office Not Otherwise Classified Tenant Occupied Class Code: 65121 Const: Non-Combustible, Sprinklered Program: Office Protection Class: 03 Liability Rate Number: 00 Territory: 010 Orange County Burglary Rate Group: 00 Inside City Limits Construction Year: 1965 TERM TOTAL ANNUAL PREMIUM $203.83 MINIMUM PREMIUM EQUIPMENT BREAKDOWN ADJUSTMENT $30.54 MINIMUM PREMIUM ADJUSTMENT 5170.23 TOTAL POLICY PREMIUM 5404.60 PAID IN FULL DISCOUNT -13.91 TOTAL POLICY PREMIUM IF PAID IN FULL $390.69 The Paid In Full Discount does not apply to fixed fees or statutory charges. The Paid In Full Discount is based on favorable loss experience for the collective group of policyholders who choose to pay their premiums in full directly to the company. Paid In Full Discount is available. Discount Applies for Affiliation with: CHAPEL HILL - CARRBORO CHAMBER OF COMMER A 4% Cumulative Multi-Policy Discount applies. Supporting policies are marked with an (X): Comm Umb( ) Comm Auto( ) WC(X) Life( ) Personal( ) Farm( ). Merit Rating Discount of 5% Applies Page 4 54643 (01-90) AUTO-OWNERS (MUTUAL) INS. CO. Issued 10-02-2014 AGENCY HIGH B RUBISH INSURANCE AGENCY Company POLICY NUMBER 91-159-372-01 15-0936-00 MKT TERR 050 Bill Company Use 35-57-NC-9311 INSURED ORANGE COUNTY LITERACY COUNCIL INC Term 11-20-2014 to 11-20-2015 SECURED INTERESTED PARTIES AND/OR ADDITIONAL INTERESTED PARTIES Loc 001 Bldg 0001 OCE FINANCIAL SERVICES Loan: 200-5028065-000 5600 BROKEN SOUND BLVD NW BOCA RATON FL 33487-3515 Interest: Loss Payable LEASED COPIER Form: BP1203 (06-89) PARAGRAPH A SIP-ID: FL147731 Agency Code 15-0936-00 Policy Number 91-159-372-01 54701 (8-94) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - CONTROLLING INTEREST This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SCHEDULE" Name of person or Organization: ORANGE COUNTY ATTN RISK MANAGER PO BOX 8181 HILLSBOROUGH, NC 27278 The following is added to Paragraph C. WHO 1S AN INSURED in the Businessowners Liability Coverage Form: 4. The person or organization shown in the Schedule or in the Declarations, but only for their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy those premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. The limit of liability for the additional insured are those specified in the written contract or agreement between the Insured and the Person or Organization named above, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. 'Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declara- tions. Includes copyrighted material of Insurance Services Office, Inc.,with its permission Copyright, Insurance Services Office, Inc., 1985 Agency Code 15-0936-00 Policy Number 91-159-372-01 54703 (8-94) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SCHEDULE* Designation of Premises (Part Leased to You): 200 N GREENSBORO ST STE C2 Name of Person or Organization(Additional Insured): CARR MILL MALL LIMITED PARTNERSHIP PO BOX 673 CARRBORO, NC 27510 Additional Premium: A. The following is added to Paragraph C. WHO IS AN INSURED in the Businessowners Liability Coverage Form: 4. The person or organization shown in the Schedule is also an insured, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule. B. The following exclusions are added: This insurance does not apply to: 1. Any 'occurrence" that takes place after you cease to be a tenant in the premises described in the Sched- ule. 2. Structural alterations, new construction or demolition operations performed by or for the person or organi- zation designated in the Schedule. The limits of insurance for the additional insured are those specified in the written contract or agreement between the insured and the person or organization named above, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declara- tions. Includes copyrighted material of Insurance Services Office, Inc.,with its permission Copyright, Insurance Services Office, Inc., 1984, 1985 Chubb Group of Insurance Companies ForeFront Portfol0o 15 Mountain View Road For Not-for-Profit Organizations Warren, New Jersey 07059 General Terms and Conditions Section cHU�B DECLARATIONS FEDERAL INSURANCE COMPANY A stock insurance company, incorporated under the laws of Indiana, herein called the Company Capital Center, 251 North Illinois, Suite 1100 Indianapolis, IN 46204-1927 Policy Number:8173-0102 THE DIRECTORS AND OFFICERS LIABILITY AND ENTITY LIABILITY, FIDUCIARY LIABILITY AND EMPLOYMENT PRACTICES LIABILITY COVERAGE SECTIONS(WHICHEVER ARE PURCHASED)PROVIDE CLAIMS MADE COVERAGE, WHICH APPLIES ONLY TO "CLAIMS" FIRST MADE DURING THE "POLICY PERIOD", OR DURING AN APPLICABLE EXTENDED REPORTING PERIOD. THE LIMIT OF LIABILITY TO PAY DAMAGES OR SETTLEMENTS WILL BE REDUCED AND MAY BE EXHAUSTED UNLESS OTHERWISE PROVIDED HEREIN, BY "DEFENSE COSTS," AND "DEFENSE COSTS" WILL BE APPLIED AGAINST THE RETENTION. IN NO EVENT WILL THE COMPANY BE LIABLE FOR"DEFENSE COSTS" OR THE AMOUNT OF ANY JUDGMENT OR SETTLEMENT IN EXCESS OF THE APPLICABLE LIMIT OF LIABILITY. READ THE ENTIRE POLICY CAREFULLY. Item 1. Organization: ORANGE COUNTY LITERACY COUNCIL Principal Address: 200 N Greensboro St. Suite C-2 Carrboro, NC 27510 Rom 2. Policy Period: (A) From: 12:01 A.M. on August 17, 2013 (B) To: 12:01 A.M. on August 17, 2016 Local time at the address shown in Item 1. Item 3. A Combined Maximum Aggregate Limit of Liability is applicable: ❑ X Yes ❑ No The Combined Maximum Aggregate Limit of Liability for all Claims under all Liability Coverage Sections each Policy Year shall be: $1,000,000.00 Item 4. Coverage is available for the following only: ❑ Yes ❑ No Directors&Officers Liability and Entity Liability Coverage Section ❑ X Yes ❑ No Employment Practices Liability Coverage Section ❑ Yes © No Fiduciary Liability Coverage Section ❑ Yes❑X No Crime Non-Liability Coverage Section ❑ Yes 0 No Kidnap/Ransom and Extortion Non-Liability Coverage Section 14-02-10190 (Ed. 1112004) Page 1 of 12 ForeFront Portfoliosm For Not-for-Profit Organizations Genera!Tenns and Conditions Section Item 5. Extended Reporting Period: (A) Additional Period: (B) Additional Premium: 1 year 75%of Annual Premium Item 6. Termination of prior policies: 8173-0102 (Aug 17, 2010 - Aug 17, 2013) In witness whereof, the Company issuing this Policy has caused this Policy to be signed by its authorized officers, but it shall not be valid unless also signed by a duly authorized representative of the Company. FEDERAL INSURANCE COMPANY Secretary President 07/25/2013 Date Authorized Representative 14-02-10190 (Ed. 11/2004) Page 2 of 12 /� PAGE 1 �o , Owners WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE COMPANY 16144 6101 ANACAPRI BLVD. , LANSING, MI 48917-3999 INFORMATION PAGE -RENEWAL AGREEMENT RENEWAL EFF. 06-17-2015 AGENCY HIGH & RUBISH INSURANCE AGENCY — 15-0936-00 PO BOX 3040 (919) 913-1144 POLICY NUMBER ITEM 1 CHAPEL HILL NC 27515 MKT TERR 050 041715 35022549 INSURED ORANGE COUNTY LITERACY COUNCIL INC ITEM 2 POLICY PERIOD COMPANY FROM 12:01 A.M. 06-17-2015 ADDRESS 200 N GREENSBORO ST STE C2 BILL TO 12:01 A.M. 06-17-2016 CARRBORO NC 27510-1849 AT THE INSURED'S MAILING ADDRESS INSURED IS - CORPORATION OTHER WORK PLACES NOT SHOWN ABOVE: ITEM 3 A. WORKERS' COMPENSATION INSURANCE: PART ONE OF THE POLICY APPLIES TO WORKERS' COMPENSATION LAW OF THE STATES LISTED HERE: NC B. EMPLOYERS LIABILITY INSURANCE: PART TWO OF THE POLICY APPLIES TO WORK IN EACH STATE LISTED IN ITEM 3. THE LIMITS OF OUR LIABILITY UNDER PART TWO ARE: BODILY INJURY BY ACCIDENT $100,000 EACH ACCIDENT BODILY INJURY BY DISEASE $100,000 EACH EMPLOYEE BODILY INJURY BY DISEASE $500,000 POLICY LIMIT C. OTHER STATES INSURANCE: PART THREE OF THE POLICY APPLIES TO THE STATES, IF ANY, LISTED HERE: AL, AR, AZ, CO, FL, GA, IA, ID, IL, IN, KS, KY, MI, MN, MO, NC, NE, PA, SC, SD, TN, UT, VA 8 WI UNLESS ALREADY LISTED IN ITEM 3A. ITEM 4 THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUALS RULES, CLASSIFICATIONS, RATES AND RATING PLANS. ALL INFORMATION REQUIRED BELOW IS SUBJECT TO VERIFICATION AND CHANGE BY AUDIT. CLASSIFICATIONS OF OPERATIONS PREMIUM BASIS RATES ESTIMATED RATE ESTIMATED CLASS TOTAL ANNUAL PER ANNUAL CODE REMUNERATION $100 PREMIUM STATE OF NORTH CAROLINA IDB 0010 (SEE FED NUM 001) DESC 001 CLERICAL OFFICE EMPLOYEES NOC 8810 151,938 .28 425 TOTAL 425 EXPENSE CONSTANT 250 675 TERRORISM-SEE FORM 27317 15 690 CATASTROPHE (OTHER THAN CERTIFIED ACTS OF TERRORISM) 15 705 SEE FORM 27322 TOTAL ESTIMATED ANNUAL PREMIUM 705 FEDERAL ID - 561433933 NC EMPLOYER CODE - 08138060 ISSUED 5-07-2015 27777 (10-88)(WC000001A) 1228 u Q-t7/' PAGE 2 wners WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE COMPANY 16144 6101 ANACAPRI BLVD. , LANSING, MI 48917-3999 INFORMATION PAGE -RENEWAL AGREEMENT RENEWAL EFF. 06-17-2015 AGENCY HIGH 8 RUBISH INSURANCE AGENCY -- 15-0936-00 PO BOX 3040 (919) 913-1144 POLICY NUMBER CHAPEL HILL NC 27515 MKT TERR 050 041715 35022549 ITEM 1 INSURED ORANGE COUNTY LITERACY COUNCIL INC ITEM 2 POLICY PERIOD COMPANY FROM 12:01 A.M. 06-17-2015 ADDRESS 200 N GREENSBORO ST STE C2 BILL TO 12:01 A.M. 06-17-2016 CARRBORO NC 27510-1849 AT THE INSURED'S MAILING ADDRESS COUNTY 068 THE PAID IN FULL DISCOUNT DOES NOT APPLY TO FIXED EXPENSE FEES, STATUTORY CHARGES OR MINIMUM PREMIUMS. THE PAID IN FULL DISCOUNT IS BASED ON FAVORABLE LOSS EXPERIENCE FOR THE COLLECTIVE GROUP OF POLICYHOLDERS WHO CHOOSE TO PAY THEIR PREMIUM IN FULL DIRECTLY TO THE COMPANY. YOUR POLICY QUALIFIES FOR THE PAID IN FULL DISCOUNT IF YOU CHOOSE TO PAY YOUR PREMIUM IN FULL. YOUR PAID IN FULL DISCOUNT MAY CHANGE AS A RESULT OF POLICY CHANGES. THESE CHANGES WILL BE REFLECTED IN A FUTURE INVOICE. TOTAL ESTIMATED ANNUAL PREMIUM 705 PAID IN FULL DISCOUNT 32- TOTAL POLICY PREMIUM IF PAID IN FULL 673 MINIMUM PREMIUM $306 NORTH CAROLINA AUDIT IS - ANNUAL ENDORSEMENTS: 27011 (WC000308 ) 27043 (WC320301C) 27279 (WC000419 ) 27317 (WC0004228) 27322 (WC000421D) 27392 27497 27506 27942 (W0000414 ) 27990 (WC000404 } YOU MAY VIEW YOUR POLICY ONLINE AT WWW.AUTO-OWNERS.COM . TO ENROLL, USE THE POLICY NUMBER 35022549 AND PERSONAL ID CODE 78A 2N8 G3T. ISSUED 5-07-2015 27777 (10-88)(WC000001A) 1229 PAGE 1 Ito-Owners WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE COMPANY ATTACHED TO AND FORMING PART OF 6101 ANACAPRI BLVD. , LANSING, MI 48917-3999 INFORMATION PAGE -RENEWAL AGREEMENT RENEWAL EFF. 06-17-2015 AGENCY HIGH & RUBISN INSURANCE AGENCY _ 15-0936-00 PO BOX 3040 (919) 913-1144 POLICY NUMBER ITEM 1 CHAPEL HILL NC 27515 MKT TERR 050 041715 35022549 INSURED ORANGE COUNTY LITERACY COUNCIL INC ITEM 2 POLICY PERIOD COMPANY FROM 12:01 A.M. 06-17-2015 ADDRESS 200 N GREENSBORO ST STE C2 BILL TO 12:01 A.M. 06-17-2016 CARRBORO NC 27510-1849 AT THE INSURED'S MAILING ADDRESS FED NUM 001 STATE NC FED ID ENTITY CORPORATION NUMBER OF EMPLOYEES 1 ORANGE COUNTY LITERACY COUNCIL INC 200 N GREENSBORO ST STE C2 CARRBORO NC 27510-1833 ISSUED 5-07-2015 2762 (4-84) 1230 CrimeSHIELD Policy for Mercantile Entities Co Code Co Code 0 Hartford Fire Insurance Company F-F-J Hartford Insurance Company of Illinois Hartford, CT 06115 Naperville, IL 60566 0 Hartford Casualty Insurance Company © Hartford Insurance Company of the Midwest Hartford, CT 06115 Indianapolis, IN 46204 Q Hartford Insurance Company of the Southeast Maitland, FL 32751 The Company is shown above by Co. Code Q POLICY NUMBER 22BDDFB3274 In return for the payment of the premium, and subject to all the terms of this Policy, we agree with you to provide the insurance stated in this Policy. DECLARATIONS ITEM 1. Named Insured: Orange County Literacy Council Inc. 2. Mailing Address: Chapel Hill, NC 27516 3. Policy Period: from May 20, 2008 until cancelled (12:01 A.M. Standard Time at Your Mailing Address) 4. Coverages, Limits of Insurance and Deductibles: Insuring Agreements, Limit of Insurance and Deductible Amounts shown below are subject to all of the terms of this policy that apply. Limit of Deductible Insuring Agreements Forming Part of This Policy Insurance Amount 1. Employee Theft $ 125,000 $ 1,500 2. Depositors Forgery or Alteration $ 0 $ 0 3. Theft, Disappearance and Destruction-Money,Securities and Other Property $ 0 $ 0 4. Robbery and Safe Burglary-Money and securities $ 0 $ 0 5. Computer and Funds Transfer Fraud $0 $ 0 5. Form Numbers of Endorsements Forming Part of This Policy When Issued: CLAIM-03, F-5011-1, F-4220-0, F-4318-0 6. Cancellation of Prior Insurance: By acceptance of this Policy you give us notice cancelling prior policies or bonds numbered: the cancellations to be effective at the time this policy becomes effective. This Policy has been signed by the Company's President and Secretary, but it shall not be binding unless it is countersigned by its authorized representative. Michael S.Wilder,Secretary Ramani Ayer,President&COO Countersigned by: Authorized Representative Form F-4201-0 Page 1 of 12 © 1998, The Hartford Wells Fargo Business Online@ Sign Off[ Home