Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2017-706-E Finance - ArtsCenter outside agency agreement
DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF45813 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT,made and entered into the first day of July 2017, ("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 The ArtsCenter, a not-for-profit corporation, located at 300-G East Main Street, Carrboro,NC 27510 ("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 The ArtsCenter agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2017 to June 30, 2018. 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 B, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of 12500 b. All funds appropriated shall be used for purposes described in Exhibit B. 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 3125. 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. (The ArtsCenter) Orange County Outside Agency Performance Agreement Revised 712017 Page I of 7 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF458B e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 —December 31; January 1 —March 31 and April 1 -June 30. Reports are due on January 12,April 13, and July 13 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. (The ArtsCenter) Orange County Outside Agency Performance Agreement Page 2 of 10 Rev. 7117 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF45813 c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers'or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury,including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance,including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury,bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents,consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A-Statutory State NC&Coverage B -Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability)required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. (The ArtsCenter) Orange County Outside Agency Performance Agreement Page 3 of 10 Rev. 7117 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF458B 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 $ 13.75 per hour. To the extent possible, Orange County recommends that The ArtsCenter 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: (The ArtsCenter) Orange County Outside Agency Performance Agreement Page 4 of 10 Rev. 7117 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF45813 County: Finance&Administrative Services Provider: The ArtsCenter Orange County 300-G East Main Street Post Office Box 8181 Carrboro,NC 27510 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. 18. 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. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php). Any violation of this requirement is a breach of the Agreement and County may immediately terminate this Agreement without further obligation on part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. 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. 19. 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 G .DOCUSlgn.ed bv: -the Provider 11/22/2017 50CA36291A6142B Date (The ArtsCenter) Orange County Outside Agency Performance Agreement Page 5 of 10 Rev. 7117 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF458B For ar oocusignedby, unty Government �6 L` Rm&t('^$""-[ 1112 712 017 0637994B755E477.. Bonnie Hammersley, County Manager Date (The ArtsCenter) Orange County Outside Agency Performance Agreement Page 6 of 10 Rev. 7117 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FY 2017-2018 Outside Agency Funding Application HUMAN SERVICES • ORANGE COUNTY • TOWN OF CARRBORO • TOWN OF CHAPEL HILL Orange County (OC) Town of Carrboro (CA) Town of Chapel Hill (CH) 200 S. Cameron Street 301 W. Main Street 405 Martin Luther King, Jr. Blvd. Hillsborough, NC 27278 Carrboro, NC 27510 Chapel Hill, NC 27514 r� 'err 4 + a`�tiyror DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION INFORMATION Each year, Orange County Government, the Town of Carrboro and the Town of Chapel Hill invite program funding requests from non-profit providers that support the delivery of vital community services. The application process is very competitive and not all applicants will be awarded funding. Recommendations for funding may be for an award amount less than that requested by the applicant. Agencies that are currently receiving funds from Orange County, the Town of Carrboro, or the Town of Chapel Hill local governments, and are also applying for new funds, must be in compliance with all terms of their current agreement(s) and must not have any outstanding audit findings, monitoring findings or concerns as determined by the municipality. Recipients are required to submit written progress reports on their SMART Measures that include: goals, description of activities/challenges, revisions of timelines/budgets, and other relevant information Funded projects will be monitored for progress and performance, financial and administrative management, and compliance with the terms of Performance/Development Agreement(s). Monitoring may involve site and/or office visit(s). Once applications are received, they are reviewed by staff for completeness and eligibility. The applications are presented to a specific application review group, depending on the funding source. The review group will make a recommendation, based on available funding and the priorities identified by the participating jurisdiction. The recommendation is