HomeMy WebLinkAbout2018-415-E Finance - Historic Hillsborough Commission outside agency agreementDocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
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 Historic Hillsborough Commission, a not - for - profit
corporation, located at 319 N. Churton Street, Hillsborough, NC 27278 ( "Provider ").
LVVIII►QY.
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 Historic Hillsborough Commission 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 $9,054.
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 $2,263.50. 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.
(Historic Hillsborough Commission)
Orange County Outside Agency Performance Agreement
Revised 712018 Page 1 of 9
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
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.
(Historic Hillsborough Commission)
Orange County Outside Agency Performance Agreement Page 2 of 9
Rev. 7118
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
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.
(Historic Hillsborough Commission)
Orange County Outside Agency Performance Agreement Page 3 of 9
Rev. 7118
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
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 Historic Hillsborough
Commission 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:
(Historic Hillsborough Commission)
Orange County Outside Agency Performance Agreement Page 4 of 9
Rev. 7118
DocuSign Envelope ID: C5C11FD4- 56CD- 48FD- BBD1- 95F2AFF7112B
County: Finance & Administrative Services
Orange County
Post Office Box 8181
Hillsborough, NC 27278
Provider: Historic Hillsborough
Commission
319 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 DocuSigned by: Provider
r�
E396827231534FC...
For an ' oocuSi9nedby, ° unty Government
66KAAj(. f%wtt.#''i�
0637994B755E477...
Bonnie Hammersley, County Manager
(Historic Hillsborough Commission)
Orange County Outside Agency Performance Agreement
Rev. 7118
8/13/2018
Date
8/14/2018
Date
Page S of 9
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
1. COVER PAGE
a) Applicant Contact Information
Applicant Organization's Legal Name: Historic Hillsbou h Commission
Applicant Organization's Physical Address: 319 N. Churton Sf. Hillsborou h NC 27278
Applicant Organization's Mailing Address: PQ Box 922 Hillsborough, NC 27275
Applicant Organization's Web Address: Burwellschool.ora
Executive Director: Kate Faherty
Telephone Number. 919.732.7451 E -Mail: Director burwelfschool.or
Tax ID Number: 56 - 085036
b) Funding Request
List all FY18 -19 Human Services H5 Funding Being Requested
For All Programs) and the Proposed Use of Funds (2 -3 lines or less)
Ch- apel
Hill - HS
$15,000
Orange
Count -HS
$5,000
Total
$30,000
8,200
1, 000
9,200
c) To the pest 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:
Executive Dlre or
Date
Signature:, � ��
Board Chairiperson D e
AGENCY INFORMATION 1/23/2018 12:09:02 PM Page 8 of 27
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
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
D x❑ a) Employees of or closely related to employees of the Town of Carrboro, the Town
of Chapel Hill, or Orange County?
x0 0 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?
L] xE c) Current beneficiaries of the program for which funds are being requested?
El x EJ 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.
Incoming board member of the Historic Hillsborough Commission, appointed by Governor Roy
Cooper: Renee Price, Orange Co. Commissioner.
NON - DISCRIMINATION
Provider agrees as part of consideration of the granting of funds by funding agencies to the
parties hereto for themselves, their agents, officials, employees and servants agree not to
discriminate in any manner of these basis of race, color, gender, national origin, age;
handicap, religion, sexual orientation, gender identity /expression, familial status or veterans
status with reference to any activities carried out by the grantee, no matter how remote. The
parties hereto further agree in all respects to conform to the provision and intent of Orange
County Civil Rights Ordinance, as amended and the Orange County Anti - discrimination
Policy. This provision is enforced by action for specific ,performance, injunctive relief; or other
remedy as by law provided; this provision shall be binding on the grantees, the successors
and assigns of the parties hereto with reference to the above subject manner.
To the best of my knowledge and belief all of the above information is true and
current. I acknowledge and understand that the existence of a potential conflict of interest
does not necessarily make the program ineligible for funding, but the existence of an
undisclosed conflict may result in the termination of any grant awarded.
Signature; Kate Fahey, MS January 23. 2018
Executive Director Date
Signature: Deborah Kodros January 23 2618
Board Chairperson Date
AGENCY INFORMATION 1/23/2018 12:09:02 PM Page 9 of 27
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
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): lncor orated Janua 1
b) Agency's PurposelMission (no more than a few sentences):
The Mission of the Historic Hillsborough Commission is to preserve the Burwell School
Historic Site and to bring its complex and layered history and the history of 1911'
Century Hillsborough and Orange County to the public as a resource of education and
community life.
c) Types of Services the Agency Provides (bullet format):
• Free guided tours five days per week
• Open to the public 23 hours per week, free admission
• Lessons and tours for school groups grades 1 through 12
• Programs for interest groups such as book clubs, DAR, history groups,
college students, etc
• Participation in town -wide events: Living History Days, Revolutionary
War Day, Last Fridays, and walking tours
• Free online database of genealogical research on the people of the site
• Rentals for weddings and events as possible
• Exhibits and brochures
d) Agency's History with Providing These Services.
The Burwell School Historic Site has welcomed more than 60,000 visitors since it opened,
including many schoolchildren learning about their community and the history of their
community. The site has hosted teachers from across the nation as part of teacher
enrichment programs sponsored by the Apprend Foundation, and has published the unique
Bonk of Burwell Students, Lives of Educated Women in the Antebellum South, by the
Commission's founding leader, Mary Claire Engstrom. Additionally the site has opened its
doors for a wide range of cultural experiences offered mostly free of charge: book readings,
music, history programs, children's programs and more.
e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes
in the past year? Is there a new Executive Director? Are there new initiatives?)
The key new initiative is the 2018 Elizabeth Hobbs Keckly Bicentennial Year —
programs and exhibits focused on her life and struggle, and targeted to the entire
region and beyond.
Agency Information 112312418 12:09. -02 PM P a g e 10 0 f 2 7
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
f) Schedule of Positions (For Entire Agency)
• Full Time Equivalent (FTE) staff will be noted as 1.00; half time as .50; quarter time as .2 5, etc.
• Calculate a Full Time Equivalent for all recorded volunteer hours using the following:
Total Volunteer Hours = Volunteer FTE
2,080
# of FTE - Full -Time Paid Positions: 0
# of FTE - Paid Part-Time Positions: 2 ositions: .3 FTE and .7 FTE
# of Volunteers: 60 # of FTE - Volunteers :1 FTE
gj Living Wage
Does this agency pay permanent employees a minimum living wage? (yes I No) YES
If yes, is this agency an Orange County Living Wage Certified Em to er? YES
If no, please explain.
Agency Information 1123/2018 12:09:02 PM Page 1 I of 27
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
hj Agency Budget
i. Is your agency currently receiving and/or requesting other (non -Human Services)
local (Town of Carrboro, Town of Chapel Hill, Orange County) government
funding? (YeslNo) yes
If yes, please list below:
Include all programs that have funding requestslawards/totals from Carrboro Chapel Hill
and Oran le GOWItY governments (other than Human Services) DO NOT include federal
funding sources, such as CDBG and HOME.
Program
FY17 -18
FY18 -19
Source
Ex: Affordable Rental
Award
0
Re oast
Rehabilitation
$20,000
Carrboro - Affordable Housing
Ex: Agency Administration
$15,000
$15,000
Carrboro — Other
Ex. Total
$15,000
$35,000
Carrboro Total Funding
Orange County Human
Services
9028
9200
OC Human Services
*Add rows or attach additional page, if needed.
ii. Submit your agency's budget. You may complete the provided template (separate
As file) or you may submit your own budget file (as long as if contains the same
information, and in a similar format, as requested in the provided template).
Agency Information 1/23/2018 12:09:02 PM Page 1 2 of 27
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Agency Budgets are required to define budget amounts for the previous program
year, current program year, and next program year for the following categories:
Revenues
• Private Donations
• Program Generated Revenue
• Local Government Grants
• Carrboro Human Services
• Carrboro Other
• Chapel Hill Human Services
• Chapel Hill Other (DO NOT include CDBG funding here)
• Orange County Human Services
• Orange County Other (DO NOT Include HOME funding here)
• Other Government Grants
• Triangle United Way
• State Government
• Federal Government (CDBG /HOMEletc.)
• Private Foundation Grants
• Other Revenue
Expenditures
• Compensation
• Rent & Utilities
• Supplies & Equipment
• Travel & Training
• Other Expenses
iii. Does your agency budget show a Surplus or Deficit? Neither
Is there a significant change? Yes /No NO
Please provide a brief explanation for Surplus or Deficit, and significant changes,
iv. What is your agency's fiscal year? July 1 2018 —June 30 2019
(Example: July 1, 2016 through June 30, 2017)
Agency Information 1/23/2018 12:09:02 PM Page 13 of 27
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Agency Budget
Operating Budget for Entire Agency
AGENCY NAME: Historic Hillsborough Commission, Inc. - The Burwell School Historic Site
AGENCY REVENUE
Private Donations
Agency Generated Revenue (fees)
Local Government Grants:
Human Services - Town of Carrboro
Other - Town of Carrboro
Human Services - Town of Chapel Hill
Other - Town of Chapel Hill
Human Services - Orange County
Other - Orange County
Other - Town of Hillsborough
Other Government Grants
Triangle United Way
State Government
Federal Government (CDBG /HOME /etc.)
Private Foundation Grants
Other Revenue
Total Agency Revenue
AGENCY EXPENSES
Compensation
Rent & Utilities
Supplies & Equipment
Travel & Training
Other Expenses:
Total Agency Expenses
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (46)1$ (437)1$ 8,500 1 2045%
FY 2018 -19 Agency Budget
Actual
2016 -17
Estimated
2017 -18
Projected
2018 -19
Percent
Change
$
4,500
$
6,500
$
7,500
15%
$
3,900
$
1,300
$
2,000
54%
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
8,857
$
9,028
$
9,200
2%
$
-
$
-
1 $
-
0
$
20,800
$
25,615
$
30,000
17%
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
7,500.00
$
7,500.00
$
-
$ (1.00)
$
26,510
$
53,320
$
60,000
$ 0.13
$
$
72,067
29,288
$
$
103,263
45,600
$
$
108,700
50,000
5%
10%
$
8,000
$
8,900
$
9,200
3%
$
3,000
$
5,000
$
6,000
20%
$
200
$
-
$
-
0
$
31,625
$
44,200
1 $
35,000
1 -21%
$
72,113
$
103,700
1 $
100,200
1 -3%
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (46)1$ (437)1$ 8,500 1 2045%
FY 2018 -19 Agency Budget
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
3. PROGRAM INFORMATION (Submit a separate Section 3 for each p
Program Name: Burwell School Historic Site Visitor Services and Accessibility
Program Primary Contact and Title: Kate Faherty, Executive Director
Telephone Number: 919 732 7451
E -Mail: Director (Mburwellschool,or
a) Indicate the type of Human Service Needs Priority, if program applicable:
❑ Priority Area #1: safety -net services for disadvantaged residents
X❑ Priority Area #2: education, mentorship, and afterschool programming for
Youth facing a variety of challenges
❑ Priority Area #3: programs aimed at improving health and nutrition of needy residents
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
Affordable Housin Neighborhoods /Residents
Affordable Healthcare
Education X X x
Family Resources
Jobs /Jobs Trainin
Food
Trans portation
Other: Please specify
cj Provide a bulleted list of other agencies, if any, with which your agency
coordinates /collaborates to accomplish or enhance the Projected Results in the Program(s)
to be funded. For each, briefly describe the coordinated /collaborative efforts,
• Orange county /Chapel Hill Carrboro Visitor Bureau
• Hillsborough Visitor Center
• Alliance for Historic Hillsborough
• Town of Hillsborough Tourism Program
• Hillsborough Chamber of Commerce
• Hillsborough /Orange County Historical Museum
• Orange Co. Library
• NC Dept. of Natural and Cultural Resources
• Office of the Governor, Boards and Commissions
PROGRAM INFORMATION 1123/2418 12:09 :02 PM Page 14 of 27
DocuSign Envelope ID: C5C11FD4- 56CD- 48FD- BBD1- 95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Program Description (3 pages OR LESS): Ensuring visitor safety and services at the Burwell
School Historic Site with a focus on the Elizabeth Keckly 2918 Bicentennial Year
The Burwell School Historic Site is the only historic house museum in Orange County that (1) is
open to the public free of charge on a regular basis, and (2) offers a range of educational
experiences designed specifically for school groups and young people. The Burwell School has
served as an educational and historical resource for Orange County since it was opened to the
public in the 1970's and maintains its focus on preserving and interpreting the site's story in a way
that is inspiring and enlightening for all generations and backgrounds. The site welcomes visitors
from across the County, State, and nation, as well as visitors from foreign countries. In the past
year these included Scotland, Germany, Norway, England, Canada, Italy, and France.
The site, circa 1821, is comprised of two acres and three buildings which were purchased by the
Historic Hillsborough Commission in the 1960's from the heirs of the last family to live there, With
funding raised primarily locally, the property was restored and furnished with donated period
antique items. Members of the Commission carried out groundbreaking research to document the
history of the site and the antebellum girls' school operated there from 1837 — 1857 by the Rev.
Robert Burwell and his wife, Anna Burwell, and which served as the model for as many as seven
subsequent schools operated by former students. From 1835 - 1842 the site was also the home
and workplace of an enslaved young woman, Elizabeth Hobbs, (later Keckly) and her story has
become an added focus of the research and programming at the Burwell School. She was born
into slavery, was subjected to incidents of harsh treatment during her time in Hillsborough, but later
achieved liberty and independence as a dressmaker, leading to a close friendship with Mary Lincoln
in the White House during the Civil War.
Research into the people of the site is a major focus of the Commission and has led to the
publication of The Book of Burwell Students and the creation of a free, online database on the
students of the School and their families; on Elizabeth Keckly, and on the Burwell family. This
database continues to grow and is available to the ,public through the Burwell School web site,
www.burwe.11school orq.
The main residence is a two - story frame structure started in 1821 and expanded in 1848 by local
builder John Berry. It is comprised of four downstairs rooms and four upstairs rooms, six fireplaces
and two massive chimneys. Behind the house stands a small brick schoolhouse comprised of two
rooms, each bracketing a fireplace, circa 1840. Additionally, a brick "necessary house" (outhouse)
stands at the back of a small southern heritage garden. The two acres of grounds are comprised of
the garden (named for the last resident to garden there, Carrie Waitt Spurgeon) and an expanse of
lawn, meadow, and tall native I heritage trees and shrubs -- linden, oak,. walnut; dogwood, camellia,
gardenia, old roses, cedars and a "state champion" Osage orange. In 2017 the exterior of the
residence building was thoroughly restored -- the 42 large, old shutters were repaired or rebuilt, and
the entire exterior scraped and repainted. This project cost almost $15,000, raised entirely through
donations and fundraising events over 2016 and 2017, and is a milestone accomplishment toward
preserving the site into its third century.
The house contains antique furniture and furnishings in keeping with its period, all of it donated
since the 1960's, primarily by local residents, and much of it Orange County pieces. There are at
least four pieces of furniture made by the noted African - American freedman, Thomas Day, whose
furniture business thrived in Milton, NC during the 1800's. Additionally the Historic Hillsborough
Commission maintains a collection of items belonging to the Burwell family, women who attended
school here, and other residents of the property, as well as an extensive and well - maintained
research collection of reference materials on the site, the region, and the history of 19`h century
Orange Co.
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
The Burwell School property is the setting for group events, tours, weddings, school tours and much
more, with an average of 4,800 people coming and going through the year. It must be maintained
carefully, including utilities, tree care, mowing, cleaning, repairs and utilities maintenance, security,
groundskeeping, site cleaning and care of all furnishings, and careful cataloging of all items in the
collection. Much of the utilities infrastructure dates to the late 1960's or earlier wiring, plumbing,
etc. as an example, the single toilet in the site dates to the early 1970's. At this time all interior
maintenance is performed by volunteers. Unfortunately the wear and tear on the floors and rugs is
soon to reach a critical state.
Visitor Services Program at the Burwell School
Today the site at 319 N. Churton St. is the setting for a wide range of activities interpreting 19th
century history for the public. For the first 20 years the site was operated on a part-time basis by
volunteers, but in the early 2000's the Historic Hillsborough Commission made the commitment to
staff the site and to have it available to the public five days f 23 hours a week, in addition to evening
programs. The staff include the Executive Director (.3 FTE), Site Manager (.7 FTE) -- this is a total
1 FTE for operational staff, plus weekend tour guides as needed (.1 FTE). Staff maintain the site,
support the operations of the Commission, conduct tours, carry out all communications and
publicity, and oversee exhibits, publications, etc. Their work is supported on the donated effort of
volunteers — members of the commission and the community, for an average of at least 2,100 hours
annually.
The activities for visitor services include:
Guided tours available to all visitors (FREE) during the site's open hours (Wednesday -
Saturday, 11 - 4, and Sunday, 1 - 4)
These tours are led by trained guides and cover the following:
- the history of the house, furnishings and ground
- early 19th century life for adults, children and enslaved persons
- the Burwell School for young ladies 1835 - 1837 — curriculum, students, etc.
- the life of Elizabeth Hobbs Keckly
- the Collins family in residence during the Civil War (the Beehive Years)
- exhibits on the history of the site, including a newly-expanded exhibit on Elizabeth
tCeckl -- including a beautiful full -size res�roduction of a dress she made for Mary
Lincoln the original is at the Smithsonian Institute.
Brochures and exhibits about the site, its residents and their historical significance
Special lessons and tours for schoolchildren of all ages, from Orange County Schools,
Chapel Hill I Carrboro Schools, Chatham County Schools and others, as well as home -
schooled groups, charter and private schools. (fee of $2 per participant) (examples of
lessons: life in the early 19th century (i.e., no electricity, no running water, no
telephones, exterior kitchens, how people dressed and visited; home remedies; 19th
century children's games, school lessons of long ago).
Afternoon l2rograms accessible to older adults includin :
poetry readings
local history lectures
tea & history events
special tours for groups such as the local DAR chapters, Questers,
book clubs, and more
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
The challenges for these services are:
• safety and comfort for all visitors in a building almost 200 years old
• publicity and communications to reach potential users
• adequate staff and support for all activities
• rigorous attention to accuracy in exhibits, publications, and tours
• exhibit preparation and maintenance
• engaging the involvement of young people in meaningful experiences
• tapping the experiences and expertise of older adults as volunteers
• maintaining up to date presence on the interest and social media - email
publicity, Facebook, Twitter, web site, etc.
The Visitor Services goals for the coming ear 2018 - 2019
• carry out six programs focused on Elizabeth Keckly (in February, March,
June, September, October, and November) for target audiences averaging
40 -100 participants per event
• serve > 7,000 visitors of all ages for little or no cost when possible
• maintain the site for the safety and comfort of the public
• increase visitor numbers of school -age children over 2017 levels, > 450„
through living history programs suitable for their grade and interest levels
Please provide the following information about the proposed program:
d) Summarize the program services proposed and how the program will address a
Town /County prioritylgoal?
The Rri ms joal of the Visitor Services ro ram is to romote and su ort histo
education for all Oran a Count residents to ensure that all visitors to the Burwell School
are able to experience a_site that while nearing200 years old, is safe and well- kept; and
to rovide visitors with meanie ful and hi h- ualit exhibits and ro rams focused on the
life of Elizabeth Hobbs Keckl
As it has for the past 40 + years, the Burwell School Historic Site will provide an important
educational resource for Hillsborough and Orange County adults and children through free,
guided tours five days a week, Wednesday through Sunday and special weekend or
evening events. The site will provide inspiring special tours and exhibits for students of all
ages with lessons and demonstrations about 19th century life and education, and the
stories of the Burwell School for Young Ladies and the life of Elizabeth Keckly. The site will
offer special experiences for Girl Scout troops who are earning their Burwell School patch.
Site safety, comfort and preservation for visitors
A steady focus must be maintained to protect the site's infrastructure and furnishing as age
and increased usage take their toll, to protect visitors and ensure a safe and comfortable
experience. The site has experienced greatly increased traffic in the past five years and
this is straining the plumbing, stairs, furniture and floors. The HHC must immediately
increase the level of interior maintenance of the main building to deal with some of these
strains and stresses and must make plans for interior wall repairs and repainting (the
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
current interior paint is over 45 years ofd). For over ten years all interior maintenance has
been done exclusively by volunteers on an "as available" basis, but with heavily increased
traffic currently, and expected for 2018 — 2019, it is now necessary to have a more regular
schedule for upkeep of the Burwell School site to ensure visitor comfort and safety,
During the program year the following will be carried out and monitored: care of the
grounds, garden walkways, steps and stairs, bathroom facilities and air quality, plus
monitoring of all floor surfaces and coverings for safety and reduction in any molds, dust, or
other irritants that can occur in a building that hosts thousands of visitors. Additionally a
replacement toilet will be installed that is water- efficient, taller and more modern in design
for the accessibility of older visitors. (The current toilet is over 40 years old).
