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2018-017-E Finance - Orange County Literacy Council performance agreement
DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 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 Literacy Council, a not - for - profit corporation, located at 200 N Greensboro Street, Suite C -2, Carrboro, NC 27510 ( "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 Literacy Council 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 15600 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. The Provider shall be paid in four equal installments in the amount of 3900. 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 Literacy Council) Orange County Outside Agency Performance Agreement Revised 712017 Page I of 7 DocuSign Envelope ID: DDOCFB62- 8EDD- 4857- ACF6- 9C98BO78AA95 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. £ 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 Literacy Council) Orange County Outside Agency Performance Agreement Page 2 of 10 Rev. 7/17 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 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: • Worker's Compensation • Commercial General Liability • Automobile Liability • Professional Liability Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee $1,000,000 Each Occurrence $2,000,000 Aggregate $500,000 Combined Single Limit $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 Literacy Council) Orange County Outside Agency Performance Agreement Page 3 of 10 Rev. 7/17 DocuSign Envelope ID: DDOCFB62- 8EDD- 4857- ACF6- 9C98BO78AA95 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 Literacy Council provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the parry addressed as follows: (Orange County Literacy Council) Orange County Outside Agency Performance Agreement Page 4 of 10 Rev. 7/17 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 County: Finance & Administrative Services Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: Orange County Literacy Council 200 N Greensboro Street, Suite C- 2 Carrboro, NC 27510 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. Fora wt-h ci4f- of the Provider 'ct Ve.io.. 38E44E98ZF8B412 _.. Date (Orange County Literacy Council) Orange County Outside Agency Performance Agreement Rev. 7/17 1/21/2018 Page 5 of 10 DocuSign Envelope ID: DDOCFB62- 8EDD- 4857- ACF6- 9C98BO78AA95 For and o&d gAgUbQf Orange County Government F&Wmf�(�Xmwsb-� Bonnie a06mme s7Iey7,7County Manager (Orange County Literacy Council) Orange County Outside Agency Performance Agreement Rev. 7/17 1/22/2018 Date Page 6 of 10 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FOR OFFICE USE ONLY Agency Orange County Literacy Council Received By Program(s) Adult Literacy, Family Reading Partne Date/Time / 1. Cover Page a. b. C. d. ® Applicant Contact Information ®Funding Requests ®Signed Application Cover Page ®Signed Disclosure of Conflicts of Interest and Clause 2. Agency Information a. ®Agency's Years in operation b. ® Agency's Purpose /Mission c. ® Agency's Types of Services Provided d. ® Agency's Experience with Programs e. ® Other Pertinent Agency Information f. ® Schedule of Positions g. ® Living Wage h. ® Agency Budget 3. Program Information a. ® Human Services Needs Priority b. ®Type of Program A separate Section 3 is c. ® Agency Collaboration required for each program. ' d. ® Summary of Program e. ® Description of Identified Need f. ® Description of Population to be Served g. ®Program Staffing, Capacity, & Expertise h. ®Program implementation Timeline i. ® Value of Investment I j. ®Impact of Reduced /No Allocation k. ® Other Pertinent Information I. ® Target Population /Beneficiary Chart M. ® Work Statement In. ® 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. ® IRS Federal Form 990 c. ® NC Solicitation License d. ® IRS Federal Tax - Exemption Letter e. ® Certificate of Insurance f. ® List of Board of Directors g. ® Solid Waste Program Fee (SWPF) Verification Application Submittal Checklist 1/31/2017 10:55:42 AM Page 1 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Orange County Literacy Council Applicant Organization's Physical Address: 200 N Greensboro St, C -2, Carrboro, NQ 27510 Applicant Organization's Mailing Address: 200 N Greensboro St, C -2, Carrboro, NC 27510 Applicant Organization's Web Address: www,orangeliteracy.orp Executive Director: Alice Denson Telephone Number:919- 914 -5163 Tax ID Number: 56- 1433933 E -Mail: adenson@_orangeliteracy.org b) Funding Request List all FYI 7-18 Human Services (HS) Funding Being Requested — For All Programs) and the Proposed Use of Funds (2 -3 lines or less) IProgram Carrboro Chapel Hill - HS Orange County- HS Total - HS Adult Literacy $5,400 $16,600 $16,000 $38,000 Family Reading Partners $ 600 $ 3,400 $ 1,000 $5,000 $6,000 $20,000 $17,000 $43,000 Totals c) To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. Signature: utive Director Signature: I _ Eloard Chairperson �/ / Qate ' Z X 17 Date AGENCY INFORMATION 1/31/2017 10:54:56 AM Page 2 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 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... VFSNC) ❑® a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? ❑® 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? ❑® c) Current beneficiaries of the program for which funds are being requested? ❑® 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. NON - DISCRIMINATION 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 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 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 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: Signature: LL Date / Date,,, � AGENCY INFORMATION 1/31/2017 10:54:56 AM Page 3 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 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):1011984 b) Agency's Purpose /Mission(no more than a few sentences): Orange Literacy envisions a community where literacy is available to all. Our mission is to help adults reach their education, employment and life goals. We do this by providing free, flexible instruction in reading, writing and basic math, English language and computer skills and GED preparation. c) Types of Services the Agency Provides(bul /et format): Please note — all services are free to our students. • One -on -one and small group instruction in reading, writing, basic math, computer literacy, GED preparation and English language skills • Comprehensive Family Literacy (Smart Start funded) • Parental Literacy (United Way funded) • Citizenship education (funded by a grant from U.S. Citizenship and Immigration Service) • Family Reading Workshops d) Agency's History with Providing These Services: Since its inception in 1984, Orange Literacy has built a strong and successful record of helping adult learners identify and achieve their short- and long -term goals. Many adult literacy and ESOL students have progressed in their employment goals, such as getting a job, being promoted to a higher - paying job or moving to a new job that pays a higher wage. Other adult learners have achieved their goal of a better education for themselves and their children by passing the GED, developing the literacy skills necessary to prepare their young children and grandchildren for school, or helping their older school -aged children with homework. In addition to Adult Literacy, our flagship program, Orange Literacy offers comprehensive family literacy (in partnership with El Centro Hispano), parental literacy classes (with the Family Success Alliance and the Making Connections Collaboration), family reading workshops (with Family Reading Partners), citizenship classes (through USCIS funding) and weekly writing workshops at the area homeless shelters. In FY17, Family Reading Partners asked to work under the umbrella of Orange Literacy for projects outside the Chapel Hill Carrboro School System. We work very closely with the NC Community College System ( NCCCS), the entity charged with providing formal Basic Skills and adult ESL instruction in the state. Orange Literacy staff adheres to NCCCS (U.S. Department of Education) standards for program quality, staff and tutor training and students and program evaluation. 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 ?) Joy Turner, our Program Director, left in October of 2016. We have separated her duties and redistributed them among existing full time employees and new part time employees. f) Schedule of Positions(For Entire Agency) Agency Information 1/31/2017 10:54:56 AM Page 4 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION • 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: 4 # of FTE - Paid Part-Time Positions: 1.5 # of Volunteers: 150 # of FTE - Volunteers:6 Please note: Orange Literacy also uses the following • Contract Instructors (hired under specific grants and by the class) — 3 FTEs • AmeriCorps Members — 2 FTEs g) Living Wage Does this agency pay permanent employees a minimum living wage? (Yes / No) yes If yes, is this agency an Orange County Living Wage Certified Employer? Ves If no, please explain. Agency Information 1/31/2017 10:54:56 AM Page 5 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION h) Agency Budget i. Is your agency currently receiving and /or requesting other(non -Human Services) local (Town of Carrboro, Town of Chapel Hill, Orange County) government funding ?(Yes /No) No If yes, please list below: Include all programs that have funding requests /awards /totals from Carrboro: Chapel Hill, and Orange County governments (other than Human Services). DO NOT include federal funding sources, such as CDBG and HOME. Program FY16- FY17-18 17 Request Award Source Ex: Affordable Rental Rehabilitation 0 $20,000 Carrboro - Affordable Housing Ex: Agency Administration $15,000 $15,000 Carrboro — Other Ex. Total $15,000 $35,0001 Carrboro Total Funding N/A N/A N/A N/A *Add rows or attach additional page, if needed. 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: r Revenues • Private Donations • Program Generated Revenue Agency Information 1/31/2017 10:54:56 AM Page 6 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A iv. PROVIDER'S OUTSIDE AGENCY APPLICATION 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) • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG /HOME /etc.) • Private Foundation Grants • Other Revenue Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel & Training • Other Expenses Does your agency budget show a Surplus or Deficit? Yes — in FY2016 only Is there a significant change? Yes /No Yes Please provide a brief explanation for Surplus or Deficit, and significant changes. FY2016 Surplus — was due to better than expected contracts, along with slower than expected spending with our citizenship grant ( USCIS). Significant changes — The grant period for our citizenship grant is October 1, 2015 - September 30, 2017. We are told that the Federal register notice for a second round of funding will be coming out in May /June. However, since it is not already out, and there is no assurance of a second round, we have chosen to budget for FY2018, showing only one quarter (July -Sept) of USCIS funding. What is your agency's fiscal year? (Example: July 1, 2016 through June 30, 2017) July 1, 2016 -June 30, 2017 Agency Information 1/31/2017 10:54:56 AM Page 7 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OL�TC3%QF AWQFY APPLICATION Operating Budget for Entire Agency AGENCY NAME: Orange County Literacy Council AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Human Services - Town of Carrboro Other - Town of Carrboro Human Services - Town of Chapel Hill Other - Town of Chapel Hill Human Services - Orange County Other - Orange County Other - Town of Hillsborough Other Government Grants Triangle United Way State Government Federal Government (CDBG /HOME /etc.) Private Foundation Grants Other Revenue Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Total Agency Expenses SURPLUS /(DEFICIT) FOR PERIOD: FY 2015 -16 Comparative Agency Budget Revised 9/29/2014 $ 9,851 $ - 1 $ - 1 0 Actual 2015 -16 Estimated 2016 -17 Projected 2017 -18 Percent Change $ 60,627 $ 87,500 $ 75,000 -14% $ - $ - $ 0 $ 4,000 $ 4,500 $ 6,000 33% $ - $ - $ - 0 $ 14,000 $ 15,000 $ 20,000 33% $ - $ - $ - 0 $ 12,000 $ 15,000 $ 17,000 13% $ 3,908 $ - $ - $ - $ - $ - 0 $ 46,318.55 $ 48,123.00 $ 49,000.00 $ 0.02 $ 64,205.53 $ 65,000.00 $ 65,000.00 $ - $ 171,714.39 $ 208,883.00 $ 181,478.00 $ 0.13 $ 4,000.00 $ 5,000.00 $ 5,000.00 $ - $ 31,321 $ 21,187 $ 22,000 $ 0.04 $ $ 412,094 288,035 $ $ 470,193 342,784 $ $ 440,478 338,978 -6% -1% $ 24,109 $ 32,980 $ 33,000 0% $ 33,338 $ 19,636 $ 12,000 -39% $ 8,780 $ 9,443 $ 8,500 -10% $ 47,981 $ 65,350 $ 48,000 -27% $ 402,243 1 $ 470,193 $ 440,478 -6% $ 9,851 $ - 1 $ - 1 0 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION(Submit a separate Section 3 for each program) Program Name: Adult Literacy Program Primary Contact and Title: Alice Denson, Executive Director Telephone Number: 919-914-5163 E -Mail: adenson(cDorangeliteracy.org a) Indicate the type of Human Service Needs Priority, if program applicable: N/A ❑ Priority Area #1: safety -net services for disadvantaged residents ❑Priority Area #2: education, mentorship, and afterschool programming for youth facing a variety of challenges ❑Priority Area #3: programs aimed at improving health and nutrition of needy residents b) Indicate the type of program for which you are requesting funding (Check all that applyto this program) Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods /Residents Affordable Housing Affordable Healthcare Education x x x x x Family Resources Jobs /Jobs Training x x x Food Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates /collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated /collaborative efforts. • Orange Literacy holds two twice- weekly classes at Efland- Cheeks Elementary School, Grady Brown Elementary School and New Hope Elementary School for non - English speaking parents of elementary school students to help them learn to communicate with teachers and school administrators. Our partners provide space, childcare and student recruitment. Orange Literacy provides intakes, pre- and post- testing, goal- setting, curriculum development, tutor training and support, instruction and instructional materials. • Orange Literacy collaborates with the other partners of the Skills Development/NCWorks Center. We provide and receive client referrals to PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 8 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION agencies including DSS Work First staff, NC Department Commerce - Employment Security Division, Joint Orange Chatham Community Action Agency, Vocational