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HomeMy WebLinkAbout2018-213-E DSS - Interfaith Council outside agency agreement DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 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 Inter-Faith Council for Social Services, Inc., a not- for-profit corporation, located at 110 West Main Street, Carrboro,NC 27514("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 Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1,2018 to June 30,2419. 2. Scope of Services. a. Provider will provide services to the residents of Orange County, as outlined in the Outside Agency Funding Application and any amendments or revision thereto (Exhibit "A") and Emergency Assistance Scope of Work ("Exhibit B"), both of which are attached and hereby incorporated into this document as if set out herein. The Scope of Services in Exhibit A 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 C. 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 funds for the provision of services described in Exhibit A, Scope of Services, and more particularly described in the Program Budget or Revised Program Budget, the maximum sum of Fifty Five Thousand, One Hundred and Fifty Dollars ($55,150). The County also agrees to appropriate funds for the provision of services described in Exhibit B, the maximum sum of Eighty Five Thousand Dolloars ($85,004). The total amounted appropriated by the County to Provider for these services shall be One Hundred and Forty Thousand,One Hundred and Fifty Dollars($140,150). b. All funds appropriated shall be used for purposes described in Exhibit A and 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 provided in Exhibits A and B, at the discretion of the County the Provider may be required to repay the funds to the County. c. Funds Appropriated for Outside Agency Funding(Exhibit A)Services. Inter Faith Council far Social Services, Inc. Orange County Outside Agency Performance Agreement Revised77I20 M DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 i. For funds appropriated for Exhibit A services, the Provider shall be paid in four equal installments in the amount of $13,787.50. 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. ii. 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. iii. Once Provider has satisfied its obligations as provided in c.1. above 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. d. Funds Appropriated for Emergency Assistance(Exhibit B) Services. i. For funds appropriated for Exhibit B services, the County will reimburse Provider for services described in Exhibit B up to the limits allocated by this Agreement. Provider shall only be reimbursed for actual expenditures for approved services. ii. For reimbursement, Provider must submit copies of bills, checks, receipts and/or other proof of expenditures to the person designated by the County. Reimbursement will be provided bimonthly. iii. For reimbursement of staff costs, Provider shall submit the payment records for staff cost. The County will reimburse the Provider monthly upon receipt of a complete and correctly filed report. e. 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 15,and July 8 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. S. 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: L 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 2 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 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. 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 3 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 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: Grange 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. 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. S. 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 4 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 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. Nan-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 park 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 Provider 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: County: Provider: Nancy Coston Executive Director Department of Social Services The Inter-Faith Council for Social Orange County Service,Inc. Post Office Box 8181 110 W. Main Street Hillsborough,North Carolina 27278 Carrboro,North Carolina 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. 5 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 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/departTnents/purchasing_Aivision/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 I IA 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. T1 DocuSigned by: If of*lhe Provider lL lu&s 10/10/2018 @317305AEFF04A9... Jackie Jenks,Executive Director Date �__--- --- .._ L-1.-111, .rn. .,lOdl1t Vf)VL'rldH1L?►1f I DocuSigned by: 1 b1nJV (, RAaMiMf.YS�f.+� 10/14/2018 (]037994@755E477... r t3onnle tiammersiey,county Manager Date 6 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Inter-f=aith Council for Social Service Applicant Organization's Physical Address: 110 W. Main Street, Carrboro, NC 27510 Applicant Organization's Mailing Address: 110 W. Main Street, Carrboro, NC 27510 Applicant Organization's Web Address:www.ifcweb.or Executive Director: Jackie,Jenks Telephone Number: (919) 929-8360 x14 E-Mail: iienkspifcmailbox.org Tax ID Number; 591224041 b) Funding Request List all FY18-19 Human Services WS) 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 Coup -HS Homelessness Prevention and Emergency $2,000 $10,000 $5,000 $17,000 Assistance: Rent and utility assistance;clothing and transportation vouchers; essential medication purchase',counsel, information and referrals Shelters: The only shelters in Orange County. $4,000 $15,000 $45,000 $64,000 HomeStart for 14 women and 10 families, Community House for 52 men, and up to 20 additional people during inclement weather Permanent Supportive Housing: Housing $10,000 $10,000 subsidies in market-rate units and case management for the County's most vulnerable residents Food security Programs: Food provision in Chapel $9,000 $10,000 $40,000 $59,000 Hill and Carrboro through the Community Kitchen (hot meals every day) and the Food Pantry roceries as often as monthly to neighbors in need Totals $15,000 $35,000 $100,000 $150,000 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: JkJUL � - 1123/18 Executive Director Date ,Signature: 1123118 Board Chairperson Date Agency Information 1/2312018 2:06:13 PM P gc-,, 2 o f 3 7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 Grange 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. Not applicable 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: J"-Az 1123118 Executive Director Date Signature.. 1123118 Board Chairperson Date ...... ......_......... ._ . Agency Information 1/23/2018 2:{}6:13 PM Page 3 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 2. AGENCY INFORMATION (Be Very Brief and Concise) Please provide the fallowing information about your agency(2 pages OR LESS): a) Years in Operation, [late of Incorporation (MonthlYear): IFC was founded in 1963 and has been operating for 55 years. It was incorporated in November 1975. b) Agency's Purpose/Mission (no more than a few sentences): IFC confronts the causes and responds to the effects of poverty in our community. We believe in a community where everyone's basic needs are met, including dignified and affordable housing, an abundance of healthy food, and meaningful social connection. c) Types of Services the Agency Provides (bullet format): IFC is a lead provider of safety-net services for Orange County, including the Towns of Chapel Hill and Carrboro. Services include: • Homelessness Prevention and Emergency Assistance: Rent and utility assistance; clothing and transportation vouchers; essential medication purchase; counsel, information and referrals • Shelter: The only shelters in Change County. HomeStart for 14 women and 10 families, Community House for 52 men, and up to 20 additional people during inclement weather • Permanent Supportive Housing: Housing subsidies in market-rate units and case management for the County's most vulnerable residents • Food Security Programs: Primary food provider in Chapel Hill and Carrboro through the Community Kitchen (hot meals every day) and the Food Pantry (groceries as often as monthly to neighbors in need) • Rapid Re-Housing Program: Short-term housing assistance and case management for homeless residents d) Agency's History with Providing These Services: In 1963, seven local women united to address the conditions of poverty in Chapel Hill and Carrboro through the coordinated efforts of volunteers. Since then, IFC has become the primary provider of basic needs services for people living and/or working in Chapel Hill and Carrboro. Originally a volunteer-run organization, IFC has built our capacity to respond quickly and competently to the diverse needs of the lowest income residents and workers in our community. 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 the past year, IFC filled a trio of key leadership positions. Following a nationwide search for its next Executive Director, IFC hired Jackie Jenks, MSW, who started in April 2617 and brings extensive, relevant experience. The organization rebuilt its finance and operations team, now under the seasoned leadership of Jeffrey Causey, MPA and CPA. IFC also hired Anna MacDonald, MDiv/MSW, as its first Development _... - .......... _ Agency Information 1/23/2018 2:46:13 PM Page 4 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Director in a decade to strategically engage the community. The Board of Directors and Executive Director Emeritus John Dorward have been invaluable in the transition, transferring relationships and institutional knowledge. Although our newest program is not a part of this funding request, IFC is in the process of subsuming the County's Rapid Re-Housing program, which was previously housed at the Orange County Department of Social. Services. This program integrates well into our continuum of services for community members experiencing homelessness by providing financial assistance and case management to those who need short-term support. f) Schedule of Positions (Far 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 IFTE 2,080 #of FTE - Full-Time Paid Positions: 28 #of FTE -Paid Part-Time Positions: 7 #of Volunteers:750 #of FTE -Volunteers: 14 g) Living Wage Does this agency pay permanent employees a minimum living wage? (Yes I No) Yes If yes, is this agency an Orange County Living Wage Certified Em la er?Yes If no, please explain. Agency Information 1123/2018 2:06:13 PM P a g e 5 o f 3 7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 h) Agency Budget i. Is your agency currently receiving and/or requesting other(non-Human Services) local (Town of Carrboro, Town of Chapel Hill, Change County) government funding? (Yes/No) Yes. IFC is also requesting capital funds for our new FeodFirst Building. We request one-time construction costs (including architecture and engineering fees) over and above the annual operating support needed for our programs. Funds may be granted as pledges to be paid over three years. 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 7-18 FYI 8-19 Source Award Request FeodFirst Building (over 3 years) $0 $150,000 Carrboro—Capital Funds FoodFirst Building (over 3 years) $0 $300,000 Chapel Hill—Capital Funds FoodFirst Building (over 3 years) $0 $300,000 Orange County -Capital Funds `Add rows or attach additional page, if needed. il. Submit your agency's budget. You may complete the provided template (separate xis 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). Attached Agency Budgets are required to define budget amounts for the previous program year, current program year, and next program year for the following categories: • Revenues o Private Donations o Program Generated Revenue * 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 © Other Revenue • Expenditures o Compensation o Rent & Utilities o Supplies & Equipment o Travel &Training o Other Expenses ..... ...-.........- Agency Information 1/23/2018 2:06:13 PM Page 6 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 iii, Does your agency budget show a Surplus or Deficit? No not for the current or future ears, There was a deficit in FY17 due to multiple transitions in leadership positions that required engaging temporary staff, a search firm, and other unforeseen expenses. We are on budget thus far for FY18 and are tracking revenue and expenses closely. Is there a significant change? Yes/No Yes Please provide a brief explanation for Surplus or Deficit, and significant changes. In FY18, IFC lost significant funding from both United Way and the Federal Access to Recovery program. Due to its own hardships, United Way reduced IFC's allocation by $36,000, and we have been notified of another $12,000 reduction for FY19. The Federal Access to Recovery program, which funded case management for IFC residents, ended its program after a three-year funding cycle - a $72,000 reduction for IFC. IFC operates on a tight budget, and this combined loss of$120,000 represents 6 percent of our annual budget. We are committed to providing for the basic needs of Orange County residents and workers, so we must explore all options. IFC has hired a Development Director and increased our fundraising goals; we must also request additional support from our government partners. iv. What is your agency's fiscal year? J u ly 1 2018 th ro ug h June 30 2019 (Example: July 9, 2096 through June 30, 2017) Agency Information 1/23/2018 2:06:13 PM Page 7 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Agency Budget Operating Budget for Entire Agency AGENCY NAME: IFC Actual Estimated Projected 7098 Percent AGENCY REVENUE 2016-17 2047-18 19 Change Private Donations $ 1,407,135 $ 1,295,863 $ 1,354,532 5% Agency Generated Revenue(fees) $ - $ - $ 20,466 0 Local Government Grants: Human Services-Town of Carrboro $ 11,950 $ 11,950 $ 15,000 26% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 31,585 $ 25,000 $ 35,000 40% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-grange County $ 48,910 $ 50,000 $ 100,000 100% Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ 103,641 $ 85,826 . $ 35,000 -59% State Government $ 76,674 $ 34,868 $ 34,868 0% Federal Government(CDBGIHOMEIetc.) I $ 22,698 $ 177,980 $ 190,812 7°Io Private Foundation Grants $ 26,850 $ 68,350 $ 68,350 0% Other Revenue $ 132,736 $ 272,846 $ 249,563 -9% Total Agency Revenue $ 1,862,'18'1 $ 2,022,+683 $ 2,103,591 4% AGENCY EXPENSES Compensation $ 1,387,742 $ 1,402,661 $ 1,458,767 4% Rent&Utilities $ 79,175 $ 87,786 $ 91,297 4% Supplies&Equipment $ 74,603 $ 61,715 $ 64,185 4% Travel &Training $ 7,139 $ 1,940 $ 2,018 4% Other Expenses: $ 618,929 $ 468,580 $ 487,323 4% MM Total Agency Expenses $ 2,167,588 $ 2,022,683 $ 2,103,590 4% SURPLUS/(DEFICIT) FOR PERIOD: $ (305,407) $ - 1 $ 0 0 FY 2018-19 Agency Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Program Budget Operating Budget for Program PROGRAM NAME: JFC - Homeless Prevention/Emergency Assistance Programs Actual Estimated Projected Percent PROGRAM REVENUE 2016-17 2017-18 2018-19 Change Private Donations $ 342,434 $ 308,571 $ 349,443 13% Program Generated Revenue $ - $ 523 $ 549 5% Local Government Grants: Human Services-Town of Carrboro $ - $ 239 $ 2,000 737% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ - $ 500 $ 10,000 1800%0 Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ - $ 1,000 $ 5,000 400% Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ - $ - 0 Other Government:Grants Triangle United Way $ 11,454 $ 2,571 $ - -100% State Government $ 54,619 $ 19,200 $ - -100% Federal Government(CDBG/H0ME1etc.) $ - $ - I $ - 0 Private Foundation Grants $ 25,985 $ 68,350 1 $ 50,000 1 -27% Other Revenue $ 440 $ - I $ - 0 Total Program Revenue $ 434,932 1 $ 400,954 $ 41+6,992 4% PROGRAM EXPENSES Compensation $ 295,350 $ 254,812 $ 265,004 40/. Rent&Utilities $ - $ - $ - 0 Supplies&Equipment $ 562 $ 5,900 $ 6,136 4% Travel&Training $ 656 $ - $ - 0 Other Expenses: $ 138,365 $ 140,242 $ 145,852 4% Total Program Expenses $ 434,933 1 $ 400,954 $ 416,992 4°Io SURPLUSI(DEFIGIT) FOR PERIOD: 1 $ (0) $ - $ (0) 0 FY 2018-19 Program Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Program Budget Operating Budget for Program PROGRAM NAME lFC -Shelters Actual Estimated 2497- Projected 2018 Percent PROGRAM REVENUE 2016-17 18 19 Chan e Private Donations $ 475,015 $ 381,709 $ 406,854 7% Program Generated Revenue $ 18,968 $ 18,968 $ 19,916 5% Local Government Grants: Human Services-Town of Carrboro $ 8,485 $ 8,485 $ 4,000 -53% Other Town of Carrboro $ - $ - $ - 0 Human Services-'Town of Chapel Hill $ 17,750 $ 17,750 $ 15,000 -15% Other-Town of Chapel Hill $ - $ $ 0 Human Services-Orange County $ 35,500 $ 35,500 $ 45,000 27%° Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ 22,055 $ 34,868 $ 34,_868 0°e° Federal Government(CDBGIHOMEletc.) $ - $ - $ - 0 Private Foundation Grants $ 151,558 $ 151,558 $ 159,136 Other Revenue $ 259,576 $ 249,563 $ 249,563 $ - Total Program Revenge $ 988,907 $ 898,401 $ 934,337 4% PROGRAM EXPENSES Compensation $ 760,823 $ 729,688 $ 758,876 4%° Rent&Utilities $ 63,282 $ 87,286 $ 90,777 4% Supplies&Equipment $ 24,080 $ 47,131 $ 49,016 4%° Travel&Training $ 3,498 $ - $ - 0 Other Expenses: $ 137,225 $ 34,296 $ 35,668 4%° Total Program Expenses $ 988,907 $ 898,401 $ 934,337 4%, SURPLUS/(DEFICIT) FOR PERIOD: 1 $ 0 Is - $ (0)1 701 FY 2018-19 Program Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Program Budget Operating Budget for Program PROGRAM NAME IFC-Permanent Supportive Housing Actual Estimated Projected Percent PROGRAM REVENUE 2016-17 2017-18 2018-19 Change Private Donations $ - $ - $ ° 0 Program Generated Revenue $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ - $ - $ - 0 Other-Town of Carrboro $ $ - $ - 0 Human Services-Town of Chapel Hill $ - $ - - 0 Other-Town of Chapel Hill $ $ - $ - 0 Human Services-Orange County $ - $ - $ 10,000 0 Other-Orange County $ - $ - $ - 0. Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ - $ - $ 0 Federal Government(CDBGIHOMEIetc.) $ - $ 145,948 $ 145,948 0% Private Foundation Grants $ - $ - $ - 0 Other Revenue $ - $ - $ - 0 Total Program Revenue $ - $ '145,948 $ '155,948 7% PROGRAM EXPENSES Compensation $ - $ 5'2,438 $ 54,536 4% Rent&Utilities $ - $ - $ - 0 Supplies&Equipment $ - $ 7,853 $ 7,538 -4% Travel&Training $ - $ 1,440 $ 1,498 4% Other Expenses: $ - $ 84,217 $ 92,377 10% Total Program Expenses $ - $ '145,948 $ 155,948 70 SURRPLUS!(DEFICITy FOR PERIOD: $ - $ - $ 0 0 FY 2018-19 Program Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Program Budget Operating Budget for Program PROGRAM NAME IFC -Food Security Programs Actual Estimated Projected Percent PROGRAM REVENUE 2016-17 2417-18 2018-19 Change Private Donations $ - $ 299,159 $ 284,150 -5% Program Generated Revenue $ - $ 7,113 $ 7,469 5% Local Government Grants: Human Services-Town of Carrboro $ - $ 3,227 $ 9,000 179% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ - $ 6,750 $ 10,000 48% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ - $ 13,500 $ 40,000 196% Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ 31,355 $ 6,999 $ - -100% State Government $ - I $ - $ - 0 Federal Government(CDBGIHOMEIetc.) $ - $ - $ - 0 Private Foundation Grants $ - $ - $ - 0 Other Revenue $ - $ 10,000 $ 10,000 0% Total Program Revenue $ 31,365 1 $ 346,748 $ 360,618 4°Io PROGRAM EXPENSES Compensation $ - $ 282,024 $ 293,305 4% Rent&Utilities $ - $ 1,236 $ 1,285 4% Supplies&Equipment $ 30 $ 5,38E $ 5,601 4% Travel&Training $ - $ 102 $ 106 4% Other Expenses: $ 31,324 $ 58,000 $ 60,320 1 4% Total Program Expenses $ 31,355 $ 346,748 $ 360,618 4°.1 SURPI_USf(DEFiCIT) FOR PERIOD: 1 $ 0 $ - $ 0 0 FY 2018-19 Program Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Homelessness Prevention and Emergency Assistance Program Program Primary Contact and Title: Kristin Lavergne, Community Services Director Telephone Number: 919-929-6380, x41 E-Mail: Wavergne @ifcmailbox.orq a) Indicate the type of Human Service Needs Priority, if program applicable: X Priority Area#1: safety-net services for disadvantaged residents ❑ Priority Area#2: education, mentorship, and afterschool programming for youth facing a variety of challenges X 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 x X x X x Affordable Healthcare Education Family Resources x x x x x Jobs/Jobs Training Fond Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinatesicol la bo rates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated/collaborative efforts. • Orange County Department of Social Services: IFC coordinates with and refers members for Emergency Assistance and other DSS programs. • Book Harvest: IFC has distributed more than 37,000 books provided by Book Harvest in the last 7 years. • PTA Thrift Shop and Club Nova Thrift Shop: Both thrift shops generously provide IFC members with vouchers to be redeemed for clothing from their stores. • Blanket Orange County_: IFC has distributed the majority of more than 3,000 blankets collected by Blanket Orange County in the last 13 years. Agency Information 112312018 2:06:13 PM Page 8 of o7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Duke Energy: IFC receives monies from Duke Energy's Share the Warmth and Share the Cool, which supports households in keeping their electric service active. It also allows IFC to purchase and distribute fans and heaters to member households. • OWASA: IFC receives monies from OWASA's Care to Share Program, which supports households in keeping their water service active. • Local Optometrists: IFC partners with several local optometrists who provide eye exams free of charge to those without insurance. This allows IFC to focus limited resources on the purchase of glasses. 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 Homelessness Prevention and Emergency Assistance Program helps residents maintain housing by alleviating acute financial stress and supporting households that face eviction, disconnection of utilities, lack of resources and inability to meet basic needs. People who live or work in Chapel Hill or Carrboro are eligible for services. Rent and Utility Assistance Staff schedule 10 appointments for the week every Tuesday. Assistance ranges from $150-$250, and households are eligible to request help once every 18 months. Emergency Assistance Some individuals are unable to meet acute needs for clothing, transportation, identification, essential medications, or information and referrals. Members can choose a "first come-first served" system Monday-Friday mornings or call on Monday to schedule an afternoon appointment that week. Appointments, which are staffed by volunteers, are usually full by 5 p.m. on Monday. Evening hours are provided through a special collaboration with UNC-Chapel Hill students, who volunteer to keep the program open until 7 p.m. two weekdays during the academic year for "Project Rush Hour." The first goal of the Board of Change County Commissioners is to ensure a community network of basic human services and infrastructure that maintains, protects, and promotes the well-being of all county residents. IFC provides safety-net services by alleviating financial stress for disadvantaged residents and low-income workers, so they can dedicate their resources to maintaining housing, health and well-being. e) Describe the community need or problem to be addressed in relation to the Ch_ aoel Hill Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of Chapel Hill Council Goals, Carrboro Sward 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. Agency Information 1/23/2018 2'.06:13 PM P a g e 9 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Both of the Towns and the County refer to affordable housing as a community need and goal or priority in their respective plans. The Carrboro Board of Aldermen encourages development that is compact, dense, and appeals to diverse lifestyles and incomes. In its 2016-2018 goals, the Chapel Hill Town Council stated its desire to create a place for everyone and to adopt and support affordable housing programs, projects and policies that increase our diversity in income, race, age and lifestyle. The Board of County Commissioners set a goal to provide decent, standard housing options for all residents regardless of household income level. Despite these priorities, low income residents of Carrbore, Chapel Hill, and Orange County struggle. Even if people make a living wage of$13.70 per hour, with a median gross rent of$970 in Orange County (as reported by Census 2012-2016), that household is paying 41 percent of its income toward housing costs. This is well above the one-third threshold recommended by federal housing subsidy programs and impedes a family's ability to meet basic needs beyond housing. By providing assistance to alleviate financial stress, IFC — in partnership with other Orange County organizations — prevents homelessness, helps meet basic needs, and ultimately ensures a diverse community. This work is in alignment with County and Town priorities. fj Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? The Homelessness Prevention and Emergency Assistance Program serves households in our community who struggle to maintain housing or meet other basic deeds. Individuals may self-refer. Information about IFC services is also shared widely, especially with other community agencies, including the Orange County Department of Social Services. The Orange County Partnership to End Homelessness, Inter-Church Housing Corporation, Community Empowerment Fund, and various congregations list IFC as a resource. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) The Community Services Director has a Masters of Social Work from UNC-Chapel Hill and has worked at IFC for 23 years. Three Client Services Representatives coordinate with each other and volunteers to operate the program on a daily basis. Volunteers serve various essential functions, including reception, administration, and client interviewing. Volunteers are screened and placed with program staff by the Volunteer Coordinator. Training for positions is hands-on and involves shadowing staff or seasoned volunteers. Agency Information 1/2312018 2:06:13 PM P a g e 1 0 o f 3 7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 h) Describe the specific period over which the activities will be carried out and include an implementation timeline. This program is ongoing through FY 19. 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) Inability to pay rent and utilities inevitably results in housing loss. While housing loss does not always lead immediately to homelessness, it is often the first step in a downward spiral. Without housing, jobs can be lost, the good will of friends and relatives can be tested and found wanting. When all resources are exhausted, homelessness occurs and emergency shelter assistance is needed. Furthermore, without resources, housing relocation is particularly challenging (The National Alliance to End Homelessness, Homelessness Prevention manual, July 2009). Being able to intervene before a situation spirals saves time and resources and spares families from the trauma of losing their home. Both Town governments have expressed interest in fostering a diverse, Inclusive community, which depends on addressing challenges that make it difficult for all to live in and be part of Orange County. If people are not in stable living situations, then achieving other goals, including participating fully in community life, will be much more difficult. IFC's Homelessness Prevention and Emergency Assistance Program is a primary means of addressing these goals. 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, we would consider reducing the hours we are open and the number of appointments we offer. This would present a hardship, especially for many members who work and need to access assistance during their off time. We would also consider reducing the number of people who receive assistance. This would present a great hardship to the community, given that we are already unable to meet the need for rent and utilities assistance. The worst scenario would be that IFC would have to close one program completely. k) What percentage of your target population is low-moderate income? 100 percent 1) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc.?) IFC has a suggestion box in the program's waiting area, and suggestions are reviewed monthly at staff meetings. IFC conducts periodic surveys to secure input about current services, unmet needs, and future plans. 1FC also has a more formal process by which members can voice serious complaints.. m) Include any other pertinent information. Every week, more households — as many as five — than IFC can accommodate request rent and utilities assistance. These community members are at greater risk of losing their housing or going without heat or water for some time. Agency Information 1/23/2018 2:06:13 PM Page 11 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Additional Program Information ny 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 627 621 625 Female 902 893 900 Total 1529 1514 1525 Ethnicity African-American 899 890 890 American Indian or Alaska Native 9 8 10 Asian 6 7 10 Caucasian 506 501 500 Native Hawaiian or other Pacific Islander 16 12 15 Other: specify_Multitraciallunknown 93 96 100 Total 1529 1514 1525 Of the above, how many Hispanic/Latino 168 167 185 Of the above, how many non-Hispanic/Latino 1361 1347 1340 Total 1529 1514 1525 Age 0-5 years 0 0 0 6-18 years 15 15 15 19-50 years 9012 893 900 51+years 612 606 61(1 Total 1529 1514 1525 Geographic Location Alamance County 2 2 2 Chatham County 31 30 31 Durham County 31 30 30 Wake County 2 2 2 Grange County Breakdown Chapel Hill Public Housing not tracked not tracked not tracked Town of Chapel Hill 1024* 1014* 1025* Town of Carrboro 382 379 390 Town of Hillsborough not tracked not tracked not tracked City of Mebane (Orange County) not tracked not tracked Orange County(Outside Municipalities) 31*' 5"" Other 26*'* 27"** 20"* Total 1529 1514 1525 *includes all of Chapel Hill(Public Housing residents and non-Public Housing residents) **Includes Hillsborough, Mebane, outside municipalities and excludes Chapel Hill and Carrboro 'People who reported as homeless or stranded and did not claim a jurisdiction Agency Information 112312018 2:06:13 PM Page 12 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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(,�pecific, 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 1001 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 Homelessness Prevention and Emergency Assistance Program: Rent and Utility Assistance, Basic Needs Services 1. Program Activity Name Homelessness Prevention and Emergency Assistance: Rent and Utility Assistance Program Goal Prevent eviction or disconnection of utility services for member households Performance Measures Track the number of fulfilled requests for assistance Previous Year Program Results 477 fulfilled requests Current Year Estimated Results 550 fulfilled requests Next Year Projected Results 550 fulfilled requests 2. Program Activity Name Homelessness Prevention and Emergency Assistance: 'Basic Needs Services Program Goal Support member'households with basic unmet needs Performance Measures Track the number of fulfilled requests for assistance Previous Year Program Results 1,052 fulfilled requests.._. Current Year Estimated Results 950 fulfilled requests Next Year Projected Results 1 950 fulfilled re uests py Program Budget 1. Submit your program budget. You may complete the provided template (separate x1s 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). Attached 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 Agency Information 1123]2018 2:06:13 PM P a g e 1 3 o f 3 7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • 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(CDBGfHOMEletc.) • Private Foundation Grants • Other Revenue • Expenditures o Compensation o Rent & Utilities • Supplies & Equipment • Travel &Training • Other Expenses 2. Program Budget Detail— Provide description of"other" budget items, not defined. Other budget items include telephone and network support, insurance, and pest control. The majority is direct assistance to program members for rent, utilities, essential medication, and other assistance. 3. This program budget represents what percent of the agency budget?20 percent 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 201+ -17 Estimated 2017-18 Projected 2018-15 Total Cost of Program $434,933 $400,954 $416,992 Total#of Individuals 1,529 1,514 1,525 Cost Per Individual $284 $264 $273 ----.... .... ........ .. Agency Information 1/23/2018 2:06:13 PM Page 14 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 3, PROGRAM INFORMATION (Submita separate Section 3 for each program) Program Name: Shelters Program Primary Contact and Title: Stephani Kilpatrick, Residential Services Director Telephone Number: 919.967.1086 x 12 E-Mail: skilpatrick @ifcmailbox.org a) indicate the type of Human Service Needs Priority, if program applicable: X Priority Area#1: safety-net services for disadvantaged residents F-1 Priority Area#2: education, mentorship, and afterschool programming for youth facing a variety of challenges X 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 Housinq x x x x Affordable Healthcare x x x x Education Family Resources x x x x Jobs/Jobs Training x x x Food x x x x Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated/collaborative efforts. To provide shelter facilities, I F C partners with • Orange County, which provides a no-cost, 25-year lease of three acres of land where HomeStart sits. We also collaborate with the County on the Emergency Solutions Grant, an essential funding source. • The Town of Chapel Hill, together with IJNC-Chapel Hill, which provides a 50-year lease for the IFC cx SECU Community House property. To improve systems of care by collaboration, IFC staff participate in • Oran-ge County Partnership to End Homelessness Leadership Team • Grande County Affordable Housing Coalition IBC? NOT SUBMIT THIS PAGE 1/2312018 2:06:13 PM Page 15 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Orange County Partnership to End Homelessness HOME Committee, which includes Orange County Project Connect, the annual Point-In-Time Counts, and planning for the Orange County Coordinated Entry system • IFC recruits and maintains cooking groups from congregations, neighborhoods, the university and businesses to prepare and serve meals at HomeStart and Community House To ensure resident access to resources and to ultimately support permanent housing goals, IFC partners with and makes referrals to • UNC Hospitals and Student Health Action Coalition SHAG} Clinic via a memorandum of understanding to provide in-kind medical care for residents through charity care and pharmacy assistance. • Piedmont Health Services through a co-located medical, mental health and dental clinic at Community House, providing an opportunity for sustained access to health care for all 1FC residents, • Orange County SOAR for residents eligible for SSI/SSDI benefits. • Community Empowerment Fund (CEF), which offers financial education, matching funds savings accounts, job and housing search help, and other services. •Veterans Administration for homeless veterans via referral. • Freedom House via memorandum of understanding for in-kind services, the Horizons Program at UNC-Chapel Hill, and AA/NA groups, which support residents with addiction and substance use issues. • Compass Center, which provides domestic violence workshops at HomeStart for both women and children. We provide a safe space for survivors to be housed, when appropriate. • The Furniture Project, organized by St. Thomas More volunteers and supported by IFC since its inception, which helps furnish homes for residents moving into housing. • PTA Thrift Shop and Club Nova Thrift Sho , which provides clothing vouchers valued at $100-150 for residents. • A Lotta Love, a local non-profit that redecorates HomeStart rooms and provides linens and other household items new HomeStart residents need. • TABLE, which delivers weekend backpack food on-site to eligible students living at HomeStart. 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 Orange County's only provider of shelter services for community members experiencing homelessness, iFC's shelters work toward Town and County goals of affordable housing, including emergency &transitional housing, as well as the goal to create a place for everyone. IFC's 24-hour residential programs offer safe living accommodations, meals, showers, and laundry facilities. Community House shelters 52 men, with an additional 17 cots available on inclement weather nights. HomeStart shelters 14 women and 10 families, with an additional 3 cots available on DO NOT SUBMIT THIS PAGE 1/23/2018 2:05:13 PM P a g e 16 c f 3 °i DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 inclement weather nights. HomeStart was a direct outcome of a 1994 Orange County Emergency Family Shelter Task Force. IFC Case Managers work toward the goal of increasing access to services through coordination and communication, increasing communication of services and how to access them, and improving coordination of services, including additional substance abuse services. Community House and HomeStart provide an array of services including job coaching and referrals to community agencies for a variety of helpful resources such as substance use treatment, clothing, identification, child care, and health insurance. IFC Residential Programs have one part-time and two full-time, plus eight volunteer Case Managers who meet with residents to establish a plan and connect them to relevant resources. Case management that empowers individuals and families is key to overcoming homelessness. Volunteer opportunities„ which increase community engagement and introduce the community to human services needs, include reception and administration, meal groups, and case managers. e) Describe the community need or problem to be addressed in relation to the Chanel Hill Human Services Needs Assessment, Orange Counly 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. In accordance with the Towns' and County's goal of affordable housing and creating a space for everyone, Community House and HomeStart provide emergency shelter and transitional housing for homeless individuals and families. We routinely have more requests for shelter than we can accommodate. The Point-in- Time Count in January 2017 found 127 homeless individuals in Orange County, up from 80 in 2016. In FY17, IFC provided shelter to 136 men, 80 women, and 54 children (unduplicated individuals). We provided an additional 98 men and 10 women with inclement weather shelter during the cold months. Through partnerships with Piedmont Health Services (PHS), UNC Health Care, Freedom House, and UNC Horizons, we work toward the goal of affordable healthcare, including additional healthcare options and additional mental health service options and additional substance abuse services. PHS has a satellite clinic located in Community House and this means that residents of both Community House and HomeStart have an easily-accessible clinic with consistent treatment providers. We also routinely make referrals to Freedom House for substance abuse services, as well as receive referrals from Freedom House to shelter their clients experiencing homelessness. Many of our family shelter referrals come from UNC Horizons, a substance abuse treatment program. f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM P a g e 1 7 o f 3 7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 IFC's shelters target community members who are homeless, whether due to lack of affordable housing, domestic violence, eviction, unemployment, low-paying jobs, mental illness, lack of support services or social supports, medical debt, and/or substance use. Individuals may self-refer, and we also accept referrals from community agencies, including Orange County Department of Social Services and Compass Center.We are on the Community Resources list put together by the Orange County Partnership to End Homelessness (OCPEH). We are working closely with OCPEH to create a Coordinated Entry system so that individuals experiencing homelessness have a clear path to obtaining shelter, with the burden taken off of the individual who is in crisis. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) Our Residential Services Director holds an MSW from UNC-Chapel Hill and has worked for IFC for more than 7 years. She oversees both 24-hour residential facilities and a staff of 10 full-time and 11 part-time employees: two Program Managers, three Case Managers, one Kitchen Coordinator, and 13 Residential Staff. The Program Managers hold MSW degrees and supervise Case Managers, Residential Staff, and volunteers responsible for daily operation of the facilities. Volunteers are evaluated based on skills and interest. They then receive overall agency orientation and shadow staff or seasoned volunteers during training. h) Describe the specific period over which the activities will be carried out and include an implementation timeline. Activities are ongoing during FY19. HomeStart and Community House are 24-hour facilities, open 365 days per year. Approximately 92 hours per week of case management services are available to residents. These programs operates regardless of weather conditions and increase capacity during inclement weather. i) Why is funding this program a good investment for the community? How does funding this program add value to the community? (259 words OR LESS) IFC is the sole provider of homeless shelters in Orange County. Without Community House and HomeStart, Orange County residents experiencing homelessness would be on the streets or displaced to surrounding counties, making it nearly impossible for them to maintain employment and make other economic and cultural contributions in Orange County. Furthermore, IFC's shelters and case management help defray high costs and unnecessary use of emergency interventions resulting from homelessness, such as emergency room visits, law enforcement interactions, and court resources. IFC has a long-standing track record of leveraging private financial and volunteer support to fill a gap in service provision that in many jurisdictions is almost fully supported by a combination of federal, state and local government funding. IFC's continued movement toward best practices will bring the Towns and County more in line with HUD goals to end homelessness, subsequently increasing funding DO NOT SUBMIT THIS PAGE 1123/2018 2;06:13 PM P a g e 18 of t . DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 eligibility. Our staff has increased efforts in collaboration with service providers to map services and develop a comprehensive local plan to end homelessness. IFC also enables Orange County to access funding through the Continuum of Care grant from the Department of Housing and Urban Development and the North Carolina Department of Health and Human Services Emergency Solutions Grant. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. iFC leverages a significant amount of funding from non-governmental sources and increases that amount annually, but private funding cannot cover the increasing cost of providing 24-hour shelter services for 90+ people on a given day. IFC depends on our government partners to join with us in assuring that your community's most low- income residents have a place to stay and a path to housing. As the only provider of shelter in the County, IFC must maintain its shelter capacity and hours of operation. Inability to fully fund our shelter programs would be devastating to the community. In addition, IFC must respond to requirements of other fenders and move into compliance with best practices. A leading grantor of homeless services, the North Carolina Department of Health and Human Services, has recommended that IFC "move towards Housing First best practices" to maintain eligibility for the Emergency Solutions Grant. This includes being a iow-barrier shelter, but we are not able to meet this recommendation with our current level of funding and staffing. Not only do we need more resources to continue the bare-bones operation we currently have in place, but in order to excel at service delivery as strongly recommended by existing grantors, we must increase our funding. IFC is committed to helping Orange County provide the best possible services to residents experiencing homelessness to help them achieve housing. We need additional funds to move closer to this goal. kj What percentage of your target population is low-moderate income? 100 percent 1) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc.?) IFC includes shelter residents in policy and procedure decision-making. We hold regular House Meetings, have a complaint and appeal processes, and conduct resident exit interviews for feedback. We also have a confidential box where residents can leave notes, which are reviewed by Program Managers. We have a new community building project called Meeting of the Minds where designated staff mobilize resident leaders to assess and advocate for their needs within the shelters and beyond. Changes made as a result of resident advocacy include increasing residents' access to their rooms and belongings, changing curfew hours, providing additional cold food storage, and enabling more resident autonomy. We have at least one current or former client on our Board of Directors. When hiring our Executive Director and other key staff positions, we include residents in the process to ask interview questions and evaluate candidates. m) Include any other pertinent information. DO NOT SUBMIT THiS PAGE 1/23/2018 2:06:13 PM Page 19 of 3 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Additional Program Information n) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, Program Target Population Demographics Actual Estimated Projected 2416-17 2017-18 2018-19 Gender Male 164* 200 220 Female 106* 104 115 Total 270 304 335 Ethnicity African-American 161 182 201 American Indian or Alaska Native 8 9 10 Asian 2 3 3 Caucasian 94 106 117 Native Hawaiian or other Pacific [slander 1 1 0 Other: specify Hispanic 4 3 4 Total 270 304 335 Of the above, how many Hispanic/Latino 4 2 3 Of the above, how many non-Hispanic/Latino 266 302 332 Total 270 304 335 Age 0-5 years 29 35 37 6-18 years 25 27 30 19-50 years 133 148 164 51+ years 83 94 104 Total 270 304 335 Geographic Location Alamance County 23** 26 28 Chatham County 23** 26 28 Durham County 39 43 47 Wake County 27 30 34 Orange County Breakdown Chapel Hill Public Housing Town of Chapel Hill (Non-Public Housing) 134 152 168 Town of Carrboro 10 12 13 Town of Hillsborough City of Mebane(Orange County) Orange County(Outside Municipalities) 14 15 17 Total 270 3041 335 *Includes adults and children "This is an estimate, as we do not collect data on Alamance and Chatham Counties DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 2 0 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 I Program Activity, which should be SMART (,apecific, 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 Shelters 1. Program Activity Name Shelters Program Goal Community House and HomeStart will provide safe shelter and case management to support residents in obtaining permanent housing Performance Measures Information logged into HMIS and internal databases Previous Year Program Results 270 homeless persons received shelter Current Year Estimated Results 304 homeless persons receive shelter, with access to full- time Case Managers Next Year Projected Results 335 homeless persons receive shelter, with access to full- time Case Managers p) Program Budget 5. 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). Attached 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 Program Generated Revenue * Local Government Grants ■ Carrboro Human Services ■ Carrboro Other ■ Chapel Hill Human Services ■ Chapel Hill Other(DO NOT include CDRG funding here) ■ Change County Human Services ■ Orange County Other(DO NOT include HOME funding here) DO NOT SUBMIT THIS PAGE 1/23/2018 2:05:13 PM Page 21 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBGIHOMEIetc.) • Private Foundation Grants • Other Revenue • Expenditures • Compensation • Rent& Utilities • Supplies & Equipment • Travel &Training • Other Expenses 6. Program Budget Detail —Provide description of"other" budget items, not defined. Other budget items for this program include telephone and network support, insurance, pest control, equipment rental and maintenance, vehicle maintenance, security system, building and grounds maintenance and repair. 7. This program budget represents what percent of the agency budget? 44% 8. 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 2019-17 Estimated 2027-18 Projected 2018-19 Total Cost of Program $988,907 $898,401 $934,337 Total #of Individuals 270 304 335 Cost Per Individual $3,662 $2,955 $2,789 D© NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 22 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 3, PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Permanent Supportive Housing Program Primary Contact and Title: Ste hani Kilpatrick, Residential Services Director Telephone Number: 919.967.1.086 x 12 E-Mail: skilpatrick@ifcmaiIbox.org a) Indicate the type of Human Service Needs Priority, if program applicable: X Priority Area#1: safety-net services for disadvantaged residents ❑ Priority Area#2: education, mentorship, and afterschool programming for youth facing a variety of challenges X 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 Neigh borhoods/Residents Affordable Housing x x x X Affordable Healthcare Education Family Resources Jobs/Jobs Training Food Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated/collaborative efforts. To improve systems of care by collaboration, IFC staff participate in • Orange County Partnership to End Homelessness Leadership Team • Orange County Affordable Housing Coalition • Orange County Partnership to End Homelessness HOME Committee, which includes Orange County Project Connect, the annual Point-In-Time Counts, and planning for the Orange County Coordinated Entry system To ensure resident access to resources, IFC partners with and makes referrals to • UNC Hospitals and Student Health Action Coalition (SHAG) Clinic via a memorandum of understanding to provide in-kind medical care for residents through charity care and pharmacy assistance. • Orange County SOAR for residents eligible for SSI/SSDI benefits. DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM P F1 q e 21 3 o f 33 7 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Community Empowerment Fund (CEF}, which offers financial education, matching funds savings accounts, job and housing search help, and other services. • Veterans Administration for homeless veterans via referral. • Freedom House via memorandum of understanding for in-kind services, the Horizons Pro ram at UNC-Chapel Hili, and AA/NA groups, which support those with addiction and substance use issues. • Compass Center, which provides domestic violence workshops geared toward both women and children. • The Furniture Promect, organized by St. Thomas More volunteers and supported by IFC since its inception, helps furnish homes for graduates of IFC residential services. • PTA Thrift Shop and Club Nova Thrift Shop, which provides clothing vouchers valued at$100-150 for IFC residents 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 of September 2017, IFC is Orange County's lead provider of Permanent Supportive Housing. We took over the HUD Permanent Supportive Housing grant from Housing for New Hope, which no longer had capacity to function in Orange County. Recognized as a best practice, Permanent Supportive Housing works toward the Town and County goals of affordable housing and creating a place for everyone, regardless of mental health or physical disability. One full-time case manager works with 14 of the County's most vulnerable, chronically homeless residents, as determined by the Orange County Partnership to End Homelessness. The case manager assists residents in obtaining and maintaining housing by providing security deposits, rent and utility assistance, and ensuring that residents can access needed resources. The case manager recruits landlords to provide market-rate housing units and supports positive relationships by troubleshooting issues with landlords and neighbors. Housing units are located throughout Orange County. Our Case Manager increases access to services through coordination and communication, increases communication of services and how to access them, and improves coordination of services. The case manager assists residents in securing and maintaining income, as well as makes referrals for resources such as clothing, identification, child care, and health insurance. The main role of the case manager is to make sure these residents have the support and resources they need to stay housed and thrive in our community. e) Describe the community creed 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, DO NOT SUBMIT THIS PAGE 1123#2018 2.06:13 PM Page 24 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 i.e. Chapel Hill Human Services Needs Assessment) to support the need for this program. In accordance with the Towns' and County's goal of affordable housing and creating a space for everyone, Permanent Supportive Housing assists community members who would otherwise be homeless in maintaining safe places to live and thrive in Orange County. Since we have only been operating the grant a few months, we do not yet have comprehensive data. However, the 14 funded vouchers allow us to serve a subset of the many more individuals who meet program criteria. This means we can provide a permanent home for 14 of Orange County's most vulnerable individuals and families experiencing homelessness. Through our partnership with UNC Healthcare and Freedom House, we work toward the goal of affordable healthcare, including additional healthcare options and additional mental health service options and additional substance abuse services. All of the clients in the Permanent Supportive Housing program suffer from some form of disability, and a main function of the program is making sure they are linked with the care they need. f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? Individuals and families who are homeless due to a lack of affordable housing, domestic violence, eviction, unemployment, low-paying jobs, mental illness, lack of support services, lack of social supports, medical debt, and/or substance use. Residents in this program experience a combination of these challenges, which makes them the most vulnerable, highest need residents in Orange County. We accept referrals from the Orange County Partnership to End Homelessness HOME Committee, which assesses vulnerability using the Vulnerability Index— Service Prioritization Decision Assistance Too[. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) Permanent Supportive Housing is staffed by one full-time Case Manager. She is supervised by IFC's Residential Services Director, who holds an MSW from UNC- Chapel Hill and has worked for IFC for more than 7 years. The Case Manager has also worked for IFC for more than 7 years, previously at both shelters. She is experienced in responding to complex needs of homeless families and is well- connected to existing resources. h) describe the specific period over which the activities will be carried out and include an implementation timeline. Activities are ongoing through FY19. 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) As the lead provider of Permanent Supportive Housing in Orange County, IFC enables Orange County to access funding through the HUD Continuum of Care DO NOT SUBMIT THIS PAGE 1123/20118 2:05:13 PM P a g r..,' 2 5 o f 3 F' DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 grant. IFC stepped in to fill a gap, as Housing for New Hope was no longer able to offer permanent supportive housing in Orange County. This program houses and stabilizes Orange County's residents who have been the most difficult to reach and help - many of these individuals are the people who come to mind when we think of the homeless population on Franklin or Main Streets, for example. Finally providing them with secure housing and resources also helps defray costs of other emergency interventions resulting from homelessness such as emergency room visits, law enforcement interactions, and court resources. j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Most of the funds for this program come from the federal government. However, due to unfunded expenses and federal match requirements, I FC relies on a combination of sources to maintain service levels. We need the support of our local government partners to sustain this program. k) What percentage of your target population is low-moderate income? 100 percent 1) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc.?) Housing First, a best practice model, asserts that every individual and family is "housing-ready" and expert on meeting their particular housing needs. Therefore, decisions regarding services are made with, and not for, residents. The resident is the main participant in decision-making about their own life. m) Include any other pertinent information. IFC is currently operating this critical program without any local government funding. Local support is needed to fund expenses that are not currently covered under this grant, including partial salary and benefits for the case manager, supplies, and increased expenses in the coming year. DO NOT SUBMIT THIS PAGE 1123/2018 2:06:13 PM Page 2 8 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Additional Program Information n) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, IFC has operated the grant since September 2017, not long enough to report data. We expect our total number to be 14. Program Target Population Demographics Actual Estimated Projected 2016-17 2017-18 2018-19 Gender Male Female Total 0 14 14 Ethnicity African-American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other: specify Hispanic Total 0 14 14 Of the above, how many Hispanic/Latino Of the above, how many non-HispaniolLatino Total 0 14 14 Age 0-5 years 6-18 years 19-50 years 51+years Total 0 14 14 Geographic Location Alamance County Chatham County Durham County _- Wake County Orange County Breakdown Chapel Hill Public Housing Town of Chapel Hill (Nan-Public Housing) Town of Carrboro Town of Hillsborough City of Mebane(Orange County) Orange County(Outside Municipalities) Total 0 14 14 DO NOT SUBMIT THIS PAGE 112312018 2:06:13 PM Page 2 7 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 106 meals per day.) Work Statement Chart for Program Permanent Supportive Housing 1. Program Activity Name Permanent Supportive Housing Program Goal IFC's 'Permanent Supportive Housing program will provide permanent housing and case management to 14 of Orange County's most vulnerable residents experiencing homelessness. Performance Measures Information logged into HMIS and internal databases Previous Year Program Results Did not operate program last year Current Year Estimated Results 14 clients Next Year Projected Results 14 clients Program Budget 9. 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). Attached 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) DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 28 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Other Government Grants • Triangle United Way • State Government • Federal Government (CDBG/HOMEIetc.) • Private Foundation Grants • Other Revenue • Expenditures © Compensation o Rent& Utilities a Supplies & Equipment © Travel &Training o Other Expenses 10. Program Budget Detail—Provide description of"other" budget items, not defined. Other budget items for this program include telephone, network support, and insurance. The majority is the direct assistance we supply to program members in the form of payments for rent and utilities. 11. This program budget represents what percent of the agency budget? 7 percent 12 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 -- $145,948 $155,948 Total # of Individuals -- 14 14 Cost Per Individual -- $10,424 $11,139 This is a new program„ and there is no data available for FY17. _ __...._........... DO NOT SUBMIT THIS PAGE 1/23/2018 2.06:13 PM Page 29 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Food Security Programs Program Primary Contact and Title: Kristin Lavergne, Community Services Director Telephone Number: 919-929-63803 x41 E-Mail: klaver ne(cDifcmailbox.or a) Indicate the type of Human Service Needs Priority, if program applicable: X Priority Area #1: safety-net services for disadvantaged residents 0 Priority Area #2: education, mentorship, and afterschool programming for youth facing a variety of challenges X 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 Neg h borhoodslResidents Affordable Housing Affordable Healthcare Education Family Resources Jobs/Jobs Training Food x x x X x Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated/collaborative efforts. To improve our local farad system by collaboration, IFC ■ participates in the Food Access Workgroup of the Orange County Food Council, which is working towards the goal for all Orange County residents to have access to healthy, affordable, local food, and ■ refers members to Orange County Department of Social Services for Food and Nutrition Services. To decrease food waste and increase access to healthy food, IFC collaborates with supply-chain partners, including non-profits, wholesale and retail businesses Farmer Foodshare: I FC purchases fresh/perishable items for the Pantry through their Wholesale Market, which connects small to mid-scale farmers [especially DO NOT SUBMIT THIS PAGE 1123/20018 2:06:13 PM Page 3 0 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 beginning farmers, female farmers and farmers of color) with residents. IFC's Pantry has also hosted cooking demonstrations. • Inter-Faith Food Shuttle: IFFS donates food that would otherwise be thrown away once a week to the Pantry and twice a week to the Community Kitchen. • Food Bank of Central and Eastern NC: The Fond Bank administers and delivers The Emergency Food Assistance Program (TEFAP) food to IFC. TEFAP is a federal program that supplements the diets of low-income Americans, including elderly people. • Weaver Street Market raises funds through the round up campaign, which allows IFC to regularly purchase fresh produce — apples, potatoes, and onions — at wholesale rates. This community project at least doubles the amount of fresh produce distributed to member households. To increase community access to healthy food, IFC leverages volunteer support. • Volunteers gather weekly food donations from grocery stores such as Trader Joe's, Fresh Market, and Harris Teeter, restaurants such as Panera, Chipotle and Caribou Coffee; congregations; and UNC-Chapel Hill dining services. Volunteers also receive, sort, stock and distribute food to Pantry members. • IFC recruits and maintains cooking rc� oups from congregations, neighborhoods, UNC-Chapel Hill, and businesses to prepare and serve meals at the Community Kitchen. • Liaisons representing 35+ congregations meet regularly for IFC updates, trainings, information sharing, organizing food collections and mobilizing volunteers and financial resources according to community need. To increase food security, IFC extends our reach by supporting smaller food security programs in our community: • The Community Kitchen provides surplus food donations every weekday to Heavenly Groceries, which began as a ministry of St Joseph's CME church and is now housed at the Marian Cheek Jackson Center, and often to Carolina Spring Senior Apartments, a low-income senior housing complex. • We share information and food resources with Chapel Hill-Carrboro Meals on Wheels, Orange Congregations-in Mission, PORCH and TABLE. 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 Community Kitchen provides around 68,000 free meals to IFC residents and hungry citizens every year. The Kitchen Manager schedules and trains volunteers to prepare and serve meals 365 days a year. Nearly all of the food is donated by local restaurants, food services, campus groups, farmers, congregations and businesses. The Community Kitchen relies heavily on volunteers— representing congregations, businesses, civic groups, neighborhoods and UNC-Chapel Hill - to prepare, serve and clean yip meals. Meal monitors support volunteer groups and address diner needs during the meal. Volunteers also pick up, receive, sort and store food donations. DO NOT SUBMIT THIS PAGE /123/2018 2:06:13 PM Page 31 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 The Food Pantry also relies on food donations and volunteers to provide around 1,100 bags of groceries to food insecure households every month. Chapel Hill and Carrboro residents and workers may receive groceries as often as once a month, and many seek emergency assistance as well. Staff, student interns and community volunteers receive, sort and stock food, interview clients and greet members at the reception desk. Evening hours are provided by UNC-Chapel Hill students who keep the Pantry open until 7 p.m. two days a week during the academic year. In addition to normal operations, approximately 800 holiday dinners are distributed in November and December to member households. Orange County aims to ensure a community network of basic human services and infrastructure that maintains, protects, and promotes the well-being of all county residents. Both Food Security Programs are safety-net services for disadvantaged residents. Food is a basic human need, and these programs meet that daily need. e) Describe the community need or problem to be addressed in relation to the Chapel Hill Human Services Needs Assessment, Orange County 130CC 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 Chapel Hill Human Services Need Assessment identifies food — specifically affordable food and access to healthy food - as a significant human need in our community. Many government and nonprofit organizations address the need for food, especially local, healthy food options. However, more needs to be done. According to 2015 data from Feeding America, Orange County had an overall food insecurity rate of 14.3 percent and 19,790 food insecure people. Out of those 19,790 food insecure people, 39 percent did not qualify for SNAP or other government-run nutrition programs. In the first half of the current year, Pantry members representing 40 households did not qualify for Food and Nutrition Services. Because the Pantry does not have strict income guidelines, IFC increases food security for these households. The Pantry does not screen out households that are receiving food services from other programs. Similarly, the Community Kitchen is open to anyone who is hungry. Both programs are available to Chapel Hill and Carrboro residents and workers free of charge. IFC works with our supply-chain partners to incorporate as much fresh, healthy food as possible into our offerings. By providing hot meals and a week's worth of groceries at a time, IFC"s Community Kitchen and Pantry, alongside other food relief organizations in Orange County, work to combat local food insecurity. f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? ... _..