HomeMy WebLinkAbout2017-048-E Aging - Brooke Hess for Master Aging Plan Intern DocuSign Envelope ID:98AB524B-CBE4-4E59-83E6-E8216C713957
[Departmental Use Only]
TITLE Master Aging Plan Intern
FY 2016-17
ORANGE COUNTY
CONTRACT UNDER $15,000.00
NORTH CAROLINA
THIS AGREEMENT, made and entered into this 1st day of February, 2017, ("Effective Date") by
and between Orange County, North Carolina, a political subdivision of the State of North Carolina, (the
"County"),party of the first part; and Brooke Hess (the "Provider"),party of the second part;
WITNESSETH:
For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby
contracts for the services of the Provider, and the Provider agrees to provide the following services to the
County in accordance with the terms of this Agreement, time being of the essence:
The services and/or materials (hereinafter referred to collectively as "Services") to be furnished
under this Agreement are as follows: work on Master Aging Plan objectives as outlined in Attachment A,
Scope of Work which attached and hereby incorporated herin
The term of this agreement rendered shall be from February 1 to June 30, 2017.
Provider represents and agrees that Provider is qualified to perform and fully capable of performing and
providing the services required or necessary under this Agreement in a fully competent, professional and
timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in
the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies,
ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not
sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or
responsibility granted or required by this Agreement,without the prior written approval of the County.
SPECIFIC TERMS
1. Payment: The County agrees to pay at the rates specified for Services satisfactorily
performed in accord with this Agreement. The amount to be paid by the County shall not exceed one-
thousand, two-hundred dollars, ($1,200.00). Payment shall be made within thirty (30) days of an invoice
properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement,
County may, without fault or penalty, withhold any payment associated with the work to be performed until
such time as said work is completed.
2. Non—waiver: Failure by County at any time to require the performance by Provider of any
of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor
shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of
this Non-Waiver Clause.
3. Independent Contractor: The Provider shall operate as an independent contractor and the
County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated
as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or
workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of
any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider.
4. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability
Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may
be required by County's Risk Manager as such insurance requirements are described in the Orange County
Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is
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DocuSign Envelope ID:98AB524B-CBE4-4E59-83E6-E8216C713957
incorporated herein by reference and may be viewed at
http://www.orangecountync.gov/departments/purchasing division/contra cts.php). If County's Risk
Manager determines additional insurance coverage is required such additional insurance shall consist of N/A
(if no additional insurance required mark N/A as being not applicable). Provider shall not commence work
until such insurance is in effect and certification thereof has been received by the County's Risk Manager.
5. Indemnity: The Provider agrees to defend, indemnify, and hold harmless Orange County
from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including reasonable
attorney's fees) arising from bodily injury, including death, to any person or persons or damage to or
destruction of any property caused in whole or in part by any negligent or intentional act or omission on the
part of the Provider, its agents, or assigns directly or indirectly related to the Services to be performed
pursuant to this Agreement on the part of the Provider.
6. Termination: This Agreement may be terminated at any time by mutual written agreement of
the parties or by the County upon written notice to the Provider. County may suspend this Agreement upon
reasonable notice to the Provider.
7. Entire Agreement and Signatures: The parties have read this Agreement and agree to be
bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the
Agreement between the parties unless and until modified in writing and signed by the parties. 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.
8. Priority: In determining the basic services to be provided, should any documents be
referenced in or attached to this Agreement, the terms of this Agreement shall have priority in any conflict
between the terms of referenced documents and the terms of this Agreement.
9. Governing Law: Both parties agree that this Agreement shall be governed by the laws of the
State of North Carolina. Provider shall at all times remain in compliance with all applicable local, state, and
federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws,
policies, rules, and regulations and the Orange County Anti-Discrimination Policy. Any violation of this
requirement is a breach of this Agreement and County may immediately terminate this Agreement without
further obligation on the part of the County. This paragraph is not intended to limit and does not limit the
definition of breach to discrimination. By executing this Agreement Provider affirms that Provider is 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.
10. Dispute Resolution: Any and all suits or actions to enforce, interpret, or seek damages with
respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in
the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the
parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding
arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of
any dispute prior to the bringing of such suit or action.
11. Non Appropriation: Provider acknowledges that County is a governmental entity, and the
validity of this Agreement is based upon the availability of public funding under the authority of its statutory
mandate. In the event that public funds are unavailable and not appropriated for the performance of County's
obligations under this Agreement, then this Agreement shall automatically expire without penalty to County
immediately upon written notice to Provider of the unavailability and non-appropriation of public funds.
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DocuSign Envelope ID:98AB524B-CBE4-4E59-83E6-E8216C713957
[SIGNATURE PAGE TO FOLLOW]
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DocuSign Envelope ID:98AB524B-CBE4-4E59-83E6-E8216C713957
IN WITNESS WHEREOF,County and the Provider have signed this Agreement, effective as of
the day first written above.
ORANGE COUNTY PROVIDER
,----DocuSigned by: DocuSigned by:
By: ^^�jostA,lit,lt, ti -ii By: brook 't,ss
I.Ot t uttger l itle':-26AE846818F24D6...
200 S. Cameron St. Brooke Hess
P.O. Box 8181 218 Crystal Circle
Hillsborough,NC 27278 Mooresville, NC 28117
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APPLES co
Service-Learning Internship Work 'Plan
servia-119601iliq
Due Date: 1/27
"APPLES will not release funds for the stipend to the host organization until the CO
work plan is received. W
I. Internship Schedule T
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Sunday Monday Tuesday Wednesday Thursday Friday Saturday M
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Fluid out of office 8-11 am in office 8-10:45 am Fluid out of office 2-5pm in office M
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M.A.P meetings Weekly check
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11. Contact Information
Intern name Brooke Hess
Title Transportation Intern
PID 720321596
III. Meeting Schedule
Day/Time,date if needed
Weekly check-in meeting Friday afternoon-including a brief written report of how Brooke has spent her time each week. (Form to
be develop ed together).
Mid-spring review 2/28/17
End of internship exit meeting 4/24/17
Potential site-visit from APPLES Middle of semester,Friday,afternoon
Pay schedule (rate,frequency): Twice:middle of internship,end of internship
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IV. Work Plan v
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Intern Responsibilities Measuring Intern Performance Intern Performance 07
Assigned duties, projects, deliverables How will success be measured? U=unsatisfactory, G=good, m
V=very'good, 0=outstanding m
U V G 0 1P
Completion of assigned tasks m
Assist in the Master Aging Plan process by participating in the within the timeframe given. m
Transportation Working Group. N
Research questions that are raised during meetings and bring back Notes taken for subgroup are j
materials to the next meeting as needed,such as Best Practice readable,and thorough. w
examples.
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Assumes note taker responsibilities for the Transportation subgroup. j
Outreach to medical practices in Orange County which are At each practice, a relationship
frequented by the Volunteer Driver Program. with a staff member is made.
The number of medical practices reached will be A card rack full of
determined by time available. transportation information is
offered.
Volunteers are recruited to
maintain card racks.
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Assistance with Volunteer Driver Program: possible projects The expectation is that a min. of
• Recruit volunteer drivers in the 2 methods for recruitment will
be tried: ex.recruitment through
Hillsborough/Efland/Cedar Grove areas of g
faith community, civic m
Orange County. organizations,flyers posted in
town,etc.. v
• Review volunteer sign up process W
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1. Development of a list
• Market the Volunteer Driver Program to older adults as a of opportunities for o w
transportation option. marketing the VDP.
2. Implementation of one N
or more.
Other Projects: 1. A newsletter template I
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• Develop an e-newsletter template to be sent to referral with the copy for the
sources, such as social workers at UNC hospital clinics. first newsletter.
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• Assist supervisor in creating a 6 month calendar of speaking 2. A calendar of speaking
engagements to groups. engagements with 3
confirmed for the
spring-summer.
*Complete the gray boxes midway
through the semester
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V. Goal Setting
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Professional goal of student Plan to achieve this goal m
1. Gain Better Understanding and Talk frequently with community members. 91
get to know the Community. N
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2. Gain confidence in different Take initiative in reaching out to individuals and community organizations/medical partners.
outreach settings.
3. Successfully complete goals and
tasks/projects and create new ideas Stay on task while working and complete projects in a timely manner.
for projects or future interns.
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VI. Expectations
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Expectations of Intern Expectations of Supervisor
Examples: Feedback on work/projects 1. That Brooke feels comfortable asking questions and o
Communication also motivated to look for solutions.
Professionalism Positive environment v
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Academic 2. That she use a variety of resources such as contacts
Direction on projects but space for new ideas. with senior citizens, OCDOA staff, University contacts,
and written materials while working on projects. T
4.
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3. That she stay in contact with me via email, phone and m
in person in regards to her work and do this in a timely m
manner.
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VII. Intern Agreement Expectations
In accepting an internship with the APPLES Spring Internship Program, I commit to do the following:
• Make a professional commitment to my sponsoring organization of at least 150 working hours according to specified schedule'.
• Complete course requirements as defined by SOWO 492 in the APPLES internship course.
• Notify APPLES of any changes in internship placement,work schedule,scheduled meetings with faculty, or contact information.
Please initial below:
I understand that as an APPLES spring intern, I am responsible for maintaining my own health insurance, as required by UNC. I also
understand that as an APPLES intern, I am a representative of the University of North Carolina at Chapel Hill and subject to the Student Code of
Governance and the Honor Code.
ga- I understand that if I do not complete the academic requirements for course credit by the final day of exams it may result in a failing
grade.
�kk If I fail to complete any of the requirements listed above, I understand that I will have to repay all or part of the funds I have received from
my internship.
$ k If I am not able to complete the entire 150 hours of my,commitment, I will notify the site supervisor,the course instructor, and APPLES
staff.
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VIII. Supervisor Agreement Expectations
In accepting an intern with the APPLES Summer Internship Program, I commit to do the following:
VMake a commitment to my intern of providing a professional experience with detailed assignments and projects. Clerical tasks will 0
comprise no more than 30%of duties. o
• Notify APPLES of any changes in internship placement,work schedule, scheduled meetings with faculty, or address changes.
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Please initial below: v
'Jig f understand that the outlined work plan assumes that the intern will be paid an amount of$1,200,for a total of 150 hours of service with W
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the sponsoring organization.The sponsoring organization and APPLES will both contribute$600 toward the Intern's funding.The partnering T
organization is responsible for paying the intern directly from its payroll. m
IX. Stipend Agreement 4.
APPLES interns receive a fixed stipend of$1,200 for the spring.The disbursement of the funds is at the discretion of the organization and is given 1P
to interns throughout the period of the internship.The amount is a taxable income and must be reported in the Form W-2 (Wages and Tax m
Statement) °'
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I understand that I need to report my earnings as taxable income.
Please sign below your agreement with the contents of this form. y
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9"60 J+ess AIP A4��- w
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Student Name ud t Signature Date
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Supervisor Name Supervisor Signature Date