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2018-443-E Finance - EmPowerment outside agency agreement
DocuSign Envelope ID: 557E0BA8 -0FDF- 4943- B1 0E- 6AB96D651 F413 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 EmPOWERment, Inc., a not - for -profit corporation, located at 109 N. Graham Street, Suite 200, Chapel Hill, NC 27516 ( "Provider "). 1.i1M1101=4 so011 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 EmPOWERment, Inc. 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 $28,250. 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 $7,062.50. 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. (EmPOWERment, Inc) Orange County Outside Agency Performance Agreement Revised 712018 Page I of 9 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651 F413 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. (EmPOWERment, Inc) Orange County Outside Agency Performance Agreement Page 2 of 9 Rev. 7118 DocuSign Envelope ID: 557E013AMFDF- 4943- 1310E- 6AB96D651 F413 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. (EmPOWERment, Inc) Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 7118 DocuSign Envelope ID: 557E0BA8 -0FDF- 4943- B1 0E- 6AB96D651 F413 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 EmPOWERment, Inc. 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: (EmPOWERment, Inc) Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 7118 DocuSign Envelope ID: 557E0BA8 -0FDF- 4943- B1 0E- 6AB96D651 F413 County: Finance & Administrative Services Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: EmPOWERment, Inc. 109 N. Graham Street, Suite 200 Chapel Hill, NC 27516 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. Fo DocuSign ;a ay: ' ` ` he Provider i�1,CbMGS �]tu� BCE548CED19F46F... Fo, DocuSi9nedby, County Government [0637994B755E477... Bonnie Hammersley, County Manager (EmPOWERment, Inc) Orange County Outside Agency Performance Agreement Rev. 7118 8/17/2018 Date 8/20/2018 Date Page S of 9 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: EmPOWERment Inc. Applicant Organization's Physical Address: 109 N. Graham Street, Suite 200, Chapel Hill, NC 27516 Applicant Organization's Mailing Address: 109_N. Graham Street, Suite 200, Chapel Hill, NC 27516 Applicant Organization's Web Address: www.empowermentinc- nc.org Executive Director: Delores Bailey Telephone Number: 919- 967 -8779 Tax ID Number: 56- 1969772 E -Mail: empowermentinencOgamail.com 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) Pro-gram Card oro Chapel Hill - HS Orange County--HS Total - HS Ex.:Youth Afterschool Program Afterschool Program Coordinator salary and materials for youth activities and projects $10,000 $15,000 $5,000 $30,000 Property manager salary and materials for Rental Property Pro ram $20,000 $20,000 $30,000 $70,000 Totals 1 $20,000 L$20,000 1 $30,000 1 $70,000 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: Signature: WIN- "Executive Director rafd'cKairperson l 12 _,Z i Date Date AGENCY INFORMATION 1/22/2018 1:34:08 PM Page 7 of 23 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B 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? El EJ 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? ❑ E 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. Board member Jabe Hunter is employed by the Chapel Hill Police Department, but he does not receive any financial benefits from being on this board. His job as assistant Chief of Police does not pose a conflict of interest with El providing affordable rental housing. 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: Signature: B rd Chai AGENCY I ORMATION Date 1122/2018 1:34:08 PM Page 8 of 23 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B 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): 21, 0311996 b) Agency's Purpose /Mission (no more than a few sentences): The mission of EmPOWERment, Inc. is to empower people and communities to determine their own destinies through affordable housing, community organizing and grassroots economic development. c) Types of Services the Agency Provides (bullet format): • Community Organizing • Provide safe affordable rental units • Rental counseling (HUD approved Housing Counseling Agency) • Provide summer employment for youth • Operate and manage small business incubator • Zone 6 champions for Family Success Alliance d) Agency's History with Providing These Services: With funding provided through the Human Services Grant, EmPOWERment, Inc. has created a one -stop shop for affordable rental management programs and services that serves the populations throughout Orange County. EmPOWERment, Inc. is the primary provider of much needed affordable rentals in Orange County. Local agencies such as Social Services, the Interfaith Council, Community Empowerment Fund, Family Success Alliance and area churches are able to refer individuals and families that are in need of a safe, clean, and affordable place to live. EmPOWERment will continue to tailor the services of the affordable rental program to include more Housing Choice voucher holders, veterans, individuals transitioning from homelessness, seniors and disabled populations. The property manager position is responsible for the management of 46 rental units throughout Orange County. These units are made available for families and individuals at income levels that range from 30 - 80% Area Media Income. • EmPOWERment has been one of the largest property managers for affordable rentals for more than 16 years. It continues to address the affordable rental demand for households at the moderate to low income range. More than 50% of our tenants are Housing Choice Voucher holders, 15% are seniors and 20% have a disability. • EmPOWERment Inc. collaborates with Social Services, Habitat for Humanity, Community Home Trust, Interfaith Council, Family Success Alliance, Club Nova, UNC Chapel Hill School of Medicine's Department of Psychiatry and Community Empowerment Fund to help place qualified residents in affordable rental units. • El provides a range of services that include: assisting with acquiring rental housing, securing utility services, rental counseling and transitioning into home ownership. • EmPOWERment, Inc. continues to assist families in transitioning from various states of homelessness into permanent housing. In this effort we worked closely with Family Success Alliance and Social Services on projects such as the Rapid Re- Housing Program and Orange County Partnership. El has transitioned three families from homelessness to permanent housing. Agency Information 1122/2018 3 :21:37 PM P a g e 9 o f 2 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION • EmPOWERment works constantly with the area police departments, our Community Outreach Program, and with UNC students and administrators to address the needs of underserved individuals in our community through program assistance and information sharing. • EmPOWERment actively collaborates with nonprofits such as Family Success Alliance and Justice United to bring light to neighborhood issues that may require Orange County attention. In conjunction with Justice United and the UNC Chapel Hill School of Public Policy, we have conducted surveys with tenants about the condition of their units. In 2017, El collaborated with FSA to bring exposure to the traffic profiling issue and conducted surveys in our mobile home communities. • EmPOWERment, Inc. continues to collaborate with Chapel of the Cross Church and local developers to provide free gently used furniture and appliances to low income families. • EmPOWERment has partnerships with local churches and faith based organizations to provide temporary financial assistance to residents in need. El continues to search out funding sources for emergency assistance programs that were established in 2015. In 2017 the M.O.M utility fund was funded by BB &T which allows El to assist over 50 families by providing assistance with utilities when tenants are experiencing financial hardships. • Empowerment continues to partner with Community Empowerment Fund to transition homeless individuals into permanent housing through "home sharing" as housemates when possible. 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 ?) Yes, we have increased our rental program capacity by adding staff and experience. We have a combined 17 years of rental property management experience and 22 years of seasoned construction experience. El added an assistant property manager as well as a specials projects manager to oversee project rehabs. Over 50 Latino families attended our 2017 Community Holiday celebration servicing over 200 attendees. 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 .25, 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: 3 # of FTE - Paid Part-Time Positions: 4.75 # of Volunteers: 1000 # of FTE - Volunteers:5 g) Living Wage Does this agency pay permanent employees a minimum living wage? (Yes / No) rimes If yes, is this agency an Orange County Living Wage Certified Employer? yes Agency Information 1/22/2018 3:21:37 PM P a g e 1 0 o f 2 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION If no, please explain. h) 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? (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). DO NOT include federal funding sources, such as CDBG and HOME. Program FY17 -18 Award FY18 -19 Request Source Ex: Affordable Rental Rehabilitation 0 $20,000 Carrboro - Affordable Housing Ex: Agency Administration $15,000 $15,000 Carrboro — Other Ex. Total $15,000 $35,000 Carrboro Total Funding Affordable Housing Develop- Mental Reserve, for property acquisition $54,128 0 Chapel Hill Community Development $11,000 $27,000 Town of Chapel Hill Total $65,128 $27,000 Total Funding *Add rows or attach additional page, if needed. Submit your agency's budget. You may complete the provided template (separate xls file) or you may submit your own budget file (as long as it contains the same information, and in a similar format, as requested in the provided template). 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 o Private Donations o Program Generated Revenue o Local Government Grants ■ Carrboro Human Services Agency Information 1/2212018 3 :21 :37 PM Pa g e 11 of 2 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Agency Budget Operating Budget for Entire Agency AGENCY NAME: 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 Orange County- Career Explorers Durham Community Land Trust Federal Government (CDBGIHOMEIetc.) 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: FY 2018 -19 Agency Budget EmPOWERment, Inc. $ 4,479 1 $ (11,830) $ (1,346) 890/, Actual 2016 -17 Estimated 2017 -18 Projected 2018 -19 Percent Change $ 64,307 $ 65,594 $ 66,906 2% $ 38,317 $ 39,084 $ 39,866 2% $ 10,000 $ 15,000 $ 20,000 33 % $ - $ - $ - 0 $ 40,500 $ 40,500 $ 47,000 16% $ 11,825 $ - $ - 0 $ 25,000 $ 25,000 $ 30,000 20% $ 73,810 $ 76,025 $ 78,305 3% $ - $ - $ - 0 $ 12,500.00 $ 12,875.00 $ 13,261.00 3% $ 4,000.00 $ - $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 $ 448,054 $ 461,496 $ 475,341 3% $ $ 728,313 315,612 $ $ 735,574 318,769 $ $ 770,679 321,957 5% 1% $ 148,824 $ 156,266 $ 164,080 5% $ 35,617 $ 37,398 $ 39,268 5% $ 7,685 $ 8,070 $ 8,474 5% $ 216,096 $ 226,901 1 $ 238,246 1 5% $ 723,834 1 $ 747,404 $ 772,025 3% $ 4,479 1 $ (11,830) $ (1,346) 890/, DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION • 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 (CDBGIHOMEfetc.) • 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? Surplus Is there a significant change? Yes /No No Please provide a brief explanation for Surplus or Deficit, and significant changes. The increase of the Family Success Alliance Staff caused an increase in income and compensation which manifested in a surplus. iv. What is your agency's fiscal year? January 1 through December 31 (Example: July 1, 2016 through June 30, 2017) For the purposes of this report we have calculated the Agency and Program Budget on a July to June fiscal year. Agency Information 1/22/2018 3:21:37 PM P a g e 12 of 2 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Rental Property Management Program Primary Contact and Title: LaTanya Davis,. Property Manager Telephone Number: 919 -967 -8779 E -Mail: latan ,LCct��empowermentinc- nc.orq 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 X X X X Affordable Healthcare Education X X X X Family Resources Jobs /Jobs Training Food Transportation Other: Please specify 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. Provide Housing and counseling for individuals that come through their programs in collaboration with: DSS Public Housing Justice United Rapid Rehousing CEF Cardinal Innovations Housing Choice Community Home Trust CHC /Orange School Sys Family Success Alliance Freedom House UNC Horizons Oxford House UNC SoM Department of Psychiatry 2. We work closely with the following agencies to provide Emergency funding sources to prevent evictions and utility disconnections: The Interfaith Council, Home Start, Local Churches, JOCCA, M.O.M.Utility Fund, DSS 3. Collaborate to find resources for financial planning to ensure property budgeting and to provide emergency financial assistance when needed: Community Empowerment Fund, Reid Consulting Services, Compass Center 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 PROGRAM INFORMATION 1/2212018 3:21:37 PM P a g e 1 3 o f 2 ? DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D65lF4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Town /County priority /goal? EmPOWERment, Inc.'s Rental Program directly addresses the Town's Goal of prioritizing affordable rental units and supporting "rental housing availability for household of all incomes" by offerina rentals to individuals that fall below 50% cif AMI. Unit Turnover Cleaning /replacements /repairs Receiving Applications Through online submission, in office visits, word of mouth and agency referrals Application Processing Income and Rental Verifications and Reference Check Pre - counseling Financial counseling, selection from verified applications on the wait list; most recent verifications reviewed Lease Signing/ Document signing/ Deposit Deposits taken and leases signed in person to provide leasing education to prospective tenants. Move In Procedure and Check list Walk through, utilities transferred to tenant Collection/ Deposit of Rent Payments Timely collections held in escrow Late Notices and Evictions Sent monthly, enforced after review and court representation sent to court Generating Monthly Rent Rolls, Board Reports and Quarterly Reports to government agencies. 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). Reference local data (using the provided links, i.e. Chapel Hill Human Services Needs Assessment) to support the need for this program, The Orange County 5 Year consolidated plan has Rental as a "High Priority" item that includes providing safe and affordable rental units for low to moderate income families. Town /Council goal - Adopt and implement affordable housing strategies, Town /Council Programs - Housing and Community: Rental Housing for Low - Income Families; Maintenance Services: Resident Services There is a critical need for affordable rental. EmPOWERment's rental program fully embodies these objectives. It is one of the largest residential landlord that accepts Housing Choice Vouchers, when other landlords refused to accept them. EmPOWERment Inc. continues to purchase units to fill and create inventory to address the critical need for affordable housing in Orange County. The EmPOWERment, Inc,, rental program has a proven track record of implementing safe, clean and affordable places for low to moderate income families to live, We have provided these services for the past 17 years. Our inventory of units has increased to 42 owned by the organization and 6 that we manage for private landlords. EmPOWERment uses a tracking log to keep account of the number of telephone calls, in office visits, and applications submitted for requested housing. In 2017 we fielded approximately 645 inquiries for rental homes. Many of the individuals seeking housing are below the poverty level and were referred to us through our collaborative efforts with other social service agencies. 81% of the inquiries and applications submitted were from minority populations and 100% were below the 80% AMI level. We have found that approximately 58 % of our inquiries are from female heads of households that include young children. PROGRAM INFORMATION 1/22/2018 3:21:37 PM P a g e 1 4 o f 2 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? Our target population is Orange County residents' looking for affordable rentals whose income falls below the 80% area median income. Our typical residents are homeless, families living at the poverty level, vets, seniors, disabled or Housing Choice Voucher holders. We give priority to these individuals. They are identified through the application, verification and counseling processes and other agencies. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) With the new home crisis approaching for mobile home renters, El is attempting to position itself to meet some of that need. EmPOWERment, Inc. has been in the property management business for 17 years. The Property Manager and her team carry out all program activities. A specials projects manager was added recently to handle new projects. They operate out of the EmPOWERment Office located in the Midway Business Center, Chapel Hill, NC. All of the EmPOWERment staff, UNC Bonner students (1) and volunteers are trained to help with the Rental Program. Our current property manager, LaTanya Davis, holds a BA in Business Management, BS in Economics and a Masters in Business Education. She is also a Broker -in- Charge with over twenty years of experience that allows her to manage units that do not belong to EmPOWERment. She manages 6 rental properties that are privately owned along with the 42 units that we currently own. Ms. Davis has been the Property Manager for ten years, overseeing the Rental Property management program including but not limited to: rental counseling, apartment turnovers, maintenance, negotiating with vendors and rent collection. Reporting to the Property Manager is the Assistant Property Manager, Valencia Thompson. She holds a MBA in Accounting and Finance and is also a Real Estate Broker. This role works with tenants, handles administrative rental duties, data collection and Website management of the Rental Program. Sarita Nwachukwu, the Director of Community Programs, has a BS in Business Management and spends 30% of her time supporting the Rental Program. She manages registration of clients, phone calls and receives maintenance requests. Brinson Hyman, Special Projects Manager, is a general contractor and comes to us with over 22 years in the construction business. He has developed and built his own housing community as well as owned and operated his own construction business. Volunteers assist with administrative duties and apartment turn- overs. The Bonner students are UNC students who spend four years with EmPOWERment to complete their work -study hours. They are trained to work on many aspects of the Rental Program with Ms. Davis and provide tremendous support. The Executive Director, Delores Bailey, has 15 years of rental property management experience with EmPOWERment, Inc. With the approval of the Board, Ms. Bailey researches and negotiates potential affordable rental projects. These units will be included in EmPOWERment's affordable rental inventory. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. EmPOWERment Inc. holds two tenant association meetings each year. We bring in speakers to discuss relative topics to educate the tenants on any challenges they may be facing. We also conduct annual HQS inspections and recertification. The tvnical veariv timeline resembles thin Spring meeting usually held in Jul Aug Sept Fall meeting in November May PROGRAM INFORMATION 1/22/2018 3:21:37 PM Page 15 of 22 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Tenant Association Meeting HQS inspections and Recertification Tenant Surveys and Tenant Assoc. Meeting 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) Funding for this program is a good investment for this community because it funds EmPOWERment's Affordable Rental Program which concentrates on adding and managing safe rental inventory that will address the lack of affordable rental for low, low to no income individuals and families. Affordable rental for those families living in Orange County earning less than 65 % of the Area Median Income, has been identified as one of the largest affordable housing needs in Orange County. The demand has been great, but the inventory to meet the growing demand must be created by purchasing existing homes, building or converting privately owned homes. The need is so great it can only be met through collaboration. EmPOWERment has been sensitive to this problem and addressing it, with the help of this funding. We provide excellent property management within our rental inventory. We spend quality time looking for potential projects that will add to affordable rental inventory, not just in certain communities but throughout Orange County. Value is added to the community by this program because it provides safe, decent housing to a variety of people living and working in Orange County like; the grocery store bagger, the ticket taker at the movies, the afterschool workers and even those families that are homeless due to circumstances they could not control. Value is added to the community because this program concentrates on helping to reduce barriers to affordable housing by: providing rental counseling, financial guiding and by connecting those in need to local resources. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. The funding from the Human Services Grant has allowed El the opportunity to increase the Rental Property Management Staff and services. As the need for affordable rentals rises, reduction in funding would adversely affect services currently being provided which would have a domino effect on response time to tenant issues. A reduction in funding or funding elimination would impact the number of people that can be assisted and staff would not be able to help as many individuals as we are able to now. Because EmPOWERment, Inc. is one of the few organizations in Orange County that works primarily with affordable rentals, a full time property management staff is essential to continued quality service. k) What percentage of your target population is low- moderate income? 100% of EmPOWERment, Inc.'s target population falls within the low- moderate income bracket. 1) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc. ?) EmPOWERment gives each tenant a survey yearly to document any concerns they may have. Each survey is reviewed and concerns are addressed with the tenant during a one -on -one feedback counseling session and at lease renewal for current tenants. m) Include any other pertinent information. Unfortunately, the waiting list for affordable rentals moves very slowly. Families are forced to live in expensive units they can't really afford or substandard apartments with little recourse. The EmPOWERment Inc. Rental Property Management Program is intentional about our units and the families we try to serve. PROGRAM INFORMATION 1/22/2018 3:21:37 PM P a g e 1 6 o f 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program 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, Program Target Population Demographics Gender Male Female Total Ethnicity African- American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other: specify (Hispanic/Latino) Total Of the above, how many Hispanic/Latino Of the above, how many non-Hispanic/Latino Total Age 0 -5 years 6 -18 years 19 -50 years 51+ years Total Geographic Location 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) Actual Estimated Projected 2016 -17 2017 -18 2018 -19 276 284 292 369 392 404 645 1 676 696 415 465 478 1 0 0 4 0 0 126 121 125 8 10 10 91 80 83 645 676 696 91 80 83 554 596 613 645 676 696 130 145 149 214 215 222 232 240 247 69 76 78 645 676 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 590 606 49 56 58 23 30 32 0 0 0 0 0 0 Total L 645 676 696 PROGRAM INFORMATION 1/22/2018 3:33:49 PM Page 17 of 22 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B 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 (Specific, 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 elderly /disabled 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 Rental Property Management 1. Program Activity Name Increase number of rental units (currently have 42 units) Program Goal Increase by three units Performance Measures Document new rental units on spreadsheet Previous Year Program Results 3 Current Year Estimated Results 3 Next Year Projected Results 2 2. Program Activity Name Housing for the most vulnerable population: i.e. homeless, disabled, and veteran populations_ Program Goal 3 Performance Measures Collaborate with other agencies to reach these populations Previous Year Program Results 4 Current Year Estimated Results 4 Next Year Projected Results 3 3. Program Activity Name Expedient unit turnover Program Goal Maintain 5% vacancy or less of online units Performance Measures Chart monthly vacancies Previous Year Program Results 98% Current Year Estimated Results 95% or less Next Year Projected Results 95% or less 4. Program Activity Name Complete annual housing inspections Program Goal Complete 90% of inspections Performance Measures Document on HQS Previous Year Program Results 100% Current Year Estimated Results 95% Next Year Projected Results 95% PROGRAM INFORMATION 1/22/2018 3:45:38 PM P a g e 1 8 o f 2 2 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B 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 Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o 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) o Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG /HOMEIetc.) • Private Foundation Grants Other Revenue • Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel & Training • Other Expenses 2. Program Budget Detail — Provide description of "other" budget items, not defined. Other program budget detail items not defined include: HOA due, management fees, property taxes, and court fees 3. This program budget represents what percent of the agency budget? 52% 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. PROGRAM INFORMATION 1/2212 018 3:45:38 PM Page 19 of 22 Actual 2016 -17 Estimated 2017-18j Projected 2018 -19 Total Cost of Program $262,309.00 $272,045.00 $282,233.00 Total # of Individuals 645 676 696 Cost Per Individual 407.00 403.00 406.00 PROGRAM INFORMATION 1/2212 018 3:45:38 PM Page 19 of 22 DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D651F4B EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION PROGRAM NAME PROGRAM REVENUE Private Donations Program Budget Operating Budget for Program EmPOWERment, Inc. Rentals Program Generated Revenue 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 (CDBGIHOME /etc.) Private Foundation Grants Other Revenue Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Total Program Expenses SURPLUS /(DEFICIT) FOR PERIOD: FY 2018 -19 Program Budget $ 111,284 1 $ 119,650 1 $ 131,196 1 10 °/a *Surplus in program budget does not include mortgage payments. Mortgage payments are included in the agency budget. Actual 2016 -17 Estimated 2017 -18 Projected 2018 -19 Percent Change $ - $ - $ - 0 $ 330,093 $ 336,695 $ 343,429 2% $ 10,000 $ 14,000 $ 20,000 43 % $ - $ - $ - 0 $ 13,500 $ 13,500 $ 20,000 48% $ - $ - $ - 0 $ 20,000 $ 27,500 $ 30,000 9% $ - $ _ - $ - 0 $ $ $ - 0 $ $ $ - 0 $ $ $ 0 $ I $ - 1 $ 0 $ $ - 1 $ 0 $ $ - $ 0 $ $ 373,593 84,534 $ $ 391,695 85,380 $ $ 413,429 86,234 6% 1% $ 21,492 $ 22,567 $ 23,696 5% $ 81,864 $ 85,958 $ 90,256 5% $ - $ - $ - 0 $ 74,419 $ 78,140 $ 82,047 5% $ 262,309 $ 272,045 $ 282,233 4% $ 111,284 1 $ 119,650 1 $ 131,196 1 10 °/a *Surplus in program budget does not include mortgage payments. Mortgage payments are included in the agency budget. DocuSign Envelope ID: 557EOBA8 -OFDF- 4943- B10E- 6AB96D65lF4B EXHIBIT "B" Scope of Services – FY 2018-19 Outside Agency Performance Agreement Agency Name: EmPOWERrnent, INC Program Name: Rental Property Management Funding Award: $28,250,00 Expense Description Anticipated Results Amount Property manager salary and material for rental roe ro m $28,250 Monitor unit turnover by maintaining five percent (5 016) vacancy or less (of 20 units) 95% Complete HQS annual housing inspections on all units (of 20 units) 100% Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019. • Continue to increase our rental inventory. • Provide counseling for potential and current rental clients. • Continue to work with local churches, other non- profits and housing agencies such as (DSS, IFC, CEF) to find affordable housing options for Orange County residents. 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 affordable rental inventory by 3 3 Provide housing for atleast 3 homeless, disabled, or veteran individual families 3 Monitor unit turnover by maintaining five percent (5 016) vacancy or less (of 20 units) 95% Complete HQS annual housing inspections on all units (of 20 units) 100% 1DocuSigned by: 1)Br_E548r_ED1CF40F Ce rtifed y (Provider's Signs e) Executive Director Title: e ee— 8/17/2018 Date: i_% [ f3 DocuSign Envelope ID: 557E0BA8 -0FDF- 4943- B1 0E- 6AB96D651 F413 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: i�t,I.bV�t,S �]cuC� Certified by 8cE548cED10F40F... (Provider's Signature) Title: Executive Director Date: 8/17/2018 (EmPOWERment, Inc) Orange County Outside Agency Performance Agreement Page 9 of 9 Rev. 7118 DocuSign Envelope ID: 557E0BA8 -0FDF- 4943 -B1 OE- 6AB96D651 1`413 ^1 EMPOI N C -0'1 DMAS ,acc3►era CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 0612512018 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 pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsoment(s), PRODUCER NAM E• _ Summers Thompson Lowry, Inc. 100 Europa Drive (A"erecAN1, Eadj: (918) 86I3y4d72 Uyc. Ncy.(918) "942^4227 Suite 571ooaa ss: Ino @STLInSure.Gom - Chapel Hill, NC 27517 -2393 D18URERI$I AFFORDING COVERAGE NAN: INSURED Empowerment, Inc. Delores Bailey 109 N. Graham St. #200 Chapel Hill, NC 27516 -2328 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 BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP L LTR TYPE OF INSURANCE POLICY NUMBER 001YYYY1 _ LIMITS A )( COMMERCIAL GENERAL LIABILITY CLAIMS MATE I " 1 OCCUR x AUTHORIZED REEPRESENTA71VE NPPI005089 EACH OCCURRENCE 0611612018 0611612019. Pa $E$ Ea D $ 1,000,000 $ i MED EXP {Any one person- $ 10,000 _ PERSONAL & AOV INJURY $ 1,fl0O,00D _ GEN'L AGGREGATE TE LIMIT APPLIES PER: $ 3.000,000 GENERAL. AGGREGATE POLICY F7 jR II LOC PRODUOTS- COMPIOPAGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT BODILY INJURY (Per son $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 1 BODILY INJURY Peracc6dettiA $ PROPERTY DAMAGE Par acc danSl . _ N yy p AUTO���p S ONLY At 01 'M UMBRELLA LIM OCCUR EACH OCCURRENCE AGGREGATE $ EXCESS LIAB CLAIMS-MADE DED j RETENTION $ B WORKERS COMPENSATN]N AND EMPLOYERS' LIABILrrY ANY PROPRIETOWPARTNERIEXECUTWE Y �j�FICCERIMEMBER EXCLUDED? IMendmory In NHj NIA ITW1;3715D15 0611612018 ]( I PER OT - STATUTE ER 06116/2019 EACH. ACCIDENT _ --� E.L. DISEASE - EA EMPLOYEE 500,1000 $_ -- 0,�00 S If yyes, describe under DESCRIPTION OF OPERATIONS below f , E.L.. DISEASE - POLICY LIMIT Soo ,aoo $ A General Liability INPP1005089 06/1612018 05/1512019 Occurrent 1,000,000 DESCRIPTION OF OPERATIONS? LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mars space is requtrad) Certificate Holder is additional Insured as respects written contract. CERTIFICATE HOLDER CANCELLATION ACORD 25 (2015103) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Government g Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 81811 Hillsborough, NC 272.78 AUTHORIZED REEPRESENTA71VE ACORD 25 (2015103) ©1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD