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HomeMy WebLinkAbout2017-475-E Finance - Child Care Services Association - Outside Agency Performance Agreement DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2017, ("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 Child Care Services Association, a not-for-profit corporation, located at 1829 East Franklin Street Bldg 1000, 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 Child Care Services Association agree as follows: 1. Term of the Agreement. The tenn of this Agreement shall be a program year beginning July 1, 2017 to June 30,2018. 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 B, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of 5250 b. All funds appropriated shall be used for purposes described in Exhibit B. 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 1312.5. 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. (Child Care Services Association) Orange County Outside Agency Performance Agreement Revised 7/2017 Page 1 of 7 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 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 12, April 13, and July 13 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. (Child Care Services Association) Orange County Outside Agency Performance Agreement Page 2 of 10 Rev. 7/17 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 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. (Child Care Services Association) Orange County Outside Agency Performance Agreement Page 3 of 10 Rev. 7/17 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 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 tenninated 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 Non-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 $ 13.75 per hour. To the extent possible, Orange County recommends that Child Care Services Association 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: (Child Care Services Association) Orange County Outside Agency Performance Agreement Page 4 of 10 Rev. 7/17 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 County: Finance &Administrative Services Provider: Child Care Services Association Orange County 1829 East Franklin Street Bldg Post Office Box 8181 1000 Hillsborough,NC 27278 Chapel Hill,NC 27514 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. 18. 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. 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 Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). Any violation of this requirement is a breach of the Agreement and County may immediately terminate this Agreement without further obligation on 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 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. 19. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below.r For mishehf of the Provider SU.t. SS 9/1/2017 27C68EE043CB483 , Date (Child Care Services Association) Orange County Outside Agency Performance Agreement Page 5 of 10 Rev. 7/17 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 7 ti 9 tIf of Orange County Government OUtUut, l'a)mwtt.V'Stu 9/5/2017 0637994B755E477... Bonnie Hammersley, County Manager Date (Child Care Services Association) Orange County Outside Agency Performance Agreement Page 6 of 10 Rev. 7/17 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FOR OFFICE USE ONLY Agency Child Care Services Association Received By Date/Time Program(s) Child Care Scholarship Program Section Subsection 1. Cover Page a. IZ Applicant Contact Information b. El Funding Requests C. 4 Signed Application Cover Page d. 1 Signed Disclosure of Conflicts of Interest and Clause 2. Agency Information a. [3] Agency's Years in operation b. IZIAgency's Purpose/Mission c. Agency's Types of Services Provided d. Agency's Experience with Programs e. Other Pertinent Agency Information f. r Schedule of Positions g. 1 4 Living Wage h. L Agency Budget 3. Program Information a. 1 Human Services Needs Priority b. ■ Type of Program A separate Section 3 is C. Ej Agency Collaboration required for each program. d. IZI Summary of Program e. Description of Identified Need f. Description of Population to be Served g. El Program Staffing, Capacity, & Expertise h. Program Implementation Timeline i. Value of Investment j. Impact of Reduced/No Allocation k. Other Pertinent Information I. 1 Target Population/Beneficiary Chart m. L Work Statement n. Program Budget, Detail, & Cost per Individual 4. Attachments a. Audit: Organizations receiving $300,000 or more in Federal financial assistance, and/or organizations with more than $500,000 of receipts and expenditures in a fiscal year, must secure an audit. b. 14 IRS Federal Form 990 c. NC Solicitation License +additional supporting document d. Ej IRS Federal Tax-Exemption Letter e. L Certificate of Insurance f. 4 List of Board of Directors g. i1 Solid Waste Program Fee (SWPF) Verification Application Submittal Checklist 1/27/2017 8:51:47 AM n ) DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Child Care Services Association Applicant Organization's Physical Address: 1829 E. Franklin St. Chapel Hill, NC 27514 Applicant Organization's Mailing Address: PO Box 901, Chapel Hill, NC 27514 Applicant Organization's Web Address: www.childcareservices.org Executive Director: Anna Carter Telephone Number: 919-967-3272 E-Mail: annacAchildcareservices.org Tax ID Number: b) Funding Request List all FY17-18 Human Services (HS) Funding Being Requested — For All Programs) and the Proposed Use of Funds (2-3 lines or less) Program Carrboro Chapel Orange Total - HS Hill - HS County- , HS CCSA Child Care Scholarship Program $7,500 $12,500 $35,000 $55,000 Child care financial assistance to children in lower-income families engaged in work, school, or trainin. related activities Totals $7,500 $12,500 $35,000 $55,000 c) 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: , CO; Executive Director Date 41 • Signature: • 4 -1 Board AT. Date -- AGENCY INFORMATION 1/27/2017 8:51:47 AM P q e 2 of onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION d) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION CLAUSE Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate fanni|ies, or their business associates... YES NO | | ■ a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, Carrboro, or Hillsborough? I- El b) Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, Hillsborough, or Orange County? c) Current beneficiaries of the project/program for which funds are requested? EZ 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 questinn, please provide a full explanation below. One of CCSA's board members, Adriana K8mrtinez, is the owner/director of a child care tgoi|ib/. Spanish for Fun Academny, which provides child care services to CCSA child care scholarship recipients. The facility receives monthly reimbursement for these services. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for thernae|ves, their mQen1s, offic/o|s, employees and servants agree not to discriminate in any manner of these basis of race, color, Qendmr, national origin, age, hmndiomp, re|igiun, sexual orientotion, gender identity/expression, familial status or veterans status with reference to any activities carried out by the 8rmntee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights (]rdinonoe, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific perfonnonce, injunctive re|ief, or other remedy as by law provided; this provision shall be binding on the Qrmnteam, the successors and assigns of the parties hereto with reference to the above subject manner. 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 program ineligible for funding, but the existence m undisclosed conflict result in the termination of any grant awarded. Signature: / _� -> -7_-� /7 ,seoutiveOireotor Date Signature: ` NN |�^ � �A��^ =�8 � ^ --- "w,�`��'� _--- ' Boar. �.'°-rsun D" / \~ ^ AGENCY INFORMATION 1/27/2017 8:51:47 AM I onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT A PROVIDERS OUTSIDE AGENCY APPLICATION 2. AGENCY INFORMATION (Be Very Brief and Concise) Please provide the following information about your agency (2 pages OR LESS): a) Years in Operation, Date of Incorporation Child Care Services Association has been in operation for 43 years and was incorporated in 1986. b) Agency's Purpose/Mission (no more than a few sentences): The mission of Child Care Services Association (CCSA) is to ensure that affordable, occesaib|e, high quality child care is available for all young children and their families. The agency has five goals: (1) to ensure that no family pays more than 10-1296 of its gross earnings to purchase child care for one child; (2) to ensure that high quality child care is accessible to all children; (3) to ensure that all child care is of high quality; (4) to model how services are delivered to young children and their families and child care providers; and, (5) to be a financially viable, strong, effective organization. c\ Types of Services the Agency Provides (bullet format): • Family support services that include child care scholarships to help low and moderate income working families who cannot pay the full cost of quality child care and child care referral services to all families needing assistance in finding a child care placement for their child; • Quality enhancement services such as scholarships for child care providers to take courses, salary supplements to improve the wages of child care workers and reduce turnover in programs, technical assistance and training to both child care centers and family child care providers; • Nutrition services through catering for child care programs and sponsorship of the federal child and adult care food program; and • Public policy research and advocacy in the field of early care and education. Some of these programs are operated for C)ronQo. Durham and Wake counties on|y, while others are operated rogiono||y/ototevvide, and some are administered nationally. d) Agency's History with Providing These Services: CCSA began in 1974 as two independent organizations: [)my Care Services Association (DCSA) in Orange County and the Durham Day Care Council (DDCC) in Durham County. Each organization was created in affiliation with its local United Way as an ongoing vehicle to meet community child care needs. In the early years of the 70's and 80's. both organizations were committed to building the supply of trained child care prmvidero, helping families find quality child care and increasing community awareness of child care issues. As the first child care resource and referral agency in North Carolina, DDCC created successful on-site technical assistance programs for child care facilities, training opportunities, and a child care referral service. DDCC was a founding member of the National Association of Child Care Resource and Referral /\Qencieo, now known as Child Care Aware of America. At the same time, Day Care Services Association (DCSA) was focused on linking child care scholarships for low income families to quality indicators and operating a meal delivery service for child care centers and homes. In addition to its direct services, DCSA collaborated with other organizations to conduct the first of many county and statewide early childhood workforce studies. The groundwork DCSA laid provided baseline data for assessing early childhood issues in North Carolina and led to the development of several innovative and effective quality improvement initiatives, including the T.E.A.C.H. Early Childhood® Pru]eot, a scholarship program for early childhood professionals. The project began in the Triangle area in 1890 and went statewide in 1993. T.E.A.C.H. now supports licenses in 23 other states and the District of Agency Information 1/27/2017 8:51:47 AM e A Of l � onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION Columbia and created and maintains the T.E.A.C.H. Early Childhood® National Technical Assistance Center. Following the success ufT.E.A.C.H.. DCSA in 1994 also created the Child Care VVA[3E8® Project, which provides salary supplements linked to progress in educational advancement and remaining employed in the child care field. GE$0 operates statewide in North Carolina with additional programs across the country. Over the course of the 1990'm. DDDC and DCSA continued their work on innovative early care and education initiatives, launching the nation's first interactive child care web ai8a, supporting the development and implementation of North Carolina's Smart Start initiative, launching a Smart Start scholarship program in [)range Countv, and increasing the reach of child care resource and referral services across the state. In 1898. after much success on parallel tracks, but recognizing the need for coordinated and consolidated efforta, the two organizations, the Durham Day Care Council and Day Care Services Association joined forces to become Child Care Services Association. Since that time CCSA has continued to grow its services for chi|dren, families and child care professionals, and lead innovation in early care and education. CCSA has been recognized as an agency of excellence by the NC Center for Non-Prmfi1s, Child Care Aware of America, and the United Way of the Greater Triangle. e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes in the past year? Is there a new Executive Director?Are there new initiatives?) No m jor changes to report. f) Schedule of Positions (For Entire Agency) • Full Time Equivalent (FTE) staff will be noted as 1.00; halftime as .50; quarter time as .25, etc. • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: Total Volunteer Hours =Volunteer FTE 2,080 # of FTE - Full-Time Paid Positions: 87 # of FTE - Paid Part-Time Positions: 10.36 # ofVolunteers: 71 # of FTE -Volunteers: .31 g) Living Wage Does this agency pay permanent employees a minimum (Yes//Vu) Yea If yes, is this agency an Orange County Living Wage Certified Employer? No CCSA is reviewing its salaries and benefits across the agency and comparing them to Wake, Durham and Orange counties' Minimum Living Wage standards, as we have staff who work and live in all three counties. CCSA may, in the future, seek to become an Orange County Living Wage Certified Employer. Agency Information 1/27/2017 8:51:47 AM P 1 8 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION h) Agency Budget I. Is your agency currently receiving and/or requesting other (non-Human Services) local (Town of Carrboro, Town of Chapel Hill, Orange County) government funding? (Yes/No) No If yes, please list below: Include all programs that have funding requests/awards/totals from Carrboro, Chapel Hill, and Orange County governments (other than Human Services). DO NOT include federal funding sources, such as CDBG and HOME. Program FY16-17 FY17-18 Source Award Request Ex: Affordable Rental 0 $20,000 Carrboro -Affordable Housing Rehabilitation Ex: Agency Administration $15,000 $15,000 Carrboro— Other Ex. Total $15,000 $35,000 Carrboro Total Funding N/A *Add rows or attach additional page, if needed. Agency Information 1/27/2017 8:51:47 AM onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION ii. Agency Budget AGENCY NAME: CHILD CARE SERVICES ASSOCIATION Actual Estimated Projected Percent AGENCY REVENUE 2015-16 2016-17 2017-18 Change Private Donations Agency Generated Revenue(fees) Local Government Grants: Orange County $ - $ $ 35,000 Town of Chapel Hill $12,500 %12,500 $12.500 0% Town of Carrboro $5,000 $0.000 $7.500 2596 Other Local: Durham County $ 29,783 Other Local: Other Local: If more than 3 sources,please provide a separate list. Non-Local Government Grants Triangle United Way 179.461 $ 169.763 ---'169,753 ---- ---% State Government $ 9.579.839 $ 10,603,688 $ 10,6Q3.08O 0% Federal Government $ 11.782.412 $ 3.993.408 $ 9.388.674 -6% Other Grants: Child Care Resources, Inc. $ 439.032 $ 510.773 * 510.773 0Y6 Other Grants:Town of Cary Miscellaneous/Other Revenue $ 2770823 $ 2,784,415 $ 2,784,415 0% Please list 3 larges Miscellanous sources: Kitchen $ 830.000.00 Foundations $ 689.527.00 University of North Carolina ~ $ 525.164.00 Total Agency Revenue IM1911 $24 161 890 $23 603 596 Mirli AGENCY EXPENSES Compensation $ 5,896,638 $ 6,345,830 $ 0.447^363 2% Rent&U0iUeo $ 126.848 $ 117.238 $ 117,238 0Y6 Supplies&Equipment $ 429.031 $ 456,697 $ 456,697 0% Travel&Training $ 208.300 $ 238`521 $ 230.521 0% Other Expenses: Please list 3 larges "Other Expenses". Wages Pass through $5.00.00 TEACH Pass through $3.612.192 Contracts with Service Pmvider$2,2en1na Total Agency Expenses MEM $24 161 890 $23 603 696 Mil SURPLUS/(DEFICIT)FOR PERIOD: U $ - U $ - I $ - � 0l Agency Information 1/27/2017 8:51:47 AM P e '7 I DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION iii. Does your agency budget show a Surplus or Deficit? No Is there a significant change? No Please provide a brief explanation for Surplus or Deficit, and significant changes. iv. What is your agency's fiscal year? July 1 — June 30 (Example: July 1, 2016 through June 30, 2017) Agency Information 1/27/2017 8:51:47 AM Page 8 of 18 onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: CCGA Child Care Scholarship Program Program Primary Contact and Title: Vivi@nEto. Director of Family Support Telephone Number: 919-403-6950 E-K8mi|: viviane@ohi|dcareae[yiceo.org a) Indicate the type of Human Service Needs Priority, if program applicable: Priority Area #1: safety-net services for disadvantaged residents L Priority Area #2: eduoaUon, rnentnrship, and afterschool programming for youth facing a variety of challenges 111 Priority Area #3: programs aimed at improving health and nutrition of needy residents b) Indicate the type of program for which you are requesting funding (Check all that apply to this program) i ---- Public Housing Program Category Youth | Adult Elderly Disabled Neighborhoods/Reside nt� Affordable Housing Affordable Healthcare Education )( Family Resources Jobs/Jobs Training X - - Food Transportation _ Other: Please specify c) 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, briefly describe the coordinated/collaborative eff � os. o Family Success Alliance: CCSA is a partner in the United Way-funded, collaborative work of the Family Success Alliance, the initiative currently led by the Orange / Hea|th Department to improve services and outcomes for children and families in high needs areas of Orange County (Zones 4 and 6). As part of the collaborative, CCSA provides child care education and referral and scholarship support to families identified and prioritized for services by Zone Navigators. ▪ Orange County Child Care Programs and Community Service Providers: CCSA provides on-site education and referral support to families at child care program and other community-based locations. CCSA has assisted child care programs that have needed to close their doors, provided on-site assistance at NCPreK events, and participated in community events with Orange County and Chapel Hill Carrboro City Schmo/a, St. Thomas More Catholic Church, and El Centro Latino, among others. CCSA's Technical Assistance and Training departments work extensively with Orange County child care programs to provide support services and professional development opportunities to improve the quality of care and education being provided to Orange County children in these settings. PROGRAM INFORMATION 1/27/2017 8:51:47 AM P q 8 onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION • Orange County Department of Social Services (DSS): CCSA provides families receiving subsidy funds through DSS with child care education and referral services. CCSA's bilingual counselors are made available to support DSS families and staff on an ongoing basis, either in person or by phone. Staff also conduct quarterly workshops on Choosing Quality Child Care for Work First clients at Orange County's DSS offices in Hillsborough. • Orange County Partnership for Young Children: CCSA has collaborated extensively with the Orange County Partnership for Young Children since the origins of Smart Start and the Orange County Partnership. Collaboration has included a prior, 15-year history delivering Scholarship services, and currently includes partnership in the implementation and delivery of technical assistance, training, and workforce development strategies. • Third Sector Alliance: CCSA participates in the Third Sector Alliance, which is a collaborative of non-profit and human service agencies in Orange County. The group composed of personnel from these agencies meets periodically to discuss the service needs of Orange County residents and to explore the possibility for coordinating efforts to meet these needs. • UNC- Chapel Hill: CCSA is an active member of the UNC Child Care Advisory Committee. This committee seeks to address the parenting and child care needs of the University community and oversees a child care allocation set aside for UNC students and University employees. Benefits to eligible Orange County residents include the provision of child care scholarship and referral services. Program Description (3 pages OR LESS) Please provide the following information about the proposed program: d) Summarize the program services proposed and how the program will address a Town/County priority/goal? Child Care Services Association (CCSA)'s Child Care Scholarship Program will provide financial assistance for child care payments to Orange County families who are working, looking for work, and/or in school or training and needing child care for their children ages 0-12 years old. The focus of the program is to enable parents to enhance their families' economic self-sufficiency and ensure that children are provided with high quality early care and education opportunities that will promote optimal growth and development. Affordable child care has been identified as a community priority both for the role it plays in supporting families' economic needs and the impact of quality child care on children's school readiness and educational attainment. e) Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services Needs Assessment, Orange County BOCC Goals . Council Town of Chapel Hill Goals, Carrboro goals, or other community priorities (i.e. Council/Board Goals). Reference local data (using the provided links, i.e. Chapel Hill Human Services Needs ' Assessment) to support the need for this program. Access 10 affordable, quality child care iaa high priority need identified throughout Countv mnd Town assessments. The Chapel Hill Human 8ervioeaNeeds Aaaeoennen1cites affordable' child care under the funding priority for Education and Family Resources. The Orange Counb/ BO��<� cites expansion ofpna-kindarQa�en services aao key strategy for innprovinQeducational outcomes for at-risk children in their Goals and Priorities. Child care is also prominently featured in the gap ona|yais, priorities and strategic plan goals for the Family Success Alliance, whose geographic focus areas include parts of Chapel Hill and the majority of Carrboro (Zone 6). ` PROGRAM INFORMATION 1/27/2017 8:51:47 /\M ,r,1 1 0 r/3 onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDER'S OUTSIDE AGENCY APPLICATION There are 7.860 children under 6 years old and 10.304 children 6-12 years old in Orange County, approximately 18.000 (8996) of whom are living in families with child care needs.' Child cana, however, costs more than most families can afford. The average annual cost for child care in Orange County for an infant in a 5-star center is over $15,200.2 This represents over 37% of the gross earnings of a family of three who just exceeds the income-eligibility guidelines for state subsidy assistance. Over 1.5OO (19Y6) children under the age mf8 and over 1.4UU (1496) children 6-12 years old in Orange County live below federal poverty guidelines, and'over'G.2OO (34%) children birth to 12 live in low-income families (i.e., at or below 200 percent of the federal poverty level and income-eligible for child care subsidies).3 The ability of the Orange County Department of Social Services (OCDSS) to meet the child care needs of these families is limited both by resources and policy guidelines. Available historical data from the state indicates that Orange County has typically served less than 25% of eligible children with subsidy assistance,* Waiting lists for OCDSS child care assistance fluctuat widely, as records are periodically purged, hmvvewer, waitlist numbers within the past five years have reached a height of over 400 children5 and CCSA's own waiting list for child care scholarships in Orange County currently exceeds 400 children.6 f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? The CCSA Child Care Scholarship program will serve approximately 120 chi|dnen, birth to 12 years old, from low-income families who live or work in {)range County. Families must meet income-eligibility guidelines based on median income levels for Orange County (as opposed to the state median income guidelines used by DSS). Families are required to be working, looking for work, or attending school or job training programs. Families are awarded scholarships based on greatest need (i.e., lowest income). Enrollment priorities include homeless families, teen porents, and children with special needs. Due to the braiding of other funding, priorities for enrollment also include affiliation with the University of North Carolina at Chapel Hill, and residency in the Family Success Alliance priority Zones, Families are identified for services through screening by CCSA education and referral counselors who speak daily with families seeking child care information and assistance. Families are also referred by community agencies and partners. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program 8xanogerandoneden�ob;' desc�he �8/n/ngprovk�odbovD/un&9en� etr.) ' Job Title incumbents Education & Experience Scholarship Rhina Orantes All have a minimum of a Bachelor's d-- in or i Early degree y Counselors Martha Alba Childhood or related human services, are fluent in Spanish Rossina Colon and English, and have a minimum of two years of experience working directly with families and children. Data & Payments Sheila Cooper Bachelor's degree in Business Administration with 12 years Associate of experience working with numbers and data and handling administrative responsibilities. 21 months with CCSA. 12011-2015 American Community Survey,5-year estimates,US Census Bureau. 2 CCSA Child Care provider data,January,2017. ,|hid. 4 Annual Child Care Subsidy Fact Sheets 2010-2015,North Carolina Division of Child Development and Early Education. DCDEE Subsidy Expenditure Report,July 2013 6 CCSA Scholarship Program Waitlist,October 28,2016 PROGRAM INFORMATION 1/27/2017 8:51:47 /\M u 0f � � onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDER'S OUTSIDE AGENCY APPLICATION Data and Provider Joy Turner Master's Degree in Social Work and 13 years of experience Relations Manager in human and social services and database systems and data management. 2 months with CC8A, ' Scholarship Kelly Eppley Master's degree in Social Work, and 19 years experience in Program Manager social services and the non-profit sector, including 8 years with CCSA and 5 years managing the Scholarship program. Director of Family Vivian Eto Master's degree in Educational Psychology Studies and 22 Support years in early care and education and the nonprofit sector, including 9 years with CCSA and 5 years as Director of Family Support. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. Scholarships are awarded on an ongoing, rolling basis dependant on the availability of funding and turnover in child caseload. Participating families are certified for new and ongoing e|iAibi|itv annually, although changes in eligibility circumstances may require re-assessment at additional times within a year. Once a family is enro||ed, contracts are written for child care payment with the child care facility selected by the family. Unless a change in facility is requested or required (due to a child's reaching a maximum age for the facility) the contract for care at the selected child care facility is effective for the duration of the family's annual scholarship eligibility. Payment for child care is issued on a monthly basis directly to the child care facility based on documentation of child attendance submitted to CCSA by the child care program. As CCSA's Child Care Scholarship program is an ongoing proQrarn, implementation of new services based on funding from the County and Towns would be immediate. i) Why is funding this program a good investment for the community? How does funding this program add value to the community? (250 words OR LESS) Supporting CCSA's Child Care Scholarship program is a dual pronged strategy that addresses Orange County's educational goals for children and economic self-sufficiency and well-being goals for families. A wealth of evidence-based programs and longitudinal research studies (Carolina Abecedarian Project, Perry Preschool Project, Chicago Child-Parent Centers) document the consistent link between high quality child care and improved co0nitive, mnadennic, and social skills for chi|dren, with gains maintained into adulthood, and the greatest impact on children in low-income families. Child care also helps families sustain their participation in the workforce, reduce dependency on public asaiatance, and move out of poverty. Studies have found that the availability of stable child care can significantly decrease employee absenteeism and reduce employee turnover", and when low-income families receive assistance with child care, they are more likely to enter and remain in the workforce and work more hours. » CCSA's Scholarship program also offers an important alternative to child care financial assistance than that offered by the state child care subsidy system operated by OCDSS. CCSA not only has the capacity to serve additional ohi|dren, but the ability to set e|iQibi|ib/ guide|inea, prioribeafor services, and other pnzgrarnnlotiopolicies for services at the /oma/, as' opposed to the state |eve/, providing the flexibility and opportunity to tailor services to better meet the needs of our local community. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation 7Shellenback, Karen,Child Care&Parent Productivity:Making the Business Case, December 2004. 8 Erdal,Tekin,Child Care Subsidy Receipt,Employment and Child Care Choices of Single Mothers,2004. PROGRAM INFORMATION 1/27/2017 8:51:47 AM P 1 o � � DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION is recommended. Elimination or reduction in funding would result, in an immediate reduction in Orange County children being served by CCSA's scholarship program. k) Include any other pertinent information. N/A PROGRAM INFORMATION 1/27/2017 8:51:47 AM Page 13 of 18 onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program Information I) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, | � Program Target Population Demographics ' Actual Estimated Projected 2015'16 2018'17 2017'18 Gender -- Male 57 55 61 � Female 56 55 59 Total 113 110 120 Ethnicity - African-American 28 27 30 American Indian or Alaska Native Asian MIMI 24 1 iiiM Caucasian Native Hawaiian or other Pacific Islander Other: Hispanic or Did not specify 28 30 Total =MEI 110 120 Of the above, how many Hispanic/Latino 8 8 8 _ Of the ebove, how many non-Hispanic/Latino 95 92 101 Total IMEMBIIMIIMIIMEMI Age 0-5 years 110 107 117 6-18 years 19-50 years 51+ years =EMI= Total =MI 110 120 Geographic Location Alamance County 4 4 4 Chatham County 2 2 2 Durham County 24 23 25 Wake County 7 7 _ 7 Other County 2 2 2 Orange County Breakdown Chapel Hill Public Housing Town of Chapel Hill (Non-Public Housing) 58 56 _ 62 Town of Carrboro 12 12 13 r-- TovvnnfHiUobonough --- 2 2 ------- 2 City of Mebane (Orange County) 1 1 1 Orange County (Outside Municipalities) 1 1 1 Total 113 110 120 PROGRAM INFORMATION 1/27/2017 8:51:47 AM P ij 0 1 4 Of i 8 onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION Work Statement m) Complete the Work Statement Chart to describe the work to be performed. This chart 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 docu/nentthe p �eohed/nfonna�on. Eve(yp/ognyrn /srmqu�edtohaveATLEA��TYFr7gna Activity, which should be SMART (Specific, Measurable, Achievable, Relevant, and Time- bound. Click on SMART Goals to learn more. • Program Activities should outline major activities the agency implements to accomplish its program goals. (i.e. Deliver meals to elderly/disabled residents.) • Program Goal should explain what the program is trying to achieve/accomplish. Goals are statements about what the program should accomplish. (i.e. Deliver 100 meals per day, Monday-Friday.) • Performance Measures describe how you will evaluate the degree in which you achieved the stated goals. (i.e. Will track the number of meals delivered each day.) • Actual Program Results use program results to indicate the actual measureable achievement of goals. If goals were not nnet, please explain. (i.e. Delivered an average of 105 meals per day.) Work Statement Chart for Program CCSA Child Care Scholarshi ramm - ' ----- Program Activity Name Eligibility Assessment, Selection and Enrollment of Families • Accept applications from Orange County families seeking assistance with child care for approximately 120 children birth to 12 years old. • Determine family-eligibility based on family income and activity requirements. Income requirements are based on median income levels for Orange County (as opposed to the state median income guidelines used by DSS). Families are required to be working, looking for work, or attending school/training programs. • Award scholarships based on enrollment priorities and program guidelines. Families are awarded scholarships based on greatest need (i.e., lowest income). Enrollment priorities include homeless families, teen porento, and children with special needs. Priorities also include children residing in the Family Success Alliance priority Zones 4 and 6 and families affiliated with UNC-CH. Program Goal Assist families in attaining and sustaining employment, education, and/or .obtnainin• b removin. barriers to child care Performance Measures 1. % of families receiving scholarship assistance because of employment, education or training needs (assessed through ongoing documentation and data tracking, per child, of parental activities and child care need) 2. % of families who report that child care scholarship assistance enabled employment, education or training (assessed through annual evaluation surveys conducted on sample of families each spring) Previous Year Program Measure 1: 9796 Measure 2: 99% Results Current Year Estimate |' K8easuns1: 90Y6 Measure 2: 90% PROGRAM INFORMATION 1/27/2017 8:51:47AM P 8 1 5 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Results Next Year Pro-ected Results Measure 1: 90% Measure 2: 90% Program Activity Name Child Care Program Selection and Reimbursement Assist families who have been awarded scholarships with finding and selecting high-quality child care. Children receiving scholarships are required to be placed in 4-5 star licensed child care facilities. Scholarship counselors are trained to assist families in understanding their child care options and providing referrals. • Reimburse licensed, 4-5 star child care programs monthly for care used by approximately 120 children on scholarship (reimbursement amounts are set at the lesser of a child care program's tuition rate or a CCSA-set, maximum reimbursement rate, minus a parental contribution or "fee"). Program Goal Provide children access to high quality child care that will facilitate their growth and development Performance Measures 1. % of children receiving scholarships enrolled in licensed, 4-5 star child care facilities (assessed through ongoing data tracking, per child, of child care facilities attended and licensure status of these facilities) 2. Average star-rating of child care facilities used by children on scholarship (assessed through ongoing data tracking, per child, of child care facilities attended and licensure status of these facilities) Previous Year Program Measure 1: 100% Measure 2: 4.8 Results Current Year Estimated Measure 1: 95% Measure 2: 4.3 Results Next Year Projected Results Measure 1: 95% Measure 2: 4.3 PROGRAM INFORMATION 1/27/2017 8:51:47 AM () onnunign Envelope ID: 1**noenn-0o44-4Ao1*eec-3n4xFoecAc41 EXHIBIT PROVIDERS OUTSIDE AGENCY APPLICATION n) Program Budget AGENCY NAME: CHILD CARE SERVICES ASSOCIATION Actual Estimated Projected Percent PROGRAM REVENUE 2015-16 ^ 2016-17 201748 Change Private Donations 1111111111111111111111111111111 0 Program Generated Revenue(fees) Local Government Grants: Orange County ElliM111111 $ -- $ - --35^UCO ----------O` Town of Chapel Hill $ 12.500 $ 12.500 12.500 0% Town of Carrboro $ 5000 $ Other Local: Other Local: Other Local: 111111111=1111111=1111111111111111111.1.11 0 If more than 3 sources please provide a separate list. Non-Local Government Grants Triangle United Way $ 34,806 $ 20,000 $ --- State Government Federal Government Other Grants: Other Grants: ,11111111.11111111111111111111111111111111111111111111 0 Miscellaneous/Other Revenue $ 506,064 Please list 3 larges Miscellanous sources: University of North Carolina $ 502.464.00 ,St Thomas More $ 3^600.00 $ Total Program Revenue $ 558 370 PROGRAM EXPENSES Compensation Rent&Utilities Supplies 8: Equipment $ 495 MINMI 0% Travel &Training $ 19 MIMI 0 Other Expenses: Please list 3 largest"Other Expenses": Child Care Scholarship $ 482.909D0 Other Expenses(Overhead) $ 21.120.00 $ - �u ' Total Program Expenses $ 558 370 NEN $ 581 248 7% SURPLUS/(DEFICIT) FOR PERIOD: k -� - K $ 0 � - U �� . " " / PROGRAM INFORMATION 1/27/2017 8:51:47 AM 7 8 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 2. Program Budget Detail — Provide description of "other" budget items, not defined. "Other Expenses" included on the budget worksheet include: 1) reimbursement/ payments to child care providers for children on scholarships; and 2) administrative overhead. 3. This program budget represents what percent of the agency budget? 2.3% 4. COST PER INDIVIDUAL This Cost per Individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2015-16 Estimated 2016-17 Projected 2017-18 Total Cost of Program $558,370 $544,564 $581,248 Total # of Individuals 113 110 120 — Cost Per Individual $4,941 $4,950 $4,844 PROGRAM INFORMATION 1/27/2017 8:51:47 AM H t DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 EXHIBIT `B" Scope of Services—FY 2017-18 Outside Agency Performance Agreement Agency Name: Child Care Services Association Program Name: Child Care Scholarship Program Funding Award: $5,250 Outline how the agency will spend Orange County's funding award. Expense Description Amount Direct reimbursement to child care providers serving CCSA Scholarship children $5,250 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2018. • Accept applications from Orange County families seeking assistance with child care for approximately 120 children birth to 12 years old. • Determine family-eligibility based on family income and activity requirements. Income requirements are based on median income levels for Orange County andfamilies are required to be working, looking for work, or attending school/training programs. • Award scholarships based on enrollment priorities and program guidelines. Families are awarded scholarships based on greatest need (i.e., lowest income). Enrollment priorities include homeless families, teen parents, and children with special needs. Priorities also include children residing in the Family Success Alliance priority Zones 4 and 6 and families affiliated with UNC-CH. • Assist families who have been awarded scholarships with finding and selecting high-quality child care. Children receiving scholarships are required to be placed in 4-5 star licensed child care facilities. • Reimburse licensed, 4-5 star child care programs monthly for care used by children on scholarship 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 % of families receiving scholarship assistance because of employment, education or training 90% (81/90) needs(assessed through ongoing documentation and data tracking,per child, of parental activities and child care need) % of families who report that child care scholarship assistance enabled employment, 90% (81/90) education or training % of children receiving scholarships enrolled in licensed,4-5 star child care facilities 95% (86/90) Average star-rating of child care facilities used by children on scholarship (assessed through 4.3 ongoing data tracking,per child, of child care facilities attended and licensure status of these facilities) DocuSigned by: , .(At/ ?WSW, President 9/1/2017 37.C68EE043C Certified by: 4"'`' Title: Director of Family Support Date: 8/24/2017 (Provider's Signature) DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 ATTACHMENT "A" Orange County Certifications—FY 2017-18 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: (At, ALSSat president 9/1/2017 Certified by: 27C68EE043CB483... Title: Date: (Provider's Signature) (Child Care Services Association) Orange County Outside Agency Performance Agreement Page 10 of 10 Rev. 7/17 DocuSign Envelope ID: 1A43D806-0D44-4AC1-898C-3042FDBCA241 CHILCAR-02 DWILSON2 ,a►CC)RC1" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `••---'' 08/25/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Hub International Southeast PHONE 919 337-0000 FAX 866 553-5124 4000 CentreGreen Way,Suite 140 (A/C,No,Ext):( ) (NC,No):( ) Cary, NC 27513 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Insurance Company 10677 INSURED INSURER B:Accident Fund General Insurance Company 12304 Child Care Services Association,Inc. INSURER C: P 0 Box 901 INSURER D: Chapel Hill,NC 27514 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR W POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD VD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR X ETD 042 87 48 02/16/2017 02/16/2018 DAMAGE TO RENTED 5500 000 PREMISES(Ea occurrence) $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRO- 3,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) ANY AUTO ETD 042 87 48 02/16/2017 02/16/2018 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 EXCESS LIAB CLAIMS-MADE ETD 042 87 48 02/16/2017 02/16/2018 AGGREGATE $ 3,000,000 DED X RETENTION$ 0 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCV 8012045 02/16/2017 02/16/2018 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Fidelity Bond ETD 042 87 48 02/16/2017 02/16/2018 Limit 500,000 A Sexual Abuse ETD 042 87 48 02/16/2017 02/16/2018 Limit 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Orange County Government is named as an additional insured with respect to the General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Manager PO Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE P-(), ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD