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Home My WebLink About2018-466-E Finance - Farmer Foodshare outside agency agreementDocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A 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 Farmer Foodshare, a not - for - profit corporation, located at 902 North Mangum Street, Durham, NC 27701 ( "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 Farmer Foodshare 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 $7,375. 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 $1,843.75. The first payment is contingent upon receipt of the agency's performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. (Farmer Foodshare) Orange County Outside Agency Performance Agreement Revised 712018 Page I of 9 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A 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. (Farmer Foodshare) Orange County Outside Agency Performance Agreement Page 2 of 9 Rev. 7118 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other parry at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof, iii. Comprehensive Automobile Liability Insurance, including hired and non -owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION • Worker's Compensation • Commercial General Liability • Automobile Liability • Professional Liability MINIMUM REQUIRED COVERAGE Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee $1,000,000 Each Occurrence $2,000,000 Aggregate $500,000 Combined Single Limit $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. (Farmer Foodshare) Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 7118 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A 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 Farmer Foodshare 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: (Farmer Foodshare) Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 7118 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A County: Finance & Administrative Services Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: Farmer Foodshare 902 North Mangum Street Durham, NC 27701 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 _ oocusigned by" - f the Provider EAR �N t AE195ME83BE435... For at DocuSigned�by, ° runty Government 66KAAj(. N *�t v'st" 0637994B755E477... Bonnie Hammersley, County Manager (Farmer Foodshare) Orange County Outside Agency Performance Agreement Rev. 7118 8/22/2018 Date 8/23/2018 Date Page S of 9 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Farmer Foodshare Applicant Organization's Physica Address: 902 N. Mangum Street, Durham, NC 27701 AW Applicant Organization's Ma' ' A ss: P.O. Box 2873, Chapel Hill, NC 27515 Applicant Organization's Web A ss: www.farmerfoodshare.org Executive Director: Gini Bell # Telephone Number: 919.360.6358 E -Ma' ni farmerfoodshare.or Tax ID Number: 27- 3717889 b) Funding Request List all FY18 -19 Human Services (HS) Funding Being Requested — For All Programs) and the Proposed Use of Funds (2 -3 lines or less) Program Carrboro Chapel Orange Total - HS Hill - HS County-HS Donation Station Program — Farmers market- $5,000 $5,000 $10,000 $20,000 based program that supports local Orange County farmers and organizations working to increase access to fresh food to community members in need. Totals $5,000 $5,000 $10,000 $20,000 c) To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. Signature: Signature: Executive Director Board Chairperson 1/23/2018 Date 1/23/2018 Date AGENCY INFORMATION 2/16/2018 1:09:05 PM Page 8 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A 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 1 FE-1 ® d) Paid providers of goods or services the program? If you have answered YES to any question, pleas NON - DISCRIMINATION ng requested? ng other financial interest in ination below. 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: Executive Director �a, r ti Signature: Board Chairperson 1/23/2018 Date 1/23/2018 Date AGENCY INFORMATION 2/16/2018 1:09:05 PM Page 9 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION 2. AGENCY INFORMATION (Be Very Brief and Concise) Please provide the following information about your agency: a) Years in Operation, Date of Incorporation: 8 years in operation, 9/2010 b) Agency's Purpose /Mission: Farmer Foodshare connects people who grow food with people who need food in ways that are economically sustainable and socially just. We believe that everyone has a right to healthy, fresh food, and that farmers deserve to make a fair wage — a system where everybody wins. c) Types of Services the Agency Provides: • Offers hunger and malnutrition relief • Provides access to fresh, healthy food for community members in need who would otherwise receive filling, but less healthy, highly processed, shelf - stable food • Supports the local farm economy for small farmers at a fair price • Provides reliable markets for local farmers • Connects local agencies with local farmers • Empowers recipients to make healthier food decisions d) Agency's History with Providing These Services: Since our inception, we have collaborated with farmers, community members, and hunger relief agencies in order to build a healthy, sustainable food system in Orange County. These community partnerships are essential to the successful performance of Farmer Foodshare operations and the execution of its mission. We believe that change happens through relationship building and community engagement. e) Other Pertinent Agency Information We hired a new volunteer coordinator, Allysan Scatterday, to oversee day -to -day operations of the Donation Station program. With funding from Orange County and the Towns of Carrboro and Chapel Hill, we successfully piloted a new Community Foodshare initiative in Orange County in partnership with Refugee Community Partnership and Transplanting Traditions. The program created the means for food insecure community members to access fresh food on a regular basis and also receive nutrition information. f) Schedule of Positions # of FTE - Full -Time Paid Positions: 7 # of FTE - Paid Part -Time Positions: 2.5 # of Volunteers: 230 # of FTE - Volunteers:6.67 (based on 13.880 total vol hrs g) Living Wage Does this agency pay permanent employees a minimum living wage? (Yes/ No) Yes Agency Information 2/16/2018 1 :09:05 PM Page 10 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION h) iv. If yes, is this agency an Orange County Living Wage Certified Employer? No If no, please explain. We hold a living Wage Certification from Durham County because our office is physically located in Durham County. Agency Budget Is your agency cuo local (Town of Cabo funding? (Yes /No) No Submit your agency's Budget attached ing and /or requesting other (non -Human Services) of Ch Lel Hill, Orange County) government Does your agency budget show a Surplus or Balanced Is there a significant change? Yes /No No Please provide a brief explanation for Surplus or Deficit, and significant changes. What is your agency's fiscal year? January 1, 2017- December 31, 2017 Agency Information 2/16/2018 1:09:05 PM Page 11 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION Program Name: Donation Station Program Program Primary Contact and Title: Katy Phillips Telephone Number: E -Mail: kate(a)-farmerfoodshare.org a) Indicate the type ouman Need4kority, if program applicable: FEK. IN Priority Area #1: safety- services for disadvantaged residents Priority Area #2: educati n, menA ip, and aft hoot programming for youth facing a variety of challenges ® Priority Area #3: programs aimed at it b) Indicate the type of program for which you nutrition of needy residents ling Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods /Residents Affordable Housing Affordable Healthcare Education Family Resources Jobs /Jobs Training Food X X X X X Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates /collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated /collaborative efforts. Donation Station operate and collect fresh, healthy food each week at each of the following Orange County Farmers Markets: • Carrboro • Chapel Hill • Eno River • Hillsborough Donation Stations provide fresh, healthy food to the following agencies: • CASA • Central Park Elementary School families (as identified through a social worker • Club Nova • Friends of DSS (Hillsborough) PROGRAM INFORMATION 2/16/2018 1:09:05 PM Page 12 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION • PORCH • Refugee Community Partnership • RSI • IFC • Homestart (IFC) • PORCH • TABLE Program Description Please provide the following information about the proposed program: .r d) Summarize the program services proposed a^ the program will address a Town /County priority /goal? The Donation Station program addresses the Human Services Priority Area #3: Improving the health and nutrition of needy residents. The Donation Station program meets this aim by collecting fresh, local food gleaned from farmers at farmers markets and /or purchased from those farmers with funds donated by shoppers. Each farmers market is paired with a partner organization of their choice. Oftentimes, organizations are chosen by the market, because the organization serves the most urgent hunger needs of the lowest income or disadvantaged populations in the immediate community. The fresh food is delivered the day it is donated. The Donation Station Program is based on requests from the participants of our partner organizations themselves. The project is also intended to support the livelihoods of our local farmers. e) Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of Chapel Hill Council Goals, Carrboro Board Priorities, or other community priorities (i.e. Council /Board Goals). The Donation Station program provides fresh, healthy food to Chapel Hill residents who cannot afford or who do not have access to nutritious food. This program is designed to meet this significant human need identified by community stakeholders in the Chapel Hill Human Services Needs Assessment. The Donation Station Program invests in the Orange County economy by making fresh food purchases from local farmers present at farmers markets. This program helps build a healthy, sustainable food system by creating partnerships between farmers and recipient agencies specifically outlined in Goal 3 of the Orange County BOCC Goals and Priorities. Our organization also adheres to the values outline in OC BOCC Goals and Priorities: Farmer Foodshare works to support local farmers, while creating community through the practice of healthy eating. PROGRAM INFORMATION 2/16/2018 1 :09:05 PM Page 13 of 2f' DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION The Donation Station program provides an additional revenue stream to maintain ethnic and economic diversity as outlined in the Town of Carrboro's Board Priority A. Our Donation Station partner at the Carrboro Farmers Market, Refugee Community Partnership, is a place that emphasizes how culinary traditions are a powerful way to celebrate and preserve cultural heritage and identity. The Donation Station program also enhances and sustains quality of life /place issues for everyone as outlined in the Town of Carrboro's Board Priority E. Farmer Foodshare has spent time cultivating relationships with partner agencies through shared meals, cooking demonstrations, and gatherings. Through our years of partnership, we have learned that participants want a more sustainable way to contribute to and make decisions about their own health. They have specifically requested access to more fresh produce on a regular basis, along with any printed fresh food educational materials created by Farmer Foodshare: f) Who is your target population of individuals to benefit from t is program and how will they be identified and connected with the program? Farmer Foodshare partners with agencies that serve populations in need: children, the elderly, refugees, individuals with disabilities and mental illness, most of whom are food insecure. Agencies are selected in conjunction with the farmers markets in Orange County with a focus on urgent hunger and persistent need. Diverse groups are intentionally chosen. We work with a range of agencies across the county, which distribute the fresh food we connect them with to a diverse demographic. We intentionally partner with agencies that support the most urgent hunger and lowest income populations and make sure that these agencies have an ongoing relationship with our farmers market partners. We annually verify the demographics our partner agencies serve and work to ensure that the voices of our clients are heard and represented in our program planning. We are a community owned and operated group — and we believe that is the key to our continued presence in the Orange County, Chapel Hill and Carrboro community. When sourcing food from local farmers, we are also intentionally diverse. We work with farmers who have been left out of "the system ", specifically with USDA defined "Limited Resource, Socially Disadvantaged and Beginning" farmers. These are farmers that are not eligible for traditional farm support and subsidies, yet who produce an enormous amount of healthy food in our communities. We believe that it is important to help both local farmers, as well as individuals and agencies that do not have access to resources. We believe that if we can introduce these groups to one another — the farmers, the agencies, and the individual recipients, that the Orange County network of community services and relationships will be strengthened. So far, we have seen this to be the case — where farmers who formerly knew nothing about hunger in our county, suddenly began growing food to donate. Our farmers at market are often generous to provide special items at a deep discount, because they know it will go to help feed the children at TABLE, or the mentally ill adults at Club Nova. And most partner agencies that want to buy PROGRAM INFORMATION 2/16/2018 1 :09:05 PM Page 14 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION additional fresh food begin to buy from local farmers and keep their dollars in the county. g) Describe the credentials of the program manager and other key staff. Donation Stations are operated by volunteers under the supervision of Allysan Scatterday, our volunteer coordinator, and Katy Phillips, director of community programs. Allysan coordinates efforts of our partner agencies and volunteers in retrieving collected donations and sharing it with recipients. Allysan has a background in public health and communications, and Katy has a strong background in education, has five years of non- profit management experience, and is a flower farmer herself. Farmer Foodshare recognizes the significant value and resource that volunteers and interns bring to the organization. Their work directly increases Farmer Foodshare's ability to empower communities to feed themselves sustainably. Volunteers participate in all aspects of the organization from staffing Farmers Market Donation Stations to helping with food deliveries; from speaking on behalf of Farmer Foodshare to hosting community meals. The effectiveness of volunteers is dependent on support and resources offered, and so all volunteers attend an orientation and receive position- specific training, the opportunity to shadow lead volunteers, and a volunteer handbook. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. The Donation Station program operates on a consistent, weekly basis and is subject to the specific farmers market's hours. 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 from Orange County, the Town of Chapel Hill and the Town of Carrboro would enable Farmer Foodshare to expand the reach of the Donation Stations in this community. This program make it possible for us to provide more fresh food to individuals at risk for malnutrition, and support more small- to mid -sized farmers in earning a healthy living. It also supports small farmers and eaters in the local community by being a standing presence at the local farmers markets. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Reduced funding will reduce our ability to re- invest in the local economy and support a growing desire for access to fresh food from our recipient agencies. Aside from providing nutritious food, we believe working to create a positive culture around food will create a community of health. Through the Donation Station, we endeavor to continue support and meet the needs of the populations we serve. We request these funds in order to keep pace with the growing demand from our community partners in Orange County, and the Towns of Chapel Hill and Carrboro. PROGRAM INFORMATION 2/16/2018 1:09 :05 PM T -�' DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION k) What percentage of your target population is low- moderate income? Farmer Foodshare works collaboratively in all our efforts to end hunger and food insecurity. By working with agencies within the community to distribute fresh produce to their networks of individual in need, we are able to support and enhance existing efforts, while keeping overhead costs low. Additionally, we have regular dialogue with our partners to provide support like recipes and fresh food safety information and help in sourcing the right kinds of produce in the right amounts. When requested, we connect with our partner agencies to provide cooking demonstrations and provide volunteers to help with food prep and packing. It is incredibly important that we are meeting the stated needs of the community and respond based on the feedback that we receive. 1) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc. ?) For our Donation Stations, we conduct an annual survey with our partner organizations to collect feedback specific to the fresh food donations and how they were used, and also to gather demographic information. We also have annual meetings with farmers market managers, recipient organizations and attend annual farmers market meetings. We report back the results from the Donation Station program to all of these partners and discuss our plans for the following year. m) Include any other pertinent information. PROGRAM INFORMATION 2/16/2018 1:09:05 PM Page 16. of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program Information n) Target Population 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 ( "Other" includes anyone designated "other" in the reports our partner agencies provide, as well as the Hispanic /Latino population, which agencies typically report as a separate group) 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 2016 -17 2017 -18 Projected 2018 -19 3,000 3,500 2,760 5,300 5,500 5,127 8,300 9,000 7,887 3,486 3,780 3,762 224 243 4 249 270 88 1660 1,800 1,665 83 90 2 2598 2,817 2,366 5,893 9,000 7,887 2,407 2,610 1,500 5,893 6,390 6,387 8,300 9,000 7,887 1,006 1,089 947 1,640 1,800 1,577 3,596 3,870 3,391 1,260 2,241 1,972 8,300 9,000 7,887 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X PROGRAM INFORMATION 2/16/2018 1:09:05 PM Page 17 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Total 1 8,300 9,000 7,887 ** Our partner agencies self- report on demographic information for program beneficiaries. Data on geographic location is not shared with us. Work Statement o) Complete the k State to describe the work to be performed. Work Statement Chart fo ogram: Donation Station 1. Program Activity Name Program Goal Program Goal: Ensure that fresh food is regularly purchased from local farmers and collected to donate to recipient agencies. We aim to feed 7,887 people, support 200 local farmers and collect 20,000 pounds of food through our Donation Stations. Performance Measures We will track the number of people fed, number of farmers supported, and pounds of food collected. Previous Year Program Results 8,300 people served, 160 farmers supported and 16,000 pounds of food collected. Current Year Estimated Results 20,000 pounds of food distributed, 9,000 people served, 200 farmers supported. Next Year Projected Results 20,000 pounds of food distributed, 7,887 people served, 200 farmers supported. PROGRAM INFORMATION 2/16/2018 1 :09:05 PM Page 18 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION p) Program Budget 1. Submit your program budget. You may complete the provided template (separate As file) or you may submit your own budget file (as long as it contains the same information, in the same format, as requested in the provided template). Program budget includedsheet alongside the agency budget. 2. Program Budget Derr PrAvide description of "other" budget items, not defined. The Donation Station p1wram will seek partnerships with local businesses in the form of sponsorship to offset costs and further promote community engagement. # 3. This program budget represents what perc a agency budget? 6_5% 4. COST PER INDIVIDUAL This Cost per Individual must reflect the total prog budget 'vided by the total number of program individuals in this application. PROGRAM INFORMATION 2/16/2018 1 :09:05 PM Page 19 of 20 Actual 2016 -17 Estimated 2017 -18 Projected 2018 -19 Total Cost of Program 76,000 84,874 93,000 Total # of Individuals 8,300 9,000 7,887 Cost Per Individual $9.16 $9.42 $11.79 PROGRAM INFORMATION 2/16/2018 1 :09:05 PM Page 19 of 20 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Agency Budget Operating Budget for Entire Agency AGENCY NAME: AGENCY REVENUE Private Donations Agency Generated Revenue (fees) Local Government Grants: Human Services - Town of Carrboro Other - Town of Carrboro Human Services - Town of Chapel Hill Other - Town of Chapel Hill Human Services - Orange County Other - Orange County Other - Town of Hillsborough Other Government Grants Triangle United Way State Government Federal Government (CDBG /HOME /etc.) Private Foundation Grants Other Revenue In -kind donations Corporate donations Consulting income / interest income Total Agency Revenue AGENCY EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Cost of goods sold Contractor fees Insurance Total Agency Expenses SURPLUS /(DEFICIT) FOR PERIOD: FY 2018 -19 Agency Budget Farmer Foodshare $ 150,626 $ 107,981 1 $ 92,461 $ (0.14) $ 20,842 $ 30,521 1 $ 47,266 $ 0.55 $ 3,717 $ 26,638 $ - $ (1.00) Actual 2016 -17 Estimated 2017 -18 Projected 2018 -19 Percent Change $ 65,112 $ 106,665 $ 176,252 65% $ 224,468 $ 476,443 $ 747,680 57% $ 1,750 $ 4,000 $ 5,000 25% $ - $ - $ - 0 $ 5,000 $ 5,000 $ 5,000 0% $ - $ - $ - 0 $ 2,500 $ 6,250 $ 10,000 60% $ - 1 $ - 1 $ - 0 $ - $ - I $ - 1 0 $ - $ - $ - 0 $ - $ - $ - 0 $ 22,549.68 $ 48,215.89 $ - $ 1.00 $ 237;677.43 $ 261,187.50 $ 350,824.00 $ 0.34 $ 175,185 $ 165,140 $ 139,727 1 $ 0.15 $ 150,626 $ 107,981 1 $ 92,461 $ (0.14) $ 20,842 $ 30,521 1 $ 47,266 $ 0.55 $ 3,717 $ 26,638 $ - $ (1.00) Is (0) $ 0 $ (0) - 200% $ $ 734,243 307,271 $1,072,901 $ 437,316 $1,434,483 $ 568,194 34% 30% $ 25,492 $ 28,462 $ 51,575 81% $ 47,722 $ 70,969 $ 74,727 5% $ 25,748 $ 26,544 $ 30,978 17% $ 328,009 $ 509,610 $ 709,010 39% $ $ $ 315,621 1,875 10,513 $ $ $ 488,529 13,581 7,499 $ $ $ 685,693 14,560 8,757 40% 7% 17% $ 734,243 $1,072,901 1 $1,434,483 1 34% Is (0) $ 0 $ (0) - 200% DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION Program Budget Operating Budget for Program PROGRAM NAME: 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 Sponsorships and business support Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Supplies & Equipment Travel & Training Other Expenses: Total Program Expenses Farmer Foodshare SURPLUS /(DEFICIT) FOR PERIOD: I $ - I $ 0 $ - 1 - 100% FY 2018 -19 Program Budget Actual 2016 -17 Estimated 2017 -18 Projected 2018 -19 Percent Change $ 45,500 $ 40,597 $ 44,000 8% $ $ - 0 $ 1,750 $ 4,000 $ 5,000 25% $ - $ - $ - 0 $ 5,000 $ 5,000 $ 5,000 0% $ - $ - $ - 0 $ 2,500 $ 6,250 $ 10,000 60% $ - 1 $ $ - 1 0 $ - $ - $ - i $ $ $ - 0 $ $ $ - 0 $ - $ - $ - 0 $ 10,000.00 $ 13,000.00 $ 14,000.00 $ 0.08 $ 11,250 $ 16,000 1 $ 15,000 $ 0.06 6iiiiiiiiiii6n, $ 55,959 $ 61,568 $ 65,900 7% $ 5,101 $ 5,960 $ 6,740 13% $ 8,630 $ 10,085 $ 11,875 18% $ 6,310 $ 7,234 $ 8,485 17% $ - $ - 0 $ 000 1 $ 84,847 $ 93,000 1 10% SURPLUS /(DEFICIT) FOR PERIOD: I $ - I $ 0 $ - 1 - 100% FY 2018 -19 Program Budget DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A EXHIBIT "B" Scope of Services – FY 2018 -19 Outside Agency Performance Agreement Agency Name: Program Name: Funding Award: Farmer Foodshare Donation Stations $7,375 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel support for managing the Donation Stations in Orange County, including the training and management of volunteers $6,875 Supplies for Donation Stations $500 Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2019. • Each week that farmers markets operate, utilize volunteers to ensure that fresh produce is regularly purchased and collected from local farmers to donate to local agencies • Each week that farmers markets operate, ensure that agencies have access to healthy, local food for their clients Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons /units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Amount of donations collected /spent with 200 farmers at 4 Orange County farmers markets, generating fresh food to donate to local agencies. $12,000 Number of meals supplemented with fresh food amassed at Orange County Donation Stations (20,000 pounds of food distributed to 7,887 individuals, using a serving size of V4 lb of fresh food per serving.) 80,000 %D;ocuSignneedby: a 94—"-- MESME435Certified by: (Provider's Sign re) Executive Director Director of Development and Title: Communications 8/22/2018 August 20, 2018 Date: DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A ATTACHMENT "A" Orange County Certifications — FY 2018 -19 Outside Agency Performance Agreement Chief Contact, Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible, phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. — DocuSigned by: 1 d;L&i ba Certified by: AE195B3ES3BE435... (Provider's Signature) Title: Executive Director Date: 8/22/2018 (Farmer Foodshare) Orange County Outside Agency Performance Agreement Page 9 of 9 Rev. 7118 DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A FARME -3 OP ID: C CERTIFICATE OF LIABILITY INSURANCE FATEIMMcDDYYYYI y 0713112018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED.. the policy (les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 919 - 932 -9990 CONTACT Chesley Kalnen Lee -Moore Insurance Agency Inc PHON P.O. Box 667 y NC. No. 919- 932 -9$90 FAX 919- 933 -0155 West End, NC 27376 E -MAIL LAIC. No): ADDRESS'- -' r��9mail.GOin Alex Maiolo -- fNSURER(S) AFFORDING COVERAGE NAJCV INSURER A: AUTO-OWN ERS INS_. COMPANY INsuRED Farmer Foodshare INSURER 13 :AON Association Services Gini Bell - - DuN Mangum St INSURER C: Durham, NC 27701 INSURER D INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD iNDiCATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _LIMITS INSR TYPE OF INSURANCE AD DL SIJBR POLICY NUMBER LIR POLICY EFF POLICY EXP ? LIMITS A x COMMERCIAL GENERAL LIABILITY CLAII.IS -MADE X OCCUR Y 95269000 EACH_OCCURRENCE 06/1512018 0611512019 ( DAAMAGE 7O RENTE0 PREMISE 2,000,000 5_ S 300,000 MED EXR Any one pemoni 5 10,000 PERSONAL 6 ADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES P €R: POLICY E] j CT ❑ LOD f:ENERALAGGREGAT€ . PRODUCT C.RMPIOPAGG S 2,000,600 , $ 2,000,000 OTHER. _ _ S A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 S BODILY INJURY Par arson X ANY AUTO 5126900000 0611512018 06/15=191 $ O'+VNED SCHEDULED -_ AUT��Opp'S ONLY AALLITOS (BODILY INJURY IPer aairlerdi gp AUTO5ONLY qUT u�NLY ^T AMAGE S UMBRELLALIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS -MADE AGGREGATE 5 DED RETENTION $ I A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN App NY PROPREEIETggO�R7PARTNERIEXECUTIVE [MandaloryinMNjEXCLUDED? F NIA f352786t1i PER I Eorf X 05129/2018 05129/2019 AC ER_ 1,000,000 t L EACH ACCIDENT 5 E DISEASE • EA EMPLOYEE 5 1.000,D00 If yes. ae5criba undo/ DESCRIP710N QF ERATIONS below E L DISEASE - POLICY LIMIT _ 1,000,000 ! B D$B Liability NFP0128555 -00 06115/2018 0611512019 DIDLI 1.000,000 DESCRIPTION OF OPERATIONS; LOCATIONS 1 VEHICLES (ACORO 161, Addwonal RemarMs Schedule, may be attached,} mdre space Is required) Orange County, its officers, official agents, and employees are listed as additional insured on General Liability policy, TOM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS, Risk Management 200 S Cameron St Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE y, ACORD 25 (2016103) (71988.2015 CORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks Of ACC] D