HomeMy WebLinkAbout2018-414-E Finance - Hillsborough Arts Council outside agency agreementDocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
OUTSIDE AGENCY PERFORMANCE AGREEMENT
THIS AGREEMENT, made and entered into the first day of July 2018, ( "Effective Date ") by and between
the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street,
Hillsborough, North Carolina, 27278, ( "County ") and Hillsborough Arts Council, a not - for - profit
corporation, located at 102 N. Churton Street, Hillsborough, NC 27278 ( "Provider ").
LVVIII►QIRIAM
WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby
enhance its availability to residents of the County, and said program addresses an important community
human services need, as identified by the Board of Commissioners.
NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set
forth, the County and Hillsborough Arts Council agree as follows:
1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1,
2018 to June 30, 2019.
2. Scope of Services.
a. Provider will provide services, as outlined in the attached Outside Agency Funding
Application and any amendments or revision thereto which is attached as Exhibit "A" and
incorporated by reference, to the residents of Orange County. The Scope of Services and
the Program Budget may be different from the original application based on County
appropriation; however, any revisions or amendments to this Agreement must be approved
in writing by the County and attached to this Agreement as Exhibit B.
b. The Provider shall be solely responsible for the means, methods, techniques, sequence,
safety program and procedures necessary to properly and fully complete the work set forth
in the Scope of Services.
3. Funding.
a. The County agrees to appropriate for the provision of services described in Exhibit A,
Scope of Services and more particularly described in the Revised Program Budget, the
maximum sum of $10,763.
b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not
used for the purposes stated shall be returned to the County. Any changes in the use of
funds must be authorized in writing by the County prior to any expenditure of the funds by
the Provider. If the funds are expended not in accordance with the Scope of Services, at the
discretion of the County the Provider may be required to repay the funds to the County.
c. The Provider shall be paid in four equal installments in the amount of $2,690.75. The first
payment is contingent upon receipt of the agency's performance agreement; the remaining
payments are contingent upon receipt of the request for reimbursement and related
supporting documentation.
d. The County's obligation to make the quarterly payments is contingent upon receipt of
Progress Reports, which show satisfactory progress toward completion of performance
measures and an accounting of expenditures as detailed in the attached Scope of Services.
(Hillsborough Arts Council)
Orange County Outside Agency Performance Agreement
Revised 712018 Page 1 of 9
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21
days after receipt of the Progress Report and Request for Reimbursement or 21 days after
due date of Progress Report whichever is later.
£ The County is not obligated to provide any other support to Provider in this or in
succeeding fiscal years.
4. Agency Reporting.
a. Provider will provide Orange County a Progress Report that includes a fiscal report and
updates on performance measures as outlined in the Scope of Services. Progress Report
dates are: July 1 — December 31; January 1 — March 31 and April 1 - June 30. Reports are
due on January 11, April 12, and July 12 of the program fiscal year.
b. Provider agrees to allow the County to inspect its financial books and records, which
document costs of those services, upon reasonable notice during normal working hours.
5. Termination.
a. In the event of any of the circumstances set forth below (hereinafter referred to as
"default "), the County may immediately terminate this Agreement, in whole or in part, and
from time to time. Notice of termination must be in writing, state the reason or reasons for
the termination, and specify the effective date of the termination:
i. In the event that Provider shall cease to exist as an organization or shall enter
bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all
of its assets, or significantly reduce its services or accessibility to Orange County
residents during the term of this Agreement; or
ii. In the event that Provider shall fail to render a satisfactory accounting as provided
section 4 above, the County may terminate this Agreement and Provider shall
return all payments already made to it by the County for services which have not
been provided or for which no satisfactory accounting has been rendered; or
iii. In the event of any fraudulent representation by the Provider in an invoice or other
verification required to obtain payment under this Agreement or other dishonesty
on a material matter relating to the performance of services under this Agreement.
iv. Nonperformance, incomplete service or performance, or failure to satisfactorily
perform any part of the work identified in the Scope of Services or to comply with
any provision of this Agreement, as determined by the County in its sole discretion.
v. Failure to adhere to the terms of applicable county, state or federal laws,
regulations, or stated public policy.
b. In the event of default by the Provider, the county may elect to terminate this Agreement, in
whole or in part and/or require the Provider to repay the funds within ten (10) business days
from written notice of default. The County may (but shall not be required to) grant the
Provider an opportunity to cure the default without termination of this Agreement. This
clause shall not be interpreted to limit the County's remedies in law or in equity.
(Hillsborough Arts Council)
Orange County Outside Agency Performance Agreement Page 2 of 9
Rev. 7118
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
c. Notwithstanding the foregoing, either party may terminate the agreement at any time
without penalty; provided that written notice of such termination is furnished to the other
parry at least 30 days prior to termination. In the event of such termination, any payment
due shall be prorated to the date of termination and any unused funds shall be returned to
the County within 10 days of termination.
d. Any termination of this Agreement for default under this section that is later deemed to be
unjustified shall be deemed a termination for convenience.
6. Insurance.
a. General Requirements. The Provider shall purchase and maintain, during the period of
performance of this Agreement, insurance:
i. Worker's Compensation. For protection from claims under workers' or workmen's
compensation acts;
ii. Comprehensive General Liability Insurance covering claims arising out of or
relating to bodily injury, including bodily injury, sickness, disease or death of any
of the Consultant's employees or any other person and to real and personal property
including loss of use resulting thereof,
iii. Comprehensive Automobile Liability Insurance, including hired and non -owned
vehicles, if any, covering personal injury or death, and property damage; and
iv. Professional Liability Insurance, covering personal injury, bodily injury and
property damage and claims arising out of or related to the performance under this
Agreement by the Consultant or his agents, consultants and employees.
b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows:
INSURANCE DESCRIPTION
• Worker's Compensation
• Commercial General
Liability
• Automobile Liability
• Professional Liability
MINIMUM REQUIRED COVERAGE
Limits for Coverage A - Statutory State
NC & Coverage B - Employers Liability
$500,000 each accident, disease policy limit and
disease each employee
$1,000,000 Each Occurrence
$2,000,000 Aggregate
$500,000 Combined Single Limit
$1,000,000 Each Occurrence
$2,000,000 Aggregate
c. All insurance policies (with the exception of Worker's Compensation and Professional
Liability) required under this Agreement shall name the County as an additional insured
party and as a certificate holder. Evidence of such insurance and all correspondence shall
be sent to:
Orange County Risk Manager
Post Office Box 8181
Hillsborough, NC 27278
d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity
defenses.
