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HomeMy WebLinkAbout2018-291-E DSS - Dispute Settlement Center servicesDocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Contract #68 -1017 The Dispute Settlement Center, Inc. Contract # 68 -1017 Fiscal Year Begins Jul y 1,.2018 Ends .tune 30,_2019 This contract is hereby entered into by and between the Orange County Department of Social Services (the "County ") and The Dispute Settlement Center, Inc. (the "Contractor ") (referred to collectively as the "Parties "). The Contractor's federal tax identification number or Social Security Number is 56- 1216584 1. Contract Documents: This Contract consists of the following documents (1) This contract (2) The General Terms and Conditions (Attachment A) (3) The Scope of Work, description of services, and rate (Attachment S) (4) Federal Certification Regarding Drug -Free Workplace & Certification Regarding Nondiscrimination (Attachment C) (5) Conflict of Interest (Attachment D) (6) No Overdue Taxes (Attachment E) (7) IRS Federal Tax. Exempt Letter or 501(c)(3) (Attachment K) (9) State and Local Certifications (Attachment N1) (10) Non- Discrimination, Clean Air Act, Clean Water Act (Attachment N) (11) Outcomes and Reporting (Attachment O) (12) Contract Determination Questionnaire These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence Among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents and this Agreement, the terms of this Agreement shall control. In the event of a conflict between or among the terms of the Contract Documents, then the Contract Documents with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Section 1, above, with Attachment A having precedence over Attachment B and so forth. If there are multiple Contract Amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective on July 1, 2018 and shall terminate on June 30, 2019. This contract must be twelve months or less. 4. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B, Scope of Work, and shall meet the requirements set forth in Attachment O, Outcomes and Reporting. 5. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid by the County to the Contractor under this contract shall not exceed $5,000. This amount consists of $5,000 in Federal (CFDA # }, State and County funds, $0 (source of other funds if applicable). [X] a. There are no matching requirements from the Contractor. [ ] b. The Contractor's matching requirement is $ , which shall consist of [ ] In -kind [ ] Cash [ ] Cash and In -kind [ ] Cash and/or In -kind The contributions from the Contractor shall be sourced from non - federal funds. The total contract amount including any Contractor match shall not exceed $5,000. 6. Reporting Requirements: Contractor shall comply with audit requirements as described in N.C.G.S. § 143C -6 -22 & 23 and OMB Circular A -133 and shall disclose all information required by 42 USG 455.104, or 42 USC 455.105, or 42 USC 455.106. Contract - General (07110) Page 1 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE CpntSaCt #6$ -1017 The Dispute Settlement Center, Inc.. 7. Payment Provisions: Payment shall be made in accordance with the Contract Documents as described in the Scope of Work, Attachment B. 8. Contract Administrators: All notices permitted or required to be given by one Party to the other and all questions about the contract from one Party to the other shall be addressed and delivered to the other Party's Contract Administrator. The name, post office address, street address, telephone number, fax number, and email address ofthe Parties' respective initial Contract Administrators are set out below. Either Party may change the name, post office address, street address, telephone number, fax number, or email address of its Contract Administrator by giving timely written notice to the other Party. For the County: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Sharron Hinton, Community Services Manager Sharron Hinton, Community Services Manager Grange County Department of Social Services Orange County Department of Social Services P.O. Box 8181 113 Mayo Street Hillsborough, NC 27278 Hillsborough, NC 27278 (919) 245 -2840 shinton co.oran e.nc.us Program Contact: Robert Gilmore, Work First Manager Orange County Department of Social Services P.Q. Box 8181 300 West Tryon Street Hillsborough, NC 27278 (919) 245 -2847 IF DELIVERED BY US POSTAL SERVICE Frances Henderson The Dispute Settlement Center, Inc. 302 West Weaver Street Carrboro, NC 27510 (919) 929 -8800 For the Contractor: IF DELIVERED BY ANY OTHER MEANS Frances Henderson The Dispute Settlement Center, Inc. 302 West Weaver Street Carrboro, NC 27514 9. No Assignment or Sub-Contract: Contractor shall not sub - contract out any of the services provided for in this Agreement or make any assignment of this Agreement (including rights to payments) without the prior written Consent of the County as specified more fully in Attachment A, General Terms and Conditions. 10. Supplementation of Expenditure of Public Funds: The Contractor assures that funds received pursuant to this contract shall be used only to supplement, not to supplant, the total amount of federal, state and local public funds that the Contractor otherwise expends for contract services and related programs. Funds received under this contract shall be used to provide additional public funding for such services; the funds shall not be used to reduce the Contractor's total expenditure of other public funds for such services. Contract - General (07 /10) Page 2 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Contract #68 -1017 The Dispute Settlement Center, Inc. 11. Disbursements. As a condition of this contract, the Contractor acknowledges and agrees to make disbursements in accordance with the following requirements: a. Implement adequate internal controls over disbursements; b. Pre -audit all vouchers presented for payment to determine: i. Validity and accuracy of payment ii. Payment due date iii. Adequacy of documentation supporting payment iv. Legality of disbursement c. Assure adequate control of signature stamps /plates; d. Assure adequate control of negotiable instruments; and e. Implement procedures to insure that account balance is solvent and reconcile the account monthly. 12. Outsourcing to Other Countries: The Contractor certifies that it has identified to the County all jobs related to the contract that have been outsourced to other countries, if any. The Contractor further agrees that it will not outsource any such jobs during the term of this contract without providing notice to the County. 13. Federal Certifications: Individuals and Organizations receiving federal funds must ensure compliance with certain certifications required by federal laws and regulations. The contractor is hereby complying with Certifications regarding Nondiscrimination, Drug -Free Workplace Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and certifications are to be signed by the contractor's authorized representative. 14. Relationship of the Parties: Contractor is an independent contractor of the County. Contractor represents that it has or will secure, at its own expense, all personnel required in performing the services under this Agreement, Such personnel shall not be employees of or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized or permitted under state and local law to perform such services. It is further agreed by Contractor that it shall obey all State and Federal statutes, miles and regulations which are applicable to provisions of the services called for herein, Neither Contractor nor any employee of the Contractor shall be deemed an officer, employee or agent of the County. 15. Termination: This Agreement may be terminated as specified in Attachment A, General Terms And Conditions. 16. Insurance Requirements: Contractor shall obtain, at its sole expense, all insurance as required in Attachment A, General Terms And Conditions. 17. Indemnification: Contractor 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 Contractor in accordance with Attachment A, General Terms And Conditions. It is the intent of this Section that Contractor indemnify County to the full extent permitted by law, 18. Entire Agreement. The parties have read this Agreement, including the Contract Documents, and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties. 19. Interpretation: When the context in which words are used in this Agreement indicates that such is the intent, words shall in the singular number shall include the plural and vice versa. The masculine gender shall include the feminine and neuter. IN WITNESS WHEREOF, the County and the Contractor have been first duly authorized, have executed and entered into this Agreement as of the day and year first above written. Contract- General (07/ 10) Page 3 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE DcuSigned by - nTmT= —MENT CENTER, INC. V �Urt �t,5 hJA,� r r56VL, 13'Q CO3ad @2C124C,1 Signature Frances Henderson Printed Name ORANGE COUNTY cuSigned by: 1�6'0 Rm�t.lrsL" 37994@755E477... Bonnie tiammerSOey, county Manager Contract 468 -1017 The Dispute Settlement Center, Inc. 7/13/2018 Date Executive Director Title 7/16/2018 Date Contract - General (07/10) Page 4 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ATTACHMEENT A GENERAL TERMS AND CONDITIONS Orange County Department of Social Services Relationships of the Parties Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees. The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the County. Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible for the performance of all of its subcontractors. Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority, the County may: (a) Forward the Contractor's payment check(s) directly to any person or entity designated by the Contractor, or (b) Include any person or entity designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all contract obligations. Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity, other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental beneficiary only. Indemnity and Insurance Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the performance of this contract. Insurance: During the term ofthe contract, the Contractor at its sole cost and expense shall provide commercial insurance of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the Contractor shall provide and maintain the following coverage and limits: (a) Worker's Compensation - The contractor shall provide and maintain Worker's Compensation Insurance as required by the laws of North Carolina, as well as employer's liability coverage with minimum limits of $500,000.00, covering all of Contractor's employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall require the subcontractor to provide the same coverage for any of his employees engaged in any work under the contract. (b) Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in the minimum . amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of Iiability.) (c) Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured /under insured motorist coverage; and a limit of $25,000.00 for medical payment coverage. The Contractor shall provide this insurance for all automobiles that are: (a) owned by the Contractor and used in the performance of this contract; (b) hired by the Contractor and used in the performance of this contract; and (c) Owned by Contractor's employees and used in performance of this contract ( "non- owned vehicle insurance "). Non -owned General Terms and Conditions — (06/16) Pagel of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE vehicle insurance protects employers when employees use their personal vehicles for work purposes. Non -owned vehicle insurance supplements, but does not replace, the car - owner's liability insurance. The Contractor is not required to provide and maintain automobile liability insurance on any vehicle — owned, hired, or non -owned -- unless the vehicle is used in the performance of this contract. (d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs. (e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are not limits, or caps, on the Contractor's liability or obligations under this contract. (f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be granted. (g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating that it is self - insured and that its self- insurance provides protection that is equal to or greater than the coverage and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be granted. (h) Providing and maintaining the types and amounts of insurance or self- insurance specified in this paragraph is a material obligation of the Contractor and is of the essence of this contract. (i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such insurance shall meet all laws of the State of North Carolina. (j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all lawful requirements of its insurer. (k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph. (1) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting certificates of insurance to the County before the Contractor begins work under this contract. Transportation of Clients by Contractor: The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2 -36 of the North Carolina Utilities Commission. Default and Termination Termination Without Cause: The County may terminate this contract without cause by giving 30 days written notice to the Contractor. Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for damages sustained by the County by virtue of the Contractor's breach of this agreement, and the County may withhold any payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this contract. Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the Contractor and attached to the contract. Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this purpose to the County. Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event or act of Clod. Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties contained herein shall survive the contract expiration or termination date unless specifically provided General Terms and Conditions — (06116) Page 2 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE otherwise herein, or unless superseded by applicable Federal or State statutes of limitation. Intellectual Property Rights Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables. Federal Intellectual Property Bankruptcy Protection .Act: The Parties agree that the County shall be entitled to all rights and benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100 -506, codified at 11 U.S.C. 365 (n) and any amendments thereto. Compliance with Applicable Laws Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having jurisdiction and/or authority. 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. Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S. Department of Health and Human Services. (HHS) policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited also on the basis of religion or political beliefs. Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment opportunity. Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability Act of 1996, P.L. 104 -91, as amended ( "HIPAA "), or its implementing regulations, it will comply with the HIPAA requirements and will execute such agreements and practices as the County may require to ensure compliance. (a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all applicable federal, state and local laws, regulations, and rules. (b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of Social Services Contract Administrator within twenty -four (24) hours after the breach is first discovered, provided that the Contractor shall report a breach involving Social Security Administration data or Internal Revenue Service Data within one (1) hour after the breach is first discovered. (c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation or rule requires the Contractor give written notice of a security breach to affected persons, the Contract shall bear the cost of the notice. Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104) Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors are encouraged to review Executive Order 24 and G.S. Sec. 133 -32. Confidentiality Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing, processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information except as otherwise provided in this contract. Oversight Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or grants entered into by State agencies or political subdivisions in accordance with General Statute 147 -64.7. Additionally, as the State funding authority, the Department of Health and Human 'Services shall have access to persons and records as a result of all contracts or grants entered into by State agencies or political subdivisions. General Terms and Conditions — (06/16) Page 3 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record retention may be longer than five years since records must be retained for a period of three years following submission of the final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this Contract has been started before expiration of the five -year retention period described above, the records must be retained until completion of the action and resolution of all issues which arise from it, or until the end of the regular five -year period described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years. Warranties and Certifications Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract ( "product" includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition function, calculation, or sequencing will support a four digit year format and will provide accurate date /time data and leap year calculations. This warranty shall survive the termination or expiration of this contract. Certification Regarding Collection of Taxes: G.S. 143- 59.1 bars the Secretary of Administration from entering into contracts with vendors that meet one of the conditions of G.S. 105- 164.8(b) and yet refuse to collect use taxes on sales of tangible personal property to purchasers in North Carolina. The conditions include. (a) maintenance of a retail establishment or offices (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c) systematic exploitation of the market by media- assisted, media - facilitated, or media - solicited means. The Contractor certifies that it and all of its affiliates (if any) collect all required taxes. E- Verify Pursuant to G. S. 143 -48.5, the undersigned hereby certifies that the Contractor named below, and the Contractor's subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes. Miscellaneous Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits, solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for such purpose, that the exclusive venue for any legal proceedings shall be Orange County, North Carolina. The place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be Orange County, North Carolina, where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement shall be determined. Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written forth and executed by duly authorized representatives of the County and the Contractor. Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in full force and effect. Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the agreement and should not be used to construe the meaning thereof. Time of the Essence: Time is of the essence in the performance of this contract. Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract without the prior written approval of the County. The term "key personnel" includes any and all persons identified as such in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the parties. Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or damage to, such property. At the termination of this contract, the Contractor shall contact the County for General Terms and Conditions — (06/16) Page 4 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE instructions as to the disposition of such property and shall comply with these instructions. Travel Expenses: Reimbursement, if provided in this Agreement, to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in the performance of this contract shall not exceed the rates established in County policy. Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105- 164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered in their reimbursement reports. Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising. Change County Lining Wage: Orange County is committed to providing its employees with a living wage and encourages agencies to which it provides funding to pursue the same goal. The County's living wage hourly standard, as adopted by the Orange County Board of County Commissioners annually, can be found in the Orange County Budget Ordinance. To the extent possible, Orange County recommends that the Contractor and all subcontractors provide a living wage, as defined in this section, to their employees. 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. General Terms and Conditions — (06/16) Page 5 of 5 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ATTACBMENT B SCOPE OF WORK Grange County Department of Social Services Federal Tax Id. or SSN 56- 1216584 Contract # 68 -1017 A. CONTRACTOR INFORMATION 1. Contractor Agency Name: The Dispute Settlement Center Inc 2. If derent from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email: 3. Name of Program (s): Conflict Resolution 4. Status: ( ) Public ( X ) Private, Not for Profit ( ) Private, For Profit 5. Contractor's Financial Reporting Year July 1, 2018 through June 30, 2019 B. Explanation of Services to be provided and to whom (include SIS Service Code): The Contractor will assist the Count, in meeting goals of family safe1y and self-sufficiency b providing Job Readiness /Conflict Resolution classes and Team Building workshops to Work First participants (SIS Code 547 Communication/Conflict Resolution classes to families involved in Child Welfare Services and Communication/Conflict Resolution/Team Building training and training curriculum and materials to Department of Social Services staff. The Contractor is required to meet all goals and outcomes listed in Attachment N. C. Rate per unit of Service (define the unit): 1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) 2. Negotiated County Rate. 75A0/hour D. Number of units to be provided: E. Details of Billing process and Time Frames; The Counjy will reimburse the Contractor for services described in this contract up to the budgetary limits of the contract allotment. The County will reimburse the Contractor at a rate of $75.00 /hour for approved services provided. For reimbursement the Contractor must submit an original and two copies of an invoice by the fifth of the month for the preceding month's ex enditures to the designated Counly Administrators. The Counjy will reimburse the Contractor monthl u on recei t of a com late and correcfl filed Wort. F. Area to be served/Delivery site(s): _Orange County Contract -Scope of Work (06/04) Page Iof 2 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE DocuSigned by: N (16 �6 . DAE1E196A83B455... Nancy Coston, Social 7/13/2018 (Date Submitted) DocuSigned by: r s kAAjW56V . 35CO3aaB2C124C8 ... Services Director (Signature of Contractor) 7/13/2018 (Date Submitted) Contract -Scope of Work (06/04) Page 2of 2 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ATTACHMENT C CERTIFICATION REGARDING DRUG -FREE WORKPLACE REQUIREMENTS AND CERTIFICATION REGARDING NONDISCRIMINATION Orange County Department of Social Services I. By execution of this Agreement the Contractor certifies that it will provide a drug -free workplace by: A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; B. Establishing a drug -free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor's policy of maintaining a drug -free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4) The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will: (1) Abide by the terms of the statement; and (2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under subparagraph (D)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and Making a good faith effort to continue to maintain a drug -free workplace through implementation of paragraphs (A), (B), (C), (D), (E), and (F). Federal Certification Drug -Free Workplace & Nondiscrimination rev. 06-2015 Pagel of 2 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE H. The site(s) for the performance of work done in connection with the specific agreement are listed below: 1. 2. (Street address) (City, county, state, zip code) (Street address) (City, county, state, zip code) Contractor will inform the County of any additional sites for performance of work under this agreement.. False certification or violation of the certification shall be grounds for suspension of payment, suspension or termination of grants, or government -wide Federal suspension or debarment 45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86,620. CERTIFICATION REGARDING NONDISCRUvffNATION The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IBC of the Education Amendments of 1972, as amended (20 U.S.C. § §1681 -1683, and 1.685- 1686), which prohibits discrimination on the basis of sex, (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. § §6101 - 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § §3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this Agreement. UcuSigned by: r s �kw�.aCc- 565, 1'o Ca3ad @2C124CS... Signature Executive Director Title Dispute Settlement Center, Inc. 7/13/2018 Agency /Organization Late (Certification signature should be same as Contract signature.) Federal Certification - Drug-Free Workplace & Nondiscrimination rev. 06 -2015 Page 2 of 2 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE OF 08AN08 COUMT7 011 pute Settlement Center, Inc, Conflict of lntetest Pollcy -A, agency offters, directors,- employees, and agents are vb €ig d 0 ahvays act in the Best interest of to organisation. This obligation requires .that any ?facer, ,director, empivyee, or agent, in the performance of Agencyr duties, seek only the furtherance oft�e Agency nii$sion. 3. The officers, directors, employees, c�r agents of the Agency shoWd neither svlic-it nor accept gratuitles, favors, or anything of monemry value from- corrziractorsjvendars_ This is not intended to preclude bona -fide Agency fund - raising activcties. - C, No officer, director, employee Dr- agent of the Agency shall participate In the seiectjon, award, or adminknatiori of a purchase or + o rtract with vendor- where, to his knowledge; any of the following has a financial Interest in that purchase or contract. 1. the off ter, director, employee, ar agent; 2_ any member of their immediate family; 3. their partner, 4. are organization in which any of the above is an officer, Jimctor, or employee; S. a person or organization velth whom an y of the above Inch duals is negotiating 6r has eny"arrerrgement concerting pro sp I;tive employment. b. Disd=ure —Any possible conflfrt of interest snail be disclosed by the person or ,persons concerned. E. 'Board Ammon — Wheri a conflict of httere5t: is relevant to a matter requiring action by the Board, the interested persons) shall call it to the atterrtion'af the Board ar d said parson(s) shall not -vote can Vie matter. In addition, the persoh(s) shall not part €cipefe in the final delibdration•or decision regarding the matter tinder consideration and shall leave the room dLirir the vote ofthe Board. When there is doubt. as-to whether a conflict exists, the marte'r rhait be resolved by vote of the Board, excludingthe person(s) concerning whose situation the doubt has arlsen_ F. Record of Conflict — The offlcial minutes of the Board shall reflect that the conflict-of- interest Was disclosed and the interested pe'rson(sl was (were) present duringthe final discu-ssigP or vote and did not vote on the rnatrer. Adopted by the Displlte Settlement Center, Inc. Board of Directors; 10/27104 (Mart Epstein) Sworn to and subscribed ha =oremeor the day -vfthe date- ofsald certification. (Frances Henderson) Sworn to and subscrlbed .before ,me an the day of the date of said certrflcat�on., ti +` "x�� „gee��rur;�•ar, q{ti 1 Ft 392 We t Weaves S reet, C,,,bvro,'N -C- 27510 s (9.19) 929 -8800U w &�-- (919) 542 -6431 w —Aisput --Tff t utg DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE •y NoRTffCARoLiNAAuPARTAaAT ofJm JU,Yxxc ,EAny►I)ELL QUf.tYCYPREter -[ON CONFLICT OF INTEREST POLICY STA TEAENT This doemuent is only required frorn not for profit organizations ONLY1 In accordance lvtth the 1' C.G.S. 143C- 6- 21 -23, every Grantee shall, file with the State agencylGrantor a copy of that Grantee's pokey addressing conflicts of interest that may arise involWng the Grantee's management employees and the members of its hoard of directors or other governing body. The policy shall address situations in which any of these individuals may directly or indirectb, relit, except as the Grantee's employees or members of its board or other gaverning body, from the Grantee's disbursing of State farnds and shall inchtde actions to be ttaLm by the Grantee or the indMdual, or Final to avoid conflicts of interest and the appearance of impropriety. ?lie policy shall be filed before the disbursing State department or agency mury disburse the grantfwids. The Grantee shall swbmir the DJJDP C'anflict ofbnterest Policy ,Statement (Forma DJJDP 13 001 ) when applidng. J``or funding, Accordingly, no rnernber or board member of the private, uonprofit entity may receive directly or indirectly, any funds received from the State of North Carolina, except for duly, authGr-iznd staff compensation and benefits, and reimbursement for expeuses actually incurred in connection with the private, nonprofit entity's business and in accordance with final approved grant agreements. WHEREAS, (Nante 'of entity) Dispute Settlement Center desires to require its Board of Directors and managirug employees to avoid coaailicts of interest or the appearance of impropriety in the disbursement of State Inds;. THEREFORE, no member of the Board of Directors or staff members of said private, nonprofit entity shall participate in the solicitation, tegotiation, formation, award, arbitration, modification, or settlement of any contract or grant funded in whale or input by State farads or of any dispute arising under such contract or grant when the director or staff members stands to benefit, either direotly or indirectly, from such grant or contract; PROVIDED, no nimaber of the Board of Directors or staff members shall be deemed to benefit directly or indirectly from any contract or grant funded in whole or in part by State feuds if he/she receives only the salary or stipend due to him/her in the normal course of employment witb, or service to, said private, nonprofit entity. FURTHERMORE, said private, nonprofit entity has written conflict of interest policies and reporting procedures applicable to board members, staff rnembers and volunteers who have any interest or any authority regarding the resources of the private, nonprofit entity. These policies have been communicated to board members, staffxnembers and volunteers arad full disclosure has been provided for any possible appearance of conflict of interest tat may exist. Form DJJDP 13 0{}1 Conflict of lbtetwL Policy Farm. Form mrture last rovised W201 1 North Carolina Departmont of Juvenile Justice and Delinyueecyhovcntion Page l of 3 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ,� N4.l mCtROL111NADEPARTi1fENT 0FJUVEAUE JI1sT2'CR lND D.E.FINQ UENCT PREPENTioAr CONFLICT D.F L1 TEREST POLICY STATEMENT The following serve-s to idendlfy and document any personal interest staff members, officers, and members of the Board of Directors may have. This document is also to be used to disclose any transacfionsr that may result In personal, frmaacr'44 professional.' andfor political gain at the expense of the NC Depanment of 1uwnHe Justice and DelinquenU Prevention. The statement requires that aft personal relationships that may inappropriately influence (bias) ra=tions be Disclosed. Reladonshrps, be it personrclr , financ* professional andlor political are required to be 4veloserd to tills Department; Conflict means a conflict or the appearance of a conflict between the private interests and official responsibilities of aperson in a pdsidon of trust. Persons in a position of trust include! staff memhem or the Board of Director L Private, nonprofit entities shall make M disdosun by notice in writing to the frill Governing Board/Comcit all conflicts of interest, if "yes" is answered to any of the following: (Check all that apply) FormDtJDP 13 001 Conflict of Interest PoliryForm Form straature last revised 04/2011 Alorih C4roliz s Deparhnent of Juvenile JUWC -- and Vclinqumay Prevention Page 2 of 3 YES NO 1. A Board member is related to a staff member. x 2. A staff ju bw in a supervisory capacity is related to another staff X member wham helsbe s ervises.. 3. A staf'finembcr is related to another staf£zr!ember. x 4. A bovid member or staff member has or may have prrrscirnai, financial, professional, andlor political gain at the expense or x benefit of1he private, no fit entity. 5. There is a business entity in which a star, board, or firmly member pmticrpates that may be viewed as having direct or indirect X influence over the private, nonprofit anti 's biisirless, 6. A std board, or faintly inember may be viewed as having direct or indirect financial gain from personal or business x investmeatslinterest in real property -held by that staff, board, or family member. 7. A staff orboard member received honorarimn or other compensation outside of the scope of employment/operations with x the rivate, norrpzofit enti that creates or ears to create Bias. $. A staff or board member secured employment with a competitor or other similar private, non root anti . x 9. Ongoing, paid consulting work outside of the staff member's current employment or board member's with your private, x norit3i'4ftt entity exists. FormDtJDP 13 001 Conflict of Interest PoliryForm Form straature last revised 04/2011 Alorih C4roliz s Deparhnent of Juvenile JUWC -- and Vclinqumay Prevention Page 2 of 3 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ra3Wiv 4 i... .i o.R TR /C+ryAi?OLRV�A�rD}.FrPARR T�ME+p2`t�T�FJ�F.,�Ui�/ UEP CONFLICT O MTEREST POLIff STATE LENT 1. If you have answered, "yes' to any of the aforementioned items you are requiTed to provide details for any transaction that exists. 2. If this statement fails to list a transaction that may exist that is non financial iu nature, please attach details. Details mwl include at least the name, and, address, or persons izvolved, and a description of the relationship and the transaction. Note-, failure to disclose any conflict of interest transaction that exists or is potential within your private, nonprofit eutity nmy result iu the Department's cessation of any further State fonds. County:., Oran e Agency's Name- (1.cg€ l Applicant) Dis pute Settlement Center, Inc. Federal Tax ® #: F561216584 Private, Nonprofit Entity Name: Executive Director's Print Nance: Sigz7, _Dispute Settlement Center, Inc. 1~ lances Henderson - Board Chair's print Matt Name: Sign Swann to and subscribed before xae on the 17ay of the date of said certifical:ion ra,;,uie jVj,nr, �NXBER rllllirl, Il9, Y4l1���� Fum D1JDP 13 001 Confl ict of interest Policy FOTM Form strumue last revised OV2011 North Carolina Department of Juvenile Justice and Do iuquency Prevention (Date ofSignamm) Page 3 of 3 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE OF ORANcFF COUNTY TO: Juvenile Crime Prevention Council— Orange NC -DPS Juvenile Justice Wtificatio t We certify that the Dispute Settlement Center, Inc. has no overdue tax debts, as di ifinecl by N.C.G.S. 105- 243.1, at the federal, state, or local level. We further understand that any person who makes a false statement in violation of N.C.G.S. 143- 6.�(b2) is-guilty of a criminal offense punishable as provided by N-C.G.S. 143- 34(b). Sworn) Staiternent Frances Henderson, tieing duly sworn, says that she is Executive Director of.the Dispute Settlement Center, !n-c, in the State of )North Carolina; and that the foregoing certification is true, accurate, and complete to the best of her knowledge and mras made and subscribed to by her- She also acknowledges and understands that any misuse of State funds tivill be reported to the appropriate authorities for further motion. Frances Henterson, txecutive vlrecror iVatary Public rate riff {IF[[!rllrl7l,r S- lot'�. ! r ;'`rrr{rrrx�nrwrr�ti 2r. ."'wn.* 302 West Wezver Strret Czrrhom; N-C. 27510 . (919) 929 -8800 . fay— (919) 942 -£431 . ,vwwA spinesettlemeator9 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ATTACHMENT K 501(c)(3) and TAX EXEMPT STATUS Orange County Department of Social Services What is a Private Non Profit Agency? Answer: A private non profit is an organization that is incorporated under State law and whose purpose is not to make a profit, but rather to further a charitable, civic, religious, scientific, or other lawful purpose. The Secretary of State's office grants corporate status to organizations in North Carolina. What is a 501(c)(3) designation? Answer: When the agency becomes a state private non profit corporation, it can then apply for 501(c)(3) designation through the IRS. Once the IRS grants 501(c)(3) status, the organization is exempt from certain taxes and any donations to the charitable organization are tax deductible. Many individuals and organizations prefer to make donations to 501(c)(3) private non profits. Who can obtain a 501(c)(3) designation? Answer: Any organization or group can apply for 501(c)(3) status, provided their charter or mission focuses on the non profit's objective. Another option is to apply for a 509(a)(1) status which falls under the 501(c)(3) umbrella. Being a 509(a)(1) designates an organization as a tax -free public charity that receives most of its support from a governmental unit or from the general public. Becoming a 509(a)(1) provides public recognition of tax- exempt status, advance assurance to donors of deductibility of contributions, exemption from certain State and federal taxes, and non profit mailing privileges. Organizations that typically qualify are churches, educational institutions, hospitals, and governmental units. To learn more about non profits, visit www.irs.gov, or call the tax- exempt helpline at 877-829 - 4933. How does a Private Non Profit obtain Tax Exempt Status? A private non profit must apply to the IRS for tax exempt status. To qualify, applicants must complete and submit to the IRS Form 1023. Once federal tax exempt status is granted, the private non profit applies for State tax exempt status by completing Form CD -435 and submitting it to the N. C. Department of Revenue. Please attach proof of 501(c) (3) or IRS tax - exempt status to this page. DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Internal Revenue Service Date: December 13, 2004 DISPUTE SETTLEMENT CENTER INC 302 W.-WEAVER ST CARRbORD NC 27510 -5004 Dear Sir or Madam: Department of.the Treasury P. Q. Box 2508 Cincinnati, OH 45201 Person to Contact. Lois Parrott 31 -07342 Customer Service Specialist Toll Free Telephone Number., 8 :00 a.m. to 6:30 p.m. EST 877 - 829 -5500 Fax Number: 5'13 -263 -3756 Federal ldentiticatioh Whriber: 56- 1216584 This is in response to your request of December 13, 2004, regarding your organization's tax - exempt status. In June 1979 we issued a determination fetter that recognized your organization as exempt from ,federal income tax.