presented to the appropriate Board/Council for consideration and approval. The Board/Council approves/adopts the final allocations. TIMELINE November 15 Funding Application Posted on Websites November 29 Funding Application Workshop Held October 18-January 23 Agency Prepares Application January 10 Q&A Session Held January 31 Application Submissions are Due March - May Application Review & Agency Presentations June Agency Funding Approval by Board/Council July Contracts Executed & Programs Begin DO NOT SUBMIT THIS PAGE 2/8/2017 5:24:23 PM Page 2 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION SUBMITTAL INFORMATION Welcome to the Outside Agency Common Funding application for local/general funds, which will be distributed through this competitive application process. All entities or organizations requesting funds must complete and submit this application prior to the deadline to be considered for FY 2017-2018 funding. The Application Submittal Deadline is: Tuesday, January 31, 2017 5:00 PM In the event of inclement weather, check the website for each Town/County you are applying to, for further instructions. Please note that late, handwritten, or incomplete applications will not be accepted. (Applications not signed by the Chair or President of the Board of Directors, are considered incomplete.) An application orientation workshop will tentatively be held on Tuesday, November 29, 2016 at 9 AM to Noon to review the application and submittal requirements. SUBMITTAL REQUIREMENTS FOR EACH MUNICIPALITY Human Services— Town Of Carrboro Applications are accepted once a year and reviewed by the Town's Human Services Advisory Commission, which makes a recommendation for funding to the Board of Aldermen for final approval. For more information about the Town of Carrboro Human Services program, see here. Questions and submittals should be directed to: Annette Stone, 301 W. Main Street Carrboro, NC 27510 919-918-7319 astone cj�townofcarrboro.org Submission: We strongly encourage applications to be single-spaced, with 12-point arial font and normal margins. Application: One (1) original plus Two (2) paper copies of the application must be hand delivered or mailed to Annette Stone, 301 West Main Street, Carrboro, NC 27510; AND One Application and Attachments files must be submitted by email. Any .pdf files must be accompanied by the original file format of .doc, .xIs, etc. DO NOT SUBMIT THIS PAGE 2/8/2017 5:24:23 PM Page 3 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Human Services — Town Of Chapel Hill In 1982, the Town established local funding to support local nonprofit organizations that carry out human service work throughout the community. Applications are accepted once a year and reviewed by the Town's Human Services Advisory Board, which makes a recommendation for funding to the Town Council for final approval. For more information about the Town of Chapel Hill Human Services program, see here. Questions and submittals should be directed to: Jackie Thompson 405 Martin Luther King Jr. Blvd. Chapel Hill, NC 27514 919-969-5081 jhompson(c�townofchapelhill.org Submission: ➢ We strongly encourage applications to be single-spaced, with 12-point arial font and normal margins. Application: Two (2) paper copies of the application with ORIGINAL signatures must be hand delivered or mailed to Jackie Thompson, 405 Martin Luther King, Jr. Blvd., Chapel Hill, NC 27514; AND Attachments: The application submittal must be accompanied by a flash drive with the application and all attachment files in electronic format. Any .pdf files must be accompanied by the original file format of .doc, .xIs, etc. Human Services— Orange County For more information about the Orange County Human Services program, see here. Questions and submittals should be directed to: Allen Coleman PO Box 8181 Hillsborough, NC 27278 (919) 245-2151 acoleman(a-)_orangecountync.gov Submission: Email application and ALL Attachments prior to the deadline. Any .pdf files must be accompanied by the original file format of .doc, .xIs, etc. Please request a delivery receipt of email with application and attachments. DO NOT SUBMIT THIS PAGE 2/8/2017 5:24:23 PM Page 4 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FOR OFFICE USE ONLY Agency Received By Program(s) Date/Time / Section Subsection 1. Cover Page a. ❑ Applicant Contact Information b. ❑ Funding Requests C. ❑ Signed Application Cover Page d. ❑Signed Disclosure of Conflicts of Interest and Clause 2. Agency Information a. ❑ Agency's Years in operation b. ❑ Agency's Purpose/Mission c. ❑ Agency's Types of Services Provided d. ❑ Agency's Experience with Programs e. ❑ Other Pertinent Agency Information f. ❑ Schedule of Positions g. ❑ Living Wage h. ❑ Agency Budget 3. Program Information a. ❑ Human Services Needs Priority b. ❑ Type of Program A separate Section 3 is c. ❑ Agency Collaboration required for each program. d. ❑ Summary of Program e. ❑ Description of Identified Need f. ❑ Description of Population to be Served g. ❑ Program Staffing, Capacity, & Expertise h. ❑ Program Implementation Timeline L ❑ Value of Investment j. ❑ Impact of Reduced/No Allocation k. ❑ Other Pertinent Information I. ❑ Target Population/Beneficiary Chart M. ❑ Work Statement n. ❑ Program Budget, Detail, & Cost per Individual 4. Attachments a. ❑ Audit: Organizations receiving $300,000 or more in Federal financial assistance, and/or organizations with more than $500,000 of receipts and expenditures in a fiscal