KecklLBicentennial Year
The primary goal of the programming for the Keckly Bicentennial programming will be bring
the story of Elizabeth Hobbs Keckly to the public in ways that illuminate her struggle and
her accomplishments, and to bring the Burwell School Historic Site programming into
balance between the story of the Burwell School (1837 - 1857) and the story of Keckly,
The year 2018 will include seven special events for the public focused on the life of
Elizabeth Keckly. Three fall in the 2017 — 18 FY, four of the seven will fall in the 2018119
program year. The programs are:
February 11: "Keckly, Liberty and the AME Church and the Payne Family of Hillsborough„
March 18: The Life of Elizabeth Keckly
June 2: Dressmaking -- Keckly's livelihood (includes hands -on program for young people)
September; Quilt show by the African American Quilting Circle of Durham in honor of the
Lincoln Quilt by Keckly (includes hands -on workshop for young people); hands - on
workshop for young people Sept. 16
October 13, 20, 21: Behind the Scenes, a play (offered six times in two weeks)
November 9: Keckly Symposium featuring writers and scholars
November 10: Pop -up Museum for Young Historians
• Additionally there will be an expanded exhibit on Elizabeth Keckly throughout
the Bicentennial year, including
• a life -size replica of a dress made by Keckly for Mary Lincoln. Also included
will be a free brochure detailing her life, funded by the FM Kirby Foundation;
• an enlarged, framed image of the Lincoln Quilt made by Keckly (now in the
collection of Kent State University),
• and images of Keckly and places or people associated with her life story.
Keckly Bicentennial School Outreach
In concert with the above events, the Burwell School will focus its marketing and outreach
to schools with programming specific to the life story of Elizabeth Keckly, This will be
accomplished through direct communication with schools and teachers. The goal will be to
welcome at least four additional school groups (i.e., an entire grade, or an entire class from
a middle school) during the 2018119 program year, with a goal of serving at least 500
students and increasing the representation of high school students by 50 %.
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
e) Describe the community need or problem to be addressed in relation to the gbp 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). Reference local data (using the provided links, i.e. Chapel Hill
Human Services Needs Assessment) to support the need for this program.
Education
As stated before, the Burwell School is the onI historic house museum in Oran e Count
that rovides ongning ongoing and direct lessons and ro rammin for school -a a children, This is
a unique and invaluable resource for educators who can bring students to experience a
setting and history within their own immediate region.
The focus for the Burwell School programming is education for all generations while
preserving a unique and beautiful historic place for future generations. Another important
goal is to inspire young people to persevere and accomplish their goals through an
understanding of the life of Elizabeth Keckly who, through her own efforts, transcended
slavery and became a successful dressmaker, businesswoman, activist and educator
during the most tumultuous period of the 19th century.
With programming that is either free or low -cost (admission is normally charged only for
events where there is food service or a paid speaker or performer, or when the event is
specifically a fundraiser). The Burwell School is an affordable destination for families
seeking to experience their community together; we often welcome multigenerational family
groups on weekends, with grandparents, parents and children touring the site together.
The visit invariably inspires conversations about what life was Pike long ago and what has
been lost or gained over the years.
And, as the Burwell School is a house museum the young visitors are able to learn good
museum manners" in a way that is enjoyable and memorable.
Older adults find the site to be a delightful resource and we find that we host a number of
senior groups on outings such as the Kiwanis "Golden Key„ club, participating in our history
teas, or scheduling tours for their history interest clubs.
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 target populations are (1) students, in particular from Orange County and CH 1 Carrboro
schools, (2) adults of all ages and abilities in Hillsborough, Orange County, and Chapel
HilllCarrboro, (3) teachers, artists, and other community leaders, (3) visitors from outside
the area.
grj Describe the credentials of the program manager and other key staff. (Ex. identify Program
Manager and credentials, describe training provided to volunteers, etc.)
Executive Director Kate_Faherty oversees the Burwell School operations. She was
Previously a 12 — year member of the Historic Hillsborough Commission and has worked as
ED of the Burwell School for over 2 years. She holds a Master's Degree in Special
Education and has more than 20 years of professional experience in education and
education administration.
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Site Manager Ronda Tucker carries out all logistic and support efforts for all programming
and ensures that the Burwell School is maintained and ready for visitors. She has 14 years
of experience in administrative support in private industry and has worked at the Burwell
School for 2 years.
Deborah Kodros is the Chair of the 30- member Historic Hillsborough Commission and
oversees, with the Executive Committee of the HHC, all programing and operations.
Treasurer Jesse Torres, who has served on the HHC for four years, provides oversight for
all financial management. The HHC operates under bylaws that govern its operations and
carries out regular meetings (8 per year) to ensure careful oversight. Each member of the
HHC serves on two working committees or serves as an officer and Commissioners
contribute many hours per year of volunteer effort.
h) Describe the specific period over which the activities will be carried out and include an
implementation timeline.
July 1, 2018 - June 30, 2019, All Burwell programming is year - round except for a short
winter break in January. All visitor services are year -round (11 months per year Four
Keckly events fail in the program year, in September, October and November. The Keckly
exhibit will be year -round during the program year and will remain in place for future years.
Outreach to schools is based around academic schedules.
0 Why is funding this program a good investment for the community? How does funding this
program add value to the community? (250 words OR LESS)
The Burwell School Historic site is the only historic house museum in Orange County that is
free and open to the public virtually year -round which offers extensive educational
Programming for school -age students. Visitors are inspired, delighted and eager to learn
more. Families learn together, students of all ages are intrigued and as they imagine life
and school for girls and boys almost 200 years ago and through the story of Elizabeth
Keckly — develop a greater understanding the toxic effects of slavery on individuals and
society.
The site is a resource of statewide and national historic importance while dedicated to
serving the communities of Hillsborough and Orange County as its key constituency,
During 2018 the Burwell School will be the onlv place in the United States to observe the
bicentennial of Elizabeth Keckly's birth in a formal and extensive manner, and the planned
observances will likely bring in many visitors from across the state and nation. The site has
already had inquiries from across the country, and this attention and these visitors will
benefit the site and the County economically and culturally. As a result of these activities
there will be proclamations observing the Bicentennial read in the US Congress and the NC
General Assembly.
j) Describe what would happen if requested funding is not awarded at all or if a reduced
allocation is recommended.
The Historic Hillsborough Commission would reduce Burwell School programming for school
groups, cut knack site maintenance, and could be forced to reduce hours of service.
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
k) What percentage of your target population is low- moderate income?
It is impossible to secure that information from our visitors who come either in large school
groups, family groups, or tour groups or who attend our community events. We are not in a
position to garner their information as they are not required to provide it in order to receive
our services.
1) What efforts do you make to seek feedback about your program from your target population
(e.g. survey, evaluations, etc.?)
We conduct evaluations of individual programs periodically; we monitor feedback on our
Facebook page and web site and we benefit greatly from teacher reviews collected by the
Hillsborough Visitor Center after school groups participate in programs.
M) Include any other pertinent information.
Additional Pro ram Information
n) Target Population
Complete the following tables, with numbers (not percentages) of individuals served and to be
served, to the best of your ability,
Unfortunately we are not able to provide specific numbers for individual demographics. Our
Participants are provided to us via schools and other organizations or come to the Burwell School
through our outreach advertising. Our demographic is constantly changing and is based on the
voluntary participation of teachers, parents, etc. We can estimate a target number for the year but
cannot estimate percentages of income, ethinicity, or age as those variables are not under our
control nor is it possible or desirable to ask that information of our visitors during their time on site.
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Program Target Population Demographics
Actual Estimated Projected
2016 -17 2017 -18 2018 -19
Gender
Male 45% 45% 45%
Female 55% 550 55%
Total 100% 100. 100 °la
Ethnicity
African - American
American Indian or Alaska Dative
Asian
Caucasian
Dative Hawaiian or other Pacific Islander
Other: specify
Total
Of the above, how many Hispanic /Latino Unknown Unknown unknown
Of the above, how many non- HispaniclLatino Unknown Unknown unknown
Total 5500 7000 8000
Age
0 -5 years
6 -18 years
19 -50 years
51+ years
Total
Geographic Location
Alamance County
225
400
225
3500
225
Chatham County
300
500
300
1000
300
Durham County
300
300
300
Wake County
0
275
275
275
range 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)
400
400
400
3500
3500
3500
540
500
500
1000
1000
1000
Total 6500 7000 7000
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EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Work Statement
o} Complete the Work Statement Chart to describe the work to be performed.
This chart is used to document program activities, program goals, performance measures,
and actual results. (Add more rows as needed) If this is a new program, you will only
document the projected information. Every program is required to have AT LEAST 1
Program Activity, which should be SMART (�2pecific, Measurable, Achievable, Relevant, and
.Time-bound. Click on SMART Goals to learn more,
• Program Activities should outline major activities the agency implements to accomplish its
program goals. (i.e. Deliver meals to elderlyfdisabled residents.)
• Program Goal should explain what the program is trying to achieve /accomplish. Goals are
statements about what the program should accomplish. (i.e. Deliver 100 meals per day,
Monday - Friday.)
• Performance Measures describe how you will evaluate the degree in which you achieved
the stated goals. (i.e. Will track the number of meals delivered each day.)
• Actual Program Results use program results to indicate the actual measureable
achievement of goals. If goals were not met, please explain. (i.e. Delivered an average of
105 meals per day.)
Work Statement Chart for Program
1. Program Activity Name Burwell School Historic Site Visitor Services and Accessibility
Program Goal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
2. Program Activity Name
Program Goal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
3. Program Activity Name
Program Goal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
4. Program Activity Name
Program Coal
Performance Measures
Previous Year Program Results
Current Year Estimated Results
Next Year Projected Results
PROGRAM INFORMATION
Improved access, safety and enrichment of visitors to the site
7000 visitors
6500 visitors
7000 visitors
7000 visitors
Keckly Bicentennial Year 2018
Carry out four programs for adults and children including 3 hands -
on workshops
400 + participants including youth, scholars, adults, and educators
NA
Three programs scheduled Feb. 2018 — June 2018
400 + participants and national media coverage
Outreach to educators re the Keckly Bicentennial Year
Increase awareness and inspiration from the Keckly story in
Orange County/Chapel Hill- Carrboro Schools.
Four additional school group visits including at least one high
school group
450 students
400 students
500 students
1/23/2018 12.28:35 PM Page 23 of 27
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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 xfs
file) or you may submit your own budget file (as long as it contains the same information,
in the same format, as requested in the provided template).
Program Budgets are required to define budget amounts for the previous program
year, current program year, and next program year for the following categories:
• Revenues
* Private Donations
Q Program Generated Revenue
o Local Government Grants
• Carrboro Human Services
• Carrboro Other
• Chapel Hill Human Services
• Chapel Hill Other (DO NOT include CDBG funding here)
• Orange County Human Services
• Orange County Other (DO NOT Include HOME funding here)
* Other Government Grants
• Triangle United Way
• State Govemment
• Federal Government (CDBGIHOMEIetc.)
• Private Foundation Grants
a Other Revenue
Expenditures
• Compensation
• Rent & Utilities
• Supplies & Equipment
• Travel & Training
• Other Expenses
2. Program Budget Detail — Provide description of "other" budget items, not defined.
3. This program budget represents what percent of the agency budget? 10 %
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.
Total Cost of Program
Total # of Individuals
Cost Per Individual
PROGRAM INFORMATION
Actual 20161 -17 Estimated 2017 -18 Projected 2018 -19
nla
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DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
Program Budget
Operating Budget for Program
AGENCY NAME: Historic Hillsborough Commission, Inc. - The Burwell School Historic Site
AGENCY REVENUE
Private Donations
Agency Generated Revenue (fees)
Local Government Grants:
Human Services - Town of Carrboro
Other - Town of Carrboro
Human Services - Town of Chapel Hill
Other - Town of Chapel Hill
Human Services - Orange County
Other - Orange County
Other - Town of Hillsborough
Other Government Grants
Triangle United Way
State Government
Federal Government (CDBG /HOME /etc.)
Private Foundation Grants
Other Revenue
Total Agency Revenue
AGENCY EXPENSES
Compensation
Rent & Utilities
Supplies & Equipment
Travel & Training
Other Expenses:
Total Agency Expenses
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (46)1$ (437)1$ 8,500 2045%
FY 2018 -19 Program Budget
Actual
2016 -17
Estimated
2017 -18
Projected
2018 -19
Percent
Change
$
4,500
$
6,500
$
7,500
15%
$
3,900
$
1,300
$
2,000
54%
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
8,857
$
9,028
$
9,200
2%
$
-
1 $
-
1 $
-
0
$
j20,, 800
$
25,615
$
30,000
17%
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
7,500.00
$
7,500.00
$
-
$ 1.00
$
26,510
$
53,320
$
60,000
$ 0.13
$
$
72,067
29,288
$
$
103,263
45,600
$
$
108,700
50,000
5%
10%
$
8,000
$
8,900
$
9,200
3%
$
3,000
$
5,000
$
6,000
20%
$
200
$
-
$
-
0
$
31,625
$
44,200
$
35,000
-21%
$
72,113
$
103,700
1 $
100,200
1 -3%
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (46)1$ (437)1$ 8,500 2045%
FY 2018 -19 Program Budget
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1 -95F2AFF7112B
EXHIiBIT "B"
Scope of Services —FY 2018 -19
Outside Agency Performance Agreement
Agency Name: Historic Hillsborough Commission, Inc.
Program. Name: The Burwell School Historic Site Visitor Services
Funding Award:
Outline how the agency will spend Orange County's funding award,
Expense Description
Wages & FICA costs for staff to operate and manage site including but not limited to
program planning & implementing programs throughout the year and to ensure visitor
Keekly Bicentennial P
19 Orange County Commissioner Approved
Amount
$8,054,00
Program Services
Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019.
• Maintain/Increase Visitors to Orange County/Town of Hillsborough Tourism
Provide free tours and educational events for visitors including students and residents.
• Operation, maintenance & upkeep of the 200 year old property and regulated visitor safety.
Anticipated Outcomes
The Anticipated Results column must include quantifiable results in the form of number of ,persons /units served within Oranise
County, only (all Towns and municipalities). If you use Dereentages. yau must also provide the total number of artici ants
within that measure's description or for an earlier Performance measure.
Performance Measures
Visitor County (including students)
Events
— Docu5igned by:
— E396827231534FC...
(Provider's Signature)
Anticipated
Results
7,000
20
Executive Director 8/13 2018
lilt: t" ate:
DocuSign Envelope ID: C5CllFD4- 56CD- 48FD- BBD1- 95F2AFF7112B
Erie CERTIFICATE OF INSURANCE
hczi it A nrAQ —THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY
Home Office • 100 Ere Insurance Place • Erie, Pennsylvania 16530 • 814870.2000
Toll free 1.800.458.0$11 • Fax 814.670.3126 • www.erleinsurer)ce.com
NAME AND ADDRESS OF AGENCY THE BALLARDAGL:NCY AGENT'S NO.
105 W KING ST .131010
HILLSBOROCJGFI, NC 27278-2543
(919)732 -2138
RES$ OF NAMED INSURED
HISTORIC HILLSBOROUGH
COMMISSION
PO BOX 922
HILLSBOROUGH, NC 27278
ERAL LIABILITY
COMMERCIAL GENERAL LI
❑ CLAIMS MADE ❑
L AGGREGATE UMIT APPLIES
POUCY ❑ PROJECT ❑
AUTOMOBILE LIABILITY
"ANY AUTO" OMED
OWNED
HIRED
NON-OWNED
ESS LIABILITY
OCCURRENCE
RETENTION S
E! IEMWORKERS C MPENSAYTION & Q86 0600392 216118 I 216119
LIABIL
DATE ISSUED (MMInDfYYI
1123118
'his certificate is Issued for information purposes only and confers
o rights on the certificate holder, It does not affirmatively or
egad y amend, extend, or otherwise alter the terms, exclusions
ind conditions of insurance coverage conlalned In the policy(ies)
ndlcated below. The terms and condtions of the policy (ies) govern
he Insurance coverage as applied to any given situation. Limits
hown may have been reduced by cialms paid. This certificate of
nsurance does not constitute a contract between the Issuing
nsurer(s), authorized representative or producer and the
;art €heats holder.
LIMITS
EACH OCCURRENCE
FIRE DAMAGE (Any One Fire)
MED EXP (ky One Perwnl
PERSONAL 8 ADV. INJURY
GENERAL AGGREGATE.
PRO DU CTS- COMPICPAGG
BODILY INJURY
[EAftI PERSONy S
PROPERTYOAMAGE S
SODILY INJURY AND
PROPERTY DAMAGE S
rnuriusn
IDILY ACOiDENT 5 500,000 EACH ACCIDENT
J11TIY DISEASE S 500.000 POLICY LIMIT
BY DISEASE S 500,000 EACH EMPLOYEE
CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION [LATE THEREOF, NOTICE WILL BE DELIV-
EREO IN AGGORDANCE WITH THE POLICY PROVISIONS.
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 lied of such endorsement (s).
NAME AND ADDRESS OF CERTIFICATE HOLDER
Orange County Human Services AUTHORIZED REPRESENTATIVE
Agency
PO Box 8181
Hillsborough, NC 27278
EIG6230 8111 // Page 1 of 1
L �l
I.
DocuSign Envelope ID: C5C11FD4- 56CD- 48FD- BBD1- 95F2AFF7112B DATE(MMNDDNYYY)
�-v r� ULK 1 IFI[,. A I t Ur LIABILITY INSURANCE 1/23/2018
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, I
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must he endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the pollcy, 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).
CONTACT
PRODUCER NAME: J. DAVID BALLARD
BALLARD AGENCY INC PHONE Na (919) 732 -9636
AC Na Exl ( (919) 732-2158 wc. ,
PO Box 1559 y ADDRESS balla_r_ d @bal lardagencyinc . cam
2
Hillsborough, NC 7278 INSURE114181 AFFORDING COVERAGE k NAICM
INSURER A : GREAT AMERICAN INSURANCE CO _ _ --
INSURED HISTORIC HILLSBOROUGH COMMISSION INSURER a GREAT AMERICAN INSURANCE CO
PO BOX 922 INSURER C GREAT AMERICAN INSURANCE CO
HILLSBOROUGH, NC 2727E INSURER
t.>
E
F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD 4
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.
ADDL
iNSR ' TYPE OF INSURANCE MMNDDIYYYI MMNDUIYYYY
LTR INSO VJVD POLICY NUMBER
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE L —^I OCCUR
X PAC4816275
GEN'L AGGREGATE LIMIT APPLIES PER
X POLICY CI JECT C LOC i
1
AUTOMOBILE LIABILITY
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON - OWNED
HIRED AUTOS FIAUTOS
X UMBRELLA LIAR OCCUR
SS LIAR UMS4816276
EXCE
I CLAIMS -MADE X
DEO RETENTION S 10 0 0 0
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIEfORIPARTNERNHXECUTIVE NIA
OFFICEPWEMBER EXCLUDED?
IMandinery In NH1
11 es, describe undo r
) R1PTION OF OPERATIONS below
2/11/17112/11/18
11/17[12/11/18
1C.iDIRECTORS &
-ERSJ IEPP4917808 1/21/1811/21/1
DESCRIPTION OF OPERATION'S I LOCATIONS 1 VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is (equired)
DIRECTORS & OFFICERS LIABILITY LIMITS $1,000,000 OTHER THAN EMPLOYMENT PRACTICES WRONGFUL ACTS
$10,000 DONOR DATA LOSS CRISIS FUND SUBLIMIT
$1,000,000 EMPLOYMENT PRACTICES WRONGFUL ACTS
$150,000 ELSA DEFENSE SUBLIMIT
LIMITS
EACH OCCURRENCE Is 1'()001000
PREMISES Ea o=urranca
S 100,000
MED EXP (Any one parson) 1$
5,000
PERSONAL& ADV INJURY
S 1 , 000 , 000
GENERAL AGGREGATE 15
3 , DOd , 000
PRODUCTS - COMPIOP AGG
$ 3,000,000
-COMBINED SINGLE rl 11
Ea aocidenE
BODILY INJURY (Per person)
$ I
I
BOO ILY INJURY (Per accideni)
S
Per n—irlptrill
Is
EACH OCCURRENCE
5
$ 1'000,000
AGGREGATE
5 1, 000'990
�
STATUTE I ER
5
E L EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYE
s
E.L. DISEASE - POLICY LIMIT
s
I
CERTIFICATE HOLDER CANCELLATION
ORANGE COUNTY HUMAN SEVICES
I
AGENCY
I PO BOX 8181
HILLSBOROUGH,NC 27278
ACORD25(2014/01) The ACORD name and logo are
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
REPRESENTATIVE /
O 1988 -2014 ACORD CORPORATION. All rights reserved.
marks of ACORD
DocuSign Envelope ID: C5C1 1 FD4-56CD-48FD-BBD1-95F2AFF7112B
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.
UocuSigned by:
Certified by: E396827231534FC...
(Provider's Signature)
Title:
Executive Director Date: 8/13/2018
(Historic Hillsborough Commission)
Orange County Outside Agency Performance Agreement Page 9 of 9
Rev. 7118