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2017-582-E Finance - OC Partnership for Young Children- Outside Agency Performance Agreement
DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB 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 Partnership for Young Children, a not-for-profit corporation, located at 120 Providence Rd, Suite 101, Chapel Hill,NC 27514 ("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Orange County Partnership for Young Children 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 5500 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 1375. 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 Partnership for Young Children) Orange County Outside Agency Performance Agreement Revised 7/2017 Page 1 of 7 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB 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 Partnership for Young Children) Orange County Outside Agency Performance Agreement Page 2 of 10 Rev. 7/17 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB 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 Partnership for Young Children) Orange County Outside Agency Performance Agreement Page 3 of 10 Rev. 7/17 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB 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 Partnership for Young Children 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 Partnership for Young Children) Orange County Outside Agency Performance Agreement Page 4 of 10 Rev. 7/17 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB County: Finance &Administrative Services Provider: Orange County Partnership for Orange County Young Children Post Office Box 8181 120 Providence Rd, Suite 101 Hillsborough,NC 27278 Chapel Hill,NC 27514 16. Entire Agreement. This Agreement,including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. 18. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). Any violation of this requirement is a breach of the Agreement and County may immediately terminate this Agreement without further obligation on part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 19. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below.rFor a apheilleatiflof the Provider L f( vta, 10/12/2017 91nsF4e47e9e44e... , Date (Orange County Partnership for Young Children) Orange County Outside Agency Performance Agreement Page 5 of 10 Rev. 7/17 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB EI F d§or i half of Orange County Government NIAA/ut, tk'GUMwtt-rStu 10/23/2017 f1637QA4R755F477 Bonnie Hammersley, County Manager Date (Orange County Partnership for Young Children) Orange County Outside Agency Performance Agreement Page 6 of 10 Rev. 7/17 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FY 2017-2018 Outside Agency Ful Hding 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 pq 'too M 7:71i tt, iv doi io r/riiiarlrii/ f j�j r iv m., Y��t,o Nhti' 1�IR�y`"r ,,, 4pEL ss DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FOR OFFICE USE ONLY Agency Orange County Partnership for Young Children Received By Program(s) Transplanting Traditions Community Farm Date/Time Section Subsection 1. Cover Page a. Fly Applicant Contact Information b. 04 Funding Requests C. I Signed Application Cover Page d. I Signed Disclosure of Conflicts of Interest and Clause 2. Agency Information a. 1 Agency's Years in operation b. Agency's Purpose/Mission c. 1-41 Agency's Types of Services Provided d. 1 Agency's Experience with Programs e. A, Other Pertinent Agency Information f. I Schedule of Positions g. 1 Living Wage h. r Agency Budget 3. Program Information a. l Human Services Needs Priority b. r1 Type of Program A separate Section 3 is c. X4 Agency Collaboration required for each program. d. i4 Summary of Program e. Description of Identified Need f. ■ Description of Population to be Served g. i4 Program Staffing, Capacity, & Expertise h. 1.1 Program Implementation Timeline i. Value of Investment j. Impact of Reduced/No Allocation k. I4 Other Pertinent Information I. k■ Target Population/Beneficiary Chart m. Work Statement n. i1 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. X4 IRS Federal Form 990 C. I NC Solicitation License d. Z IRS Federal Tax-Exemption Letter e. I1 Certificate of Insurance f. 4,4 List of Board of Directors g. Solid Waste Program Fee(SWPF)Verification Application Submittal Checklist 1/31/2017 3:59:06 PM Page 2 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Orange County Partnership for Young Children Applicant Organization's Physical Address: 120 Providence Road, Suite 101, Chapel Hill, NC 27514 Applicant Organization's Mailing Address: 120 Providence Romd, Suite 101. Chapel HiU, NC 27514 Applicant Organization's Web Address: yvvvvv.Vnangounnartotart orq Executive Director: Robin Pulver Telephone Number: 919-967-9091 E-Mail: rpulverorangesmartstart.orq Tax ID Number: b) Funding Request List all FY17-10 Human Services (HS) Funding Being Requested— For All Programs) and the Proposed Use of Funds (2-3 lines or less) Program, Carrbunm Chapel Orange Total, - HS Hill 'HS Cmunty~HS Ex Youth Afemuhoo| Program $10.000 $16.000 $5,000 � ` $30,000 Afterschool Program Coordinator salary and materials for youth activities and projects Transplanting Traditions Community Farm $7,500 $7,600 $7,500 $22,500 Staffing, contractual services, and materials to support the activities of Transplanting Traditions Community Farm, a community farm for refugees from Burma. Contracted services include a native translator from Burma. _ Totals AGENCY INFORMATION 1/31/2017 3:59:06 PM Page 3 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION c) To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. 6Fe 1 //7-3/// Signature: Executive Director Date Signature: ) 3 1 7/ Board Chairperson Date AGENCY INFORMATION 1/31/2017 9:29:10 AM Page 7 of 24 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION d) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION CLAUSE Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate families, or their business associates... YES NO Z | a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? Z b) Members of or closely related to members of the governing bodies of the Town of Carrboro, the Town of Chapel Hill, or Orange County? -- 14 c) Current beneficiaries of the program for which funds are being requested? C 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. Orange County Commissioner Mia Burroughs is a board member, appointed by the County Commissioners to the OCPYC Board of Directors; Board member Colleen Bridger and her designee Coby Austin are employees of the Orange County Health Department; Board member Lucinda Munger leads the Orange County Library; Todd Wirt, superintendant of Orange County SChools, and Kerry Moore, director of CHCCS Head Start and Pr8-K, serve On the board; Emily Bivins is an employee of the CHCCS. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themee|ven, their ogento, nffioia|s, employees and servants agree not to discriminate in any manner of these basis of race, oo|or. Bender, national nrigin, oge, hondimap, re/i0ion, sexual orientoUon, gender identity/expnesoion, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific perfonnonce, injunctive na|ief, or other remedy as by law provided; this provision shall be binding on the 0nanteem, the successors and assigns of the parties hereto with reference to the above subject manner. AGENCY INFORMATION 1/31/2017 3:59:06 PM P a g e 5 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: Executive Director Date --- Signature: , 5 -.7 _ (-- ( / 3 / // --? Board Chairperson Date AGENCY INFORMATION 1/31/2017 9:32:10 AM Page 9 of 24 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB 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: 23 years Date of Incorporation (Month/Year): August 1993 b) Agency's Purpose/Mission (no more than a few sentences): The mission of the Orange County Partnership for Young Children (OCPYC) is to ensure that all young children arrive at school healthy and ready to succeed. We focus on the early years of a child's life from birth to age five, which is the most critical time in a child's development. Our program priorities focus on the county's most vulnerable families and children. c) Types of Services the Agency Provides (bullet format): OCPYC's services include: • Administration and technical assistance for Orange County's NC Pre-K providers • Administration of Smart Start funding that provides programming in parenting education, literacy programming, early childhood education, children's health, early intervention, and family support • Training and technical assistance for child care providers on early education and health related topics • Training and technical assistance for child care providers to improve nutrition, provide opportunities for exercise, and provide enrichment activities through building outdoor learning environments. The Partnership operates the Transplanting Traditions Community Farm that serves low- income families in the refugee and immigrant community. Its services include: • Development and maintenance of 8 acres of land for cultivation • Training and technical assistance on sustainable agriculture practices, native plant development, and healthy food and nutrition strategies • Training in entrepreneurship and successful business practices • Development of markets for crops • Implementation of a Community Supported Agriculture program • Implementation of a food sharing program for hunger relief • Implementation of a teen program • Development of a cultural community space • Continued