Rehabilitation, Good Work, and Disabilities Awareness Council. • We work closely with Adult Basic Education (ABE), GED and ESOL instructors from Durham Technical Community College and Alamance Community College. We provide tutors for students who need individual assistance at DTCC's Skills Development Center site as well as other sites across the county. We also work similarly with ACC for students in northern Orange who choose to go to this school. • We receive client referrals and self - referrals from human services agencies including: Freedom House, Community House, Project HomeStart, Orange County Health Department, Orange County Mental Health, Horizons, IFC, Chapel Hill Housing Authority, Chapel Hill Carrboro Schools, Orange County Schools, El Centro Hispano, Church World Service • A number of area churches, organizations, agencies and businesses provide free space for Orange Literacy programs. These include: Orange County Public Library, Carrboro Branch Library, Chapel Hill Public Library, UNC -CH, the Karen Center of NC and Aldersgate United Methodist Church We hold on -going classes at: Robert and Pearl Seymour Senior Center and the Chapel Hill Public Library • Orange Literacy works with Project Literacy students (a UNC Campus Y program) to tutor University employees, work with ESOL students and volunteer in the Creative Writing Program at the InterFaith Council's men's and women's shelters. • Orange Literacy sources AmeriCorps Members from the Student Coalition for Action in Student Education (SCALE) at UNC's School of Education. • With funding from the Orange County Partnership for Young Children, Orange Literacy works in partnership with El Centro Hispano to provide a comprehensive family literacy program, with instruction for both parents and their pre - school children. • Orange Literacy is an active participant in the Orange County Family Success Alliance Collaborative (FSA). We provide literacy instruction to parents and other caregivers, targeting the curriculum to skills and content necessary to help them work with their children to build both their own and their child's literacy skills. Further, Orange Literacy's Executive Director is a member of the Family Success Alliance Advisory Council. • Orange Literacy is also a member of the United Way of the Greater Triangle - funded Making Connections Collaborative, focused on early childhood education throughout the county. As with the FSA, we provide literacy instruction to parents and other caregivers, targeting the curriculum to skills and content necessary to help them work with their children to build both their own and their child's literacy skills. • In collaboration with Church World Service, Orange Literacy has received a grant from the U.S. Citizenship and Immigration Service (USCIS) to provide citizenship instruction in Orange, Durham and Alamance Counties. In Orange County, we are currently holding classes in conjunction with the Orange County Public Library, the Refugee Support Center and the Chapel Hill Public Library. Each of these partners provides space and assistance in PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 9 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION recruiting students. Orange Literacy provides intakes, pre- and post- testing, goal- setting, curriculum development, tutor training and support, instruction and instructional materials. Program Description(3 pages OR LESS) Please provide the following information about the proposed program: d) Summarize the program services proposed and how the program will address a Town /County priority /goal? Orange Literacy will continue to provide high quality, free one -on -one and small group instruction in reading, writing, basic math, digital literacy, English and GED and citizenship prep to adults living or working in Orange County. By helping individuals to build the literacy and language skills they need to participate more fully in the local workforce, the educational system and the community as a whole, we are helping to create a welcoming and friendly community that provides all people with access to opportunities and supports and improves economic vitality. e) Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services Needs Assessment, Orange County_ BOCC 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. Orange Literacy addresses the problem of adult illiteracy in Orange County. Goals to benefit the community include: • providing quality, equitable education for those outside the K -12 system • helping individuals to move beyond low- skilled, low paying jobs to living wage jobs • preparing residents to take advantage of job training opportunities as well as curriculum and certification programs offered by area community colleges • promoting economic self- sufficiency. Although studies vary on the exact number of adults with significant literacy needs in Orange County, most estimate the need to be between 12% and 15% of the adult population. Conservative estimates place the percent of adults (25 years old and older) without a high school diploma or GED at 6.8% and those who never progressed past the 9t" grade at 4 %. Further, for young adults between the ages of 18 and 24, 6.5% have not earned a high school diploma or GED and are not enrolled in school (American FactFinder, 2005 -2009 U.S. Department of the Census). These numbers do not take into account the growing number of county residents needing ESOL instruction. English is not the primary language in approximately 12% of Orange County households; 4.9% of residents report that they do not speak English "very well." In PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 10 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION North Carolina, 84% of Latinos report speaking a language other than English at home (Pew Hispanic Center). Studies find that almost half of adults classified as Limited English Proficiency (LEP) have nine years or less of education, and 64% do not have a high school degree (The Language of Opportunity, 2003). In Chapel Hill - Carrboro City Schools, only 66.2% of Latino youth graduated from high school in 4 years in 2010, as compared to 92.5% of white students (2011 Orange County Health Assessment). Similarly, most Karen /Burmese refugees have had little to no access to formal education and are often unable to read or write in their native language. Many immigrants live in isolation and lack access to community resources due to low education levels and unfamiliarity with U.S. education, health, government, housing, and economic systems. In addition, racial and ethnic diversity differs across the county. Hillsborough has the largest percentage (37.1 %) of non -white residents, with 29.5% Black residents and 6.6% Hispanic /Latino residents. Orange County's Hispanic /Latino population almost doubled between 2000 and 2010 -- from 4.5% to 8.2% respectively. The highest concentration is in Carrboro, where Hispanics /Latinos comprise 13.8% of the population. And while Orange County's Hispanic /Latino population mirrored that of the state (8.2 %), the county's Asian population was almost three times higher: 6.7% for the county compared to 2.2% for the state. The highest concentration of Asians was in Chapel Hill, totaling 11.9% of the population in 2010, up from only 4.1 % in 2000 (2011 Orange County Health Assessment). According