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2017-708-E Finance - Public Gallery outside agency agreement
DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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 Public Gallery of Carrboro, DBA WCOM Community Radio, 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 Public Gallery of Carrboro,DBA WCOM Community Radio 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 1000 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 250. 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. (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Revised 712017 Page I of 7 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD d. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 —December 31; January 1 —March 31 and April 1 -June 30. Reports are due on January 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. hi 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 (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Page 2 of 10 Rev. 7117 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers'or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof, iii. Comprehensive Automobile Liability Insurance,including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance,covering personal injury,bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents,consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • 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 (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Page 3 of 10 Rev. 7117 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves,their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender,national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County's living wage is $ 13.75 per hour. To the extent possible, Orange County recommends that Public Gallery of Carrboro, DBA WCOM Community Radio 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 (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Page 4 of 10 Rev. 7117 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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: County: Finance&Administrative Services Provider: Public Gallery of Carrboro, DBA Orange County WCOM Community Radio Post Office Box 8181 300-G East Main Street Hillsborough,NC 27278 Carrboro,NC 27510 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 and on behalf of the Provider (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Page S of 10 Rev. 7117 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD DocuSigned by: Q Vf k.WnA(�'S 1112 212 017 aDUCAODAnSDasc... Date For Doc uSignedby, [� :'ounty Government 66ln�At (' RMKAL^ i 11/27/2017 0637994B755E477... Bonnie Hammersley, County Manager Date (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Page 6 of 10 Rev. 7117 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION FOR OFFICE USE ONLY Agency _Public Gallery of Carrboro Received By Program(s) _WCOM Community Radio 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 9:06:10 AM P a g e 1 o f 1 8 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Public Gallery of Carrboro Applicant Organization's Physical Address: 300-G East Main St: Carrboro, NC 27510 Applicant Organization's Mailing Address: 300-G East Main St,; Carrboro, NC 27510 Applicant Organization's Web Address: www.wcomfm.org Executive Director: NONE Telephone Number Board Chair: 919-675-2787 Board chair E-Mail: art(@artmenius.com Tax ID Number: 56-2010901 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 Count -HS Ex. Youth Afterschool Program $10,000 $15,000 $5,000 $30,000 Afterschool Program Coordinator salary and materials for youth activities and projects WCOM Community Radio operational expenses $1,000 $0 $1,000 $2,000 Totals $1,000 $0 $1,000 $2,000 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: Not Applicable N/A Executive Director Date Signature: P January 24, 2017 Board Chairperson Date AGENCY INFORMATION 2/8/2017 9:06:10 AM Page 2 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: Not Applicable N/A Executive Director Date Signature: January 24, 2017 Board Chairperson Date AGENCY INFORMATION 2/8/2017 9:06:10 AM Page 3 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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): January 1997 Twenty years in operation b) Agency's Purpose/Mission (no more than a few sentences): to educate, inspire, and entertain the diverse populations of Carrboro, Chapel Hill and nearby areas. We cultivate local music and facilitate the exchange of cultural and intellectual ide as, with particular regard for those who are overlooked or under- represented by other media outlets. We provide a space for media access and education by providing equipment and training to our community. c) Types of Services the Agency Provides (bullet format): • Locally owned and operated broadcast media • Training for residents in radio production and broadcasting • Practical broadcasting experience for residents • Delivery of public service announcements • In depth