-'Our records Indicate that your organization is currently exempt under section 501(c)(3) of the lhternal. Revenue Code. ©ur'records indicate thiat your organization is also classified as a public charity under. sections 509(a)(1) and 170(b)(1)(A )(vi) of the Internal Revenue Code. V Our records indicate that contributions to your organization are deductible under section 170 of the Code, and that,you are qualified. to receive tax deductible bequests, devises, transfers or gifts under section 2055; 2106 or 2522 'of the Internal Revenue Code. If yeti have any questions, please call us at the-telephone number shown in the heading of this letter. Sincerely, Janna K. Skufca, Director, TE /GE Customer Account Services DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ATTACHMENT M STATE AND LOCAL CERTIFICATION Contractor Certifications Required by North Carolina Law Orange County Department of Social Services Instructions The person who signs this document should read the text of the statutes listed below and consult with counsel and other knowledgeable persons before signing. • The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at: htt : / /www.nc a.state.nc.us/EnactedLe islation /Statutes /PDF[B Article /Cha ter 64 /Article 2. pd • The text of G.S. 105- 164.8(b) can be found online at: http:// www. ncga. state.ne.us/EnactedLegislation/ Statutesl PDF /BySectiorUChapter�1.05 /GS 105 - 164.8. df • The text of G.S. 143 -48.5 (S.L. 2013 -418, s. 2.(d)) can be found online at: http: / /www.ncpa state nc us/SessionsJ2013 /Bills /House /PDF /H786v6.pdf • The text of G.S. 143 -59.1 can be found online at: htt : / /www.nc a.state.nc.us/EnactedLe islation /Statutes /PDF /B Section/Cha ter 143 /GS 143 -59.1. df • The text of G.S. 143 -59.2 can be found online at: htt : / /www.nc a.state.nc.us /EnactedLe isiation/Statutes /PDFB Section/Cha ter 143/GS 143-59.2. pd • The text of G.S. 147- 33.95(g) (S.L. 2013 -418, s. 2. (e)) can be found online at: http• /Iwww ncaa state nc us/Sessions /2013 /Bills /House /PDF /H786v6.pdf • The text of Orange County Living Wage Contractor Policy which is attached to this document. Certifications (1) Pursuant to G.S. 143.48.5, the undersigned hereby certifies that the Contractor named below, and the Contractor's subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its employees through the federal E- Verify system." E- Verify System Link: www.uscis.gov Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina. General Statutes. However, local government is subject to and must comply with North {Carolina General Statute § 153A- 99.1., which states in part as follows: Counties Must Use &Verify. - Each county shall register and participate in E- Verify to verify the work authorization of new employees hired to work in the United States. (2) Pursuant to G.S. 143- 59.1(b), the undersigned hereby certifies that the Contractor named below is not an "ineligible Contractor" as set forth in G.S. 143- 59.1(a) because: (a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied under Article 5 of Contractor Certifications Required by North Carolina Law Pagel of 3 revised May 30, 2018 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Chapter 105 of the General Statutes on its sales delivered to North Carolina when the sales met one or more of the conditions of G.S. 105- 164.8(b); and (b) [check one of the following boxes] ❑ Neither the Contractor nor any of its affiliates has incorporated or reincorporated in a "tax haven country" as set forth in G.S. 143- 59.1(c) (2) after December 31, 2001; or The Contractor or one of its affiliates has incorporated or reincorporated in a "tax haven country" as set forth in G.S. 143- 59.1(c)(2) after December 31, 2001 but the United States is not the principal market for the public trading of the stock of the corporation incorporated in the tax haven country. (3) Pursuant to G.S. 143- 59.2(b), the undersigned hereby certifies that none of the Contractor's officers, directors, or owners (if the Contractor is an unincorporated business entity) has been convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid solicitation. (4) The undersigned hereby certifies further that: (a) He or she is a duly authorized representative of the Contractor named below; (b) He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of the Contractor; and (c) He or she understands that any person who knowingly submits a false certification in response to the requirements of G.S. 143- 59.1and -59.2 shall be guilty of a Class I felony. (5) Pursuant to the Orange County Living Wage Contractor's Policy: (a) The undersigned certifies that the Contractor pays the employees who perform services under this contract a living wage (in Orange County currently $14.25 per/hr.) Check here 0 if contractor pays employees performing under this contract a living wage. if Contractor does not pay employees a living wage, what is the wage that employees performing services under this contract paid Dispute Settlement Center, Inc. UocuSigned by: FrXKt0 kAAJWS K, 7/13/2018 — 35CG3A462C124C8... Wgnature or k omracror- s Authorized Agent Date Frances Henderson Executive Director oocusigned by: ractor's Authorized Agent Title �GGtt�W YaY'1AkW- Mediation Coordinator �17F78CB324E450... 61 w imuss Title ]enifer Yarnelle 7/13/2018 Printed Name of Witness Date The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and date this document immediately thereafter. Contractor Certifications Required by North Carolina Law Page 2 of 3 revised May 30, 2018 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Section I: General Government and Administration Policy 10.0: Living Wage Contractor Policy Reviewed by: County Attorney /County Manager Approved by: County Manager Original Effective hate: April 21, 2016 Revisions: Policy Statement It is the policy of Orange County to ensure its employees, and all individuals who provide services for Orange County, are paid a living wage. Purpose To encourage all vendors and contractors to pay a living wage to all employees who perform work pursuant to a contract with Orange County. Applicability Applies to all Orange County contracts and purchases. Policy 10.1 Living Wage 10.1.1 Orange County is committed to providing its employees with a living wage and encourages all contractors and vendors doing business with Orange County to pursue the same goal. Orange County's living wage is $14.25 per hour. To the extent possible, Orange County recommends that contractors and vendors seeking to do business with Orange County provide a living wage to their employees. 10.1.2 Prior to final execution of a contract with Orange County all contractors and vendors seeking to do business with Orange County shall submit to the County's representative a statement indicating whether those employees who will perform work on the Orange County contract are paid at least the living wage amount set out above. If such employees do not make at least the living wage amount set out above the contractor or vendor shall indicate in the statement the actual amount paid to such employees. For bid projects this statement should be submitted as part of the bid packet. This policy may be reviewed annually and updated as needed by the Manager's Office Contractor Certifications Required by North Carolina Law Page 3 of 3 revised May 30, 2018 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Contract #68 -1017 Dispute Settlement Center ATTACHMENT N Orange County Department of Social Services/Human Services CERTIFICATION REGARDING NONDISCRIMINATION, CLEAN AIR ACT, CLEAN WATER ACT Certification Regarding Nondiscrimination The Contractor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88 -352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. § §1681 -1683, and 1685 - 1686), which prohibits discrimination on the basis of sex; (c) Section 544 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. § §6101- 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92 -255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91 -616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. § §3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this Agreement. The Contractor must comply with Executive Order 11246, entitled "Equal Employment Opportunity," as amended by Executive Order 11375, and as supplemented by the Department of Labor Regulations (41 CFR Part 60): The Executive Order prohibits federal contractors and federally- assisted construction contractors and subcontractors who do over $10,000 in Government business in one year from discriminating in employment decisions on the basis of race, color, religion, sex, or national origin. The Executive Order also requires Government . contractors to take affirmative action to ensure that equal opportunity is provided in all aspects of their employment. Meanie 1 Access for LEP Individuals: The Contractor that participate in the SNAP must take reasonable steps to ensure that LEP persons have meaningful access to programs, services, and benefits. This includes the requirement to provide bilingual program information and certification materials and interpretation services to single language minorities in certain project areas. SNAP Contractors that do not provide meaningful access for LEP individuals risk violating prohibitions against discrimination based on National Origin in the Food and Nutrition Act of 2008, as amended, Title VI of the Civil Rights Act of 1964 (Title VI) and SNAP program regulations at 7 CFR 272A(b). They also risk noncompliance with the USDA policy guidance titled, "Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons ", published in 79 FR 70771 - 70784 (November 28, 2014). The Contractor should develop an implementing plan to address the language assistance needs of the LEP population served. This may include contracting for oral interpretation services, hiring bilingual staff, arranging telephone interpreters and/or language lines, coordinating community volunteers, translating vital documents, and providing written notice that language services are available in appropriate languages. Quality and accuracy of the language service is (Federal Certification -Non.- Discrimination, Clean Air, Clean Water) (01/2018)Page I of 4 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Contract # (Contractor) critical in order to avoid serious consequences to the LEP person and to the recipient. LEP needs should be considered in developing budgets and front line staff should understand how to obtain language assistance services. For additional assistance and information regarding LEP matters, please also visit http:llwww.Igligov-. Ensuring Equal Qpportuti ty Access for Persons with Disabilities: The Contractor must also ensure equal opportunity access for persons with disabilities. This includes ensuring that communications with applicants, participants, members of the public, and companions with disabilities are as effective as communications with people without disabilities. Contractors that do not provide persons with disabilities equal opportunity access to programs may risk violating prohibitions against disability discrimination in the Rehabilitation Act of 1978, the American with Disabilities Act (ADA) of 1990, as amended, and SNAP program regulations. DOJ published revised final regulations implementing Title 11 and Title al of the ADA on September 15, 2410. These regulations are codified at 28 CFR Part 35 "Nondiscrimination on the Basis of Disability in State and Local Government Services" and at 28 CFR Part 36 "Nondiscrimination on the Basis of Disability in Public Accommodations and Commercial Facilities ". In accordance with the implementing regulations, Contractors must provide auxiliary aids and services where necessary to ensure effective communication and equal opportunity access to program benefits for individuals with disabilities. The type of auxiliary aids and services required will vary, but a Contractor may not require an individual with a disability to bring another individual to interpret, and may rely on a person accompanying a disabled individual only in limited circumstances. When a Contractor communicates with applicants and beneficiaries by telephone, it must provide text telephone services (1TY) or have access to an equally effective electronic telecommunications system to communicate with individuals who are deaf, hard of hearing, or hearing impaired. Contractors must also ensure that interested persons, including persons with impaired vision or hearing, can obtain information as to the existence and location of accessible services, activities, and facilities. For more information, please visit the ADA website: http: / /www.ada.gov. IV. The Clean Air Act, Section 346; 42 U.S.C. §7401 et seq. (1974) a. No Federal agency may enter into any contract with any person who is convicted of any offense under section 113(c) for the procurement of goods, materials, and services to perform such contract at any facility at which the violation which gave rise to such conviction occurred if such facility is owned, leased, or supervised by such person. The prohibition in the preceding sentence shall continue until the Administrator certifies that the condition giving rise to such a conviction has been corrected. For convictions arising under section 113(c)(2), the condition giving rise to the conviction also shall be considered to include any substantive violation of this Act associated with the violation of 113(c)(2). The Administrator may extend this prohibition to other facilities owned or operated by the convicted person. b. The Administrator shall establish procedures to provide all Federal agencies with the notification necessary for the purposes of subsection (a). c. In order to implement the purposes and policy of this Act to protect and enhance the quality of the Nation's air, the President shall, not more than 180 days after enactment of the Clean Air Amendments of 1974 cause to be issued an order (1) requiring each Federal agency authorized to enter into contracts and each Federal agency which is empowered to extend Federal assistance by way of grant, loan, or contract to effectuate the purpose and policy of this Act in such contracting or assistance activities, and (2) (Federal Certification -Non- Discrimination, Clean Air, Clean Water) {0112018 }Page 2 of 4 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE Contract # (Contractor) setting forth procedures, sanctions, penalties, and such other provisions, as the President determines necessary to carry out such requirement. d. The President may exempt any contract, loan, or grant from all or part of the provisions of this section where he determines such exemption is necessary in the paramount interest of the United States and he shall notify the Congress of such exemption. e. The President shall annually report to the Congress on measures taken toward implementing the purpose and intent of this section, including but not limited to the progress and problems associated with implementation of this section. [42 U.S.C. 76061 V. The Clean Water Act; 33 U.S.C. §1251 et seq. (1972) a. No Federal agency may enter into any contract with any person who has been convicted of any offense under Section 309(c) of this Act for the procurement of goods, materials, and services if such contract is to be performed at any facility at which the violation which gave rise to such conviction occurred, and if such facility is owned, leased, or supervised by such person. The prohibition in preceding sentence shall continue until the Administrator certifies that the condition giving rise to such conviction has been corrected. b. The Administrator shall establish procedures to provide all Federal agencies with the notification necessary for the purposes of subsection (a) of this section. c. In order to implement the purposes and policy of this Act to protect and enhance the quality of the Nation's water, the President shall, not more than 180 days after the enactment of this Act, cause to be issued an order: (i) requiring each Federal agency authorized to enter into contracts and each Federal agency which is empowered to extend Federal assistance by way of grant, loan, or contract to effectuate the purpose and policy of this Act in such contracting or assistance activities, and (ii) setting forth procedures, sanctions, penalties, and such other provisions, as the President determines necessary to carry out such requirement. d. The President may exempt any contract, loan, or grant from all or part of the provisions of this section where he determines such exemption is necessary in the paramount interest of the United States and he shall notify the Congress of such exemption. e. The President shall annually report to the Congress on measures taken in compliance with the purpose and intent of this section, including, but not limited to, the progress and problems associated with such compliance. f. No certification by a contractor, and no contract clause, may be required in the case of a contract for the acquisition of commercial items in order to implement a prohibition or requirement of this section or a prohibition or requirement issued in the implementation of this section. g. In paragraph (1), the term "commercial item" has the meaning given such term in section 4(12) of the Office of Federal Procurement Policy Act (41 U.S.C. 403(12)). (Federal Certification- Non - Discrimination, Clean Air, Clean Water) (0112018)Page 3 of 4 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE I UocuSigned hy: �r5Alnf� ,tid @2C1.5 2dCS . RAAkA , Executive Director 3C63.. -- Signature Title Dispute Settlement Center, Inc. 7/13/2018 Agency /Organization Date (Certification signature should be same as Contract signature.) Contract # (Contractor) (Federal Certification- Non - Discrimination, Clean Air, Clean Water) (01 /2018)Page 4 of 4 DocuSign Envelope ID: 23D00540- 4B67- 4A91- B622- 510CAEF24EEE ATTACHMENT O QUTCON4ES AND REPORTING Orange County Department of Social Services By signing and submitting this document, the Contractor certifies that it agrees to the following: 1. The Contractor agrees to participate in program, fiscal and administrative monitoring and/or audits, making records and staff time available to Federal, State and County staff. 2. The Contractor agrees to take necessary steps for corrective action, as negotiated within a corrective action plan, for any items found to be out of compliance with Federal, State, and County laws, regulations, standards and/or terms of the Contract. 3. The Contractor agrees that continuation of and/or renewal of this Contract is contingent on meeting the following requirements. The Contractor agrees to: A. Provide Job Readiness /Conflict Resolution Workshops to Work First clients referred by the County. a. The maximum number of billable hours per class is 33 and includes all prep time. B. Provide Team Building Workshops to Work First clients referred by the {County. a. The maximum number of billable hours per class is 6 and includes all prep time. C. Provide Communication/Conflict Resolution classes to families or individuals involved with Child Welfare Services and referred by the County per year. a. The maximum number of billable hours per class is 27 and includes all prep time. D. Submit invoices to the appropriate administrator. a.. Work First and staff training invoices to Sharron Hinton b. Child Welfare Services invoices to Denise Shaffer E. Help to ensure that 80% of Work First clients enrolled in classes obtain employment within 3 months of completion and maintain employment for at least 6 months after the class ends. F. Help to ensure that 80% of clients referred through child welfare will have no instances or no repeat instances of child maltreatment. G. Maintain client records that date and document the service delivered to the individual, a valid authorization for service, program records, and documents and other evidence that reflect program operations. H. Furnish information to the County, as requested, to support provision of service(s) pursuant to this Contract and the full cost of the service, and submit changes, as needed or required for review and approval by the County. 1. Maintain books, records, documents and other evidence and accounting procedures that reflect all direct and indirect costs expended under this Contract. A current, complete inventory of all equipment purchased under the terms of this Contract must be kept. J. Retain all financial and program records for a period of three years from the date of final payment under this agreement or until all audits continued beyond this period are completed. Federal auditors and any persons authorized by the Division of Social Services or the County Uocusignw b` " ' " - ight to examine any of these materials. L�r'R)A.WS61A, eosnae2c124ca... Signature Executive Director Title Dispute settlement Center, Inc. 7/13/2018 Agency /Organization Date (Certification signature should be same as Contract signature.) Outcomes (06/04) Page 1 of 1 DocuSign Envelope ID: 23DO0540- 4B67- 4A91- B622- 510CAEF24EEE CERTIFICATE OF LIABILITY INSURANCE DATEIM:OrYYnI 6 511 612 01 8 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE [TOES 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 doe8 not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Diane Nadeau 'AM, _ PHON o {9t9) 858.4511 k9 : (919) 968 8991 Business Insurers of Carolinas E-MAIL dnadealr[�6usiness- insurers.com ADDRESS: 806 Eastowne Drive, Suite 268 INSURERS APFORDING COVLRAGE NAIL t PO Box 2538 INSURERA: American Liberty Insurance Co 25186 Chapel Hill NC 27515 -2536 INSURED INSURER B: Employers Mutual Casualty 21415 INSURER C: DISPUTE SETTLEMENT CENTER IMC IN5U RER D : _ 302 W WEAVER ST 51-L A INSURER E; $ 300,000 INSURER F: S 5,000 CARRBORO NC 27516 -6904 rc ®—le ATC 1,11 lsaaCV• CLI951622265 riFVL4`iew wwRr -R. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NIC nMTHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 LTR TYPE0FINSLIRANCE INSDL wun. POLICY NU MBER FULIL; E POI D1YExv _ LIMITS - X COMMERCIAL GENERALLIAE01 -rN EACH OCCURRENCE $ 1,009,000 � CLAIMS -MADE L J cccVR D PREIMISES f Ea . cz4t, ' e .- $ 300,000 MED EXP (Any ono parmn) S 5,000 A 4WS"87 0611712418 06117/2418 PERSONAL &ADV INJURY S 3EN 'L AGGREGATE L PUT APPLIES PER; GF NF RAI AGGREGATE $ 2.060,000 PRODUCTS- COMPICIPADG 8 2,000,000 F] FRO- POLICY PRO- LOC OTHER. Hired /borrowed S 1,600,900 AUTOMOSILELIABILITY Co (1 1 WEDSINGLELIMrr $ U00ILY INJURY (PEr I%mW $ ANY AUTO BODILY INJURY (Per a IdEnt) ; OWNED SCHEDU LED AUTOS ONLY AUTOS HIRED NON•OWNED AUTOS ONLY AUTOS ONLY - PROPERTY DAMAGE P o r acedentl $. S HOLAWS-MADE OCCUR EACH OCCURRENCE $ 4UMBRELLALIAB AGGREGATE S EXCESS LIAa DEF) I RETENTION $ $ 8 WQRXFRS COMPENSATION AND EMPLOYERS' LIABILITY YIlI ANY PROPRIETORIPA RTNER/6XF CUTIVE ❑ OFFICERIMEMSHX EXCLUDED? (Man datary In NH) N f A 4H84487 0611712018 06/17/2019 PER OTM STATUTE IER E.L. EACH ACCIDENT g 100,449 E.L. DISEASE - EA EMPLOYEE S 100,000 E.L. DISEASE - POLICY LIMIT S 500.000 If yyes, describe under DESCRPT3ONOF OPrRATIONS Galaw DESCRIPTION OF OPERAfIONSI LOCATIONS VEHICLES iALORD 901, Addl(lonal Remarks Schedule, may bo attached if mom space is required) Orange County Government PO Box 8181 Hillsborough ACORD 25 (2016103) VHI�, SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESFNTATIVE INC 27278 V I'"001•LU 10 f k LJKU L1JK!'4lE[Ii] IVIY. fill rlalllu rG3GIYCU. The ACORD name and logo are registered marks of ACORD