HomeMy WebLinkAbout2017-524-E Finance - Orange County Rural Alliance - Outside Agency Performance Agreement DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
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 Orange County Rural Alliance, a not-for-profit
corporation, located at 4901 Schley Road, 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 Orange County Rural Alliance agree as follows:
1. Term of the Agreement. The term 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 12500
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 3125. 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.
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement
Revised 7/2017 Page 1 of 7
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
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.
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement Page 2 of 10
Rev. 7/17
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
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.
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement Page 3 of 10
Rev. 7/17
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
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 Orange County Rural Alliance
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:
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement Page 4 of 10
Rev. 7/17
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
County: Finance &Administrative Services Provider: Orange County Rural Alliance
Orange County 4901 Schley Road
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.
For a �� rx�f the Provider
Noma Mat, 9/21/2017
64852B90181C459...
Date
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement Page 5 of 10
Rev. 7/17
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
r j
For rapnitokiAff of Orange County Government
otAAt,tt, hotwkt.V'S 9/22/2017
nAl7AQ4a15sa4.71
Bonnie Hammersley, County Manager Date
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement Page 6 of 10
Rev. 7/17
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A
PROVIDER"S 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--'1\-0210, 111111$1,II 11 , " IIA 11111
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DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A
PROVIDER"S OUTSIDE AGENCY APPLICATION
FOR OFFICE USE ONLY
Agency Orange County Rural Alliance (OCRA) Received By
Program(s) Meal delivery program for rural senior Date/Time /
77777777777777777777777777777777777777777777777777777
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. x1=1 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
m. x❑ Work Statement
n. x❑ 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. x❑ IRS Federal Form 990 (notation provided)
c. x❑ NC Solicitation License (application provided)
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 4:36:09 PM Page 2 r "' '
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A
PROVIDER"S OUTSIDE AGENCY APPLICATION
1, COVER PAGE
a) Applicant Contact Information
Applicant Organization's Legal Name: OCRA (Orange County Rural Alliance)
Applicant Organization's Physical Address: 490t Schley Rd, Hillsborough, NC 27278
Applicant Organization's Mailing Address: PO Box 642, Hillsborough, NC 27278
Applicant Organization's Web Address: none
Executive Director: Norma B. "White
Telephone Number: 919732-8527 E-Mail: newhite@embaromalLoorn
Tax ID Number:
b) Funding Request
List all FYI 7i8 Human Services (HS) Funding Being Requested—
For All Programs) and the Proposed Use of Funds (2-3 lines or less)
Program Carftgoro Chattel Orange Total
-HS Hill - HS County:HS
Ex, Youth Afterschool Program $10,0$• $15,000 $5,000 $30 000
Afterschool Program Coordinator salary and materials
for youth aonvities andiardiects
Deliver meals for 50 rural homebound seniors three
times per week for 50 weeks $25,000
Totals $26,000
e) 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 boar' of the
applicant
1,74,1„.4, 7,1310 17,1(47
Signature: Norma B. White January,26, 2017
President Date
Signature Alex Castrelorr January 20, 2017
Board Chairperson Date:
AGENCY INFORMATION 1/26/2017 3A2.32 PM e 3 ri
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A
PROVIDER"S OUTSIDE AGENCY APPLICATION
d) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION
cLo4usE
Are any of the Board Members or employ,-s of the agency which will be carrying out this program
or members of their immediate fairrillies, or their business associates„
YES NO
X0 l: a) Employees of or closely related to employees of the Town of Carrboro, the Town of
Chapel Hill, or Orange County?
El 0 b) Members of or closely relat;,ii to members of the governing bodies of the Town of
Carrboro the Town of Chapel Hill, or Orange County?
, ,
[:::1 Li c) Current beneficiaries of the program for which funds are being requested?
r: [J d) Paid providers of goods or services to the program or having other financial interest in
the program?
If you have answered YES to any question, please provide a full explanation below,
Archie Daniel is a i part-time employee of the Sheriffs Office, responsible for leading the SALT
program, He s a volunteer with OCRA,and receives no compensation.
NON-DiscRirteNATION
Provider agrees as part of consideration of the granting of funds by funding agencies to 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, gender identity/expression, 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
intent .
respects to conform to the provision and ntent of Orange County Civil Rights Ordinance, as
amended and the Orange County Anti-discrimination Policy, This provision is enforcz,* 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.