interviews with area politicians, government officials, authors, and other leaders. • Programing produced by local teenagers • A significant number of radio programs produced by local African-American programmers • Local event calendar • Locally produced Spanish language programs d) Agency's History with Providing These Services: WCOM has been providing all these services to the community since late 2004. Our 71 volunteers range in age from 14 to 86 and include blind and elderly hosts. Public Gallery of Carrboro was originally created to facilitate the extraordinary Art on Weaver public art project in 1997. Ruffin Slater filed an application with the FCC for a low power FM radio license in June 2001 for WCOM. License granted in December 2002. In September 2003 WCOM received a federal PTP grant for 75% of startup costs. WCOM began broadcasting in 2004 from an old bank building on Weaver Street in Carrboro with its transmitter at Scroggs Elementary in Chapel Hill. The studio moved first to 208 East Main and then in September 2012 to space rented from The ArtsCenter. The Carrboro BOA named November 6, 2014 "Community Radio Day" in Carrboro to recognize WCOM's tenth anniversary. 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?) During 2016, the Public Gallery of Carrboro implemented enhanced earned and unearned income efforts and stronger financial planning with great success, turning a Agency Information 2/8/2017 9:06:10 AM Page 4 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION $1500 deficit into a $1000 surplus, allowing PGC to start rebuilding its operating reserve. PGC began an intensive process of upgrading broadcast equipment and software. 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: 0 # of FTE - Paid Part-Time Positions: 0 # of Volunteers: 71 # of FTE - Volunteers:2.4 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. Not applicable; no permanent employees to pay Agency Information 2/8/2017 9:06:10 AM Page 5 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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) No If yes, please list below: Include all programs that have funding requests/awards/totals from Carrboro, Chapel Hill, and Orange County governments (other than Human Services). DO NOT include federal funding sources, such as CDBG and HOME. Program FYI 6-17 FYI 7-18 Source Award Request Ex: Affordable Rental 0 $20,000 Carrboro - Affordable Housing Rehabilitation Ex: Agency Administration $15,000 $15,000 Carrboro— Other Ex. Total $15,000 $35,000 Carrboro Total Funding *Add rows or attach additional page, if needed. ii. Submit your agency's 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, and in a similar format, as requested in the provided template). Agency Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o Program Generated Revenue o Local Government Grants ■ Carrboro Human Services ■ Carrboro Other ■ Chapel Hill Human Services ■ Chapel Hill Other (DO NOT include CDBG funding here) Agency Information 2/8/2017 9:06:10 AM Page 6 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION ■ 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 9:06:10 AM Page 7 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Agency Budget Operating Budget for Entire Agency AGENCY NAME Public Gallery of Carrbero dba WCOM Actual Estimated roles aPercent AGENCY REVENUE 2016-16 2016-17 2017-19 Change PrivateDanabmis 151D4 S 9DOO 8000 0% Agency Generated Revenue Ifees) $ 9,1527 5 1 D,Doo $ 10,501) 5% Loeai Government Grants: Human Services-Town of Camboro $ 753 5 1,Dflo $ 1,00C D% Other-TovmofCareihoro $ 2,5123 S $ D Human SerAoes-Town€rr Chapel Hill ; - 5 $ D Other-Town of Chapel Hill $ - 5 $ D Human Services-Orange Cou my S 25 D 5 1,11410 $ 1.001) D% Oltrer-Orange County S 5 - $ D Other-Town cf Hilsborough S 5 $ D 011her Goverrrrient Grants Triangle United Way S S $ C. State GcrVemrnent S S $ d Federal Government(CDBUHOMEletc.) S S $ C. Private Foundation Gra its S 2,301DO S ttrer 1.750.00 $ .CDC.C1D 4% O Revenue 5 '.'24 5 - $ - C. Total Agency Revenue $ 22,355 S 19 J50 $ 20.500 4.' AGENCY EXPENSES Conmx-nsafim $ 915 S 250 S MC 3% Rent&utifffies $ 9.292 S 9,150 9 0,50C 4% Supplies&Equipment $ 4,207 S 4,0,34 5 4,50C 1% Travel&Training 5 - $ - S D CH]her Expenses: $ 6,879 S 4,155 S 4,50C 3% Total Agency Expenses 3 21,293 $ 18,225 $ 19,350 6% SURPLU&(DEFICIT) FOR PERIOD: 1,0621 $ 1..5251 $ 1,150 1 FY 21115-16 Canparative Agerxry Budget Devised gr29M14 iii. Does your agency budget show a Surplus or Deficit? Surplus Is there a significant change? Yes/No Yes Please provide a brief explanation for Surplus or Deficit, and significant changes. Agency Information 2/8/2017 9:06:10 AM Page 8 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Moved from $1570 deficit in 2015 to $1062 surplus in 2016 through increasing earned and unearned income by almost $8000. This is our start on rebuilding our cash reserves, which we had drawn down for three years after our rent more than tripled. iv. What is your agency's