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2018-444-E Finance - Habitat for Humanity outside agency agreement
(Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Revised 7/2018 Page 1 of 9 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 Habitat for Humanity, Orange County, NC, Inc., a not-for-profit corporation, located at 88 Vilcom Center Drive, Suite L110, Chapel Hill, NC 27514 (“Provider”). WITNESSETH: 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 Habitat for Humanity, Orange County, NC, 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 $41,250. 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 $10,312.50. 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. DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 (Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Page 2 of 9 Rev. 7/18 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. 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. f. 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 DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 (Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 7/18 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. 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 party 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 MINIMUM REQUIRED COVERAGE x Worker's Compensation Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee x Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate x Automobile Liability $500,000 Combined Single Limit x Professional Liability $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 DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 (Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 7/18 d. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 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 Habitat for Humanity, Orange County, NC, 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 DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 (Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Page 5 of 9 Rev. 7/18 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: 16. E ntire 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 and on behalf of the Provider _____________________________ _______________________ , Date For and on behalf of Orange County Government _______________________________ ________________________ County: Finance & Administrative Services Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: Habitat for Humanity, Orange County, NC, Inc. 88 Vilcom Center Drive, Suite L110 Chapel Hill, NC 27514 DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 (Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Page 6 of 9 Rev. 7/18 Bonnie Hammersley, County Manager Date DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 7 of 23 1. COVER PAGE a) Applicant Contact Information Applicant Organization’s Legal Name: Habitat for Humanity of Orange County Applicant Organization’s Physical Address: 88 Vilcom Center Drive, Suite L110, Chapel Hill, NC 27514 Applicant Organization’s Mailing Address: 88 Vilcom Center Drive, Suite L110, Chapel Hill, NC 27514 Applicant Organization’s Web Address: www.orangehabitat.org Executive Director: Susan Levy Telephone Number: (919) 932-7077 ext. 211 E-Mail: slevy@orangehabitat.org Tax ID Number: 58-1603427 b) Funding Request List all FY18-19 Human Services (HS) Funding Being Requested (For All Programs) and the Proposed Use of Funds (2-3 lines or less) Program Carrboro -HS Chapel Hill -HS Orange County-HS Total Home Preservation $5,000 $10,000 $50,000 $65,000 Totals $5,000 $10,000 $50,000 $65,000 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: 1/23/18 Executive Director Date Signature: 1/23/18 Board Chairperson Date d) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION CLAUSE EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 8 of 23 Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate families, or their business associates… YES NO a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? b) Members of or closely related to members of the governing bodies of the Town of Carrboro, the Town of Chapel Hill, or Orange County? c) Current beneficiaries of the program for which funds are being requested? d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/ expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: 1/23/18 Executive Director Date Signature: 1/23/18 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 9 of 23 Board Chairperson Date 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): Habitat was incorporated on April 13, 1984. It has been in operation for 33 years. b)Agency’s Purpose/Mission (no more than a few sentences): Habitat for Humanity of Orange County changes lives by bringing together God’s people and resources to help families in need build and own quality affordable homes in safe and supportive communities. Habitat’s vision is an Orange County where everyone has a decent place to live. c) Types of Services the Agency Provides (bullet format): x Habitat for Humanity of Orange County is a local nonprofit organization affiliated with Habitat for Humanity International. Habitat provides affordable homeownership opportunities for families who live and/or work in Orange County, earn between 30% and 60% of the area median income, and live in substandard housing. Habitat was incorporated in 1984, and completed its first home in 1987. Since that first home, Habitat has built more than 270 affordable homes throughout the County. Through its New Home Construction program, Habitat uses donations and volunteer labor to construct energy-efficient, green-certified, high-quality homes, and then sells those homes to qualifying families. The buyers receive an affordable mortgage, and mortgage payments are recycled to build future homes. Homebuyers are required to contribute 275 hours of sweat equity toward the construction of their own and other Habitat homes. Habitat retains the right of first refusal to repurchase a Habitat home if the owner wishes to sell. Habitat uses deferred-payment second mortgages and equity sharing to ensure that the community’s investment of funds and labor will continue to benefit low- income families if the original buyer sells the home. x Since 2010, Habitat has also provided home repairs to low-wealth homeowners. To date, Habitat has completed more than 110 repair projects. Through these projects, Habitat recognizes and seeks to address the ongoing need for affordable work on existing homes in the communities where it builds. Repairs are an important aspect of Habitat’s affordable housing strategy because they offer low-cost assistance to homeowners living in deteriorating or unsafe homes, which improves their quality of life as well as the quality of life of other neighborhood residents. Habitat is also committed to strengthening the neighborhoods where it builds by developing relationships and supporting other neighborhood improvement initiatives identified by neighborhood residents. x In carrying out its affordable housing and community strengthening activities, Habitat seeks to educate and empower its homebuyers through a series of relevant workshops and one-on-one trainings. Habitat also strives to educate the broader community about the crisis in affordable housing by introducing and involving hundreds of new volunteers from all walks of life into its work each year. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 10 of 23 Habitat promotes the positive value of diversity by uniting people of varied economic, religious, social, and racial backgrounds to work together toward a common goal – building and repairing decent homes in partnership with families in need. d)Agency’s History with Providing These Services: Habitat is requesting funding for its Home Preservation program. Habitat first began completing exterior home repairs in 2010. Habitat has received government funding for these projects in the past, and has proven its ability to successfully complete and report the agreed upon work. In addition, during the fall of 2016 Habitat piloted providing critical repairs to homeowners in Northside and Pine Knolls. These repairs were also subject to grant funding restrictions and reporting. In total, Habitat has successfully completed more than 110 repair projects in Orange County. 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?) Habitat is working on its first senior housing community within the Waterstone development in Hillsborough. Habitat expects to break ground this spring on the infrastructure for 24 homes designed to accommodate seniors ages 55 and up. This project meets an urgent and growing need for affordable senior housing in the county. Habitat also hired a full-time Home Preservation Manager in the first quarter of FY18 to manage the construction side of our expanded home repair program. 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/2,080 = Volunteer FTE # of FTE - Full-Time Paid Positions: 19 # of FTE - Paid Part-Time Positions: 0 # of Volunteers: 2,140 # of FTE - Volunteers: 8 g) Living Wage Does this agency pay permanent employees a minimum living wage? (Yes / No) Yes If yes, is this agency an Orange County Living Wage Certified Employer? Yes If no, please explain. h) Agency Budget EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 11 of 23 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 2 repair projects in Carrboro $2,334 $0 Carrboro – Affordable Housing Special Revenue Fund 7 new homes in Northside $105,000 $0 Chapel Hill – Affordable Housing Development Reserve Sewer and other work at 326 McMasters Street $25,000 $0 Chapel Hill – Affordable Housing Development Reserve Planning, development, and infrastructure for 24 senior housing units in Hillsborough $425,000 $500,000 Orange County – Affordable Housing Bond Planning, development, and infrastructure for 24 senior housing units in Hillsborough $0 $125,000 Hillsborough – Other Total $557,334 $625,000 *Add rows or attach additional page, if needed. ii.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: x 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/HOME/etc.) Private Foundation Grants EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 12 of 23 o Other Revenue x Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel & Training o Other Expenses iii. Does your agency budget show a Surplus or Deficit? Yes, for FY17 we show a deficit of $260,895; for FY18 a deficit of $377,025; and for FY19 a surplus of $54,319. Is there a significant change? Yes/No No, no significant changes. Please provide a brief explanation for Surplus or Deficit, and significant changes: The FY17 deficit is primarily due to delays in completing and closing on the homes built in Northside that year, resulting in NCHFA and HOME funds not being received until the next year. The FY18 deficit is primarily due to the upfront costs of planning, design, and infrastructure for our upcoming senior housing development in Hillsborough. iv. What is your agency’s fiscal year?(Example: July 1, 2016 through June 30, 2017) July 1 through June 30 3. PROGRAM INFORMATION(Submit a separate Section 3for each program) Program Name: Home Preservation Program Primary Contact and Title: Marisa Martini, Community Development Manager Telephone Number: (919) 932-7077 ext. 232 E-Mail: mmartini@orangehabitat.org a) Indicate the type of Human Service Needs Priority, if program applicable: Priority Area #1: safety-net services for disadvantaged residents Priority Area #2: education, mentorship, and afterschool programming for youth facing a variety of challenges Priority Area #3: programs aimed at improving health and nutrition of needy residents EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 13 of 23 b) Indicate the type of program for which you are requesting funding. (Check all that apply to this program) 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. x Each month the Jackson Center, Habitat, and Rebuilding Together of the Triangle (RTT) staff gather for a critical repair meeting to discuss applicants and homeowner needs in the Northside and Pine Knolls communities. Each agency takes on portions of an individual homeowner’s repair requests so that we can provide the greatest impact across a broad base of residents. x The Jackson Center staff helps market Habitat repair programs to families in Northside and Pine Knolls. They spearheaded the creation of a common application that meets the needs of multiple repair agencies to determine homeowner need and eligibility. The Jackson Center participates in Habitat home repairs and new construction by providing volunteer labor, and they perform their own critical repairs in Northside through the Promise of Homes program. x RTT uses both volunteers and subcontractors to perform repairs in Orange, Durham, and Wake Counties. The RTT program director provided invaluable assistance to the Habitat program director in establishing a successful repair program. RTT and Habitat collaborate on repairs for individual households in Orange County by sharing resources. x Orange County Urgent Repair performs minor and major repairs throughout Orange County. Urgent Repair and Habitat have provided informal referrals to one another since the inception of Habitat’s repair program. With funding to expand our repair program we plan to be more intentional in collaborating and developing a repair coalition that benefits residents countywide. x Habitat coordinates with the Blue Ribbon Youth Leadership Institute to provide volunteer opportunities for high school students who can then apply for a scholarship to assist with higher education if they complete 30 hours of service with Habitat, primarily on repair projects. The funding for the scholarship program is provided by an anonymous donor. Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods/Residents Affordable Housing X X X Affordable Healthcare Education Family Resources Jobs/Jobs Training Food Transportation Other: Please specify EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 14 of 23 x Habitat is a member of the Orange County Affordable Housing Coalition, a group of housing providers and advocates who are working together to increase resources for the full range of housing needs in Orange County, including home repair. Habitat’s Executive Director currently chairs the Coalition. x Habitat staff and volunteers work with established leaders in the neighborhoods they serve, and also strive to identify and nurture new leaders, providing support and training as needed. Habitat’s commitment to strengthening neighborhoods includes a variety of trainings and workshops that promote leadership specifically for the youth and adults who reside there. Collaborative efforts that began several years ago with both the Rogers-Eubanks Neighborhood Association (RENA) and the Fairview Community Watch enhance the overall quality of life in each neighborhood, and also serve to spread the word about Home Preservation and ensure that residents who could benefit from the program are identified and referred. Collaborative efforts in the Rogers Road community have engaged representatives from the Department on Aging, Piedmont Health Services, St. Paul AME Church, RENA, Justice United, Habitat’s Youth United program, Blue Ribbon Mentor Advocates, and the UNC Campus Chapter of Habitat for Humanity. x Habitat staff participated in the 2017-2020 Master Aging Plan Work Group on Housing, which made recommendations to the MAP Leadership Team regarding coordination of repair programs to help residents age in place. x Habitat is a member of the recently formed Orange County Home Repair Coalition. This Coalition is comprised of Habitat, RTT, Orange County Urgent Repair, and the Department on Aging's Handy Helpers program. The purpose of this Coalition is to increase coordination and communication, better utilize resources across repair programs, and provide more comprehensive repairs to better preserve affordable housing stock in Orange County. Program Description (3 pages OR LESS) Please provide the following information about the proposed program: d) Summarize the program services proposed and how the program will address a Town/County priority/goal? Affordable housing was selected as the top goal and priority of the Orange County Board of Commissioners for FY17. Affordable housing was identified as the number one human services need in Chapel Hill by the 2012 assessment. The Chapel Hill Town Council has also established the overarching goal of creating a place for everyone in 2016-2018. Under that goal, the Council pledges to adopt and support affordable housing programs and to sustain the momentum of the Northside Neighborhood Initiative. The Town of Carrboro also has a goal to increase the number of affordable housing units in the Town. Habitat’s Home Preservation program assists with all of the aforementioned priorities. Habitat launched A Brush with Kindness (ABWK) as a pilot program in 2009 with two projects in Hillsborough. When Habitat formalized the program in 2010, it also created an informal Advisory Committee, inviting other repair program providers to EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 15 of 23 meet to share information and referrals for repairs within the county. The services Habitat provided through ABWK complemented those provided by JOCCA, Rebuilding Together of the Triangle, and Orange County’s Urgent Repair and Rehab programs. All of these agencies provided referrals to Habitat’s ABWK program, and Habitat refers clients to them. Overall, 30% of applicants come through agency referrals, and the remaining 70% come through targeted neighborhood marketing and word of mouth. In 2012, Habitat was asked by the Town of Chapel Hill to implement ABWK in the Northside/Pine Knolls neighborhood on a pilot basis. In the fall of 2016, Habitat piloted a critical repair initiative in Northside/Pine Knolls with one-time funding from Lowe’s Home Improvement and Habitat for Humanity International. Due to the success of this endeavor, this year Habitat merged its ABWK and critical reapir programs into the comprehensive Home Preservation program, which is now available in all three Towns and in the County. This program allows us to contribute even more to the combined efforts to meet the growing need for home repairs. To date, Habitat has received over 250 applications for home repair. So far in FY18, 100% of the Orange County residents who have received repairs through the program were elderly and/or disabled. This is part of an ongoing retention strategy to help existing homeowners stay in their homes, while also increasing the attractiveness of neighborhoods. e) Describe the community needor 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. Habitat will continue to address the Towns’ and County’s priority need for affordable homeownership for low- and very low-income renters through its new home construction program. However, Habitat’s experience working with residents in the communities where it builds new homes has helped to identify an underserved need among low-income homeowners, especially those who are elderly or disabled. Habitat has had direct experience with low-income families in Orange County who are struggling to maintain the exterior and interior of their homes, and who need modifications to their homes so that they may continue to live in and enjoy them. Rot, peeling paint, sagging gutters, broken doors, unsafe porches, roof leaks, plumbing damage, holes in floors, and lack of accessibility impact the safety, livability, and value of individual homes in places like Carrboro, Fairview, Northside, Pine Knolls, and Rogers Road, as well as in more rural areas of the county like Cedar Grove, Efland, and Mebane. 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 targeted population for Home Preservation is senior homeowners in Carrboro, Chapel Hill, Efland, and Hillsborough. This population has self-identified as having EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 16 of 23 the highest physical and financial need. In the past five years, Habitat has received numerous requests for interior critical repairs and roof replacements. We will market the program through the social services department, Orange County aging resource guide, community meetings, and faith group bulletins. Home Preservation recipients must own their home and be current on their mortgage, homeowners insurance, and property taxes. Recipients must earn 80% or less of the area median income. In FY17, approximately 90% of the Orange County residents who participated in the program were elderly and/or disabled. The average recipient income was 45% of the area median income. Habitat does not consider age, race, gender, religion, or any other protected status when evaluating applications. Habitat receives referrals from and partners with local senior support organizations and other low-income service providers. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) The activities of Habitat’s Home Preservation program will be carried out primarily by Marisa Martini, Community Development Manager, and Ed Kuczynski, Home Preservation Manager. Ms. Martini is responsible for marketing the program, processing program applications, meeting with homeowners, recruiting volunteers, and conducting homeowner satisfaction surveys, while Mr. Kuczynski is responsible for assessing potential projects, obtaining supplies, coordinating subcontractors, and supervising volunteers. The program activities will be carried out primarily at the Habitat office and on the project site, which could be the home of any qualifying family in Orange County. Ms. Martini and Mr. Kuczynski began leading the repair program in 2017. Both overlapped with outgoing program staff, ensuring plenty of time for training and a smooth transition. Ms. Martini and Mr. Kuczynski are both highly qualified for their current roles. After receiving her Masters of Public Health from UNC-CH, Ms. Martini interned with the Orange County Department on Aging. Among other tasks, she worked closely with Habitat staff to coordinate and lead affordable senior housing focus groups, which are still informing Habitat’s policy and design decisions as we plan for our first senior housing development. Following this, she interned with Habitat’s Family Services Department until she was hired on as full-time staff. Mr. Kuczynski is a licensed general contractor, and comes to Habitat after owning his own residential remodeling company for 25 years. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. Home Preservation is an ongoing program. Projects are completed throughout the year. At all times, there will be projects at different stages in the process, such as application, approval, assessment of repairs needed, volunteer and funder recruitment, work days, and evaluation. There is an abundant need for home repairs throughout the Towns and County. On average, Habitat repairs 2.5 homes each month. Construction work typically occurs during the week with subcontractors or on weekends with volunteers. Staff works throughout the week to administer the EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 17 of 23 program. For an exterior repair completed primarily by volunteers, the average timeline is seven months from the time of application to the time of the repairs being completed, final payment being made, and the homeowner signing off that they are satisfied with the work. For a critical repair completed primarily by subcontractors, the average timeline is three months. We anticipate the following timeline: July 2018-August 2018 Market Home Preservation program and touch base with applicants on waiting list August 2018 Annual youth paint blitz September 2018-December 2018 Perform home repairs with volunteers and subcontracted labor October 2018-March 2019 Attend community meetings to market program to community members January 2019-June 2019 Perform home repairs with volunteers and subcontracted labor 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) The Home Preservation program directly targets the need to maintain the existing stock of affordable homes in our community. This program meets a long-term demonstrated need from community residents and helps meet the affordable housing goals and priorities of the Towns and County. For over 30 years, Habitat for Humanity has successfully stewarded its resources to provide safe, decent new homes for more than 270 families, and repair projects for more than 110 homeowners. Our vision is for everyone to have a decent place to live. Habitat mobilizes volunteers and subcontractors who are mission-oriented to assist with home repair in order to 1) meet the physical need, 2) keep costs low, and 3) provide much-needed interaction between community members of diverse socioeconomic statuses, ages, religious practices, political affiliations, etc. Habitat’s model of collaboration and a hand up, not a handout, engages homeowners and other housing agencies to provide the greatest impact on residents. On its own, Habitat does great affordable housing work, but in combination with local government and community advocates we are able to accomplish far more. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. We arrived at this project design through a comprehensive strategic planning process and by identifying the critical actions necessary to achieve our mission and vision. In 2016, our pilot of volunteer-led repairs and subcontractor-led repairs gave us a great framework for expenses and timeline to perform repairs. In 2017, government funding support was critical to transitioning to our comprehensive Home Preservation program, which provides both interior and exterior repairs. Our Board of Directors identified Home Preservation as a strong and growing program that fulfills the mission and vision of Habitat. They also identified the strength of this program in connecting new donors, volunteers, and sponsors with the need for affordable housing solutions in our community. Funding for this project will allow us to maintain the quality and quantity of the services we provide. Our commitment to EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 18 of 23 communities has been that we will partner with individuals, associations, government, and funders to carry out our mission to the best of our ability and provide safe, decent, affordable housing to as many people as possible. As is demonstrated by our Program Budget, multiple government and non-government funding sources must be combined to make this program a success, and every dollar requested is critical. If a reduced allocation is recommended, or if the requested funding is not awarded at all, the core activities described in this proposal will be carried out to a lesser degree commensurate to the funding allocation. k) What percentage of your target population is low-moderate income? All, 100%, of our target population is low- or moderate-income. l) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc.?) In 2017, we developed and implemented a Home Preservation Feedback Survey. After a project is finished, we set up a final meeting with the homeowner. They sign their certificate of repair completion, and are also given the option to complete the Home Preservation Feedback Survey. The survey collects data on several different areas, including communication, timeline, quality of the repair, experience working with Habitat, and changes in quality of life. m) Include any other pertinent information. The Cost per Individual table below indicates that our cost per repair project is increasing over time. This is a result of the shifting mix of lower-cost exterior projects, and higher-cost critical projects. In FY17, 18 exterior repairs and 13 critical repairs were completed. In FY18 and FY19, we anticipate 10 exterior repairs and 20 critical repairs. This shift to more critical, expensive repairs drives up the cost per project. Although more expensive, we believe this is worthwhile and worth the cost. Critical repairs such as replacing leaking roofs and rotted floors are exactly that – critical. The homeowners, mostly elderly and/or disabled, would eventually be unable to continue living in their homes. These repairs allow them to age in place and stay in a situation that is affordable to them. Additionally, the data below show that we completed 31 repairs total in FY17, and plan to complete 30 in FY18, and again in FY19. Again, this slight decrease in total repairs is a result of shifting to a higher number of larger, more critical repairs. This year we have new staff leading the program, including a full-time staff person on the construction side for the first time. We believe that 30 repairs will remain feasible in FY19 with our current staffing and capacity. 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. Note: This chart is completed for heads of household only. Program Target Population Demographics Actual Estimated Projected EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 19 of 23 2016-17 2017-18 2018-19 Gender Male 7 7 7 Female 24 23 23 Total 31 30 30 Ethnicity African-American 24 26 26 American Indian or Alaska Native 0 0 0 Asian 2 2 2 Caucasian 5 2 2 Native Hawaiian or other Pacific Islander 0 0 0 Other: specify __________________ 0 0 0 Total 31 30 30 Of the above, how many Hispanic/Latino 0 1 1 Of the above, how many non-Hispanic/Latino 31 29 29 Total 31 30 30 Age 0-5 years 0 0 0 6-18 years 0 0 0 19-50 years 3 3 3 51+ years 28 27 27 Total 31 30 30 Geographic Location Alamance County 0 0 0 Chatham County 0 0 0 Durham County 0 0 0 Wake County 0 0 0 Orange County Breakdown Chapel Hill Public Housing 0 0 0 Town of Chapel Hill (Non-Public Housing) 24 11 11 Town of Carrboro 2 3 3 Town of Hillsborough 3 6 6 City of Mebane (Orange County) 0 0 0 Orange County (Outside Municipalities) 2 10 10 Total 31 30 30 Work Statement o) Complete the Work Statement Chart to describe the work tobe 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. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 20 of 23 x Program Activities should outline major activities the agency implements to accomplish its program goals. (i.e. Deliver meals to elderly/disabled residents.) x 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.) x 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.) x 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: Home Preservation Program Activity Name Home Preservation Program Goal Provide 30 interior/exterior home repairs for low- and moderate-income homeowners in Orange County. Performance Measures By June 30, 2018, complete 30 interior/exterior repair projects for low- and moderate-income homeowners in Orange County. Previous Year Program Results 31 home repairs completed countywide Current Year EstimatedResults 30 home repairs completed countywide Next Year Projected Results 30 home repairs completed countywide p) Program Budget 1. Submit your program 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, 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: x 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/HOME/etc.) Private Foundation Grants EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Page 21 of 23 o Other Revenue x Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel & Training o Other Expenses 2. Program Budget Detail –Provide description of “other” budget items, not defined. Other Revenue: loan payments from homeowners. Other Expenses: materials and subcontracted labor. 3. This program budget represents what percent of the agency budget? Home Preservation represents 6.2% of Habitat’s FY17 budget, 5.5% of FY18, and 6.5% of FY19. 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. Actual 2016-17 Estimated 2017-18 Projected 2018-19 Total Cost of Program $192,263 $246,660 $251,430 Total # of Individuals 31 30 30 Cost Per Individual $6,202 $8,222 $8,381 4.ATTACHMENTS Description of Required Attachments a) Financial Audit A recent financial audit that should cover CY 2016, for calendar year agencies, and FY 2016-17, for fiscal year agencies. For agencies with prior year revenues totaling $500,000 or more a financial audit, prepared by a certified public accountant is required. Agencies with prior year revenues of less than $500,000 may submit a completed Schedule of Receipts and Expenditures form (see application materials), in lieu of an audit/report. Agencies with a certified audit/report should not complete the form. b) IRS Federal Form 990 A copy of the agency’s 2016 Form 990 is required. The specific form depends upon the agency’s financial activity. Review the IRS’ table guide, for more details. For Form 990-N (e-postcard) filers, include a copy of the postcard, with the agency’s application materials. c) NC Solicitation License EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Agency Budget Operating Budget for Entire Agency Actual 2016-17 Estimated 2017-18 Projected 2018-19 Percent Change -$ -$ 0 1,091,731$ 1,124,930$ 1,160,680$ 3% -$ -$ 5,000$ 0 -$ 2,334$ -$ -100% 1,500$ -$ 10,000$ 0 55,000$ 130,000$ -$ -100% 30,000$ 37,500$ 50,000$ 33% 33,738$ 425,000$ 500,000$ 18% -$ -$ 125,000$ 0 753$ 320$ 320$ 0% -$ -$ -$ 0 187,455$ 392,037$ 195,000$ -50% Private Foundation Grants180,000$ 210,750$ 175,000$ -17% 1,241,527$ 1,822,814$ 1,686,000$ -8% top 3 Other Proj 2018-2019: - Mortgage pmts580,000 - NCHFA390,000 - ReStore proceeds240,000 2,821,704$ 4,145,685$3,907,000$-6% 1,114,382$ 1,256,593$ 1,278,700$ 2% 73,830$ 73,724$ 75,488$ 2% 87,822$ 83,800$ 76,800$ -8% 37,722$ 28,700$ 36,350$ 27% 1,768,843$ 3,079,893$ 2,385,343$ -23% top 3 Other Proj 2018-2019: - Construction, Land Costs1,807,000 - NCHFA payments146,850 - Work Comp, Gen Liab, Other Ins 45,000 3,082,599$ 4,522,710$3,852,681$-15% (260,895)$ (377,025)$ 54,319$ 114%SURPLUS/(DEFICIT) FOR PERIOD: Travel & Training Other Expenses: Total Agency Expenses Supplies & Equipment Federal Government (CDBG/HOME/etc.) Other Revenue Total Agency Revenue AGENCY EXPENSES Compensation (incl. Benefits) Rent & Utilities State Government 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 Agency Generated Revenue (fees) Local Government Grants: Human Services - Town of Carrboro Other - Town of Carrboro Private Donations AGENCY NAME:Habitat for Humanity, Orange County, NC, Inc. AGENCY REVENUE FY 2015-16 Comparative Agency Budget Revised 9/29/2014 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Habitatkeepsacashreserveofatleast6months ofoperatingcapitalonhandatalltimes.We currentlyhaveabout8monthsofoperatingexpenses inreserve.Thiscashcoversalldeficitscausedby timingissues.Thereserveisalsoinplacetocover landdevelopmentcoststhatarenotcoveredbygovernment funding.(perSusanLevy3/13/2018e-mail). DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 Program Budget Operating Budget for Program PROGRAM REVENUE Actual 2016-17 Estimated 2017-18 Projected 2018-19 Percent Change Private Donations -$ -$ -$ 0 Program Generated Revenue 128,171$ 146,826$ 126,430$ -14% Local Government Grants: Human Services - Town of Carrboro -$ -$ 5,000$ 0 Other - Town of Carrboro-$ 2,334$ -$ -100% Human Services - Town of Chapel Hill1,500$ -$ 10,000$ 0 Other - Town of Chapel Hill-$ -$ -$ 0 Human Services - Orange County30,000$ 37,500$ 50,000$ 33% Other - Orange County-$ -$ -$ 0 Other - Town of Hillsborough-$ -$ -$ 0 Other Government Grants Triangle United Way-$ -$ -$ 0 State Government-$ -$ -$ 0 Federal Government (CDBG/HOME/etc.)30,000.00$ 50,000.00$ 50,000.00$ 0% Private Foundation Grants-$ -$ -$ 0 Other Revenue 2,592$ 10,000$ 10,000$ 0% Total Program Revenue192,263$246,660$251,430$2% PROGRAM EXPENSES Compensation 96,190$ 113,020$ 117,540$ 4% Rent & Utilities 8,100$ 8,340$ 8,590$ 3% Supplies & Equipment 6,300$ 7,000$ 7,000$ 0% Travel & Training 3,000$ 3,300$ 3,300$ 0% Other Expenses: (Materials & subcontractors)78,673$ 115,000$ 115,000$ 0% Total Program Expenses192,263$246,660$251,430$2% SURPLUS/(DEFICIT) FOR PERIOD:-$ -$ -$ 0 PROGRAM NAME: Home Preservation EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 (Habitat for Humanity, Orange County, NC, Inc.) Orange County Outside Agency Performance Agreement Page 10 of 9 Rev. 7/18 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. Certified by: _______________________ Title: __________________________ Date: ___________ (Provider’s Signature) DocuSign Envelope ID: 1263366F-0902-4D24-AE16-FC2EBB866669 07/24/2018 Summit Insurance Group, Inc. PO Box 2485 Huntersville NC 28070 Stephanie Freeman (704) 659-2141 (704) 659-2148 stephanie@sumins.com Habitat For Humanity Orange County, NC, Inc. 88 Vilcom Center Dr. Ste L110 Chapel Hill NC 27514 Builders Mutual Insurance Company - Tip 10844 Consolidated Program Ins. Services, Inc. CL1832803603 A Y BRP0017274 04/01/2018 04/01/2019 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 A PCA0009233 04/01/2018 04/01/2019 1,000,000 Medical payments 5,000 A MUB0001005 04/01/2018 04/01/2019 2,000,000 2,000,000 A PWC1011231 04/01/2018 04/01/2019 1,000,000 1,000,000 1,000,000 B Volunteer Accident/DI NHH000489 04/01/2018 04/01/2019 $250,000 Orange County Government is considered an additional insured with respects to the General Liability per written contract Orange County Government PO Box 8181 Hillsborough NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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