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2018-667-E Finance - Triangle Bikeworks outside agency agreement
(Triangle Bikeworks) Orange County Outside Agency Performance Agreement Revised 7/2018 Page 1 of 9 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2018, (“Effective Date”) by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Triangle Bikeworks, a not-for-profit corporation, located at 115 West Main Street , Suite C1, 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 Triangle Bikeworks agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2018 to June 30, 2019. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application and any amendments or revision thereto which is attached as Exhibit “A” and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $3,790. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of $947.50. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. DocuSign Envelope ID: EE049453-18E5-41D0-B66D-B62773A7BC09 (Triangle Bikeworks) Orange County Outside Agency Performance Agreement Page 2 of 9 Rev. 7/18 e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 – December 31; January 1 – March 31 and April 1 - June 30. Reports are due on January 11, April 12, and July 12 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as “default”), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten (10) business days from written notice of default. The County may (but shall not be required to) grant the 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. DocuSign Envelope ID: EE049453-18E5-41D0-B66D-B62773A7BC09 (Triangle Bikeworks) Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 7/18 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. DocuSign Envelope ID: EE049453-18E5-41D0-B66D-B62773A7BC09 (Triangle Bikeworks) Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 7/18 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County’s living wage is $ 14.25 per hour. To the extent possible, Orange County recommends that Triangle Bikeworks 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: DocuSign Envelope ID: EE049453-18E5-41D0-B66D-B62773A7BC09 (Triangle Bikeworks) Orange County Outside Agency Performance Agreement Page 5 of 9 Rev. 7/18 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 18. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For and on behalf of the Provider _____________________________ _______________________ , Date For and on behalf of Orange County Government _______________________________ ________________________ Bonnie Hammersley, County Manager Date County: Finance & Administrative Services Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: Triangle Bikeworks 115 West Main Street , Suite C1 Carrboro, NC 27510 DocuSign Envelope ID: EE049453-18E5-41D0-B66D-B62773A7BC09 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application 1. COVER PAGE ig Apalicant Contact Information Applicant Organization's Legal Name: Triangle Bikewarks Applicant Organization's Physical Address: 117WestMain I. Suite C1 Carrboro NC 2 510 Applicant Organization's Mailing Address: 117 West Main Street Carrboro NC 27510 Applicant Organization's Web Address: Trian iebikework .or Executive Director: Kevin Hicks Telephone Number: 919-408-7513 E-Mail: kevinCa7trianglebikewyrks.org Tax ID Number: 46-1229632 b) Funding Request List all FY18-19 Human Services (HS) Funding Being Requested— For All Programs) and t a Proposed Use of Funds (2-3 lines or less) Program _Y f Carrboro Chapel Orange Total -H$ ilk l HS Coun -HS Ex.Youth Afterschool Program $10,000 $15,000 $5,000 $30,000 Afterschool Program Coordinator salary and materials for youth activities and projects Spoken Revolutions Cycling Program $7,500 $7,500 $7,500 $22,500 Totals 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: � 6 . � �-YS 6 E ecuti Director pate Signature: eBoalChairperson Date b DocuSign Envelope ID: EE049453-18E5-41 D0-B66D-l362773A7l3C09 EXHIBITA: 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 ❑ ❑X a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? ❑ ❑X 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? ❑ ❑X c) Current beneficiaries of the program for which funds are being requested? ❑ ❑X 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: Jan 15, 2018 E cutive Director Date Signature. Jan 15, 2018 Board Chairperson Date DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: 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 2011 b) Agency's Purpose/Mission (no more than a few sentences): The mission of Triangle Bikeworks (TBW) is to enrich the mind, body and spirit of youth through transformative community, cultural and cycling experiences in the Triangle of North Carolina. c) Types of Services the Agency Provides (bullet format): • Afterschool program • Summer bicycling tour d) Agency's History with Providing These Services: In 2010, a group of 7 youth embarked on a 60-mile journey through and around the coastal town of Edenton, NC. After successfully completing that initial ride, the Spoke'n Revolutions (SnR) Youth Cycling program was born in 2011. The SnR program has developed into an afterschool and summer program where teens are prepared to successfully complete history-filled cycling journey of 500 miles or more. Through these adventures, youth realize their strength and increase confidence and leadership skills, preparing them to be active and healthy members of their community. SnR is now moving into it's seventh season, having cycled over 6,300 miles. Past tour routes include the Underground Railroad, the Lewis and Clark Trail, and the Atlanta, GA to Washington, DC ride linking the Dr. King Historic Site with the Dr. King Memorial. Tour routes have also included the Gullah Geechee Cultural Heritage Corridor and the Cherokee Trail of Tears. The Spoken' Revolutions project was born out of the need to provide youth of color with avenues for health and educational enrichment when traditional sports and school curricula weren't serving their needs. The program gives youth of color access to bicycles, gear, training expertise and cycling experiences that are usually out of reach for this population. 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?) In 2017, Triangle Bikeworks hired a temporary part-time Development Associate and a part-time administrative position to assist in the goal of increasing the agency's capacity to serve more youth. Agency Information 1/23/2018 1:34:47 PM P a g e 1 0 o f 2 6 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application f) Schedule of Positions (For Entire Agency) • Full Time Equivalent(FTE) staff will be noted as 1.00; half time as .50; quarter time as .25, etc. • Calculate a Full Time Equivalent for all recorded volunteer hours using the following: Total Volunteer Hours = Volunteer FTE 2,080 # of FTE - Full-Time Paid Positions: 0 # of FTE - Paid Part-Time Positions: .25 # of Volunteers: 13 # of FTE -Volunteers: 1.3 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. Triangle Bikeworks does not have any permanent employees at this point. Our year- round staff is volunteer and our season cycling program is staffed with temporary, contract employees and volunteers. Agency Information 1/23/2018 1:34:47 PM Page 11 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 EXHIBITA: 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 Oran_qe County governments (other than Human Services). DO NOT include federal funding sources, such as CDBG and HOME. Program FYI 7-18 FYI 8-19 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 • Private Donations • Program Generated Revenue o Local Government Grants • Carrboro Human Services • Carrboro Other • Chapel Hill Human Services Agency Information 1/23/2018 1:34:47 PM Page 12 of 26 DocuSign Envelope ID: EE049453-18E5-41 D0-B66D-B62773A7BC09 EXHIBITA: Provider's Outside Agency Application • Chapel Hill Other (DO NOT include CDBG funding here) • Orange County Human Services • Orange County Other (DO NOT Include HOME funding here) • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG/HOME/etc.) • Private Foundation Grants • Other Revenue • Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel & Training • Other Expenses 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. Additional fundraising was implemented to support the addition of a temporary, part-time Development Associate and a part-time administrative position to assist the Executive Director, who volunteers his time to the agency and works another full-time position. In addition, the organization was reimbursed for expenses incurred during the 2017 summer program which required fundraising to compensate for this delay in funding. Fourth quarter fundraising adds to larger dollar numbers at end of year. What is your agency's fiscal year? January 1, 2018 - December 31, 2018 (Example: July 1, 2016 through June 30, 2017) Agency Information 1/23/2018 1:34:47 PM Page 13 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application Program Budget Operating Budget for Program PROGRAM NAM Spoke'n Revolutions Youth Cycling Actual Estimated Projected Percent PROGRAM REVENUE 2016-17 2017-18 2018-19 Change Private Donations $ 1,500 $ 1,875 $ 2,100 12% Program Generated Revenue $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ 1,000 $ 3,000 $ 7,500 150% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 1,000 $ - $ 7,500 0 Other-Town of Chapel Hill $ - $ - $ - 0 Human Services- Orange County $ 1,000 $ 2,200 $ 7,500 241% Other- Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ - $ - i Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ - $ - $ - 0 Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 Private Foundation Grants $ 6,570 $ 9,038 $ 10,000 $ 0.11 Other Revenue $ - $ - $ - 0 Total Program Revenue $ 11,070 $ 16,113 $ 34,600 115% PROGRAM EXPENSES Compensation $ 2,400 $ 3,060 $ 3,060 0% Rent& Utilities $ 600 $ 1,433 $ 1,433 0% Supplies & Equipment $ 1,861 $ 1,962 $ 500 -75% Travel &Training $ - $ 658 $ 700 6% Other Expenses: Spoke'n Revolutions Prgm 1 $ 4,734 1 $ 5,911 1 $ 25,100 1 325% Total Program Expenses $ 9,595 $ 13,024 1 $ 30,793 136% SURPLUS/(DEFICIT) FOR PERIOD: $ 1,475 $ 3,089 1 $ 3,807 237/6 FY 2018-19 Program Budget DocuSign Envelope ID: EE049453-18E5-41 D0-B66D-B62773A7BC09 EXHIBITA: Provider's Outside Agency Application 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Spoke'n Revolutions Program Primary Contact and Title: Kevin Hicks, Executive Director Telephone Number:919-452-2272 E-Mail: kevin(cDtrianglebikeworks.orq a) Indicate the type of Human Service Needs Priority, if program applicable: ❑ Priority Area #1: safety-net services for disadvantaged residents X❑ 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 Family Resources Jobs/Jobs Training Food Transportation X Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated/collaborative efforts. • Youth Forward is a youth organization that provides technical assistance and program funding. • YouthWorx on Main is a nonprofit collaborative for youth-serving organizations that houses the Triangle Bikeworks office. • The Chapel Hill Carrboro City Schools provide assistance with youth recruitment. • The Blue Ribbon Mentor-Advocate program is a support program designed to improve the achievement of students of color. They assist TBW with recruitment efforts. PROGRAM INFORMATION 1/23/2018 1:34:47 PM P a g e 1 4 o f 2 6 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application Program Description (3 pages OR LESS) Please provide the following information about the proposed program: d) Summarize the program services proposed and how the program will address a Town/County priority/goal? The Spoke'n Revolutions program address the Town/County Priority Area #2 - education, mentorship, and afterschool programming for youth facing a variety of challenges. Our program offers educational enrichment for low to middle income youth of color during the after school hours and summer months, when learning loss occurs. We provide afterschool and summer cycling programs that include a focus on the relevant cultural and natural histories of the youth of color we serve. During the school year, the Spoke'n Revolutions program provides close to 30 hours of afterschool programming. Students meet after school to participate in training rides, educational lectures, community service projects, and team building activities. These activities culminate in a two-week summer tour where students cycle an average of 50 miles each day, camp most nights, make visits to historical and educational sites, and participate in daily journaling and team building activities. e) Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of Chapel Hill Council Goals, Carrboro Board Priorities, or other community priorities (i.e. Council/Board Goals). Reference local data (using the provided links, i.e. Chapel Hill Human Services Needs Assessment) to support the need for this program. The Spoke'n Revolutions program helps fulfill several community priorities by providing low cost/free activities that positively engage low-income youth of color, reduce summer learning loss, and prepare students for success after high school. (Town of Chapel Hill Human Services Needs Assessment, p6) (Orange County BOCC Goals and Priorities Goal 6, p3) Summer learning loss compounds the persistent achievement gap that has been documented in our community. This is especially true for the low—income minority students that our program serves. The loss in learning over the course of summer holidays varies across grade level, subject matter, and family income. The Spoke'n Revolutions program prevents summer learning loss by encouraging students' natural curiosity and taking the time to explore and study the surroundings of our selected cycling route. This method has extraordinary and lasting impacts on students who study American history, natural history and environmental science as they visit historical and educational sites along the route. PROGRAM INFORMATION 1/23/2018 1:34:47 PM Page 15 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application Math is incorporated into everyday touring tasks such as mapping routes, determining distance and speed, and cooking for a large group. Students write in journals to improve writing skills and process what they are learning. The intensive two week camp period is also an ideal environment for staff to work with campers on softer skills such as teamwork, communication skills and conflict resolution. SnR staff administer pre and post tour surveys that measure the knowledge, skills and abilities of campers. Survey topics include the history and environmental science subject matter that is covered on the tour route. We expect the summer gains shown in these surveys to translate into increased engagement in the classroom. The SnR afterschool program is free to students and they are supported in raising a portion of the cost of their summer tour. Transportation is provided to students for afterschool training rides, educational sessions, and throughout the summer tour. (Orange County BOCC Goals and Priorities, p1) 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 target population for the Spoke'n Revolutions program, are youth of color that reside in Orange County. Youth are between the ages of 11-18, and groups are usually 50% male and 50% female. Most students are from low income households. On average, we our participants are: 35% Black 30% Southeast Asian 5% Native American 30% Latino/a Youth are identified through teacher and peer recommendations and interest meetings held at schools. Youth are also identified through the school system's AVID (Advancement Via Individual Determination) program, a college readiness system designed to increase the number of students who enroll and succeed in higher education and in their lives beyond high school. Community nonprofits such as the Refugee Community Partnership and and El Centro Hispano are sought after to refer students to the program g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) Kevin Hicks is the program manager who initiated the first tour in 2010 and continues to oversee the program as the Executive Director. To this date, TBW is the only organization in the Southern US providing this type of program for youth of color. Mr. Hicks is a certified instructor under the League of American Cyclists, which qualifies him to teach bike road safety to youth and young adults. He is also a PROGRAM INFORMATION 1/23/2018 1:34:47 PM P a g e 1 6 o f 2 6 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application board member for the North Carolina Interscholastic Cycling Association and board chair of the Youth Forward board of directors. Itzayana (Itza) Salazar-Martinez is an original member of the Spoke'n Revolutions program from 2011. Itza has been a participant and/or coordinator for the summer tours in six of the seven previous tours. She is a valued member of the organization and is the embodiment of what we are accomplishing at Triangle Bikeworks. Each year she suggests or implements process improvements with the goal of providing a better and lasting experience for participants. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. October - December: Regroup youth from previous tour and recruit new student athletes. Staff researches and organizes details of the summer tour route. Students are equipped with bicycles and gear. January - March: Begin bi-weekly group rides to build fitness and start team building activities. Youth fundraising starts (students are challenged to raise $300 on their own). Route and logistics planning continues, including contacting local officials and groups along the tour route to arrange tours and educational visits. April - May: Afterschool programs continue and include educational lectures and community service projects. Youth continue training rides. June - July: Pre tour survey administered. Final preparations for summer tour. July 7: The 2-week summer tour begins. July - August: Tour wrap-up and debriefing with youth, post tour surveys. Pre and post tour surveys, staff observation counts and outcomes analyzed. 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 Spoke'n Revolutions (SnR) program is a good investment for the community because it provides quality youth programming to youth of color, a vulnerable population, at a low cost. The SnR program was started by volunteers and continues to be primarily a volunteer-run organization with low overhead costs. Funding the SnR program adds value to the community by investing in the next generation of community members and guiding them to become healthy, competent, and responsible adults. Our afterschool and summer cycling programs help students develop skills, knowledge, and a variety of other personal and social assets to function well during adolescence and adulthood. We consistently observe positive outcomes in our alumni as they move on to higher education, employment, and adulthood. 100% of SnR participants have graduated from high school, with 90% moving on to college. PROGRAM INFORMATION 1/23/2018 1:34:47 PM P a g e 1 7 o f 2 6 DocuSign Envelope ID: EE049453-18E5-41 D0-B66D-B62773A7BC09 EXHIBITA: Provider's Outside Agency Application In addition to the educational benefits, the SnR program promotes healthy living behaviors that prevent obesity by providing students with a bicycle and an empowering cycling experience that gives them the skills and confidence to become lifelong cyclists. Finally, the success of SnR youth has a ripple effect in the community. While our program is provided free of cost, youth are supported to raise a portion of their own tour cost. As friends and family give financial and moral support to SnR youth, they also become invested in their success, hold them accountable, and encourage siblings and friends to try the program. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. If requested funding is not awarded at all, fewer youth will be able to participate in the 2018 Spoke'n Revolutions program. For instance, in 2016, only 5 youth participated in the Underground Railroad program due to decreased staffing capacity. This number was down significantly from prior years when 9-12 youth participated each year, with a quarter of each year's alumni returning for the next tour. If funding is reduced, more emphasis will be placed on supporting the participating youth to fundraise the necessary funding for all 20 youth to join the tour. k) What percentage of your target population is low-moderate income? 100% 1) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc.?) SnR staff administer pre and post tour surveys that measure the knowledge, skills and abilities of students, and collect their thoughts and comments on the program. Two weeks after the summer tour there is a follow up parent/guardian survey designed to record changes in the behavior of their child and to collect program feedback. m) Include any other pertinent information. Additional Program Information PROGRAM INFORMATION 1/23/2018 1:34:47 PM P a g e 1 8 o f 2 6 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application n) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, Program Target Population Demographics Actual Estimated Projected 2016-17 2017-18 2018-19 Gender Male 4 11 10 Female 1 9 10 Total 5 20 20 Ethnicity African-American 3 7 7 American Indian or Alaska Native Asian 1 6 6 Caucasian Native Hawaiian or other Pacific Islander Other: specify_Latino/a 1 7 7 Total 5 20 20 7 Of the above, how many Hispanic/Latino 1 7 Of the above, how many non-Hispanic/Latino 4 13 13 Total 5 20 20 Age 0-5 years 6-18 years 5 20 20 19-50 years 51+ years Total 5 20 20 Geographic Location Alamance County Chatham County Durham County 0 0 6 Wake County 1 1 4 Orange County Breakdown Chapel Hill Public Housing Town of Chapel Hill (Non-Public Housing) 4 10 5 Town of Carrboro 0 6 5 Town of Hillsborough City of Mebane (Orange County) Orange County (Outside Municipalities) 3 Total 5 20 20 PROGRAM INFORMATION 1/23/2018 1:34:47 PM Page 19 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 EXHIBITA: Provider's Outside Agency Application Work Statement o) Complete the Work Statement Chart to describe the work to be performed. This chart is used to document program activities, program goals, performance measures, and actual results. (Add more rows as needed) If this is a new program, you will only document the projected information. Every program is required to have AT LEAST 1 Program Activity, which should be SMART (�jpecific, _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 1. Program Activity Name Spoke'n Revolutions Program Goal To decrease summer learning loss for student participants. Performance Measures In 2018 the Spoke'n Revolutions program will serve 20 students with afterschool and summer programs. In 2018 the SnR program have a 95% program satisfaction rate among participants and their parents/guardians. Pre and post 2018 tour assessments will show a 90% increase in student gains in historical and environmental knowledge to include the natural and cultural history of the Raleigh watershed region and the NC coastal region as outlined in the tour curriculum. 2018 summer tour participants will show an increase in soft skills including team building, communication, and leadership skills. Previous Year Program Youth were able to recount learning moments and Results experiences while on the Trail of Tears tour well into the school year. December 2017) Current Year Estimated in 2018, 90% of high school students already studying Results American history will build upon and deepen their PROGRAM INFORMATION 1/23/2018 1:34:47 PM Page 20 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 EXHIBITA: Provider's Outside Agency Application knowledge of NC and American history. This aligns with the NC Essential Standards - Social Studies - American History Course II AH2.H.2 Analyze key political, economic and social turning points in American History using historical thinking. AH2.H.3 Analyze how conflict and compromise have shaped politics, economics and culture in the United States. AH2.H.4 Analyze how conflict and compromise have shaped politics, economics and culture in the United States. AH2.H.5 Understand how tensions between freedom, equality and power have shaped the political, economic and social development of the United States. Next Year Projected After the 2018 tour, 95% of youth participants will Results understand the value of clean water and their personal impact on the quality of the water that they and others drink. After the 2018 tour, 100% of program participants will have a deeper knowledge of NC and American history. After the 2018 tour, 90% of 2018 tour participants will have increased levels of self-esteem and confidence that will improve student classroom performance in the 2018/2019 school year. 2. Program Activity Name Program Goal Performance Measures Previous Year Program Results Current Year Estimated Results Next Year Projected Results 3. Program Activity Name Program Goal Performance Measures Previous Year Program Results PROGRAM INFORMATION 1/23/2018 1:34:47 PM Page 21 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 EXHIBITA: Provider's Outside Agency Application Current Year Estimated Results Next Year Projected Results 4. Program Activity Name Program Goal Performance Measures Previous Year Program Results Current Year Estimated Results Next Year Projected Results PROGRAM INFORMATION 1/23/2018 1:34:47 PM Page 22 of 26 DocuSign Envelope ID: EE049453-18E5-41 DO-666D-662773AMC09 EXHIBITA: Provider's Outside Agency Application p) Program Budget 1. Submit your program budget. You may complete the provided template (separate As file) or you may submit your own budget file (as long as it contains the same information, in the same format, as requested in the provided template). Program Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues • Private Donations • Program Generated Revenue • 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) • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG/HOME/etc.) • Private Foundation Grants • Other Revenue • Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel & Training • Other Expenses 2. Program Budget Detail — Provide description of "other" budget items, not defined. 3. This program budget represents what percent of the agency budget? 50% 4. COST PER INDIVIDUAL This Cost per Individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2016-17 Estimated 2017-18 Projected 2018-19 Total Cost of Program $6,724 $18,288 $25,100 Total # of Individuals 12 24 27 Cost Per Individual $561 $731 $930 PROGRAM INFORMATION 1/23/2018 1:34:47 PM Page 23 of 2 DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 EXHIBIT "B" Scope of Services—FY 2018-19 Outside Agency Performance Agreement Agency Name: Triangle Bikeworks Program Name: Spoke'n Revolutions Youth Cycling Funding Award: $3790.00 Outline how the agency wills end Orange County's funding award. Expense Description Amount Tour Staff wages $1000 Food for tour including snacks,beverages,and 3 meals a day $2000 Support vehicle driver(contracted staff) $790 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2019. • Afterschool programming including training rides, educational lectures, team building activities and community service projects. • 3-day cycling excursions studying North Carolina and U.S.history • 2-week summer cross-country bike tour of 700 miles 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 particwnants within that measure's descri tp ion or for an earlier performance measure. Performance Measures Anticipated Results 2019 enrollment in a Spoke's Revolutions SnR after school or summer cycling ro am 20 Percentage of program satisfaction rate among 2018 SnR program participants and their 95 parents/auardians Number of SnR youth that will show an increase in their knowledge of historical and 18 environmental subjects including the natural and cultural history of the Raleigh watershed region and the NC coastal regional.Measured through pre and post tour surveys. (total number of participants- 15 Number of SnR youth that will show an increase in their use of soft skills that include team 19 building,communication,and leadership skills.Measured through pre and post tour surveys and team coaches'participation counts. (total number of participants- 15) L DocuSign/edd by: Executive Director 10/3/2018 5886E 3CO524 C. Certified by: Title:_Executive Director_ Date: _Aug 29,2018 Provider s Signature) DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 ATTACHMENT "A" Orange County Certifications—FY 2018-19 Outside Agency Performance Agreement Chief Contact,Administrators,Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title,residential address;phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing,with the name, physical address,mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. DocuSigned by: Executive Director 10/3/2018 Certified by: Title: Date: (Provider's Signature) (Triangle Bikeworks) Orange County Outside Agency Performance Agreement Page 9 of 9 Rev. 7118 DocuSign Envelope ID: EE049453-18E5-41 DO-B66D-B62773A7BC09 75/25/2018 E(MMIDD/YYYY) � CERTIFICATE OF LIABILITY INSURANCE 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: Anita M.Chick,CIC,CISR,CIIP Marsh &McLennan Agency LLC PHONE FAX 1400 Eastchester Drive, St 200 (A/C.No Ext: 336-899-2402 A/c No):212-607-6550 High Point NC 27265 ADDRESS: Anita.Chick@marshmma.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Alliance Member Services 10023 INSURED TRIAN03 INSURERS: North American Elite Insurance Company 29700 Triangle Bikeworks PO Box 17202 INSURER C, Chapel Hill NC 27514 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:821208680 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICYNUMBER MM/DDIYYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY 201837804 6/11/2018 6111/2019 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence $500,000 MED EXP(Any one person) $0 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY❑X PRO- ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 JECT OTHER: $ A AUTOMOBILE LIABILITY 201837804 6/11/2018 6/11/2019 COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Improper Sexual Conduct 201837804 6/11/2018 6111/2019 Each Claim/Aggregate $1MM/$2MM B Auto Physical Damage CWA001528502 6/11/2018 6111/2019 Hired Car $50 Comp/$100Coll DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Human Services ACCORDANCE WITH THE POLICY PROVISIONS. 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