To the best of my knowledge and belief all of the above information is true and
current I acknowledge and understand that the :,xisterice of a potential conflict of Interest
does not necessarily make the program ineligible for funding, but the existence of an
..
undisclosed conflict may r :lult in the termination of any grant awarded.
Signature: _
Norma B.White Jan. 26 2017
„ ...... _ . , ... ,
Executi Director Date
Alex
Signature: Alex Cat5tro JR Jan. 26 2017
,
Board Chairperson Date
AGENCY INFORMATION 1/26,2017 342:32 PM ill a g e 4 () I 1 7
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A
PROVIDER"S 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): 11/02/16
b) Agency's Purpose/Mission (no more than a few sentences):
OCRA is part of a community-based alliance that is building awareness of the needs of rural
seniors and supports them with what they need to age in place with independence and
dignity. OCR helps with access to county services, safe homes, nutritious food and friendly
human contact. OCRA delivers hot meals to rural seniors in underserved areas.
c) Types of Services the Agency Provides (bullet format)
• Nutritious meals
• Social contact
• Liaison with county services
d) Agency's History with Providing These Services:
OCRA evolved out of the SALT/Project Engage initiative where 20 volunteers now visit over
200 vulnerable rural seniors. Through regular visits over the last 18 months, volunteers
created personal relationships and trust with their "clients". Through that relationship, it was
clear that - some clients would benefit from nutritious, hot meals on a regular basis.
OCRA started a formal meal delivery program in Nov, 2016 with volunteers/caterers
donating meals for 40 rural seniors one time per week. In 2 1/2 months we have delivered
over 360 meals. In many cases, SALT/PE volunteers are delivering the meals during their
regular visits.
We are in the process of scaling up and expect to be delivering meals three times a week to
50 clients by mid-year.
Social visitation is on-going, coordinating OCRA volunteers with volunteers from the SALT
program and Project Engage program.
OCRA informs the seniors of events, services, and information that the County has to offer.
e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes
n the past year? Is there a new Executive Director?Are there new initiatives?)
OCRA is a new initiative evolved out of an 18-month effort of SALT/PE volunteers visiting
seniors.
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: 0
# of Volunteers:25 # of FTE -Volunteers: 3.5
Agency Information 2/8/2017 4:36:09 PM Page 5 • .f I "' '
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PROVIDER"S OUTSIDE AGENCY APPLICATION
g) Living Wage
Does this agency pay permanent employees a minimum living wage? (Yes/No) n/a
If yes, is this agency an Orange County Living Wage Certified Employer?
If no, please explain.
There are no employees. This is an all- volunteer organization.
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
*Add rows or attach additional page, if needed.
ii. Submit your agency's budget. You may complete the provided template (separate
xls file) or you may submit your own budget file
Budget included in attachments
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iii. Does your agency budget show a Surplus or Deficit? OCRA's operations are
designed to scale up as grants are received. Agency is designed to operate without a
deficit.
Is there a significant change? Yes/No No, this is a new initiative.
Please provide a brief explanation for Surplus or Deficit, and significant changes.
iv. What is your agency's fiscal year? Jan 1,2017 through Dec 31, 2017
(Example: July 1, 2016 through June 30, 2017)
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PROVIDER"S OUTSIDE AGENCY APPLICATION
3. PROGRAM INFORMATION (Submit a separate Section 3 for each program)
Program Name: OCRA (Orange County Rural Alliance)
Program Primary Contact and Title: Norma B. White, President
Telephone Number: 919-732-8527 E-Mail: n.b.white @embargmail.com
a) Indicate the type of Human Service Needs Priority, if program applicable:
x❑Priority Area #1: safety-net services for disadvantaged residents
❑ Priority Area #2: education, mentorship, and afterschool programming for
youth facing a variety of challenges
X❑ 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
Program Category Youth Adult Elderly Disabled Public Housing
Neighborhoods/Residents
Affordable Housing
Affordable Healthcare
Education
Family Resources
Jobs/Jobs Training
Food X X
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 efforts.
• SALT (a program of the Orange County Sheriff's office) volunteers coordinate and
collaborate with OCRA to identify rural seniors in need and assist with meal delivery
• Project Engage (PE)(a program of Orange County Dept of Aging) volunteers coordinate
and collaborate with OCRA to visit seniors and to help deliver hot meals.
• Emergency Medical Services and Fire Departments collaborate to identify
vulnerable seniors in the community
• Orange County Department of Aging provides resources and materials about community
and county services, and programs that are pertinent to seniors
• Department of Social Services, identifies rural seniors needing assistance
• Local churches and Civic Groups (such as St Matthews, Little River Presbyterian, the
Efland Faith Collaborative and Schley Grange) help identify and serve rural seniors and to
provide volunteers. They have also provided in-kind donations of meals.
• OCIM Food Pantry provides emergency food to vulnerable homebound seniors
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PROVIDER"S OUTSIDE AGENCY APPLICATION
Program Description (3 pages OR LESS)
Rural Orange County has a growing senior population with many individuals over 65 They face
unique issues that are characteristic of rural life: relative isolation and limited community
infrastructure: limited availability of healthcare and social services, remote from shopping and food,
no public transportation.
In 2015, volunteers from the Orange County's senior leadership program (Project EngAge (PE)
partnered with the Sheriff's visitation program (SALT), and began visiting seniors in rural Orange
County. Today there are over 210 seniors that are visited or contacted weekly. The partnership with
SALT and PE provided the inspiration for OCRA.
During visits volunteers noticed unmet needs such as empty food pantries, the need for minor home
repairs (accessibility problems and the need for ramps, grab bars, etc.) SALT/PE began to
occasionally provide food, build access ramps, and handle minor repairs for their senior clients. We
realized that more was needed, and OCRA was formed to provide a reliable source of food for
selected seniors. This was of particular importance because neither Chapel Hill-Carrboro or OCIM
Meals on Wheels have resources to provide routes in our remote rural areas, and many of our
clients are not eligible for services via OCIM's policies.
OCRA now delivers meals once a week to about 40 seniors, and is securing funds and resources to
provide meals three times a week to 50 seniors.
Today, OCRA provides meals that are donated or purchased by local businesses, churches and
individuals. Meal distribution is planned one week in advance. Meals are picked up by volunteers
at designated locations (churches or restaurants). Volunteers deliver food to clients. Volunteers are
matched with clients via SALT. OCRA clients are located throughout rural Orange County— in every
unincorporated township. OCRA volunteers are individually insured for liability and supplemental
auto when they are distributing meals.
OCRA has a total of 25 part-time volunteers who work together to organize the work, and to prepare
and deliver meals every week. With more funding we are prepared to scale up the number of meals
and clients served on a weekly basis.
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?
Consistent with Orange County Commissioners' Goal to "Create a Safe Community" as a Social
Justice Value, OCRA is helping to create safe homes and community connections for rural elderly
who are aging-in-place. These proud seniors have strong connections to their homes, churches
and communities, and do not have the resources for assisted living or affluent senior housing.
They are not "asking for help". Through relationships built with the SALT/PE/OCRA volunteers,
these seniors are becoming more connected with their community and resources available through
the county. Seniors who would otherwise be isolated in a remote rural area, are building trust with
visitation teams, and becoming receptive to help and support.
OCRA also supports Commissioners Goal 2 "to Promote an interactive and engaging system of
governance that reflects community values, mentioning internet access." Many rural seniors do
not have computers or skills necessary to interact with the internet. They rely on the old-fashioned
way of getting information....personal contact. OCRA with the help of SALT/PE shares social
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connection with the seniors and keeps them informed on community events and of County
services available. This connection enables seniors to be part of the County and a valued part of
their community.
Through our alliances with churches, civic groups and local businesses, OCRA (with SALT and
PE) is creating distinctive community connections that are encouraging pride and camaraderie
amongst many rural seniors.
Describe the community need or problem to be addressed in relation to the Chape/ Hill Human
Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of Chape/ Hill
Council 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.
Food insecurity plagues 15% of the population of Orange County, with another 47% just
above the poverty level who are unable to qualify for federal assistance or county social services.
For rural seniors, there's the complication of transportation and they are unable to participate in
meal programs offered through the county's senior centers or community centers. These seniors
(and some disabled rural residents) rely solely on charitable food assistance. Local Meals on
Wheels agencies serve some of these citizens but do not reach out into the remote rural areas that
are served by OCRA.
Based on the American Community Survey, four thousand seniors live in the unincorporated area
of the county.(2010 census). The five rural townships (Bingham, Cheeks, Cedar Grove, Little
River, Eno) have seen a 50% increase in the rate of growth in the seniors over 65+ (US 2010
census) between 2000 and 2010. This number reflects the steady aging of the rural population not
an influx of retirees to retirement communities. The growth rate of seniors in rural Orange County
far out-paces the rate of growth (21%) in the urban areas.
In our short time of operation, SALT/PE identified over 200 seniors for regular visitation and 40
who benefit from meals. The need is much greater and we are poised to reach further with more
funds.
e) Who is your target population of individuals to benefit from this program and how will they be
identified and connected with the program?
The target population of individuals is rural homebound or disabled seniors who need help
providing nutritious meals for themselves. These seniors are typically identified by SALT/PE
volunteers, Department of Social Services, local churches and civic groups, and EMS
professionals.
f7 Describe the credentials of the program manager and other key staff. (Ex. Identify Program
Manager and credentials, describe training provided to volunteers, etc.)
OCRA's Leadership Team
Norma White, President
Founding member OCRA (Orange County Rural Alliance); Volunteer SALT (Seniors and Law
Enforcement Together) program, (Sheriff's Office); Project Engage Senior Leader; volunteer OCIM
Meals on Wheels; secretary Orange County Voice (OCV); past Chair Orange County Historic
Preservation Committee (1990's); founding member Hillsborough Tree Board; initial member
Occoneechi Mountain Park Committee; founder Girl Scout troop- rural northern Orange County;
owner N.B. White &Assoc, Inc.
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Archie Daniel, Vice-President
Founding member of OCRA (Orange County Rural Alliance). Part-time employee of SALT program
(Sheriff's Office); coordinator with Project Engage and Handy Helpers (Dept of Aging); trainer of
SALT volunteers; Volunteer OCIM Meals on Wheels; former building contractor; Retired Captain
Orange County Sheriff's Office.
Alex Castro Jr., Chairman of the Board
Founding member of OCRA; Organizing member of PE; past board member Orange County
Advisory Council on Aging; Orange County Transportation Board; board member Chapel
Hill/Carrboro Meals on Wheels, board member Habitat for Humanity. President Orange County
Voice; transportation consultant; Retired US Navy Commander.
Bonnie Hauser, Treasurer
Founding member of OCRA; Organizing member of PE; board member Northern Orange NAACP;
board member Big Brothers Big Sisters of the Triangle, board Maple View Agricultural Education
Center; Legislative Chair, Schley Grange; founder Orange County Voice; retired partner
management consulting firm (PricewaterhouseCoopers)
Norma White and Archie Daniel are jointly responsible for managing the OCRA Program and
coordinating the activities of 25 active volunteers. Many officers and volunteers of OCRA have
been trained under the guidance of OCIM's Meals on Wheels, Chapel Hill-Carrboro Meals on
Wheels, Project Engage, SALT and other senior assistant programs. All volunteers receive
background checks and have been vetted for service. Most have over 2 years experience working
with seniors. Many are retired nurses/social workers (although they are not volunteering in a
clinical capacity). New volunteers not associated with SALT or PE are required to have personal
references and to accompany a SALT volunteer at least three times to meet the seniors before
being able to deliver meals. All OCRA volunteers live in rural Orange County.
g) Describe the specific period over which the activities will be carried out and include an
implementation timeline.
Today, OCRA is serving one meal per week to 40 seniors in rural Orange County. As additional
funds and grants are secured over the next year, we expect to increase meal frequency to three
times a week. By January 2018, we expect to be fully operational serving three meals a week to all
OCRA clients.
We recruit and train volunteers regularly, allowing OCRA to scale up our services to serve more
clients and increase the frequency of meals.
h) 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)
Funding this program helps to provide a much needed safety net and improves the quality of life
for Orange County's rural seniors. OCRA is part of an overall effort to help rural seniors living and
aging in place in their community. Nutritious meals for vulnerable seniors is a proven way to
reduce social isolation and depression, reduce emergency visits, and provide countless other
benefits. OCRA is the first program to reliably provide meals to underserved rural communities.
Through strong alliances and ties to the community, OCRA funds go very far. OCRA Is an all-
volunteer organization. Many meals are donated or deeply discounted.
Though ongoing contact with seniors, OCRA volunteers can identify or prevent risks facing rural
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seniors. OCRA extends the reach of Orange County's services for seniors by bringing resources
such as the Handy Helpers or Falls Prevention to rural areas. The coalition/alliance of all the
partners within the community is strengthened as well when all work together for the common
good, and the community thrives.
i) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is
recommended.
If funding is reduced and other financial sources were not available, OCRA would have to
recalibrate how many meals could be delivered. In either case vulnerable rural seniors will suffer,
as there is no other agency or civic organization who is reliably bringing hot meals to their homes.
It is likely that the program would cease entirely as meal acquisition is primarily donor driven at
present.
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j) Supplemental: Map of OCRA Meal Distribution Network
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PROVIDER"S OUTSIDE AGENCY APPLICATION
Additional Proclram Information
k) 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 2016-17 2017-18
Gender *2 months
Male 13 17 17
Female 29 33 33
Total 42 50 50
Ethnicity
African-American 9 13 13
American Indian or Alaska Native 0
Asian 0
Caucasian 33 37 37
Native Hawaiian or other Pacific Islander
Other: specify
Total 42 50 50
Of the above, how many Hispanic/Latino
Of the above, how many non-Hispanic/Latino
Total 0 0 0
Age
0-5 years
6-18 years
19-50 years 1 2 2
51+ years 41 (avg 81.3) 48 48
Total 42 50 50
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 1 2 2
City of Mebane(Orange County) 2 2 2
Orange County(Outside Municipalities) 39 46 46
Total 42 50 50
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PROVIDER"S OUTSIDE AGENCY APPLICATION
Work Statement
I) 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.
• 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 met, please explain. (i.e. Delivered an average of
105 meals per day.)
Work Statement Chart for Program, Orange County Rural Alliance (OCRA)
a) Program Activity Name Deliver meals to elderly/disabled rural residents
Program Goal Deliver 50 meals, Three times (M,W,F)a week
Performance Measures Will track the number of meals delivered each week
Previous Year Program Results 2 mos in operation (Nov-Dec) one meal reliably delivered each
week to 40 seniors
Current Year Estimated Results 4000 meals delivered July 1, 2017-June 31,2018 for 50 seniors
Next Year Projected Results 7500 meals delivered July 1,2018-June 31, 2019 for 50 seniors
b) Program Activity Name
Program Goal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
c) Program Activity Name
Program Goal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
d) Program Activity Name
Program Goal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
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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).
Separate Spreadsheet provided
2. Program Budget Detail — Provide description of"other" budget items, not defined.
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 $39,250
Total # of Individuals 50
Cost Per Individual $785
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Agency Budget
Operating Budget for Entire Agency
AGENCY NAME: Orange County Rural Alliance (OCRA)
Actual Estimated Projected Percent
AGENCY REVENUE 2015-16 2016-17 2017-18 Change
Private Donations $ - $ 8,000 $ 12,500 56%
Agency Generated Revenue (fees) $ - $ - $ - 0
Local Government Grants:
Human Services-Town of Carrboro $ - $ - $ - 0
Other-Town of Carrboro $ - $ - $ - 0
Human Services-Town of Chapel Hill $ - $ - $ - 0
Other-Town of Chapel Hill $ - $ - $ - 0
Human Services- Orange County $ - $ - $ 25,000 0
Other- Orange County $ - $ - $ - 0
Other-Town of Hillsborough $ - $ - $ - 0
Other Government Grants
Triangle United Way $ - $ - $ - 0
State Government $ - $ - $ - 0
Federal Government (CDBG/HOME/etc.) $ - $ - $ - 0
Private Foundation Grants $ - $ - $ - 0
Other (In-kind donations) $ - $ 2,000 $ 3,375 $ 0.69
Total Agency Revenue $ - $ 10,000 $ 40,875 309%
AGENCY EXPENSES
Compensation $ - $ - $ - 0
Rent& Utilities $ - $ - $ - 0
Supplies & Equipment $ - $ 7,200 $ 35,750 397%
Travel & Training $ - $ - $ - 0
Other Expenses (insurance and finance): $ - $ 2,000 $ 4,000 100%
Total Agency Expenses $ - $ 9,200 $ 39,750 332%
SURPLUS/(DEFICIT) FOR PERIOD: $ - I $ 800 I $ 1,125 I 41%
FY 2015-16 Comparative Agency Budget
Revised 9/29/2014
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE XHIBIT A
PROVIDER"S OUTSIDE AGENCY APPLICATION
4. ATTACHMENTS
a) Financial Audit
New organization (Nov. 2, 2016 incorporated)
b) IRS Federal Form 990
As a new organization, OCRA will submit an EZ990 postcard for 2016.
c) NC Solicitation License
Solicitation License Exemption has been applied for (application provided in attachments).
Approval will be submitted when received.
d) IRS Federal Tax-Exemption Letter
A copy of the IRS Tax-exemption Letter is attached.
e) Certificate of Liability Insurance
Certificate attached
e) List of Board of Directors
NEED THIS LIST
• Alex Castro Jr., Chair, 919 619-1510, 5915 Morrow Mill Road, Chapel Hill NC 27516,
retired, 3 year term
• Norma White, President, 919 732-8527, 4901 Schley Road, Hillsborough NC 27278,
retired, 3 year term,
• Archie Daniel, Vice President, 919 210-7876, 2110 Davis Drive, Hillsborough NC 27278,
SALT Coordinator for OC Sheriff's Dept (Part-time), 3 year term
• Bonnie Hauser, Treasurer, 919 732-9316, 4301 Sugar Ridge Road, Hillsborough,
Retired, 3 year term
• Karen Barrows, Secretary, 919 732-4491, 3816 Twin River Farm Road, Hurdle Mills
27541
f) Solid Waste Program Fee (SWPF) Verification
OCRA does not have an office. The corporate office listed as 4901 Schley Rd, the private residence
of Norma White. Letter certifying that SW fee is paid is provided.
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EXHIBIT`B"
Scope of Services—FY 2017-18
Outside Agency Performance Agreement
Agency Name: Orange County Rural Alliance
Program Name: "Let's Do Lunch"Meals on Wheels
Funding Award: $12,500
Outline how the agency will spend Orange County's funding award.
Expense Description Amount
Costs associated with meal acquisition for 70 seniors,from commercial kitchen $12,000
Supplemental snacks/desserts 5,00
Program Services
Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2018.
• Continue to recruit clients and volunteers by building networks with churches, civic and
neighborhood groups
• Establish a permanent site for food staging and preparation.
• Fund additional meals and administrative expenses using other grants and donations received
from the community
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
Provide meals weekly to 70 people growing as substantiated by volunteers and donations 70
Build volunteer team to support reliable meal distribution to growing need 25
volunteers
DocuSigned by:
VUAa President 9/21/2017
Certified by: 64652Bo0181cA 9 Title: Date:
(Provider's Signature)
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE
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:
VUAa President 9/21/2017
Certified by: 64852B90181C459 Title: Date:
(Provider's Signature)
(Orange County Rural Alliance)
Orange County Outside Agency Performance Agreement Page 10 of 10
Rev. 7/17
Client#: 73888 NCHILL2
_
DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE DATE(MM/DDIYYYY)
ti IL,kor IN Ul, tocrs. lir I t•/A I C. kJ r L'ABILITY II SLJRANCE 1131/2017
--- --
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
1 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT' If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER
NAME:
The CIMA Companies, Inc, PHONE 703 739-9300
(A/C,Nu,Ext); 0761 703739
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? 2750 Killarney Or Suite 202 EMAIl
ADDRESS:
' Woodbridge, VA 22192-4124 ''PP ODUC FR
CUSTOMER ID 0
703 739-9300
INSURER(S)AFFORDING COVERAGE ,NAIC P
INS UR ED INSURER A,Alliance of Nonprofits for Ins 10023
Orange County Rural Alliance (OCRA)
INSURER 13
4901 Schley Road
INSURER C:
, Hillsborough, NC 27278 '
,
INSURER D
INSURER E
_ INSURER F:
,............................_____________
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
-------
I HIS 6 10 DER I IF Y THAI [I-1E POLICIES OF INSURANCE L ISTED BELOW I IAVE BEEN ISSUED TO THE INSURED NAMED ABOVE EOR TI IE POLICY PERIOD
IN DrAT ED.NOT WITI ISTANDING ANY REQUIREMEN1,TERM OR CONDITION OF ANY CONTRACT OR OT I-IER DOCUMENT win I RESPECT TO WHICH TI IIS ,
CEH f WICATE 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 SI IOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,
I nin"--"—"------ ADDL UN,, ' POLICY EFF POLICY EXP ' ---
TYPE Or INSURANCE N,FR vo ; POLICY NUMBER 'MM/00/YYYY MM/DD1YYYY LIMITS
, A GENERAI LIABII ITY 201750439 01/31/2017 01/31/20181 EACH OCCURRENCF E11,000,000
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DI,SCRIPT ION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space e,required)
Orange County, NC is listed as additional insured under the general liability policy with respects to
operations performed by the name insured,
CERTIFICATE HOLDER CANCELLATION
_ _....... ........_____
i Orange County, NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH'THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
01988-2009 ACORD CORPORATION,All rights reserved,
ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S345374/N1345373 JX..1