to data from the National Adult Literacy Survey (NALS), 15% of Orange County adult residents have Level 1 literacy skills (functionally illiterate) and 18% have Level 2 literacy skills (significant literacy needs). The majority of Orange Literacy students are in this group: adults who are not yet ready for GED or even ABE classes, who cannot communicate in English and /or who face multiple barriers to educational enhancement. Most of our students have low educational achievement levels. Many of our students had limited opportunities to attend school, or fell behind in the traditional public school system and never caught up, becoming public school dropouts as soon as they were old enough. Non - native speakers face additional challenges. For example, by the time Latino children enter kindergarten, there is already a considerable gap between their reading and math skills and those of children in different socio- economic class and racial /ethnicity groups in the United States (West, Denton & Germino- Hausken, 2000; Reardon, 2005). This gap widens as children progress through their educational careers (Rathbun, West, & Hausken, 2004), leading to inequitable outcomes in high school graduation rates and in subsequent enrollment and completion of higher education. f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 11 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION We will provide services to any interested adults living or working in Orange County. Individuals select themselves into the program. Using nationally- accepted, standardized tests, we pre -test potential students to determine their skill level and post -test to measure progress. ESOL students who pre -test out of the program (too high) can participate in conversation classes. For students who have tested out of regular classes, we hold novels -based reading/ discussion classes designed to help them transition to the reading requirements of a University class. g) Describe the credentials of the program manager and other key staff.(Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) The program is overseen by Alice Denson, Executive Director. She has more than 25 years experience working with nonprofits, with more than 12 years in adult literacy. The program is managed by: • Diana Daniel - Lorente (Adult Basic Education) — Diana has over five years experience in adult education and holds a Masters in Adult Education. • Heather Bucurel (English for Speakers of Other Languages) — Heather served as an AmeriCorps with Orange Literacy before returning to graduate school where she earned her M.A. in Teaching English as a Second Language. She has over seven years of teaching experience. Most tutoring is done by volunteers. However, we do use paid instructors in specific cases, when it is required by a funding source, or when the hours are not conducive to recruiting volunteers (such as those designed for workers during an overnight shift). We hold classes and have pairs meet all over the county, including at Orange County elementary schools, on UNC campus, at both the Chapel Hill and Orange County (Main) Libraries and at our Carrboro office. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. We offer literacy services year- round. However, the number of classes and variety of location is fewer during the summer months. In a typical year, i) Why is funding this program a good investment for the community? How does funding this program add value to the community? (250 words OR LESS) Strong literacy skills are fundamental to getting and keeping a well - paying jobs which in turn affects the ability to find adequate housing, secure healthcare and develop the resources necessary to care for a family. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. If we were to receive reduced funding, we would need to scale back the services that we can offer. k) Include any other pertinent information. N/A PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 12 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program Information 1) 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 Gender Male Female Total Ethnicity African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other: specify _multi- cultural Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51+ years Total 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 City of Mebane (Orange County) Orange County (Outside Municipalities) Actual Estimated Projected 2015 -16 2016 -17 2017 -18 202 272 225 331 381 343 533 653 568 61 70 70 274 352 324 175 253 210 296 330 288 2 20 25 1 0 0 533 653 568 259 301 244 274 352 324 533 653 568 0 0 0 5 8 10 426 513 463 102 132 95 533 ' 653 568 46 35 33 5 0 5 76 75 20 6 12 6 Total [ 528 653 1 568 PROGRAM INFORMATION 1/31/2017 10:54:56 AM P a g e 13 of 2 6 218 240 229 93 135 110 76 125 130 2 20 25 6 11 10 Total [ 528 653 1 568 PROGRAM INFORMATION 1/31/2017 10:54:56 AM P a g e 13 of 2 6 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Work Statement m) Complete the Work Statement Chart to describe the work to be performed. This chart is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the projected information. Every program is required to have AT LEAST 1 Program Activity, which should be SMART (,2pecific, Measurable, Achievable, Relevant, and Time- bound. Click on SMART Goalsto 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 Adult Literacy. 1. Program Activity Fulltime student status Name Program Goal 60% of all students will receive 12 or more hours of instruction Tutors /instructors track collect student attendance and Performance Measures report this information monthly to Orange Literacy staff. Data is tracked in LACES, an online database provide and monitored by the NC Community College System. Previous Year Program 63% (329 of 527) became fulltime students Results 65% Current Year Estimated Results Next Year Projected '66% Results 2. Program Activity Post - testing Name 60% of students who reach fulltime status will be post - Program Goal tested Performance Measures Students are pre- tested on entry into the program. Students who reach the prescribed number of hours according to the testing instrument CASAS or TABE Previous Year Program 64% (212 of 329) of fulltime students were post- tested Results Current Year Estimated 65% Results PROGRAM INFORMATION 1/31/2017 10:54:56 AM P a g e 1 4 o f 2 6 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Next Year Projected 66% Results 3. Program Activity Measureable progress Name Program Goal Of those fulltime students who are pre and post- tested, 60% will make measureable progress on a federally recognized standardized test. Performance Measures Once a student has reached the prescribed number of hours, s /he will be post- tested on a federally recognized, standardized test - either CASAS or TABE. Progress is defined as increasing one's score on the appropriate post -test. Previous Year Program 77% (163 of 212) of students who were post- tested Results made measureable progress Current Year Estimated 75% Results Next Year Projected 75% Results 4. Program Activity Name Program Goal Performance Measures Previous Year Program Results Current Year Estimated Results Next Year Projected Results PROGRAM INFORMATION 1/31/2017 10:54:56 AM P a g e 1 5 o f 2 6 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION n) Program Budget 1. Submit your program budget. You may complete the provided template (separate As 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: Revenues • Private Donations • Program Generated Revenue • 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) • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG /HOME /etc.) • Private Foundation Grants • Other Revenue Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel & Training • Other Expenses 2. Program Budget Detail — Provide description of "other" budget items, not defined. Other items include communications - internet access, cloud storage, telephones and copier /scanner. 3. This program budget represents what percent of the agency budget? 57% 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. j Actual 2015- 16 Estimated 2016- 17 Projected 2017- 18 Total Cost of Program $238,714 $290,883 $252,671 Total # of Individuals 533 653 568 Cost Per Individual $447 $445 $445 PROGRAM INFORMATION 1/31/2017 10:54:56 AM P a g e 1 6 o f 2 6 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Program Budget Operating Budget for Program PROGRAM NAME Adult Literacy PROGRAM REVENUE Private Donations Program Generated Revenue Local Government Grants: Human Services - Town of Carrboro Other - Town of Carrboro Human Services - Town of Chapel Hill Other - Town of Chapel Hill Human Services - Orange County Other - Orange County Other - Town of Hillsborough Other Government Grants Triangle United Way State Government Federal Government (CDBG /HOME /etc.) Private Foundation Grants Other Revenue Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Total Program Expenses SURPLUS /(DEFICIT) FOR PERIOD: I $ 0 $ - is - I 0' Actual 2015 -16 Estimated 2016 -17 Projected 2017 -18 Percent Change $ 37,000 $ 37,500 $ 33,193 -11 %. $ - $ - $ - 0 $ 4,000 $ 4,500 $ 5,400 20 % $ - $ - $ - 0 $ 14,000 $ 15,000 3; 16,600 11% $ $ - 0 $ 12,000 $ 15,000 $ 1.6,000 7% $ - 1 $ - 1 $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 $ 171.714.39 $ 208,883.00 $ 181,478.00 $ 0.13 $ - 1 $ - $ - 0 $ - $ 10,000 $ - $ 1.00 $ $ 238,714 196,161 $ $ 290,883 233,086 $ $ 252,671 202,807 -13% -13% $ 21,024 $ 28,033 $ 31,000 11% $ 18.029 $ 15,564 $ 9,564 -39% $ 3,500 $ 8,200 $ 4,600 -44% $ - $ 6,000 $ 4,700 -22% $ 238,714 $ 290,883 $ 252,671 -13% SURPLUS /(DEFICIT) FOR PERIOD: I $ 0 $ - is - I 0' DocuSign Envelope ID: DDOCF662 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION(Submit a separate Section 3 for each program) Program Name: F_a__mily- Reading Partners - Orange County Literacy Council Program Primary Contact and Title: Nancy Zeman /Program Co- Founder and Co- Manager Telephone Number: 919 -225 -0075 E -Mail: nwzeman @cs.com o) Indicate the type of Human Service Needs Priority, if program applicable: ❑ Priority Area #1: safety -net services for disadvantaged residents X Priority Area #2: education, mentorship, and afterschool programming for youth facing a variety of challenges ❑Priority Area #3: programs aimed at improving health and nutrition of needy residents p) Indicate the type of program for which you are requesting funding (Check all that applyto this program) Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods /Residents _ Affordable Housing Affordable Healthcare Education X X X Family Resources X X X Jobs /Jobs Training Food Transportation Other: Please specify q) 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. • Chapel Hill - Carrboro City Schools -- identify students /families who could benefit from books in the home and family reading time; schedule programs at the schools (family nights; adolescent parenting program at the high schools during lunch) • Family Success Alliance -- identify students /families who could benefit from books in the home and family reading time; schedule home visits and school programs • UNC Hospitals Horizons Program— conduct on -site visits to provide books and talk with recovering mothers about the importance for reading with their children • Book Harvest, a non - profit located in Durham, NC, will donate some gently used books PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 17 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Program Description(3 pages OR LESS) Please provide the following information about the proposed program: r) Summarize the program services proposed and how the program will address a Town /County priority /goal? Family Reading Partners (FRP), first implemented in the Chapel Hill - Carrboro School District in 2011 addresses the youth education priorities of the community. FRP brings families together around books, encourages reading and conversation, builds home libraries, and addresses the achievement gap that exists between lower and higher income families in the Chapel Hill- Carrboro community. Whether we take the program into the family's neighborhoods, the families come into their elementary schools in the evening, or we meet adolescent parents during lunchtime at their high school, the goal is to encourage reading together as a family unit. Parents /guardians learn they are their child's (children's) first and most important teacher. During a session, research is introduced on why reading with young children is critical for kindergarten /school readiness. The program facilitator models for parents how to read and have good conversation around books with their children. High quality books used for modeling are pre - selected for the age group, ethnicity, language spoken in the home, and interest. Parents learn to be both story readers and storytellers in a way that encourages them to be excellent reading role models for their children. Both parents and children alike learn to use the power of language to discover more about themselves, their families, and their communities through quality literature. New copies of the books that have been read are given to the families. In addition, each child present (regardless of age) may self - select a few additional books to take for their home libraries. s) Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services feeds Assessment, Grange County BOCC Goals and Priorities, Town of Chapel Hill Council Goals, Carrboro Board Priorities, 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. The Chapel Hill Human Services Needs Assessment lists education as one of the top six human services needs. The report states that, while Chapel Hill- Carrboro is known for its excellent public school system, participants in the assessment felt "the education system and network of family services is not meeting the needs of all children and families. The report further outlines, under the "Quality, equitable education for all" section that the "public school system is not adequately equipped to effectively teach and support at -risk youth and LEP [Limited English Proficient] students ". The Town of Chapel Hill Goals list "creating a place for everyone" and "nurturing our community" as two priorities. The Carrboro Board of Aldermen outline that their ultimate goal is "creating and maintaining Carrboro as a sustainable community that is a highly desirable place to live ". Getting books into the hands of children who don't have them and encouraging early family reading, will reduce the "preparedness gap" and make them ready for kindergarten. By promoting continued family reading, we should see students reading on grade level by third grade (goal of the Campaign for Grade -Level PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 18 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION reading). Data show that success in school is a key indicator for success and happiness in life as an adult, a dream we have for all the children in our community. FRP addresses ways to have children succeed academically. Success in school for the children involved in this program will lead to an increased chance for further education and stable employment, with a decrease in homelessness. In recent years, research and reporting on early childhood literacy has burgeoned. All data indicate that family reading is critical to a child's academic achievement and that the earlier that begins, the greater the results. • In January, 2017, the US Department of Housing and Urban Development (HUD) and the US Department of Education (ED) launched the Book -Rich Environment Initiative, a collaborative effort to establish strong, local coalitions that support public housing agencies (PHAs) nationwide with providing diverse, high - quality books and literacy support to children and families in public and HUD - assisted housing. • The American Academy of Pediatrics recently issued a policy statement recommending that all pediatric primary care should include literacy promotion, starting at birth. That means pediatricians should now be routinely advising parents about how important it is to read, even to very young children, as part of a child's health care plan (AAP, 2014). • A child from a low- income family hears an average of 8 million fewer words per year than a child from a wealthier family - -or more than 30 million fewer words by the time the child turns four. This "30 Million Word Gap" is shown to be a key factor in the achievement between high- and low- income students. Further studies show that by the time a child with this word gap enters kindergarten, the language gap may be irreversible (Newman &Kratochwill, 2012). • Studies show that the brains of children whose parents read to them have a significantly greater activation in a region that involves multisensory stimulation. Reading pictures books with young children means they hear more words, while at the same time their brains practice creating the images associated with those words (Klass, 2015). • Home library size has a substantial effect on educational attainment. Studies show that access to books especially benefits children from disadvantaged families (Jacobs, 2014). t) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? FRP focuses on literacy with low- income families. While children of all ages are welcome, we target families with children ages pre -birth through second grade, with the idea that, the earlier family reading begins, the more likely the children will be successful readers, reading on grade level by third grade. We will work with the Towns of Chapel Hill and Carrboro to identify beneficiaries in public housing PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 19 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4857- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION facilities and other locations (ex. Horizons, refugee center) where economically disadvantaged families are receiving support. u) Describe the credentials of the program manager and other key staff.(Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) Family Reading Partners events will be carried out by the co- founder of the program, Nancy Zeman, as well as trained volunteers, most of whom are retired certified literacy teachers. v) Describe the specific period over which the activities will be carried out and include an implementation timeline. FRP sessions will be carried out over at least a five -six week period in each location. Sessions will generally be held once per week at a time best - suited for the neighborhood (mid -day or early evening). A total of at least four five -week sessions will be held in 2017 -18. w) 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 Chapel Hill - Carrboro community is one where education is highly valued and where success in school is a priority for our children. Many of our families do not read with their children, a situation that will adversely affect these children and impede their path to academic success. The reasons are varied: from not realizing this is a priority to not knowing how to read themselves. FRP addresses these issues to get our families reading together. x) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. A reduced allocation would allow for fewer sessions (the cost per session is approximately $250). If funding is not awarded, this program would not go into the low income neighborhoods where families who would benefit most from this literacy initiative live. y) Include any other pertinent information. N/A PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 20 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program Information z) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, I Program Target Population Demographics j Gender Male Female Total Ethnicity African - American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other: specify Total Of the above, how many Hispanic /Latino Of the above, how many non - Hispanic /Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51+ years Total Geographic Location AlamanceCounty Chatham County Durham County Wake County Orange County Breakdown Chapel Hill Public Housing 50 60 Town of Chapel Hill (Non - Public Housing) Town of Carrboro 10 Town of Hillsborough City of Mebane (Orange County) Orange County (Outside Municipalities) Actual Estimated Projected 2015 -16 2016 -17 2017 -18 Total 1 0 50 1 70 PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 21 of 26 20 25 10 30 50 35 0 20 50 30 70 Total 1 0 50 1 70 PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 21 of 26 25 30 10 30 50 60 0 20 50 30 70 5 10 0 50 70 Total 1 0 50 1 70 PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 21 of 26 20 10 10 30 50 60 0 50 70 Total 1 0 50 1 70 PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 21 of 26 20 15 15 10 10 50 0 50 70 Total 1 0 50 1 70 PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 21 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Work Statement aa) 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 (,2pecific, Measurable, Achievable, Relevant, and Time - bound. Click on SMART Goals to learn more. • Program Activitiesshould 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 Measuresdescribe 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 - Family Reading Partners - Orange County Literacy Council 5. Program Activity Name Model for parents how to have good conversations around books with their children Program Goal Increase children's exposure to books; practice school readiness skills: have fun with books Performance Measures # of sessions /attendees Previous Year Program Results NA Current Year Estimated Results 18 sessions /25 attendees Next Year Projected Results 25 sessions /70 attendees 6. Program Activity Name Model for parents a variety of books, both fiction and nonfiction, from multiple genres Expand children's knowledge of the world through exploration of books; expand children's vocabulary # and types of books read Program Goal Performance Measures Previous Year Program Results NA Current Year Estimated Results Over 50 books shared; over 50% nonfiction Next Year Projected Results Over 70 books shared; at least 25% nonfiction 7. Program Activity Name Parents and children read and enjoy together Provide opportunities for quality parent -child interaction; parents are more empowered and see themselves as child's most important teacher Program Goal Performance Measures Parents answer survey about what they have learned from modeling sessions Previous Year Program Results NA Current Year Estimated Results 100% of parents say they have learned better how to share books with their children and have quality conversations around books with their child Next Year Projected Results 100% of parents say they have learned better how to share books with their children and have quality conversations around books with their child PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 22 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 23 of 26 7Performance Program Activity Name Give quality literature to families to increase the number of books in their home libraries Program Goal Increase the number of books in the home of participants Measures # of books families receive Previous Year Program Results NA Current Year Estimated Results Families have access to books that can be read together Next Year Projected Results PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 23 of 26 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION bb) Program Budget 5. Submit your program budget. You may complete the provided template (separate As 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: Revenues • Private Donations • Program Generated Revenue • 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) • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG /HOME /etc.) • Private Foundation Grants • Other Revenue Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel & Training • Other Expenses 6. Program Budget Detail — Provide description of "other" budget items, not defined. 7. This program budget represents what percent of the agency budget? .09 %% 8. COST PER INDIVIDUAL This Cost per Individual must reflect the total program budget divided by the total number of program individuals in this application. PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 24 of 26 Actual 2015 -16 Estimated 201647 Projected 2017 -18 ' Total Cost of Program NA $2850 $4000 Total # of Individuals NA 50 70 Cost Per Individual NA $57 $57 PROGRAM INFORMATION 1/31/2017 10:54:56 AM Page 24 of 26 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 XHIBIT A PROGRAM NAME PROGRAM REVENUE Private Donations PROVIDER'S OUTSIDE AGENCY APPLICATION Program Budget Operating Budget for Program Family Reading Partners- Orange County Literacy Council Program Generated Revenue Local Government Grants: Human Services - Town of Carrboro Other - Town of Carrboro Human Services - Town of Chapel Hill Other - Town of Chapel Hill Human Services - Orange County Other - Orange County Other - Town of Hillsborough Other Government Grants Triangle United Way State Government Federal Government (CDBG /HOME /etc.) Private Foundation Grants Other Revenue Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Total Program Expenses SURPLUS /(DEFICIT) FOR PERIOD: Actual 2015 -16 Estimated 2016 -17 Projected 2017 -18 Percent Change $ - $ - $ - 0 $ - $ - $ - 0 $ - $ - $ 600 0 $ - $ - $ - 0 $ - $ - $ 3,400 0 $ - $ - 0 $ - $ - $ 1,000 0 $ _ $ - $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 $ - $, - $ - 0 $ - $ - S - 0 0 $ - $ - $ 1 $ 5,000 $ 1,500 0 0 $ - $ - $ 0 $ - $ 3,500 0 $ $ - $ - 0. $ $ I $ - 0 $ - 1 $ I $ 5,000 0 $ - I $ - Is - I 0 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 EXHIBIT `B" Scope of Services — FY 2017 -18 Outside Agency Performance Agreement Agency Name: Orange County Literacy Council Program Name: Adult Literacy Funding Award: $15,600 Outline how the agency will spend Orange County's funding award. Expense Description Amount Rent Books and Materials 15,200 400 568 Number of enrolled students who become fulltime (12 hours or more) 340 Fulltime students who reach required minimum number of instructional hours are post- tested on 224 federally recognized, standardized test Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2018. • Adult Literacy Program - on -going individualized and small group instruction to adult learners who want to improve their reading, writing, basic math, basic computer, English language and GED preparation skills. • Provide Family Reading Partner sessions to interested parents and parenting groups. 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 Enrollment in Adult Literacy Program 568 Number of enrolled students who become fulltime (12 hours or more) 340 Fulltime students who reach required minimum number of instructional hours are post- tested on 224 federally recognized, standardized test Students who are post- tested will make measurable progress on a federally recognized 168 standardized test Provide Family Reading Partner sessions to at least 15 parents and their children 15 At least 12 Family Reading Partner participants (parents) will report they have learned better how 12 to share books with their children and have quality conversations around books with their child — DocuSigned by: �1414EIVFBB412... Executive Director Certified Title: Executive Director rovider's Signature) 1/21/2018 Date: 11.27,2017 DocuSign Envelope ID: DDOCF1362 -8EDD- 41357- ACF6- 9C98BO78AA95 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. Certified by: Docu Signed by: 41" '9` "jO" Executive Director 1/21/2018 5BE44E187F8B412... Title: Date: (Provider's Signature) (Orange County Literacy Council) Orange County Outside Agency Performance Agreement Page 10 o f ' 10 Rev. 7/17 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 t4uti - ow1wrs Page 1 AGENCY COPY (MUTUAL) INSURANCE COMPANY 6101 ANACAPRI BLVD., LANSING, MI 48917 -3999 AGENCY HIGH & RUBISH INSURANCE AGENCY 15- 0936 -00 MKT TERR 050 (919) 913-1144 INSURED ORANGE COUNTY LITERACY COUNCIL INC ADDRESS 200 N GREENSBORO ST STE C2 CARRBORO NC 27510 -1849 Policy change: Effective Date of Change MO DY YR Cross out old information and write in the changes. ENTITY: Corporation PROPERTY COVERAGES - ALL DESCRIBED LOCATIONS Special Coverage Form TERRORISM - CERTIFIED ACTS BUSINESS LIABILITY PROTECTION COVERAGES Aggregate Limit (Other than Products- Completed Operations) Products - Completed Operations Aggregate Liability and Medical Expense Medical Expense - Per Person Personal Injury Tenants Fire Legal - Any One Fire Hired Auto & Non -Owned Auto Liability TERRORISM - CERTIFIED ACTS DED FORMS THAT APPLY TO ALL LOCATIONS: 54510 (08 -09) 54961 (11 -11) BP0009 (01 -87) 54679 (06 -92) 54319 (07 -06) 54867 (03 -08) 54656 (08 -91) 64776 (01 -16) 54663 (01 -03) 54643 (01 -90) Issued 10 -05 -2017 BUSINESSOWNERS POLICY DECLARATIONS Renewal Effective 11 -20 -2017 POLICY NUMBER 91 -159- 372 -01 Company Use 35 -57 -NC -9311 Company POLICY TERM Bill 12:01 a.m. 12:01 a.m. to 11 -20 -2017 11 -20 -2018 LIMITS PREMIUM $2.92 LIMITS PREMIUM $2,000,000 $12.93 11000,000 Included 1,000,000 Included 5,000 Included Included Included 50,000 Included 1,000,000 31.51 2.20 BP0002 (01 -87) BP0006 (01 -87) 54709 (04 -10) 54098 (05 -07) 54088 (09 -09) 64728 (02 -14) OCT 12 201 DocuSign Envelope ID: DD0CFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 Page 2 AUTO - OWNERS (MUTUAL) INS. CO. AGENCY COPY AGENCY HIGH & RUBISH INSURANCE AGENCY 15- 0936 -00 MKT TERR 050 INSURED ORANGE COUNTY LITERACY COUNCIL INC 54643 (01 -90) Issued 10 -05 -2017 Company POLICY NUMBER 91 -159- 372 -01 Bill Company Use 35 -57 -NC -9311 Term 11 -20 -2017 to 11 -20 -2018 LOCATION 001 LOCATION: 200 N GREENSBORO ST STE C2 CARRBORO NC 27510 -1833 COVERAGES DED LIMITS PREMIUM Addl Insured - Managers or Lessors of Premises Included $21.88 Addl Insured - Controlling Interest Included 21.88 Businessowners Addl Insured Endorsement Included 21.88 TERRORISM - CERTIFIED ACTS INCLUDED SEE FORM(S) 59350 (01 -15), 54309 (07 -08), 59390 (01 -15) ADDITIONAL FORMS FOR THIS LOCATION: BP0007 (01 -90) IL0162 (04 -90) 54094 (03 -07) 54238 (12 -01) 54244 (05 -07) 54309 (07 -08) 54605 (11 -88) 54661 (08 -91) 59350 (01-15) 64747 (04 -15) LOC 001 BLDG 0001 COVERAGES DED LIMITS PREMIUM Business Personal Property - REPL. COST $500 $28,930 $111.11 Adjusted Value Factor 0.0080 Business Income And Extra Expense 12 Months Included Limitation of Coverage for Fungi, Mold, See Form Included Dry Rot, Wet Rot and Bacteria Equipment Breakdown 500 See Form 3.78 ADDITIONAL FORMS FOR THIS BUILDING: 54841 (10 -09) 54701 (08 -94) 54703 (08 -94) 54619 (08 -94) BP1203 (06 -89) SECURED INTERESTED PARTIES: See Attached Schedule DocuSign Envelo pe ID: DDOCFB B6 22- 8EDD- 4B57- ACF6- 9C98BO78AA95 t © uto— ow1wrs Page 3 AGENCY COPY (MUTUAL) INSURANCE COMPANY 6101 ANACAPRI BLVD., LANSING, MI 48917 -3999 AGENCY HIGH & RUBISH INSURANCE AGENCY 15- 0936 -00 MKT TERR 050 (919) 913 -1144 INSURED ORANGE COUNTY LITERACY COUNCIL INC ADDRESS 200 N GREENSBORO ST STE C2 CARRBORO NC 27510 -1849 Policy change: Effective Date of Change MO DY YR Cross out old information and write in the changes. 54643 (01 -90) Issued 10 -05 -2017 BUSINESSOWNERS POLICY DECLARATIONS Renewal Effective 11 -20 -2017 POLICY NUMBER 91- 159 - 372 -01 Company Use 35 -57 -NC -9311 Company POLICY TERM Bill 12:01 a.m. 12:01 a.m. to 11 -20 -2017 11 -20 -2018 RATING INFORMATION Occupancy: Office Not Otherwise Classified Tenant Occupied Class Code: 65121 Const: Non - Combustible, Sprinklered Program: Office Protection Class: 03 Liability Rate Number: 00 Territory: 010 Orange County Burglary Rate Group: 00 Construction Year: 1965 TERM TOTAL ANNUAL PREMIUM 5230.09 MINIMUM PREMIUM EQUIPMENT BREAKDOWN ADJUSTMENT $31.22 MINIMUM PREMIUM ADJUSTMENT $178.81 TOTAL POLICY PREMIUM $440.12 PAID IN FULL DISCOUNT -22.56 TOTAL POLICY PREMIUM IF PAID IN FULL $417.56 The Paid In Full Discount does not apply to fixed fees or statutory charges. Paid In Full Discount is available. Discount Applies for Affiliation with: CHAPEL HILL - CARRBORO CHAMBER OF COMMER A 2% Cumulative Multi-Policy Discount applies. Supporting policies are marked with an (X): Comm Umb( ) Comm Auto( ) WC(X) Life( ) Personal( ) Farm( ). Billing Type: Company Bill - Full Pay Account 009652074 Merit Rating Discount of 5% Applies 440120190 1000 DocuSign Envelope ID: DDOCFB62- 8EDD- 4B57- ACF6- 9C98BO78AA95 Page 4 54643 (01 -90) AUTO- OWNERS (MUTUAL) INS. CO. AGENCY COPY Issued 10 -05 -2017 AGENCY HIGH & RUBISH INSURANCE AGENCY Company POLICY NUMBER 91- 159- 372 -01 15- 0936 -00 MKT TERR 050 Bill Company Use 35 -57 -NC -9311 INSURED ORANGE COUNTY LITERACY COUNCIL INC Term 11 -20 -2017 to 11 -20 -2018 SECURED INTERESTED PARTIES AND /OR ADDITIONAL INTERESTED PARTIES Loc 001 Bldg 0001 OCE FINANCIAL SERVICES Loan: 200- 5028065 -000 5600 BROKEN SOUND BLVD NW BOCA RATON FL 33487 -3515 Interest: Loss Payable LEASED COPIER Form: BP1203 (06 -89) PARAGRAPH A SIP -ID: FL147731 Agency Code 15- 0936 -00 Policy Number 91 -159- 372 -01 54701 (8 -94) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - CONTROLLING INTEREST This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SCHEDULE* Name of Person or Organization: ORANGE COUNTY ATTN RISK MANAGER PO BOX 8181 HILLSBOROUGH, NC 27278 The following is added to Paragraph C. WHO IS AN INSURED in the Businessowners Liability Coverage Form: 4. The person or organization shown in the Schedule or in the Declarations, but only for their liability arising out of: a. Their financial control of you; or b. Premises they own, maintain or control while you lease or occupy those premises. This insurance does not apply to structural alterations, new construction and demolition operations performed by or for that person or organization. The limit of liability for the additional insured are those specified in the written contract or agreement between the Insured and the Person or Organization named above, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. *Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declara- tions. Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 1985 Agency Code 15- 0936 -00 Policy Number 91 -159- 372 -01 54703 (8 -94) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: BUSINESSOWNERS POLICY SCHEDULE* Designation of Premises (Part Leased to You): 200 N GREENSBORO ST STE C2 Name of Person or Organization (Additional Insured): CARR MILL MALL LIMITED PARTNERSHIP PO BOX 673 CARRBORO, NC 27510 Additional Premium: A. The following is added to Paragraph C. WHO IS AN INSURED in the Businessowners Liability Coverage Form: 4. The person or organization shown in the Schedule is also an insured, but only with respect to liability aris- ing out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule. B. The following exclusions are added: This insurance does not apply to: 1. Any "occurrence" that takes place after you cease to be a tenant in the premises described in the Sched- ule. 2. Structural alterations, new construction or demolition operations performed by or for the person or organi- zation designated in the Schedule. The limits of insurance for the additional insured are those specified in the written contract or agreement between the insured and the person or organization named above, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. * Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declara- tions. Includes copyrighted material of Insurance Services Office, Inc., with its permission Copyright, Insurance Services Office, Inc., 1984, 1985 Agency Code 15- 0936 -00 Policy Number 91- 159 - 372 -01 54619 (8 -94) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESSOWNERS ADDITIONAL INSURED ENDORSEMENT THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE BUSINESSOWNERS LIABILITY COVERAGE FORM. SCHEDULE* Name of Person or Organization: ORANGE COUNTY PARTNERSHIP FOR YOUNG CHILDREN 120 PROVIDENCE RD, STE 101, CHAPEL HILL NC 27514 Address: 200 N GREENSBORO ST STE C2 CARRBORO NC 27510 Interest: ADDL INSD It is agreed: WHO IS INSURED is amended as follows: The person or organization shown above is an insured but only with respect to their liability: 1. to which this insurance applies; and 2. which arises out of the specific interest described above. The limits of insurance for the additional insured are those specified in the written contract or agreement between the Insured and the person or organization named above, not to exceed the limits provided in this policy. These limits are inclusive of and not in addition to the limits of insurance shown in the Declarations. All other terms and conditions of the policy apply. *If the information is not shown in the Schedule, it will be shown in the Declarations.