fiscal year? January 1, 2017 thru December 31, 2017 (Example: July 1, 2016 through June 30, 2017) Agency Information 2/8/2017 9:06:10 AM Page 9 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: WCOM Community Radio Program Primary Contact and Title: Art Menius, Board Chair Telephone Number: 919-675-2787 E-Mail: art(a-)artmenius.com a) Indicate the type of Human Service Needs Priority, if program applicable: ❑ Priority Area #1: safety-net services for disadvantaged residents ❑ Priority Area #2: education, mentorship, and afterschool programming for youth facing a variety of challenges ❑ Priority Area #3: programs aimed at improving health and nutrition of needy residents b) Indicate the type of program for which you are requesting funding (Check all that apply to this program) Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods/Residents Affordable Housing Affordable Healthcare Education Family Resources Jobs/Jobs Training Food Transportation Other: Please specify XX Local Community created media including Broadcasting Training & experience for residents; Mentoring XX XX XX XX 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. • The "Wacqueline Stern Show" and "The Wake Up Call" are video recorded and broadcast on the People's Channel. TPS has shot and provided to us video resources for promotion of the station and its services. • The Strowd Roses Foundation and Shared Visions are funders of WCOM radio • Programming collaboration is developing with Little Raleigh Radio and WHUP-LPFM in Hillsborough. • Frank Porter Graham Bilingual School provides student produced Spanish Language Programming DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM P a g e 1 0 o f 1 8 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION • The ARC and WCOM collaborate on broadcast opportunities for special needs individuals. • Native Voices One provides programming to WCOM Program Description (3 pages OR LESS) Please provide the following information about the proposed program: d) Summarize the program services proposed and how the program will address a Town/County priority/goal? As a community radio station WCOM, the Public Gallery of Carrboro provides broadcasting training and opportunity for citizens of all ages, sexual orientations, and races; WCOM provides ample opportunity for airing Public Service Announcements (PSAs) from non-profits, schools, and government agencies in the towns and counties; locally owned and operated media on a daily basis. Carrboro's 20/20 vision reads "The town should continue to encourage and support artistic and cultural activity." Orange County's Comprehensive plan calls for expanding recreational activities available to citizens of all ages. 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. The need for recreational opportunities and entertainment to citizens; the need for locally produced media on a daily basis; the need for opportunities for non-profits, schools, and government entities to distribute information to citizens; the need for citizens to hear interviews from government officials and candidates for office; the need to promote and provide artistic and cultural activity. f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? The Public Gallery of Carrboro provides radio to Carrboro, Chapel Hill, and southern Orange County. Residents throughout the county and the world can listen to WCOM over the Internet. WCOM offers programming training to any citizen who desires it. WCOM provides broadcasting opportunities to any citizen who completes training and has an acceptable program concept. WCOM offers more Spanish language, all locally produced, than any station in Orange County. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) As an all-volunteer community radio station that both serves the community and empowers residents to create media for their neighbors, a team of volunteers operates WCOM and thus lead the program. Art Menius, board president, has 33 years of non-profit management and fundraising experience and ten years in radio. DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 11 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Chief trainer Karl Blake has worked for several public and commercial radio stations, currently WCHL. Program Committee chair Dave Bellin has served more than a decade on that group, while hosting programs throughout that period. Chief engineer Donald Brumfield has retired from a career in the high tech field, while putting in more than thirty years as a jazz DJ on radio and at live events. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. July 1, 2017 to June 30, 2018: WCOM will broadcast 24 hours per day, each day of the year, offering diverse voices of our community with both talk and music programming. July 1, 2017 to June 30, 2018: WCOM will provide radio broadcasting training to all who request it. July 1, 2017 to June 30, 2018: WCOM will continue daily air Public Service Announcements (PSAs) from non-profits in Orange County whenever provided to us in time. Each Friday we will continue to offer a weekly calendar of local events at 6PM Fridays. 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) WCOM is the only radio station devoted to serving southern Orange County and the only broadcast media outlet in Carrboro. We offer a number of radio programs produced by local African-American programmers and featuring music rooted in African-American traditions. We offer locally produced Spanish language programs. This provides diverse voices of the community unavailable elsewhere. Through WCOM the Public Galley of Carrboro offers an open platform for PSAs from local non-profits throughout our offerings. The "Time Out" program on Mondays at 5PM provides in depth and thought interviews with important people in our community, including annual visits by Congressman David Price, a series of interviews with Town of Carrboro department heads, and regular appearances by former Carrboro mayor and State Senator Ellie Kinaird. Currently, "Time Out" presents monthly interviews with Town of Carrboro department heads. Wednesday's "Wake Up Call" offers interviews with Orange County leaders such as County Commissioners Mark Marcopolis, Renee Price, and Chapel Hill mayor Pam Hemminger. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Public Gallery of Carrboro would continue to operate community radio station WCOM 24 hours per day. If we are unable to match the revenue from another source, we would be forced to reach into our limited reserves as we did 2013 through 2015. k) Include any other pertinent information. Listeners Served DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 12 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION WUNC-FM 91.5 is the only radio station licensed to Orange County that subscribes to the Arbitron rating service. WCHL, WXYZ, WCOM, and WHUP do not due both to the expense and because there are little more than a dozen Arbitron reporters in Orange County, making for less than accurate reports. Our website receives 800 visits per day. The median number of online listeners at any one time to our Internet streaming is 8.85, which enumerates aggregation services such as Tuneln Radio as just one listener, although WCOM's channel has more than 700 subscribers. We broadcast 24 hours per day. Thus any one 24-hour period would generate a minimum of 212.4 listener-hours. For a year that bare minimum computes to 77,526 online listener hours. DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 13 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Additional Program Information 1) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, Program Target Population Demographics Actual Estimated Projected 2015-16 2016-17 2017-18 Gender Male 42 42 44 Female 29 33 36 Total 71 75 80 Ethnicity African-American 10 12 15 American Indian or Alaska Native 1 1 1 Asian 2 2 3 Caucasian 58 60 61 Native Hawaiian or other Pacific Islander 0 0 0 Other: specify 0 0 0 Total 71 75 80 Of the above, how many Hispanic/Latino 6 8 9 Of the above, how many non-Hispanic/Latino 65 67 71 Total 71 75 80 Age 0-5 years 0 0 0 6-18 years 5 6 7 19-50 years 40 41 43 51+ years 26 28 30 Total 71 75 80 Geographic Location Alamance County 1 0 1 Chatham County 4 5 6 Durham County 12 12 12 Wake County 2 3 3 Orange County Breakdown Chapel Hill Public Housing Unknown Unknown Unknown Town of Chapel Hill (Non-Public Housing) 19 20 20 Town of Carrboro 23 24 25 Town of Hillsborough 1 1 1 City of Mebane (Orange County) 0 0 0 Orange County(Outside Municipalities) 9 10 12 Total 71 75 80 DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 14 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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 _WCOM_Community Radio 1. Program Activity Name On Air Broadcasting Program Goal 100% of the time on air Performance Measures Time on air broadcasting Previous Year Program Results 99.7% Current Year Estimated Results 99.25% Next Year Projected Results 99.8% 2. Program Activity Name Training new broadcasters Program Goal 15 people trained per year Performance Measures Number trained Previous Year Program Results 12 Current Year Estimated Results 14 Next Year Projected Results 15 3. Program Activity Name Adding new programming Program Goal 7 new programs added per year Performance Measures Number of new shows added Previous Year Program Results 6 Current Year Estimated Results 12 Next Year Projected Results 10 4. Program Activity Name Program Goal Performance Measures Previous Year Program Results Current Year Estimated Results Next Year Projected Results DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM P a g e 1 5 o f 1 8 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION n) Program Budget 1. Submit your program budget. You may complete the provided template (separate As file) or you may submit your own budget file (as long as it contains the same information, in the same format, as requested in the provided template). Program Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o Program Generated Revenue o Local Government Grants ■ Carrboro Human Services ■ Carrboro Other ■ Chapel Hill Human Services ■ Chapel Hill Other (DO NOT include CDBG funding here) ■ Orange County Human Services ■ Orange County Other (DO NOT Include HOME funding here) o Other Government Grants ■ Triangle United Way ■ State Government ■ Federal Government (CDBG/HOME/etc.) ■ Private Foundation Grants o Other Revenue • Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel & Training o Other Expenses DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 16 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Program Budget Operating Budget for Entire Program PROGRAM NAME WCOM Community Radio Actual Estinhated Projected Percent PROGRAM REVENUE 2015-16 201&A7 2017-LB Change Prorate Donations 5 6.1 E4 -5 C EDo .5.D01] fl% Program Generated Revenue(fees) S 9,827 5 C,E-ao $ 1 D.50C 5% Local Government Grants: Human Semices-Town.of C.amboro 5 750 5 1,113U $ 1.7+_C 13% t]iher-Tower of CarrSoro 5 2,5E7 5 - $ - fl Human Services-Town of Chapel Hill S - 5 - $ - U Other-Town of Chapel Hill $ - 5 - $ - 9 Human Services-orange County S 252 5 1,11110 $ 1.3 C fl% Other-orange County S - 5 - $ f] other-Town of Hilsborough S - 5 - $ 0 4titier Gowerrwnent Grants Triangle Unied Way S - S - $ o State went S - $ - $ 0 Federal Grnremment(C09 HDMEIeta.) S - S - $ - o Privale Fotion Grants S 2.3Cr7.Er 5 1,750-U1} $ 2,l}{H}.op 4fn Otltier Revenue 5 '24 5 - $ - o Total Program Revenue S 22,355 $ 19,750 $ 20,500 4, PROGRAM EXPENSES Compensation $ 915 S E150 S g5D t]% Rent&Ltilitiies $ 9,292 S g,150 $ 9,50D 4% Supplies&Equipment $ 4,207 S 4060 $ 4,50D 11% Travel&Training 5 - $ - -$ - t] Other Expenses: $ 6,870 $ 4,105 $ 4.5013 8% Total Program Expenses $ 21, $ 111 5 I $ 19,350 69 SURPLUS(DEFICIT) FOR PERIOD: 1 1,0621 $ 11,5251S 1,150 , 5°Y FY 2015 18 Cnnpafatrte Prx,'Budget Revised 9l2QW14 2. Program Budget Detail — Provide description of "other" budget items, not defined. Major Other Expenses: Insurance - $1668 Advertising and Promotion - $2549 DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 17 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD XHIBIT A PROVIDER'S OUTSIDE AGENCY APPLICATION Service Providers - $1267 Dues - $476 Fees - $419 3. This program budget represents what percent of the agency budget? 100% 4. COST PER INDIVIDUAL This Cost per Individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2015-16 Estimated 2016-17 Projected 2017-18 Total Cost of Program $21,293 $18,225 $19,350 Total # of Individuals 71 75 80 Cost Per Individual $299.90 $243 $241.88 DO NOT SUBMIT THIS PAGE 2/8/2017 9:06:10 AM Page 18 of 18 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD EXHIBIT"B" Scope of Services—FY 2017-18 Outside Agency Performance Agreement Agency Name: Public Gallery of Carrboro DBA: WCOM LP Radio Program Name: Funding Award: $1,000 Outline how the agency will spend Orange County's funding award. Expense Description Amount General Operation Support—Training,Replacement and Maintenance of broadcast equipment $1000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2018. • Broadcasting services • Training citizens and development of communication methods via radio • New program offerings 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 New shows added 10 New persons trained 15 On air performance 99.8% OacuSigned by: 7- F!Vf k jAiv's Chairman of the Board 11/22/2017 Certified by: bo92 Do ASD4sc... Title: Board chair Date:_7-5-2017 4 (Provider's Signature) DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD 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. Dam Signed by: 1Vf ktupus Chairman of the Board 11/22/2017 Certified by: 0D96ca0oaa5D48c... Title: Date: (Provider's Signature) (Public Gallery of Carrboro,DBA WCOM Community Radio) Orange County Outside Agency Performance Agreement Page 10 of 10 Rev. 7117 DocuSign Envelope ID:3B67A5FD-6776-4322-9152-0531CA4BC4BD OP ID: SF ,a►�'R0. CERTIFICATE OF LIABILITY INSURANCEFDAT�E(MMIDDIYYYY)17 07/11/2017 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 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 Lee-Moore Insurance Agency Inc PHONE FO.BOX 667 A/C No Ext: INC,AI No): West End,NC 27376 E-MAIL Alex Maiolo ADDRESS: PRODUCER pUBLI-1 CUSTOMER ID M INSURER(S)AFFORDING COVERAGE NAIC# INSURED Public Gallery of Carrboro Inc INSURER A:Hartford Insurance 14397 Ernie Hood,Treasurer 300-G East Main Street INSURER B Carrboro, INC 27510 INSURER C: 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MMIDD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 22SBABG0187 06/03/2017 06/03/2018 DAMAGE TO RENTED 300 000 PREMISES Ea occurrence $ CLAIMS-MADE L OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 1-1 POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (PER ACCIDENT) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 7 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE Alex Maiolo ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD