HomeMy WebLinkAbout2018-328-E Aging - Jennifer Sugg wellness instructorDocuSign Envelope ID: F02746BF- D92E- 42E9- ACB1- 079917CF5B3E
[Departmental Use Only]
TITLE Wellness Instructor
FY 2018 -19
ORANGE COUNTY
CONTRACT UNDER $5,000.00
NORTH CAROLINA
THIS AGREEMENT, made and entered into this twentieth day of July, 2018, ( "Effective Date ")
by and between Orange County, North Carolina, a body politic and corporate organized under the laws of the
State of North Carolina, (the "County "), party of the first part; and Jennifer Sugg (the "Provider "), party of
the second part;
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 services to the
County in accordance with the terms of this Agreement, time being of the essence:
The services and/or materials and/or construction (hereinafter referred to collectively as "Services ")
to be furnished under this Agreement are as follows: Fit Feet Clinic services
The term of this agreement rendered shall be from July 1, 2018 to June 30, 2019.
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. Provider agrees that Provider shall not
sub - contract any of the services to be provided in this Agreement, nor shall Provider assign any right or
responsibility granted or required by this Agreement, without the prior written approval of the County.
SPECIFIC TERMS
1. Payment: The County agrees to pay at the rates specified for Services satisfactorily
performed in accord with this Agreement. The amount to be paid by the County shall not exceed two -
thousand, five - hundred dollars, ($20.00 per hour). Payment shall be made within thirty (30) days of an
invoice properly submitted to County. 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.
2. Non — waiver: Failure by County at any time to require the performance by Provider of any
of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor
shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of
this Non - Waiver Clause.
3. Independent Contractor: The Provider shall operate as an independent contractor, and the
County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated
as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or
workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of
any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider.
4. 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
Revised 10/17 (Mgr appry 5k 6/18)
DocuSign Envelope ID: F02746BF- D92E- 42E9- ACB1- 079917CF5B3E
incorporated herein by reference and may be viewed at
http: / /www.orangecountync.gov /departments /purchasing division /contracts.php). If County's Risk
Manager determines additional insurance coverage is required such additional insurance shall be designated
here personal liability insurance (if no additional insurance required mark N/A 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.
5. Indemnity: The Provider agrees, without limitation, to defend, indemnify, and hold harmless
Orange County from all losses, liabilities, claims, demands, suits, costs, damages or expenses (including
reasonable attorney's fees) arising from bodily injury, including death, to any person or persons or damage to
or destruction of any property caused in whole or in part by any negligent or intentional act or omission on
the part of the Provider in carrying out Provider's duties and obligations related to the Services to be
provided in this Agreement.
6. 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. County may suspend this Agreement upon
reasonable notice to Provider.
7. Entire Agreement and Signatures: 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. Modifications
may be evidenced by telefacsimile signature. This Agreement together with any amendments or
modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent
of the Parties to utilize electronic signatures and the intent of the parties to comply with Article 11A and
Article 40 of North Carolina General Statute Chapter 66.
8. Governing Law and Priority_: Both parties agree that this Agreement shall be governed by
the laws of the State of North Carolina and Orange County. Provider shall at all times remain in compliance
with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state
and federal anti - discrimination laws, policies, rules, and regulations and the Orange County Non -
Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by
reference and may be viewed at
http: / /www.oran eg countync. og v/ departments / purchasing_ division /contracts.php.). Any violation of this
requirement 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 limit the
definition of breach to discrimination. 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 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 list created by the State Treasurer pursuant to G.S. 147 - 86.81. By executing this Agreement Provider
affirms Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina
General Statutes. In determining the basic services to be provided, should any documents be referenced in or
attached to this Agreement, the terms herein shall have priority in any conflict between the terms of
referenced documents and the terms of this Agreement.
9. Dispute Resolution: Neither party may initiate binding arbitration. Any disputes shall be
resolved by nonbinding mediation. If such mediation fails either party may initiate litigation to resolve the
dispute. Should either party initiate litigation to settle any dispute involving the terms of this Agreement
such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County,
North Carolina.
Revised 10/17 (Mgr appry 5k 6/18) 2
DocuSign Envelope ID: F02746BF- D92E- 42E9- ACB1- 079917CF5B3E
10. 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.
IN WITNESS WHEREOF, Orange County and the Provider have signed this Agreement, effective
as of the day first written above.
ORANGE COUNTY
DocuSigned by:
By: ,�al� iGt, `+lbw
B7E9�2696F454FA... it
200 S. Cameron St.
P.O. Box 8181
Hillsborough, NC 27278
Revised 10/17 (Mgr appry 5k 6/18)
PROVIDER
OacuSigned by:
By: �x(�+
Title, 76Ea6FS59C824A4 ...
Jennifer Sugg, RN
PO Box 272
Bynum, NC 27228
DocuSign Envelope ID: F02746BF- D92E- 42E9- ACB1- 079917CF5B3E
HEALTHCARE PROVIDERS SERVICE
ORGANIZATION PURCHASING GROUP
CNA Cerfif icate of Junwance
OCCURRENCE POLICY FORM
PRODUCER BRANCH PREFIX POLICY NUMBER
018098 970 HPG 0617869543 -8
Named Insured
Jennifer Sugg
PO Box 272
Bynum, NC 27228 -0272
Medical Specialty Code
Registered Nurse 80964 j
onso
nurses service orpanizition
Print Date: 04/20/18
Policy Period:
From 04/22118 to 04/22/19 at 12:01 AM Standard Time
Program Administered by:
Nurses Service Organization
1100 Virginia Drive, Suite 250
Fort Washington, PA 19034.3278
1 -800 -247 -1500
www.nso.com /renew
Insurance is provided by:
American Casualty Company of Reacting, Pennsylvania.
333 South Wabash Avenue Chicago, Illinois 60604
Professlonol Liability
$1,000 „000 each claim
$6,000,000 aggregate
Your professional liability limits shown above include the following:
• Good Samaritan Liability
• Malplacement Liability • Personal Injury Liability
• Sexual Misconduct included in the PL Limit shown above subject to $25,000 aggregate sublimit
Coverage Extensions
License Protection
$
25,000 per proceeding
$
25,000
aggregate
Defendant Expense Benefit
$
1,000 per clay limit
$
25,000
aggregate
Deposition Representation
$
10,000 per deposition
$
10,000
aggregate
Assault
$
25,000 per incident
$
25,000
aggregate
Includes Workplace Violence Counseling
Medical Payments
$
25,000 per person
$
100,000
aggregate
First Aid
$
10,004 per incident
$
14,000
aggregate
Damage to Property of Others
$
10,000 per incident
$
10,000
aggregate
Information Privacy (HIPAA) Fines & Penalties
$
25,000 per incident
$
25,000
aggregate
Workplace Liability
Workplace Liability Included in Professional Liability Limit shown above
Fire and Water Legal Liability Included in the PL limit above subject to $150,000 aggregate sublimit
Personal Liability $1,000,000 aggregate
Total: $106.00
Premium reflects employed, full -time rate.
Policy Forms & Endorsements (Please see attached list fora general description of many common policy forms and endorsements.)
G- 121500 -1) G- 121501 -C G- 121503 -C CNA82011 G- 145184 -A G- 147292 -A CNA81753 CNA81758 GSL13424 GSL15563
GSL15564 GSL15565 GSL17101 CNA84052 CNA80051 G- 123846 -C32 GSL10546NC
Chairman of the Board secretary
Keep this Certificate of Insurance in a safe place. This Certificate of Insurance and proof of payment are your proof of coverage.
There is no coverage in force unless the premium is paid in full. In order to activate your coverage, please remit premium in full by
the effective date of this Certificate of Insurance.
Form #: G- 141241 -B (3/2010) Master Policy: 188711433
100 - 2WRAUR -H1 201004M006