year, must secure an audit. b. ❑ IRS Federal Form 990 c. ❑ NC Solicitation License d. ❑ IRS Federal Tax-Exemption Letter e. ❑ Certificate of Insurance f. ❑ List of Board of Directors g. ❑ Solid Waste Program Fee (SWPF) Verification Application Submittal Checklist 2/8/2017 5:24:23 PM Page 5 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: The ArtsCenter Applicant Organization's Physical Address: 300-G East Main St, Carrboro, NC 27510 Applicant Organization's Mailing Address: SAME Applicant Organization's Web Address: www.artscenterlive,org Executive Director: Daniel Y. Mayer Telephone Number: 919-929-2787 x 217 E-Mail: dmaYer(a)-artscenterlive.org Tax ID Number: 51-0198497 b) Funding Request List all FY17-18 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 Ex. Youth Afterschool Program $10,000 $15,000 $5,000 $30,000 Afterschool Program Coordinator salary and materials for youth activities and projects General Support Arts Programs $20,000 $17,500 $37,500 ArtsCenter Youth Education Department $15,000 $15,000 Totals $20,000 $17,500 $15,000 $52,500 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. Signatu 7 Execu# ' D- c Date , Signature: Board Chairperson Date AGENCY INFORMATION 1/27/2017 12:56:30 PM Page 6 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT 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. Michael Parker is an ArtsCenter Board Member and a member of the Chapel Hill Town Council. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Sin ure: 12-7gt xe u it Date i Signature: 30 3 t �— Board Chairpdidon VDate AGENCY INFORMATION 1/27/2017 12:56:30 PM Page 7 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT 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): April 1975 b) Agency's Purpose/Mission (no more than a few sentences): The ArtsCenter exists in order to educate and inspire artistic creativity and to enrich the lives of people of all ages. c) Types of Services the Agency Provides (bullet format): The ArtsCenter is organized into five departments: • ArtSchool. ArtSchool at The ArtsCenter is Orange County's most comprehensive non-profit resource for continuing education in the arts on a non-degree, community basis. The ArtSchool now offers more than 350 classes in all artistic disciplines for all experience levels and ages, awards more than 15 scholarships annually, and offers work-study opportunities. • Youth Programs. The ArtsCenter has provided artistically excellent, age- appropriate and accessible arts experiences to Triangle families for more than 30 years. Currently, The ArtsCenter offers the 54-event School Show Series, ArtsCamp in the summer, AfterSchool Arts Immersion and Arts In Education during the school day to area youth and families. Youth Arts Classes (YAC) include fine art classes for youth and workshops and camps year round in acting, drawing, painting, writing, photography, ceramics, dance, acting for the camera, improvisation and more. • Concerts. The ArtsCenter presents at least 60 concerts and jams for adults each year, representing the spectrum of musical genres by touring artists including folk, blues, Celtic, rock, singer-songwriter, old-time, and bluegrass. • Gallery. The Nicholson Gallery features the work of local and regional artists on a rotating basis. The Gallery exhibitions highlight the work of more than 100 local and regional artists in 12 exhibitions a year. The Emerging Artist Corridor exhibits 12 visual artists over one year who are at the beginning of their professional careers. • Theatre. International theatre at its most local, ArtsCenter Stage showcases the work of emerging and established artists hailing from next door to around the world. ArtsCenter Stage features newer works, while its second-stage series includes improvisation and storytelling, musicals and operas, stand-up comedy and film screenings, new works in development and theatre for younger and older audiences. d) Agency's History with Providing These Services: The ArtsCenter began as one painting class, in a walk-up studio on East Main Street in Carrboro, in 1974. From that modest first step and the extraordinary creative vitality of Carrboro, Chapel Hill, and Orange County as a whole, an amazing community arts and education organization was born. During 2016, The ArtsCenter served more than 95,000 people, one third under the age of 18. Our work created a local economic impact estimated at $3,488,830, generating 111 full time jobs and $328,000 in state and local tax revenue. Agency Information 2/8/2017 5:24:23 PM Page 8 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Our core services are The ArtSchool (serving 15-105 year olds) and our youth programs (serving pre-K through high schoolers through Afterschool Arts Immersion, Arts-In Education, ArtsCamp, School Shows, and Youth Art Classes). Additionally, we serve audiences via theater performances, live concerts, and gallery exhibitions. Many of these activities are coordinated collaboratively with other community organizations, area businesses, area schools, and local governmental agencies. The ArtsCenter has decades of experience in providing quality arts programming for our community, in providing educational youth programs in the arts, and continues to develop new programs and initiatives to serve Orange County's diverse residents. The ArtsCenter's growth is due to ever increasing community demand and demonstrates the high need for our programs. e) Other Pertinent Agency Information (Ex. Has the agency experienced any major changes in the past year? Is there a new Executive Director?Are there new initiatives?) The ArtsCenter has completed 6 months of our current year-long strategic planning process. To date, the plan renews our current mission, affirms our lead programs and key objectives, and calls for new community engagement coordination to increase outreach and impact. Last year, with support from the Town of Carrboro, Town of Chapel Hill, and Orange County, plus area foundations, individual donors, and the North Carolina Arts Council, The ArtsCenter gave $45,000 in scholarships ($42,538 in youth scholarships; $2,462 in adult scholarships). 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: 9 # of FTE - Paid Part-Time Positions: 6 # of Volunteers: 165 # of FTE - Volunteers:1 g) Living Wage Does this agency pay permanent employees a minimum living wage? (Yes/No) No If yes, is this agency an Orange County Living Wage Certified Employer? If no, please explain. The ArtsCenter has completed the first step of our process to become a Living Wage Employer by recently increasing the lowest wages from $10/hr to $11/hr. We have plans to increase this hourly wage again this year and will become an Orange County Living Wage Certified Employer within 24 months at the latest. Agency Information 2/8/2017 5:24:23 PM Page 9 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT 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) Yes If yes, please list below: Include all programs that have funding requests/awards/totals from Carrboro, Chapel Hill, and Orange County governments (other than Human Services). DO NOT include federal funding sources, such as CDBG and HOME. Program FYI 6-17 FYI 7-18 Source Award Request 10 x 10 Play Festival $4,000 $4,000 Carrboro Tourism Development Auth. Elf Fair $1,000 $1,000 Carrboro Tourism Development Auth. Total Other Carrboro Funding 5,000 $5,000 Artist in Residence-Title 1 schools 15,000 $5,000 Orange County Schools 10x10 Play Festival $1,500 Orange County Arts Commission Summer Camp Artists support $1,000 Orange County Arts Commission Grady Brown Artist in Residence $5,000 Orange County Arts Commission Title 1 School addition in 17-18 Total Other Orange County $17,500 $10,000 *Add rows or attach additional page, if needed. ii. Submit your agency's budget. (See Attached) Agency Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o Program Generated Revenue o Local Government Grants ■ Carrboro Human Services ■ Carrboro Other ■ Chapel Hill Human Services ■ Chapel Hill Other (DO NOT include CDBG funding here) ■ Orange County Human Services ■ Orange County Other (DO NOT Include HOME funding here) o Other Government Grants ■ Triangle United Way ■ State Government ■ Federal Government (CDBG/HOME/etc.) • Private Foundation Grants o Other Revenue • Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel & Training o Other Expenses Agency Information 2/8/2017 5:24:23 PM Page 10 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION iii. Does your agency budget show a Surplus or Deficit? Surplus Is there a significant change? Yes/No No Please provide a brief explanation for Surplus or Deficit, and significant changes. The ArtsCenter has run a slight surplus each year for the past 3 years. iv. What is your agency's fiscal year? January 1 — December 31, 2017 This is a change beginning January 1, 2017. Previously our fiscal year ran from July 1 of one year through June 30 of the following year. Agency Information 2/8/2017 5:24:23 PM Page 11 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: The ArtsCenter- Youth Department (Orange County) (A separate request for General Support will be sent to the Towns of Carrboro & Chapel Hill) Program Primary Contact and Title: Julie Tomkovick Telephone Number: 919-929-2787 x 213 E-Mail: development(c-)artscenterlive.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 X X X X X Family Resources Jobs/Jobs Training Food Transportation Other: Art Exhibits & Performances X X X X X 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. • Chapel Hill Carrboro City Schools (Youth programs planning and participants) • Orange Co. Schools (Youth programs planning and participants) • Orange Co Human Services (Youth programs planning and funder) • Chapel Hill-Carrboro PTA (Youth programs planning and funder) • OCAC (Youth programs and theater funder) PROGRAM INFORMATION 2/8/2017 5:24:23 PM Page 12 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Program Description (3 p max) ArtsCenter Youth Department (Orange County) 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? Youth Programs-- The ArtsCenter will provide one year of youth educational and arts activities that reach approximately 30,000 children primarily from Orange County. The ArtsCenter's Youth Education department includes School Shows, Artist-In-Residence residencies, summer ArtsCamps, Afterschool Arts Immersion, and Youth Arts Classes. We are seeking funding for scholarships for underserved children to participate in Afterschool Arts Immersion (at The ArtsCenter) and for Artist-In-Residence residencies (in Orange County Schools). Youth Education fits well within the above Carrboro and Chapel Hill goals as well as Orange County BOCC Goals #6: "Ensure a high quality of life and lifelong learning that champions diversity [and] education at all levels..." 