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2016-588-E Finance - The ArtsCenter - Outside Agency Performance Agreement
DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT,made and entered into the first day of July 2016, ("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 The ArtsCenter, a not-for-profit corporation, located at 300-G East Main 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 The ArtsCenter agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2016 to June 30, 2017. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application 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 and the Program Budget 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 as Exhibit B. 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 Revised Program Budget, the maximum sum of 10000. 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 four equal installments in the amount of $2,500. The first payment is contingent upon receipt of the agency's performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. (The ArtsCenter) Orange County Outside Agency Performance Agreement Revised 8/2016 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 e. Once Provider has satisfied its obligations as provided in (d) payment will be made 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 that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 —December 31; January 1 —March 31 and April 1 - June 30. Reports are due on January 13,April 14, and July 14 of the program fiscal year. 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. (The Arts Center) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 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 iv. Professional Liability Insurance, covering personal injury,bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. 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 • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate 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. (The Arts Center) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 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 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. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County'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 and the Orange County Anti-discrimination Policy. 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 $ 13.15 per hour. To the extent possible, Orange County recommends that The ArtsCenter 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: (The ArtsCenter) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 County: Finance&Administrative Services Provider: The ArtsCenter Orange County 300-G East Main Street Post Office Box 8181 Carrboro,NC 27510 Hillsborough,NC 27278 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire 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. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 18. 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 th.e.. Provider )� 10/25/2016 61128 Date For and dlehlgdafOrange County Government 1561A,UA,tt, tka"mt-IrStt t1 10/26/2016 0637994&74SE44.7 Bonnie Hammersley, County Manager Date (The ArtsCenter) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 ATTACHMENT "A" Orange County Certifications—FY 2016-17 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. DocuSigned by: Certifiedby: -1.1� Title: Executive Director Date: 10/25/2016 50CA30291A01428... (Provider's Signature) (The Arts Center) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 Exhibit A Provider's Outside Agency Application APPLICATION SUBMITTAL CHECKLIST FOR OFFICE USE ONLY Received By mm Agency The ArtsCenter Date/Time Complete Y/N Program(s) Youth Education (Orange County) Kamnani««ki IMAlfra«difgaMONAM IMINCUM,UMNfifolWwMUMWOM'� (Program(s) General Support(Town of Carrboro and Town of Chapel Hill) in a separate application! Section Subsection For CDBG & HOME - HUD Regulations 1. Cover Page a. ❑ Applicant Contact Information b. ❑ Project/Program Contact Information c. ❑ Funding Requests Identified d. ❑ Signed Application Cover Page 2. Agency a. ❑ Agency's Years in operation 24 CFR 570.506, Information - b. ❑ Agency's Purpose/Mission 570.507, 570.610; 24 c. ❑ Agency's Types of Services Provided CFR Parts 84 or 85 d. ❑ Agency's Experience e. ❑ Other Pertinent Information 3. Program/ a. ❑ Type of Application and Program Identified 24 CFR 570.200(a), Project b. ❑ Summary of Program 570.201-570. 208, Information - c. El Description of Identified Need 507.503 (for each d. ❑ Description of Population to be Served program/ project for e. ❑ Activity Manager and Location Description which funding f. ❑ Activity Implementation Timeline is requested) g. ❑ Agency Collaboration h. ❑ Describe Impact of Reduced/No Allocation i. ❑ Other Pertinent Information j. ❑ Complete Target Population/Beneficiary Chart k. ❑ Complete Schedule of Positions I. ❑ Signed Conflict of Interest Disclosure m„ ❑ Complete Work Statement ilPage DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's Outside Agency Application MAIN APPLICATION .................................................................... _._._w 24 CFR 570.200(a), 4. Financial (for Program Budget Worksheet and Detail should reflect 570.201-570. 208, each expenses for the entire program and ALL sources of 507.503 program/ funding. 24 CFR 570.506, project for 570.507, 570.601, which funding a. ❑ Program Budget Worksheet 570.602, 570.607(b), is requested) b. ❑ Program Budget Detail 570.611 24 CFR c. El Cost Per Unit 570.502-570.504, d. [' Agency Operating Budget Worksheet 570.506, 570.507, 570.610; 24 CFR Parts 84 or 85, and OMB Circulars A-87 or A- 122; Treasury Circular 1075 5. Supplemental A. ❑ Part A: CDBG & HOME Sections (as B. ❑ Part B: Construction/Rehab applicable) 6. Attachments a. ❑ Audit: Organizations receiving$300,000 or more OMB Circular A-133 in Federal financial assistance, and/or organizations with more than $500,000 of receipts and expenditures in a fiscal year, must secure an audit. b. ❑ IRS Federal Form 990 c. ❑ NC Solicitation License d. ❑ IRS Federal Tax-Exemption Letter e. ❑ Certificate of Insurance f. ❑ List of Board of Directors 24 CFR Parts 84 or 85 g. ❑ Articles of Incorporation/Bylaws 24 CFR 570.208, h. [' Authorization to Request Funds 570.500(c), 570.611 i. ❑ Authorized official designation j. 1113-R Fee Verification Main Application 1/21/2016 4:03:32 PM Page 2 of DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's Outside Agency Application MAIN APPLICATION 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: The ArtsCenter Applicant Organization's Physical Address: 300-G East Main St., Carrboro, NC 27510 Applicant Organization's Mailing Address: SAME Applicant Organization's Web Address: www.artscenterlive.org Executive Director: Daniel Y. Mayer Telephone Number: 919-929-2787x217 E-Mail: dmayer @artscenterlive.org DUNS Number: 029686396 (Dun & Bradstreet, Inc. provides this number at no charge, and it is required for Federal funding recipients.) b) Project/Program Contact Information Project/Program Name: The ArtsCenter's arts and education programs Project/Program Primary Contact and Title: Julie Tomkovick, Development Director Telephone Number: 919-929-2787x213 E-Mail: development@artscenterlive.org c) Funding Request Identification Total Project/Program Cost: $1,627,741 Total Amount of Funds Requested: $45,000 Proposed Use of Funds Requested (2-3 Line Maximum): Support for ArtsCenter Educational Youth Pro•rams from Oran s e Count . here is a se iterate a.Oration for General Su**on of one ear of ArtsCenter Programs from the Town of Carrboro and Town of Chapel Hill.1 Please check all types, sources, and amounts of funding being requested. You must submit an application package for each funding source. *The Participating Jurisdiction reserves the right to fund projects from any funding source, subject to eligibility and funding constraints. ❑ CDBG Non-Construction (CH) $ ❑ Grant El Loan El CDBG Construction (CH) $ ❑ Grant El Loan L=l HOME CHDO $ ❑ Grant ❑ Loan HOME Other $ [' Grant ❑ Loan ® Human Services: ® Carrboro $20000 ® Chapel Hill $15000 ® Orange County $10000 d) To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. Signature M.. ;ecut° Directo Dat Signature: E4 l ( 1 1 :Toard r airperson D to Main Application 1/21/2016 4:03:32 PM Page 3 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider'sa i518 gewyialication 2. AGENCY INFORMATION Please provide the following information about your agency (Limit of 2 pages total): a) Years in Operation, Date of Incorporation (Month/Year) 41 years, April 1975 b) Agency's Purpose/Mission The ArtsCenter exists in order to educate and inspire artistic creativity and to enrich the lives of people of all ages. c) Types of Services the Agency Provides The ArtsCenter services and programs cover five main areas: ArtSchool. ArtSchool at The ArtsCenter is Orange County's most comprehensive non-profit resource for continuing education in the arts on a non-degree, community basis. The ArtSchool now offers more than 370 classes in all artistic disciplines for all experience levels and ages, awards more than 15 scholarships annually, and offers work-study opportunities. Youth Programs. The ArtsCenter has provided artistically excellent, age-appropriate and accessible arts experiences to Triangle families for more than 30 years. Currently, The ArtsCenter offers area youth and families: the School Show Series with 90 shows; the SuperFun Concert Series for family audiences; ArtsCamp for kids in the summer months; AfterSchool Arts Immersion through the school year; Arts In Education during the school day; and year round Youth Arts Classes (YAC) including fine art classes, workshops, and mini-camps in acting, drawing, painting, writing, photography, ceramics, dance, digital music composition, improvisation and more. Scholarships are available for all Youth programs. Gallery. The Nicholson Gallery features the work of local and regional artists on a rotating basis. This gallery highlights the work of more than 100 local and regional artists in 12 exhibitions a year as solo or group shows. The Emerging Artist Corridor provides 12 monthly exhibits featuring visual artists at the beginning their professional careers. Theatre. International theatre at its most local, ArtsCenter Stage showcases the work of emerging and established artists hailing from next door to around the world. ArtsCenter Stage features newer works, while its second-stage series includes improvisation and storytelling, musicals and operas, stand-up comedy and film screenings, new works in development and theatre for younger and older audiences. ArtsCenter Stage is community-oriented theatre with a commitment to developing new artists and audiences, especially through the annual 10 x 10 short play festival and bi-annual Redbird New Plays festival. Concerts. The ArtsCenter presents approximately 60 concerts and jams for adults each year, representing the spectrum of musical genres by touring artists including folk, blues, Celtic, rock, singer-songwriter, old-time, and bluegrass. Recent sold out shows include Bill Frisell and Asleep at the Wheel. d) Agency's Experience with Similar Programs as the Funding Request The ArtsCenter began as one painting class in a walk up studio on East Main Street in Carrboro in 1974. From that modest first step and the extraordinary creative vitality of Carrboro, an amazing Main Application 1/21/2016 4:03:32 PM Page 4 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider'sathi eATagalication community arts and education organization was born. During 2015, The ArtsCenter served more than 110,000 people, one third under the age of 18. Our work created a local economic impact estimated at $3,488,830, generating 111 full time jobs and $328,000 in state and local tax revenue. Our core services are The Art School (serving 15-105 year olds) and our youth programs (serving pre-K through high schoolers through Afterschool Arts Immersion, Arts-In Education, ArtsCamp, School Shows, and Youth Art Classes). Additionally we serve audiences via theater performances, live concerts, and gallery exhibits. Many of these activities are coordinated collaboratively with other community organizations, area businesses, area schools, and local governmental agencies and departments. The ArtsCenter has decades of experience in providing quality arts programming for our community and in providing educational youth programs in the arts, and continues to develop new programs and initiatives to serve Orange County's diverse residents. e) Other Pertinent Agency Information We partner to provide services together with other institutions including: the Ackland Museum, Chapel Hill Carrboro City Schools, Friends of World Music, Chapel Hill-Carrboro PTA, Downtown CH Partnership, Empowerment Inc., Peoples Channel, Triangle Weavers, Orange Co Human Services, Orange Co. Schools, OCAC, Town of Carrboro, Town of Chapel Hill, UNC-CH/Orange Co. Partnership for Children, and WCOM-FM, as well as many area businesses. As a rental venue, we provide a community gathering place to: Arts In Action, Carrboro Music Festival, Chapel Hill-Carrboro Chamber of Commerce, Ethical Humanist Society, New Life Church, First In Families, Girls Rock NC, NC Squares, NC Youth Tap Ensemble, Redeye Distribution, Sacred Arts Tour, Triangle Jazz Orchestra, Triangle Youth Ballet, and UNC's Med School/ Business School/ Law School/and Pharmacy School and other area organizations. Main Application 1/21/2016 4:03:32 PM Page 5 of 20 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's Outside Agency Application MAIN APPLICATION 3. PROJECT/PROGRAM INFORMATION Agency & Program Name: The ArtsCenter–ArtsCenter Youth Education Program Su••ort As you complete your application, complete only those sections that pertain to the type of application you are submitting. The application is divided into several sections and not all sections apply to every project. Every applicant MUST complete the main application. a) Check the type of funding request for this application package submittal and complete the application and supplemental application sections as specified below: ® Human Services (Main Application Only) ❑ AH Non-Construction (Main Application Only) ❑ AH Construction—(Main Application AND Part B) ❑ AHDR Non-Construction (Main Application Only) ❑ AHDR Construction —(Main Application AND Part B) ❑ CDBG Non-Construction — (Main Application AND Part A) • CDBG Construction —(Main Application AND Part A AND Part B) ❑ HOME CHDO Set-aside —(Main Application AND Part A) ❑ HOME Other —(Main Application AND Parts A AND Part B) Indicate the type of program for which you are requesting funding: Program Category Youth Adult Elderly Disabled Public Housing (not elderly) Neighborhoods/Residents Education _.� X X X X Health and Nutrition Job Training S•orts &Arts Activities X X X X Pre-School Activities After-School Activities X Mentoring Transportation Housin Other: Please specify Program/Project Description (Label your responses as outlined below; not to exceed 3 pages.) Please provide the following information about the proposed program/project: b) Summarize the program services proposed and how the program will address the chosen Town/County priority? The ArtsCenter will provide one year of youth educational and arts activities that reach more than 31,000 children primarily from Orange County. The ArtsCenter's Youth Education division includes School Shows, Arts-In-Education residencies, summer ArtsCamps, Afterschool Arts Immersion, Youth Art Classes, and SuperFun series. We are seeking funding for scholarships for underserved children to participate in Afterschool Arts Immersion (at The ArtsCenter) and Arts-I n- Education residencies (in Orange County Schools). Youth Education fits well within the BOCC Goal #6: "Ensure a high quality of life and lifelong learning that champions diversity [and] education at all levels..." Main Application 1/21/2016 4:03:32 PM P a g e 6 a l' 2 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provid ersaithi 91/4epfsffeyo-kffili cation c) Describe the local need or problem to be addressed in relation to the Consolidated Plan or other community priorities (i.e. Council/Board Goals). Cite local data to support the need for this program and the population being served. As noted in the BOCC strategic goals adopted in 2009:, it is important to the county to (Goal # 3:) Implement planning and economic development polices which create a balanced, dynamic local economy...which promotes diversity ... while embracing community values and (Goal #6:) "Ensure a high quality of life and lifelong learning that champions diversity [and] education at all levels..." The ArtsCenter as a whole on contributes to fulfilling goal #3 and the Youth Education division helps reach goal #6 with the diversity of artists and cultures represented. The need for ArtsCenter programs and services is reflected in the organizations growth statistics: In 1987, we served 60,000 patrons annually—in FY2014-15, we served more than 110,000. The ArtsCenter regularly surveys youth program parents to ensure that patron expectations are being met, to learn new and evolving needs, to discover new populations to be served, and to gather suggestions for improvement. Orange County and Chapel Hill Carrboro City School teachers, administrators, and PTA regularly evaluate the quality and value of the School Shows and Arts-In-Education residencies, which are both designed to reinforce current NC standards and curricula. Pages 84-85 of the Consolidated Plan note that "Orange County, North Carolina is home to a university, hospitals, and some manufacturing establishments and therefore has a diverse economy. The three (3) largest categories of jobs in Orange County in business by sector is as follows: Arts, Entertainment, Accommodations - 4,693 jobs; Education and Health Care Services - 4,025 jobs; Retail Trade - 2,942 jobs." As an employer of more than 1000 artists per year on a part time or contract basis, The ArtsCenter contributes to the health and diversity of Orange County employment and acts as an economic engine for our area. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries. The ArtsCenter Youth division will continue to serve more than 31,000 children under the age of 18. The demographics of our largest youth sub-program, School Shows, mirror the populations of Orange County Schools and Chapel Hill Carrboro City Schools and serve more than 26,000 youth annually. Arts-In-Education residencies reach every class in all three Title 1 elementary schools in the Orange County Schools. Afterschool Arts Immersion serves elementary schoolers, Youth Art Classes serve 1st through 12th graders, and summer ArtsCamps serve rising Kindergartners through high schoolers. Participants are reached through printed materials sent through schools; school social workers, teachers and counselors often help identify students needing scholarships and help guide parents to our services. The ArtsCenter provides $20,000 in youth scholarships annually. e) Who specifically will carry out the activities and in what location will they be carried out? Under the leadership of Executive Director, Daniel Y. Mayer, the primary activities will be coordinated by Education Director, Phaedra Kelly; by Youth Education Coordinator, Jesse Hollars; and by School and Family Programs Coordinator, Jillian Lea. The primary location is at The ArtsCenter at 300-G East Main Street in Carrboro. Some School Shows are presented at Orange County Schools or Chapel Hill Carrboro City Schools; Arts in Education Residencies take place at the three Title 1 Orange County Elementary Schools, and the alternative Orange County High Main Application 1/21/2016 4:03:32 PM Page 7 of 2 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's axigiclikAlayikalication School. Afterschool Arts Immersion occasionally hold field trips (such as to the Hargraves Center) and uses other off-site locations as needed. f) Describe specifically the period over which the activities will be carried out, the frequency with which the activities will be carried out, and the frequency with which services will be delivered. Include an implementation timeline. The activities will be provided from July 1, 2016 – June 30, 2017. Afterschool Arts Immersion, Youth Arts Classes, Art-In-Education residencies will be scheduled to follow the local school calendars, August - June. ArtsCamps run through 10-12 weeks (depending on local school years) in June, July, and August. Budgetary planning occurs every spring. Program planning, implementation, and evaluation is ongoing throughout the year. g) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, give specific examples of the coordinated/collaborative efforts. • Chapel Hill Carrboro City Schools, CH-Carrboro PTA, Orange County Schools- Afterschool Arts Immersion and School Show partners, coordinators and participants • Orange Co. Schools, UNC-CH/Orange Co. Partnership for Children—Arts-In-Education partners, coordinators and participants • Other public, private, and charter schools from Durham, Wake, Chatham, and Alamance counties— School Show participants h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Orange County funding is an important part of The ArtsCenter's overall funding strategy for youth scholarships and is a valued endorsement of the center's programs and services. The ArtsCenter has served Orange County and surrounding area residents for more than 40 years; we are a strong component of the county's thriving creative community and economy. If this request is not funded in full or at all, then scholarships and services will be reduced and adjusted accordingly. i) Include any other pertinent information. None at this time. Program/Project Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff I) Disclosure of Potential Conflicts of Interested must be signed m) Complete the Work Statement Chart to describe the work to be performed, and be sure to attach copies of all data collection tools that will be used to verify achievement of program goals and objectives. Describe who will be responsible for monitoring progress. Main Application 1/21/2016 4:03:32 PM Page 8 of DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider'sa ilibOgrayrNilication Information to Complete j.) Target Population Complete the following tables to the best of your ability. Show numbers of participants and percentages, as applicable, in each category. Please indicate whether this project/program will serve: ❑ Persons ❑ Households ® Units Program: General Support Unit= an attendee of an ArtsCenter program Program Beneficiary Demo.ra.hics Actual Estimated Projected 2014-15 2015-16 2016-17 I Gender Male 15,772 15,772 16,403 Female 15,772 15,772 16,403 Total 31,544 31,544 32,806 Of the females, how many are single- female Head of Households (Omit for Human Services) NA NA 1 NA Ethnicity African-American 7,886 7,886 8,207 American Indian or Alaska Native Asian 2,839 2,839 2,996 Caucasian 16,403 16,403 17,031 Native Hawaiian or other Pacific Islander Other 4,416 4,416 4,572 Total 31,544 31,544 32,806 - Of the above, how many Hispanic/Latino 4,416 _... 4,416 4,572 Of the above, how many non- Hispanic/Latino 27,128 27,128 28,234 Total 31,544 31,544 32,806 ,I Age _............................ ............... 0-5 years 1,451 1,451 1,556 6-18 years 30,093 30,093 31,250 19-50 years 51-61 years 62+ years MIM Total 31,544 31,544 1 32,806 Geographic Location Durham City 3,154 3,154 3,280 Durham County 504 504 525 Carrboro 4,338 4,338 4,508 Chapel Hill 18,395 18,395 19,027 Main Application 1/21/2016 4:03:32 PM Page 9 of DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Providers.QIts.icielAmxyrfsfilication Chapel Hill Public Housing Residents Unknown Unknown Unknown Orange County 2,536 2,536 2,690 Raleigh Wake County 283 283 295 Alamance, Chatham, &Walk up 2,334 2,334 2,481 Total 31,544 31,544 32,806 Income Level-See following chart (Omit for HS) < 30%Area Median Income ..._NA NA NA NA .._______________........ .___ .......__...._..__.....__.....m. ................................ .... ..... ........................................_....N_...................................._. 31-50%Area Median Income NA NA NA 51-80%Area Median Income NA NA NA > 80%Area Median Income NA NA NA Total 0 0 0 Special Needs (Omit for HS) Elderly (Over 62) NA NA NA Disabled (not elderly) NA NA NA Homeless NA NA NA People with HIV/Aids NA NA NA Total 0 0 0 CDBG & HOME ONLY- Area Benefit Activities (Infrastructure and Public Facilities) Street Census Tract Block Group Total Persons #LMI Persons 2015 Area Median Family income Limits U.S. Department of Housing & Urban Development (HUD) 2015 Area Median Family Income Limits Effective March 15, 2015 Income 1 2 3 4 5 6 7 8 Level person people people people people people people people 30% AMI $14,150 $16,200 $20,090 $24,250 $28,410 $32,570 $36,730 $40,890 Main Application 1/21/2016 4:03:32 PM Page 1 0 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's Outside Agency Application MAIN APPLICATION 50% AMI $23,600 $27,000 $30,350 $33,700 $36,400 $39,100 $41,800 $44,500 80% AMI $37,750 $43,150 $48,550 $53,900 $58,250 $62,550 $66,850 $71,150 100% AMI $47,188 $53,938 $60,688 $67,375 $72,813 $78,188 $83,563 $88,937 115% AMI $54,266 $62,028 1 $69,791 $77,481 $83,734 $89,916 $96,097 $102,278 i htt;,://www.huduser®or+/•ortal/datasets/il/1115/FY2015 IL nc.*df k.) Schedule of Positions Please include program staff positions followed by volunteer positions; these financial figures should match the personnel figures in your Agency Comparative Budget Excel Form. Similar positions can be combined. (i.e., 8 Occupational Therapists can be inserted as one line item). If provided, indicate: Position Titles % (R) *= Position FTE* program Actual Estimated Projected ; %Total Retirement Vacant Staff+ 2014-15 2015-16 2016-17 Budget Plan (H) Health Plan Accounts Director 1 30 49332 51305 53357 3.3 H Youth Education Coordinator 1 100 50108 52112 54197 3.3 H Education Director 1 25 45319 47132 49017 3.0 H ArtSchool Assistant ,25 0 6619 30000, 30000 1.9 _Gallery Director .50 0 11713 12182 12669 0.8 School & Family 1 Coordinator 1 100 30243 31453 32711 2.0 H Youth Assistant 1 100 43142 44868 46662 2.9 H Development Director 1 30 45314 47127 49012 3.0 H Concert& Managing Director 1 5 43951 45709 47537 2.9 H Operations Assistant .5 0 7288 7580 7580 0.5 Executive Director 1 10 13880 80000 80000 5.1 H Marketing Director 1 10 32666 33973 1 35332 1 2.2 H Main Application 1/21/2016 4:03:32 PM Page 1 1 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider'sa iWiTexyrAlication H Theater Director _�. 1 0 41464.I............... 20000 20000 1.3_ � .. _ Theater Managers 1 0 30665 31892 ._.... ..._.... g 33168 2.0 Marketing Assistant X25 0 4605 10000 15000 0.6 Bartenders .25 0 2879 2994 3114 0.2 Youth Counselors 1.5 100 23880 24835 1 25829 1.6 Instructors 15.5 33 460009 478409 1 497546 30.7 Cleaning Staff .5 33 14533 15000 15000 1.0 Volunteer Hours 1.0 Notes:. • Similar positions can be combined: i.e. 8 Occupational Therapists can be inserted as one line item, • ** Full Time Equivalent staff will be noted as 1.00; half time as .50; quarter time as .25, etc. • + Denotes the percentage of staff time involved with this program. • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: Total Volunteer Hours =Volunteer FTE 1,960 Main Application 1/21/2016 4:03:32 PM P a el e 1 2 • f 2 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's aktRce yy8wrAlication I.) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST Are any of the Board Members or employees of the agency which will be carrying out this project, or members of their immediate families, or their business associates: YES NO ❑ ® a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? ® ❑ b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? Michael Parker is an ArtsCenter Board Member who is serving a current term with the Chapel Hill Board of Aldermen. ❑ ® c) Current beneficiaries of the project/program for which funds are requested? ❑ ® d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the project ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. g - / l Si natu� " 4 xecu ive Dirt for Date Signature: A. •ard Chairperson D to Main Application 1/21/2016 4:03:32 PM Page 1 3 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's MAIN APPLICATIONlication m.) Work Statement APPLICATION This form is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the projected information. • Program Activities should outline major activities the agency implements to accomplish its program goals. • Program Goal should explain what the program is trying to achieve/accomplish. Goals are statements about what the program should accomplish. SMART Goals • Performance Measures describe how you will evaluate the degree in which you achieved the stated goals. • Actual Program Results use program results to indicate the actual measureable achievement of goals. If goals were not met, please explain. Actual Estimated Projected 2014-15 2015-16 2016-17 Program Activity 1 Afterschool Arts Afterschool Arts Afterschool Arts Immersion (AAI) Immersion (AAI) Immersion(AAI) Offer AAI to 40 Offer AAI to 55 students Offer AAI to 70 students Program Goal students monthly, monthly, plus Youth Art monthly, plus Youth Art plus Youth Art Classes Classes Performance Measures AAI &Class AAI & Class AAI & Class re•istrations re.istrations re.istrations Served 40 AAI youth Serve 55 AAI youth Serve 70 AAI youth Program Results monthly & 240 monthly & 240 through I monthly & 240 through throughyrouth classes _youth classes youth classes Program Activity 2 Arts in Education Arts in Education Arts in Education Residencies (AIE) Residencies (AIE) Residencies (AIE) Hold 10 AIE artist Hold 12 AIE residencies Hold 14 AIE residencies Program Goal 1 residencies in Title 1 in Title 1 Orange Co in Title 1 Orange Co Orange Co Schools Schools for 1400 Schools for 1400 Performance Measures Artist contracts, class Artist contracts, class Artist contracts, class records, content tests records, content tests records, content tests Program Results Held 16 residencies Offer 12 residencies for Offer 14 residencies for for 1455 students 1400 students 1400 students Program Activity 3 School Shows School Shows School Shows - Present 70 School Present 75 School Present 80 School Schools at the Schools at the Schools at the Program Goal ArtsCenter & in area ArtsCenter& in area ArtsCenter & in area schools that enhance schools that enhance schools that enhance NC curricula NC curricula NC curricula Main Application 1/21/2016 4:03:32 PM 113ago 14 of 2 * DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's lfice$gexyr A •lication• School Show School Show schedule, School Show schedule, Performance Measures schedule, contacts, & contacts, &teacher contacts, &teacher teacher guides.�, •uides guides Presented 89 School Present 75 School Present 80 School Program Results Shows; received 85% Shows; received 85% Shows; received 85% positive student& positive student& positive student & teacher evaluations teacher evaluations teacher evaluations Activity 5 Summer Camps Summer Camps Summer Camps Offer 10 wks of Program Goal camps and teen Offer 11 wks of camps Offer 10 wks of camps for 1200 kids, and teen classes and teen classes Performance Measures Summer camps & Summer camps & youth Summer camps & youth class schedule class schedule outh class schedule Offered 11 wks of Offer 11 wks of camp & Offer 10 wks of camp & Program Results camp &teen class teen class reaching teen class reaching reaching 1281 youth 1400 youth 1400 youth Main Application 1/21/2016 4:03:32 PM Page 15 of 20 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's.O.uW�eAge�yriqlication 4. FINANCIAL INFORMATION FOR SERVICE PROGRAMS a.) Program Budget Please complete a Program Budget Excel Form for each requested program. The Program Budget should reflect only figures and amounts associated with the Program(s) for which you are seeking funding and not the total agency budget. If the program's finances experienced significant changes that you would like to explain, please use the space below. It is required that your Excel budget worksheet be embedded on the next page. You must also submit an electronic copy of the MS Excel file with your application, as a separate file. Main Application 1/21/2016 4:03:32 PM Page 1 6 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's rkjhdAeg8Wripalication Program Budget Agency/Program The ArtsCenter-Youth Programs Actual Estimated Projected Percent PROGRAM REVENUE 2014-15 2015-16 2016-17 I Change Private Donations $ 2,653 $ 2,786 $ 2,925 5%. Agency Generated Revenue(fees) $ 454,452 $ 463,541 $ 472,812 2% Local Government Grants: Orange County $ 7,000 $ 7,000 $ 7,000 0% Town of Chapel Hill 0 Town of Carrboro 0 Other Local: OCAC $ 7,500 $ 7,500 i $ 7,500 0% Local: 0 Other Local; � � 0 If more than 3 sources,please provide a separate list. Non-Local Government Grants Triangle United Way 0 State Gmemment 0 Federal Government 0 Other Grants:Foundations $ 167,752 $ 171,107 $ 174,529 2%'' Other Grants Corporate $ 2,900 $ 3045 $ 3,197 5%1'' Miscellaneous/Other Revenue 0: Rease list 3 largest Miscellanous sources: $ Total Agency PIPEIPEEIMMMIII PROGRAM EXPENSES Compensation $ 396,326 $ 428„666 NM Rent&Utilities $ 36„436 $ 37,893 $ 39,409 4% Supplies&Equipment $ 25,482 $ 26,246 $ 27,034 3% Travel&Training 288 $ 294 $ 300 2% Other Expenses: $ 63,739 $ 65,014 $ 66,314 2% Please list 3 largest"Other Expenses": Depreciation $ 12,453.00 Interest $ 23,585,00 Transportation $ 17,260,00 Total Agency Expenses 522,271 $ 541,626 $ 561,723 4% SURPLUS/(DEFICIT)FOR PERIOD: 1$ 119,986 $ 113,353 $ 106,240 -60•" Main Application 1/21/2016 4:03:32 PM Page 1 " 1 2e DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued ProviVigkWit,,,I5LiaoRpta4 Application Program Budget Detail What is the cost to deliver your project/program? List each project/program element in the table below, including the cost of each element, the quantity and unit of measure, and the subtotal for each element. Where necessary, allocate costs to the use of shared space, vehicles or equipment. Exam+le Pro!ram: Credit Counselin! Class Cost Elements Cost($) ; Quantity/Unit of Measure ; Subtotal( ) Credit Counseling Teacher–in class $25 96 hours(8 hrs/mth x 12 months) $2,400 Credit Counseling Teacher—class prep $25 48 hours(4hrs/mth x 12 mths) $1,200 -Credit Counselor—one-on-one $20 120 hours (10 hrs/mth x12 mths $2,400 Materials $25 120 course packets/credit reports $3,000 Total $9,000 Complete the table below for the project/program for which you are requesting funds. Attach additional rows/pa_ es as needed. Program: ArtsCenter/ Youth Division- cost elements specific to this $10,000 request ii/ii,i;, !' ,� %ii ' i i � / i iii i ,�, �i: i, / �/ Cost Elements fost � 4uar�t IUnrtc�rr���siurte � � bt��l Afterschool Arts Immersion Scholarships $345 14.5 months of AAI Scholarships $5,000 t fees $1650 % Half of 6 Artist residencies $5000 Arts-In-Education artist �.._. � _._._._.�._... ... .......__..........................�.._._.. Total $10,000 b.) Cost per Unit Actuai 2014-1 Estimated ates 2015-16 „Prof tec 2016-17 Total Cost of Program $522,271 $541,626 $561,723 Total # of Units 31,544 31,544 32,806 Cost Per Unit $16.55 $17.17 $17.12 This Cost Per Unit must reflect the total program budget and the total number of program beneficiaries (households or persons) in this application and must be consistent with report submittals from previous years (if applicable). Main Application 1/21/2016 4:03:32 PM Page 18 of DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's axihcek78c�yfilication c.) Agency Operating Budget Please show all sources and amounts of funding for your entire current fiscal year. What is your agency's fiscal year? Example: July 1, 2016 through June 30, 2017. Submit operating budget in your own format. Do not include funds that have been applied for but not yet awarded: If the total revenue is not the same amount as the budget for any fiscal year, please attach a statement explaining the deficit or surplus. It is required that your Excel budget worksheet be embedded on the next page. You must also submit an electronic copy of the MS Excel file with your application, as a separate file. Main Application 1/21/2016 4:03:32 PM Page 19 of DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider ahts�liert iiyOplication Section VI.Financial Data Operating Budget for Entire Agency AGENCY NAME: The ArtsCenter Actual Estimated Projected Percent AGENCY REVENUE 2014-15 2015-16 2016-17 Change Private Donations $ 101,876 $ 106,970 $ 112,318 5% Agency Generated Revenue(fees) $ 938,840 MOM Local Government Grants: Orange County $ 6,750 $ 7,000 $ 10,000 0% Town of Chapel Hill $ 10,000 $ 10,000 $ 15,000 50% Town of Carrboro $ 15,000 $ 15,000 $ 20,000 33% Other Local: OCAC $ 10,500 $ 10,500 $ 10,500' 0% Other Local: NCAC $ 47,028 $ 47,000 $ 47,000 0% Other Local: Other Carrboro Funding $ 5,000 $ 5,000 $ 5,000 0% more than 3 sources,pease provide a separate list. Non-Local Government Grants Triangle United Way 0 State Government 0 Federal Government 11111111.11111111111111111 0 Other Grants:Foundations $ 270,648 $ 276,061 I $ 281,582 2% Other Grants:Corporate $ 5,062 $ 5,315 I $ 5,581 5% Miscellaneous/Other Revenue $ 149,826 MENEERIIIIIIII Reese list 3 largest Mscellanous sources: Rental $ 65,261,00 Concession 5 48,694.00 Special Events $ 22,883.00 Total Agency Revenue $ 1 540 161 $ 1 577 003 AGENCY EXPENSES Compensation $ 957,610 $ 995,914 $ 1,035,751 4% Rent&Utilities $ 157,637 $ 163,942 $ 170,500 4% Supplies&Equipment $ 53,763 $ 55,376 $ 57,037 3%I Travel&Training $ 2,685 $ 2,739 $ 2,793 2% Other Expenses: $ 341,867 $ 348,704 $ 355,678 2% Reese list 3 largest"Other Expenses". Depreciation 5 33,656.00 Marketing $ 50,348 00 Professional Fees $ 71,123 00 Total Agency Expenses $ 1,566 675 SURPLUS/(DEFICIT)FOR PERIOD: $ 26,589 $ 10,326 $ 5,962 I w42°:,I Main Application 1/21/2016 4:03:32 PM Page 2 0 of 2 0 DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's Outside Agency Application Program Budget Agency/Program: The ArtsCenter-Youth Division PROGRAM REVENUE lActual 14-15 Est.15-16 Proj.16-1 %Change Private Donations $2,653 $2,786 I $2,925 5% Agency Generated Revenue(fees) $454,452 $463,541 I$472,812 ■ MI Local Government Grants: Orange County $7,000 $7,000 $7,000 0% Town of Chapel Hill IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 0 Town of Carrboro 0 Other Local: OCAC $7,500 $7,500 $7,500 0%; Other Local: 01 Other Local: IIIIIIIIIIIMMMIHMIMIII 0I If more than 3 sources, IIIIMIIIUIIIIIIM1IMIMI11 please provide a separate list. Non-Local Government Grants MEE Triangle United Way 0 State Government IIIIIIIIIIIIIIIIIIIMIMIIII°rrr, 0 Federal Government 1 0 Other Grants: Foundations $167,752 $171,107 $174,529 2% Other Grants: Corporate $2,900 $3,045 $3,197 5% Miscellaneous/Other Revenue 11111111111111.0111111111111 Please list 3 largest Miscellanous sources: $ . $ Total Program Revenue $642,257 $654,979 I $667,963 2% PROGRAM EXPENSES Compensation $396,326 I $412,179 $428,666 4% Rent&Utilities $36,436 I $37,893 $39,409 4% Supplies&Equipment $25,482 I $26,246 $27,034 3% Travel&Training $288 $294 $300 2% Other Expenses: $63,739 $65,014 $66,314 2% Please list 3 largest"Other Expenses": Depreciation $12,453.00 Interest $23,585.00 Transportation $17,260.00 Total Program Expenses $522,271 $541,626 I $561,723 4%) SURPLUS/(DEFICIT)FOR PERIOD: 1 $119,986 1$113,353 $106,240 -6% DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 t A - continued Provider's Outside Agency Application Section VI.Financial Data D)Operating Budget for Entire Agency AGENCY NAME: The ArtsCenter AGENCY REVENUE Actual 1415 Est.15-16 Proj.16-17 %Change Private Donations $101,876 $106,970 $112,318 1 5% Agency Generated Revenue(fees) $918,471 $936,840 $955,577 2% Local Government Grants: Orange County $6,750 $7,000 $10,000 0% Town of Chapel Hill $10,000 $10,000 $15,000 I 50% Town of Carrboro $15,000 $15,000 $20,000 33%1 Other Local: OCAC $10,500 $10,500 $10,500 0% Other Local: NCAC $47,028 $47,000 $47,000 0% Other Local: Other Carrboro Funding $5,000 $5,000 $5,000 I 0% If more than 3 sources, please provide a separate list. illE=11. Non-Local Government Grants Triangle United WayII_ IIIIIIIII 0 State Government -®I 0 Federal GovernmentIIIIIIIIIMiliIa 0 Grants: Foundations $270,648 $276,061 $281,582 1 2% Other Grants: Corporate $5,062 $5,315 $5,581 5%1', Miscellaneous/Other Revenue : . 1 $157,317 $165,183 5% Please list 3 largest Miscellanous sources: MO Rental $65,261.00 I IIIIIII Concession $48,694.00 Special Events $22,883.00 1MIE Total Agency Revenue p $1,540,161 $1,577,003 I$1,62.7,741 AGENCY EXPENSES Compensation $957,610 $995,914 I$1,035,751 4% Rent&Utilities $157,637 $163,942 $170,500 4% Supplies&Equipment $53,763 $55,376 $57,037 3% Travel&Training $2,685 $2,739 $2,793 1 2% Other Expenses: $341,867 $348,704 $355,678 Please list 3 largest"Other Expenses", I Depreciation $33,656.00 IIIIIIIIII I Marketing $50,348.00 IM Professional Fees $71,123.00 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIMMIIIIII Total Agency Expenses $1,513,562 1 $1,566,675MIIIIIII 4% SURPLUS/(DEFICIT)FOR PERIOD: 1 $26,599 1 $10,328 IIIIMIII -4;2%', DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 EXHIBIT `B" Scope of Services—FY 2016-17 Outside Agency Performance Agreement Agency Name: The ArtsCenter Funding Award: $10,000 Outline how the agency will spend Orange County's funding award. Expense Description Amount Programmatic Expenses—Scholarships for After School and Supplies 10,000 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 30,2016. • Afterschool Arts Immersion(AAI) • Art in Education Residencies (AIE) • School Shows • Summer Camps Anticipated Outcomes 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 Serve AAI youth monthly 55 AM youth Classes held for AAI youth 32 classes Offer residencies for 1400 students 14 residencies Present School Shows 54 shows Receive positive student and teacher evaluations 85 % Offer summer camp for 1500 youth 10 weeks DocuSigned by: — '� Executive Director 10/25/2016 '`m—SUC:A36291 AU142b... DocuSigned by: 61Aa Development Director 10/26/2016 Certified by: 4,13 Title: Date: (Provider's Signature) DocuSign Envelope ID: E8534F48-BEAD-4670-896E-4E8718B819E1 ___--., ARTSC-1 OP ID: MR ACORO° DATE(MMIDDlVYYY) CERTIFICATE OF LIABILITY INSURANCE CE 07/18/2016 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME; Chapel Hill Insurance A+gyr LLC Summers Thompson Lowry,Inc. PHON£ SAX 100 Europa Drive Suite 57 I P ,aP� t 919-968-4472 (A/c,No 919-942-4221 Chapel HIVI,N 27517 E.44 Luk TLlnsure co C.Dube Thompson CPCU ARM AoDR s e m INSURERS AFFORDING COVERAGE NAIC INSURER A:Great American Ins Co of NY INSURED The Arts Center Inc. INSURER B:FFVA Mutual Insurance Co. 300 G East Main Street Carrboro,NC 27510 INSURER C:Great American Alliance Ins Co INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS„ IL R S A b PobOY EFF POLICY EXP TYPE OF INSURANCE III I POUCY NUMBER MMIDD ) IMMIDDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TQ illP4r f A X COMMERCIAL GENERAL LIABILITY PAC4296967 07/01/2016 07/01/2017 PPEvisEsjLau Curren ) $ 100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN°L AGGREGATE LIMIT APPLIES PER: PRODUCTS $ 2,000,000 POLICY PRD LOC Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED IadNraLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED -- 'I SCHEDULED BODILY INJURY(Per accident) $ ,,,.,.. AUTOS NON-OWNED OP$6`(`1'DAMAor HIRED AUTOS ,..... AUTOS r�ERAI"�G1DI�Nn�,,,, $ X EXCESS AB AB X CLAIMS MADE UMB4296968 07/01/2016 07/01/2017 G AGGREGATE OCCURRENCE $ 1,000,00l � q � 1 DED J X RETENTION$ 10000 WORKERS COMPENSATION WC STATU- IOTH AND EMPLOYERS'LIABILITY ,TORY t(„(y11T$ x,.ER Y I N B ANY PROPRIETOR/PARTNER/EXECUTIVE WC8400032267 01/01/2016 01/01/2017 E EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N IA (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ 500,0001 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) For Information Purposes CERTIFICATE HOLDER CANCELLATION ORANGE2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. Human Services Dept. 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