Loading...
HomeMy WebLinkAbout2018-292-E Human Rights Relations -ASL CSDHH contractDocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 NORTH CAROLINA COUNTYWIDE AGENCY ASL INTERPRETER SERVICES AGREEMENT $15,000 OR LESS ORANGE COUNTY This Countywide American Sign Language Interpreter Services Agreement ( "Agreement"), made and entered into this 1st day of July, 2018, ( "Effective Date ") by and between Orange County, North Carolina a body politic and corporate of the State of North Carolina ( "County ") and Communication Services for the Deaf and Hard of Hearing (CSDHH), ( "Provider "). WITNESSETH; For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the following Interpretation and Transliteration Services to the County in accordance with the terms of this Agreement: A. Contract. This Contract consists of this document and additional documents checked below: 1. For Health Department: i. M Health Department Additional Terms and Conditions ii. ® Business Associates Agreement iii. ® Condition of Contract Statement 2. For Department of Social Services: i. ❑ The General Terms and Conditions (Attachment A); ii. The Scope of Work, description of services, and rate (Attachment B); iii. Federal Certification Regarding Drug -Free Workplace (Attachment C); iv. ® Conflict of interest (Attachment D); v. No Overdue Taxes (Attachment E); vi. ❑ Outcomes and Reporting (Attachment N) These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. B. Services Scope of Work. a. This Agreement is for the Provider to furnish the services of qualified American Sign Language interpreters who interpret between English and American Sign Language with the County's clients and staff. b. By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. c. Time is of the essence with respect to this Agreement.. d. The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. Revised 06118 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 2. Responsibilities of the Provider a. Services. The Provider shall provide the County with all Basic Services required in Section 3 within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i. The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional quality and accuracy of all work related to the Basic Services. ii. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii. The provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv. Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider.. v. Provider agrees that Provider, its employees, agents and its subcontractors, if any, shall be required to comply with all federal, state and local antidiscrimination laws, regulations and policies that relate to the performance of Provider's services under this Agreement. vi. If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it and/or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. Basic Services. The Provider will furnish American Sign Language Interpreter and Transliteration Services (referred to collectively as "Services ") under this Agreement as follows: a. Professional Conduct. The Provider and Interpreters shall adhere to the standards of professional conduct of an interpreter while conducting the services to include the following: Revised 46/18 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 i. The Provider shall provide qualified persons to the County to interpret between English and American Sign Language staff and clients. ii. The Provider and Interpreters shall relate to all County clients and staff in a respectful and professional manner. iii. The Provider and Interpreters will interpret the information being shared between client/family and staff as clearly as possible, without additional personal comments or biases on the topic being discussed. iv. The Provider shall provide Interpreters with valid NC Interpreting and Transliterating license and proof of certification through the Registry of Interpreters for the Deaf (RID). v. The Provider will follow the National Association of the Deaf https: /- nad.or>;1 Registry of Interpreters for the Deaf htt : / /wcvw.rid.or ethics /code Code of Professional Conduct and is hereby incorporated by reference. b. Procedures and Guidelines upon acceptance of assignment: i. The Provider agrees to provide at least 24 hour notice if the Interpreter is unable to participate in a scheduled client contact. ii. Neither the Provider nor Interpreters shall give out their home telephone number or cell phone number for later contact between the client and Provider. If asked, the Provider should generally instruct clients to call the Health Department front desk staff to schedule an appointment or to inquire about services. c. Client Confidentiality. i. The Provider acknowledges that they or their employees may have access to information that is confidential and provided by state and federal laws and agrees to comply with all privacy policies, regulations, and laws as well as the Health Insurance Portability and Accountability Act (HTPAA) of 1996 (P.L.104 -191). ii. The Provider agrees to protect confidential information (e.g., client name, appointment type, telephone number, health information) that they or their employees may receive in doing business with County. The Provider shall ensure proper, safe storage and protection of client information during use, and shreddingfdeletion of such information when it is no longer necessary for business purposes. iii. Breaches of client confidentiality will result in automatic termination of this Agreement. 4. Duration of Services a. Term. The terns of this Agreement shall be from July 1, 2018 to June 30, 2019. b. Scheduling of Services. The Provider shall schedule and perform their activities in a timely manner. Should the County determine that the Provider is behind schedule, it Revised 06118 3 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 may require the Provider to expedite and accelerate his efforts, including providing additional resources and working overtime, as necessary, to perform his services in accordance with the approved project schedule at no additional cost to the County. c. The Commencement Date for the Provider's Basic Services shall be July 1, 2018. 5. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services under this Agreement as provided in Section 3 above. The total amount of the Agreement shall not exceed Five Thousand Dollars ($5,000) in both Basic Services and Reimbursable Expenses. a. Basic Services shall be payable at as follows: i, Standard Rate of services shall be paid at rate of $50.00 per/hour for services performed Monday — Friday, 8:00 a.m. 6:00 p.m. ii. Non- Standard Rate of services shall be paid at a rate of $60.00 for per/hour for services performed from Monday — Friday, 6:00 p.m. — 8 :00 a.m., weekends and holidays. iii. The County shall pay for a minimum of two hours of service for each appointment. After the initial two hours, service shall be billed in fifteen (15) minute increments. b. Reimbursable Expenses. Reimbursable expenses are in addition to the fees for Services. Mileage shall be a reimbursable expense for travel to and from the job site, starting at the Interpreter's home or the Provider's office, whichever is closer to the extent reasonable and actually incurred by the Provider with respect to the Services provided. c. Invoice Procedure. Provider shall complete and submit the County Invoice to County staff within three weeks of the time services are rendered. The Interpreter will record the start and finish time worked to the minute. After the first two (2) hours of service, payment will be calculated and paid in 15 minute increments. ii. Cancelled Appointment. In the event of a cancelled appointment, the County will reimburse the Provider for two (2) hours of interpreter services in the event of a same day cancelled appointment (includes appointments for clients who do not show up for an appointment, and for those who cancel an appointment with less than 24 hour notice). If an appointment is cancelled between 24 and 48 hours before a scheduled appointment, the County will reimburse Provider for one (1) hour of interpreter services. In the event of a cancelled same day appointment, Interpreters are required to stay until relieved of duty by the individual in charge. County staff may require other interpreter- related services in place of the scheduled appointment. As stated above, the Provider may submit an invoice in the event of a broken appointment (with less than 48 hour notice). iii. Unexpected Closing or Delayed Opening. In the case of an unexpected closing or delayed opening (e.g., inclement weather) of the Health Department, the Provider shall not be paid for missed appointments. When in doubt, the Provider or the Interpreter can call (919) 732 -8181 to see if county offices are Revised 06 /18 4 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 open or are on a delayed schedule. When possible, the Interpreter is also asked to help call hisiher scheduled clients to inform them of the delay or closing. d. Payment for Basic Services and Reimbursable Expenses shall become due and payable within thirty (30) days of Provider properly invoicing County. Payment shall be subject to provisions of Sections 5 (a) and (b). e. Disputes. In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Should Provider fail to perform its duties under the terms of this Agreement, County may, without fault or penalty, withhold any payment associated with the work to be performed until such time as said work is completed. f, Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County. a. The County has designated (Annette M. Moore) to act as the County's representative with respect to the Project and shall have the authority to render decisions within guidelines established by the County Manager and/or the County Board of Commissioners and shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. Insurance: Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by County's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http:/l oranpgcounrync .gov /purchasingicontracts .asp). If County's Risk Manager determines additional insurance coverage is required such additional insurance shall consist of NIA (if no additional insurance required mark NIA as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity. The Provider agrees to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from bodily injury including death or property damage to any person or persons caused in whole or in part by the negligence or 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 provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Errors and Omissions. Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. 10. Amendments to the Agreement. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment Revised 06118 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 11. Termination: This Agreement may be terminated at any time by mutual written agreement of the parties or by the County upon written notice to the Provider. 12. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. 13. Suspension. County may suspend the Basic Services and this Agreement at any time for County's convenience and without penalty to County upon three (3) days' notice to Provider. Upon any suspension by County, Provider shall discontinue work on the Basic Services and shall not resume the Basic Services until notified to proceed by County. 14. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Independent Contractor: The Provider 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 Provider 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. C. Governing Law. Both parties agree that this Agreement shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms Provider is 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. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified on the Iist created by the State Treasurer pursuant to G.S. 147 - 86.51. d. Non- Discrimination. 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 non - 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 _divisioiVeontracts.php.) Any violation of the Orange County Non - Discrimination Policy is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not Iimit the definition of breach to discrimination. Revised 06/18 6 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 e. Dispute Resolution: Any and all suits or actions to enforce, interpret, or seek damages with respect to any provision of, or the performance or non - performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Grange County, North. Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. f. Entire Agreement and Si agn Lures: The parties have read this Agreement 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 unless and until modified in writing and signed by the parties. 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 I IA and Article 40 of North Carolina General Statute Chapter 66. g. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. h. Ownership of 'Work Product. Should Provider's performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. Additional Terms and Conditions. The County may have additional terms and conditions that shall be provided as an attachment(s) and is (are) hereby incorporated by reference. Precedence Among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Section A above, with this contract document having the highest precedence then the first listed document and the last - listed document having the lowest precedence. If there are multiple Contract .Amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. k. Non - Appropriation. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non- appropriation of public funds. It is expressly agreed that County shall not activate this non - appropriation provision for its convenience or to circumvent the requirements of this Agreement, but only as an emergency fiscal measure during a substantial fiscal crisis. In the event of a change in the County's statutory authority, mandate and /or mandated functions, by state and /or federal legislative or regulatory action, which adversely affects County's authority to continue its obligations under this Agreement, then this Revised 06/18 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County's legal authority. 1. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Attention: Human Rights Director P.O. Box 8181 Hillsborough, NC 27278 Provider's Name CDSHH c/o Executive Director 1175 Revolution Dr, Studio 15 Greensboro, NC 27405 IN WITLESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: DocuSigned by: By: t • " � AL, (�cu�wrt YS� Bonnie Han 01 7094B755E477... Revised 06118 8 PROVIDER: DocuSigned by: Bv: L '. 0-Wt JA,5 E1484B5820FF400... Kelle Owens Executive Director Printed Name and Title DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 Orange County Health Department Additional Terms and Conditions These are additional terms and condition to the Agreement between Orange County and Provider to the Countywide Agency ASL, Interpreter Agreement. The additional terms and conditions shall supersede any terms and conditions in the original contract and are hereby incorporated as follows: Add to Subsection B.3.a Basic Services Vi. The Interpreters are required to sign the OCHD Conditions of Contract Statement containing the confidentiality, Title X and public health activities in emergency situations information which is hereby incorporated by reference. Add to Subsection B.3.d d. Medical Documentation. Prior to beginning work, the Provider is required to: L In addition to the CSDHH interpreter immunization requirements, all interpreters and transliterators sent to work at the Orange County Health Department must have record of a Tdap immunization on file. i. If there is current measles, mumps and rubella activity in the area, then a second dose of NVAR or proof of an adequate titer may be required prior to work at the OCHD. Revised 08118 9 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 BUSINESS ASSOCIATE AGREEMENT This Business Associate Agreement ( "Agreement ") is made effective the First day of July, 2018, by and between Orange County Government through its Orange County Health Department ( "Covered Entity "), and Communication Services for the Deaf and Hard of Hearing (CSDHH), ( "Business Associate "). Covered Entity and Business Associate may be referred herein individually as a "Party" or collectively as the "Parties This Agreement supersedes any previously executed Business Associate Agreement between the Parties. WITNESSETH: WHEREAS, Sections 261' through 264 of the federal Health Insurance Portability and Accountability Act of 1996 ( "HIPAA "), Public Lave 104 -191, as modified by the Health Information Technology for Economic and Clinical Health Act ( "HITECH "), Public Law 111 -5, known as "the Administrative Simplification provisions," direct the Department of Health and Human Services to develop standards to protect the security, confidentiality and integrity of health information; and WHEREAS, pursuant to the Administrative Simplification provisions, the Secretary of Health and Human Services ( "Secretary ") has issued regulations modifying the Privacy, Security, Breach Notification, and Enforcement Rules at 45 CFR Parts 160 and 164, as the same may be amended from time to time (the " HIPAA Security and Privacy Rule "); and WHEREAS, the Parties wish to enter into or have entered into an arrangement whereby Business Associate will provide certain services to Covered Entity, and, pursuant to such arrangements, Business Associate may be considered a "Business Associate" of Covered Entity as defined in the HIPAA Security and Privacy Rule (the agreement evidencing such arrangement is detailed below and hereinafter referred to as the "Service Agreement(s) "); and WHEREAS, Business Associate may have access to Protected Health Information (as defined below) in fulfilling its responsibilities under such arrangement; THEREFORE, in consideration of the Parties' continuing obligations under the Service Agreement, compliance with the HIPAA Security and Privacy Rule, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree to the provisions of this Agreement in order to address the requirements of the HIPAA Security and Privacy Rule and to protect the interests of both Parties. 1, DEFINITIONS (a) Service Agreement. Agreement(s) for services affected by this HIPAA Business Associate Agreement, which this Business Associate Agreement shall be attached to, and is (are) hereby incorporated by reference, and which shall be taken and considered as a part of this document the same as if fully set out herein; Countywide Agency ASL Interpreter Services Agreement $15,000 or Less, dated July 1, 2018 for Communication for the Deaf and Hard of Hearing (b) Catch -all Provision. Except as otherwise defined herein, any and all capitalized terms in this Agreement shall have the definitions set forth in the HIPAA Security and Privacy Rule, 45 CF'R Parts 160 and 164, subparts A and E. In the event of an inconsistency between the provisions of this Agreement and mandatory provisions of the HIPAA. Security and Privacy Rule, as amended, the HIPAA Security and Privacy Rule shall control. Where provisions of this Agreement are different than those mandated in the HIPAA Security and Privacy Rule, but are nonetheless permitted by the HIPAA Security and Privacy Rule, the provisions of this Agreement shall control. April 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 (c) Electronic Protected Health Information. Protected Health Information that is transmitted by or maintained in Electronic Media (as defined in the F1 PAA Security and Privacy Rule), (d) Protected Health Information. "Protected Health Information" shall have the same meaning as the term in 45 CFR § 164.143, limited to the information created or received by Business Associate from or on behalf of Covered Entity and includes without limitation "Electronic Protected Health Information." Business Associate acknowledges and agrees that all Protected Health Information that is created or received by Covered Entity and disclosed or made available in any form, including paper record, oral communication, audio recording, and electronic display by Covered Entity or its operating units to Business Associate or is created or received by Business Associate on Covered Entity's behalf shall be subject to this Agreement. (e) Required by Law. "Required by Law" shall have the same meaning as the term in 45 CFR § 164.143. 11. OBLIGATIONS AND ACTIVITIES OF BUSINESS ASSOCIATE (a) Use and Disclosure. Business Associate agrees to fully comply with the requirements under the H1PPA Security and Privacy Rule applicable to Business Associates and not to use or disclose Protected Health Information other than as permitted or required by this Agreement, the Service Agreement or as Required by Law. To the extent Business Associate carries out obligations of Covered Entity under the HIPAA Security and Privacy Rule, Business Associate shall comply with the applicable provisions of the HIPAA Security and Privacy Rule as if such use or disclosure were made by Covered Entity, Business Associate agrees to comply with Covered Entity's policies regarding the minimum necessary use or disclosure of Protected Health Information. (b) Appropriate Safeguards. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of Protected Health Information other than as provided for by this Service Agreement(s), this Agreement or as Required by Law. This includes the implementation physical, technical and administrative safeguards to prevent use or disclosure of Protected Health Information other than as permitted in this Agreement or Required by Law and reasonably and appropriately protect the confidentiality, integrity, and availability of any Electronic Protected Health Information that it creates, receives, maintains, or transmits on behalf of Covered Entity as required by the HIPAA Security and Privacy Rule. The Business Associate shall maintain appropriate documentation of its compliance with the RWPA Security and Privacy Rule, including, but not limited to, its policies, procedures, records of training and sanctions of members in its workforce. (c) Assurances. Business Associate agrees to provide Covered Entity with written assurances that any Protected Health Information placed on any type of mobile media, including, but by no means limited to, lap top computers, Ipads and mobile phones, is encrypted in accordance with guidance issued by the Secretary. (d) Agents and Subcontractors. Business Associate shall require any agents, including any subcontractors, to whom it provides Protected Health Information from Covered Entity that is created, received, maintained or transmitted on behalf of Business Associate to agree by written contract with Business Associate to the same (or greater) restrictions, conditions and requirements that apply to Business Associate with respect to such information, and to agree to implement reasonable and appropriate safeguards to protect any of such information that is Electronic Protected Health Information. In addition, Business Associate agrees to take reasonable steps to ensure that its employees' actions or omissions do not cause Business Associate to breach the terms of this Agreement. Apr# 2016 DocuSign Envelope ID: 3A4lC8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 (e) Mitigation of Breach. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is known to Business Associate of a use or disclosure of Protected Health Information by Business Associate in violation of the requirements of this Agreement, as well as to provide complete cooperation to Covered Entity should Covered Entity elect to review or investigate such noncompliance or Security Incident. Business Associate shall cooperate in Covered Entity's breach analysis and/or risk assessment, if requested. Furthermore, Business Associate shall cooperate with Covered Entity in the event that Covered Entity determines that any third parties must be notified of a Breach, provided that Business Associate shall not provide any such notification except at the direction of Covered Entity. (f) Breach Reporting. Business Associate shall report in writing to Covered Entity's Privacy Officer (see Exhibit A), any use or disclosure of Protected Health Information that is not in compliance with the terms of this Agreement, as well as any Security Incident and any actual or suspected Breach, of which it becomes aware, without unreasonable delay, and in no event later than forty -eight (48) hours of such discovery. For purposes of this Agreement, "Security Incident" means the attempted or successful unauthorized access, use, disclosure, modification, or destruction of information or interference with system operations in an information system. Such notification shall contain the elements required by 45 C.F.R. § 164.410. (g) Compliance. To the extent applicable, Business Associate will comply with (i) Covered Entity's Notice of Privacy Practices; (ii) any limitations to which Covered Entity has agreed in regard to an Individual's permission to use or disclose his or her Protected Health Information; and (iii) any restrictions to the use or disclosure of Protected Health Information to which Covered Entity has agreed or is required to agree. (h) Government Access. Business Associate will make its internal practices, books and records available to the Secretary of the Department of Health and Human Services for purposes of determining compliance with the terms of the HIPAA Security and Privacy Rule, and, at the request of the Secretary, will comply with any investigations and compliance reviews, permit access to information, and cooperate with any complaints, as Required by Law. Without unreasonable delay and, in any event, no more than 48 hours of receipt of the request or notification, Business Associate will notify Covered Entity in writing of any request by any governmental entity, or its designee, to review Business assessment of any kind. G) Electronic Transactions. If Business Associate conducts any Standard Transactions for or on behalf of Covered Entity, Business Associate shall comply with the requirements under the Electronic Transaction Rule. 0) Audit. Business Associate shall permit Covered Entity, in its discretion, to conduct an audit of Business Associate's compliance with this Agreement, HIPAA, and HITECH. Such audit may consist of an onsite, visit, a series of inquiries that require written responses, or both. Business Associate shall promptly and completely respond to Covered Entity's requests for information in support of the audit, which shall not be conducted more than once annually except in cases of an actual or reasonably suspected Security Incident or reasonably suspected noncompliance with this Agreement, HIPAA or HITECH. Each Party shall bear its own costs associated with the audit. (k) Identity Theft. Business Associate shall implement Identity Theft Monitoring Policies and Procedures to protect any patient information that may be breached by the Business Associate to the extent applicable under the Federal Trade Commission's Red Flag Rules. (1) HITECH Compliance. Business Associate shall; April 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 A. Not receive, directly or indirectly, any impermissible remuneration in exchange for Protected Health Information or Electronic Protected Health Information, except as permitted by HITECH § 13405(d) or the HIPPA Regulations; B. Comply with the marketing and other restrictions applicable to Business Associates contained in HITECH § 13406 and the HIPPA Regulations, C. To the extent required under HITECH § 13404, fully comply with the applicable requirements of 45 CFR 164.502(e)(2) for each use and disclosure of Protected Health Information; D. To the extent required under HITECH § 13401, fully comply with 45 CFR §§ 164.308, 164.310, 164.312, and 164.316; E. To the extent required under HITECH § §13401 and 13404, comply with the additional privacy and security requirements that apply to Covered Entities in the same manner and to the same extent as Covered Entity is required to do so; and F. To the extent required under the HIPPA Regulations, comply with the privacy and security requirements that apply to Business Associates. (m) State Privacy Laws. Business Associate shall understand and comply with state privacy laws to the extent that such privacy laws are not preempted by HIPPA or HITECH. III. PERMITTED USES AND DISCLOSURES BY BUSINESS ASSOCIATE (a) Use of Protected Health Information on Behalf of Covered Entity. Except as otherwise limited in this Agreement, Business Associate may use or disclose Protected Health Information to perform functions, activities or services for, or on behalf of, Covered Entity described in the Service Agreement, provided that such use or disclosure would not violate the HIPPA Security and Privacy Rule if it were made by Covered Entity or would not violate the Covered Entities minimum necessary policies. (b) Other Uses of Protected Health Information. Except as otherwise limited in this Agreement, Business Associate may use Protected Health Information within its workforce for the proper management and administration of Business Associate not to include Marketing or Commercial Use and to carry out the legal responsibilities of Business Associate; and (c) Third Party Confidentiality. Except as otherwise limited in this Agreement, Business Associate may disclose Protected Health Information for the proper management and administration of Business Associate or to carry out the legal responsibilities of Business Associate, provided that if Business Associate discloses any Protected Health Information to a third party for such purpose, the Business Associate shall enter into a written agreement with such third party requiring the following: A. Disclosure only as Required by Law; or B. Business Associate obtains reasonable assurances from the person to whom the information is disclosed that the information will remain confidential and will be used or further disclosed only as Required by Law or for the purpose for which it was disclosed to the person, and the person notifies Business Associate of any instances of which it is aware in which the confidentiality, integrity, and or availability of the Protected Health Information has been breached immediately upon becoming aware. (d) Business Associate may provide data aggregation services relating to the health care operations of Covered Entity pursuant to any agreements between the Parties evidencing their business relationship as permitted by 45 CFR § 164.504(e)(2)(i)(B), 4 April 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 (e) Other Uses Strictly Limited. Nothing in this Agreement shall permit the Business Associate to share Protected Health Information with Business Associate's affiliates or contractors except for the purposes of the Service Agreement(s) between the Covered .Entity and Business Associate(s) identified in Section I (a) of this Agreement, (f) Covered Entity Authorization for Additional Uses. Any use of Protected Health Information by Business Associate, its affiliate or Contractor, other than those purposes of this Agreement, shall require express written authorization by the Covered Entity, and a Business Associate Agreement or amendment as necessary. Activities which are prohibited include, but are not limited to, Marketing, as defined by 45 CFR § 164,503 or the sharing for Commercial Use or any purpose construed by Covered Entity as Marketing or Commercial Use, even if such sharing would be permitted by federal or state laws, (g) Business Associate may de- identify Protected Health Information only at the specific direction of and only for the use of Covered Entity. Business Associate may not sell Protected Health Information except at the direction of Covered Entity and in compliance with the requirements of the HIPAA Security and Privacy Rule. lV. AVAILABILITY OF PHI (a) Access to Protected Health Information. Business Associate agrees, in the event the Business Associate maintains protected health information in a Designated Record Set, to make available, within ten (10) days of a request by Covered Entity in a time and manner designated by Covered Entity, Protected Health Information in a Designated Record Set, to Covered Entity or as directed by Covered Entity, to an individual in order to meet the requirements of 45 CFR § 164.524 of the HIFAA Security and Privacy Rule. (b) Amendments to Protected Health Information. In the event that the Business Associate maintains Protected Health Information in a Designated Record Set, Business Associate agrees to make any arnendment(s) to Protected Health Information in a designated record set that the Covered Entity directs or agrees to pursuant to the I1<IIPAA Security and Privacy Rule at the request of Covered. Entity of an individual, within ten (10) days of receipt of a request from Covered Entity and in the time and manner designated by Covered Entity. (c) Accounting of Disclosures. Business Associate agrees to maintain and make available the information required to provide an accounting of disclosures, as required by 45 CFR § 164.528 of the HIPAA Security and Privacy Rule. Business Associate will comply with Covered Entity's policy regarding accounting of disclosures. (d) Document Disclosures. In the event an Individual makes a request under this Section of the Agreement directly to Business Associate, Business Associate will notify Covered Entity of such request within three (3) business days and shall cooperate with, and act only at the direction of Covered Entity in responding to such request. V. OBLIGATIONS OF COVERED ENTITY (a) Notice of Privacy Practices. Covered Entity shall provide Business Associate with the notice of privacy practice that Covered Entity produces in accordance with 45 CFR § 164.520, as well as any changes to that notice. (b) Notice of Changes in Individual's Access or Protected Health Information. Covered Entity shall provide Business Associate with any changes in, or revocation of, permission by an 5 Apr!! 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 h-idividual to use or disclose Protected Health Information, is such changes affect Business Associate's pennitted or required uses. (c) Notice of Restriction in Individual's Access to Protected. Health Information. Covered Entity shall notify Business Associate of any restrictions to the use or disclosure of Protected Health Information that Covered Entity has agreed in accordance with 45 CFR § 164.522 to the extent that such restriction may affect Business Associate's use of Protected Health Information. VI. PERMISSABLE REQUESTS BY COVERED ENTITY Requests Permissible Under HIPAA. Covered Entity shall not request Business Associate to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy or Security Rule. VII. TERMINATION (a) Term. This Agreement shall be effective as of the date first set forth above and shall tenninate upon the earlier of (i) the termination of all agreements between the parties, and (ii) the termination by Covered Entity for cause as provided herein. (b) Termination for Cause. Notwithstanding anything in this Agreement to the contrary, Covered Entity shall have the right to terminate this Agreement and the Service Agreement immediately if Covered Entity determines that Business Associate has or will violated any material term of this Agreement. Upon Covered Entity's knowledge of a material breach by Business Associate, Covered Entity shall provide an opportunity for Business Associate to cure the breach or end the violation. Covered Entity may terminate this Agreement if Business Associate does not cure the breach or end the violation within the time period specified by Covered Entity. If termination, cure or end of the violation is not feasible, Covered Entity may report the violation to the Secretary. (c) Obligation of Business Associate Upon Termination. At termination of this Agreement, the Service Agreement (or any similar documentation of the business relationship of the Parties), or upon request of Covered Entity, whichever occurs first, Business Associate, shall: A. if feasible, return (in a manner or process approved by the Covered Entity) or destroy all Protected Health Information, regardless of form, including but not limited to paper or electronic format, received from Covered Entity, or created, maintained or received by Business Associate on behalf of Covered Entity. Business Associate shall retain no copies of the Protected Health Information. This provision shall also apply to Protected Health. Information and other confidential information in the possession of sub- contractors or agents of Business Associate. B. If such return or destruction is not feasible, Business Associate shall (i) retain only that Protected Health Information necessary for Business Associate to continue its proper management and administration or to early out its legal responsibilities; (ii) return or destroy the remaining Protected Health Information that the Business Associate still maintains in any form; (iii) extend the protections of this Agreement to the retained Protected Health Information; (iv) limit further uses and disclosures to those purposes that make the return or destruction of the Protected Health Information not feasible; and (v) return or destroy the retained Protected Health Information when it is no longer needed by Business Associate. (d) Survival. This paragraph shall survive the termination of this Agreement and shall apply to Protected Health Information created, maintained, or received by Business Associate and any of its subcontractors. April 2016 DocuSign Envelope ID: 3A4lC8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 VIII. MISCELLANEOUS (a) indemnification. Business Associate agrees to indemnify, defend, and hold harmless Covered Entity, its officers, agents, contractors and agents, against, and in respect of, any and all claims, losses, expenses, costs, damages, obligations, penalties, and Iiabilities which Covered Entity may incur by reason of Business Associate's breach of or failure to perform any its obligations pursuant to this Agreement, including but not limited to any injury or damages arising from any noncompliance with this Agreement or any Security Incident attributable to the negligence of Business Associate, including failure to execute the terms of this Agreement. Further, Business Associate agrees to indemnify, defend, and hold harmless Covered Entity, its officers, employees, contractors and agents, against all costs and expenses, including but not limited to, reasonable legal expenses, which are incurred by or on behalf of Business Associate in connection with the defense of such claims. (b) Disclaimer. Covered Entity makes no warranty or representation that compliance by Business Associate with this Agreement, HIPAA, HITECH, or the HIPAA Regulations will be adequate or satisfactory for Business Associate's own purposes. Business Associate is solely responsible for all decisions made by Business Associate regarding the safeguarding of Protected Health Information. (c) Assistance in Litigation or Administrative Proceedings. Business Associate shall make itself, and any .subcontractors, employees, affiliates or agents assisting Business Associate in the performance of its obligations under this Agreement, available to Covered Entity, at no cost to Covered Entity, to testify as witnesses, or otherwise, in the event of litigation or administrative proceedings being commenced against Covered Entity, its directors, officers or employees based upon a claimed violation of HIPAA, HITECH, the HIPAA Regulations, or other laws relating to security and privacy, except where Business Associate or its subcontractor, employee or agent is named adverse party. (d) Survival, The obligations of Business Associate under this Agreement shall survive the expiration, termination, or cancellation of this Agreement, the Service Agreement and/or the business relationship of the parties, and shall continue to bind Business Associate, its agents, employees, contractors, successors, and assigns as set forth herein. (e) Ownership of Information. Covered Entity holds all right, title, and interest in and to the Protected Health Information and Business Associate does not hold and will not acquire by virtue of this Agreement or by virtue of providing goods or services to Covered Entity, any right, title, or interest in or to the PHI or any portion thereof. (f) Right to Injunctive Relief. Business Associate expressly acknowledges and agrees that the breach, or threatened breach, by it of any provision of this Agreement may cause Covered Entity to be irreparably harmed and that Covered Entity may not have an adequate remedy at law. Therefore, Business Associate agrees that upon such breach, or threatened breach, Covered Entity will be entitled to seek injunctive relief to prevent Business Associate from commencing or continuing any action constituting such breach without having to post a bond or other security and without having to prove the inadequacy of any other available remedies. Nothing in this paragraph will be deemed to limit or abridge any other remedy available to Covered Entity at law or in equity. Except as expressly stated herein or in the HIPAA Security and Privacy Rule, the parties to this Agreement do not intend to create any rights in any third parties. (g) Amendment. The Parties agree to take such action as is necessary to amend this Agreement from time to time as is necessary for Covered Entity to comply with the requirements of the HIPSS Regulations. In addition, this Agreement may be amended or modified by the Parties only in writing. April 2015 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 (h) Assignment. No Party may assign its respective rights and obligations under this Agreement without the prior written consent of the other Party. (i) Independent Contractor. None of the provisions of this Agreement are intended to create, nor will they be deemed to create any relationship between the Parties other than that of independent parties contracting with each other solely for the purposes of effecting the provisions of this Agreement and any other agreements between the Parties evidencing their business relationship. This Agreement will be governed by the laws of the State of North Carolina. No change, waiver or discharge of any liability or obligation hereunder on any one or more occasions shall be deemed a waiver of performance of any continuing or other obligation, or shall prohibit enforcement of any obligation, on any other occasion. 0) Regulatory References. A reference in this Agreement to a section in HIPAA, MTECH or the HIPAA Regulations means the section as it currently is in effect or as amended. (k) Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a meaning that permits Covered Entity to comply with the HIPAA Regulations. The parties agree that, in the event that any documentation of the arrangement pursuant to which Business Associate provides services to Covered Entity contains provisions relating to the use or disclosure of Protected Health Information that are more restrictive than the provisions of this Agreement, the more restrictive provisions will control. The provisions of this Agreement are intended to establish the minimum requirements regarding Business Associate's use and disclosure of Protected Health Information. (I) Severability. In the event any part or parts of this Agreement are held to be unenforceable, the remainder of this Agreement will continue in effect. In addition, in the event a party believes in good faith that any provision of this Agreement fails to comply with the then- current requirements of the 14IPAA Security and Privacy Rule, such party shall notify the other party in writing. For a period of up to (30) thirty days, the parties shall address in good faith such concern and amend the terms of this Agreement, if necessary to bring it into compliance. If, after such thirty -day period, a party believes in good faith that the Agreement fails to comply with the HIPAA Security and Privacy Rule, then either party has the right to terminate upon written notice to the other party. (m) Notices and Communications. All instructions, notices, consents, demands, or other communications required or contemplated by this Agreement shall be in writing and shall be delivered to the Party at the address below: For Covered Entity: For Business Associate Orange County Housing, Human Rights CSDHH and Community Development c/o Executive Director ATTN: Director 1175 Revolution Dr. Studio 15 300 W. Tryon Street Greensboro, NC 27405 Hillsborough, NC 27278 (n) Strict compliance. No failure by any Party to insist upon strict compliance with any terms or provisions of this Agreement, to exercise any option, to enforce any right, or to seek any remedy upon any default of any other Party shall affect, or constitute a waiver of, any Party's right to insist upon such strict compliance, exercise that option, enforce that right, or seek that remedy with respect to that default or any prior, or contemporaneous, or subsequent default. No custom or practice of the Parties at variance with any provisions of this Agreement shall affect, or constitute a waiver of, any Party's right to demand strict compliance with all provisions of this Agreement. (o) Governing Law. This Agreement shall be governed and construed in accordance with the laws of the State of North Carolina except to the extent that North Carolina laws have been pre - empted by HIPAA and without giving effect to principals of conflicts of law. Jurisdiction shall be Orange County, April 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 North Carolina, for purposes of litigation resulting from disagreements of the Parties for purposes of this Agreement and the Service Agreement(s). (p) E- Verify. Employers and their subcontractors with 25 or more employees as defined in Article 2 of Chapter 64 of the NC General Statutes must comply with E- Verify requirements to contract with governmental units. E- Verify is a Federal program operated by the United States Department of Homeland Security and other federal agencies, or any successor or equivalent program used to verify the work authorization of newly hired employees pursuant to federal law. Where applicable, failure to maintain compliance with the requirements of Article 2 of Chapter 64 of the North Carolina General Statutes shall constitute breach of this Agreement. If applicable, by executing this Agreement, Business Associate affirms that they are in compliance with Article 3 of Chapter 64 if the North Carolina General Statutes. IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written above. COVERED ENTITY: BUSINESS ASSOCIATE: By: 5UocuSigned by'. Doc u Sig ned by: - bbvaut. By: 0-WU&S 0637994B755E477... E1484B5820FF400... Title: County Manager Title: Executive Director April 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 EXH031T A COVERED ENTITY PRIVACY OFFICER CONTACT INFORMATION To report to Covered Entity any use or disclosure of Protected Health Information not in compliance with the terms of this Agreement that might be considered a privacy breach, Business Associate should contact the Privacy Officer at the applicable entity. To report to Covered Entity any Security Incident (as defined in the Agreement), Business Associate should contact Carla Julian (919) 245 -2434, or the Security Officer at The Orange County Health Department. 10 April 2016 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 ORANGE COUNTY HEALTH DEPARTMENT Contracted Interpreters Conditions of Contract Statement Confidentiality As a Contract Interpreter for Orange County Health Department (OCHD), I acknowledge that I may have access to information that is confidential as mandated by state and federal law, HIPAA regulation and/or Orange County policy. I recognize my legal obligation as a Contractor to maintain the confidentiality of information about former and current recipients of OCHD services. I understand that release of information determined to be confidential by law to unauthorized persons may result in criminal prosecution. I further understand that the failure to maintain legally required confidentiality of information constitutes "misconduct" within the meaning of the Orange County Personnel Ordinance and may lead to disciplinary action, including termination of contract. If a question arises regarding whether a release of information may be public record vs. confidential client information, I will seek assistance from an OCHD Clinic Manager. Title X Information Requirement OCHD provides services solely on a voluntary basis. A client's acceptance of service is not a prerequisite to eligibility or receipt of a non -Title X service (Family Planning). As an OCHD Contract Interpreter, you may be subject to prosecution under Federal law if you coerce or endeavor to coerce any person to undergo an abortion or a sterilization procedure. As an Interpreter, your responsibility is to convey the message from the provider to the client to the best of your ability, without prejudice or personal bias. If you are present when an OCHD employee attempts to coerce a person to undergo an abortion or a sterilization procedure, discontinue interpreting, and report this to the Clinic Manager. Public Health Activities in Emergency Situations In order to fulfill the responsibilities of the department in emergency situations or in training, and due to our limited number of bilingual staff, you may be asked to work at emergency shelters or other locations designated by the Health Director or emergency operations. You may also be asked to participate in emergency drills and exercises. As a Contractor, you do have the right to decline any of these special requests. I certify that I have read and understand the conditions stated above. I have had an opportunity to discuss the conditions and requirements of my contract with a designated agency representative. Contractor Name: Kel l e Owens Date: DocuSigned by: Contractor Signature: " 0 -W",,5 DocuSigned by: OCHD Representative: ';'' Pt�VICA (YaWkr ° 2F52C29B147F405... Date: 7/12/2018 Date: 7/16/2018 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 ATTACHMENT A GENERAL TERMS AND CONDITIONS Orange County Department of Social Services and Department on Aging 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 cheek(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 liability.) (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 — (06115) Page 1 of 5 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 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 ofthe 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 Futilities 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 detennined. 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 God. 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: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 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 ofthe 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 Iocal 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- 8+6.58. 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 2040, as amended (22 U.S.C. 7104) Executive Carder # 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 — (05/16) Page 3 of 5 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 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 ofthe 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 office; (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 Z of Chapter 64 of the NC General Statutes. Miscellaneous Choice of Law: The validity ofthis 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 Grange 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 form 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. Readings: 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 — (06116) Page 4 of 5 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 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 perfonnance 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. 145164.14; 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. Orange County Living 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 Change 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 I 1 and Article 40 of North Carolina General Statute Chapter 66. General Terms and Conditions — (06116) Page 5 of 5 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 Contract # ATTACHMENT B SCOPE OF WORK Orange County Department of Social Services Federal Tax Id. or SSN 56- 1117075 Contract # A. CONTRACTOR INFORMATION CSDIH 1. Contractor Agency Name: CommLinication Services for the Deaf and Hard of Hearin CSSDHH) 2. I, f different from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email:. 3. Name of Program (s): ASL and Transliteration Services 4. Status: ( ) Public (X ) Private, Not for Profit () Private, For Profit 5. Contractor's Financial Reporting Year July 1, 2018 through .Tune 30, 2019 B. Explanation of Services to be provided and to whom (include SIS Service Code): The Contractor will provide American Sign Language interpretation and Transliteration services to the County. 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. Standard Rate of services shall be paid at rate of $50.00 per/hour for services performed Monday- Friday, 8 :00 a.m. -- 6:00 p.m. Non - Standard Rate of services shall be aid at a rate of $ 60.00 for per/hour for services performed from Monday -- Friday-6:00 j2.m. — 8:00 a.m. weekends and holiday The County shall pay for a minimum of two hours of service for each a ointment, After the initial two hours service shall be billed in fifteen 15 minute increments. D. Number of units to be provided: Contract -Scope of Work (06104) Page I of 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 Contract # CSDHH E. Details of Billing process and Time Frames; The County will reimburse the Contractor for services described in this contract up to the budgetary limits of the contract allotment. Standard Rate of services shall be paid at rate of $50.00 per/hour for services verformed Monday -- Frida 8:00 a.m. — 6:00 p.m. Non- Standard Rate of services shall be paid at a rate of 60.00 for per/hour from Monday — Friday 6:00 p.m. — 8:00 a.m. weekends and holida s for approved services provided and travel at the county rate. For reimbursement, the Contractor must submit the Grange County Department of Social Services Invoice for Payment of Interpreting Services form to the County staff at the time services are rendered. County staff will verify the information sign the form and forward the form to the desi nated Coun Administrator. The County will reimburse the Contractor monthly upon receipt of a complete and correctly filed report. Per hour reimbursement will begin at the time the Contractor meets with Count sy taff for the a ointment and ends when the Cognly staff and Contractor contact is completed. There will be a minimum of two (2 )hour of service for an appointment. Mileage reimbursement will be for round trio from the Contractor's home or work site to the prearranged appointment site. F. Area to be served /Delivery site(s): Orange y Dom Signed by: (Signal 0637994B755E477... person) 7/16/2018 (Date Submitted) UocuSigned by: t. Owt ws _ (signs E14&FB5820FF400... 0 7/12/2018 (Date Submitted) Contract -Scope of Work (06/04) Page 2of 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 ATTACHMENT C CERTIFICATION REGARDING DRUG -FLEE WORKPLACE REQUIREMENTS 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 (06104) Pagel of 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 U. The site(s) for the performance of work done in connection with the specific agreement are listed below: 1. 113 Mao Street (Street address) ty, county, state, zip code) 2. 2541 Homestead Road (Street address) 7 ty, 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 (Section 4 CFR Part 85, Section 85.515 and 86,620). II DocuSigned by: Signat _ E148465820FF40f) — Title Executive Director Communication Services for the DHH 7/12/2018 Agency /Organization Date (Certification signature should be same as Contract signature.) Federal Certification - Drug -Free Workplace (06/04) Page 2 of 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 ATTACHMENT D CONFLICT OF INTEREST POLICY Orange County Department of Social Services Conflict of Interest Defined: A conflict of interest is defined as an actual or perceived interest by a (Contractor /staff member /Board member) in an action that results in, or has the appearance of resulting in, personal, organizational, or professional gain. A conflict of interest occurs when an employee /Contractor/Board member has a direct or fiduciary interest in another relationship. A conflict of interest could include: Ownership with a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Employment of or by a member of the Board of Directors /Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Contractual relationship with a member of the Board of Directors /Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Creditor or debtor to a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. ➢ Consultative or consumer relationship with a member of the Board of Directors/Trustees or an employee where one or the other has supervisory authority over the other or with a client who receives services. The definition of conflict of interest includes any bias or the appearance of bias in a decision - making process that would reflect a dual role played by a member of the organization or group. An example, for instance, might involve a person who is an employee and a Board member, or a person who is an employee and who hires family members as consultants. Employee/Contractor/Board Member Responsibilities: It is in the interest of the organization, individual staff, and Board members to strengthen trust and confidence in each other, to expedite resolution of problems, to mitigate the effect and to minimize organizational and individual stress that can be caused by a conflict of interest. Employees are to avoid any conflict of interest, even the appearance of a conflict of interest. This organization serves the community as a whole rather than only serving a special interest group. The appearance of a conflict of interest can cause embarrassment to the organization and jeopardize the credibility of the organization. Any conflict of interest, potential conflict of interest, or the appearance of a conflict of interest is to be reported to your supervisor immediately. Employees are to maintain independence and objectivity with clients, the community, and organization. Employees are called to Conflict of Interest Policy (06/44) Page 1 of 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 maintain a sense of fairness, civility, ethics and personal integrity even though law, regulation, or custom does not require them. Acceptance of Gifts: Employees, members of employee's immediate family, and members of the Board are prohibited from accepting gifts, money or gratuities from the following: a. Persons receiving benefits or services fronr the organization; h. Any person or organization performing or seeking to perform services under contract with the organization; and c. Persons who are otherwise in a position to benefit front the actions of any employee of the organization. Employees may, with the prior written approval of their supervisor, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. If the employee is acting in any official capacity, honoraria received by an employee in connection with activities relating to employment with the organization are to be paid to the organization. NOTARIZED CONFLICT OF INTEREST POLICY State of North Carolina County of Orange certify that I have read the forgoing information understand it, an that no conflict of interest exists in the execution of this contract. � n 'I Signature Sworn to and subscribed before me on the � day of , 201 . v� �i�' �J-\" -1) otary Signature an, Seal) My Conu- nission Expires: OFFICIAL SEAT. s Notary Public, North Carolina COUNTY OF FORSYTH ■ �` MIC FLUE J INES t � My comm!ss +on Expires Conflict of Interest Policy (06104) Page 2 of 2 DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 Exhibit E Communication Services for the Deaf and Hard of Hearing 1175 Revolution Mill Dr., Studio 15 Greensboro, NC 27405 To: Orange County Department of Social Services Certification: I certify that I do not have any overdue tax debts, as defined by N,C.G.S. 105- 243.1, at the federal, State, or local level. I further understand that any person who makes a false statement in violation of N.C.G.S. 143- 6.2(b2) is guilty of a criminal offense punishable as provided by N.C,G.S. 143- 34(b). Sworn Statement: I, being duly sworn, say that I am the Director of Comniunication Services for the Deaf and Hard of Hearing, in the State of North Carolina; and that the foregoing certification is tike, accurate and complete to the best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any misuse of State funds will be reported to the appropi-Ae/Authorities for firrther action. Signature Sworn to and subscribed before me on the (Notary Signai<rr and Seal) qday of 1 , 201. My Conunission Expires: 1 � - )' 'o OFFICIAL SEAL, Notary Public, North Carolina COUNTY OF FORSYTH •.�� NJIC EL E J NES My Commission Expires t i.j DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 A`C71 3 a �� CERTIFICATE ©F LIABILITY INSURANCE DATE(MMIDDIYYYY) 7/6/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(5), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions Of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Craft Insurance Center 823 North Elm Street FO Box 14946 Greensboro NC 27415 CONTACT Phyllis Carter CIC, CISR NAME: PHONE ExUb (336) 375 -0600 1 F� No: {336)375 -70014 ADDRESS :Poarter @oraftinsurance.cam INSURERS AFFORDING COVERAGE NAIC N INSURERA:Seleative Ina, Co. Of America 12572 INSURED Guilford County Communications Center for The Deaf and Hard of Hearing, Ina . '1175 Revolution Mill Drive, Studio 15 Greensboro NC 27405 -5079 INSURER B: Hartford Property & Casualty 34690 INSURER C . 12/6/2618 INSURER D: $ 1,000,000 INSURER E: PREMISES Me occur ante 1 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN DEDUCED BY PAID CLAIMS. I LTR TYPE OF INSURANCE L vvvo. POLICY NUMBER POLICY EFF (MWDDNYY'Yl POLICY EXP IMMIDDfYYYYI LIMITS AI X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR S 1629360 12/6/2617 12/6/2618 EACH OCCURRENCE $ 1,000,000 PREMISES Me occur ante $ MED EXP (Any one person) $ 10,000 PERSONAL & ACV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ JECT PRO- F-] LOC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS- COMPIOPAGG $ 3,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED S NGL LI 1 Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAG£ Peraocidenl $ $ A X UMBRELLA LIAB EXCESS LAS X OCCUR CLAIMS -MADE S 1629360 12/6/2017 12/6/2018 EACH OCCURRENCE $ 1,000,000 AGGREGATE _ _ $ 1,000,000 DIED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEX.ECUTIVE OFFICEWMEMBER EXCLUDED7 N (Mandatory In NH) If yes, descri be under DESCRIPTION OF OPERATIONS bekrw NIA 22W2CCI6834 4/26/2016 4/26/20119 X PER ERH- E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101, Additional Remarks Schedule, may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION mvaleko @orangecountync.go Orange County Department of Human Rights and Relations 260 South Cameron Street Hillsborough, NC 27278 ACORD 25 (2014101) INS025 f2n14nI1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE P Cartier, CIC, CISR /P�'�. C 1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and toga are registered marks of ACORD