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 goals, 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. As noted in the Orange County BOCC strategic goals adopted in 2009: it is important to the county to (Goal # 3:) Implement planning and economic development polices which create a balanced, dynamic local economy...which promotes diversity ... while embracing community values and (Goal #6:) "Ensure a high quality of life and lifelong learning that champions diversity [and] education at all levels..." The ArtsCenter as a whole on contributes to fulfilling goal #3 and the Youth Education division helps reach goal #6 with the diversity of artists and cultures represented. The need for ArtsCenter programs and services is reflected in the organizations growth statistics: In 1987, we served 60,000 patrons annually—in FY2015-16, we served more than 95,000. The ArtsCenter regularly surveys ArtSchool students, Youth Program Parents, and theater, concert, and gallery attendees to ensure that patron expectations are being met, to learn new and evolving needs, to discover new populations to be served, and to gather suggestions for improvement. Orange County and Chapel Hill/Carrboro City School teachers, administrators, and PTA regularly evaluate the quality and value of the School Shows and Artist In Residence residencies, which are both designed to reinforce current NC standards and curricula. Pages 84-85 of the Consolidated Plan note that "Orange County, North Carolina is home to a university, hospitals, and some manufacturing establishments and therefore has a diverse economy. The three (3) largest categories of jobs in Orange County in business by sector is as follows: Arts, Entertainment, Accommodations - 4,693 jobs; Education and Health Care Services - 4,025 jobs; Retail Trade - 2,942 jobs." As an employer of more than 1000 artists per year on a part-time or contract basis, The ArtsCenter contributes to the health and diversity of Orange County employment and acts as an economic engine for our area. PROGRAM INFORMATION 2/8/2017 5:24:23 PM Page 13 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? ArtsCenter youth department demographics closely reflect the demographics of our Orange County community because we bring school classes to our site to see School Shows, bring touring artists directly into local schools for performances for the entire student body, and bring teaching artists into 3 Title 1 Orange County Schools (Central Elementary, New Hope Elementary, and Efland Check Elementary schools) for 5 day in-school residencies for every class at every grade level. Youth-- The demographics of our largest youth group, School Shows, mirror the populations of Orange County Schools and Chapel Hill/Carrboro City Schools and serve more than 26,000 youth annually. Artists in Residence (AIR) residencies (formerly Arts-In- Education) reach every class in three Title 1 elementary schools in the Orange County School system. Afterschool Arts Immersion serves elementary schoolers, Youth Art Classes serve 1st— 6th graders, and summer ArtsCamps serve rising Kindergartners — 12th graders. Participants are reached through printed material sent directly through schools to parents, school social workers, teachers, and counselors often help identify students needing scholarship and help guide parents to our services. Last year, The ArtsCenter provided more than 29,777 youth experiences and gave $42,538 in youth scholarships. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) Under the leadership of Executive Director, Daniel Y. Mayer, the primary activities will be coordinated by: Youth Education Coordinator, Jesse Hollars; and Artist in Residence Coordinator, Virginia Queen Danford. Their credentials are listed below. Dan Mayer, The ArtsCenter's Executive Director since August 2015, has decades of non- profit management experience from the Kirkland Performance Center, PARKWAY III Consulting, and the NEA, among other organizations. He brings a balanced artistic vision with business acumen. Mayer's educational background includes a BA in Political Science and Art History from Claremont McKenna College, a JD from Case Western Reserve University, and an Arts Administration Fellowship from the National Endowment for the Arts (NEA). Jesse Hollars, who joined us in 2014, is our Youth Education Coordinator for Afterschool Arts Immersion, ArtCamps, Artist in Residence, School Shows, and Youth Art Classes. Jessie Hollars graduated from UNC-CH with a degree in gender studies in 2012 and is a textile artist. Mayer and Hollars work closely with our Artist in Residence Coordinator, Virginia Queen Danford, who has been an actor and teaching artist for more than two decades; Danford has managed similar school residency programs in NY and NC. Danford received her BAF in Acting from West Virginia University and her MFA from Pennsylvania State University. PROGRAM INFORMATION 2/8/2017 5:24:23 PM Page 14 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION h) Describe the specific period over which the activities will be carried out and include an implementation timeline. The activities will be provided from July 1, 2017 — June 30, 2018. Afterschool Arts Immersion, Youth Arts Classes, and Artist in Residence will be scheduled to follow the local school systems calendars from August through June. ArtsCamps run for 10-12 weeks (depending on the local school calendars) in June, July, and August. Budgetary planning now occurs in the summer and fall. Program planning, implementation, and evaluation is ongoing throughout the year. i) Why is funding this program a good investment for the community? How does funding this program add value to the community? (250 words OR LESS) The ArtsCenter has provided quality youth programing to Orange County Youth for more than 30 years. The arts are a proven valuable tool for learning. According to research compiled by Americans for the Arts, arts education "nurtures important values, including team-building skills; respecting alternative viewpoints; and appreciation and awareness of different cultures and traditions." Furthermore, they state that exposure to the arts "plays a central role in cognitive, motor, language, and social-emotional development; motivates and engages children in learning, stimulates memory, facilitates understanding, enhances symbolic communication, promotes relationships, and provides an avenue for building competence." Studies show that students involved in the arts score (on average) 100 points higher on their SATs, are four times more likely to participate in a math or science fair, are 17% more likely to volunteer, and 20% more likely to vote as adults. Low income students are 18% less likely to drop out of school while participating in the arts. The ArtsCenter's own testing after School Shows and AIR residencies show that student have an 87% proficiency of content covered in these programs. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Funding from the Town of Carrboro, Town of Chapel Hill, and Orange County is an important part of The ArtsCenter's overall funding strategy. It is a valued endorsement of our programs and services. The ArtsCenter has served the residents of Carrboro, Chapel Hill, Orange County, and surrounding area residents for more than 40 years with quality arts programming and arts education opportunities. During this time we have contributed to our local community's economic development, brought visitors to our area, and become a driver of the thriving creative community of all three jurisdictions. If this request is not funded in full or at all, then services will be reduced and adjusted accordingly. k) Include any other pertinent information. Last year, The ArtsCenter gave $45,000 in scholarships ($42,538 in youth scholarships; $2,462 in adult scholarships). PROGRAM INFORMATION 2/8/2017 5:24:23 PM Page 15 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program Information for Youth Division Only 1) Target Population Complete the following tables, with numbers of individuals served and to be served. Program Target Population Demographics Actual Estimated Projected 2015-16 2016-17 2017-18 Gender Male 15,186 15,300 15,810 Female 14,591 14,700 15,190 Total 29,777 30,000 31,000 Ethnicity African-American 7,444 7,500 7,750 American Indian or Alaska Native 60 60 62 Asian 2,382 2,400 2,480 Caucasian 15,722 15,840 16,368 Native Hawaiian or other Pacific Islander Other: specify Latinx 4,169 4,200 4,340 Total 29,777 30,000 31,000 Of the above, how many Hispanic/Latino 4,169 4,200 4,340 Of the above, how many non-Hispanic/Latino 25,608 25,800 26,660 Total 29,777 30,000 31,000 Age 0-5 years 1,370 1,380 1,426 6-18 years 28,407 28,620 29,574 19-50 years 51+ years Total 29,407 30,000 31,000 Geographic Location Outside of NC or Other NC County Alamance County 149 150 155 Chatham County 298 300 310 Durham County 3,573 3,600 3,720 Wake County 298 300 310 Orange County Breakdown Unk Chapel Hill Public Housing Unknown Unknown Town of Chapel Hill (Non-Public Housing) 17,271 17,400 17,980 Town of Carrboro 4,169 4,200 4,340 Town of Hillsborough 1,787 1,800 1,860 City of Mebane (Orange County) 149 150 155 Orange County(Outside Municipalities) 2,084 2,100 2,170 Total 29,777 30,000 31,000 PROGRAM INFORMATION 2/8/2017 5:24:23 PM Page 16 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Work Statement m) 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 General Support of The ArtsCenter 1. Program Activity Name AfterSchool Arts Immersion (AAI) &Youth Art Classes Program Goal Serve 60 youth monthly through AAI and Youth Art Classes Performance Measures AAI &Class registrations Previous Year Program Results Served 55 youth monthly through AAI and Youth Art Classes Current Year Estimated Results Serve 70 youth monthly through AAI and Youth Art Classes Next Year Projected Results Serve 60 youth monthly through AAI and Youth Art Classes 2. Program Activity Name Artist in Residence (AIR) residencies Program Goal Hold 14 AIR residencies in 3 Title 1 Orange Co Schools for 1200 students Performance Measures Artist contracts, class records, content tests Previous Year Program Results Offered 14 residencies for 1410 students Current Year Estimated Results Offer 16 residencies for 1275 students Next Year Projected Results Offer 16 residencies for 1200 students: if we can afford to add Grady Brown Elementary, then 20 residencies for 1600 students 3. Program Activity Name School Shows Program Goal Present 50 School Schools at the ArtsCenter& in area schools that enhance NC curricula Performance Measures School Show schedule, contacts, &teacher guides Previous Year Program Results Presented 75 School Shows; received 85% positive evaluations Current Year Estimated Results Present 54 School Shows; receive 85% positive evaluations Next Year Projected Results Present 50 School Shows; receive 85% positive evaluations 4. Program Activity Name Summer Arts Camps & Mini-Camps Program Goal Offer 10-11 wks of camps and teen classes (depending on schools) Performance Measures Summer camps &youth class schedule Previous Year Program Results Offered 11 wks of camp and teen class for 847 youth via 1500 units Current Year Estimated Results Offer 10 wks of camp/teen class reaching 800 youth via 1500 units Next Year Projected Results Offer 10-11 wks of camp/teen class for 800 youth via 1500 units PROGRAM INFORMATION 2/8/2017 5:24:23 PM P a g e 17 of 2 0 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION n) Program Budget (See Attached) 1. Submit your program budget. You may complete the provided template (separate xls file) or you may submit your own budget file (as long as it contains the same information, in the same format, as requested in the provided template). Program Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o Program Generated Revenue o Local Government Grants ■ Carrboro Human Services ■ Carrboro Other ■ Chapel Hill Human Services ■ Chapel Hill Other (DO NOT include CDBG funding here) ■ Orange County Human Services ■ Orange County Other (DO NOT Include HOME funding here) o Other Government Grants ■ Triangle United Way ■ State Government ■ Federal Government (CDBG/HOME/etc.) ■ Private Foundation Grants o Other Revenue • Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel & Training o Other Expenses 2. Program Budget Detail — Provide description of"other" budget items, not defined. The other expenses include: depreciation ($12,052), bank fees ($15,392), extra performer fees ($1,881), transportation ($23,900), and rent ($410). 3. This program budget represents what percent of the agency budget? 39.5% 4. COST PER INDIVIDUAL (For Youth Programs Only) This Cost per Individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2015-16 Estimated 2016-17 Projected 2017-18 Total Cost of Program 587,225 572,173 593,378 Total # of Individuals 29,777 30,000 31,000 Cost Per Individual $19.72 $19.72 $19.14 PROGRAM INFORMATION 2/8/2017 5:24:23 PM Page 18 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Agency Budget Operating Budget for Entire Agency AGENCY NAME: The ArtsCenter Actual Estimated 2016 Projected Percent AGENCY REVENUE 2015-16 17 2017-18 Change Private Donations $ 95,076 $ 91,154 $ 95,712 5% Agency Generated Revenue (fees) $ 947,118 $ 964,261 $ 1,002,831 4% Local Government Grants: Human Services-Town of Carrboro $ 15,000 $ 15,000 $ 20,000 33% Other-Town of Carrboro $ - $ 5,000 $ 5,000 0% Human Services-Town of Chapel Hill $ 10,000 $ 12,500 $ 17,500 40% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ 7,000 $ 10,000 $ 15,000 50% Other-Orange County $ 9,500 $ 17,500 $ 10,000 -43% Other-Town of Hillsborough $ - $ - 1 $ - 0 Other Government Grants Triangle United Way $ - $ - 1 $ - 0 State Government $ 50,721.00 $ 50,721.00 $ 50,721.00 $ - Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 Private Foundation Grants $ 218,161.00 $ 253,500.00 $ 258,570.00 $ 0.02 Other Revenue $ 194,891 $ 155,500 $ 163,275 $ 0.05 Total Agency Revenue $ 1,547,467 $ 1,575,136 $ 1,638,609 049% AGENCY EXPENSES Compensation $ 1,024,360 $ 1,079,291 $ 1,122,463 Rent&Utilities $ 161,207 $ 201,215 $ 209,264 4% Supplies & Equipment $ 112,288 $ 132,320 $ 136,290 3% Travel &Training $ 18,848 $ 14,836 $ 15,133 2% Other Expenses: $ 169,691 $ 145,460 $ 148,369 2% Total Agency Expenses $ 1,486,394 $ 1,573,122 1 $ 1,631,519 1 4% SURPLUS/(DEFICIT) FOR PERIOD: 1 $ 61,073 $ 2,014 $ 7,090 1 252% FY 2015-16 Comparative Agency Budget Revised 9/29/2014 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 4. ATTACHMENTS Description of Required Attachments a) Financial Audit A recent financial audit that should cover CY 2015, for calendar year agencies, and FY 2015-16, for fiscal year agencies. For agencies with prior year revenues totaling $500,000 or more a financial audit, prepared by a certified public accountant is required. Agencies with prior year revenues of less than $500,000 may submit a completed Schedule of Receipts and Expenditures form (see application materials), in lieu of an audit/report. Agencies with a certified audit/report should not complete the form. b) IRS Federal Form 990 A copy of the agency's 2014 Form 990 is required. The specific form depends upon the agency's financial activity. Review the IRS' table guide, for more details. For Form 990-N (e- postcard) filers, include a copy of the postcard, with the agency's application materials. c) NC Solicitation License A copy of the agency's current solicitation license is required. Organizations that solicit contributions in North Carolina, directly or through a third party, must renew their licenses annually. For more details, refer to the NC Secretary of State's licensing website and its Frequently Asked Questions Guide (PDF), about exemptions. If exempt per N.C.G.S. § 131 F-3, include a copy of the exemption letter with the agency's application materials. d) IRS Federal Tax-Exemption Letter A copy of the agency's IRS tax-exempt letter that confirms its nonprofit status is required. An agency can request a copy of its letter from the IRS' Customer Account Services. e) Certificate of Liability Insurance A copy of the agency's current certificate, from the agency's insurance carrier. Table 1 below outlines insurance types and minimums required, for each jurisdiction. If exempt from Worker's Compensation compliance, include a statement explaining why, with the agency's application materials. *Note: If Approved for Funding: Approved agencies must provide an updated insurance certificate. The update should reflect the funding jurisdiction as an additional insured party and certificate holder and provide coverage for the duration of the funding period (July 1 — June 30). Renewal certificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. DO NOT SUBMIT THIS PAGE 2/8/2017 5:24:23 PM P a g e 1 9 o f 2 0 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1ED7AF458B XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required INSURANCE TOWN OF CARRBORO TOWN OF CHAPEL HILL ORANGE COUNTY3 Worker's Limits for Coverage Compensation' A - Statutory State Limits for Coverage A - Limits for Coverage A - NC, for each Statutory State NC, for Statutory State NC, for employee each employee each employee Limits for Coverage Limits for Coverage B - Limits for Coverage B - B - Employers Employers Liability of: Employers Liability of: Liability of: $100,000 Each Occurrence $500,000 each $1 million Each $100,000 BID for each accident, $500,000 Occurrence employee BID for each employee $1,000,000 BID $500,000 BID limit $500,000 for BID limit limit Commercial $100,000 Property General Damage Liability $1 million Each Liability $1,000,000 Bodily $1 million Each Occurrence Occurrence Injury and Property $2 million Aggregate j ry p y $2 million Aggregate Damage Limit Automobile Not Applicable $1 million Each Occurrence $500,000 Each Liability Occurrence Professional $1 million Each Liability Not Applicable Not Applicable Occurrence $2 million Aggregate 1. Visit the NC Industrial Commission's website for more information regarding Coverage A. Also, note that if an agency uses subcontractors, it must require subcontractors to have workmen's compensation insurance. 2. Bodily Injury by Disease (BID) 3. Please visit Orange County's contracts webpage for more information about the County's risk assessment procedures. f) List of Board of Directors Provide the following information about each board of director's member: name, telephone number, address, occupation or affiliation of each member and the list must identify the principal officers of the governing body, and length of term. g) Solid Waste Program Fee (SWPF) Verification This fee finances Orange County's recycling and waste reduction program. Submit either a.) proof of payment of the agency's FY 2016-17 Solid Waste Program Fee, OR b.) a statement on agency letter head indicating exemption and specify the person(s), business, etc. that is responsible for paying this fee. DO NOT SUBMIT THIS PAGE 2/8/2017 5:24:23 PM Page 20 of 20 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF45813 EXHIBIT"B" Scope of Services—FY 2017-18 Outside Agency Performance Agreement Agency Name: The ArtsCenter Program Name: Youth Education Funding Award: $12,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Programmatic Expenses—Scholarships for After School and Supplies $8,500 Programmatic Expenses—Efland-Cheeks Artist Residencies $4,000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2018. • Afterschool Arts Immersion(AAI) • Art in Education Residencies(AIE) • School Shows • Summer Camps 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 Serve AAI youth monthly 50 youth Offer Artist in Residence programs for 4 Orange County Title 1 schools 20 residencies Present School Shows(at The ArtsCenter&in area schools) 55 Sch. Shows Offer summer camps and teen arts classes 1000 youth DoCUSigned by: Certified by: Title: Executive Director Date: 1112212017 50CA36291.761426... (Provider's Signature) DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF45813 ATTACHMENT "A" Orange County Certifications—FY 2017-18 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: Certified by: _ ��7�sarase2siaa1a2a Title: Executive Director Date: 11/22/2017 ... (Provider's Signature) (The ArtsCenter) Orange County Outside Agency Performance Agreement Page 10 of 10 Rev. 7117 DocuSign Envelope ID:C4C09F35-022B-45DE-8313-4A1 ED7AF458B ARTSCEN-01 DMASON ACQ► � CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/17/2017 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Summers Thompson Lowry, Inc. PHONE FAX 100 Europa Drive (A/C,No,Et):(919)968-4472 (A/C,No):(919)942-4221 Suite 571 ADD"RIESS:Info@STLinsure.com Chapel Hill,INC 27517-2393 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Great American Ins CO of NY INSURED INSURER B:Great American Alliance Ins Co The Arts Center Inc. INSURER C:FFVA Mutual Insurance Co 300 G East Main Street INSURER D: Carrboro,INC 27510 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM DD Y MM/DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR PAC4296967 07/01/2017 07/01/2018 PREMIDAMASES aocc occurrence) 1,000,000 PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO PAC4296967 07/01/2017 07/01/2018 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PerOac RTY DAMAGE $ AUTOS ONLY AUTOS ONLY B X UMBRELLA LIAB X I OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE UMB4296968 07/01/2017 07/01/2018 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER WC8400032267 01/01/2017 01/0112018 500,000 OFFICERPMEMBER EXCLUDED?ECUTIVE ❑ N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A General Liability PAC4296967 07/01/2017 07/01/2018 Each Abuse 1,000,000 A General Liability PAC4296967 07/01/2017 07/01/2018 Each Act 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) For Information Purposes CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE _RC 11 n(E S swwn�A,5 ACORD 25(2016/03) 1 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD