HomeMy WebLinkAbout2018-447-E Finance - OE Enterprises Inc performance agreementDocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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 OE Enterprises, Inc., a not - for - profit corporation,
located at 348 Elizabeth Brady Road, Hillsborough, NC 27278 ( "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 OE Enterprises, 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 $54,550.
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 $13,637.50. 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.
(OE Enterprises, Inc.)
Orange County Outside Agency Performance Agreement
Revised 712018 Page 1 of 9
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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.
(OE Enterprises, Inc.)
Orange County Outside Agency Performance Agreement Page 2 of 9
Rev. 7118
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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
• 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.
(OE Enterprises, Inc.)
Orange County Outside Agency Performance Agreement Page 3 of 9
Rev. 7118
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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 OE Enterprises, 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:
(OE Enterprises, Inc.)
Orange County Outside Agency Performance Agreement Page 4 of 9
Rev. 7118
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
County: Finance & Administrative Services
Orange County
Post Office Box 8181
Hillsborough, NC 27278
Provider: OE Enterprises, Inc.
348 Elizabeth Brady Road
Hillsborough, NC 27278
16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire
Agreement between the parties and shall supersede, replace or nullify any and all prior
Agreements of understandings; written or oral, relating to the matters set forth herein, and any
such prior Agreements or understandings shall have no force or affect whatsoever on this
Agreement. The County and Provider have read this Agreement and agree to be bound by all of
its terms, and further agree that this Agreement constitutes the complete and exclusive statement
of the Agreement between the County and Provider.
17. Severability. All clauses found herein shall act independently of each other. If a clause is found
to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It
is understood by the parties hereto that if any part, term or provision of this Agreement is by the
Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United
States, the validity of the remaining portions or provisions shall not be affected, and the rights
and obligations of the parties shall be construed and enforced as if the Agreement did not contain
the particular part, term or provision held to be invalid.
a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of
respective parties hereunder shall be governed by the laws of the State of North Carolina. By
executing this Agreement Provider affirms that Provider and any subcontractors of Provider are
and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General
Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and
has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer
pursuant to G.S. 147 - 86.58.
18. Signatures. This Agreement together with any amendments or modifications may be executed
electronically. All electronic signatures affixed hereto evidence the intent of the Parties to
comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66.
IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on
the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures
below.
For Docusignek by : ° wider
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For DocuSigned by: County Government
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OG3799d6755E477...
Bonnie Hammersley, County Manager
(OE Enterprises, Inc.)
Orange County Outside Agency Performance Agreement
Rev. 7118
8/20/2018
Date
8/20/2018
Date
Page S of 9
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
1. COVER PAGE
a) Applicant Contact Information
Applicant Organization's Legal Name: OE Enterprises, Inc.
Applicant Organization's Physical Address: 348 Elizabeth Brady Rd.
Hillsborouah, NC 27278
Applicant Organization's Mailing Address: 348 Elizabeth Brady Rd.
Hillsborough, NC 27278
Applicant Organization's Web Address: www.oeenterprises.org
Executive Director: Margaret Samuels
Telephone Number: 919 - 732 -8124
Tax ID Number: 57- 0740781
E -Mail: samuelsm(a)oeenterprises.org
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)
Proqram
Carrboro
Chapel
Orange
Total
- HS
Hill - HS
County -HS
Transitions to Employment
$4,000
$10,000
$54,550
$68,550
Proposed use of funds: Personnel costs
associate with providing vocational
placement, training, and community
integration supports for students and adults
who have disabilities.
Totals
$4,000
$10,000
$54,550
$68,550
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.
-Na
Signature:
Executive Director
Date
Signature: a'- v (3qw��
Board Chairperson V Date
AGENCY INFORMATION 1/22/2018 1:53 :42 PM
1/22/18
1/22/18
Page 2 of 18
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
d) DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION
CLAUSE
Are any of the Board Members or employees of the agency which will be carrying out this program
or members of their immediate families, or their business associates...
YES NO
❑ ® a) Employees of or closely related to employees of the Town of Carrboro, the Town of
Chapel Hill, or Orange County?
❑ ® b) Members of or closely related to members of the governing bodies of the Town of
Carrboro, the Town of Chapel Hill, or Orange County?
❑ ® c) Current beneficiaries of the program for which funds are being requested?
❑ ® d) Paid providers of goods or services to the program or having other financial interest in
the program?
If you have answered YES to any question, please provide a full explanation below.
NON - DISCRIMINATION
Provider agrees as part of consideration of the granting of funds by funding agencies to the
parties hereto for themselves, their agents, officials, employees and servants agree not to
discriminate in any manner of these basis of race, color, gender, national origin, age,
handicap, religion, sexual orientation, gender identity /expression, familial status or veterans
status with reference to any activities carried out by the grantee, no matter how remote. The
parties hereto further agree in all respects to conform to the provision and intent of Orange
County Civil Rights Ordinance, as amended and the Orange County Anti - discrimination
Policy. This provision is enforced by action for specific performance, injunctive relief, or other
remedy as by law provided; this provision shall be binding on the grantees, the successors
and assigns of the parties hereto with reference to the above subject manner.
To the best of my knowledge and belief all of the above information is true and
current. I acknowledge and understand that the existence of a potential conflict of interest
does not necessarily make the program ineligible for funding, but the existence of an
Signature:
Ex uie Dire
Signature: ; a)'(
Board Chairoe
1/22/18
Date
1/22/18
Date
AGENCY INFORMATION 1/22/2018 1:53:42 PM
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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): 37 Years — Nov/1981
b) Agency's Purpose /Mission (no more than a few sentences):
The Purpose /Mission of OE Enterprises is creating opportunities for personal and
professional growth for persons with disabilities or other barriers to employment.
OE Enterprises promotes achievements, self - reliance, life choices and respect
through connecting individuals with disabilities and their community.
c) Types of Services the Agency Provides (bullet format):
• Community -based work experiences
• Facility based work adjustment services
• Volunteer work serving the community
• Community integration services
• Self -help skill acquisition including adaptive and socialization skills
• Job placement services
• Job coaching services
• Long -term employment supports
• Career counseling
• Retirement services
• Work evaluation
• School to work transition services — pre - employment transition services
d) Agency's History with Providing These Services:
OE Enterprises serves as a major employment resource for the Orange County
community and provides vocational and pre - employment training to individuals with
disabilities and other disadvantages. Training is tailored to the individual's abilities and
designed to meet specific vocational goals. OE Enterprises has been a fixture in the
North Carolina business community for over 40 years with its roots in the Orange
County area and providing community employment services for 25+ years. OE
Enterprises, Inc. (OE) was incorporated on November 19, 1981 as Orange Industries,
a public non - profit agency that was formerly part of OPC Mental Health Center serving
individuals with disabilities in the Orange County area. In October, 2003 Orange
Enterprises established a federal set -aside custodial operation in Winston -Salem and
has since established similar sites across North Carolina and in South Carolina. In
2005 Orange Enterprises expanded services to Alamance and Caswell counties,
changing the organization's name to OE Enterprises. OE expanded services to
Durham County in 2009 and Rockingham County in 2010.
Through our mission, OE meets the employment needs of Orange County citizens with
disabilities as well as the Orange County employment community. OE's Transition
program provides job experiences to students, allowing them to make informed choices
upon graduation and explore employment or post- secondary education options. The
purpose is to provide an opportunity for students to develop marketable and
Agency Information 1/22/2018 1:53:42 PM Page 4 of 18
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
transferable skills. In addition to work skills, students learn life skills- such as resume
building, daily living, and social skills. Our job coaches assist students with disabilities
transitioning from high school by developing a student's strengths and working towards
independence in areas such as employability, transportation, and daily living skills.
Individuals who receive services from OE have the opportunity to go to work every day,
earn a salary, pay taxes, buy goods and contribute to their communities. Individuals
learn needed skills and work habits that lead to community employment. Senior
employees have the opportunity to participate in integrated community -based senior
citizen and retirement activities. OE has helped thousands of individuals with
disabilities gain employment and work towards self- sufficiency.
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 ?)
OE continues to increase our work through the Consumer Production Packaging
Initiative. Last year, we were awarded a contract from UNCEOL - SUPERTite glue from
Spain. In business for 40 years, this is the first time selling in North America. OE is their
Order Fulfillment center through SourceAmerica's Consumer Products Packaging
Group (CPPG). OE provides pallet shipments to national chains like 011ie's and Texas
Art Supply, as well as individual orders to customers through SUPERTite's e- commerce
platforms.
OE is working with HYFAB, a Greensboro manufacturing company that makes industrial
heating and air conditioning units. We assist them in manufacture a distribution
manifold that will requires soldering copper tubes to the manifold and pressure relief
valve. OE initially makes the parts in Hillsborough to supply their inventory needs and
will eventually place an individual at their plant in Greensboro.
Our janitorial contracts continue to hold steady. We added AW of North Carolina in early
2017, which is an outside contract to clean the parking lots and grassy areas around the
100 acre site. AW manufactures transmissions for Toyota. We have three staff working
there five days per week.
Our order Fulfillment division has grown. Norm's Farms out of Pittsboro, NC is a family
owned business that sells elderberry jams, jellies and extracts in over 900 stores on the
east coast. They outgrew their garage and has partnered with OE to take over the
shipping for them. We ship their bulk products to the supermarkets and other stores all
over the US. Their business continues to grow each month.
OE is very excited about our new venture with Orange County School Systems and
Vocational Rehabilitation. Through this collaboration, OE is offering pre - employment
transition services to both high school and middle school students on a much larger
scale than in the past. Services focus on job exploration, work based learning,
workplace readiness, higher education counseling, and self- advocacy. We have staff
working with students both in classroom settings and on job sites in the community.
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DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
f) Schedule of Positions (For Entire Agency)
• Full Time Equivalent (FTE) staff will be noted as 1.00; half time as .50; quarter time as .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: 101
# of FTE - Paid Part -Time Positions: 47
# of Volunteers: 6 # of FTE - Volunteers: .75
g) Living Wage
Does this agency pay permanent employees a minimum living wage? (Yes/ No) Yes,
OE pays all full time Orange County staff a living wage and provides benefits
including health insurance.
If yes, is this agency an Orange County Living Wage Certified Employer? No
If no, please explain. OE has not submitted an application for consideration.
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DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
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) No
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
Orange County — Mail Services
$52380.00
$52380.00
Orange County
Orange County Library — Janitorial
Services
$1140.00
$1140.00
Orange County
Guardian Ad Litem Offices - Janitorial
Services
$2600.00
$2600.00
Orange County
Solid Waste - Janitorial Services
$18516.00
$18516.00
Orange County
Cedar Grove Community Center/ Efland
Cheeks Community Center Janitorial
Services
$33512.64
$33512.64
Orange County
*Add rows or attach additional page, if needed.
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DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
ii. Submit your agency's budget. You may complete the provided template
(separate xls file) or you may submit your own budget file (as long as it contains
the same information, and in a similar format, as requested in the provided template).
Agency Budget
Operating Budget for Entire Agency
AGENCY NAME: OE Enterprises, Inc.
AGENCY REVENUE
Private Donations
Agency Generated Revenue (fees)
Local Government Grants:
Human Services - Town of Carrboro
Other - Town of Carrboro
Human Services - Town of Chapel Hill
Other - Town of Chapel Hill
Human Services - Orange County
Other - Orange County
Other - Town of Hillsborough
Other Government Grants
Triangle United Way
State Government
Federal Government (CDBG /HOME /etc.)
Private Foundation Grants
Other Revenue
Total Agency Revenue
AGENCY EXPENSES
Compensation
Rent & Utilities
Supplies & Equipment
Travel & Training
Other Expenses:
Total Agency Expenses
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (508,038) $ (91,048)1 $ 3,000 1 103%
Agency Information 1/22/2018 1:53:42 PM P a g e 8 o f 18
Actual
2016 -17
Estimated
2017 -18
Projected
2018 -19
Percent
Change
$
7,733
$
7,515
$
7,500
0%
$
6,103,684
$
6,300,486
$
6,330,801
0%
$
3,800
$
4,000
$
4,000
0%
$
-
$
-
$
-
0
$
6,000
$
10,000
$
10,000
0%
$
-
$
-
$
-
0
$
51,000
$
54,550
$
54,550
0%
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
10,000.00
$
15,000.00
$
15,000.00
$ -
$
101,117.64
$
108,148.64
$
108,148.64
$ -
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$6,283,335
$ 5,264,743
$6,499,699
$ 5,156, 590
$6,530,000
$ 5,100, 000
0%
-1%
$
230,389
$
202,173
$
204,000
1%
$
368,218
$
309,644
$
310,000
0%
$
141,296
$
142,340
$
140,000
-2%
$
786,727
$
780,000
$
773,000
-11%
$6,791,373
$6,590,747
$6,527,000
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (508,038) $ (91,048)1 $ 3,000 1 103%
Agency Information 1/22/2018 1:53:42 PM P a g e 8 o f 18
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
iii. Does your agency budget show a Surplus or Deficit? Both
Is there a significant change? Yes /No Yes
Please provide a brief explanation for Surplus or Deficit, and significant changes.
OE has focused on right sizing the business in relation to federal and state
program and funding mandates and changes. OE sold an asset obtained just
prior to the financial downturn. A result OR is not mortgage and debt
free. Approximately 2 years of losses were projected by the OE Board as
these transitions take place. OE expects to end FY 17 -18 more positive and
18 -19 with a surplus.
iv. What is your agency's fiscal year? July 1, 2018 -June 30, 2019
(Example: July 1, 2016 through June 30, 2017)
Agency Information 1/22/2018 1:53:42 PM P a g e 9 o f 18
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
3. PROGRAM INFORMATION (Submit a separate Section 3 for each program)
Program Name: Transitions to Employment
Program Primary Contact and Title: Margaret Samuels
Telephone Number: 919-732-8124 E -Mail: samuelsm(@oeenterprises.org
a) Indicate the type of Human Service Needs Priority, if program applicable:
® Priority Area #1: safety -net services for disadvantaged residents
❑ Priority Area #2: education, mentorship, and afterschool programming for
youth facing a variety of challenges
❑ Priority Area #3: programs aimed at improving health and nutrition of needy residents
b) Indicate the type of program for which you are requesting funding
(Check all that apply to this program)
Program Category
Youth
Adult
Elderly
Disabled
Public Housing
Neighborhoods /Residents
Affordable Housing
Affordable Healthcare
Education
Family Resources
Jobs /Jobs Training
X
X
X
X
Food
Transportation
Other: Please specify
PROGRAM INFORMATION 1/22/2018 1:53:42 PM
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
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.
• Chamber of Commerce, Cardinal Innovations, Alliance Behavioral Healthcare, and
the United Way Greater Triangle. We maximize opportunities, create relationships
with local business that may employ Orange County residents with disabilities and
ensure that we network for all the available opportunities for our clients. We organize
and participate in job fairs and community training with DSS and the school
systems. We work with the college systems to engage volunteers, assist in recruiting
staff and provide information to students interested in this profession.
• Vocational Rehabilitation (VR) and the NC Division of Services for the Blind (DSB)-
OE collaborates on many levels with VR and DSB. From coordination of services at
the local level to leading planning initiatives at the state level, OE's interaction with
both state agencies assist our Orange County citizens with disabilities in securing a
better future though employment.
• Food insecurity and basic needs- Because of our longevity OE has strong
connections with Orange Congregation in Mission (OCIM); Interfaith Council for
Social Services; Orange County Department of Social Services and through these
relationships we assist our clients with unmet basic needs including food. We also
hold an annual blood collection drive at our Orange County location in collaboration
with the American Red Cross.
• Third Sector Alliance - Through the Third Sector Alliance, OE is able to take an active
part with other funded agencies to "provide a collective voice for the nonprofit
sector ". OE is member of the Third Sector Alliance and is represented on the
steering committee.
• State Advocacy Organizations - OE also interacts with other agencies in our field
throughout North Carolina by participating in two organizations, the NC Association
for Persons Supporting EmploymentFirst (NC APSE) and the NC Association of
Rehabilitation Facilities (NCARF), to share ideas and training.
• Group Homes /Housing supports and Transportation - Many of the individuals we
support receive services through various residential providers in the area. Housing
is extremely important in employment success. Collaborating with these agencies
assists our consumers in meeting their residential needs. We collaborate closely
with OPT and Chapel Hill Transit as our clients rely heavily on public transportation
to get back and forth to work.
PROGRAM INFORMATION 1/22/2018 1:53:42 PM
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
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?
Town Priority: Jobs /Job Training: OE will utilize all funding from Human Services grant to
expand our current mission by supporting staffing and transportation. Our program
addresses the above issues by providing employment readiness training, job coaching,
volunteer experiences, and vocational placement and support to high school students and
adults with disabilities. By preparing individuals for the transition to employment from high
school we increase their chances of obtaining and maintaining employment. By providing
work training, placement, and support to adults with disabilities we are addressing the rate
of unemployment among individuals with disabilities in Orange County.
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 needs assessment for Chapel Hill shows a high priority need in the area of "local adult
education and job training opportunities." The national unemployment rate for 2017 was
4.1%, with a North Carolina average of 4.5 %. The Orange County unemployment rate for
*2017 averaged 4.0% ( *statistics for December not yet released - Bureau of Labor
Statistics).
Unemployment is an issue that, at one time or another, affects most Americans. This is a
more prevalent issue among those in the disability community and the availability of job
training and engagement programs are limited. The 2011 Orange County Community
Health assessment reported that the unemployment rate for individuals with a disability was
23.2% statewide, but jumps to 41.1% in Orange County. According to the Office of
Disability Employment Policy (ODEP), the 2017 employment rate (labor force participation)
of individuals with disabilities of working age is 20.9 %. Many of those who are employed
face underemployment.
A troubling statistic includes the data that at all levels of education, persons with a disability
were much less likely to be employed than were their counterparts with no disability
http:// www. bls. gov /news.release /pdf /disabl.pdf). Orange County employment is concentrated in
government and University positions. Per the 2011 Community Health Assessment, the
unemployment rate for individuals with only a high school diploma or equivalent stands at
26.2 %. here are fewer opportunities for younger, entry level workers and there is increased
competition for these jobs due to the UNC Student population (Orange County Community
Health Assessment 2011, p70 -71).
There are few services available for integration of individuals with disabilities into
established senior retirement and community activities Services for disabled senior
citizens remain a critical need. Mobility, vision, hearing, and balance issues become even
more impactful for seniors with disabilities. Most seniors lose community and family
PROGRAM INFORMATION 1/22/2018 1:53:42 PM _ .
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
support as they age and for seniors with disabilities this can be life altering as family
members may have been their caretakers.
Many individuals with disabilities are reliant on public assistance for survival. Securing
employment gives individuals the dignity of work and increases physical health outcomes.
Working allows a person to be less reliant on public assistance and turns a tax recipient
into a tax payer.
f) Who is your target population of individuals to benefit from this program and how will they
be identified and connected with the program?
OE will serve students, adults and senior citizens who have a disability or other barriers to
employment. Most of our referrals come from Vocational Rehabilitation, Orange County
Schools, and Alliance /Cardinal MCOs, but we also are connected with individuals seeking
services from Social Services, residential providers, families, self - referrals and other
community members. OE serves individuals with varying disabilities to include
development/intellectual disabilities, physical disabilities, behavioral health challenges,
substance use disorders, hearing and visual impairments as well as those with extensive
criminal backgrounds. Students receiving transition services are age 14 through 22 years
of age.
g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program
Manager and credentials, describe training provided to volunteers, etc.)
OE's Job Development Specialists and Job Coaches work with individuals (both adults and
students) during the process of finding employment and job skill acquisition. All staff
working with individuals in the community must have a minimum of three years experience
with population served and all of our Job Development Specialists have a Bachelor's
degree. All employment staff and services provided are supervised by staff deemed as
Qualified Professionals (QP) by the State of NC. QPs are individuals who hold a Bachelor's
degree in a human services area with two years of experience with individuals served.
h) Describe the specific period over which the activities will be carried out and include an
implementation timeline.
Measurable activities will begin July 1, 2017 through June 30, 2018. At the beginning of
services, each person participates in creating a written individual plan to meet their unique
needs. Length of service, frequency and amount of time spent in different phase of service
is customized for each person. Individuals participating in OE's pre - vocational services
through ADVP are offered services 7 hours a day /5 days a week. Our community based
employment services may vary from daily to weekly services. The frequency varies
depending on the stage in which the individual is with their employment search and training
phase. Our transition job coaches provide services in the high schools five days a week
and two days a week in the middle school.
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 this employment program through OE benefits all community stakeholders. For
individuals with disabilities, employment helps to gain a sense of self - worth, achieve
PROGRAM INFORMATION 1/22/2018 1:53:42 PM o J e 13 of 1
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
financial independence, and recognize important social roles like community involvement
and volunteerism. Working plays a vital role in mental and physical health by improving
overall wellness, resulting in decreased reliance on medical professionals. Once a person
is employed they become a taxpayer! Taxpayers experience reductions in the costs of
governmental programs. One study examining the timeframe from 2002 -2007 quoted that
for every $1 used to fund employment services, taxpayers received $1.46 back in the form
of taxes paid, savings from alternative programs, and a reduction in governmental
subsidies. Employers see a positive economic return when hiring individuals with
disabilities. There is a decreased turnover rate among this cohort, reducing the costs
associated with recruiting and training. Employers also receive monetary incentives for
hiring under - employed populations. Hiring individuals with disabilities improves employer
image, increasing sales. Society enjoys the benefit of an integrated workforce, increased
tolerance, and acceptance of differences. Increasing and diversifying the workforce
advances our nation's productivity and economy.
j) Describe what would happen if requested funding is not awarded at all or if a reduced
allocation is recommended.
OE has worked hard in Orange County for over 40 years to assist individuals with
disabilities in being a respected and integral part of their community. We continually look
for efficiencies and ways to maximize all of our funding. We are so grateful and
appreciative to the funds provided by Orange County, Town of Chapel Hill and the Town of
Carrboro. Over the years we have seen both local and state dollars decrease due to the
recession, lack of investment in social services and mental health needs and constant
change to systems of managing Medicaid dollars and cuts in rates to federal and state
dollars while experiencing increases in operating expenses. Without the Orange County
funds work with students in the middle /high schools, adult program participants, and
seniors would be in jeopardy. It is challenging for individuals with disabilities to find, obtain,
and keep jobs. Our staff engages in difficult work and we are always maximizing
efficiencies to ensure efficient and effective use of public dollars. Should OE see funding
reductions, we would be forced to reduce service provision.
k) What percentage of your target population is low- moderate income?
100%
1) What efforts do you make to seek feedback about your program from your target population
(e.g. survey, evaluations, etc. ?)
OE seeks feedback from program participants through annual satisfaction surveys. We
track individual employment outcomes, engage program participants in various stakeholder
committees within OE, and conduct annual program evaluations.
m) Include any other pertinent information.
PROGRAM INFORMATION 1/22/2018 1:53:42 PMT a
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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
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
87
82
87
80
98
103
167
180
190
70
78
83
0
0
0
1
2
2
94
95
99
0
0
0
2
5
6
167
180
j 190
2
5
6
165
177
184
167
180
190
0
0
0
26
28
30
95
102
108
47
50
52
167
180
j 190
0
0
0
0
0
0
9
10
5
0
0
0
Total 1 167 180 1 190
PROGRAM INFORMATION 1/22/2018 1:53:42 PM Page 15 of 18
71
77
81
12
13
15
12
13
15
23
25
27
39
42
52
Total 1 167 180 1 190
PROGRAM INFORMATION 1/22/2018 1:53:42 PM Page 15 of 18
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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 Transitions to Employment
1. Program Activity Name
Student Participant Employment
Program Goal
15 student participants will obtain jobs in the community or
increase their marketability through post- secondary education
Performance Measures
Student participants obtaining jobs in the community or
increasing their marketability through post- secondary
education.
Previous Year Program Results
5 (Obtaining jobs in the community)
Current Year Estimated Results
15
Next Year Projected Results
25 student participants will obtain jobs in the community or
increase their marketability through community based
vocational opportunities.
2. Program Activity Name
Adult Participant Employment
Program Goal
50 adult participants will obtain jobs in the community
Performance Measures
Number of adults placed in competitive employment
Previous Year Program Results
41
Current Year Estimated Results
50
Next Year Projected Results
3. Program Activity Name
50 adult participants will obtain jobs in the community
Senior Engagement
Program Goal
10 senior adult participants (age 55 +) will participate in
Community Senior and retirement activities
Performance Measures
Measuring meaningful senior activities and retirement
participation of disabled elderly program participants
Previous Year Program Results
10
Current Year Estimated Results
11
Next Year Projected Results
10 senior adult participants (age 55 +) will participate in
Community Senior and retirement activities
PROGRAM INFORMATION 1/22/2018 1:53:42 PM P a g � 1 6 s t 11
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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:
Program Budget
Operating Budget for Program
PROGRAM NAMI Transitions to Employment
PROGRAM REVENUE
Private Donations
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 (CDBG /HOME /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: 1 $ (107,716)1 $ 4,992 1 $ 7,265 1 46%
2. Program Budget Detail — Provide description of "other" budget items, not defined.
No other budget items noted.
PROGRAM INFORMATION 1/22/2018 1:53:42 PM
Actual
2016 -17
Estimated
2017 -18
Projected
2018 -19
Percent
Change
$
7,733
$
7,500
$
7,500
0%
$
979,853
$
1,150, 682
$
1,155, 000
0%
$
3,800
$
4,000
$
4,000
0%
$
-
$
-
$
-
0
$
6,000
$
10,000
$
10,000
0%
$
-
$
-
$
0
$
51,000
$
54,550
$
54,550
0%
$
-
1 $
-
1 $
-
0
$
-
$
-
$
-
0
$
-
$
-
$
-
0
$
101,117.64
$
108,148.64
$
108,148.64
$ -
$
-
$
-
$
0
$
-
$
-
$
-
0
$
-
$
-
$
0
$1,149,504
$ 1,003,287
$1,334,881
$ 1,070,387
$1,339,199
$ 1,070,387
0%
0%
$
50,917
$
51,170
$
51,886
1%
$
73,093
$
76,703
$
75,807
-1%
$
44,689
$
46,629
$
46,854
0%
$
85,234
$
85,000
$
87,000
2%
1$1,257,2210
$1,329,889
$1,331,933
0%
SURPLUS /(DEFICIT) FOR PERIOD: 1 $ (107,716)1 $ 4,992 1 $ 7,265 1 46%
2. Program Budget Detail — Provide description of "other" budget items, not defined.
No other budget items noted.
PROGRAM INFORMATION 1/22/2018 1:53:42 PM
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION
3. This program budget represents what percent of the agency budget? 20%
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 1/22/2018 1:53:42 PM Page 18 of 18
Actual 2016 -17
Estimated 2017 -18
Projected 2018 -19
Total Cost of Program
$1,257,220
$1,329,889
$1,331,933
Total # of Individuals
167
180
190
Cost Per Individual
$7,528
$7,388
$7,010
PROGRAM INFORMATION 1/22/2018 1:53:42 PM Page 18 of 18
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
EXHIBIT "B"
Scope of Services — FY 2018 -19
Outside Agency Performance Agreement
Agency Name: OE Enterprises, Inc.
Program Name: Transitions to Employment
Funding Award: $54,550.00
Outline how the agency will spend Orange County's Funding award.
Expense Description
Amount
Personnel costs associate with providing vocational placement, training, and community
integration su pports for students and adults who have disabilities.
$54,550.00
50
Number of adult participants (age 55 +) who participate in meaningful senior activities through the
program
10
Program Services
Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019.
• Job Club Services: In small group settings within the school, OE staff assists students in
exploring various occupations, industries, career options, develop resumes, increase interviewing
skills, and discuss skills needed to maintain employment. They will also explore options to post-
secondary education and careers where advanced degrees/certifications are necessary.
• Job Development Services: Individual services work with the individual to evaluate skills,
interests, preferences, and support steeds of the job seeker, and then assist the person in finding
employment that snatches.
• Senior activity services: Provides guidance and education to assist individuals with disabilities in
participating in chosen activities in their communities. This includes Moth individual and group
activities that assist individuals in connecting with our community partners.
Anticipated Outcomes
The Anticipated Results column must include quantifiable results in the form of number of persons /units served within Oranee
Count►, only (all Towns and municipalities). If You use percentages, van must also pro-Ode the total number of participants .
within that measure's description or for an earlier performance measure
Performance Measures -
Anticipated
Results
25
Number of student participants obtaining jobs in the community or increase their marketability
through community based vocational opportunities.
Number of adult participants placed in competitive employment.
50
Number of adult participants (age 55 +) who participate in meaningful senior activities through the
program
10
DocuSigned by:
Sa*v s CEO 8/20/2018
72A830902D8843D...
Certified b :.i Ct I t A XUUkAkk Title] Q,? Date:.? f
Provider's ignature)
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D760E06A5D2
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.
D"uSigned by:
Sa*mts
Certified by: �aasso�ososs43D... Title:
(Provider's Signature)
CEO Date: 8/20/2018
(OE Enterprises, Inc.)
Orange County Outside Agency Performance Agreement Page 9 of 9
Rev. 7118
DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D76OE06A5D2
ACCOR" CERTIFICATE OF LIABILITY INSURANCE
r AaJM�a,8 YI
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED„ the policy(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 an
this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s),
PRODUCER
NAME CT Tammy Srown
Jennings Bryan - Chappell Insurance Services
PO Box 1118
PHONE {336) 227 -7458 (336) 343.1000
A70 No E :t : AIC. Na
n aQ R €Lss. tammyb@jbcins.com
INSURE R(S) AFFORDING COVERAGE
NAIL #
Burlington INC 27216
INSURER A: Philadelphia Indeminity Ins. Co.
18058
INSURED
INSURER B: Accident Fund General Insurance Company
12304
OE Enterprises, Inc.
INSURER C:
$ 100.000
348 Elizabeth Brady Road
INSURER a
$ 5.000
INSURER E :
Hillsborough INC 27278
INSURER F:
COVERAGES CERTIFICATE NUMBER: CL187303754 14"ISION! NI]PARFR-
THIS ISTO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTNTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 07HER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
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TYPE Of INSURANCE
INSR
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POLICY NUMBER
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DEO
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WORKERS COMPENSATION
AND EMPLOYERS` LIABILITY
ANY PROPRILTORIPARTNE E;XECUTiVE YIN i
UFRCLR+MEMBER EXCLUOEE7�
(Mandatory in NH)
If describe under
DESCRIPTION OF OPERATIONS be4ow
NIA
,2000021234
0710112018
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07/01/2019
STATUTE X ERR,
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEE
$ 500,000
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E.L. DISEASE - PIULICY LIMIT
S SOO,p00
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Professional Liability Sexual AbuselMalestafian
PHSD1361269
06730f2018
06130/2019
$1,000,000
$1,000,000
$2,000,000
$2,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required
&Ma Z's 1111a Nf!'IIR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. BOX 5101
AUTHORIZED REPRESENTATIVE
HIIlsborough. NC 27275 " -I, •I,
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