HomeMy WebLinkAbout2015-317-E DSS - Holcomb and Cabe to provide legal consultation to agency staff regarding child welfare issues and adult protective cases of OC DSS $165,000 DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401 DOE9 Contract 468-2001
Holcomb and Cabe,L.L.P.
Contract# 68-2001 Fiscal Year Begins Julyl. 201.5_Ends June 30,2016
This contract is hereby entered into by and between the Orange County Department of Social Services (the "County")and
Holcomb and Cabe, L.L.F. (the "Contractor") (referred to collectively as the "Parties"). The Contractor's federal tax
identification number or Social Security Number is
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&Certification Regarding Nondiscrimination(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) State Certifications (Attachment M)
(10) Outcomes and Reporting(Attachment N)
(11) Contract Determination Questionnaire
These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or
agreements.
1. 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.
2. Effective Period: This contract shall be effective on July 1,2015 and shall terminate on June 30,2016.The contract may
automatically be extended for two additional one year terms under the same terms of this Agreement unless one of the
Parties provides the other with notice of intent to terminate or amend no later than 60 days prior to the end of the contract
term. This contract must be twelve months or less.
3. 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 shall meet the requirements set forth in Attachment N, Outcomes and Reporting.
4. 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$165,000. This
amount consists of$165,000 in Federal (CFDA # _ _�, State and County funds, $0 (source of other funds if
applicable.
[X] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor's matching requirement is $ , which shall consist of:
[ ]In-kind [ ] Cash
[ ] Cash and In-kind [ ] 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 $165,000.
5. Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon termination of this contract.
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6. Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 &23 and OMB Circular—CFR
Title 2 Grants and Agreements, Part 200, and shall disclose all information required by 42 USC 455.104, or 42 USC
455.105, or 42 USC 455.106,
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 Parry to the other and all questions about
the contract from one Party to the other shall be addressed and delivered to the other Party'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 Parry 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.
9. Key Personnel: Carol Holcomb is the Key Personnel assigned to the performance of this contract. Ms. Holcomb must
perform at least 80 percent of all services described in the Scope of Work, Attachment B.
For the County:
IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS
Denise Shaffer, Social Work Program Director Denise Shaffer, Social Work Program Director
Orange County Department of Social Services Orange County Department of Social Services
P.O. Box 8181 2501 Homestead Road
Hillsborough,NC 27278 Chapel Hill,NC 27516
(919)245-2246
dshafferoco.oran e.nc.us
For the Contractor:
IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS
Carol Holcomb Carol Holcomb
Holcomb and Cabe, L.L.P. Holcomb and Cabe,L.L.P.
2013 S. Lakeshore Drive 2013 S. Lakeshore Drive
Chapel Hill,NC 27514 Chapel Hill,NC 27514
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14. No Assignment or Sub-Contract: Contractor shall not sub-contract out any of the services provided for in this
Agreement or make any assignment of this Agreement(including rights to payments)without the prior written Consent of
the County as specified more fully in Attachment A, General Terms and Conditions.
11. Supplementation of Expenditure of Public Funds: The Contractor assures that funds received pursuant to this contract
shall be used only to supplement, not to supplant, the total amount of federal, state and local public funds that the
Contractor otherwise expends for contract services and related programs.Funds received under this contract shall be used
to provide additional public funding for such services; the funds shall not be used to reduce the Contractor's total
expenditure of other public funds for such services.
12. Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to make disbursements in
accordance with the following requirements:
a. Implement adequate internal controls over disbursements;
b. Pre-audit all vouchers presented for payment to determine:
i. Validity and accuracy of payment
ii. Payment due date
iii. Adequacy of documentation supporting payment
iv. Legality of disbursement
c. Assure adequate control of signature stamps/plates,
d. Assure adequate control of negotiable instruments; and
e. Implement procedures to insure that account balance is solvent and reconcile the account monthly.
13. Outsourcing to Other Countries: The Contractor certifies that it has identified to the County all jobs related to the
contract that have been outsoureed to other countries,if any.The Contractor further agrees that it will not outsource any
such jobs during the term of this contract without providing notice to the County.
14. Federal Certifications: Individuals and Organizations receiving federal funds must ensure compliance with certain
certifications required by federal laws and regulations. The contractor is hereby complying with Certifications regarding
Nondiscrimination, Drug-Free Workplace Requirements, Environmental Tobacco Smoke, Debarment, Suspension,
Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor's authorized representative.
15. Relationship of the Parties: Contractor is an independent contractor of the County.Contractor represents that it has or
will secure,at its own expense,all personnel required in performing the services under this Agreement. Such personnel
shall not be employees of or have any contractual relationship with the County. All personnel engaged in work under this
Agreement shall be fully qualified and shall be authorized or permitted under state and local law to perform such services.
It is further agreed by Contractor that it shall obey a]I State and Federal statutes,rules and regulations which are applicable
to provisions of the services called for herein. Neither Contractor nor any employee of the Contractor shall be deemed an
officer, employee or agent of the County.
16. 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.
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 11 A and Article 44 of North Carolina General Statute
Chapter 66.
[SIGNATURE PAGE TO FOLLOW]
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DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401 DOE9 Contract#68-2001
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HOLC ��G""�ABE,L.L.P.
(Ark N ( mt 7/1/2015
Signature Date
Carol Holcomb
Printed Name Title
ORANGE T119,NORTH CAROLINA
,Vt tf �A�xw�t V S 7/6/2015
By: _
Bonnie Hamm Mtl Mt;,'County Manager Date
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DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401DOE9
Contract 068-2001
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ATTACHMENT A
GENERAL TERMS AND CONDITIONS
Orange County Department of Social Services
Relationships of the Parties and Contractor that any such person or entity, other than
the County or the Contractor,receiving services or benefits
Independent Contractor: The Contractor is and shall be under this contract shall be deemed an incidental
deemed to be an independent contractor in the performance beneficiary only.
of this contract and as such shall be wholly responsible for
the work to be performed and for the supervision of its Indemnity and Insurance
employees. The Contractor represents that it has, or shall
secure at its own expense, all personnel required in Indemnification: The Contractor agrees to indemnify and
performing the services under this agreement. Such hold harmless the County and any of their officers,agents
employees shall not be employees of, or have any and employees,from any claims of third parties arising out
individual contractual relationship with the County. or any act or omission of the Contractor in connection with
the performance of this contract.
Subcontracting: The Contractor shall not subcontract any
of the work contemplated under this contract without prior Insurance: During the term of the contract,the Contractor
written approval from the County. Any approved at its sole cost and expense shall provide commercial
subcontract shall be subject to all conditions of this insurance of such type and with such terms and limits as
contract. Only the subcontractors specified in the contract may be reasonably associated with the contract. As a
documents are to be considered approved upon award of minimum, the Contractor shall provide and maintain the
the contract. The County shall not be obligated to pay for following coverage and limits:
any work performed by any unapproved subcontractor. (a) Worker's Compensation - The contractor shall
The Contractor shall be responsible for the performance of provide and maintain Worker's Compensation
all of its subcontractors. Insurance as required by the laws of North
Carolina,as well as employer's liability coverage
Assignment: No assignment of the Contractor's with minimum limits of$500,000.00,covering all
obligations or the Contractor's right to receive payment of Contractor's employees who are engaged in any
hereunder shall be permitted. However, upon written work under the contract. If any work is sublet,the
request approved by the issuing purchasing authority,the Contractor shall require the subcontractor to
County may: provide the same coverage for any of his
(a) Forward the Contractor's payment check(s) employees engaged in any work under the
directly to any person or entity designated by the contract.
Contractor, or (b) Commercial General Liability - General
(b) Include any person or entity designated by Liability Coverage on a Comprehensive Broad
Contractor as a joint payee on the Contractor's Form on an occurrence basis in the minimum
payment check(s). amount of$1,000,000.00 Combined Single Limit.
In no event shall such approval and action obligate the (Defense cost shall be in excess of the limit of
County to anyone other than the Contractor and the liability.)
Contractor shall remain responsible for fulfillment of all (c)Automobile Liability Insurance: The Contractor
contract obligations. shall provide automobile liability insurance with a
combined single limit of$500,000.00 for bodily
Beneficiaries: Except as herein specifically provided injury and property damage; a limit of
otherwise,this contract shall inure to the benefit of and be $500,000.00 for uninsuredlunder insured motorist
binding upon the parties hereto and their respective coverage; and a limit of$25,000.00 for medical
successors. It is expressly understood and agreed that the payment coverage. The Contractor shall provide
enforcement of the terms and conditions of this contract, this insurance for all automobiles that are:
and all rights of action relating to such enforcement, shall (a) owned by the Contractor and used in the
be strictly reserved to the County and the named performance of this contract;
Contractor.Nothing contained in this document shall give (b) hired by the Contractor and used in the
or allow any claim or right of action whatsoever by any performance of this contract; and
other third person.It is the express intention of the County
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(c) Owned by Contractor's employees and The contractor will maintain Insurance requirements if
used in performance of this contract("non- required as noted under Article 7 Rule R2-36 of the North
owned vehicle insurance"'). Non-owned Carolina Utilities Commission.
vehicle insurance protects employers when
employees use their personal vehicles for Default and Termination
work purposes. Non-owned vehicle
insurance supplements, but does not Termination Without Cause: The County may terminate
replace,the car-owner's liability insurance. this contract without cause by giving 30 days written
notice to the Contractor.
The Contractor is not required to provide and maintain
automobile liability insurance on any vehicle—owned, Termination for Cause: If, through any cause, the
hired, or non-owned--unless the vehicle is used in the Contractor shall fail to fulfill its obligations under this
performance of this contract. contract in a timely and proper manner,the County shall
(d) The insurance coverage minimums specified in have the right to terminate this contract by giving written
subparagraph(a)are exclusive of defense costs. notice to the Contractor and specifying the effective date
(e) The Contractor understands and agrees that the thereof. In that event,all finished or unfinished deliverable
insurance coverage minimums specified in items prepared by the Contractor under this contract shall,
subparagraph (a) are not limits, or caps, on the at the option of the County, become its property and the
Contractor's liability or obligations under this contract. Contractor shall be entitled to receive just and equitable
(f) The Contractor may obtain a waiver of anyone or more compensation for any satisfactory work completed on such
of the requirements in subparagraph (a) by materials,minus any payment or compensation previously
demonstrating that it has insurance that provides made. Notwithstanding the foregoing provision, the
protection that is equal to or greater than the coverage Contractor shall not be relievcd of liability to the County
and limits specified in subparagraph (a). The County for damages sustained by the County by virtue of the
shall be the sole judge of whether such a waiver Contractor's breach of this agreement,and the County may
should be granted. withhold any payment due the Contractor for the purpose
(g) The Contractor may obtain a waiver of any one or more of setoff until such time as the exact amount of damages
of the requirements in paragraph(a)by demonstrating due the County from such breach can be determined. In
that it is self-insured and that its self-insurance case of default by the Contractor, without limiting any
provides protection that is equal to or greater than the other remedies for breach available to it,the County may
coverage and limits specified in subparagraph(a). The procure the contract services from other sources and hold
County shall be the sole judge of whether such a the Contractor responsible for any excess cost occasioned
waiver should be granted. thereby. The filing of a petition for bankruptcy by the
(h) Providing and maintaining the types and amounts of Contractor shall be an act of default under this contract.
insurance or self-insurance specified in this paragraph
is a material obligation of the Contractor and is of the Waiver of Default: Waiver by the County of any default
essence of this contract. or breach in compliance with the terms of this contract by
(i) The Contractor shall only obtain insurance from the Provider shall not be deemed a waiver of any
companies that are authorized to provide such subsequent default or breach and shall not be construed to
coverage and that are authorized by the Commissioner be modification of the terms of this contract unless stated
of Insurance to do business in the State of North to be such in writing, signed by an authorized
Carolina.All such insurance shall meet all laws of the representative of the County and the Contractor and
State of North Carolina, attached to the contract.
(j} The Contractor shall comply at all times with all lawful
terms and conditions of its insurance policies and all Availability of Funds: The parties to this contract agree
lawful requirements of its insurer. and understand that the payment of the sums specified in
(k) The Contractor shall require its subcontractors to this contract is dependent and contingent upon and subject
comply with the requirements of this paragraph. to the appropriation, allocation, and availability of funds
(1) The Contractor shall demonstrate its compliance with for this purpose to the County.
the requirements of this paragraph by submitting
certificates of insurance to the County before the Force Majeure: Neither party shall be deemed to be in
Contractor begins work under this contract. default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of
Transportation of Clients by Contractor: war,hostile foreign action,nuclear explosion,riot,strikes,
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civil insurrection,earthquake,hurricane,tornado,or other
catastrophic natural event or act of God. Health Insurance Portability and Accountability Act
(HIPAA): The Contractor agrees that, if the County
Survival of Promises: All promises,requirements,terms, determines that some or all of the activities within the
conditions, provisions, representations, guarantees, and scope of this contract are subject to the Health Insurance
warranties contained herein shall survive the contract Portability and Accountability Act of 1996, P.L. 104-91,
expiration or termination date unless specifically provided as amended ("HIPAA"), or its implementing regulations,
otherwise herein, or unless superseded by applicable it will comply with the HIPAA requirements and will
Federal or State statutes of limitation, execute such agreements and practices as the County
may require to ensure compliance.
Intellectual Property Rights
(a) Data Security: The Contractor shall adopt and
Copyrights and Ownership of Deliverables: All apply data security standards and procedures
deliverable items produced pursuant to this contract are the that comply with all applicable federal, state and
exclusive property of the County. The Contractor shall not local laws,regulations, and rules.
assert a claim of copyright or other property interest in
such deliverables. (b) Duty to Report: The Contractor shall report a
suspected or confirmed security breach to the
Federal Intellectual Property Bankruptcy Protection local Department of Social Services Contract
Act: The Parties agree that the County shall be entitled to Administrator within twenty-four(24)hours
all rights and benefits of the Federal intellectual Property after the breach is first discovered,provided that
Bankruptcy Protection Act, Public Law 100-506,codified the Contractor shall report a breach involving
at 11 U.S.C. 365 (n)and any amendments thereto. Social Security Administration data or Internal
Revenue Service Data within one (1)hour after
Compliance with Applicable Laws the breach is first discovered.
Compliance with Laws: The Contractor shall comply (c) Cost Borne by Contractor: If any applicable
with all laws, ordinances, codes, rules, regulations, and federal, state,or local law,regulation or rule
licensing requirements that are applicable to the conduct of requires the Contractor give written notice of a
its business, including those of federal, state, and local security breach to affected persons,the Contract
agencies having jurisdiction and/or authority. Pursuant to shall bear the cost of the notice.
the terms of North Carolina General Statute 153A-449(b)
no County may enter into a contract with a contractor Trafficking Victims Protection Act of 2000
unless the contractor and the contractor's subcontractors The Contractor will comply with the requirements of
comply with the requirements of Article 2 of Chapter 64 of Section 106(g) of the Trafficking Victims Protection Act
the North Carolina General Statutes. Where applicable, of 2000,as amended(22 U.S.C. 7104)
failure to maintain compliance with the requirements of
Article 2 of Chapter 64 of the General Statutes constitutes Executive Order#24: It is unlawful for any vendor,
Provider's breach of this Agreement. By executing this contractor, subcontractor or supplier of the state to make
Agreement Provider affirms Provider is in compliance with gifts or to give favors to any state employee. For
Article 2 of Chapter 64 of the North Carolina General additional information regarding the specific
Statutes. requirements and exemptions, contractors are
encouraged to review Executive Order 24 and G.S. Sec.
Title VI,Civil Rights Compliance: In accordance with 133-32.
Federal law and U.S. Department of Agriculture(USDA)
and U.S. Department of Health and Human Services Confidentiality
(HHS) policy, this institution is prohibited from
discriminating on the basis of race,color, national origin, Confidentiality: Any information, data, instruments,
sex, age or disability. Under the Food Stamp Act and documents, studies or reports given to or prepared or
USDA policy, discrimination is prohibited also on the assembled by the Contractor under this agreement shall be
basis of religion or political beliefs. kept as confidential and not divulged or made available to
any individual or organization without the prior written
Equal Employment Opportunity: The Contractor shall approval of the County.The Contractor acknowledges that
comply with all federal and State laws relating to equal in receiving,storing,processing or otherwise dealing with
employment opportunity. any confidential information it will safeguard and not
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further disclose the information except as otherwise sales of tangible personal property to purchasers in North
provided in this contract. Carolina. The conditions include: (a) maintenance of a
retail establishment or office; (b) presence of
Oversight representatives in the State that solicit sales or transact
business on behalf of the vendor; and (c) systematic
Access to Persons and Records: The State Auditor shall exploitation of the market by media-assisted, media-
have access to persons and records as a result of all facilitated, or media-solicited means. The Contractor
contracts or grants entered into by State agencies or certifies that it and all of its affiliates (if any) collect all
political subdivisions in accordance with General Statute required taxes.
147-64.7. Additionally,as the State funding authority,the
Department of Health and Human Services shall have E-Verify
access to persons and records as a result of all contracts or
grants entered into by State agencies or political Pursuant to G.S. 143-48.5 and G.S. 147-3395(g), the
subdivisions. undersigned hereby certifies that the Contractor named
below,and the Contractor's subcontractors,complies with
Record Retention: Records shall not be destroyed, the requirements of Article 2 of Chapter 64 of the NC
purged or disposed of without the express written consent General Statutes, including the requirement for each
of the Division. State basic records retention policy employer with more than 25 employees in North Carolina
requires a]1 grant records to be retained for a minimum of to verify the work authorization of its employees through
five years or until all audit exceptions have been resolved, the federal E-Verify system." E-Verify System Link:
whichever is longer. If the contract is subject to federal www.uscis.gov
policy and regulations,record retention may be longer than
five years since records must be retained for a period of Miscellaneous
three years following submission of the final Federal
Financial Status Report, if applicable, or three years Choice of Law: The validity of this contract and any of its
following the submission of a revised final Federal terms or provisions,as well as the rights and duties of the
Financial Status Report. Also, if any litigation, claim, parties to this contract,are governed by the laws of North
negotiation, audit, disallowance action, or other action Carolina.The Contractor, by signing this contract,agrees
involving this Contract has been started before expiration and submits,solely for matters concerning this Contract,to
of the five-year retention period described above, the the exclusive jurisdiction of the courts of North Carolina
records must be retained until completion of the action and and agrees, solely for such purpose, that the exclusive
resolution of all issues which arise from it,or until the end venue for any legal proceedings shall be Orange County,
of the regular five-year period described above,whichever North Carolina. The place of this contract and all
is later. The record retention period for Temporary transactions and agreements relating to it, and their situs
Assistance for Needy Families (TANF) and MEDICAID and forum,shall be Orange County,North Carolina,where
and Medical Assistance grants and programs must be all matters,whether sounding in contract or tort,relating to
retained for a minimum of ten years. the validity,construction, interpretation,and enforcement
shall be determined.
Warranties and Certifications
Amendment: This contract may not be amended orally or
Date and Time Warranty: The Contractor warrants that by performance. Any amendment must be made in written
the product(s) and service(s) furnished pursuant to this form and executed by duly authorized representatives of
contract("product"includes,without limitation,any piece the County and the Contractor.
of equipment,hardware,firmware,middleware,custom or
commercial software,or internal components,subroutines, Severability: In the event that a court of competent
and interfaces therein)that perform any date and/or time jurisdiction holds that a provision or requirement of this
data recognition function, calculation, or sequencing will contract violates any applicable law, each such provision
support a four digit year format and will provide accurate or requirement shall continue to be enforced to the extent it
date/time data and leap year calculations. This warranty is not in violation of law or is not otherwise unenforceable
shall survive the termination or expiration of this contract. and all other provisions and requirements of this contract
shall remain in full force and effect.
Certification Regarding Collection of Taxes: G.S. 143-
59.1 bars the Secretary of Administration from entering Headings: The Section and .Paragraph headings in these
into contracts with vendors that meet one of the cond itions General Terms and Conditions are not material parts of the
of G.S. 105-164.8(b)and yet refuse to collect use taxes on
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agreement and should not be used to construe the meaning Department of Revenue for a refund of all sales and use
thereof. taxes paid by them in the performance of this contract,
pursuant to G.S. 105-164.14; and (b) exclude all
Time of the Essence: Time is of the essence in the refundable sales and use taxes from all reportable
performance of this contract. expenditures before the expenses are entered in their
reimbursement reports.
Key Personnel: The Contractor shall not replace any of
the key personnel assigned to the performance of this Advertising: The Contractor shall not use the award of
contract without the prior written approval of the County. this contract as a part of any news release or commercial
The term "key personnel" includes any and all persons advertising.
identified as such in the contract documents and any other
persons subsequently identified as key personnel by the Orange County Living Wage: Orange County is
written agreement of the parties. committed to providing its employees with a living wage
and encourages agencies to which it provides funding to
Care of Property: The Contractor agrees that it shall be pursue the same goal. The County's living wage hourly
responsible for the proper custody and care of any property standard, as adopted by the Orange County Board of
furnished to it for use in connection with the performance County Commissioners annually, can be found in the
of this contract and will reimburse the County for loss of, Orange County Budget Ordinance. To the extent possible,
or damage to, such property. At the termination of this Orange County recommends that the Contractor and all
contract, the Contractor shall contact the County for subcontractors provide a living wage, as defined in this
instructions as to the disposition of such property and shall section,to their employees.
comply with these instructions.
Signatures: This Agreement together with any
Travel Expenses: Reimbursement, if provided in this amendments or modifications may be executed
Agreement, to the Contractor for travel mileage, meals, electronically. All electronic signatures affixed hereto
lodging and other travel expenses incurred in the evidence the intent of the Parties to comply with Article
performance of this contract shall not exceed the rates 11A and Article 40 of North Carolina General Statute
established in County policy. Chapter 66.
Sales[Use Tax Refunds: If eligible,the Contractor and all
subcontractors shall: (a) ask the North Carolina
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ATTACHMENT B
SCOPE OF WORK
Orange County Department of Social Services
Federal Tax Id.or SSN
Contract# 68-2001
A. CONTRACTOR INFORMATION
1. Contractor Agency Name: Holcomb and Cabe L.L.P.
2. Ifdifferent from Contract Administrator Information in General Contract:
Address
Telephone Number: Fax Number: Email:
3. Name of Program (s): Legal Services
4. Status: ( )Public ( ) Private,Not for Profit (X)Private, For Profit
5. Contractor's Financial Reporting Year July 1 2015 through June 34 2016
B. Explanation of Services to be provided and to whom (include S1S Service Code): The
Contractor will provide legal consultation to agency staff regarding child welfare issues and adult
protective services cases. The Contractor will conduct court proceedings and handle other legal
matters on behalf of the County related to adoption foster care, adult protective services and
child protective services The Contractor is required to meet all goals and outcomes 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.
$165/hour
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. For
reimbursement,the Contractor must submit an original and two copies of an invoice by the fifth
of the month for the preceding month's expenditures to the designated County Administrator.
The County will reimburse the Contractor monthly upon receipt of a complete and correct) filed
report.
The Contractor shall be compensated at the hourly rate set forth in this contract for attendance at
programs, meetings and seminars relating to Social Services law, and for any,training provided to
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the Department's employees, and shall be reimbursed for lodging and transportation necesSaa for
attendance at those programs, meetings. seminars and presentations.
The Contractor shall be reimbursed for the services of clerks and legal assistants hired to assist
the Contractor in the erformance of the Contractor's duties to the County and the cost of faxin
telephone copying and postal expenses at a flat rate of $500.00/month. Related costs_ and
expenses advanced by the Contractor on behalf of the County shall be reimbursed to Contractor.
The Contractor shall be reimbursed for the services of expert witnesses hired to assist the
Contractor in the performance of the Contractor's duties to the County.
F. Area to be served/Delivery site(s): _Orange County _ _
DocuSigned by: DocuSigned by:
DAE1 E196A839455... 9FB97,4 6b...
(Signature of County Authorized Person) (Signature of Contractor)
7/2/2015 7/1/2015
(Date Submitted) (Date Submitted)
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
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
(13)(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).
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II. The site(s) for the performance of work done in connection with the specific agreement are listed
below:
1.
(Street address)
(City, county, state,zip code)
2.
(Street address)
(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(45 C.F.R. Section
82.510. Section 4 CFR Part 85, Section 85.615 and 86.620).
CERTIFICATION REGARDING NONDISCRIMINATION
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These
include but are not limited to: (a)Title VI of the Civil Rights Act of 1964 (P.L. 88-352)which prohibits
discrimination on the basis of race, color or national origin; (b)Title IX of the Education Amendments of
1972, as amended(20 U.S.C. §§1681-1.683, and 1685-1686),which prohibits discrimination on the basis
of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended(29 U.S.C. §794),which prohibits
discrimination on the basis of handicaps; (d)the Age Discrimination Act of 1975, as amended(42 U.S.C.
§§6101-6107),which prohibits discrimination on the basis of age; (e)the Drug Abuse Office and
Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug
abuse; (f)the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation
Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g)Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended,
relating to nondiscrimination in the sale, rental or financing of housing; (h)the Food Stamp Act and
USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and(i)the
requirements of any other nondiscrimination statutes which may apply to this Agreement.
F uSigned by:
6,L N hpx� Attorney
Signature Title
Holcomb & Cabe, LLP 7/1/2015
Agency/Organization Date
(Certification signature should be same as Contract signature.)
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ATTACHMENT D
CONFLICT OF INTEREST POLICY
Orange County Department of Social Services
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to
avoid any conflict of interest, even the appearance of a conflict of interest. The Organization's
Board of DirectorslTrustees or other governing body, officers, staff and agents are obligated to
always act in the best interest of the organization. This obligation requires that any Board member
or other governing person, officer, employee or agent, in the performance of Organization duties,
seek only the furtherance of the Organization mission. At all times, Board members or other
governing persons, officers, employees or agents, are prohibited from using their job title, the
Organization's name or property, for private profit or benefit.
A. The Board members or other governing persons, officers, employees, or agents of the
Organization should neither solicit nor accept gratuities, favors, or anything of monetary value
from current or potential contractors/vendors., persons receiving benefits from the Organization or
persons who may benefit from the actions of any Board member or other governing person,
officer, employee or agent. This is not intended to preclude bona-fide Organization fund raising-
activities.
B. A Board or other governing body member may, \vith the approval of Board or other governing
body, receive honoraria for lectures and other such activities while not acting in any official
capacity for the Organization. Officers may, with the approval of the Board or other governing
body, receive honoraria for lectures and other such activities while on personal days,
compensatory time, annual leave, or leave without pay. 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 a Board or other
governing body member, officer.. employee or agent is acting in any official capacity, honoraria
received in connection with activities relating to the Organization are to be paid to the
Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization
shall participate in the selection; award, or administration of a purchase or contract with a vendor
where, to his knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee or agent;
2. Any member of their family by whole or half blood, step or personal relationship or
relative-in-law,
3. An organization in which any of the above is an officer, director, or employee,
4. A person or organization with whom any of the above individuals is negotiating or has
any arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance
of a conflict of interest is to be reported to the Board or other governing body or one's supervisor
immediately.
E. Board action -- When a conflict of interest is relevant to a matter requiring action by the
Board of Directors%Trustees or other governing body. the Board member or other governing
person, officer, employee, or agent (person(s)) must disclose the existence of the conflict of
interest and be given the opportunity to disclose all material facts to the Board and members of
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committees with governing board delegated powers considering the possible confl ict of interest.
After disclosure of all material facts, and after any discussion with the person, he/she shall leave
the governing board or committee meeting while the determination of a conflict of interest is
discussed and voted upon. The remaining board or committee members shall decide if a conflict
of interest exists. In addition, the person(s)shall not participate in the final deliberation or
decision regarding the matter under consideration and shall leave the meeting during the
discussion of and vote of the Board of DirectorslTrustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other
governing body has reasonable cause to believe a member, officer, employee or agent has failed
to disclose actual or possible conflicts of interest, it shall inform the person of the basis for such
belief and afford the person an opportunity to explain the alleged fililUre to disclose. If, after
hearing the person's response and after making further investigation as warranted by the
circumstances, the Board of DirectorsTrustees or other governing body determines the member,
officer, employee or agent has failed to disclose an actual or possible conflict of interest, it shall
take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board
delegated powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or
possible conflict of interest, the nature of the conflict of interest, any action taken to
determine whether a conflict of interest was present, and the governing board's or
committee's decision as to whether a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the
transaction or arrangement that presents a possible conflict of interest, the content of the
discussion, including any alternatives to the transaction or arrangement, and a record of
any votes taken in connection with the proceedings.
Approved by:
L
Name of Or 7anization
��W Y Y
Signaturi of Organization Official
4t. 6� ,2.0 t
Date
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NOTARIZED CONFLICT OF INTEREST POLICY
State of North Carolina
County of Orange
I, nni'4/ 1� . CCU Notary Public for said County and State,
certify that (6,40 tCunR� personally appeared before me this
day and acknow ledaed that he/she is �A�J xwl k t/ of
l'uyab +1-(_&bc. U-P and by that authority dul y 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
Sworn to and subscribed before me this day of Zell 5"
i ERp .
(Official Seal) ,,`a '..... .
Notary Public 0
My Commission expiresa
•. ..................C.r ��6.
Conflict of Interest Policy(06,'04) Page 3 of 3
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HOLCOMB & C ABE. LLP
1
�'l"1'fIIL\H:TS;t'1'LAW
127 ToABERHii"L PLACE
BUILDING 100
E_'11A1'N;L II11.I„ �fOI:'1'II [":11 217514
TELEPHONE:(919)928-5701
CAROL J.HOLCOMB TELEFAX(9191 741-5817
SAMANTHA HYATT CASE W W W.HOLCC-MBC.ABE.COM
E-MAIL:CJH*HOLCOMBCABE.COM
June 9, 2015
TO: ORANGE COUNTY DEPARTMENT OF SOCIAL SERN710ES
Certification:
We certify that Holcomb & Cabe, LLP does not have any overdue tax debts, as defined by
N.C.G.S. 145-243.1, at the federal, State or local level. We further understand that any person
Nvho makes a false statement in violation of N.C.G.S. 1430-6-23(c) is guilty of a criminal
offense punishable as provided by N.C.G.S. 143C-10-1(b).
Sworn Statement:
Carol J. Holcomb and Samantha H. Cabe, being duly sworn, say that we are partners of Holcomb
& Cabe, LLP. of Chapel Hill in the State of North Carolina; and that the foregoing certification
is true, accurate and 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 to the
appropriate authorities for further action.
Carol J. H I onib, Partner am ha H. Cabe, Partner
Sworn to and subscribed before me on the day of the date of said certification.
My Gof m i& jon Expires: / zo/o
otary gnature and eal
'
Q' ri
_j c'}��,•,5,'
DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401DOE9
Contract#68-2001
Holcomb and Cabe,L.L.P.
ATTACHMENT G
CERTIFICATION REGARDING LOBBYING
Orange County Department of Social Services
Certification for Contracts, Grants, Loans and Cooperative Agreements
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 Federal, state or
local government agency, a Member of Congress, a Member of the General Assembly, an officer or
employee of Congress, an officer or employee of the General Assembly, an employee of a Member
of Congress, or an employee of a Member of the General Assembly in connection with the awarding
of any Federal or state contract, the making of any Federal or state grant,the making of any Federal
or state loan,the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal or state 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 Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or
employee of Congress,an officer or employee of the General Assembly, an employee of a Member
of Congress, or an employee of a Member of the General Assembly in connection with the awarding
of any Federal or state contract,the making of any Federal or state grant,the making of any Federal
or state loan,the entering into of any cooperative agreement, and the extension, continuation,
renewal, amendment, or modification of any Federal or state contract, grant, loan, or cooperative
agreement,the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to
Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers(including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements)and that all subrecipients shall certify and disclose
accordingly.
(4) 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 and not
more than $100,000 for each such failure.
Notwithstanding other provisions of federal OMB Circulars A-122 and A-87, costs associated with the
following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure,through in kind or cash contributions, endorsements,publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign,
political action committee, or other organization established for the purpose of influencing the
outcomes of elections;
(3) Any attempt to influence: (i)The introduction of Federal or State legislation; or(ii)the enactment or
modification of any pending Federal or State legislation through communication with any member
or employee of the Congress or State legislature(including efforts to influence State or local
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officials to engage in similar lobbying activity), or with any Government official or employee in
connection with a decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i)The introduction of Federal or State legislation; or(ii)the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity
or propaganda, or by urging members of the general public or any segment thereof to contribute to
or participate in any mass demonstration, march, rally,fundraising drive, lobbying campaign or
letter writing or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings,
gathering information regarding legislation, and analyzing the effect of legislation, when such
activities are carried on in support of or in knowing preparation for an effort to engage in
unallowable lobbying.
The following activities as enumerated in Paragraph B arc excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the
performance of a grant, contract or other agreement through hearing testimony, statements or letters
to the Congress or a State legislature, or subdivision,member, or cognizant staff member thereof, in
response to a documented request(including a Congressional Record notice requesting testimony or
statements for the record at a regularly scheduled hearing)made by the recipient member, legislative
body or subdivision, or a cognizant staff member thereof; provided such information is readily
obtainable and can be readily put in deliverable form; and further provided that costs under this
section for travel, lodging or meals are unallowable unless incurred to offer testimony at a regularly
scheduled Congressional hearing pursuant to a written request for such presentation made by the
Chairman or Ranking Minority Member of the Committee or Subcommittee conducting such
hearing.
(2) Any lobbying made unallowable by subparagraph A(3)to influence State legislation in order to
directly reduce the cost,or to avoid material impairment of the organization's authority to perform
the grant, contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant,contract,
or other agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs,total lobbying costs shall be
separately identified in the indirect cost rate proposal, and thereafter treated as other unallowable
activity costs in accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit,as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as
being allowable or unallowable pursuant to this section complies with the requirements of this
Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of
complying with this paragraph during any particular calendar month when: (1)the employee
engages in lobbying(as defined in subparagraphs(a)and(b)) 25 percent or less of the employee's
compensated hours of employment during that calendar month, and(2)within the preceding five-
year period,the organization has not materially misstated allowable or unallowable costs of any
nature, including legislative lobbying costs. When conditions(1)and(2)are met, organizations are
not required to establish records to support the allowability of claimed costs in addition to records
already required or maintained. Also, when conditions(1)and(2)are met,the absence of time logs,
calendars, or similar records will not serve as a basis for disallowing costs by contesting estimates of
lobbying time spent by employees during a calendar month.
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(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any
significant questions or disagreements concerning the interpretation or application of this section.
Any such advance resolution shall be binding in any subsequent settlements, audits or investigations
with respect to that grant or contract for purposes of interpretation of this Circular; provided,
however,that this shall not be construed to prevent a contractor or grantee from contesting the
lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly,
an employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act
regarding a federally sponsored agreement or regulatory matter on any basis other than the merits of the
matter.
r DocuSigned by:
r ;6'L Attorney
o�nnc�acs...
Signature Title
Holcomb & cabe, LLP 7/1/2015
Agency/Organization Date
(Certification signature should be same as Contract signature.)
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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 further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion- Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it 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.
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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
(1) The prospective lower tier participant certifies,by submission of this proposal,that neither it
nor its principals is presently debarred, suspended,proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this transaction by any Federal department or
agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in
this certification, such prospective participant shall attach an explanation to this proposal.
L�6'uSigned by:
Attorney
B07.4}C-74C—...Signatu Title
Holcomb & Cabe, LLP 7/1/2015
Agency/Organization Date
(Certification signature should be same as Contract signature.)
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ATTACHMENT M
STATE CERTIF[CATION
Contractor Certifications Required by North Carolina Law
Orange County Department of Social Services
Instructions
The person who signs this document should read the text of the statutes listed below and consult with counsel and other
knowledgeable persons before signing.
• The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
htt ://www.nc a.state.ne.us/EnactedLe islation/Statutes/PDF/BvArticlelCha ter 64/Article 2. df
• The text of G.S. 105-164.8(b) can be found online at:
htt�//www.nega.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-164.8.pdf
• The text of G.S. 14348.5 (S.L. 2013-418, s. 2.(d))can be found online at:
htt_p://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
• The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.ne.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-59_.1.pdf
• The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.ne.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-59.2.pdf
• The text of G.S. 147-33.95(8)(S.L. 2013-418, s. 2. (e))can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/BiIIs/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(8), the undersigned hereby certifies that the Contractor named
below, and the Contractor's subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC
General Statutes, including the requirement for each employer with more than 25 employees in North Carolina to
verify the work authorization of its employees through the federal E-Verify system." E-Verify System Link:
www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina General Statutes.
However, local government is subject to and must comply with North Carolina General Statute §153A-99.1.,
which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the work
authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below is not an
"ineligible Contractor"as set forth in G.S. 143-59.1(a)because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied under Article 5 of
Chapter 105 of the General Statutes on its sales delivered to North Carolina when the sales met one or
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more of the conditions of G.S. 105-164.8(6); and
(b) [check one of the following boxes]
❑ Neither the Contractor nor any of its affiliates has incorporated or reincorporated in a "tax haven
country" as set forth in G.S. 143-59.1(c) (2)after December 31, 2001; or
❑ The Contractor or one of its affiliates has incorporated or reincorporated in a "tax haven country"
as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but the United States is not the
principal market for the public trading of the stock of the corporation incorporated in the tax
haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor's officers, directors,
or owners (if the Contractor is an unincorporated business entity) has been convicted of any violation of Chapter
78A of the General Statutes or the Securities Act of 1933 or the Securities Exchange Act of 1934 within 10 years
immediately prior to the date of the bid solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of the
Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in response to the
requirements of G.S. 143-59.land-59.2 shall be guilty of a Class 1 felony.
Holcomb & Cabe, I-I-P
Con c r s e_ KAY
(� lTr7�CO 7/1/2015
�7_C1E9R7gtZG�arS
Signature of Contractor's Authorized Agent Date
Carol Holcomb . Attorney
Printe l me a onPgtox's Authorized Agent Title
J aw 1C� ((,,aotoL
Partner
Ei- Sp'IRd'3dd-
Signature of Witness Title
Samantha H Cabe 7/1/2015
Printed Name of Witness Date
The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and date
this document immediately thereafter.
Contractor Certifications Required by North Carolina Law Page 2 of 2
DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401DOE9
Contract#68-2001
Holcomb and Cabe,L.L.P.
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:
1. The Contractor agrees to participate in program, fiscal and administrative monitoring and/or audits,
making records and staff time available to Federal, State and County staff.
2. The Contractor agrees to take necessary steps for corrective action, as negotiated within a corrective
action plan, for any items found to be out of compliance with Federal, State, and County laws,regulations,
standards and/or terms of the Contract.
3. The Contractor agrees that continuation of and/or renewal of this Contract is contingent on meeting the
following requirements. The Contractor agrees to:
A. Assure that all court proceedings be conducted within the timeframes required by General
Statute.
B. Provide case consultation to Orange County Department of Social Services staff within a
reasonable timeframe so as to assure client safety and compliance with North Carolina laws and
regulations.
C. Assure that all court orders are prepared in a timely manner.
I DocuSigned by:
a.v'oC lka�caw��
Attorney
_ s�nFan7nnc7dcs
Signature Title
Holcomb & Cabe, LLP 7/1/2015
Agency/Organization Date
(Certification signature should be same as Contract signature.)
Outcomes (06/04) Pagel of]
DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401DOE9
a
LAWYERS LIABILITY INSURANCE 5020 Weston Parkway,Suite 200 919.677.8900 TEL
s COMPANY OF Cary, North Carolina 27513 800.662.8843 TOLL FRfE
Past Office Box 1929 919.67,.9641 rAx
MUTUAL NORTH CAROLINA Cary, North Carolina 27512-1929 www.lawyersmutuainc.com
Declarations
HOLCOMB& CABE LLP
127 TIMBERHILL PLACE
CHAPEL HILL, NC 27514
Policy Number. 31629- 3
Policy Period 07/01/2015 to 07/01/2016
12:01 A.M.Standard Time at the address of the Named Ensured stated herein
Retroactive Date: 07/01/2013
Limits of Liability: A. $ 1,000,000 A. Applicable to any individual claim or one or more
related claims. All claims arising out of the same,
related or continuing professional service.
B. $ 1,000,000 B. Aggregate limit of the Company's liability for all
damages and claims expenses without regard to
the number of Insureds, claims, demands, suits,
pleadings or claimants.
Deductible: C. $ 5,000 C. See Condition � "Deductible and Limit of
(including claims expenses) Liability," of the Policy.
Premium: $ 4,026
Endorsement Attachments:
012
In witness whereof,Lawyers Mutual Liability Insurance Company of North Carolina has caused this policy to be signed by its President and
Secretary and countersigned by a duly authorized agent of the Company.
5�L l 14��_
Secretary
Pre4ident V Authorized Agent
Lawyers Professional Liability Policy (This is a Claims-Made Policy. Defense costs are a part of the Policy
Limits and reduce the amount available to pay losses. You should read your policy for a complete
understanding of its Terms, Conditions&Coverages).
(10/0512012) PolicyForm 31629 - 2015
DocuSign Envelope ID: FFE3DC52-8928-4566-9C5B-5108C401DOE9
>° R LIABILITY INSURANCE 5020 Weston Parkway, Suite 200 919.677.8900 TEL
o Cary, North Carolina 27513 800.662.8843 TOLL FREE
919.677.9641 Fax
ER COMPANY OF
MUTUAL NORTH CAROLINA Post Office Box 1929
Cary, North Carolina 27512-1929 www.iawyersmutuainc.com
Attorney Listing / Prior Acts_Limitation Endorsement
This Endorsement, effective 12:01 A.M. on 07/01/2015 forms a part of Policy No. 31629-3 (the
"Policy") issued by LAWYERS MUTUAL LIABILITY INSURANCE COMPANY OF NORTH CAROLINA(the
"Company")and applies to HOLCOMB& CABE LLP (the"Named Insured").
It is hereby understood and agreed that as to each attorney listed below as anlnsured under this
Policy, this Policy shall not apply to such Insureds acts or omissions occurring, or series of
related act(s) or omission(s) beginning, prior to the date listed individually for each Insured below
("Prior Acts Date").
Ail Policy provisions, terms, and conditions, except as provided otherwise in this endorsement,
remain in full force and effect.
Affvrney Name Licensing State License Prior Acts Date
for Other) Number
1. SAMANTHA HYATT CABE NC 28461 09/03/2002
2. CAROL )AN HOLCOMB NC 16357 04/34/1989
Authorized Agent
END#: 012 (12/17/2014) Page 1 of 1 AttyListPALE 31629 - 2015