__......... _._..--.__ -- DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM P a g e 32 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 The Food Security Programs serve food insecure households in our community as well as those who contribute to Chapel Hill-Carrboro as workers. Individuals may self-refer. Information is also shared widely with other community agencies, including the Orange County Department of Social Services. We are on the Community Resources list put together by the Orange County Partnership to End Homelessness and the Inter-Church Housing Corporation. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) The Community Services Director has an MSW from LING-Chapei Hill and has worked at IFC for 23 years. Three Client Services Representatives work with each other and the volunteers to operate the Food Pantry program on a daily basis. Our Kitchen Manager has 25+ years of professional food service experience, is ServSafe certified, and volunteered at the Community Kitchen before he was hired. He and three part-time assistants provide coverage, manage volunteers serving lunch and dinner, and receive and process food donations between the hours of gam and 8pm. Volunteers serve a variety of functions, including meal prep and serving, meal monitoring, reception, food pick-up, food sorting and stocking, and member interviewing. Volunteers are screened and placed with the Kitchen or Pantry programs by our Volunteer Coordinator. Training for positions is hands-on and includes shadowing staff or seasoned volunteers. by Describe the specific period over which the activities will be carried out and include an implementation timeline. Activities are ongoing throughout FY19. iy Why is funding this program a good investment for the community? Haw does funding this program add value to the community? (250 words OR LESS) When people don't have enough food or have to choose inexpensive foods with low-nutritional value, it can seriously impact their health and functioning. Family members in food-insecure households are also more likely to struggle with psychological and behavioral health issues, and kids who go hungry are more likely to have problems in school and social situations (Feeding America, 2018). Achieving higher goals, including participating fully in the community, becomes more difficult if not impossible. The Towns have prioritized fostering a diverse, inclusive community and addressing challenges that make it difficult for all to live in and be part of Orange County. IFC helps ensure that basic food needs are met so people can thrive. Since its founding, IFC has embraced involvement of the entire community as a means to achieving our goals. Our dependence upon volunteers to staff our Community Kitchen and Food Pantry not only means that we are able to provide food security to so many, it also provides opportunities for increased community engagement and fostering a community based on mutual respect and acceptance. DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 33 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 j) Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. IFC would need to consider reducing hours of service, number of meals provided at the Community Kitchen, or number of households that receive groceries. The worst case scenario would be that IFC would have to close one program completely. k) What percentage of your target population is low-moderate income? 100 percent l) What efforts do you make to seek feedback about your program from your target population (e.g. survey, evaluations, etc.?) IFC has a suggestion box in its waiting area at the Pantry, and suggestions are reviewed monthly at staff meetings. IFC has also conducted periodic surveys to secure input about current services, unmet needs and future plans. IFC also has a more formal process by which members can voice serious complaints. m) Include any other pertinent information. IFC is in the quiet phase of our capital campaign to construct a new building at our Carrboro location, which will house both the Community Kitchen and the Food Pantry. This new site will provide more residents with food security and do so in a more dignified and equipped setting that allows for a client choice pantry. Operations will also be more efficient. Food donations and volunteers will report to one site, enabling better coordination, preparation and distribution. Provided we reach our fundraising goal on time, we hope to open the new building by fall 2020. Additional Program Information n) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability.. The data in the following table is only for Food Pantry members, as we do not collect demographics on Community Kitchen diners. The Kitchen provides lunch to 75 and dinner to 50 diners each day—an estimated 103 unduplicated diners per year. Diners represent a diverse group in terms of ethnicity, age, and geographic location. The program currently serves more men due to its history of being co-located with the men's shelter until two years ago. DO NOT SUBMIT THIS PAGE 112312018 '2:00:13 PM Page 34 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Program Target Population Demographics Actual Estimated Projected 241617 2417-18 2018-19 Gender Male 1515 1501 1476 Female 2179 2161 2189 Total 3694 3662 3665 Ethnicity African-American 2241 2222 2232 American Indian or Alaska Native 11 14 15 Asian 8 11 12 Caucasian 1090 1082 1066 Native Hawaiian or other Pacific Islander 11 15 15 Other: specify _Multiracial/Unknown 333 316 325 Total 3694 3662 3665 Of the above, how many Hispanic/Latino 406 403 425 Of the above, how many non-RspaniclLatino 3288 3259 3240 Total 3694 3662 3665 Age - 0-5 years 0 0 0 6-18 years 37 36 36 19-50 years 2179 2161 2169 51 f years 1478 1465 1460 Total 3694 3662 3665 Geographic Location Alamance County 4 4 4 Chatham County 74 73 73 Durham County 74 73 73 Wake County 4 4 4 Orange County Breakdown Chapel Hill Public Housing not tracked not tracked not tracked Town of Chapel Hill 2475' 2454* 2482* Town of Carrboro 924 916 920 Town of Hillsborough not tracked not tracked not tracked City of Mebane(Orange County) not tracked not tracked not tracked Orange County(Outside Municipalities) L 73— 72** 75'°* Other 66*** 66""' 34"* Total 3694 31362 3665 *Includes all of Chapel Hill (Public Housing and Non-Public Housing) "Includes Hillsborough, Mebane, and outside municipalities, and excludes Chapel Hill and Carrboro ***People who reported as homeless or stranded and did not claim a jurisdiction DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 35 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 (�pecific, Measurable, Achievable, Relevant, and Time- bound. Glick 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 achievelaccomplish. 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 Food Security Programs: Food Pantry, Community Kitchen 1. Program Activity Name Food Security Programs: Food Bantry Program Goal The Food Pantry will collect or purchase enough non-perishable food items to provide groceries as often as once per month to member h_ ouseholds Performance Measures Staff will track number of bags of groceries and holiday dinners distributed Previous Year Program Results 13,275 bags of groceries Current Year Estimated Results 13,880 bags of groceries Next Year Projected Results 13,000 bags of groceries 2. Program Activity Name Food Security Programs: Community'Kitchen Program Goal A hot, nutritious meal will be served to any hungry person who shows up at mealtimes at the Community Kitchen Performance Measures Staff determines number of meals served by counting trays at the end of each meal service Previous Year Program Results 68,845 hot meals Current Year Estimated Results 65,224 hot meals Next Year Projected Results 65,000 hot meals p) Program Budget 13. Submit your program budget. You may complete the provided template (separate xls file) or you may submit your own budget file(as long as it contains the same information, in the same format, as requested in the provided template). included as attachment. 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 .. .......... DG NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 36 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Private Donations • Program Generated Revenue • Local Government Grants • Carrboro Human Services • Carrboro Other • Chapel Hill Human Services • Chapel Hill Other(DO NOT include CDSG 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(CD13G/HOME/etc.) • Private Foundation Grants • Other Revenue • Expenditures • Compensation • Rent & Utilities • Supplies & Equipment • Travel &Training • Other Expenses 14. Program Budget Detail—Provide description of"other" budget items, not defined. Other budget items include telephone and network support, insurance, and trash removal, some food and other supplies. 15. This program budget represents what percent of the agency budget? 7 percent 16. COST PER INDIVIDUAL This Cast 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 201.8-19 Total Cost of Program $31,355* $346,748 $360,618 Total #of Individuals 31857** 3,825** 3,828*' Cost Per Individual $8.13 $90.65 $94.21 'Budget number only includes partial expenses due to changes in accounting of the program expenses. In 2016-17, the Community Kitchen was co-located with Community House and was considered part of the shelter budget. "Numbers include both Food Pantry(from chart above)and the estimated 163 Community Kitchen diners(not included in chart, as we do not collect demographics from this group). -- ......_. DO NOT SUBMIT THIS PAGE 1/23/2018 2:06:13 PM Page 37 of 37 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 1. COVER PAGE a) Applicant Contact Information Applicant Organization's Legal Name: Inter-Faith Council For Social. Service Applicant Organization's Physical Address: 110 W. Main Street, Carrboro, NC 27510 Applicant Organization's Mailing Address: 110 W. Main Street Carrboro NC 27510 Applicant Organization's Web Address: http://www.ifcweb.org Executive director: Jackie,leaks Telephone Number: 919-929-5380x14 E-Mail.iienks(ztifcmaJbox.org Tax ID Number: 59-1224041 b) Funding Request List all FY18-19 Human Services fHS] Funding Being Requested— For All Programs) and the Proposed Use of Funds (2-3 lines or less) Program am Carrboros Chapel Orange Total -HS Hill-HS County-HS Food For the Summer $1,500 $1,500 $1,500 $4,500 Teen Ambassador program, Middle School Pilot program and materials 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: Executive Director Date Signature: Beard Chairperson Date ............ .. .... AGENCY INFORMATION 1/2312038 12:16:05 PM Page 8 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 grange 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: JoaAje J& 1123118 Executive Director Date Casw Signature: 1123118 Board Chairperson Date AGENCY INFORMATION 1/2312018 12:16:05 PM Pa g e g of 2 6 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 3. PROGRAM INFORMATION (Submit a separate Section 3 for each program) Program Name: Food For the Summer Program Primary Contact and Title: Kristin Laveralne Telephone Number: 919-929-6380 x41 E-Mail: : klavergne @ifcmailbox.org a) Indicate the type of Human Service Needs Priority, if program applicable: El 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 X 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 progran) Program Category Youth Adult Elderly Disabled Public Housing Neighborhoods/Residents Affordable Housing Affordable Healthcare Education X X Family Resources Jobs/Jobs Trainin X X Food X x Transportation Other: Please specify c) Provide a bulleted list of other agencies, if any, with which your agency coordinates/collaborates to accomplish or enhance the Projected Results in the Program(s) to be funded. For each, briefly describe the coordinated/collaborative efforts. • Town of Chapel Hill ■ Family Success Alliance • Chapel Hill-Carrboro City • Food For All (UNC) Schools • The Friday Center • Town of Carrboro . Book Harvest • Orange County • YMCA of the Triangle • NC Dept of Public Instruction • No Kid Hungry NC • PORCH • TABLE DO NOT SUBMIT THIS PAGE 1/23%2018 12:16:05 PM Page 14 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 prioritylgoal? Food for the Summer provides nutritious weekday meals at walkable sites and summer camps throughout the Chapel Hill-Carrboro City School district (CHCCS) to children under 18 for the full summer break. Meals are prepared in several CHCCS school cafeterias by cafeteria staff and distributed by a network of volunteers. In addition to daily meals, Food for the Summer offers opportunities for enrichment which help alleviate the "Summer Slide" experienced by many children over the summer. Enrichment opportunities include; • Fun Buckets: Buckets filled with sidewalk chalk, jump ropes, frisbees, games and more are brought to the sites daily to provide opportunities for outside play. • Free Book Wednesdays: With the help of Book Harvest, free books are available for children to take home each week. • Pap-In Guests: Occasional visits from special guests like the local fire and police departments provide children with an opportunity to learn about health, safety and community. • Enrichment Opportunities: Arts & Crafts, Nutrition Activities, free summer swim lessons and more are provided by volunteer organizations. Community Engagement opportunities: Last year, Food for the Summer engaged more than 600 community volunteers, including a significant number of youth volunteers. In addition, we employed four high school students and two volunteer interns as part of our Teen Ambassador program which provided leadership training and job skills to high school students who live within the district. Their duties included planning and participating in meal site enrichment activities, helping to organize the "End of Summer Eclipse Party", engaging with children and volunteers on a daily basis and participating in a PhotoVoice research project aimed at documenting key aspects of the program. Meeting Town and County Goals: The Food for the Summer program addresses the widening problem of summertime food insecurity which will affect 3,500- children during the eleven week summer break. In addition, the program provides literacy, cultural enrichment and recreational opportunities— all of which add up to healthier children and better academic outcomes. Last summer we provided 48,978 meals (with 20,246 delivered by FFTS volunteers), thousands of free books and 122 free swimming lessons to children living in Chapel Hill, Carrboro and Orange County. This year, we expect to increase these numbers.. DO NOT SUBMIT THIS PAGE 1123120118 12:16:45 PM P a g e 15 o f 2 6 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Connecting with Families: Last summer, we hosted two community events to deepen connections with the community and raise awareness about the Food For the Summer program: Food for the Summer Dick-off at Northside Elementary which included a cookout, bounce house, farmer's market and activities for families. End of the Summer Eclipse Party which included safe eclipse viewing, face-painting, games, food and more for 330— 350 members of the community. Connects Families and Children with Year-round services: Again this summer, Food for the Summer worked closely with TABLE -- providing information to families at meal sites, handing out and collecting applications for TABLE backpack deliveries and assisting with weekly backpack distribution. e) Describe the community need or problem to be addressed in relation to the Ch_ apel Hill Human Services Needs Assessment, Orange County BOCC Goals and Priorities, Town of Chanel 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 Food For the Summer program addresses several items identified in the Human Services Needs Assessment including: Providing healthy meals to children and youth at no charge on weekdays throughout the summer break Providing free activities that positively engage children and youth from at-risk and low-income households f) Who is your target population of individuals to benefit from this program and how will they be identified and connected with the program? Our target population is the 3,400 children and youth in the CHCCS district who qualify for Free & Reduced Lunch. We use data provided by the school district to identify meal sites that are walkable for identified populations. We do outreach through school social workers, community partners (IFC, PORCH, TABLE), and through the town's Housing & Human Services communication channels. We display posters in healthcare clinics and public places throughout Chapel Hill & Carrboro and send home flyers, translated in numerous languages, in children's backpacks as well as in PORCH donation bags and TABLE backpacks. g) Describe the credentials of the program manager and other key staff. (Ex. Identify Program Manager and credentials, describe training provided to volunteers, etc.) DO NOT SUBMIT THIS PAGE 1/23/2013 12:16:05 PM P a g e 16 o f 2 6 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Menu planning and food preparation are overseen by Liz Cartano, Director of Dining for Chapel Hill- Carrboro City Schools; Program Director: We are in the process of hiring a summer-time program director. Candidates for the position tend to have their MSW or experience in education (teachers or teachers' aides); Site Coordinators: We are in the process of hiring this year's Site Coordinators. Candidates are, typically, undergraduate and graduate students at UNC. The Program Director and Site Coordinators will undergo extensive training, including programs required by the North Carolina Department of Public Instruction. A manual has been written and is provided to each. Volunteers participate in a two hour orientation and receive a daily briefing when they arrive to pick up food. h) Describe the specific ,period over which the activities will be carried out and include an implementation timeline. February: Interviews and hiring of Program Director, Site Coordinators Meeting with Social Workers to provide information on program March-May: Site identification and certification Kick-off event; Participation in community events (Touch-A-Truck; Summer Reading Launch) Staff training; Volunteer orientations June—Aug: June 12 — First day of weekday meal service Early July— JumpStart Carnival (Hargraves Community Center) Wednesdays—"Free Book Wednesdays„ Pop-in guests/enrichment programs weekly August 25 — Final day of summer meal service 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) Food for the Summer is a tremendous investment for several reasons: Food for the Summer provides meals and enrichment opportunities in locations that are walkable for hundreds of Chapel Hill and Carrboro families and children for the entire, eleven-week summer. The program: • Makes it possible for area summer camps to be part of the Summer Meals program by utilizing volunteers to deliver lunches and snacks daily. DC NOT SUBMIT THIS PAGE 1/23/2018 12:16:05 PM Pa g e 17 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 • Utilizes federal USDA Summer Meals funding to cover food and meat preparation costs, which brought an additional $127,663 (all summer meals) into our community last year; • Extends summer-time employment for cafeteria workers at three schools for the entire ten week summer as opposed to the limited 2 — 3 weeks of summer school; Provides summer-time employment opportunities for teen-aged and college student; • Provides flexible, rewarding volunteer opportunities for families and teens; Connects children with public safety workers through lunch-time visits from the fire department and • Connects families with TABLE for year-round assistance by providing program information and collecting application forms at meal sites as well as assisting with weekly backpack distribution. • Encourages a healthy lifestyle by increasing outdoor time and offering opportunities for creative outdoor play. • Helps reduce "summer slide" by providing enrichment activities and free books. Describe what would happen if requested funding is not awarded at all or if a reduced allocation is recommended. Our grant request is intended to fund stipends and mentorship opportunities for participants in the Food For the Summer Teen Ambassador program who come from low-income families. Without that funding, teens will be asked to volunteer their time and we will not be able to run the "special" activities: and learning opportunities we have planned for them. k) What percentage of your target population is low-moderate income? One hundred percent (100%) I) What efforts do you make to seek feedback about your program from your target population (e.g.. survey, evaluations, etc.?) Under the direction of Jessica Soldavini, a Doctoral Student in the UNC Department of Nutrition and Graduate Research Assistant for No Kid Hungry NC at the UNC Center for Health Promotion and Disease Prevention, conducted surveys with a broad range of Food For the Summer participants - including children, parents and volunteers. Survey questions addressed all aspects of the Food For the Summer program - including how kids liked the food, favorite enrichment activities and suggestions for next year. Other information was collected through Meal Site Volunteer Journals and a PhotoVoice project involving our Youth Ambassador team. Administrative data obtained from program sponsors and NC Department of Public Instruction has also been analyzed. All results have been shared with the Fond For the Summer partnership and are being considered as we plan for next year. Additionally, we have been working closely with the school social workers in order to create stronger connections with the parents to increase awareness of the program and to learn how Food For the Summer can better serve their children next summer. DO NOT SUBMIT THIS PAGE 1/23/2618 12:16:65 PM Page 18 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 m) Include any other pertinent information. In order to qualify for federal funds, Food For the Summer meal sites were, predominantly, "Open Sites" where children were not required to register. As a result, information about race and ethnicity is not available. 2017 Meal Sites included a mix of public housing, non-public housing, community centers and parks including: • Chapel Hill: Airport Gardens, Colony Woods, Dobbins Hill, Eastwood, Elliot Woods Apartments, Hargraves Community Center, Pine Gate Apartments, Pine Grove Mobile Home Park, Pritchard Park, South Estes Apartments, Trinity Court • Carrboro: Carolina Apartments, Elliott Woods Apartments, Estes Park Apartments, Royal Park Apartments In addition, volunteers delivered meals to several camp programs including: Rogers Road, Teen Center FPG Kindergarten Readiness, Community Schools and Hargraves Center.. Looking ahead to 2018: We are encouraged by on-going conversations between CHCCS and the Town of Chapel Hill to provide opportunities for more children to attend Parks & Recreation camps where they can stay engaged throughout the day and receive breakfast, lunch and snacks (all delivered by our volunteers). We know, however, that there will continue to be children and youth — especially middle schoolers—who will not attend camp all summer. With the help of school social workers, we are working to identify one or two pilot sites and new program ideas to reach those individuals. While we specifically target children in the CHCCS district, we also reach out through local Preschool programs to ensure that area families with younger children who are not currently in the school system are aware that the program is available and open to them. DG NOT SUBMIT THIS PAGE 1/23/2018 12:16:08 PM Page 19 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Additional Program Information n) Target Population Complete the following tables, with numbers (not percentages) of individuals served and to be served, to the best of your ability, Program Target Population Demographics Actual Estimated Projected 2016-17 2017-18 2018-19 Gender Male Female Total 0 0 0 Ethnicity African-American American Indian or Alaska Native Asian Caucasian Native Hawaiian or other Pacific Islander Other; specify Total 0 0 0 Of the above, how many Hispanic/Latinos Of the above, how many non-HispanictLatino Total 0 0 0 Age 0-5 years 6-18 years 19-50 years 51+ years Total 0 0 0 Geographic Location Alamance County Chatham County Durham County Wake County Orange County Breakdown Chapel Hill Public Housing Town of Chapel Hill (Non-Public Housing) Town of Carrboro Town of Hillsborough City of Mebane(Orange County) Orange County(Outside Municipalities) Total 0 0 0 .... . . ...... DO NOT SUBMIT THIS PAGE 1/23/2018 12:16:05 PM Page 20 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 infonnation. Every program is required to have AT LEAST 9 Program Activity, which should be SMART (,apecific, 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 achievelaccomplish. 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 905 meals per day.) Work Statement Chart for Program Food For the Summer 1. Program Activity Dame Food For the Summer Program Goal To provide healthy lunches and enrichment activities on weekdays to children and youth in the CHCCS system who qualify for Free & Reduced Lunch throughout the entire summer break. Performance Measures Number of meal sites; Number of days served; Number of meals served; Number of volunteers engaged; Previous Year Program Results Meal Sites: 14 (plus camps) Days Served; 54 Total Meals Served: 48,145 Volunteer-delivered meals: 22,000 Volunteers engaged: 650+ Volunteer slots: 1,700—2,000 Current Year Estimated Results Meal Sites: 14 (plus camps) Days Served: 54 Total Meals Served: 45,978 Volunteer-delivered meals: 20,246 Volunteers engaged: 650+ Volunteer slots: 1,700—2,000 Next Year Projected Results Meal Sites: 15 (iglus camps) Days Served: 54 Total Meals Served: 51,000 Volunteers engaged: 650+ Volunteer slots: 1,700-2,000 2. Program_Activity Name Program Goal Performance Measures Previous Year Program Results Current Year Estimated Results Next Year Projected Results DG NOT SUBMIT THIS PAGE 1/23/2018 12:16:05 PM Page 21 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 3. Program Activity Name Program Goal Performance Measures Previous Year Program Results 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 ... . ..... ............ DO NOT SUBMIT THIS PAGE 112312018 12:16:05 PM P a g e 22 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 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 (CDBGIHOMEIetc.) • Private Foundation Grants • Other Revenue • Expenditures o Compensation • Rent& utilities • Supplies& Equipment • Travel &Training • Other Expenses 2. Program Budget Detail —Provide description of"other" budget items, not defined. In the past year, IFC filled a trio of key leadership positions including rebuilding its finance and operations team. Systems are in place to be able to provide more detailed information about Food for the Summer revenues and expenses moving forward. 3. This program budget represents what percent of the agency budget? nla% Food for the Summer is a self-standing program carried out by community collaboration that includes the IFC. IFC is acting as a sponsor. 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. Cost per individual cannot be calculated. As noted before the program runs Open Sites, which means that kids do not preregister. Actual 2015-17 Estimated 2077-18 Projected 2015-19 Total Cost of Program DO NOT SUBMIT THIS PAGE 1/23/2018 12:16:05 PM Page 2 3 of 26 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Agency Budget Operating Budget for Entire Agency AGENCY NAME: IFC Actual 2016- Estimated Projected 2018 Percent AGENCY REVENUE 17 2017-18 19 Change Private Donations $ 1,407,136 $ 1,295,863 $ 1,360,656 5% Agency Generated Revenue(fees) $ - $ - $ - Local Government Grants: Human Services-Town of Carrboro $ 11,950 $ 11,950 $ 17,125 43% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 31,585 $ 25,000 $ 36,000 44% Other-Town of Chapel Hill $ 3,100 $ 12,832 $ 12,832 0% Human Services-Orange County $ 48,910 $ 50,000 $ 71,875 444%Other-Orange County $ - $ - $ -Other-Town of Hillsborough $ - $ - $ -Other Government Grants Triangle United Way $ 103,641 $ 85,826 $ 35,000 State Government $ 76,674 $ 34,868 $ 34,868 Federal Government(CDBG/HOMEIetc.) $ 19,598 $ 165,148 $ 165,148 Private Foundation Grants $ 26,850 $ 68,350 $ 23,350 -66'o Other Revenue $ 132,736 $ 272,846 $ 272,846 $ - Total Agency Revenue $ 1,862,182 $ 2,022,683 $ 2,029,700 0% AGENCY EXPENSES Compensation $ 1,387,742 $ 1,402,661 $ 1,458,767 4%0 Rent&Utilities $ 79,175 $ 87,786 $ 91,297 4% Supplies&Equipment $ 74,603 $ 61,716 $ 64,185 4% Travel&Training $ 7,139 $ 1,940 $ 2,018 4%p Other Expenses: $ 618,929 $ 468,580 $ 487,323 4% Total Agency Expenses $ 2,167,588 $ 2,022,683 $ 2,103,690 4% SURPLUS/(DEFICIT) FOR PERIOD: $ (305,407) $ - 1 $ (73,890) 0 FY 2418-19 Agency Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 Program Budget Operating Budget for Program PROGRAM NAME Food for the Summer Program (sponsored by Inter-Faith Council) Actual Estimated 2017- Projected 2018 Percent PROGRAM REVENUE 2016.17 18 19 Change Private Donations $ 14,425 $ 9,688 $ 13,500 39% Program Generated Revenue $ - _$_ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ $ - $ 1,500 0 Other-Town of Carrboro $ $ - 0 Human Services-Town of Chapel Hill $ - $ - $ 1,600 0 Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Change County $ $ - $ 1,500 0 Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough _$ - $ - $ 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ - $ - $ - 0 Federal Government(CDBGIHOMEIetc.) $ - $ - $ - 0 Private Foundation Grants $ - $ - $ 12,000 0 Other Revenue $ - $ - $ - 0 Total Program Revenue $ 14,425 $ 9,688 $ 30,000 210% PROGRAM EXPENSES Compensation $ 1,500 $ 6,610 $ - -100% Rent&Utilities $ - $ 162 $ - -100% Supplies&Equipment $ - $ - $ 0 Travel&Training $ - $ - $ - 0 Other Expenses: $ 120 $ 25,000 $ - -100% Total Program Expenses $ 1,620 $ 31,772 $ 30,000 -6% SURPLUS!(DEFICIT) FOR PERIOD: $ 12,805 1 $ (22,084) $ - 1007/. FY 2018-19 Program Budget DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 Exhibit B Emergency Assistance Scope of Services Federal Tax Id.or SSN 59-1224041 Contract# A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Inter-Faith Council for Social Service, Inc. 2. I_f derent from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email: 3. Name of Program(s):Emergence Assistance 4. Status: ( )Public (X)Private,Not for Profit ( )Private,For Profit 5. Contractor's Financial Reporting Year July 1,2018 through June 30,2019 B. Explanation of Services to be provided and to whom: Through the Emergency Assistance Program,the Contractor will assist eligible individuals with rent and related costs as well as Orange Water and Sewer Authority(OWASA)bills and related costs.The County will reimburse the Contractor up to $5,000/month,unless prior approval by County,for a total of$60,000 for the contract period for rent/related costs and/or Orange Water and Sewer Authori OWASA bills/related costs.To be eligible clients must: be residents of Grange County,have income at or below 200%of the Federal Poverty Level, and have a household experiencing a financial crisis. Payments are limited to$200 within a 12-month period.The Coun will also reimburse the Contractor for staff costs(including salmy,FICA and fringe) for administering the Emergency Assistance Program up to$25,000 for the contract period.The Contractor will submit program paperwork provided by Cog=at time and dates designated by Coup U. C. Funding reimbursement limits by category: Rent/related costs and OWASA bills/related casts $60,000 65,000 per month) Staff costs: salary,FICA,.fringe $25,000 D.Number of units to be provided:NA E.Area to be served/DelivM site(s): Change County DocuSigned by: DocuSigned by: Wm 13B317305AEFFNA9.lt. Y� &s DAE1E196A83B455... .. Nancy Coston,Social Services Director (Signature of Contractor) 10/10/2018 10/10/2018 (Date Submitted) (Date Submitted) 9 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 Scope of Services—FY 2018-19 Outside Agency Performance Agreement Agency Name: Inter-Faith Council for Social Service Program Name: Shelters Funding Award: $28,650 Outline how the agency will spend Orange County's funding award. Expense Description Amount Pro Earn staff sal and benefits $28,650 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2019. • Provide safe shelter and case management to support residents in obtaining permanent housing. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Oran 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_ Number of homeless persons receiving shelter with access to full-time case managers 250 Docu5igned by: Certified by; [3)"&t, Yt&S Title: Executive Director late: 10/10/2018 @,,,SAEFFNA9... (Provider's Signature) Orange County Outside Agency Performance Agreement Revised 612018 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 EXMff 4`09 Scope of Services—1 Y 2018-19 Outside Agency Performance Agreement Agency Name: Inter-Faith Council for Social Service Program Name: Food Security programs Funding Award: $25,000 Outline how the agency will spend Orange County's funding award. Expense Description Amount Program staff salary and benefits $25,000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2019. • Collect or purchase enough non-perishable food items to provide groceries as often as once per month to member households. • Serve a hot,nutritious meal to any hungry person who shows up at mealtimes at the Community Kitchen. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Uri 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 Number of bags of groceries and holiday dinners distributed 10,000 Number of meals served 50,000 Docu5igned by: [3a&G � AS l7 Executive Director 10/10/2018 Certified by: Title: atc: @317305AEFF04A9... (Provider's Signature) 2 DocuSign Envelope ID: EB294A71-C7D1-4EE4-82B7-60A6149320D4 EX11MIT"C" Scope of Services—FY 2018-19 Outside Agency Performance Agreement Agency Name: Inter-Faith Council for Social Service Program Name: Food for the Summer Funding Award: $1,500 Outline how the agency will spend Orange County's funding award. Expense Description Amount Staff salary $1,500 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2019. • Provide healthy lunches and enrichment activities on weekdays to children and youth in the Chapel Hill Carrboro School System who qualify for free and reduced lunch throughout the entire summer break. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange Couotv.,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 Number of meal sites 12 Number of days served 45 Number of total meals served 48,000 Number of volunteers engaged 600 Number of volunteer slots 1,500 Docu5igned by: ,�Gt.(,� G , t tn,�S Executive Director 10/10/2018 Certified by' B317305AEFF04A9 Title. Date. (Provider's Signature) 3 DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-6OA614932OD4 INTECOU-01 MSUMMERS �ca►z© CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDOiYYYY) 14� 1 0911312018 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 pollcy(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 suchppendorsement(s). PRODUCER NAMEACT Mregan Summers Summers Thompson Lawry,Inc. PHONE ExO:(919)539-5318 (arc,No):(919)942-4221 100 Europa Drive Suite 571 A®❑riEESS Megan @STLinsure.com Chapel Hill,NC 27517-2393 INSURERS AFFORDING COVERAGE NAIL* INSURER A:Alliance for Non-Prdflts for Insurance Risk Retention Group 10023 INSURED INSURER B:Association Insurance Company Inter-Faith Council for Social Service Inc. INSURERC:Hartford Fire Insurance Company 19682 110 W.Main Street INSURER D:The Hanover ins Co 22292 Carrboro,NC 27510 INSURER E: INSURER F: COVERAGES CERTIFICATE DUMBER: 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 CONTRACTOR 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. fNSR DL UBft POLICY EFF POLICY EXP L TYPE OF INSURANCE INSD MIND POLICY NUMBER MrDDrYYYY MMIDQ LIMrrS A X COMMERCIAL GENERALLUIBILITY EACH OCCURRENCE $ 1,000,OOD CLAIMS-MADE OCCUR �( 2016-17838 0710112018 07/0112019 DR M SES°E 000wrr nce $ 500,000 Professional 1M/2M A MEDEXP JAny one rson $ 20,000 X SEXUAL ABUSE 1M12M PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPL[ES PER: GENERAL AGGREGATE $ 2,000'000 POLICY JECT LOC PRODUCTS-COMPIOP AGG $ 2'000,000 OTHER: C4MBINEDSINGLELIMIT 1,000,000 A AUTOMOBILE LIABILITY Ea eacid.r t $ X ANY AUTO 016-17838 07101/2018 117/0112019 BODILY INJURY Per ersan $ OYMED SCHEDULED AUTOS ONLY AAJTCSS ] BODILY INJURY Per occident HAUTCSDS ONLY AUTOS W Op Y PaCr aogdenf MACE $ A X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 1,000,000 EXCESS LIAB CLAIMS-MADE X 01 7-1 78 38-UMB 07101/2018 07101/2015 AGGREGATE $ DIED X RETENTION$ 1(),000 Aggregate 1,000,000 WORKERS COMPENSATION X PER E_R - STATUTE AND EMPLOYERS'LIABILITY YIN 0522-000320-115 07101/2D18 07/0112019 1,000,000 RIE ANY PROPRIETORIPARTNE F-CUTIVE NIA E.L.EACH ACCIDENT $ OFFICER/MEME EXCLUDED? (Mandatory InNFI) E.L.DISEASE-EAEMPLO $ 1,000,000 If yes,de scribe under 1,000,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT C Crime(Includes Burg 22BDDHK5511 07/01/2018 071011201.9 Crime/ERISA 100,000' D D&O/Employment Pract LM68785106 07101/2018 0710112019 D&OI Employment Prac 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If mote space Is required) It is understood and agreed that the certificate holder is included as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 HIIIsborough, NC 27278 AUTHORIZED REPRESENTATIVE A" 1 Swrn m�.w y I l ACORD 25(2016103) O 1988-2018 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID: EB294A71-C7D1-4EE4-8287-60A6149320D4 POLICY NUMBER: 2018-17838 COMMERCIAL GENERAL LIABILITY Named Insured: Inter-Faith Council for Social Service CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Cr Organization(s): Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy.The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II--Who Is An Insured is amended to S. With respect to the insurance afforded to these include as an additional insured the person(s) or additional insureds, the following is added to organization(s) shown in the Schedule, but only Section III—Limits Of Insurance: with respect to liability for"bodily injury", "property damage" or"personal and advertising injury" If coverage provided to the additional insured is caused, in whole or in part, by your acts or required by a contract or agreement, the most we omissions or the acts or omissions of those acting will pay on behalf of the additional insured is the on your behalf: amount of insurance: 1. In the performance of your ongoing operations; 1. Required by the contract or agreement; or or 2. Available under the applicable Limits of 2. In connection with your premises owned by or Insurance shown in the Declarations, rented to you. whichever is less. However: This endorsement shall not increase the 1. The insurance afforded to such additional applicable Limits of Insurance shown in the insured only applies to the extent permitted by Declarations. law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 26 04 13 Q Insurance Services Office, Inc., 2012 Page 1 of 1