(Hillsborough Arts Council)
Orange County Outside Agency Performance Agreement Page 3 of 9
Rev. 7118
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
7. Relationship of the Parties. Provider is an independent contractor of the County. Provider
represents that they have or will secure, at his own expense, all personnel required in performing
the services under this Agreement. Such personnel shall not be employees or have any
contractual relationship with the County. All personnel engaged in work under this Agreement
shall be fully qualified and shall be authorized and permitted under federal, state and local law to
perform such services.
8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws,
ordinances, orders and regulations of the federal, state or local governments, as well as their
respective departments, commissions, boards, and officers, which are in effect at the time of
execution of this Agreement or are adopted at any time following execution of this agreement.
9. Subcontract. The County and Provider deem the services provided under this Agreement to be
personal in nature and Provider may not subcontract any rights or duties under this Agreement to
any other party without prior written consent from the County.
10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to
any other party without the prior written consent of the County.
11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all
loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury,
including death or property damage, to any person or persons caused in whole or in part by the
negligence or willful misconduct of the Provider, except to the extent same are caused by the
negligence or willful misconduct of the County. It is the intent of this section to require Provider
to indemnify the County to the extent permitted under North Carolina law. Nothing in this
section is intended to affect or abrogate the County's sovereign immunity defenses.
12. Non - Appropriation. This Agreement is subject to the availability of funds to purchase the
specified services and may be terminated at any time if such funds become unavailable.
13. Non - Discrimination. Provider agrees as part of consideration of the granting of funds by Orange
County the parties hereto for themselves, their agents, officials, employees and servants agree not
to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap,
religion, sexual orientation, familial status or veterans status with reference to any activities
carried out by the grantee, no matter how remote. The parties hereto further agree in all respects
to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and
the Orange County Non - discrimination Policy. This provision is enforced by action for specific
performance, injunctive relief, or other remedy as by law provided; this provision shall be
binding on the grantees, the successors and assigns of the parties hereto with reference to the
above subject manner.
14. Living Wage. Orange County is committed to providing its employees with a living wage and
encourages agencies if funds to pursue the same goal. The County's living wage is $ 14.25 per
hour. To the extent possible, Orange County recommends that Hillsborough Arts Council
provide a living wage to its employees.
15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the
last known address shall constitute sufficient notice to the County and the Provider. All notices
required and/or made pursuant to this Agreement to be given to the County and the Provides shall
be in writing and mailed to the party addressed as follows:
(Hillsborough Arts Council)
Orange County Outside Agency Performance Agreement Page 4 of 9
Rev. 7118
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
County: Finance & Administrative Services
Orange County
Post Office Box 8181
Hillsborough, NC 27278
Provider: Hillsborough Arts Council
102 N. Churton Street
Hillsborough, NC 27278
16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire
Agreement between the parties and shall supersede, replace or nullify any and all prior
Agreements of understandings; written or oral, relating to the matters set forth herein, and any
such prior Agreements or understandings shall have no force or affect whatsoever on this
Agreement. The County and Provider have read this Agreement and agree to be bound by all of
its terms, and further agree that this Agreement constitutes the complete and exclusive statement
of the Agreement between the County and Provider.
17. Severability. All clauses found herein shall act independently of each other. If a clause is found
to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It
is understood by the parties hereto that if any part, term or provision of this Agreement is by the
Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United
States, the validity of the remaining portions or provisions shall not be affected, and the rights
and obligations of the parties shall be construed and enforced as if the Agreement did not contain
the particular part, term or provision held to be invalid.
a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of
respective parties hereunder shall be governed by the laws of the State of North Carolina. By
executing this Agreement Provider affirms that Provider and any subcontractors of Provider are
and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General
Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and
has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer
pursuant to G.S. 147 - 86.58.
18. Signatures. This Agreement together with any amendments or modifications may be executed
electronically. All electronic signatures affixed hereto evidence the intent of the Parties to
comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66.
IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on
the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures
below.
For BoeuSigned�by:1r (the Provider
sw'R V�
768276E89FA843F...
For oocusignedby: _ - County Government
fbltiln.l!e
0637994B755E477...
Bonnie Hammersley, County Manager
(Hillsborough Arts Council)
Orange County Outside Agency Performance Agreement
Rev. 7118
8/14/2018
Date
8/14/2018
Date
Page S of 9
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
1. COVER PAGE
a) Applicant Contact Information
Applicant Organization's Legal Name: Hillsborough Arts Council
Applicant Organization's Physical Address: 102 North Churton Street
Applicant Organization's Mailing Address
Applicant Organization's Web Address
Executive Director:
Telephone Number:
Electronic Mail:
Tax ID Number:
Hillsborouah. NC 27278
102 North Churton Street
Hillsborough, NC 27278
HillsboroughArtsCouncil.org
N/A -Neil Stutzer, Chair
919 643 -2500
info (c-DHillsboroughArtsCouncil.org
56- 2163979
b) Funding Request
List all FY18 -19 Human Services (HS) Funding Being Requested —
For All Programs) and the Proposed Use of Funds (2 -3 lines or less)
Program
Carrboro
Chapel
Hill - HS
Orange
County -HS
Total
—HS
Organizational Development for Community
Outreach and Sustainability
$16,500
$16,500
Totals
$16,500
$16,500
The proposed funding is for expanding the Program Coordinator position from half -time
to full -time.
c) To the best of my knowledge and belief all information and data in this
application is true and current. The document has been duly authorized by the
governing board of the applicant.
Signature: N/A
Executive Director
Signature: /yell yeaeZee
Board Chairperson
Date
1/17/2018
Date
AGENCY INFORMATION 2/11/2018 4:28:29 PM Page 6 of 26
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
d) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON
DISCRIMINATION CLAUSE
Are any of the Board Members or employees of the agency which will be carrying out this
program or members of their immediate families, or their business associates?
YES NO
❑ ® a) Employees of or closely related to employees of the Town of Carrboro, the Town of
Chapel Hill, or Orange County?
❑ ® b) Members of or closely related to members of the governing bodies of the Town of
Carrboro, the Town of Chapel Hill, or Orange County?
❑ ® c) Current beneficiaries of the program for which funds are being requested?
❑ ® d) Paid providers of goods or services to the program or having other financial interest in
the program?
If you have answered YES to any question, please provide a full explanation below.
NON - DISCRIMINATION
Provider agrees as part of consideration of the granting of funds by funding agencies to the
parties hereto for themselves, their agents, officials, employees and servants agree not to
discriminate in any manner of these basis of race, color, gender, national origin, age,
handicap, religion, sexual orientation, gender identity /expression, familial status or veterans
status with reference to any activities carried out by the grantee, no matter how remote.
The parties hereto further agree in all respects to conform to the provision and intent of
Orange County Civil Rights Ordinance, as amended and the Orange County Anti-
discrimination Policy. This provision is enforced by action for specific performance,
injunctive relief, or other remedy as by law provided; this provision shall be binding on the
grantees, the successors and assigns of the parties hereto with reference to the above
subject manner.
To the best of my knowledge and belief all of the above information is true and
current. I acknowledge and understand that the existence of a potential conflict of
interest does not necessarily make the program ineligible for funding, but the
existence of an undisclosed conflict may result in the termination of anv arant
awarded.
Signature: N/A
Executive Director
Signature: /e%'6tutZei�
Date
1/17/2018
Board Chairperson Date
AGENCY INFORMATION 2/11/2018 4:28:29 PM Page 7 of 26
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
2. AGENCY INFORMATION (Be Very Brief and Concise)
Please provide the following information about your agency (2 pages OR LESS):
a) Years in Operation, Date of Incorporation (Month/Year): 02/1987
b) Agency's Purpose /Mission (no more than a few sentences):
The mission of the Hillsborough Arts Council is to enrich our community through the
arts.
• Engaging diverse audiences in arts events and educational programs
• Fostering recognition and appreciation of the arts
• Providing avenues to artists, arts organizations and audiences for connecting
with one another
c) Types of Services the Agency Provides (bullet format):
Services we provide are:
• Education
• Support local artists and organizations both as a resource and by mentoring.
• Provide significant cultural events in our schools, communities and in Northern
Orange County.
• Provide venues for local emerging artists to sell their work in the Hillsborough
Arts Council Gallery and Gift Shop and at events.
• Build cross - cultural community ties by providing art related events for all ages
available to all communities.
d) Agency's History with Providing These Services:
For thirty years, the Hillsborough Arts Council (HAC) has brought people together to
enjoy parades, art, music, and poetry. These services have been coordinated with
other organizations, attract visitors and contribute to economic development. Until
two years ago these services have been delivered by an all- volunteer organization.
The HAC has been successful in promoting the arts while the community itself has
been growing dramatically. There is now more to manage and it must be managed
more professionally. While the addition of a half -time Program Coordinator has
improved operations, the HAC is still struggling to keep pace with growth. The
situation is getting more urgent as several of the most active Board members will
soon be leaving.
The HAC seeks funding to support growing ongoing operations as well as to
advance initiatives aimed at serving more diverse communities and improving
long -term sustainability.
e) Other Pertinent Agency Information
As we have finished our second year having a part time Program Coordinator, the
HAC has seen significant change. In June, after an extensive search, and with the
help of the OC Arts Commission, we hired a new Program Coordinator with
qualifications that match our needs well into the future. Her focus on the logistical
Agency Information 2/11/2018 4:28:29 PM Page 8 of 26
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
support of our volunteers has freed up some of the Board members' time to focus on
more strategic tasks, but not nearly enough.
The following paragraphs list the responsibilities of the Program Coordinator. The
problem is that there is just too much work to be done by a half -time staff member.
Much of it is still done by our very active Board members, when their time would be
better spent on major fundraising initiatives, organizational development and long-
term sustainability. Therefore, any investment to increase Coordinator hours would
have a significant payoff.
The part -time Program Coordinator is responsible for:
• Event Coordination. A very large volume of activity must be hosted every
year: 13 programs encompassing more than 50 events of various kinds
involving approximately 20,000 people, providing opportunities for
approximately 400 artists to sell their products, and enabling approximately
8,000 people from all over the world visit our gallery and gift shop.
• Volunteer Recruitment and Placement. Volunteer involvement is the
lifeblood of the HAC, and it must continually increase as HAC activities expand.
The work includes holding interest meetings, creating and managing an on -line
system for recruiting volunteers and assigning them to specific tasks, and
distributing a monthly volunteer e- newsletter.
• Marketing and Public Relations. Videos, photography and graphics are
created to promote events through the Hillsborough Arts Council website. Other
activities include a monthly e- newsletter, calendar management, press
releases, social media, radio programs, signage, banners and print media.
• Funding Development. Community and corporate fundraising are coordinated
and expanded through an annual donor letter, grant writing and charity events
to meet the Council's fundraising goals.
• Community Liaison. Positive relationships are developed and maintained
with local and county government and school officials, business leaders, civic
groups, art patrons and current and potential funding organizations and
agencies.
f) Schedule of Positions (For Entire Agency)
# Full -time Paid Positions
# Half -time Positions:
# Volunteer Hours:
Total FTE
g) Living Wage
FTE
0 0.00
1 x 0.5 = 0.50
11,044 _ 2080 = 5.31
5.81
Does this agency pay permanent employees a minimum living wage? Yes
If yes, is this agency an Orange County Living Wage Certified Employer? Yes
If no, please explain.
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DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
h) Agency Budget
Is your agency currently receiving and /or requesting other (non -Human
Services) local (Town of Carrboro, Town of Chapel Hill, Orange County)
government funding? (Yes /No) Yes
If yes, please list below:
Include all programs that have funding requests /awards /totals from Carrboro,
Chapel Hill, and Orange County governments (other than Human Services).
Program
FY17 -18
Award
FY18 -19
Request
Source
HAC support
9,750
16,500
OC Outside Agency Grant
HAC support
10,000
16,500
Town of Hillsborough
HAC Support
4,847
5,000
OC Arts Commission
Last Fridays
12,935
12,935
Hillsborough Tourism Board
Art Walk
1,474
700
Hillsborough Tourism Board
Art Walk
1,113
300
OC Arts Commission
River Park Concert
5,000
5,000
Hillsborough Tourism Board
Plein Air: Paint it Orange
500
500
Hillsborough Tourism Board
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
ii. Submit your agency's budget. You may complete the provided template
(separate xls file) or you may submit your own budget file
Agency BudgetA1:N38
Operating Budget for Entire Agency
AGENCY NAME: Hillsborough Arts Council
AGENCY REVENUE
Private Donations
Agency Generated Revenue (fees & sales)
Local Government Grants:
Human Services - Town of Carrboro
Other - Town of Carrboro
Human Services - Town of Chapel Hill
Other - Town of Chapel Hill
Human Services - Orange County
(OCOAG)
Other - Orange County (OCAC)
Other - Hillsborough (Town & T. Bd.)
Other Government Grants
Triangle United Way
State Government
Federal Government
Private Foundation Grants
Other Revenue
Total Agency Revenue
AGENCY EXPENSES
Compensation
Rent & Utilities
Supplies & Equipment
Travel & Training
Other Expenses:
Total Agency Expenses
Actual
2016 -17
Estimated
2017 -18
Projected
2018 -19
Percent
Change
$32,938
$31,000
$38,000
23%
$27,991
$40,238
$40,500
1%
0
0
0
0
$7,500
$9,500
$16,500
74%
$7,370
$5,726
$6,000
5%
$28,360
$29,409
$32,000
9%
0
0
0
$7,700
$5,000
$7,000
40%
0
$111,859
$33,416
$119,873
$33,416
$140,000
$50,000
17%
50%
$14,705
$17,000
$17,000
0%
$7,476
$10,194
$10,000
-2%
0
$43,455
$60,256
$50,000
-17%
7$99,052
$120,866
$140,000
16%
SURPLUS /(DEFICIT) FOR PERIOD: 1 $12,807 $(7) $0 1 100%
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
iii. Does your agency budget show a Surplus or Deficit? Yes
Is there a significant change? Yes /No Yes
Please provide a brief explanation for Surplus or Deficit, and significant changes.
There was an Actual 2016 -17 surplus of $12807. Outcomes were better than
expected for Grants ($7,200 vs expected $500) and Sale of Goods (net $14,688
vs expected $6,200), resulting in a surplus for the year.
iv. What is your agency's fiscal year? July 1, 2017 through June 30, 2018
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DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
3. PROGRAM INFORMATION (Submit a separate Section 3 for each program)
Program Name: Organizational Development for Community Outreach and Sustainabil
Program Primary Contact and Title: Neil Stutzer, Chair
Telephone Number: 919 643 -2500 E -Mail: info (c)hillsboroughartscouncil.org
a) Indicate the type of Human Service Needs Priority, if program applicable:
❑ Priority Area #1: safety -net services for disadvantaged residents
® Priority Area #2: education, mentorship, and afterschool programming for youth
facing a variety of challenges
❑ Priority Area #3: programs aimed at improving health and nutrition of needy
residents
b) Indicate the type of program for which you are requesting funding
(Check all that apply to this program)
Program Category
Youth
Adult
Elderly
Disabled
Public Housing
Neighborhoods /Residents
Affordable Housing
Affordable Healthcare
Education
X
X
X
X
Family Resources
Jobs /Jobs Training
X
X
X
X
Food
Transportation
Other:
1. Quality of life and lifelong
learning
2. Economic Development
X
X
X
X
X
X
X
X
c) Provide a bulleted list of other agencies, if any, with which your agency
coordinates /collaborates to accomplish or enhance the Projected Results in
the Program(s) to be funded. For each, briefly describe the
coordinated /collaborative efforts.
All our events are coordinated with external organizations and individuals. The
following lists the primary collaborative efforts.
• Burwell School: Last Fridays, shared events, co- marketing and fundraising
• St. Matthews Episcopal Church: Shared events, co- marketing and fundraising
• Orange County Public Library: Handmade Parade and Lantern Walk
Workshops, shared events and co- marketing.
• Orange County Historical Museum: Last Fridays, Free Spirit Freedom, ArtCycle
donated materials for Fairview's Art in the Park, additional shared events and co-
marketing
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DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
• Orange County Community Players: Ad hoc committee to seek out a
performance and classroom space in Hillsborough.
• Orange County Schools:
• Student Art Show: shared events and co- marketing
• ARTCYCLE collection: material sharing and co- marketing for Orange County
Schools
• Cultural Explosion, Orange County Schools: a school program in which HAC
staffs a booth
• Year End Senior Art Show: a collaboration with the Library and Chamber of
Commerce
• Artists as Speakers: (informal but ongoing), exploring what it takes to be a
working artist in the real world
• Student volunteering in the HAC to fulfill community involvement
requirements.
• Town of Hillsborough: Selection of the town Poet Laurate, event contract to
produce and develop Last Fridays, co- marketing
• Hillsborough Chamber of Commerce: Member and coordination with local
merchants.
• Orange County Visitors Center: Arts & Craft Show, shared events and co-
marketing
• Alliance for Historical Hillsborough: The HAC is a partner in the Alliance.
• Efland Cheeks Community Center: Ongoing support in developing an Art and
Culture Committee, identifying and implementing ongoing programming
Program Description (3 pages OR LESS)
Please provide the following information about the proposed program:
d) Summarize the program services proposed and how the program will address a
Town /County priority /goal?
HAC is responsible for a wide variety of cultural events and activities. For details
please see the list of 13 different categories of activities in the Work Statement
Chart of Section 3.n. These activities support Town and County goals by
contributing to the quality of life, lifelong learning, the creative arts, economic
development, and building community across cultural lines.
The HAC seeks funding to expand the position of Program Coordinator from half-
time to full -time. This would provide support for growing ongoing operations and
advance initiatives aimed at serving more diverse communities and improving
long -term sustainability.
The HAC faces a classic bootstrapping situation in a period of growth. Professional
staff and equipment are needed in order to raise more funds, but funds are needed
first to pay for the staff and equipment. Support from grants will be needed for a few
years while other sources of revenue are developed to the point of sustainability.
More specifically the requested funds would enable better management of ongoing
activities while taking over many everyday tasks that are now being done by Board
members, including
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• Responding to emails
• Grant writing
• Leading committee meetings
• Develop system to estimate the size and demographics of event attendance
• Liaison with collaborating organizations
This, in turn, will allow Board members to spend more time to
• Develop major fundraising and sponsorship opportunities
• Institute formal strategic planning and organizational development
• Develop relationships with community leaders
• Increase diversity of communities served
• Increase outreach efforts
• Develop marketing plans to attract more volunteers, donations, grants and
major sponsors
• Increase net operating income from retail operations
• Plan income - earning new programs, such as of offering art classes to the
public and in schools, including our growing group of home school families
e) Describe the community need or problem to be addressed in relation to the Chapel Hill
Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of
Chapel Hill Council Goals, Carrboro Board Priorities, or other community priorities (i.e.
Council /Board Goals).
The HAC supports the following formal goals of our local governing bodies.
Chapel Hill Human Services Needs Assessment
Under Education and Family Resources, HAC addresses the goals of "Quality
equitable education for everyone" and "Youth support and activities (low- cost /free
activities that positively engage children and youth)." HAC provides workshops
for both the Handmade Parade and the Lantern Walk events. We also plan to
offer more art education classes both inside and outside the school system.
Under Jobs & Jobs Training, HAC strives to create more jobs for artists,
particularly through planned classes both inside and outside the school system.
Orange County BOCC Goals and Priorities
Goal 3 is to Implement planning and economic development policies which
create a balanced, dynamic local economy, and which promote diversity,
sustainable growth, and enhanced revenue while embracing community values.
HAC's promotion of the arts is a well - established driver of clean economic
development as is its attraction of tourists to its cultural events.
Goal 6 is to Ensure a high quality of life and lifelong learning that champions
diversity, education at all levels, libraries, parks, recreation, and animal welfare.
HAC's workshops and art classes support this goal.
Town of Chapel Hill Council Goals
In the category of Create a Place for Everyone, the goal to "Leverage
partnerships to increase cultural arts" is directly supported by the HAC.
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In the category of Support Community Prosperity, the goal to "Focus resources to
achieve economic development goals" is supported by HAC's development of the
arts community and the attraction of tourists to its cultural events.
In the category of Develop Good Places, New Spaces, the goal to "Initiate
planning, funding and design for creative arts" is directly supported by the HAC.
Carrboro Board Priorities,
In category E, Enhance and sustain quality of life /place issues for everyone, goal
7 is to "Help citizens develop a human environment that promotes trust, mutual
respect, acceptance, happiness and well- being," and goal 12 is to "Provide
classes, workshops, trips, camps and other general recreational activities to meet
the varied leisure interests and needs of the community." Both are supported by
the HAC.
f) Who is your target population of individuals to benefit from this program and how
will they be identified and connected with the program?
The HAC primarily serves residents of Central and Northern Orange County through
its programming. Our outreach is expanding primarily through the schools, churches
and Community Centers.
A major component of HAC's outreach efforts is to work through the county's 22
local Community Centers. The first mentoring project was begun this year with the
Efland- Cheeks Community Center (ECCC). HAC Board members approached
ECCC leadership and offered to help them develop arts programming. Plans were
developed for (1) a show of locally produced art, and (2) a continuing process for
arts programming. The first show opened on January 7, 2018, as described in the
News of Orange County:
https: / /nam03.safelinks. protection. outlook. com/? url= http° /o3A %2F %2Fwww.newsoforange.com%
2Farts and entertainment %2Farticle 1 a5e9e72- fbb4 -11 e7 -b6f4-
73c91844d329.htm1 &data= 02 %7C01 % 7C% 7C7dc9f76f2d0843e6c7ac08d55ed3eb5b %7C84df9e
7fe9f640afb435aaaaaaaaaaaa %7C1 %7C0 %7C636519186626745901 &sdata= 1MaNn4tRi1 P3SM
hgsMzflnJAg7DILfwYINA9dKZrEEM %3D &reserved =0
The HAC would like to do more work like this.
g) Describe the credentials of the program manager and other key staff. (Ex. Identify
Program Manager and credentials, describe training provided to volunteers, etc.)
The HAC has a part -time Program Coordinator, Eileen Ferrell. A Hillsborough
resident, Eileen brings to the role a local's sensibility combined with a wealth of
experience in nonprofit management. She holds a B.A. in Sociology and a Master of
Social Work from UNCCH. She has been an Americorps VISTA volunteer (Durham
Schools). Her other nonprofit experience includes work in Orange County at
Volunteers for Youth and the Carolina Center for Public Service, and then in Wake
County at the Institute for Nonprofits at N.C. State University. She now serves as
part -time executive director of Strowd Roses, Inc., a Chapel Hill - Carrboro
foundation.
Our volunteers bring skills as artists and teachers, in addition to a wide range of
professional expertise: merchandising, accounting, advertising, strategic planning,
grant- writing, business operations, etc. The HAC taps the broad talent available in
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Orange County and focuses it on hosting opportunities for joyful human interaction
and growth through the arts.
h) Describe the specific period over which the activities will be carried out and include
an implementation timeline.
The work supported by this grant enables year -round programming and
organizational development, all of which promotes tourism and benefits
Hillsborough's economic and cultural climate. As detailed below, some ongoing
activities occur only during part of the year. Each of these programs is chaired and
implemented by volunteers. Their success and enthusiasm are enabled by our
Program Coordinator.
HAC Gallery and Gift Shop operates year- round.
Last Fridays are held from spring through fall.
Last Friday Art Walk, is held from January through November.
The Handmade Puppet Parade happens every even year in October.
Lantern Walk, happens once each year in December.
Parlor Concerts occur during the months of January, February and March.
Hillsborough Downtown Arts and Crafts Show is held each year in April.
Arts Alive happens year -round as local talent is available.
Free Spirit Freedom is a year -round program.
ArtCycle is a year -round program most active when school is in session.
River Park Concert is held once each year in October.
With additional funding, new outreach efforts will seek to expand the geographic and
ethnic diversity of the population served. HAC will build upon the successes of the
recent program at the Efland- Cheeks Community Center.
i) Why is funding this program a good investment for the community? How does
funding this program add value to the community? (250 words OR LESS)
A strong arts community adds to the quality of life, which in turn, is a key factor for
business and industry in finding new locations where they can attract a talented
workforce. Thus, Orange County's arts community in general and the Hillsborough
Arts Council specifically are important drivers of economic development in
Hillsborough and Orange County. They are crucial elements of the County's
character that distinguishes it from other parts of the Triangle and state. They
strengthen Orange County's position in a highly competitive region as an attractive
location to live and for business investment.
Several years ago, Orange County participated in Arts & Economic Prosperity IV, a
national survey ( www.artsorange.org /index- 4extra.html ). It reported:
Nonprofit arts and culture organizations in Orange County, NC spent a
total of $85.4 million during fiscal year 2010. This spending - $63.9 million
by nonprofit arts and culture organizations and an additional $21.5 million
in event - related spending by their audiences — supports 3,352 full -time
equivalent jobs and generates $8.0 million in local and state government
revenue.
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It is likely that these figures have grown considerably since 2010.
More important than economic development, though, is HAC's contribution to
community building. Many of HAC's events are participatory. Workshops bring
people together to share the joy of creating. The associated events bring out those
same people to march together. This process can provide tools to proactively
promote the values of diversity and inclusion in our community.
j) Describe what would happen if requested funding is not awarded at all or if a
reduced allocation is recommended.
If the HAC fails to secure funding for a full -time Program Coordinator, then it will
struggle to keep up with growth in existing programs. The problem will become
especially acute when several active Board members retire in the upcoming year.
In addition to the impact on ongoing activities, failure to secure funding will limit
planned efforts to
• Develop major fundraising and sponsorship opportunities
• Institute formal strategic planning and organizational development
• Increase net operating income from retail operations
• Develop a system to estimate the size and composition of event attendance
• Develop relationships with community leaders,
and it would likely put off new efforts to
• Increase diversity of communities served
• Increase outreach efforts
• Develop marketing plans to attract more volunteers, donations, grants and
major sponsors
• Plan income - earning new programs, such as of offering art classes to the
public and in schools, including our growing group of home school families
k) What percentage of your target population is low- moderate income?
We do not have a way to estimate this quantity. It is probably close to the value for
the Hillsborough general population. Getting this kind of information is one of the
new activities for the Program Coordinator that is proposed above.
1) What efforts do you make to seek feedback about your program from your target
population (e.g. survey, evaluations, etc. ?)
One of our goals is to develop and implement statistical surveys to be developed
and shared with /in conjunction with other arts and cultural organizations, the Town
and County.
m) Include any other pertinent information.
Additional Program Information
n) Target Population
Because most of our events attract crowds in open spaces, we are unable to give accurate
head counts. Our population breakdowns are based on estimated percentages applied to
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estimated total headcounts. Our events also include many repeat customers, so it is
impossible to correct for duplicate counts across multiple events. We are working towards
more accurate tracking of the one -on -one services we provide. The OC Sheriff's officers
will work with us on this.
Gender
Ethnicity
Age
Program Target Population Demographics
Male
Female
Total
African - American
American Indian or Alaska Native
Asian
Caucasian
Native Hawaiian or other Pacific Islander
Other: specify
Total
Of the above, how many Hispanic /Latino
Of the above, how many non - Hispanic /Latino
Total
0 -5 years
6 -18 years
19 -50 years
51+ years
Total
Actual Estimated Projected
2016 -17 2017 -18 2018 -19
9,500
10,500
11,500
9,500
10,500
11,500
19,000
21,000
23,000
3,800
4,620
5,750
190
210
230
380
420
460
13,870
15,750
16,560
19,000
21,000
23,000
760
0
0
19,000
21,000
23,000
11520
1,680
3,450
17,480
19,320
19,550
19,000
21,000
23,000
2,280
2,100
2,300
2,470
3,150
3,450
9,500
12,600
13,800
5,700
3,150
3,450
19,000
21,000
23,000
Geographic Location See below for geographic information
Alamance County
Chatham County
Durham County
Wake County
Orange County Breakdown
Chapel Hill Public Housing
Town of Chapel Hill (Non - Public Housing)
Town of Carrboro
Town of Hillsborough
City of Mebane (Orange County)
Orange County (Outside Municipalities)
Total 19,000 21,000 23,000
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4,000
4,500
2,500
3,000
19,000
8,000
8,000
1,500
1,500
5,000
6,000
Total 19,000 21,000 23,000
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Geographic distribution: Many HAC events are open- admission outdoor events spread
through downtown Hillsborough. We do not have the means to estimate the geographical
origin of attendees. We do have information about the population that has visited the
Gallery and Gift Shop, which follows.
The Gallery and Gift Shop served over 8,461 customers this past year, an increase of 22 %.
40% of them were tourists, coming from:
• 60 North Carolina cities and towns: Hillsborough, Chapel Hill, Carrboro, Cedar Grove,
Efland, Hurdle Mills, Rougemont, Apex, Asheboro, Banner Elk, Burlington, Cary,
Charlotte, Concord, Creedmoor, Duck, Dunn, Durham, Elon, Fayetteville, Fuquay-
Varina, Gastonia, Goldsboro, Graham, Greensboro, Greenville, Haw River,
Hendersonville, Hickory, High Point, Holly Springs, Jamestown, Kannapolis,
Kernersville, Lillington, Lumberton, Mebane, Mooresville, Mount Airy, Oxford,
Pinehurst, Pittsboro, Raleigh, Reidsville, Roxboro, Sanford, Wake Forest, Wendell,
Wilmington, Winston - Salem, Yanceyville, Zebulon, Eden, Caldwell, Whitsett,
Youngsville, Warrenton, Saxapahaw, Washington, Tryon.
• 40 states + DC: The only states not appearing were Alaska, Arkansas, Idaho, Kansas,
Montana, Nebraska, North Dakota, Oklahoma, Oregon, Vermont.
• 7 foreign countries + 1 U.S. Territory: Canada, Mexico, England, Ireland, Germany,
Australia, Sweden, Puerto Rico
Work Statement
o) Complete the Work Statement Chart to describe the work to be performed.
Work Statement Chart for Program Organizational Development for Community
Outreach and Sustainabilitv
The Program Coordinator responsibilities have a direct impact on all of HAC's major
activities, which are listed below.
1. Program Activity Name
HAC Gallery and Gift Shop
Program Goal
Provide venue to showcase and market products of local artists
Performance Measures
Number of visitors
Total revenue
Previous Year Program Results
6,935
$42,430
Current Year Estimated Results
8,500
$45,000
Next Year Projected Results
9,500
$50,000
2. Program Activity Name
Last Fridays
Program Goal
Attract locals and visitors to downtown Hillsborough to enjoy the
arts, and share information through community booths
Performance Measures
Number of events
Total attendance
Previous Year Program Results
6
9,000
Current Year Estimated Results
6
9,000
Next Year Projected Results
6
9,500
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3. Program Activity Name
Last Friday Art Walk
Program Goal
Attract locals and visitors to downtown Hillsborough to enjoy the
arts and support local vendors
Performance Measures
Number of events
Total attendance
Previous Year Program Results
10
4,800
Current Year Estimated Results
10
4,800
Next Year Projected Results
11
5,000
4. Program Activity Name
The Handmade Puppet Parade
Program Goal
Build community and attract visitors by celebrating shared creativity
and community pride
Performance Measures
Number of marchers
Total attendance
Previous Year Program Results
600
3,500
Current Year Estimated Results
n/a
n/a
Next Year Projected Results
700
4,500
5. Program Activity Name
Lantern Walk
Program Goal
Build community and attract visitors by celebrating shared creativity
and community pride
Performance Measures
Number of participants
Previous Year Program Results
2,000
Current Year Estimated Results
2,400
Next Year Projected Results
2,500
6. Program Activity Name
Parlor Concerts
Program Goal
Provide intimate venues for appreciation of accomplished
performers
Performance Measures
Number of events
Total attendance
Previous Year Program Results
4
180
Current Year Estimated Results
2
90
Next Year Projected Results
4
180
7. Program Activity Name
Hillsborough Downtown Arts and
Crafts Show
Program Goal
Promote the work of local artists
Performance Measures
Total attendance
Previous Year Program Results
1,500
Current Year Estimated Results
1,500
Next Year Projected Results
1,800
8. Program Activity Name
Free Spirit Freedom
Program Goal
Celebrate the diversity of Orange County's historic past and future
through photography and narrative, providing opportunities to learn
about the contributions of African Americans to our community
Performance Measures
Number of events
Total attendance
Previous Year Program Results
1
100
Current Year Estimated Results
2
200
Next Year Projected Results
3
200
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9. Program Activity Name
Art Cycle
Program Goal
Encourage citizens to contribute new and used supplies to students
in school art classes
Performance Measures
Value of contributions
Previous Year Program Results
$8,000
Current Year Estimated Results
$3,000
Next Year Projected Results
$8,000
10. Program Activity Name
River Park Concert
Program Goal
Promotes local talent and provide a youth workshop prior to the
event
Performance Measures
Number of attendees
Number of workshop
Previous Year Program Results
n/a
n/a
Current Year Estimated Results
4,000
1
Next Year Projected Results
5,000
2
11. Program Activity Name
Art in Education
Program Goal
Supply art education classes in local schools
Performance Measures
Number of classes
Number of students
Previous Year Program Results
8
120
Current Year Estimated Results
1
15
Next Year Projected Results
8
120
12. Program Activity Name
Community Outreach
Program Goal
Increase the diversity of community served
Performance Measures
Number of outreach meetings
Previous Year Program Results
2
Current Year Estimated Results
20
Next Year Projected Results
35
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
p) Program Budget
1. Submit your program budget. You may complete the provided template (separate As
file) or you may submit your own budget file (as long as it contains the same information,
in the same format, as requested in the provided template).
Program Budget
Operating Budget for Entire Program
AGENCY NAME:
PROGRAM REVENUE
Private Donations & Sponsorships
Agency Generated Revenue (fees)
Local Government Grants:
Human Services - Carrboro
Other - Town of Carrboro
Human Services - Chapel Hill
Other - Town of Chapel Hill
Human Services - Orange County
Other - Orange County
Other - Town of Hillsborough
Other Government Grants
Triangle United Way
State Government
Federal Government
Private Foundation Grants
Other Revenue
Total Program Revenue
PROGRAM EXPENSES
Compensation, taxes & insurance
Supplies & Equipment
Travel & Training
Other Expenses:
Total Program Expenses
SURPLUS /(DEFICIT) FOR PERIOD:
Hillsborough Arts Council
Actual
2016 -17
Estimated
2017 -18
Projected
2018 -19
Percent
Change
$4,000
$3,000
$12,000
300%
$2,300
$1,050
$5,000
376%
0
0
0
0
$7,500
$9,750
$16,500
69%
0
$10,000
1 $10,000
1 $16,500
1 65%
0
0
0
0
0
$23,800
$23,800
$23,800
$23,800
$50,000
$50,000
110%
110%
0
0
0
$23,800
$23,800
$50,000
110%
$0 I $0 I $0
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
2. Program Budget Detail — Provide description of "other" budget items, not defined.
3. This program budget represents what percent of the agency budget?
50,000 = 140,000 = 0.357, or 36%
4. COST PER INDIVIDUAL
This Cost per Individual must reflect the total program budget divided by the total
number of program individuals in this application.
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Actual 2016 -17
Estimated 2017 -18
Projected 2018 -19
Total Cost of Program
$23,800
$23,800
$50,000
Total # of Individuals
19,000
21,000
23,000
Cost Per Individual
$1.25
$1.13
$2.17
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
4. ATTACHMENTS
Description of Required Attachments
a) Financial Audit
A recent financial audit that should cover CY 2016, for calendar year agencies, and FY
2016 -17, for fiscal year agencies. For agencies with prior year revenues totaling $500,000 or
more a financial audit, prepared by a certified public accountant is required. Agencies with
prior year revenues of less than $500,000 may submit a completed Schedule of Receipts
and Expenditures form (see application materials), in lieu of an audit/report. Agencies with a
certified audit /report should not complete the form.
b) IRS Federal Form 990
A copy of the agency's 2016 Form 990 is required. The specific form depends upon the
agency's financial activity. Review the IRS' table guide, for more details. For Form 990 -N (e-
postcard) filers, include a copy of the postcard, with the agency's application materials.
c) NC Solicitation License
A copy of the agency's current solicitation license is required. Organizations that solicit
contributions in North Carolina, directly or through a third party, must renew their licenses
annually. For more details, refer to the NC Secretary of State's licensing website and its
Frequently Asked Questions Guide (PDF), about exemptions. If exempt per N.C.G.S. §
131 F -3, include a copy of the exemption letter with the agency's application materials.
d) IRS Federal Tax - Exemption Letter
A copy of the agency's IRS tax - exempt letter that confirms its nonprofit status is required. An
agency can request a copy of its letter from the IRS' Customer Account Services.
e) Certificate of Liability Insurance
A copy of the agency's current certificate, from the agency's insurance carrier. Table 1
below outlines insurance types and minimums required, for each jurisdiction. If exempt from
Worker's Compensation compliance, include a statement explaining why, with the agency's
application materials. *Note: If Approved for Funding: Approved agencies must provide an
updated insurance certificate. The update should reflect the funding jurisdiction as an
additional insured party and certificate holder and provide coverage for the duration of the
funding period (July 1 — June 30). Renewal certificates must be sent to the jurisdiction 30
days prior to any expiration date, cancellation or modification of any stipulated insurance
coverage.
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required
INSURANCE
TOWN OF CARRBORO
TOWN OF CHAPEL HILL
ORANGE COUNTY3
Worker's
Limits for Coverage A
Limits for Coverage A -
Limits for Coverage A -
Compensation'
- Statutory State NC,
Statutory State NC, for each
Statutory State NC, for
for each employee
employee
each employee
Limits for Coverage B
Limits for Coverage B -
Limits for Coverage B -
- Employers Liability
Employers Liability of:
Employers Liability of:
of:
$100,000 Each Occurrence
$500,000 each accident,
$1 million Each
$100,000 BID for each
$500,000 BID for each
Occurrence
employee
employee
$1,000,000 BID limit
$500,000 BID limit
$500,000 for BID limit
Commercial
$100,000 Property
General Liability
Damage Liability
$1 million Each Occurrence
$1 million Each
$1,000,000 Bodily
$2 million Aggregate
Occurrence
Injury and Property
$2 million Aggregate
Dama e Limit
Automobile
Not Applicable
$1 million Each Occurrence
$1 million Each
Liability
Occurrence
Professional
$1 million Each Occurrence
$1 million Each
Liability
Not Applicable
$2 million Aggregate
Occurrence
$2 million Aggregate
Sexual Abuse &
$1 million Each Occurrence
$1 million Each
Molestation
Not Applicable
$2 million Aggregate
Occurrence
$2 million Aggregate
Cyber Liability
$1 million Each Occurrence
$1 million Each
Not Applicable
$2 million Aggregate
Occurrence
$2 million Aggregate
1. Visit the NC Industrial Commission's website for more information regarding Coverage A. Also,
note that if an agency uses subcontractors, it must require subcontractors to have workmen's
compensation insurance.
2. Bodily Injury by Disease (BID)
3. Please visit Orange County's Risk Management page for more information about the County's
Minimum Insurance Requirements.
f) List of Board of Directors
Provide the following information about each board of director's member: name, telephone
number, address, occupation or affiliation of each member and the list must identify the
principal officers of the governing body, and length of term.
g) Solid Waste Program Fee (SWPF) Verification
This fee finances Orange County's recycling and waste reduction program. Submit either a.)
proof of payment of the agency's FY 2017 -18 Solid Waste Program Fee, OR b.) a statement
on agency letter head indicating exemption and specify the person(s), business, etc. that is
responsible for paying this fee.
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1 W4 so I 1111"Iu
Scope of Services — FY 2018 -19
Outside Agency Performance Agreement
Agency Name: Hillsborough Arts Council
Program Name: Organizational Development for Community Outreach and Sustainability
Funding Award: $10,763
Outline how the agency will spend Orange County's funding award.
Expense Description Amount
Personnel- Salaries and FICA
Program Support- Professionalize Administration and Develop Financial and Service Partnerships $10,763
Program Services
Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019.
• Sustain current programming
• Develop major fundraising and sponsorship opportunities
• Increase net operating income from retail operations
Anticipated Outcomes
The Anticipated Results column must include quantifiable results in the form of number of persons /units served within Orange
County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants
within that measure's description or for an earlier performance measure.
Performance Measures
Anticipated
Results
Increase the total people served by developing new outreach efforts, partnerships, board
Additional
development and marketing efforts.
10,000
people
served
Implement 2 major annual fundraising events
2 additional
events
Increase income from our retail operations
+$10,000
DocuSigned by:
Ew� Sww Chai r 8/14/2018
Certified by: 166276E8El FA843F... Title: Date:
(Provider's Signature)
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED220CC
ATTACHMENT "A"
Orange County Certifications — FY 2018 -19
Outside Agency Performance Agreement
Chief Contact, Administrators, Chief Executive Officer and Chief Financial Officer
I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief
financial officer for my agency with this Agreement and that I will keep it current to the County of Orange.
The list should be in writing with the name, title, residential address; phone and email address and if
possible, fax number.
Officers and Board of Directors
I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and
that we will continue to update the list as changes occur. The list should be in writing, with the name,
physical address, mailing address and if possible, phone, fax and email address.
Budget Submission
I certify that I have provided a budget for the period to be covered by funding Orange County, and that any
substantive changes made to this budget have been in advance authorized in writing by Orange County.
Annual Financial Review
I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget
adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a
separate sheet of paper.
Alignment with Organization's Mission
I certify that the programs and services for which this funding is requested align with the mission of the
organization.
Intended Purpose
I certify that the funds provided to the agency under the terms of this Agreement will be used for a public
purpose and shall only be used for the purposes intended and any money not used for those purposes will be
promptly returned to Orange County.
DocuSigned by:
14, sw- t r
Certified by: 76621111PFAWF...
(Provider's Signature)
Title: Chair
Date: 8/14/2018
(Hillsborough Arts Council)
Orange County Outside Agency Performance Agreement Page 9 of 9
Rev. 7118
p
DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED22OCC DATE(MMfDDlYYYY)
UtK i 11-IL;A 1 It Ur LIABILITY INSURANCE 1/22/2018
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL" INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of tho policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsernent(s).
PRODUCER
BALLARD AGENCY INC
PC Box 1559
Hillsborough, NC 27278
NAME J. David Ballard _
PHONE (919)7322158 "- '
_ (919) 732 -9636
RIC No EM) A1C,NG
ADDRESS Ballard @ba11ardagencyinc . com
INSURERMI AFFORDING COVERAGE
NAICIP
INSURER A . GREAT AMERICAN INSURANCE CO . A
POLICY NUMBER
INSURED HILLSBOROUGH ARTS COUNCIL
PO BOX 625
HILLSBOROUGH, NC 27278
INSURER B
LIMITS
INSURER C
INSURER D:
INSURER E
INSURER F
I
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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$1,000,000 OCC WRONGFULL
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AIDIRECTOR & OFFICERS EPP4917790 1/16/181/16/19
ACTS $1,000,000 OCC
LIABILITY
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DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Addlilonal Remarks Schedule. may be attached If Moro space Is required) '
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$1,000,000 AGGREGATE LIMIT
CFRTIFiCATE HOLDER CANCELLATION
ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE j
THE PO BOX 8181 ACCORDANCE WITH DATE THEREOF. NOTICE WILL BE DELIVERED IN
THE POLICY PROVISIONS.
HILLSBOROUGH, NC 27278
AUTH 12ED REPRESENTATIVE
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