I Locations I Contact Us( Online Security Guarantee e Accounts , Transfers&Payments Brokerage Account Services Messages&Alerts Online Solutions Open an Account Overview : Bill Pay Transfers Bill Pay Overview Payments Payees eBills Reports Notices User Profile <Back to Previous Paae Payments Help To report a problem with a Payment Details Ej Help payment in Payment Processed,Check Cashed or Stop/Return status,select the Inquire about your payment link.We recommend that you The Hartford (Account Number xxxxxx4907) wait until after the Deliver By date to verify whether the Payment Account Send On Payee Name Amount Reference payee received the payment. and Address # Learn more about: XXXXXXXXX3689 BUSINESS CHECKING 04/28/2015 THE $182.00 GB49LKD6 Address on File HARTFORD Payment Twe INSURANCE Check Number PO BOX Deliver By 660916 Stop/Return DALLAS,TX 75266 Name on Account ORANGE COUNTY LITERACY COUNCIL Business Name ORANGE COUNTY LITERACY COUNCIL Payment Type Electronic Memo/Invoice# bonding Deliver By 05/01/2015 Status Payment Processed on 04/28/2015 Transaction Details Proof of Payment Questions about this payment? Inquire about your payment Bill Pay Overview I Payments I Payees I eBills I Reports I Notices I User Profile Overview I Bill Pay I Transfers Accounts I Transfers&Payments I Brokerage I Account Services I Messages&Alerts I Online Solutions I Open an Account Home I Locations I Contact Us I Privacy,Security & Legal I Sign Off 0 Equal Housing Lender ©2001-2015 Wells Fargo.All rights reserved. Insurance Bill Page 1 Pay 0.6ring:WWW. h4hartfdnic- rtlseiVicecerrteit For Billing Questions Call:1-866-467-8730 7 a.m.to 7 p.m. Central Time(Mon-Fri) THE HARTFORD Billing Company: Report Bond Claims to: 1-888-266-3488 Hartford Fire Insurance Company Bill Date: 04/20/15 Billing Account#: 12274907 To Pain Ft 1.;$182.00 —In—imu—m0we.-$18-2.00 * JM: - I Due Date. If your payment is not received by the due date,a late fee of$30.00 will be assessed. Named Insured: ORANGE COUNTY LITERACY COUNCIL Your Agent: HIGH & RUBISH INSURANCE AGENCY 01 IMPORTANT ME-S—SAPP ACCIOUNTSU�ARY Previous Account Balance $182.00 Thank you for renewing your insurance with The Hartford. Payments &Adjustments -$182.00 Premium Activity $182.00 New Fee(s) $0.00 Account Balance $182.00 TRANSACTION DEWLS(since your last bill) Trransaataun paymentpayments! Premtutn F" Policy Type MM Date t Act" 0212311S Renewal 228DDFB3274 Fidelity $182.00 0510SM4 Payment-Thank You -$182.00 L sJO-W Thank you for selecting The Hartford. We appreciate your business. .............................................. Please detach here and inseft with your pa, yment, Wrae the account number an the check and make pay le The H rtfo pay to e a rd. Check below and complete Account reverse side to request: Number: 12274907 Payment Due Date 05r20115 ❑ Address Changes ❑ Policy Cancellation Amount Pay in Full --mimmum 0K Mail Payments To: [Enclosed: 00 The Hartford P 0 Box 660916 2131 Dallas, TX 75266-0916 ORANGE COUNTY LITERACY COUNCIL INC IIII-Ill JI--11111111111 I'll I III III I IIIIIII IIIIWI 200 N GREENSBORO ST STE C-2 CA CARRBORO, NC 27510 2212274907172702810000001820000000018200810003 68148821 04120/15 32 22 12274907 27 NU57