outreach to and information sharing with the community d) Agency's History with Providing These Services: The TTC Farm focuses on serving low-income families in the refugee and immigrant community by providing refugee adults and youth access to land, healthy food and agricultural and entrepreneurial opportunities. The farm provides a cultural community space for families to come together, build healthy communities and continue agricultural traditions in the Piedmont of N.C. According to 2015 data, 75% of families served by TTC Farm are considered low income based on the U.S. Federal Poverty Guidelines. The Farm is designed to collaboratively and comprehensively address the issues of obesity, economic instability and food insecurity. The TTC Farm is located outside of Chapel Hill and Carrboro just 4 miles from the largest refugee neighborhood in the county. In Spring 2007, OCPYC, concerned with issues of childhood obesity and food insecurity, launched the Healthy Kids Campaign with the start of 3 community gardens that provided gardening, nutrition and outdoor education programming to low-income families, with 90 percent refugee and immigrant families. These became known as the Growing Healthy Kids Community Gardens. In 2010, OCPYC received the Refugee Agricultural Partnership Grant from the Office of Refugee Resettlement allowing 14 refugee families to move from the Growing Healthy Kids community gardens to Triangle Land Conservancy land, forming Transplanting Traditions Community Agency Information 1/31/2017 3:59:06 PM Page 7 of 1 8 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Farm (TTCF). TTCF is entering its seventh year of operation currently on 8 acres, directly supporting 32 refugee families or 140 individuals. Based on 2016 Year End data, 867 additional refugee individuals received fresh traditional produce grown by TTCF farmers on a regular basis. We have been involved with health-related initiatives, including the community gardens mentioned above. The Healthy Kids Campaign sought to ensure that children were provided with opportunities for healthy eating and exercise through working with child care providers and caregivers to develop strategies for better nutrition and active play. We have been a partner with the North Carolina Partnership for Children and the Blue Cross Blue Shield Foundation of North Carolina for 6 years in implementing SHAPE NC, a program that works with child care providers to improve nutritional offerings, exercise through active play, and enriching activity through building outdoor learning environments. We expanded this program to serve 10 centers. This year we developed the Growing Green Early Educators Garden Network to support the development of healthy nutrition practices, child care gardens, outdoor learning environments, and incorporation of STEM concepts into outdoor learning. 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?) The organization has not experienced any major changes in the past year with administration or staffing. The Partnership has introduced a major initiative hosting the development of the Campaign for Grade Level Reading and built on its SHAPE NC work through developing the Growing Green Network mentioned above and being selected to participate in a statewide Farm to Childcare collaborative. 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: 8.00 Executive Director, 1.00; Director, Programs and Evaluation, 1.00; Project Director, TTCF, 1.00; Assistant Project Director, TTCF, 1.00; Program Manager, 1.00; Senior Program Coordinator, 1.00; Office Manager, 1.00; Finance and Contracts Associate, 1.00 # of FTE - Paid Part-Time Positions: .5 Agricultural Specialist, TTCF, .5 # of Volunteers: 145 # of FTE - Volunteers:.07 g) Living Wage Does this agency pay permanent employees a minimum livin wa•e? (Yes/No) Yes If yes, is this agency an Orange County Living Wage Certified Employer? No If no, please explain. Orange County Partnership for Young Children will apply to receive Living Wage Certified Employer in conjunction with the submission of this application. h) Agency Budget I. Is your agency currently receiving and/or requesting other (non-Human Services) local (Town of Carrboro, Town of Chapel Hill, Orange County) government funding? (Yes/No) No Agency Information 1/31/2017 3:59:06 PM Page 8 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION ii. Submit your agency's budget. You may complete the provided template (separate xis 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). 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? Surplus Is there a significant change? Yes/No Yes Please provide a brief explanation for Surplus or Deficit, and significant changes. Surplus of the agency budget represent funds that will be used to cover next fiscal year expenses since there is a $50,000 grant for Transplanting Tradition Community Farm that has ended and additional funding will be needed. iv. What is your agency's fiscal year? July 1, 2017 through June 30, 2018 (Example: July 1, 2016 through June 30, 2017) Agency Information 1/31/2017 3:59:06 PM Page 9 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Transplanting Traditions Community Farm Program Primary Contact and Title: Kelly Owensby Telephone Number: 919-967-9091 E-Mail: kowensbyorangesmartstart.org a) Indicate the type of Human Service Needs Priority, if program applicable: Priority Area #1: safety-net services for disadvantaged residents IA Priority Area #2: education, mentorship, and afterschool programming for youth facing a variety of challenges A 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 Family Resources Jobs/Jobs Training X X X Food X X X Transportation Other: Please specify (Health/Nutrition) X X X 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. • Triangle Land Conservancy (TLC): Provides land, infrastructure, and support in expansion. A unique collaboration, the only of its kind between a land conservancy agency and a non-profit educational farm in the state. • KCNC (Karen Communities of North Carolina): Helping to connect with local refugee families. • PORCH (People Offering Relief for Chapel Hill and Carrboro Homes): TTC Farm both donates and sells produce from the farm to PORCH. PORCH provides service opportunities to teen program • Art Therapy Institute: Event collaboration and client services overlap • Conservation Fund and Resourceful Communities: Provides strategic planning and fundraising support to TTCF. • Carrboro Farmers Market: Support for teen program, marketing education, and Farm to Pre-K • Chapel Hill Farmers Market: Support for farm marketing • Chapel Hill Carrboro Youth Forward: Resource and network for other youth orgs PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 10 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION • CEFS (Center for Environmental Farming Systems): Resource and network for racial equity training and agricultural support • NC FYI (North Carolina Food Youth Initiative): Teen program support • CFSA(Carolina Farm Stewardship Association): Farm tour and public outreach support • RAFI (Rural Advancement Foundation International): Promotion and support of new farmers through funding and training • UNC Chapel Hill: School of Social Work field placement intern and School of Public Health and APPLES intern program • Chapel Hill Service League: Volunteer and funding support • Chapel Hill/Carrboro Sunrise Rotary Club: Volunteer and advocacy support • Lantern Restaurant— Fundraising, marketing collaboration and cooking classes • OC Cooperative Extension Service: Support for Farm to Pre-K development • Child Care Services Association: Support for Farm to Pre-K development • Community School for People Under Six: Participation in Farm to Pre-K development Program Description (3 pages OR LESS) Please provide the following information about the proposed program: • Summarize the program services proposed and how the program will address a Town/County priority/goal? Funding for this program would support initiatives that address childhood obesity, food insecurity, and economic instability in Orange County. These issues adversely affect the refugee and immigrant communities in Orange County, specifically in Chapel Hill and Carrboro. North Carolina resettles some of the highest numbers of refugees each year. Although the population of Chapel Hill/Carrboro makes up less than 1% of the total population of N.C., over 10% of the total refugee population from Burma lives in this area. The TTC Farm focuses on serving low-income families in the refugee and immigrant community. Services proposed include the continued access to land to grow healthy traditional foods, weekly translated workshops focused on agricultural topics and small farm business development; youth programming focused on nutrition, active living and leadership development; implementation of a "Share a Share" program in collaboration with PORCH, which provides traditional vegetables for 118 refugee families in need on a monthly basis while providing economic support for TTCF farmers; and outreach to support Farm to Pre-K activities, which will link the farm to the broader community and promote healthy growth and development of our young children. • Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services Needs Assessment, Orange County 1;OCC Goals and Priorities, Town of Chapel 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. Community priorities include safety-net services for disadvantaged residents, including developing economic opportunities; education, mentorship, and afterschool programming for youth facing a variety of challenges and programs aimed at improving health and nutrition of needy residents. OCPYC is requesting funding aimed at improving economic stability through our farm incubator, health and nutrition of refugee residents in need, and creating linkages to the broader community. OCPYC has provided and expanded these services since the farm's inception in 2011. Studies of other refugee and immigrant communities in the U.S. have shown high rates of obesity in resettled refugee children PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 11 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION which may be based on stress, food insecurity, caregivers' unfamiliarity with local food culture, poverty and lack of access to familiar food items. According to the U.S. Census, North Carolina has significantly higher food insecurity rates (17.1%) than the national average (14.7%). Over a quarter of minorities, which include refugees and immigrants, are classified as food insecure by the USDA making the work of the TTC Farm crucial. The earlier families can be reached, and these barriers addressed, the more successful and healthier families will be. Childhood obesity and weight continue to be prevalent issues in Orange County, statewide and nationally. According to the 2012 North Carolina Nutrition and Physical Activity Surveillance System (NC-NPASS), Orange County had an overweight/obesity rate of 30.1% for children 2-4 years of age. This puts the county 61st overall in overweight percentage and 47th in obesity out of 100 counties. Research shows that weight gain begins within ten years of immigration. (Obesity Among US Immigrant Subgroups Duration of Residence, Goal, McCarthy, Phillips, Wee, JAMA, 12/15/04-VOI 292, No. 23) Transplanting Traditions Community (TTC) Farm strives to address the needs of the entire family through providing a space to grow healthy, culturally appropriate foods and provide educational workshops on nutrition and healthy eating. Access to culturally appropriate fresh food directly impacts the daily diets and health of those involved with the project. Based on data collected during 2016 year end interviews, refugee farmers with TTC Farm reported they saved an average of $82.00 on groceries per week by growing at the farm. This is also specifically due to families able to grow culturally appropriate and familiar vegetables that are otherwise hard to find in N.C. • Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? The TTC Farm focuses on serving low-income families in the refugee and immigrant community. The TTC Farm is located outside of Chapel Hill and Carrboro just 4 miles from the largest refugee neighborhood in the county. The location of the farm allows for increased accessibility and regular attendance to programming directly, correlated to the success of the program and significant program growth each year. Beneficiaries are identified through referrals within the refugee community and from refugee support agencies. Data is collected through intake interviews and end of year evaluations with each family. • Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) Since 2010, Kelly Owensby, project director, has provided program development and teaching and organizing in the refugee community and holds a BA in anthropology and environmental studies. Her experience includes hands-on agriculture experience on local farms in sustainable specialty crops. Since 2012, Nicole Accordino, assistant project director, has provided program development expertise and coordinates volunteers, youth programming, and outreach efforts, and she holds a BA in sustainable agriculture. She has extensive experience with garden-based curriculum development. Vera Fabian, agricultural specialist, works with the CSA and mentors beginning farmers. Her experience includes hands-on farming and community garden development and instruction for schools. Maria Hitt, Growing Up Healthy program manager, is a public health educator with extensive experience in developing community gardens, outdoor learning environments, and programs in healthy nutrition, and is currently leading OCPYC's farm to childcare activities. PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 12 of 1 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION • Describe the specific period over which the activities will be carried out and include an implementation timeline. Activities and services are carried out year round. Translated classroom workshops focused on agricultural topics, finance, business planning, conflict resolution and leadership occur Jan-Feb twice a week. Hands-on, on-farm workshops occur March-November twice a week. Share a Share program food distribution occurs monthly during the farming season. Referrals and connections to service providing agencies occur year round. Workshops and technical assistance for teen programming occur on an event basis one to two times per month during the school year and weekly during summer break. Outreach activities with the Farm to Childcare activities will take place across the year. • 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) The TTC Farm is designed to collaboratively and comprehensively address the issues of obesity, economic instability and food insecurity. Refugee farmers with TTC Farm are able to both increase supplemental income through selling produce as well as increase fresh fruits and vegetable intake by growing food for their families to consume. In 2016, farmers earned $42,516 through the CSA program. In order to make the fruits and vegetables grown on the farm more accessible to the greater refugee and immigrant community, farmers market produce within in their own community, sales of traditional produce in 2016 reached $6,406. In addition TTCF formed the Share a Share program in collaboration with hunger relief agency PORCH in order to get more fresh traditional produce to refugee families in need. In 2016, the program donated 1,915 pounds of traditional produce to PORCH and supported 118 refugee families. Additionally, expanding outreach efforts to the child care community through the Farm to Childcare Collaborative increases market potential, increases healthy food consumption, and builds cultural understanding. • Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. This funding helps to ensure that our farm staffing is supported, our outreach efforts are supported, and that we can retain our translator/interpreter. The translator is critical to the operation and function of the farm. With a reduced allocation, we would steer human services funding toward supporting the translator/interpreter and seek other sources of funding for other personnel. • Include any other pertinent information. Highlights of results for our Transplanting Traditions Community Farm include: • TTCF donated 1,213 pounds of food grown by TTCF farmers to PORCH for an average of 118 refugee families during first half of FY year 16-17 • 20 TTCF farmers grew for Share a Share program in collaboration with PORCH • In 2016 TTCF donated a total of 1,915 pounds of food to PORCH for 118 refugee families • 5 farmers grew for 150 CSA members for 20 weeks during first and second quarter of FY 16-17 • In 2016 , 5 farmers earned $42,516 through CSA program • 100% of farmers report decrease in food insecurity based on information gathered during 2016 Year End interviews conducted in December of 2016. • Summer and afterschool programming was regularly provided for 9 refugee teens. PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 13 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION • On-farm summer programming was provided weekly for an average of 15 refugee children • TTCF staff and teen interns provided 1 7 tours to 305 individuals July 1, 201 6-Dec 30. 2016 • Additionally, as part of the Growing Green network, 8 workshops were held with 87 teachers from 24 childcare facilities; total participants was 164 Additional Proqram Information • Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be 8en/ed, to the best of your ability, Program Target Population Demographics Actual Estimated Projected 2815-16 2016'17 2017'18 Gender Male 787 490 515 Female 777 488 537 Total 1.564 984 1.052 Ethnicity African-American 11 10 American Indian or Alaska Native Asian 1,461 995 1,032 Caucasian 35 7 Native Hawaiian or other Pacific Islander Other: specify Hispanic/Latino 57 3 Total 1,564 995 1.052 Of the above, how many Hispanic/Latino 57 3 Of the above, how many non-Hispanic/Latino Total 57 0 3 Age 0-5 years 103 98 6-18 years _ 423 431 19-50 years 366 418 514- years 103 105 Total 0 995 1.052 Geographic Location Alamance County Chatham County Durham County __ Wake County Orange County Breakdown Chapel Hill Public Housing * PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 14 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Town of Chapel Hill (Non-Public Housing) 918 507 519 Town of Carrboro 461 427 449 Town of Hillsborough 10 City of Mebane (Orange County) 61 74 Orange County(Outside Municipalities) 185 Total 1564 995 1,052 *Do not currently collect data on public housing differentiation Work Statement O 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. O Program Activities should outline major activities the agency implements to accomplish its program goals. (La Deliver meals to elderly/disabled residents.) O 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.) O 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 Transplanting Traditions Community Farm 1. Program Activity Name Workshops in Sustainable Agriculture Program Goal Decrease food insecurity in the refugee and low-wealth communities in Orange County(80% of participants will report a decrease in food insecurity) Performance Measures Surveys, interviews, number of individuals served, number of workshops Previous Year Program Results 100% of participants will report a decrease in food insecurity Current Year Estimated Results 100% of participants will report a decrease in food insecurity Next Year Projected Results 100% of participants will report a decrease in food insecurity 2. Program Activity Name Share a Share Program Goal Decrease food insecurity in the refugee and low-wealth communities in Orange County(80% of participants will report a decrease in food insecurity) Performance Measures Surveys, interviews, number of individuals served Previous Year Program Results 118 refugee families served through Share a Share Current Year Estimated Results 118 refugee families served through Share a Share Next Year Projected Results 118 refugee families served through Share a Share PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 15 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 3. Program Activity Name Business and Market Education with the Community Supported Agriculture Activity Program Goal In order to improve economic weIIbeing in the refugee community, provide agricultural initiatives, business planning and market education focusing on financial risk management, farm production costs and developing markets Performance Measures At lease 5 refugee farmers will participate in the CSA connecting to at least I 00 CSA customers and I refugee farmer with the Chapel Hill Farmer's market; maintain a refugee farmer's market stand in Carrboro on Wed and Sat;farmers earn over$60,000 in supplemental income through produce sales; number of workshops _provided Previous Year Program Results 5 farmers participate in CSA; TTCF provides 25 hours of classroom workshops, 72 hours of hands-on farm training; $70,080 earned in total produce sales Current Year Estimated Results 5 farmers participate in CSA; TTCF provides 25 hours of classroom workshops, 72 hours of hands-on farm training; $70,000 earned in total produce sales Next Year Projected Results 5 farmers participate in CSA; TTCF provides 25 hours of classroom workshops, 72 hours of hands-on farm training; $70'000 earned in total 'roduce sales 4. Program Activity Name T een Leadership and J b Skill u Program Goal Increase oommunicetion, job and leadership skills for refugee and immigrant teens Performance Measures Attendance records; program implementation schedules Previous Year Program Results 8 refugee teens receive communication,job and leadership skills Current Year Estimated Results 10 refugee teens receive communication,job and leadership skills Next Year Projected Results 10 refugee teens and one refugee program assistant receive communication, ob and leadershi. skills 5. Program Activity Name Community Outreach Program Goal Provide education and outreach to the greater Orange County community through tours and working with the emerging Farm to Pre-K work in the county Performance Measures Tour log; number of workshops for Pre-K and child care providers Previous Year Program Results 17 tours Current Year Estimated Results 20 tours Next Year Pr jected Results 20 tours; 18 workshops PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 16 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 0 Program Budget 1. Submit your program budget. You may complete the provided template (separate xis 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). Program Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: 0 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 Ia 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, 3. This program budget represents what percent of the agency budget? 5% 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 I Estimated 2016-17 Projected 2017-18 Total Cost of Program $160,375 $154,784 $165,567 Total # of Individuals 1,564 995 1,052 Cost Per Individual $103 $156 $157 PROGRAM INFORMATION 1/31/2017 3:59:06 PM Page 17 of 18 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Agency Budget Operating Budget for Entire Agency AGENCY NAME: Orange County Partnership for Young Children Actual Estimated Projected 2017 Percent AGENCY REVENUE 2015-16 2016-17 18 Change Private Donations $ 236,681 $ 186,681 $ 186,681 0% Agency Generated Revenue(fees) $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ 3,500 $ 4,000 $ 7,500 88% -Town of Carrboro $ - $ - 0 Human Services-Town of Chapel Hill $ 3,000 $ 4,000 $ 7,500 88% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services -Orange County $ 12,000 $ 3,500 $ 7,500 114% Other-Orange County $ - $ - $ 0 Other-Town of Hillsborough $ $ $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ 2,842,536 $ 2,842,536 $ 2,842,536 $ Federal Government(CDBG/HOME/etc.) $ 6,000 $ - $ - 0 Private Foundation Grants $ - $ - $ - 0 Other Revenue $ 6,758 $ - $ - 0 Total Agency Revenue $3,110,475 ` $ 3,040,717 $ 3,051,717 0% AGENCY EXPENSES Compensation $ 517,596 $ 522,772 $ 528,000 1% Rent& Utilities $ 47,368 $ 47,842 $ 48,320 1% Supplies& Equipment $ 57,105 $ 57,676 $ 63,253 10% Travel&Training $ 11,240 $ 11,240 $ 11,240 0% Other Expenses: $ 2,413,532 $ 2,391,532 $ 2,391,532.00 0% Total Agency Expenses $3,046,841 $ 3,031,062 " $ 3,042,345 0% SURPLUS/(DEFICIT) FOR PERIOD: $ 63,634 I $ 9,655 I $ 9,372 I -3% FY 2015-16 Comparative Agency Budget Revised 9/29/2014 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Program Budget Operating Budget for Program PROGRAM NAME Transplanting Traditions Community Farm Actual Estimated Projected Percent PROGRAM REVENUE 2015-16 2016-17 2017.18 Change Private Donations $ 183,609 $ 148,609 $ 148,609 0% Program Generated Revenue $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ 3,500 $ 4,000 $ 7,500 88% Other-Town of Carrboro $ $ $ 0 Human Services-Town of Chapel Hill $ 3,000 $ 4,000 $ 7,500 88% Other-Town of Chapel Hill $ - $ - $ 0 Human Services- Orange County $ 12,000 $ 3,500 $ 7,500 114% 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 Revenue E11 $ $ 0 Total Program Revenue $ 202,109 $ 160,109 $ 171,109 7% PROGRAM EXPENSES Compensation $ 74,156 $ 74,527 $ 75,272 1% Rent& Utilities $ 3,799 $ 3,837 $ 3,875 1% Supplies & Equipment $ 26,218 $ 20,218 $ 28,218 40% Travel &Training $ 1,567 $ 1,567 $ 1,567 0% Other Expenses: $ 54,635 $ 54,635 $ 56,635 4% Total Program Expenses $ 160,375 $ 154,784 $ 165,567 7% SURPLUS/(DEFICIT) FOR PERIOD: $ 41,734 $ 5,325 J $ 5,542 I 4%1 DocuSign Envelope ID: E519448F-9F6D-4100-BF62-D7625621FFEB EXHIBIT"B" Scope of Services—FY 2017-18 Outside Agency Performance Agreement Agency Name: Orange County Partnership for Young Children Program Name: Transplanting Traditions Community Farm Funding Award: $5,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Staffing—Personnel and Contracted Services(including Burmese translator) $5,500 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2018. • Business Technical: Provide 25 hours of classroom workshops in agricultural, business planning and market education. • Business Technical: Provide 72 hours of hands-on technical assistance focusing on farm training, risk management, farm production costs, and developing markets. 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. Anticipated Performance Measures Results Refugee families served through Share a Share program 118 refugee families Number of farmers participating in CSA 5 farmers Percentage of participants reporting a decrease in food insecurity(total#of families; 118) 80% DocuSigned by: Pamtx Executive Di rector 10/12/2017 Atiw11A8F404 •0944B Certified by , Title: e ( /4,./ b/rIvolz)( Date: 7 /7 (Provider's Signature) DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB 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. r rDocuSigned by: li u Puttwx 10/12/2017 Executive Director Certified by: s1naFaea�eos41e... Title: Date: (Provider's Signature) (Orange County Partnership for Young Children) Orange County Outside Agency Performance Agreement Page 10 of 10 Rev. 7/17 DocuSign Envelope ID:E519448F-9F6D-4100-BF62-D7625621FFEB ORANCOU-04 MROBERTS ,4 G'ORC1" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `••---'� 09/05/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Summers Thompson Lowry,Inc. PHONE 919 968-4472 FAx 919 942-4221 100 Europa Drive (A/C,No,Ext):( ) (NC,No):( ) Suite 571 ADDREss:info @STLinsure.com Chapel Hill,NC 27517-2393 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Alliance for Non-Profits for Insurance Risk Retention Group INSURED INSURER B:Hartford Underwriting Insurance Company 30104 Orange County Partnership for INSURER C:Carolina Casualty Insurance Young Children 120 Providence Rd Ste 101 INSURER D: Chapel Hill,NC 27514 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR W POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD VD (MM/DD/YYYY) (MM/DD/YYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 201736915 08/10/2017 08/10/2018 DAMAGE-sr O RENTED 5500 000 PREMISE (Ea occurrence) $ MED EXP(Any one person) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRO- 3,000,000 POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) ANY AUTO 201736915 08/10/2017 08/10/2018 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE 201736915UMB 08/10/2017 08/10/2018 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 22WECIT8297 10/01/2017 10/01/2018 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? 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