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2016-632-E Finance - Community Empowerment Fund - Outside Agency Performance Agreement
DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C 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 Community Empowerment Fund, a not-for-profit corporation, located at 208 N. Columbia Street, Suite 100, Chapel Hill,NC 27514 ("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 Community Empowerment Fund agree as follows: 1. Term of the Agreement. The tenn 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 7500. 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 $1,875. 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. (Community Empowerment Fund) Orange County Outside Agency Performance Agreement Revised 8/2016 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C 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. (Community Empowerment Fund) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C 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. (Community Empowerment Fund) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C 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 Community Empowerment Fund 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: (Community Empowerment Fund) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C County: Finance &Administrative Services Provider: Community Empowerment Fund Orange County 208 N. Columbia Street, Suite 100 Post Office Box 8181 Chapel Hill,NC 27514 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 on �(� ike Provider -aeht' wt-St 11/2/2016 Date For and o ei iofiGtir'ange County Government bOtA,in,lt, tbaMwttXS(L 11/4/2016 06370040755E477 Bonnie Hammersley, County Manager Date (Community Empowerment Fund) Orange County Outside Agency Per/onnance Agreement Rev. 8/16 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C 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: AkOlhit, (Pt-St 11/2/2016 Certified by: Title: Program coordinator Date: (Provider's Signature) (Community Empowerment Fund) Orange County Outside Agency Performance Agreement Rev. 8/16 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C Exhibit A Provider' 000, ,,,itnfi)L ,glication 1. COVER PAGE (Each program requires a separate application.) a) Applicant Contact Information Applicant Organization's Legal Name: The Community Empowerment Fund Applicant Organization's Physical Address: 108 W. Rosemary Street, Chapel Hill, NC275,16 Applicant Organization's Mailing Address: 108 W. Rosemary Street, Chapel Hill, NC 27516 Applicant Organization's Web Address: ,www.communityempowermentfund.org Executive Director: Maggie West Telephone Number: 919-200-0233 E-Mail: maggiewAcommunityef.org DUNS Number: 036791351 (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: Advocate Program Project/Program Primary Contact and Title: Ma..ie West Program Coordinator Telephone Number: 919-200-0233 E-Mail: maggiew(d),communityetorg c) Funding Request Identification Total Project/Program Cost: $144,960, Total Amount of Funds Requested: $14,000 Proposed Use of Funds Requested (2-3 Line Maximum): CEF is requesting funding to provide relationship-based support to individuals experiencing or at-risk of experiencing homelessness: We propose to assist participants in gaining employment, housing, and personal savings. 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. LI CDBG Non-Construction (CH) $ Ei Grant El Loan LI CDBG Construction (CH) 0 Grant 0 Loan 0 HOME CHDO (OC) E Grant Loan 0 HOME Other (OC) I] Grant 1] Loan I Human Services: I Carrboro $2,000 Chapel Hill $4 500 I Orange County $7,500 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: Executive Director Date Signature: (7) / (P 6 Board Chairperson Date Main Application 1/24/2016 1 :54:12 PM , DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION 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) Founded in 2009, CEF has served the Orange County community for over six years. CEF incorporated on October 28, 2010. b) Agency's Purpose/Mission The Community Empowerment Fund cultivates opportunities, assets, and communities that support the alleviation of homelessness and poverty. CEF enables and sustains transitions out of homelessness, We offer matched savings accounts, financial education, workforce development, and relationship-based support to homeless and near-homeless individuals. CEF emphasizes a person-centered approach to overcoming crises and building towards long-term possibilities. Through our programs, CEF assists members in gaining employment, stable housing, and financial security. c) Types of Services the Agency Provides CEF ensures homeless and near-homeless individuals are able to successfully transition to independence by combining a focus on employment, housing, financial literacy, and community support. Based on our experience in the community, individuals experiencing homelessness need gateways and connections to resources and opportunities that will help them achieve self-reliance. This includes connections to greater employment opportunities as well as housing options that fit their income. Additionally, households recovering from an episode of homelessness often face significant financial barriers even after gaining employment. Poor credit histories, lack of a bank account, limited transportation, and acute cash flow crises challenge a family's ability to successfully maintain employment and housing. Thus, addressing an individual's crisis of homelessness requires integrated service delivery. CEF also provides our members with a targeted, incentivized opportunity to build savings through our Safe Savings Accounts. CEF opens goal-oriented savings accounts to help members save for the future, prepare for emergencies, and budget with limited incomes, Accountholders have limited access to withdrawals of their savings until they reach their goals with CEF, and once Savers achieve their goal CEF matches their accomplishments at 10 percent. Through this account, members have successfully saved to move out of the shelter, to purchase a car, and to build an emergency fund. Members are also able to use the account to save for regular, large expenses, like car insurance, Christmas shopping, or school supplies. Meanwhile, CEF's Opportunity Classes provide homeless and near-homeless individuals with the skills and resources to transition into and sustain self-sufficiency and permanent housing. Formerly homeless program graduates teach the courses, delivering life skills lessons in a manner that is increasingly relevant and powerful for participants. d) Agency's Experience with Similar Programs as the Funding Request The combined suite of CEF's services has proven to be effective at enabling members to gain employment, secure housing, and build savings. To date, CEF members have saved over $430,000 towards personal savings goals since our savings program began in 2010. Meanwhile, in 2014 Main Application 1/25/2016 8:36:39 AM DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION alone CEF assisted 140 members in gaining employment and 90 in moving out of homelessness, Our volunteer advocates are a key component of our ability to successfully serve our members, contributing 18,858 hours of volunteer support directly working with CEF members in 2014, making a total in-kind contribution to CEF valued at an estimated $434,043 by the Independent Sector. e) Other Pertinent Agency Information CEF serves Orange and Durham Counties of North Carolina, with offices in both locations. Main Application 1/25/2016 8:36:39 AM 5 2 5 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APP LICA ION 3, PROJECT/PROGRAM INFORMATION Agency & Program Name: _Community Empowerment Fund, Advocate Program 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 required application and required supplemental sections (Parts) as specified below: 01 Human Services (Main Application Only) El CDBG Non-Construction — (Main Application AND Part A) El CDBG Construction — (Main Application AND Part A AND Part B) El HOME CHDO Set-aside — (Main Application AND Part A) El HOME Other — (Main Application AND Part A AND Part B) Indicate the type of program for which you are requesting funding: Disabled Public Housing Program Category Youth Adult Elderly (not elderly) Neighborhoods/Residents Education Health and Nutrition MEIN' Job Trainin• Sports and Arts Activities Pre-School Activities II After-School Activities Mentoring X Transportation Housin• Other: Please specify Main Application 1/25/2016 8:36:39 AM - 1 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION 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? Recognizing the need for wrap-around support and the varied circumstances of homeless and near- homeless individuals, CEF's advocates meet every week with their members to provide person- centered support. Advocates check on progress towards goals, take new action steps, and brainstorm possibilities. More broadly, CEF's day-to-day operations serve as a one-stop center for individuals and families to receive comprehensive help. Advocates assist our members with: • Employment: Building resumes, applying for jobs, acquiring interview attire, gaining soft skills, upgrading knowledge • Financial Capability and Financial Services: Opening bank accounts, building budgets, setting up direct deposit, monitoring expenses, planning for the future, setting savings goals, building credit • Housing: Searching for housing, paying bills on time, accessing weatherization resources, reducing utility expenses • Community Resources: Connecting to public benefits and to agencies to assist with basic needs, emergency food, mental health services, primary and acute health care, and public benefits These activities combine to create personalized pathways out of acute crisis situations to financial security. In order to best assist members in achieving independence, our advocates remain in contact with members after their move from the shelter. Our relationships continue beyond these transitions, providing us the opportunity to help members realize long-term dreams of financial stability and security. As a melded approach including education,job training, and mentoring within the Town/County's service array, CEF supports the needs of low-resource adults and individuals with disabilities (30% of CEF's members have a disability). In August of 2015 CEF expanded our Advocate Program to incorporate a pilot of an Integrated Service Center approach. Through co-located services and an integrated service delivery model, CEF proposes to provide person-centered support that encourages multiple agencies to coordinate services seamlessly and avoid duplication. Integrated service delivery is an evidence-based model "by which human service organizations share resources in order to coordinate care and service delivery. It involves seeing clients as three-dimensional individuals who often have more than one need at a time, and it requires a high level of collaboration between organizations and agencies in order to be effective" Social Solutions, 2015). Additionally, research demonstrates that integrated service delivery models which bundle employment, work supports, and financial capability services were "three to four times more likely to achieve a major economic outcome, such as gaining employment or building an emergency savings fund, than were un-integrated services (LlSO National Office, 2015). o) 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. The Orange County HOME Consortium Consolidated Plan identifies the need for support services for homeless persons and persons who are at-risk of becoming homeless as a high priority area, The Plan goes on to further identify the high priority of services for disabled persons. Additionally, Main Application 1/25/2016 8:36:39 AM P c 7 o t 2 5 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION CEF's services were independently cited in the Consolidated Plan as a part of the assessment of the institutional delivery structure, stating, "CEF fills a great need for relationship based, client- centered job-readiness, job search, and life skills services" (p 108). In 2011, the Town of Chapel Hill adopted an Affordable Housing Strategy, CEF's work is directly in line with the Town's goals of promoting financial and housing independence for low-income families and transitioning those in shelter to affordable accommodations. Over 90% of members who graduate from CEF's Advocate Program are able to sustain independent housing after transitioning from the shelter at least 12 months. With 17,8% of residents in Orange County living below the federal poverty level (according to US census data from 2009-2013), too many families in our community are living paycheck to paycheck and thus lack the ability to develop personal savings —whether to smooth volatile income streams or to make investments for the future, Without savings or emergency funds, these families are living on the brink of homelessness. d) Describe the population to be served or the area to benefit and indicate how you will identify beneficiaries, CEF works with a significantly disadvantaged population: • 100% of prospective clients earn below 50% of area median income • Vast majority of clients earn below 30% of area median income • 70% of clients are minorities • 30% of clients have a disability • 10% of clients are immigrants CEF has built a reputation in the target community as a go-to agency to assist in transitions out of homelessness, Our Rosemary Street office reflects these ideals and serves as a welcoming space for homeless or at-risk individuals to seek assistance, connect to resources, or just to escape the elements, We reach out to vulnerable and disenfranchised members of the community through word-of-mouth, partner agency referrals, and most importantly, client-to-client referrals. e) Who specifically will carry out the activities and in what location will they be carried out? The program will be led by two staff members in our Orange County office -- the Advocate Program Coordinator and Member Services Coordinator. The Advocate Program Coordinator leads our efforts to train advocates, coordinate all support for advocates, manage advocate schedule, and direct our team of student leaders. The Member Services Coordinator leads the intake process for new members, and coordinates the support for members once they have become engaged to ensure they receive appropriate support from advocates and are connected to the appropriate partners. The Member Services Coordinator also directs and manages the Integrated Service Center, 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 of CEF's Advocate Program occur six days a week, year-round. On a daily basis members are able to schedule appointments with CEF advocates to work one-on-one towards their personal goals, The initiatives within the Advocate Program that require an implementation timeline are especially our efforts to conduct seasonal activities, including volunteer advocate trainings which are held three times annually (January, May, and September), along with specialized training tracks in financial coaching (September— December), employment counseling (October — December), and housing advocacy (February — Celebrations to recognize the achievements of CEF members are also held seasonally, in April, July, and December, Main Application 1/25/2016 8:36:39 AM p q (-„, 8 o 2 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION 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, • Orange County Partnership to End Homelessness (OCPEH), Job Partners Program o CEF helped develop and now administers the OCPEH Job Partners Program which was created to help people with the highest barriers become job-ready and to find employment, Through this collaboration, we connect local employers with qualified, unemployed Orange County residents who have potential barriers to employment (e.g. criminal record, lack of work history, homelessness), This partnership has significantly enhanced the ability of Advocates to help members reach employment goals by acting as part of a formal, structured connection to county employers. Partner agencies in this collaboration include, but are not limited to: • Chapel Hill-Carrboro Chamber of Commerce • Job Link Career Center • Vocational Rehabilitation, Inc. • Department of Social Services • Compass Center for Women & Families • UNC Temporary Services • Avant Staffing • OCPEH, 100,000 Homes Task Force o CEF is a committed member of the 100,000 Homes Task Force, a collaboration of 20+ agencizs in Orange County that coordinates services for vulnerable, unsheltered members of the community. This ongoing collaboration significantly enhances the results of CEF programs as we are in constant contact with key service providers who are engaged in treatment and support for our members.Advocates gain institutional knowledge and mentorship through this established partnership. CEF built and maintains the shared cloud-based platform used by the agencies to screen potential referrals to the 100,000 Homes Task Force using a nationally recognized vulnerability assessment. • Inter-Faith Council for Social Service and Housing for New Hope o CEF works closely with area homeless services to gain program referrals and accomplish our goal of enabling sustained transitions out of homelessness. Service coordination includes: the co-location of services by Housing for New Hope in CEF's office; weekly contact between agency staff to collaborate on assisting sheltered and unsheltered individuals in accessing appropriate services or otherwise achieving goals. • Center for Excellence in Community Mental Health & Freedom House o CEF partners with community mental health clinics and substance abuse counselors to provide ongoing advocate support to individuals receiving treatment. We assist in referring new clients to agency services, and accept referrals from both agencies for assistance in gaining employment, financial coaching, and savings assistance, • Orange County Department of Housing, Human Rights & Community Development; CASA; Jackson Center; Justice United; EmPOWERment, Weaver Community Housing Association o CEF works with a collaboration of housing providers and housing advocates to ensure that Orange County residents who receive Housing Choice Vouchers (aka Section 8 vouchers) can find landlords willing to accept their vouchers, Our role has been to provide the one-on-one support to the tenants themselves, discerning their housing needs, locating the housing that will fit their needs, and making sure they have everything they need to successfully transition. h) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. CEF's impact in the community has only grown over the years, as we continue to serve an ever- Main Application 1/25/2016 8:36:39 AM 9 o f 2 5 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION increasing number of residents of Orange County on an annual basis. The wrap-around services provided through our Advocate Program, and now with the incorporation of the Integrated Service Center, have made CEF a go-to resource for everything from getting identification to finding a home. If the requested funding is not awarded or if a reduced allocation is recommended, CEF staff will doggedly pursue other fundraising activities to ensure that this reduction in the town or county's commitment does not translate into a reduction of services. i) Include any other pertinent information: Program/Protect Information j) Complete the Target Population and Program Beneficiary Demographics Chart k) Complete the Schedule of Positions Chart for Program Staff 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, 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 E Households E Units Program: Advocate Pro•ram Pro*ram Beneficia 0:mo.ra.hics Actual Estimated Projected 2014-15 2015-16 2016-17 Gender Male 362 374 386 Female L 282 296 301 Total 703 726 750 Of the females, how many are single- female Head of Households (Omit for Human Services) Ethnicity African-American 356 368 380 American Indian or Alaska Native 16 17 18 Asian 2 2 2 Caucasian 197 203 210 Native Hawaiian or other Pacific Islander 1 1 1 Other _131 135 139 Total 703 726 750 Of the above, how many Hispanic/Latino 30 - 31 32 .1 Main Application 1/25/2016 8:40:17 AM P , 10 of 25 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION Of the above, how many non- Hispanic/Latino 673 695 718 Total 703 726 750 Age ., .. 0-5 years 0 0 0 6-18 years 14 14 14 ... 19-50 years 397 _ 410 423 .... 51-61 years 252 260 _ 269 62+ years 40 41 42 Total 703 726 750 Geographic Location . Durham City 0 0 0 ___ __ Durham County i 0 0 0 ... Carrboro 48 50 52 Chapel Hill 655 676 698 Chapel Hill Public Housing Residents 19 20 21 Orange County 703 726 750 Raleigh 0 0 0 Wake County 0 0 0 Total 703 726 750 Income Level—See following chart (Ornit for HS) < 30% Area Median Income 693 716 1 739 31-50% Area Median Income 9 9 9 51-80% Area Median Income 1 1 1 > 80% Area Median Income 0 0 0 Total 703 726 750 S clal Needs (Omit for HS) . . . . Elderly (Over 62) 40 41 42 Disabled (not elderly) 215 222 229 Homeless 297 307 _ 317 . People with HIV/Aids N/A N/A N/A Total . 552 570 589 Main Application 1/25/2016 8:40:17 AM V ,J i) ,,,, 11 o 2 ''') ..... _ ..._ DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider'sryA�l+,$it502r � lication NH CDBG & HOME ONLY - Area Benefit Activities Infrastructure and Public Facilities 1112152M10 Block Grou• 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 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 $69,791 $77,481 $83,734 $89,916 $96,097 $102,278 http://www.huduser.orq/portalidatasets/i1/1115/FY2015 IL nc.pdf Main Application 1/25/2016 8:36:39 AM r � DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued ProviderWykige_Agency. i ••lication vi-LluAl I 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: 1 1 Position Titles % (R) Actual Estimated I Projected % Total 1 * = Position Program Retirement 2014-15 2015.16 2016-17 Budget 11 Vacant Staff+ an 1 (H) Health Plan Program Coordinator 1.0 35% $32,694 $38,325 $39 550 11% Operations I 1 Coordinator 1.0 40% $33,294 $38,325 $39,550 11% .1111111 Durham Program Coordinator 1.0 50% $18,326 $29,326 $34,200 9% 111111 Durham Operations 11 Coordinator $12,364 MEM oordinator $0 $0 0% NM Savings Program 1 Ill Coordinator 50% $2,850 $12 335 $14,560 4% MIN Member Services Coordinator 1.0 100% $0 $21,425 $32,100 9% 11=1 Advocate Program 1 1 Coordinator 1,0 90% $5,700 $6,100 $11,677 3% MI Advocate Program Associate 1 75% $2,460 $6,573 $9,945 3% MEM Durham Fellow 1.0 40% $0 1 $21,750 $22,100 6% ME IM Accountant .10 0% $2,455 $3 028 $3,028 1% ME 5-6 1 1 Summer Interns Seas. 80% $15,854 $17,566 $17,500 5% =11 Financial Coaching Coordinator VISTA 1.0 100% $0 $0 $6 100 . 2% 1 1 Collaborative Amencorss VISTA 1,0 0% $5,200 $6 200 $6 200 2% Opportunity Class 1 111 Leaders 2 .50 1 0% $11,760 $11,804 $14380 4% .111 #Advocate Team IIMII Leaders 100% $0 $0 $0 0% #Student Program Leaders 60% $0 1 $0 $0 0% IMMO VOLUNTEER HOURS' (20,000 1 annually total from 10.2 advocates FTE 100% 0 0 0 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. Main Application 1/25/2016 8:34:03 AM , 1 '1 ' 1 i 2 ') • DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provide0A9e01Petg9 •plication • Calculate a Full Time Equivalent for ail recorded volunteer hours using the following: Total Volunteer Hours = Volunteer FTE 1,960 Main Application 1/25/2016 8:34:03 AM 2 1 4 0 2 5 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application MAIN APPLICATION 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 EJ 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? [3 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. CEF has incorporated into our By-Laws the requirement that at least one former or current beneficiary (Member) of our program serve on the Board of Directors at all times. Currently, two Members serve on the Board of Directors. These members of the Board of Directors provide invaluable advice based on their particular experiences working with the organization directly, and like all members of the Board of Directors, sign an annual conflict of interest disclosure outlining any potential conflicts that may arise based on their dual relationship with the organization, 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. 1 ( Signature: Executive oirector Date 3 Signature: / 1 c Board Chairperson Date Main Application 1/24/2016 1:47:35 PM R I 5 c 2 1 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's GA• - • f 78 t •Rilication m.) Work Statement 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 Goak, • 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. Main Application 1/25/2016 8:34:03 AM DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider'sOMM. Rilication Actual 2024-2011 ffitiPteted 2010 2014, Projected 2016-2017 Member moteteollatif CEO Momber meets with el CU advocates to dea the advocates to Amin the program,JeAr:%pewee,me prognam,joins Omportuntor Vase to gam carver readiness Cram.to goo career mad 00000 and financial 000 to and arta fimenetal bat%and continue*to meet AAP CEO continues to meet emaCEF advocate%Advocates assist advocates,Advocate,rime mate Mr to grafting revise, member Or arafong resume, emptying err ermaloymerst, applying for arnaleyrnera„ navigating Son ers to New 011000400 010 add to rhudgegme bee oouto erre kgarterre oxen mid For earatirie greet es outlined On enhairaym me ea porta g Mr interviews,tor:pleoto 2014,201P Qnck.pde Partner interview:,one pining tremicsorteion on needed,CO' with tap]fervicee to transportation am nearled,1E0 elm managed the Me Asetrhail clench menntset4 to will elm*manage the Asit, tot*0 of the Orange cermumet record expunction, Partnere imitative of the County Faremensh rio to EP seances Peeled a deedef Cramp Crop%0000004,00 Harnelatemess at mem to PFTM4F7,01,4 to to Durham End Nomereemee toot memo ammo member;0000 to rmpn.go 'Technical Camp en Ay to aster members mauls records end nth r Merle% ,Collage to an:00000 member 1 thin no r r coSoto ettag gurin orn sage meet to0 000000 00 trit hem and employment by ormageting connecting errouttly%yam area degree pare%that can Propane Acted 1 direct%wee gee Agladeierwe AR,Orem, e to careers At itoot 124 member:chid 125 mewhera m gem greater AT least 140 rateinbeg vela Prop Olt Noel min greater employment egehishowent 40 in greeter employment Amass employment 000000 Amen arrytartmert gots AIMS;ernalogrilAnt'Statue Ape,intake end encument upon Muerte and Potence upon[intake and declarer% a hinges in employment 01005 chempc In emeroyment Mater Change/00 emearimeni through 0000b0 weetimp and enough meekly meetirp and Mato,throve weeder mph%faro*toot o0000 ropier for low,up with mg et tap and regular , Refferradtme Measures Amerneen, membert lup with roernbers 113 mom torn pined greedier I employ meet A Mee that tont,'libooted Setae preoren not 40000 metes our pars too ampioyment end 0000np wad 1 a nirsienereled%cue on houvrig broadloom that woo rateomege to our At lent 12$members le CEP,. At least I40 mentbers rag mangy S iteegs based on asivocace Program PM gag CEP's Advocate Program yell to smoothies cram For emelt cri greater a tri Oav ment followleg gain greater employment Prom orm Results holders to derticeiza I to,r rant entry, follow in„Are rarn entry New etrategted 10 0014 to misting act MOP outlined to 1014-2010 lneurdet We are Merneser meets with CEF parthheating in an eaten advocator to Otto 06 a budget, part nertihR4 W000 the Center meet pen 1.0.11a keel manes for Advanced Pine$000 01 Mentor meets with CEF plum and establish metro Doke University to create eatieetea to dirk a Melee, pads,Mamba:deems CEF new'neon ticeo thaourege mete a parametrized troxratg, daft Mamas Reetwilt end members gong the WAY isligh and estaishea swAnv Arahootes*soot mambo%in towards oreigairilg their 40000 Member oporoo cEr ateraving their coo rtits pips tompoterm govaigi pals Sada Seemed account and and snaking regatta dogmata Addrtionslly,don nd 2046- Advocates eget members tn When member achieves goal 2017 we will be soiling cut achieving them mange plant aricr eirmitiamo From an eordence'besect made and%Firma.miural AAPARRA Opportunity Cranes,Ut t retie OUT online Member Wharf rrienhar achieves goal meager SR,/fno Ott ram of servicn eerier%to Ortivide and graduate from 10 pcheigit Tim year(CO has advocates with'ice Irce Ocrocrodorta creme,Cif added maw 000000405 00 guides le cent:rico mg ITIPAChn MO rip et to roe of further onmottrage membey fOmantOo coach Irig ceihRiarts Pet m Tom Activity 2 10 percent, too mach their parsondi scat, meth members, At lase 75 memicen Pil At font 71 members MX At reatt 60 members Pa make primness towards mese program towards make PFORf et,unwinds Program Ace personatime biomes gawk!, pareonerted sayings goat ,person g Itoed savings goats. Apowat end istangectier ACCOUfq toot transaction Account and thentaction record,rn CEF Sea Mery records o000 Seo Soon gis records'In CEO Safe Savings Accounts records,Aterearars Accounts records AtourSt hitoguots records Accetrinta 0 000000 0000000td and martaime are maintained and reemaged are ertaintainee end by CEF,enalaring COO to by(IF,enabling CEP to 0000 000444 by CEP,Pe talog mon tor Proem bewared monger progress togrecia CEP 00 00,0000 mpg% goals and A taccessfut goo r goon oda suceede goer %weed:,pith and pecessfe Flefformence Meatuses ormornerm, ton,oomoo 000 ontO atesnment Al ream 7$members arid At[PP 902 members will achiehe 15%of trier mamba I achieve 25%of their Ata aegis 4001 or greater, persona.sa gimp pal or aseings pare goo Moen tong, ,prate,Menge pert ore term pale and ithig often toteiterrn pale one represents At ben/Rant ateir 25%NM tents'a%Rh its.;t'ia 01 mernbare kth avaiti 25° et for lowtresou Ace nmemlattela step for lbw,resource their persomet levee 400 to towards gotta ag f medal ,nouseholds toward, Provost Results greater, 4,011q1bedn1 'giggler•f inettclar weir Age t, Member earls with CEO Member were with CEF New strategies to add te advocator to Asessch for adomicatm to aressch for too et mg ear/egret out tired to Spidttng,appic For Moon& hoping,epic for hoot tog 2014,2016 include We will and navigate:wadable,robot and navigate anranabie roost I be collo ecrebng watt 04000000 to secure hoostrog 0000000 to biome homing, 1 network of 040 000005 to CEP advocates cconect OFF advocate schnatm co liedively revert landlord, merited,/to rectocars for m0000b0005uo mono torn for o 00400 aerie iota rum gore e Re steer Shame es tawhitsrai ARS ASIA.nemN 00 0000ec0000 00011. Program nativity 3 needed for modem needed for oo0000-to gdatilat tem At eset hougeholds to At Most 40 housetods tee At least 50 households will toonotoor,tate rtrapenderte tem cit ron Into independere gag not on ette edeptedin at it A a' a AP-Thai till). '''•"1'15' 112 • 9,3 AM prcvarn thenhar me programer RR. periltiperers who pin porampernts who gem, 1 tiverticipents who gem irteleittpcbmt howo ha mdapomdent herring Independent housing toOt 000000 Varrtml entrance bat weer growl YR tIMPItnce between trallgrate mco And get,determined through 000d eve deberintned throve, and exit determined DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application Actual Estimated 20115-2016 Projected 20914-20116 2011620112' Member meets with 1-2 CEF Member meets with 1-2 CEF advocates to join the program, advocates to join the program, joins Opportunity Class to gain joins Opportunity Class to gain career readiness and financial career readiness and financial skills, and continues to meet skills, and continues to meet with CEF advocates.Advocates with CEF advocates,Advocates assist member in crafting assist member in crafting resume,applying for resume, applying for employment,navigating employment, navigating New strategies to add to barriers to employment, barriers to employment, existing activities outlined in preparing for interviews, and preparing for interviews, and 2014-20116 include: Partner gaining transportation as gaining transportation as with legal services to connect needed, CEF will also manage needed,CEF also manages the members to criminal record the Job Partners initiative of Job Partners initiative of the expunction services, Develop the Orange County Orange County Partnership to a deeper partnership with Partnership to End End Homelessness as a means Durham Technical Homelessness as a means to to assist members with 1Community College to assist members with criminal criminal records and other improve member access to records to attain employment barriers to attain employment 'training and degree by connecting directly with by connecting directly with programs that can lead to Program Activity 1 area employers. area employers. careers. At least 120 members will gain 125 members will gain greater',At least 140 members will Program Goal greater employment employment, again greater employment Assess employment status Assess employment status Assess employment status upon intake and document upon intake and document upon intake and document changes in employment status changes in employment status changes in employment through weekly meetings and through weekly meetings and !status through weekly regular follow-up with regular follow-up with meetings and regular follow- Performance Measures members, members, up with members, 113 members gaineo greater employment, A factor that contributed to the program not quite meeting our goals In employment and savings was an intensified focus on housing transition that was responsive to our community's At least 125 members in CEF's At least 140 members in needs based on a mounting Advocate Program will gain CEF's Advocate Program will crisis for voucher-holders in greater employment following gain greater employment Program Results particular. Iprogram entry, following program entry DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application existing activities outlined in 2014-2016 include: We are Member meets with CEF participating in an exciting advocates to build a budget, partnership with the Center make a personalized savings for Advanced Hindight at Member meets with CEF plan, and establish savings Duke University to create advocates to build a budget, goals. Member opens a CEF new incentives to encourage make a personalized savings Safe Savings Account and members along the way plan,and establish savings Advocates assist members in towards achieving their goals. Member opens a CEF achieving their savings plans longer-term savings goals, Safe Savings Account and and making regular deposits, Additionally, during 2016- Advocates assist members In When member achieves goal 12017 we will be rolling out an achieving their savings plans and graduates from levidence-based model and making regular deposits, Opportunity Classes, CEF through our online member When member achieves goal matches savings at a rate of 10 services platform to provide and graduates from percent,This year CEF has advocates with topical guides Opportunity Classes, CEF added new incentives to for conducting financial matches savings at a rate of 10 further encourage members to coaching sessions with Program Activity 2 percent, reach their personal goals. members. At least 75 members will make At least 75 members will make At least 90 members will progress towards personalized progress towards personalized make progress towards Program Goal savings goals savings goals personalized savings goals. Account and transaction Account and transaction I Account and transaction records in CEF Safe Savings records in CEF Safe Savings records in CEF Safe Savings Accounts records.Accounts Accounts records, Accounts lAccounts records. Accounts are maintained and managed are maintained and managed are maintained and managed by CEF, enabling CEF to by CEF,enabling CEF to by CEF,enabling CEF to monitor progress towards monitor progress towards monitor progress towards goals and successful goal goals and successful goal goals and successful goal Performance Measures attainment, attainment. attainment. At least 75 members will At east 90 members wi achieve 25%of their personal achieve 25%of their personal savings goal or greater, savings goal or greater. Savings goals are often long- Savings goals are often long- ' term goals, and 25% term goals, and 25% represents a significant step represents a significant step 62 members achieved 25%of for low-resource households for low-resource households their personal savings goal or towards building financial towards buildling financial Program Results greater, wellbeing, wellbeing. Member works wit CEF Member works with CEF advocates to search for advocates to search for New strategies to add to housing,apply for housing, housing, apply for housing, existing activities outlined in and navigate available social and navigate available social 2014-2016 include: We will services to secure housing. services to secure housing. be collaborating with a CEF advocates connect CEF advocates connect network of agencies to members to resources for members to resources for collectively recruit landlords furniture and other items as furniture and other items as willing to house our Program Activity 3 needed for move-in, needed for move-in, Irespective client populations. DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outside Agency Application At least 40 households will At least 40 households will At least 50 households will transition into independent transition Into independent transition into independent Program Goal housing housing. housing. Numr o program Number of program Number of program participants who gain participants who gain participants who gain independent housing independent housing between Independent housing between between program entrance program entrance and exit, program entrance and exit, and exit,determined through determined through regular determined through regular regular updates and updates and continued follow- updates and continued follow- continued follow-up with Performance Measures up with members up with members members 69 households transitioned 40 households will transition 150 households will transition from homelessness and into from homelessness and into from homelessness and into Program Results housing independent housing independent housing wvoca e "rogram' Program Coordinator trains Coordinator trains advocates advocates in both generalist in both generalist skills and skills and specialized coaching specialized coaching (e.g. (e.g. financial, employment, financial, employment,taxes, taxes, area resources). area resources), Coordinator Coordinator convenes weekly convenes weekly meetings of meetings of volunteer team volunteer team leaders, who leaders,who in turn provide in turn provide one-on-one New strategies to add to one-on-one support to support to advocates for !existing activities outlined in advocates for troubleshooting troubleshooting challenges 2014-2016 include: Increased challenges with members and with members and outreach to Spanish-speaking Program Activity 4 brainstorming solutions, brainstorming solutions, volunteer advocates CEF will continue to grow our volunteer base and 190 'volunteer advocates will At least 150 volunteer At least 150 volunteer provide active support to advocates will provide active advocates will provide active Program Goal members support to members, support to members. Check volunteer records to Check volunteer records to Check volunteer records to determine levels of activity determine levels of activity determine levels of activity and retention following and retention following and retention following Performance Measures volunteer training, volunteer training, volunteer training. vo unteers engage, actively as advocates In 2014- 2015.This reduced number was based in part on our determination at the start of the year that an improved CEF will maintain an active and CEF will maintain an active and model would be to require committed group of at least committed group of at least more of a commitment from a ,150 volunteer advocates to 150 volunteer advocates to smaller number of volunteers, provide direct, relationship- provide direct, relationship- s which has proved to be very lbased support to CEF based support to CEF Program Results fruitful, members, members. onnunign Envelope ID:oF9F1o1u-CEoB-4eFn-9oFc+moAenca1o4n [ /\- continued Provider's Outside Agency Application August 2015, CEF coordinates an Integrated Service Center through our recently expanded Chapel Hill office, co-locating services from partner organizations Housing for New Hope and the UNC Center for Excellence in Community Mental Health. CEF staff coordinate on-site appointments between multiple agencies, I coonect|ng[EFmanbemto these services and the clients of other agencies to CEF's programs. CEF staff also lead service coordination between participating Program Activity 5 ' � _ agencies. Engage at least 8 partner agency progr ms in the Program Goal Integrated Service Center rParticipatory feedback and guidance team members engaged in the integrated service I ' delivery model assessing communication, coordination, and the Performance Measures_--- streamlining t of services eeam �� -- - -- agenc/espnage* in the Integrated Service Center will build a functioning system for cross- agency service coordination, with at least 8 programs Program Results actively engaged, DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's Outsi.de Asiency Application MAIN APPLICATION Progress will be monitored by the Operations Coordinator in collaboration with the Advocate Program team. The CEF team monitors outcomes on a monthly basis utilizing a data dashboard that spans all of these program outcome components. As a reference for the data collection tools used by CEF to track this information, please find enclosed in our packet the CEF New Member Introduction form, filled out by all members upon intake. The information related to Housing and Income is updated every 3 months in our Client Relationship Management datbase during their engagement with CEF. Main Application 1/25/2016 8:34:03 AM ' 1 8 2 5 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's MilNdAe' •eacyT�pplication 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. The CEF Advocate Program is a dual geography program serving Orange and Durham Counties. As such, the overall program budget represents expenses for both counties' programs. CEF's initiatives in Durham County have grown significantly over the last year in response to community demand, and have begun to catch up with our presence in Orange County. As a result, the program budget for the CEF Advocate Program has grown significantly for our Durham initiatives (including $35,000 in personnel costs. Thus, though it may appear as though we have swiftly rising program expenditures, our Orange County expenditures only account for a total of$10,000 in increased personnel' costs. Additionally, very importantly, although this is a dual geography program, all funds requested from Human Services funding and received from the Town of Carrboro, the Town of Chapel Hill, and Orange County are solely expended for costs associated with our Orange County programming. Main Application 1/25/2016 8:34:03 AM DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider'stshl'. -,A• +plication Main Application 1/25/2 016 8:34:03 AM P 0 -5 f 2 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's ()IitsidR •Pnev AnoliCatiOrl IVIAIN A 1CATION Program Budget Agency/Program: Commu nit Ern yowerment Fund Advocate Prot ram Actua' ' Estimated .r*lectied •ercent AGENCY REVENUE 2014-15 1 2015-16 2016-17 Change Private Donations =1111 $ 22,210 $ 26 512 19% Agency Generated Revenue(tees) $ 7778 $ 4,750 $ 14,000 195% Local Government Grants: Orange County IMINIMMO 7,500 e*/o Town of Chapel Hill $ 2 500 It 3,500 $ 4 000 14% Town of Camber° On 2,000 00/ 01/0 Other Local: Orange County Partnership to Ent $ 12,000 $ - -100% Other Local $ $ 1 $ 0 Other Local, $ $ Ell1111111.11111 0 It more than 3 sources pease prowle a separate I.st Non-Local Government Grants Triangle United Way $ $ 0 State Government 101111.111211 $ Federal Government $ $ 0 Other Grants: Live to Give Charitable Trust $ 30,000 $ 30,000 30 150 01.41D Other Grants: Oak Foundation 111j111111 $ 25 000 $ 25 000 0% Miscellaneous/Other Revenue $ 29,000 $ 38 000 $ 69,000 82%I Please tat 3 largest MisceIlenous sources PNC Foundation $ 9,000.00 Bank of America 'Charitable $ 10,000.00 Duke University $ 10„000.00 Total Agency Revenue 93 590 144 960 178 012 NMI AGENCY EXPENSES Compensation $ 65,681 $ 110,867 $ 140783 27% Rent&Utilities $ 10,601 $ 17 619 $ 19,829 MI Supplies&Equipment $ 4,582 $ 4,657 $ 5,000 7% Travel&Training $ 816 $ 1,398 $ 1,400 0% 1 Oth,:r Expenses: $ 11,910 $ 10,419 $ 11,000 6% Pease usr 3 Iargest"Other Expenses" Direct Member Support $ 8,530,15 1 Professional Database Dev't $ 2,459.70 Insurance $ 436.32 Total Agency Expenses ", 93 590 144 960 178 012 MI/ SURPLUS/(DEFICIT) FOR PERIOD: 15 01 $ 015 0 150%1 Main Application 1/25/2016 8:34:03 AM f 2 ; DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued PrOViqA:rf,p Le7 As -n Application b.) 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. Exams le Pros ran. Credit Counselin• Class cost Elements Cost($) Ott;ritityitlnit of NI tir: Subtotal($) Credit Counseling Teacher-in class I $25 96 hours (8 hrsimth x 12 months). $2,400 Credit Counseling Teacher-class prep $25 48 hours (4hrsimth x 12 mths) I $1,200 Credit Counselor-one-on-one $20 120 hours (10 hrs/mth x12 mins $2,400 r=1111111.111111111111 $25 120 course packets/credit reports $3,000 Total $9,000 Complete the table below for the„proiect/program for which you are requesting funds. Attach additional rows/pages, as needed. Program: Advocate Pro Cost Elements Cost $ Quantit /Unit of measure Sentotil $ Saler for Member Services Coordinator $30,000 'Year-round roil ram delive $30,000 Sala for Advocate Prooram Coordinator $11,667 2nd suarter hire for FT SU.*art $11,667 VISTA •osition for Advocate Proro ram $6,200 Year-round sr°.ram delive $6,200 Advocate Protram Associate $7 459 Year-round orooram su sort 1 $7 459 $2500-$3000 Summer interns for .ro ram 4 $11,750 Proloram Coordinator $13,107 Year-round *roto ram su.sort $13,107 0/erations Coordinator $14,980 Year-round *fa'ram su.tort $14,980 Salaries for Durham •rosram staff $29,874 Year-round Durham aro!ram $29,874 Facilities fOr *rooram delive $19,829 Percent allocation of total $19,829 S&E: Food & Drinks-Graduate/Celebrate $500 4 events annuall x $500 $2,000 S&E: Printin & Co. info $1,200 Costs for toner; • ser, alloc, $1,200 S&E: Pro.ram Materials 11 $1,500 Direct ex Denses for materials $1,500 S&E: Postage $300 Starnes for member services $300 Staff& volunteer develo.ment-trainin $300 Averaoe of$350/staff x 4 $1,400 Pa roll Ex enses FICA $10,176 Percent allocation $10,176 Benefits $5,670 Percent allocation I $5,670 Direct Member Su•sort $2,579 Tar eted client assistance $2,579 Professional database develooment $75 A. lox, 50 hours of codin. x $75 I $3,780 Main Application 1/25/2016 8:34:03 AM DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provicigfpiplit9 i I 7 R5K1 Application Course fees for UNC-CH advocate training $1,500 1 semester UNC-CH course fee $1,500 $586 EMIIIIIIIIIIIIIIIIIIIII Percent allocation of total $586 Conferences &Membershi ios $594 1 Fees for su ioortive assOns $594 Online Services $1,140 Annual license fee for CRM $1,340 Pa roll Services $521 Percent allocation of total $521 IIIMIIIII Total $178 012 C.) Cost per Unit Actual 201445 Estimated 201546 I Projected 2018.17 Total Cost of Program $93,590 $144,960 1 $178,012 Total * of Units 446 460 475 Cost Per Unit $209.84 $315.30 $374.76 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). Annotation on the Cost per Unit Chart: Our program budget spans both of our programmatic geographies (Orange and Durham Counties) while the outcomes and demographic numbers we ran for this application are only focused on Orange County. Main Application 1/25/2016 8:34:03 AM _.... _...22 ..22 .. DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider's ktitNidx 19acy_Agtptication GA' I ION d.) 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 1/25/2016 8:34:03 AM 24 f 2 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C t A- continued Provider'p1NsAye5,c.ty[ •plication Section 1/1 Financial Data Operating Budget for Entire Agency AGENCY NAME: Community Empowerment Fund ctu ' stiirtated *rojecteti -ercent AGENCY REVENUE 2014.15 201646 2016.17 11 Chan.e Private Donations $ 52,000 $ 80 000 15% Agency Generated Revenue(fees) $ 13,900 $ 15,050 Local Government Grants: Orange County 5 5,000 $ 7 500 $ 7 500 0% Town of Chapel Hill ", 2,500 3 500 1. 4 500 -% Town of Cart:beim $ 2,000 111111.1111Esall 011, Other Local: Oran.e Coun Partnershi.to En( '11E11111111111111IIIIII aM11111111111111111 -100% °titer Lcal: $ Other .ocal: 1. 1. 3 111111111111111111111119 "di more then 3 sou/Piss,Piegse Provide a separate Iwsit Non-Local Government Grants Triangle United Way 11311111111111IMIlialiiientill.1111111111. mi State Government I $ - 0 Federal Government Other Grants; Live to Give Charitable Trust ". 30,000 1, 30 000 10,000 Other Grants, Oak Foundation $ ,ss0 60,000 ". 60 000 111111111111111111M1 Miscellaneous/Other Revenue $ 130 019 $ 148,333 5 200 350 Piease 3 larges,t Misrpellamous sources Sloan Family Foundation S 24,000 00 Rose Foundation $ 25,000 00 Duke Universitt $ 20,000 00 Total Agency Revenue 30 9 IIIM!!111111111./ AGENCY EXPENSES Compensation $ 152 029 $ 269,724 M Mil il Rent&Utilities $ 19,932 .I,MIIIIII31111111111111.628 $ 36 720 Supplies&Equipment $ 9,507 I $ 10 10.586 $ 11 718 Travel&Training $ 2,015 5 2 590 $ 3 430 Other Expenses: . 26,872 I $ 34 880 $ 39 082 Peese list 3.a.rgest'Ober E,x penses" Direct Memider Suplool-t 5 8 530 14 Matching Savings Contributions $ 11 762 00 Professional Database Devi $ 4 555 00 Total Agency Expenses 2 0 3 5 288 360 6 . 111.11111 SURPLUS/(DEF1OIT)FOR PERIOD: $ 20 674 $ 13 948 4 1 274 -i09., Main Application 1/25/2016 8:34:03 AM ' 2 DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C EXHIBIT `B" Scope of Services—FY 2016-17 Outside Agency Performance Agreement Agency Name: Community Empowerment Fund Funding Award: $7,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel Expenses for Program Coordinator 7,500 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. • New strategies to add to existing activities outlined in 2014-2016 include: Partner with legal services to connect members to criminal record expunction services. Develop a deeper partnership with Durham Technical Community College to improve member access to training and degree programs that can lead to careers. • Account and transaction records in CEF Safe Savings Accounts records. Accounts are maintained and managed by CEF, enabling CEF to monitor progress towards goals and successful goal attainment. • New strategies to add to existing activities outlined in 2014-2016 include: We will be collaborating with a network of agencies to collectively recruit landlords willing to house our respective client populations. 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 At least 140 members will gain greater employment 140 At least 90 members will achieve 25%of their personal savings goal or greater. Savings goals are 90 often long-term goals,and 25%represents a significant step for low-resource households towards buildling financial wellbeing. Households will transition from homelessness and into independing living 50 DocuSigned by: haeht, �s Program Coordinator 11/2/2016 Certified by: t Title: Date: (Provider's Signature) DocEnvelope ID:BF9F1016 CEDB 4BF6 9DF2 A6DAB623164C MDD DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE R054 1/22/2016 THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BB&T INSURANCE SERVICES INC/PHS sac,,"N,Ext): (866) 467-8730 FAX (NC, (888) 443-6112 272545 P: (866) 467-8730 F: (888) 443-6112 AE DIRI ESS: PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAIC# CHARLOTTE NC 28229 INSURER A: Sentinel Ins Co LTD 11000 INSURED INSURER B: INSURER C: COMMUNITY EMPOWERMENT FUND INSURERD: 108 W ROSEMARY ST INSURERE: CHAPEL HILL NC 27516 INSURERF: 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. LVSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EPP POLICY EXP LIMITS LTR INSR WVD (MJPDD/YYYY) /MM/DD/YYYYI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $2, 000, 000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $1, 000, 000 PREMISES(Ea occurrence) A X General Liab 22 SBM BN9653 01/26/2016 01/26/2017 MED EXP(Any one person) $10, 000 PERSONAL&ADV INJURY $2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4, 000, 000 POLICY PRO X LOC PRODUCTS-COMP/OP AGG $4, 000, 000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $2, 000, 0 0 0 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 22 SBM BN9653 01/26/2016 01/26/2017 BODILY INJURY(Per accident) $ A AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION S $ WORKERS COMPEVSATIOS PER OTH- AND EMPLOYERS'LIIRILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured' s Operations . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Orange County DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 AUTHORIZED REPRESENTATIVE 200 S CAMERON ST 7e-,� HILLSBOROUGH, NC 27278 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD