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2017-521-E Finance - Hillsborough Arts Council - Outside Agency Performance Agreement
DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 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 Hillsborough Arts Council, a not-for-profit corporation, located at 102 N. Churton Street, Hillsborough,NC 27278 ("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 Hillsborough Arts Council 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 9750 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 2437.5. 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. (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Revised 7/2017 Page 1 of 7 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 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. (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Page 2 of 10 Rev. 7/17 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 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. (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Page 3 of 10 Rev. 7/17 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 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 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 Hillsborough Arts Council 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: (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Page 4 of 10 Rev. 7/17 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 County: Finance &Administrative Services Provider: Hillsborough Arts Council Orange County 102 N. Churton Street Post Office Box 8181 Hillsborough,NC 27278 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. 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. 7 t, For a apiirifxof the Provider 1t M' x 9/21/2017 76F276G89GO8a3R , Date (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Page 5 of 10 Rev. 7/17 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 1Fo ruk:-,•rbe alf of Orange County Government bbtbut, t'A.iMwte-rStt,(1 9/21/2017 37954B755E477... Bonnie Hammersley, County Manager Date (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Page 6 of 10 Rev. 7/17 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION FY 2017-2018 Outside Agency Funding Application HUMAN SERVICES • ORANGE COUNTY • TOWN OF CARRBORO • TOWN OF CHAPEL HILL Orange County (OC) Town of Carrboro (CA) Town of Chapel Hill (CH) 200 S. Cameron Street 301 W. Main Street 405 Martin Luther King, Jr. Blvd. Hillsborough, NC 27278 Carrboro, NC 27510 Chapel Hill, NC 27514 <Cph !1/7 1q4,011 al 1, si i ^ CARqNISf' -'0 / DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION INFORMATION Each year, Orange County Government, the Town of Carrboro and the Town of Chapel Hill invite program funding requests from non-profit providers that support the delivery of vital community services. The application process is very competitive and not all applicants will be awarded funding. Recommendations for funding may be for an award amount less than that requested by the applicant. Agencies that are currently receiving funds from Orange County, the Town of Carrboro, or the Town of Chapel Hill local governments, and are also applying for new funds, must be in compliance with all terms of their current agreement(s) and must not have any outstanding audit findings, monitoring findings or concerns as determined by the municipality. Recipients are required to submit written progress reports on their SMART Measures that include: goals, description of activities/challenges, revisions of timelines/budgets, and other relevant information Funded projects will be monitored for progress and performance, financial and administrative management, and compliance with the terms of Performance/Development Agreement(s). Monitoring may involve site and/or office visit(s). Once applications are received, they are reviewed by staff for completeness and eligibility. The applications are presented to a specific application review group, depending on the funding source. The review group will make a recommendation, based on available funding and the priorities identified by the participating jurisdiction. The recommendation is presented to the appropriate Board/Council for consideration and approval. The Board/Council approves/adopts the final allocations. TIMELINE November 15 Funding Application Posted on Websites November 29 Funding Application Workshop Held October 18-January 23 Agency Prepares Application January 10 Q&A Session Held January 31 is ti Submissions are e March - May Application Review & Agency Presentations June Agency Funding Approval by Board/Council July Contracts Executed & Programs Begin DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM M: „ ::I II 2 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION SUBMITTAL INFORMATION Welcome to the Outside Agency Common Funding application for local/general funds, which will be distributed through this competitive application process. All entities or organizations requesting funds must complete and submit this application prior to the deadline to be considered for FY 2017-2018 funding. The Application Submittal Deadline is: Tuesday, January 31, 2017 5:00 PM In the event of inclement weather, check the website for each Town/County you are applying to, for further instructions. Please note that late, handwritten, or incomplete applications will not be accepted. (Applications not signed by the Chair or President of the Board of Directors, are considered incomplete.) An application orientation workshop will tentatively be held on Tuesday, November 29, 2016 at 9 AM to Noon to review the application and submittal requirements. SUBMITTAL REQUIREMENTS FOR EACH MUNICIPALITY Human Services— Town Of Carrboro Applications are accepted once a year and reviewed by the Town's Human Services Advisory Commission, which makes a recommendation for funding to the Board of Aldermen for final approval. For more information about the Town of Carrboro Human Services program, see here. Questions and submittals should be directed to: Annette Stone, 301 W. Main Street Carrboro, NC 27510 919-918-7319 astone @townofcarrboro.org Submission: ➢ We strongly encourage applications to be single-spaced, with 12-point arial font and normal margins. ➢ Application: One (1) original plus Two (2) paper copies of the application must be hand delivered or mailed to Annette Stone, 301 West Main Street, Carrboro, NC 27510; AND ➢ One Application and Attachments files must be submitted by email. Any .pdf files must be accompanied by the original file format of .doc, .xls, etc. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM „::: i ::I 0 20'1 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION Human Services — Town Of Chapel Hill In 1982, the Town established local funding to support local nonprofit organizations that carry out human service work throughout the community. Applications are accepted once a year and reviewed by the Town's Human Services Advisory Board, which makes a recommendation for funding to the Town Council for final approval. For more information about the Town of Chapel Hill Human Services program, see here. Questions and submittals should be directed to: Jackie Thompson 405 Martin Luther King Jr. Blvd. Chapel Hill, NC 27514 919-969-5081 jthompson©townofchapelhill.org Submission: ➢ We strongly encourage applications to be single-spaced, with 12-point arial font and normal margins. ➢ Application: Two (2) paper copies of the application with ORIGINAL signatures must be hand delivered or mailed to Jackie Thompson, 405 Martin Luther King, Jr. Blvd., Chapel Hill, NC 27514; AND ➢ Attachments: The application submittal must be accompanied by a flash drive with the application and all attachment files in electronic format. Any .pdf files must be accompanied by the original file format of .doc, .xls, etc. Human Services— Orange County For more information about the Orange County Human Services program, see here. Questions and submittals should be directed to: Allen Coleman PO Box 8181 Hillsborough, NC 27278 (919) 245-2151 acoleman @orangecountync.gov Submission: ➢ Email application and ALL Attachments prior to the deadline. Any .pdf files must be accompanied by the original file format of .doc, .xls, etc. Please request a delivery receipt of email with application and attachments. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM „1 ,,j i ::I II 2 'i DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION FOR OFFICE USE ONLY Agency Hillsborough Arts Council Received By Program(s) Overall HAC Support Date/Time / Section Subsection 1. Cover Page a. x❑ Applicant Contact Information b. x❑ Funding Requests c. x❑ Signed Application Cover Page d. x❑Signed Disclosure of Conflicts of Interest and Clause 2. Agency Information a. x❑ Agency's Years in operation b. x❑ Agency's Purpose/Mission c. x❑ Agency's Types of Services Provided d. x❑ Agency's Experience with Programs e. x❑ Other Pertinent Agency Information f. x❑ Schedule of Positions g. x❑ Living Wage h. x❑ Agency Budget 3. Program Information a. x❑ Human Services Needs Priority b. x❑ Type of Program A separate Section 3 is c. x❑ Agency Collaboration required for each program. d. x❑ Summary of Program e. x❑ Description of Identified Need f. x❑ Description of Population to be Served g. x❑ Program Staffing, Capacity, & Expertise h. x❑ Program Implementation Timeline i. x❑ Value of Investment j. x❑ Impact of Reduced/No Allocation k. x❑ Other Pertinent Information I. x❑ Target Population/Beneficiary Chart we only have %see note under I m. x❑ Work Statement 4. Attachments a. N/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. x❑ IRS Federal Form 990 c. x❑ NC Solicitation License d. x❑ IRS Federal Tax-Exemption Letter e. x❑ Certificate of Insurance f. x❑ List of Board of Directors g. x❑ Solid Waste Program Fee (SWPF) Verification Application Submittal Checklist 2/8/2017 9:36:40 AM M: I :: 5 :; II 2 1 DocuSign Envelope ID:C8F16CD1-FF19-486F-8DD6-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION m1'7E37E771 ;,111100ilic, G t jj,j,111 .1 ApplicY;Int Organization's Legal ? ?al ie: Hillsborough Arts Council Applicant OrganizY;Ilog's Physical Address: 102 Nollh Churtal Street pplic nt Org.nization's ?ailing Address: Same Applicant Organization's Web Address: .hilisboroughartscounciLorg Executive Director: Neil Stutzer, Chair(We don't have an Executive Director) Telephone Number: 919 643-2500 y)1'11,11f (J,I, L Tax ID Nu' lbw:: ? ) F 1 1180? st List .11 FYI 71 i S 0 1 e JJj Fu °di 0 01r ei g Re est s F r f$11 Fir.,12, r.orns.) a th r 110 11 doe of Funs lid's r 1 so) Prj rrborp çp Oranqp. Total IlS C Ex. Youth Afterschool Program $10,000 $15,000 $5,000 $30,000 Afterschool Program Coordinator salary and materials for youth activities and projects Continue to partially support the salary of our sole $12,000 $12,000 part•time staff position (Program Director)who, in turn, provides logistical support for 200+volunteers. Our end goals are to(1) sustain current programs, (2) expand revenue generating art lessons and retail opportunities, and (3) use our 30th anniversary to rebrand HAG and build development efforts. tals 112,00P $12,001 y) 11 th. best If y y b lief .11 I to All d 0,1 in thl 11111111H tko is tr„. all 11 c drr It. To 100 0 0 e. 11„1 e?? y th- go 11 licant Si nt r IA Executive Director Date Yr./ 7 7LL21 oard Chirp rson Date AGE? CY111FORMATIOIII 1/24/2017 948:26 A? 1 ' DocuSign Envelope ID:C8F16CD1-FF19-486F-8DD6-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION d) IlliSCLOSURE OF PO 1 Ell "i 1 II1L 0 ,01NFLICTS SE 1, 1111. 111-S ,111 ISC wl USE Are a ly of the Board embers or e liployees of the agency hich will se crrying out this program or embers of their ediate families, or their business associates ES 12Q L a) Employees of or closely related to e ployees If the Tow of Carrboro, the To n of Chapel Hill, or Or-nge County? h) lei hers of or closely related to me lhers of the gover ing bodies of the Tow of C. rrboro, the Town of Chapel Hill, or Orange County? [I] X c) Current benefici-ries of the program for which funds re being requested? d) Paid providers f goods or services t the program or hiving other fins l cial interest in the program? If you have ens ere YES to any question, 101 s pr.vide f II exil ti hn 1,1 01110111-DISC1,111111 Provider agrees as part of consideration of the grant g of funds by funding agencies to the parties hereto for ter Iselves, their agents, officials, employe-s and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sex lel rientation, gen ler identity/expression, familial status or veter ins status with reference to any--ctivities carried out by the grantee, II lafter ho rern.te, The parties hereto further agree in II respects to •nforr to the provision and intent of Orange County Ci il Rights Ordinance, as a nded and the Orange County Anti-discrimination Policy. This provisio is enforced by ctio for specific performance, injunctive relief„ or other re ledy as by la provi led; this pro ision shall be binding on the lumtees, the success IS and assi,ins of the parties hereto with referenct to the above s bject wanner. T tos :t fir,11 kn e n• v Ji f II iT th s iT,ir ati n is tr dl c rre iL er tal tht th ist . c, Jip intl..] on i t of int IA'.1+st 1ses it 111111.c.ss,riiy 11-ile the II r 1,1r. 11 inliç le fir f ify ding, IlittieL istel2o. of nn.L_d 1011 clIlLtk. liCt 4 II ay result J the it.ro .1pLaraly Siint, Executive Director Date - /- Sign-.41 re: 1 1^1 oard Chairp0••.rs n Date AGE CY PI FOR AT1011 1/24/201'7 9:38:26 AM / DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 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 (Month/Year): February, 1987 (30 Years) b) Agency's Purpose/Mission (no more than a few sentences): The mission of the Hillsborough Arts Council is to "Enrich our community through the arts". We have been fulfilling our purpose of education, supporting local artists and providing significant cultural events in our schools, in the Hillsborough Arts Council Gallery and Gift Shop and in public venues. c) Types of Services the Agency Provides (bullet format): The mission of the Hillsborough Arts Council is to "Enrich our community through the arts". Services we fulfill are: o Education o Supporting local artists both as a resource and by mentoring. o Providing significant cultural events in our schools. o Provide local emerging artists a venue to sell their art in the Hillsborough Arts Council Gallery and Gift Shop and at events. o Provide art related events for all ages available to all communities. d) Agency's History with Providing These Services: For thirty years, the Hillsborough Arts Council (HAC) has created venues for"community" and "creativity" to joyfully connect. In doing so, we generate benefits that range from the personal pleasure in attending a concert or purchasing an artist's product to broader social and financial benefits for this area. We bring people together to enjoy parades, music, and poetry, with spillover interactions and coordination with downtown merchants. We intentionally capture and share our diverse history in community events. We provide venues for local artists to showcase and share their talents. The success of our growth has been to provide the art and cultural needs to the communities through interaction and listening to the people we serve. 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?) In this past year, as a direct result of creating the position of Program Coordinator, the HAC has seen strong and significant change. The following document we prepared shows that with your support, we have not only met but exceeded our goals. With such advances, we realized that our Program Coordinator also surpassed her goals and is now taken on the title of Program Director to more accurately reflect the extent of her responsibilities. The Impact of Funding the Program Coordinator HAC FY16-17 The following is a summary of the impact that Orange County funding has made and because of the funding, what the Hillsborough Arts Council was able to accomplish this past year. Without a doubt, one area of support - hiring a Program Coordinator- greatly enhanced our capacity to DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM :i o 8 00 i DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION provide so much quality programming in Hillsborough and the surrounding areas. In addition, with her focus on programming, our board was able to shift its focus to governance, development and strategic planning. This shift allowed us to immediately do several things. We had the time to apply for more grants, expand our newly formed sponsorship program, meet with others to collaborate and successfully expand our outreach within our community. Here are four brief highlights, followed by a more complete description of our progress over the last year, thanks to the focus of our Program Coordinator and enthusiasm of our volunteers: 1. The Gallery and Gift Shop increased sales by 35%. 2. We now have three programs (the Arts and Crafts Show, the River Park Concerts and the Parlor Concerts) that are self-sustaining. 3. Volunteering increased 200%, enabling 56 successful arts events. 4. We saved $1,800 by shifting responsibilities for website maintenance from a contractor to staff. The part-time Program Coordinator for the Hillsborough Arts Council is responsible for the coordination of our programming, volunteer recruitment, fundraising activities, and grant writing, as well as providing support to program chairs. Here are examples of how her focus generated benefits for the HAC: • Marketing and Public Relations—The Program Coordinator actively promoted existing Hillsborough Arts Council programs by creating content in the form of videos, photography and graphics. These forms of multimedia are used to promote events through the Hillsborough Arts Council website, a monthly e-newsletter, calendar management, press releases, social media, radio programs, signage, banners and print media. We are now able to eliminate the need to subcontract our newsletter and website services. • Fund Development—The Program Coordinator coordinated and expanded annual community and corporate fundraising efforts by keeping donors in touch with all the HAC programs by creating and sharing videos, photography and graphics. She also coordinates our traditional fundraising efforts, which include an annual donor letter, grant writing and charity events to meet the Council's fundraising goals. • Volunteer Recruitment and Placement—Volunteer involvement increased 200% this year due to her attention to their ongoing recruitment, placement and supervision and nurturance in support of our programs. For example, the Program Coordinator organized a loyal group of volunteers by holding an interest meeting, creating a simple on-line system of signing up for volunteer opportunities, and by sending a monthly volunteer e-newsletter. • Community Liaison—Our Program Coordinator developed and maintains positive relationships as the key liaison with local and county government and school officials, business leaders and civic groups, art patrons and current and potential funding organizations and agencies. Thanks to the attention and energy of our Program Coordinator, HAC has a new partnership with WHUP'S Lunch Crunch show host, Will Baker. She appears on a radio show monthly with key leaders to speak about the HAC's current activities. • Event Coordination—This part time position coordinated the hosting of 56 events of various kinds, providing opportunities for 380 artists to sell their products, helping 8000 people from all over the world visit our gallery and gift shop, and involving approximately 20,000 people. Events include Last Fridays and the Handmade Parade. • Program Specific Returns. o ArtCycle, the program that collects new and gently used art and music supplies and distributes them to Orange County Schools increased 1000% DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM :"° q 0 9 2 If 2 4 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION o Last Fridays had a season of wide reaching entertainment and new town participants. o Parlor Concerts, while maintaining 100% attendance, increased profits by 150%. o The Arts and Craft Show has been revived by the attention of three local artists who were willing to take on the responsibility of organizing it. This program is now self-funded. o The Gallery and Gift Shop increased sales by 35%, benefitting 51 local artists. With two summer interns under the Program Coordinator, the team met with similar businesses to determine the best physical layouts, marketing strategies, and point-of-sale systems. They interviewed and photographed our artists and their work to create web site presence for those who do not have one. o We expanded our Art in Education programing to include an afterschool program. Initiated by the Arts Council, partnering with the OC Family Alliance and OC Schools, is funded by a Mary Duke-Biddle Grant. The program is provided in two Title I schools in the fall and the spring and employs local artists as the instructors. The Goals for the Program Director HAC FY17-18 Priority 1: Sustain current programs • Keep up the success. The Program Director takes primary responsibility for coordinating the logistical, promotional, and volunteer support for our varied programming. Her attention to programmatic support frees the board to focus on its greater strategic focus on strengthening the impact of our local arts community. Priority 2: Expand revenue generating arts lessons and retail opportunities. • Increasing earned income is key to our goal of greater self-sustainability. We will look into the feasibility of offering art classes to the public and in the schools, including our growing group of home school families. Our intention is to meet with the schools to learn what the needs and resources are, then seek guidance with other arts organizations that have successfully instituted similar programming. We also want to hear directly from the students and propose creating a high school Student Advisory Committee to the Arts. Its role would be to provide input directly to the HAC board of directors, as well be a model of civic engagement. • Adding technology with point-of-sale hardware and software. This will enable our volunteers to use their time more efficiently and prepare the organization to expand into earned income programing. For example, this tracking system will enable new arts education programming through art classes taught by local artists. We continually work on enhancing our gallery sales system as well. Priority 3: Use the 30th anniversary to rebrand HAC and strengthen our development efforts • Rebranding to coincide with our 30th year anniversary this year will bring about a new awareness of the richness of art Hillsborough and the surrounding area has to offer its citizens and the tourists we host. Marketing through photos and videos will show how the HAC enables our community to work and play together. • Redesigning our historically modest development efforts will emphasize our invitation to this community to partner in generating the local creative spark we all enjoy. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM Page "'10 22 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION f) Schedule of Positions (For Entire Agency) • Full Time Equivalent(FTE) staff will be noted as 1.00; half time 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: 0 # of FTE - Paid Part-Time Positions: 1 # of Volunteers: 200 # of FTE -Volunteers: 3 (approximately 6,000 hours) g) Living Wage Does this agency pay permanent employees a minimum living waste? (Yes/No) Yes If yes, is this agency an Orange County Living Wage Certified Employer? No If no, please explain. —We did not know about this but will now become one. 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) Yes, The Town of Hillsborough 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 HAC support 7,500 12,000 Orange County HAC support 10,000 10,000 Town of Hillsborough Last Fridays 11,460 12,000 Hillsborough Tourism Board Last Fridays 1,500 1,500 OC Arts Commission Art Walk 1,300 1,300 Hillsborough Tourism Board Art Walk 1,500 1,500 OC Arts Commission Handmade Parade 4,850 0 (off Hillsborough Tourism Board year) Handmade Parade 1,500 0 (off OC Arts Commission year) Free Spirit Freedom 1,500 1,500 OC Arts Commission Art in Education 0 1500 OC Arts Commission *Add rows or attach additional page, if needed. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM ' ' , i . o II 2 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION ii. Submit your agency's budget. You may complete the provided template (separate xls file) or you may submit your own budget file (as long as it contains the same information, and in a similar format, as requested in the provided template). See Attachment. Agency Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o Program Generated Revenue o Local Government Grants • Carrboro Human Services • Carrboro Other • Chapel Hill Human Services • Chapel Hill Other(DO NOT include CDBG funding here) • Orange County Human Services • Orange County Other(DO NOT Include HOME funding here) o Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG/HOME/etc.) • Private Foundation Grants o Other Revenue • Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel & Training o Other Expenses iii. Does your agency budget show a Surplus or Deficit? Yes Is there a significant change? Yes/No Yes Please provide a brief explanation for Surplus or Deficit, and significant changes. FY 15-16 deficit covered by carry over of Stickwork funds. FY16-17 deficit covered by carry over of Mary Duke Biddle Afterschool grant. iv. What is your agency's fiscal year? July 1, 2016 through June 30, 2017 (Example: July 1, 2016 through June 30, 2017) DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:1.0 AM Page 1 2 ei If 2 0'1 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Overall HAC Support Program Primary Contact and Title: Neil Stutzer, Chair Telephone Number: 919 643-2500 E-Mail: nstutzer @hillsboroughartscouncil.org a) Indicate the type of Human Service Needs Priority, if program applicable: ❑ Priority Area #1: safety-net services for disadvantaged residents X Priority Area#2: education, mentorship, and afterschool programming for youth facing a variety of challenges 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) Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods/Residents Affordable Housing Affordable Healthcare Education X X X X Family Resources Jobs/Jobs Training X X X X Food Transportation Other: Please specify Afterschool activities, Mentoring, Art activities, Preschool activities. X X X X DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM Page '13 a0 24 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION 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 efforts. All our events are coordinated with external organizations and individuals. The following lists the primary collaborative efforts. • Burwell School: Last Fridays, shared events, co-marketing and fundraising • St. Matthews Episcopal Church: Shared events, co-marketing and fundraising • Orange County Public Library: Handmade Parade and Lantern Walk Workshops, shared events and co-marketing. • Orange County Historical Museum: Last Fridays, Free Spirit Freedom, ArtCycle donated materials for Fairview's Art in the Park, additional shared events and co-marketing • Orange County Community Players: Ad hoc committee to seek out a performance and classroom space in Hillsborough. • Orange County Schools: ➢ Student Art Show: shared events and co-marketing ➢ ARTCYCLE collection: material sharing and co-marketing for Orange County Schools ➢ Cultural Explosion, Orange County Schools: a school program in which HAC staffs a booth ➢ Year End Senior Art Show: a collaboration with the Library and Chamber of Commerce ➢ Youth Collaborative Weekend: artists and students working together ➢ After School Programming: Arts programming funded by a Mary Duke Biddle Grant, collaborating with Family Success Alliance ➢ Artists as Speakers: (informal but ongoing), exploring what it takes to be a working artist in the real world ➢ Student volunteering in the HAC to fulfill community involvement requirements. • Town of Hillsborough: Selection of the town Poet Laurate, event contract to produce and develop Last Fridays, co-marketing • Orange County Visitors Center: Arts & Craft Show, shared events and co-marketing • Alliance for Historical Hillsborough-The HAC is a partner in the Alliance. 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 the chosen County priority. The programming by the HAC expanded and become more efficient once we hired a part-time Program Coordinator in 2015. Her focus on the logistical support of our volunteers also freed up the HAC Board to focus on strategic planning that will ensure the long-term sustainability of our work. We ask that Orange County continue its support of that position because of the multiplier effect it generates. The organization has benefitted in terms of strengthened infrastructure, and the community has benefitted through enhanced and expanded arts programming. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM o : q g II 2 el DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION While our programming will continue to build incrementally in 2017-18, we plan on one significant new effort. We will use our 30th anniversary in 2017 to strengthen our branding as a collaborative community arts coalition, as well as our development efforts. We continue to upgrade our technology and systems so as to institutionalize and improve our operations, primarily for the end goal of strengthening how we market local arts through the HAC gallery. We support local artists by working directly with them. We continue our efforts to develop fee-for-service programs, designed to enhance arts education in our public schools, charter schools, and in the home schooling community. While currently limited by not having studio space, we hope to eventually harness the expertise and contagious enthusiasm of local artists and the public to offer lessons to the general community. e) Describe the local need or problem to be addressed in relation to the Orange County BOCC Goals and Priorities. Reference local data to support the need for this program. The Hillsborough Arts Council primarily aligns with the BOCC's interests in (1) promoting the well- being of all county residents by creating art events for people of all ages and incomes to join and enjoy and (2) supporting the economic self-sufficiency of Orange County artists by providing venues to promote and support their work. In addition, the HAC supports tourism by hosting compelling community events, augments the limited arts programming of our school system, and creates platforms for recognizing the history and contributions of minority populations within our community. HAC events brought about 19,000 of us together last year and expanded our sense of belonging in this community. Of these participants, about 30% were tourists. A strong arts community adds to the quality of life, which, in turn, is a key consideration for business and industry in finding new locations where they can attract a talented workforce. The local arts community helps distinguish Orange County from other parts of the state and adds to its attractiveness for business investment. Several years ago, a national survey called Arts & Economic Prosperity IV, reported that "nonprofit arts and culture organizations in Orange County, NC, spent a total of$85.4 million during fiscal year 2010. This spending....and an additional $21.5 million in event-related spending by their audiences — supports 3,352 full-time equivalent jobs and generates $8 million in local and state government revenue."1[1] We have been working closely with the local Arts Commission to designate Orange County as an arts destination. 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 HAC primarily serves residents of central and northern Orange County through its programming. Our outreach is expanding primarily through the schools, by contacting all students and their families. g) Describe the credentials of the program manager and other key staff. The HAC has one part-time Program Director, Kristen Prelipp, who employs impressive organizational skills while expanding her knowledge of nonprofit management. She is an accomplished professional photographer and understands the challenges faced by independent artists. Our volunteers bring skills as artists and teachers, in addition to a wide range of professional expertise: merchandising, accounting, advertising, strategic planning, grant-writing, business operations, etc. The HAC taps the broad talent available in Orange County and focuses it on hosting opportunities for joyful human interaction and growth through the arts. 1[1] http://www.americansforthearts.org/by-program/reports-and-data/research-studies-publications/arts-economic- prosperity-iv/local-regional-findings DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM Page 1 5 If 22 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION h) Describe the specific period over which the activities will be carried out and include an implementation timeline. The work supported by this grant enables year-round programming, all of which promotes tourism and benefits Hillsborough's economic and cultural climate a. HAC Gallery and Gift Shop operates year-round. b. Last Fridays happen spring — fall, bringing both locals and visitors to downtown Hillsborough to enjoy the arts, and share information through community booths. c. Last Friday Art Walk, January through November, provides a walking tour of our diverse arts and crafts and encourages sales. d. The Handmade Puppet Parade, happening every even year in October, and the Solstice e. Lantern Walk, happening in December, bring people together in creative workshops and joyful, peaceful participation. f. Parlor Concerts, is within the months of January through March, are hosted in the intimate settings of historic homes of Hillsborough. g. Hillsborough Downtown Arts and Crafts Show in April promotes the work of local artists. h. Arts Alive happens year-round as local talent is available and brings local authors, photographers, and musicians together with citizens to experience their combined talents in ways beyond the usual "readings" format. i. Free Spirit Freedom a year-round program celebrates the diversity of Orange County's historic past and future through photography and narrative, providing opportunities to learn about the contributions of African Americans to our community. j. ArtCycle is a year-round program most active when school is in session, encourages citizens to contribute new and used supplies to students in school art classes. k. New Afterschool Art Program is starting with two weeks in the fall and two in the spring, brings our diverse student populations together, working on projects to be presented in Hillsborough. Each of these programs is chaired and implemented by volunteers. Their success and enthusiasm are enabled by our Program Director. i) Why is funding this program a good investment for the community? How does this program add value to the community (250 words or less). The Hillsborough Arts Council builds human connection by providing lively ongoing programs, services, and events. We bring people together to enjoy local creative resources, to encourage the artful expression of individuals of all ages, to provide a market for local artists, and to encourage local economic vitality through tourism. Activities range from one-on-one coaching in creative projects, to intimate parlor concerts, to Last Friday community events, to parades watched by thousands of people. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Without support from Orange County, our work will slow down, and we might miss time-limited opportunities to build on our 30th anniversary, as well as the exciting momentum we enjoyed in 2016. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM Page I b o 0 f 2 0'I DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION At this critical stage of our evolution toward sustained professionalism, our board would have to divert their attention away from strategic development back to programmatic support. k) Include any other pertinent information We have worked toward laying the seeds to grow our sustainability. By improving recognition of the Hillsborough Arts Council as a community resource and energizer, we have greatly increased participation from the community. This public effort has been apparent by achieving self-sustainability in three programs, Parlor Concerts, River Park Concert and the Arts and Craft Show. In addition, though not yet self-sustaining, the Gallery& Gift Shop sales shows a 35% increase as well as our Art in Education Programs in Orange County Schools with a 1000% increase in one sub-program. With continued support, we will continue financial growth in this area while exploring areas to creating an earned funding stream. 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. Because most of our events are in an open forum, we are unable to give accurate head counts. Our crowd estimation method only permits percentage estimates. Our events enjoy repeat customers, and thousands of people enjoy the parades. It is not possible to generate a de-duplicated count of those who enjoy the community events or make purchases from the gallery. We are working towards more accurate tracking of the one-on-one services we provide. Program Target Population Demographics Actual Estimated Projected 2015-16 2016-17 2017-18 Gender Male 9000 9500 10,500 Female 9000 9500 10,500 Total 18000 19000 21,000 Ethnicity African-American 10% 20% 25% 0 American Indian or Alaska Native 1% 1% 1% Asian 2% 2% 2% Caucasian 85% 73% 7 Native Hawaiian or other Pacific Islander Other: Mixed Ethnicity 2% 2% 4% Total 100% 100% 100% 15% Of the above, how many Hispanic/Latino 5% 8% Of the above, how many non-Hispanic/Latino 95% 92% 85% Total 100% 100% 100% Age 0-5 years 10% 12% 10% 6-18 years 15% 13% 15% 19-50 years 50% 50% 60% DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM Page g e o 1 2 'i DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION 51+ years 25% 30% 15% Total 100% 100% 100% Geographic Location— Alamance County Chatham County Durham County Wake County Orange County Breakdown Chapel Hill Public Housing Town of Chapel Hill (Non-Public Housing) Town of Carrboro Town of Hillsborough 18,000 19,000 21,000 City of Mebane (Orange County) Orange County (Outside Municipalities) Total 0 0 0 Program stats and demographics It is our observation that many people who attend our events arrange their travel plans to come to our events, as well as make spontaneous visits to the Gallery while stopped off the interstate for a break. • Gallery and Gift Shop-We enjoyed 8,461 customers this past year, an increase of 22%. 40% of them were tourists, coming from: ➢ North Carolina-60 cities and towns represented from mountains to the coast o Hillsborough, Chapel Hill, Carrboro, Cedar Grove, Efland , Hurdle Mills, Rougemont, Apex, Asheboro, Banner Elk, Burlington, Cary, Charlotte, Concord, Creedmoor, Duck, Dunn, Durham, Elon, Fayetteville, Fuquay-Varina, Gastonia, Goldsboro, Graham, Greensboro, Greenville, Haw River, Hendersonville, Hickory, High Point, Holly Springs, Jamestown, Kannapolis, Kernersville, Lillington, Lumberton, Mebane, Mooresville, Mount Airy, Oxford, Pinehurst, Pittsboro, Raleigh, Reidsville, Roxboro, Sanford, Wake Forest, Wendell, Wilmington, Winston-Salem, Yanceyville, Zebulon, Eden, Caldwell, Whitsett, Youngsville, Warrenton, Saxapahaw, Washington, Tryon. ➢ 40 states + DC (no visitors recorded in survey from Alaska, Arkansas, Idaho, Kansas, Montana, Nebraska, North Dakota, Oklahoma, Oregon, Vermont) ➢ 7 foreign countries + 1 U.S. Territory: Canada, Mexico, England, Ireland, Germany, Australia, Sweden, Puerto Rico DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM Page 18 If 22 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION This chart reflects visitors each of the months, January thru November. 1600 1400 12100 1000 800 60C iisatcar s0""201.6a 400 �u 200 �.... 0 1 2 3 4 5 6 7 8 9 1.0 11 • Parlor Concerts—40-50 people per event; usually 4 events per year. People come from the surrounding areas, often bringing visiting guests from outside the area and other states. • Arts & Crafts juried art show- Approximately 1500 people for this April event come from surrounding counties and other states. • Last Fridays- between 1,000 and 2,000 people per event, April through September; 15% are tourists coming from surrounding counties and other states. • Winter Solstice Lantern Walk- 2,000 people from surrounding counties • Art Walk-300/night for extended season (February, March, October, and November); 600/night for regular season (April - September), with people from surrounding counties. • Handmade Parade-2,000 to 3,000 thousand people from surrounding counties and other states. • Free Spirit Freedom- 100 per event (once or twice a year). Expect events in Jan and Feb 2018. Ongoing displays draws people from surrounding counties and other states. • Handmade Parade- 600 participants, 3,500 audience on the 3rd Sunday of October, on even years. 50% are tourists from around the country. • Art in Education- School year programs are underway and vary by schools. All 7,484 students have access to some kind of interaction with the HAC. 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 document the projected information. Every program is required to have AT LEAST 1 Program Activity, which should be SMART (Specific, Measurable, Achievable, Relevant, and Time- bound. Click on SMART Goals to learn more. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM P u c 9 e' If 2 ''1 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION • 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 measurable achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of 105 meals per day.) Work Statement Chart for Pro,ram: Hillsborough Art Council 1. Program Activity Name Priority 1 Program Goal Sustain current programming. Performance Measures Number of events and attendees Previous Year Program Results 55 events, 12,000-14,000 Current Year Estimated Results 56 events, 18,000 participants Next Year Projected Results 56 events, 21,00 participants 2. Program Activity Name Priority 2 Program Goal Expand revenue generating arts lessons and retail opportunities Performance Measures Conduct research and collaborative efforts to enhance the likely success of arts lessons, in schools and to the public. Conduct research on and implement best practices for supporting retail opportunities, in the gallery, through special events, or through strategies yet to be defined, such as on-line marketing Previous Year Program Results Arts lessons: -0- Retail: $28,761 Gross Gallery&Gift Shop Sales. Current Year Estimated Results Arts lessons: -0- Retail: $30,900 Gross Gallery and Gift Shop Sales Next Year Projected Results Arts lessons: $1,000, if we have staff/volunteer support Retail: $35,000 Gross Gallery&Gift Shop Sales 3. Program Activity Name Priority 3 Program Goal Use the 30th Anniversary to rebrand HAC and strengthen our development efforts Performance Measures Presentation and marketing about the new brand and celebration of HAC's successes-to-date, increased revenue from development efforts, increased involvement from more and new community supporters. Previous Year Program Results Fundraising Revenue: (Contributions) $27,778 Current Year Estimated Results Revenue: (Contributions) $35,580 Next Year Projected Results Revenue: (Contributions) $51,000 4. Program Activity Name Program Goal Performance Measures Previous Year Program Results Current Year Estimated Results Next Year Projected Results DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM u 0 04 2 0 o II 2 4 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION n) Program Budget 1. Submit your program budget. You may complete the provided template (separate xls file) or you may submit your own budget file (as long as it contains the same information, in the same format, as requested in the provided template). See Attachment Program Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues O Private Donations O Program Generated Revenue O Local Government Grants • Carrboro Human Services • Carrboro Other • Chapel Hill Human Services • Chapel Hill Other (DO NOT include CDBG funding here) • Orange County Human Services • Orange County Other (DO NOT Include HOME funding here) O Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG/HOME/etc.) • Private Foundation Grants O Other Revenue • Expenditures O Compensation O Rent & Utilities O Supplies & Equipment O Travel & Training O Other Expenses 2. Program Budget Detail — Provide description of "other" budget items, not defined. Please see attached budget. 3. This program budget represents what percent of the agency budget? 100% 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 $104,903 $99,453 $106,500 Total # of Individuals 18,000 19,000 21,000 Cost Per Individual $5.82 $5.23 $5.08 DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM rug ,, 2 1 i If 2 'l DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION . ATTACHMENTS Description of Required Attachments a) Financial Audit A recent financial audit that should cover CY 2015, for calendar year agencies, and FY 2015-16, for fiscal year agencies. For agencies with prior year revenues totaling $500,000 or more a financial audit, prepared by a certified public accountant is required. Agencies with prior year revenues of less than $500,000 may submit a completed Schedule of Receipts and Expenditures form (see application materials), in lieu of an audit/report. Agencies with a certified audit/report should not complete the form. b) IRS Federal Form 990 A copy of the agency's 2014 Form 990 is required. The specific form depends upon the agency's financial activity. Review the IRS' table guide, for more details. For Form 990-N (e- postcard) filers, include a copy of the postcard, with the agency's application materials. c) NC Solicitation License A copy of the agency's current solicitation license is required. Organizations that solicit contributions in North Carolina, directly or through a third party, must renew their licenses annually. For more details, refer to the NC Secretary of State's licensing website and its Frequently Asked Questions Guide (PDF), about exemptions. If exempt per N.C.G.S. § 131 F-3, include a copy of the exemption letter with the agency's application materials. d) IRS Federal Tax-Exemption Letter A copy of the agency's IRS tax-exempt letter that confirms its nonprofit status is required. An agency can request a copy of its letter from the IRS' Customer Account Services. e) Certificate of Liability Insurance A copy of the agency's current certificate, from the agency's insurance carrier. Table 1 below outlines insurance types and minimums required, for each jurisdiction. If exempt from Worker's Compensation compliance, include a statement explaining why, with the agency's application materials. *Note: If Approved for Funding: Approved agencies must provide an updated insurance certificate. The update should reflect the funding jurisdiction as an additional insured party and certificate holder and provide coverage for the duration of the funding period (July 1 — June 30). Renewal certificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM u 2 e If 2 2 DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 EXHIBIT A - PROVIDERS OUTSIDE AGENCY APPLICATION Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required INSURANCE TOWN OF CARRBORO TOWN OF CHAPEL HILL ORANGE COUNTY3 Worker's Limits for Coverage Compensation A - Statutory State Limits for Coverage A - Limits for Coverage A - NC, for each Statutory State NC, for Statutory State NC, for employee each employee each employee Limits for Coverage Limits for Coverage B - Limits for Coverage B - B - Employers Employers Liability of: Employers Liability of: Liability of: $100,000 Each Occurrence $500,000 each $1 million Each $100,000 BID for each accident, $500,000 Occurrence employee BID for each employee $1,000,000 BID2 $500,000 BID limit $500,000 for BID limit limit Commercial $100,000 Property General Damage Liability $1 million Each Liability $1,000,000 Bodily $1 million Each Occurrence Occurrence Injury Property $2 million Aggregate y and Pro p y $2 million Aggregate Damage Limit Automobile Not Applicable $1 million Each Occurrence $500,000 Each Liability Occurrence Professional $1 million Each Liability Not Applicable Not Applicable Occurrence $2 million Aggregate 1. Visit the NC Industrial Commission's website for more information regarding Coverage A. Also, note that if an agency uses subcontractors, it must require subcontractors to have workmen's compensation insurance. 2. Bodily Injury by Disease (BID) 3. Please visit Orange County's contracts webpage for more information about the County's risk assessment procedures. f) List of Board of Directors Provide the following information about each board of director's member: name, telephone number, address, occupation or affiliation of each member and the list must identify the principal officers of the governing body, and length of term. g) Solid Waste Program Fee (SWPF) Verification This fee finances Orange County's recycling and waste reduction program. Submit either a.) proof of payment of the agency's FY 2016-17 Solid Waste Program Fee, OR b.) a statement on agency letter head indicating exemption and specify the person(s), business, etc. that is responsible for paying this fee. DO NOT SUBMIT THIS PAGE 2/8/2017 9:36:40 AM u g o If 2 01 DocuSign Envelope ID:C8F16CD1-FF19-486F-8DD6-57316D1FCD54 EXHIBIT"B" Scope of Services—FY 2017-18 Outside Agency Performance Agreement Agency Name: Hillsborough Arts Council Program Name: Overall HAC Support Funding Award: $9750 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel-Salaries and FICA Program Support-Professionalize Administration and Develop Financial and Service Partnerships $9750 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2018. • Sustain current programming. + Expand revenue generating arts lessons and retail opportunities. + Use the 30th Anniversary to rebrand HAG and strengthen our development efforts. 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 Increase the number of events to include fundraising and outreach while 3 new events and 4,000 additional increasing participation participants for a total of 21,000 Add to our Arts in Education(AIE)program to include art lessons. Create an income of$1000 for To increase productivity of our retail space ME. Increase retail revenue by$5000 To rebrand and remarket to increase revenue and community support. Increase revenue(contributions) by$15,000 DocuSigned by: M lL Sfu475tX Chair 9/21/2017 Certified by: 76,776FR9FAR41F Title: Chair Date: 8.30.17 (Provider's Signature) DocuSign Envelope ID:C8F16CD1-FF19-486F-8006-57316D1FCD54 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: rttiL SfutV Chair 9/21/2017 Certified by: rrA2 ar_, Title: Date: (Provider's Signature) (Hillsborough Arts Council) Orange County Outside Agency Performance Agreement Page 10 of 10 Rev. 7/17 DocuSign Envelope ID:C8F16CD1-FF19-486F-8DD6-57316D1FCD54 BALLARD AGENCY INC PO Box 1559 INVOICE Hillsborough, NC 27278 Phone:(919)732-2158 Date: 1/17/2017 Fax:(919)732-9636 Producer: Entered by: HILLSBOROUGH ARTS COUNCIL Customer Due Date Invoice.# PO BOX 625 HILLSBOROUGH, NC 27278 Policy Number Policy Effective Policy Expiration EPP4917790 1/16/2017 1/16/2018 -Please detach and return with remittance- Amount Remitted $ Policy:EPP4917790 Effective: 1/16/2017 to 1/16/2018 Company . tine of Business Transaction Description Premium GREAT D&O LIABILITY RENEWAL S713.00 AMERICAN INSURANCE CO. Please Pay This Amount S713.00 NOTES THANK YOU FOR YOUR BUSINESS! Do'S =else ID:C8F16CD1-FF19-486F-8DD6-57316D1FCD54 DATE %ACIR 1 IrI mom 1 L 'jr LIABILITY INSURANCE 1/17(/2017 Y) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ` i 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(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ■ NMEAI I J. David Ballard BALLARD AGENCY INC PHONE 919) 7 32-215 8 FAX PO Box 1559 (A/MANo,Exo (A/C,No):(91 9)732-9636 AADDRESS:ballard @ballardagencyinc.com Hillsborough, NC 27278 INSURER(S) AFFORDING COVERAGE NAlca INSURER A:GREAT AMERICAN INSURANCE CO.A INSURED HILLSBOROUGH ARTS COUNCIL INSURER B' PO BOX 625 INSURER C • HILLSBOROUGH, NC 27278 INSURER 0 . 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 ADM SUER ' POLICY EFF I POLICY EXP I LTR I TYPE OF INSURANCE INSG IWVD I POLICY NUMBER I(MM/DD/YYYY) �(MM/DD/YYYY)I LIMITS I COMMERCIAL GENERAL LIABILITY I I EACH OCCURRENCE i S I---- UAMAGE TO REN I ED I I CLAIMS-MADE I I OCCUR I . I , PREMISES(Ea occurrence) I$ HI MED EXP(Any one person) I S I I PERSONAL&ADV INJURY I$ I GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 1$ I I POLICY 71 78: I LOC PRODUCTS-COMP/OP AGG t 5 1I OTHER: I I I IS COMBINED SINGLE LIMIT i S I AUTOMOBILE LIABILITY I I I I (Ea accident) �I ANYAUTO I ( I I I I BODILY INJURY(Per person) : $ I ALL OWNED `-----I SCHEDULED I ; I BODILY INJURY(Per accident); S —'AUTOS AUTOS NON-OWNED I PROPERTY DAMAGE I$ HIRED AUTOS AUTOS I I (Per accident) I C IS I I I i I 1 I UMBRELLA LIAR I I OCCUR I EACH OCCURRENCE IS I I EXCESS LIAB I CLAIMS-MADE AGGREGATE ;$ 1 I DED I I RETENTIONS I I I$ I I WORKERS COMPENSATION ( J I PER STATUTE I UM- ! l ER AND EMPLOYERS'LIABILITY I YIN ANY OFFICER/MEMBER I NIA ( I I E.L EACH ACCIDENT I$ OFFICER/MEMEER EXCLUDED I E.L DISEASE-EA EMPLOYE S (Mandatory in NH) I .__ .. I II yes,describe under I I j E.L.DISEASE-POLICY LIMIT S I DESCRIPTION OF OPERATIONS below 1$1,000,000 OCC WRONGFULL A DIRECTOR & OFFICERS EPP4917790 1/18/171/18/18ACTS $1,000,000 OCC LIABILITY EMPLOYMENT PRACTICES DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE I 4/ n I ArCov�" / � 61, ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:C8F16CD1-FF19-486F-8DD6-57316D1FCD54 nii Erie CERTIFICATE OF INSURANCE DATE ISSUED(MOONY) insurance° 1/18117 -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY--- Home Office • 100 Erie Insurance Place • Erie,Pennsylvania 16530 • 814.870.2000 Toll free 1.800.458.0811 • Fax 814.870.3126 • www.erieinsurance.com . NAME AND ADDRESS OF AGENCY GENT'S NO. II i'' p i• G COVERAGE THE BALLARD AGENCY INC iNC �, ERIE 'TEA_ �1� 105 W KING ST JJ 1 010 Co LL;111I►a 1 ['1ri:'• .iVICIV T.to'�CCO Agri HILLSBOROUGH,NC 27278-2543 Co.:E VIE INSU•'1 5'C A Not App cal e r e Indemnl �y o. 'ttorn; -In-Fact 11t y �ptad:111 . 104∎Iykilrh,:Zh1 a IZI�rIr,tiAI:T (919)732-2158 r ei��'T �.i7i1 1 .�111:Tc1∎[141191 1711 This certificate is issued for information purposes only and confers NAME AND ADDRESS OF NAMED INSURED no rights on the certificate holder.It does not affirmatively or negatively amend,extend,or otherwise alter the terms,exclusions HILLSBOROUGH ARTS COUNCIL and conditions of insurance coverage contained in the policy(ies) 102 N.CHURTON ST. Indicated below.The terms and conditions of the policy(ies)govern the insurance coverage as applied to any given situation.Limits HILLSBOROUGH,NC 27278 shown may have been reduced by claims paid.This certificate of insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer and the certificate holder. This Is to certify that policies,as indicated by the Policy Number below,are In force for the Named Insured at the time that the Certificate is being issued. !! 'qppy 1}ry r)s{ Mile' LIMITS _ LTR Ins d TYPE OF INSURANCE POLICY NUMBER MI A,Idl`111r ur 1 U:li , ,I)r 11,17 —._ E ®GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 Q32 1000580 8/10/16 8/10/17 ®COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any One Fire)$ 1,000,000 ❑CLAIMS MADE ®OCCUR MED EXP(My One Person) I S 5,000 0 I PERSONAL&ADV.INJURY I S 1,000,000 ❑ GENERAL AGGREGATE Is 2,000,000 GEN'L AGGREGATE UMIT APPLIES PER,' PRODUCTS-COMP/OPAGG,S 2,000,000 ❑POLICY ❑PROJECT ❑LOCI I 0 AUTOMOBILE LIABILITY ' ! BODILY INJURY ❑"ANY AUTO"'NON OWNIED)' BODILY INJURY I S ❑OWNED (EACH ACCIDENT) I S ❑HIRED i PROPERTY DAMAGE I.S ❑NON-OWNED BODILY INJURY AND PROPERTY DAMAGE S ❑GARAGE I I COMBINED ii Q EXCESS UABIUTY I EACH OCCURRENCE IS ❑OCCURRENCE AGGREGATE IS S ❑RETENTION s IS i I I E WORKERS COMPENSATION& I 1/18/17 , 1/18/18 STATUTORY EMPLOYERS LIABILITY I Q58 1800607 BODILY' ACCIDENT S 500,000 EACH ACCIDENT INJURY' DISEASE S 500,000 POLICY LIMIT BY I DISEASE S 500,000 EACH EMPLOYEE OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIV- ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). NAME AND ADDRESS OF CERTIFICATE HOLDER ORANGE COUNTY AUTHORIZED REPRESENTATIVE PO BOX 8181 HILLSBOROUGH,NC 27278 . --A.)/2...i77---;1-:,4" ,"" EIG6230 8/11 Page I of 1