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HomeMy WebLinkAbout2019-423-E DSS - Chatham Transit nonemergency medical transportation DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contiact#68-1019 Chatham Transit Network Contract#68-1019 Fiscal Year Begins July 1. 2019 Ends June 30 , 2020 This contract is hereby entered into by and between the Orange County Department of Social Services (the "County") and Chatham Transit Network(the"Contractor')(referred to collectively as the"Parties"). The Contractor's federal tax identification number or Social Security Number island County DUNS !Number is 1. Contract Documents: This Contract consists of the following documents (1) This contract (2) The General Terms and Conditions (Attachment A) (3) The Scope of Work, description of services, and rate (Attachment B) (4) Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C) (5) Conflict of Interest(Attachment D) (6) No Overdue Taxes (Attachment F) (7) Certification Regarding Transportation (Attachment J) (8) If applicable, IRS federal tax exempt letter or 501 (c)(Attachment K) http:llwww.irs.gov/pub/irs-filI/k1023,pdf (9) State Certification (Attachment M) (10) Non-Discrimination, Clean Air, Clean Water(Attachment N) (11) Outcomes and Reporting (Attachment O) These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in Paragraph 1, above, with the first-listed document having the highest precedence and the last-listed document having the lowest precedence. If there are multiple Contract Amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective on July 1, 2019 and shall terminate on June 30, 2020, This contract must be twelve months or less. 4. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B, Scope of Work, and shall meet the requirements set for in Attachment O, Outcomes and Reporting. 5. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid by the County to the Contractor under this contract shall not exceed$1. This amount consists of$1 in Federal funds (CFDA# ), $ 0 in State Funds, $0 in County funds ® a. There are no matching requirements from the Contractor. ❑ b. The Contractor's matching requirement is$ , which shall consist of: ❑ In-kind ❑ Cash ❑ Cash and In-kind ❑ Cash and/or In-kind The contributions from the Contractor shall be sourced from non-federal funds. The total contract amount including any Contractor match shall not exceed$11. 6. Reversion of Funds: Any unexpended grant funds shall revert to the County Department of Social Services/Human Services upon termination of this contract. 7. Reporting Requirements: Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22&23 and OMB Circular-CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106. 8. Payment Provisions: Payment shall be made in accordance with the Contract Documents as described in the Scope of Work, Contract-General (06/19) Page 1 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract468-I019 Chatham Transit Network Attachment B. 9. Contract Administrators: All notices permitted or required to be given by one Party to the other and all questions about the contract from one Party to the other shall be addressed and delivered to the other Party's Contract Administrator. The name, post office address, street address, telephone number, fax number, and email address of the Parties' respective initial Contract Administrators are set out below. Either Party may change the name,post office address,street address, telephone number, fax number, or email address of its Contract Administrator by giving timely written notice to the other Party. For the County: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Lindsey Shewmaker, Human Services Manager Lindsey Shewmaker, Human Services Manager Orange County Department of Social Services Orange County Department of Social Services P❑ Box 8181 PO Box 8181 Hillsborough, NC 27278 Hillsborough, NC 27278 919-245-2817 919-245-2817 Ishewmaker@orangecountync.gov Ishewmaker@orangecountync.gov For the Contractor: IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS Anna Testerman Anna Testerman Chatham Transit Network Chatham Transit Network P.O. Box 1032 P.O. Box 1032 Pittsboro, NC 27312 Pittsboro, NC 27312 919-542-5136 919-542-5136 10. Supplementation of Expenditure of Public Funds: The Contractor assures that funds received pursuant to this contract shall be used only to supplement, not to supplant; the total amount of federal, state and local public funds that the Contractor otherwise expends for contract services and related programs. Funds received under this contract shall be used to provide additional public funding for such services; the funds shall not be used to reduce the Contractor's total expenditure of other public funds for such services. 11. Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to make disbursements in accordance with the following requirements: (a) Implement adequate internal controls over disbursements; (b) Pre-audit all vouchers presented for payment to determine: • Validity and accuracy of payment • Payment due date ■ Adequacy of documentation supporting payment • Legality of disbursement (c) Assure adequate control of signature stamps/plates; (d) Assure adequate control of negotiable instruments, and (e) Implement procedures to insure that account balance is solvent and reconcile the account monthly. 12. Outsourcing to Other Countries: The Contractor certifies that it has identified to the County all jobs related to the contract that have been outsourced to other countries, if any. The Contractor further agrees that it will not outsource any such jobs during the term of this contract without providing notice to the County. 13. Federal Certifications: Contract-General (06/19) Page 2 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract#68-1019 Chatharn Transit Network Individuals and Organizations receiving federal funds must ensure compliance with certain certifications required by federal laws and regulations. The contractor is hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace Requirements, Environmental Tobacco Smoke, Debarment, Suspension, ineligibility and Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and certifications are to be signed by the contractor's authorized representative. 14. Specific Language Not Previously Addressed: ( can be defied if not needed) 15. Signature Warranty: The undersigned represent and warrant that they are authorized to bind their principals to the terms of this agreement. The Contractor and the County have executed this contract in duplicate originals, with one original being retained by each party. Docu5igned by:: 'A' �Ut.Ut.A. j-(,Sh 6U& 7/2/2 019 82E360X5=52488. 5lgnature Date Anna Testerman Executive Director Printed Name Title Docusigned by: 'I^cwu5 Ak MA, 7/11/2019 OA3ES1B12B304B4 . Signature (must be legally authorized to sign contracts for County DSS) Date Travis Myren Deputy County Manager Printed Name Title oocusignedby: ?en pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. 0 � 7/8/2019 704E51S1ACC1409. 6Ignature of Uounty I-finance Officer Date Contract-General (06/19) Page 3 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT A GENERAL TERMS AND CONDITIONS Orange County Department of Social Services Relationships of the Parties the County or the Contractor,receiving services or benefits under this contract shall be deemed an incidental Independent Contractor: The Contractor is and shall be beneficiary only. deemed to be an independent contractor in the performance of this contract and as such shall be wholly responsible for Indemnity and Insurance the work to be performed and for the supervision of its employees. The Contractor represents that it has,or shall Indemnification: The Contractor agrees to indemnify and secure at its own expense, all personnel required in hold harmless the County and any of their officers,agents performing the services under this agreement. Such and employees,from any claims ofthird parties arising out employees shall not be employees of, or have any or any act or omission of the Contractor in connection with individual contractual relationship with the County. the performance of this contract. Subcontracting: The Contractor shall not subcontract any Insurance: During the term ofthe contract,the Contractor of the work contemplated under this contract without prior at its sole cost and expense shall provide commercial written approval from the County. Any approved insurance of such type and with such terms and limits as subcontract shall be subject to all conditions of this may be reasonably associated with the contract. As a contract.Only the subcontractors specified in the contract minimum, the Contractor shall provide and maintain the documents are to be considered approved upon award of following coverage and limits: the contract. The County shall not be obligated to pay for (a) Worker's Compensation - The contractor shall any work performed by any unapproved subcontractor. provide and maintain Worker's Compensation The Contractor shall be responsible for the performance of Insurance as required by the laws of North all of its subcontractors. Carolina,as well as employer's liability coverage with minimum limits of$500,000.00,covering all Assignment: No assignment of the Contractor's of Contractor's employees who are engaged in any obligations or the Contractor's right to receive payment work under the contract. If any work is sublet,the hereunder shall be permitted. However, upon written Contractor shall require the subcontractor to request approved by the issuing purchasing authority,the provide the same coverage for any of his County may: employees engaged in any work under the (a) Forward the Contractor's payment check(s) contract. directly to any person or entity designated by the (b) Commercial General Liability - General Contractor,or Liability Coverage on a Comprehensive Broad (b) Include any person or entity designated by Form on an occurrence basis in the minimum Contractor as a joint payee on the Contractor's amount of$1,000,000.00 Combined Single Limit. payment check(s). (Defense cost shall be in excess of the limit of In no event shall such approval and action obligate the liability.) County to anyone Other than the Contractor and the (c)Automobile Liability Insurance: The Contractor Contractor shall remain responsible for fulfillment of all shall provide automobile liability insurance with a contract obligations. combined single limit of$500,000.00 for bodily injury and property damage; a limit of Beneficiaries: Except as herein specifically provided $500,000.00 for uninsured/under insured motorist otherwise,this contract shall inure to the benefit of and be coverage; and a limit of$25,000.00 for medical binding upon the parties hereto and their respective payment coverage. The Contractor shall provide successors. It is expressly understood and agreed that the this insurance for all automobiles that are: enforcement of the terms and conditions of this contract, (a) owned by the Contractor and used in the and all rights of action relating to such enforcement,shall performance of this contract; be strictly reserved to the County and the named (b) hired by the Contractor and used in the Contractor.Nothing contained in this document shall give performance of this contract; and or allow any claim or right of action whatsoever by any (c) Owned by Contractor's employees and other third person.It is the express intention of the County used in performance of this contract("non- and Contractor that any such person or entity, other than owned vehicle insurance"). Non-owned General Terms and Conditions-(06/16) Page 1 of 5 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E vehicle insurance protects employers when employees use their personal vehicles for Termination Without Cause: The County may terminate work purposes. Non-owned vehicle this contract without cause by giving 30 days written insurance supplements, but does not notice to the Contractor. replace,the car-owner's liability insurance. Termination for Cause: If, through any cause, the The Contractor is not required to provide and maintain Contractor shall fail to fulfill its obligations under this automobile liability insurance on any vehicle—owned, contract in a timely and proper manner, the County shall hired,or non-owned--unless the vehicle is used in the have the right to terminate this contract by giving written performance of this contract. notice to the Contractor and specifying the effective date (d) The insurance coverage minimums specified in thereof. In that event,all finished or unfinished deliverable subparagraph(a)are exclusive of defense costs. items prepared by the Contractor under this contract shall, (e) The Contractor understands and agrees that the at the option of the County, become its property and the insurance coverage minimums specified in Contractor shall be entitled to receive just and equitable subparagraph (a) are not limits, or caps, on the compensation for any satisfactory work completed on such Contractor's liability or obligations under this contract. materials,minus any payment or compensation previously (f) The Contractor may obtain a waiver of any one or more made. Notwithstanding the foregoing provision, the of the requirements in subparagraph (a) by Contractor shall not be relieved of liability to the County demonstrating that it has insurance that provides for damages sustained by the County by virtue of the protection that is equal to or greater than the coverage Contractor's breach ofthis agreement,and the County may and limits specified in subparagraph(a). The County withhold any payment due the Contractor for the purpose shall be the sole judge of whether such a waiver of setoff until such time as the exact amount of damages should be granted. due the County from such breach can be determined. In (g) The Contractor may obtain a waiver of any one or more case of default by the Contractor, without limiting any of the requirements in paragraph(a)by demonstrating other remedies for breach available to it,the County may that it is self-insured and that its self-insurance procure the contract services from other sources and hold provides protection that is equal to or greater than the the Contractor responsible for any excess cost occasioned coverage and limits specified in subparagraph(a). The thereby. The filing of a petition for bankruptcy by the County shall be the sole judge of whether such a Contractor shall be an act of default under this contract. waiver should be granted. (h) Providing and maintaining the types and amounts of Waiver of Default: Waiver by the County of any default insurance or self-insurance specified in this paragraph or breach in compliance with the terms of this contract by is a material obligation of the Contractor and is of the the Provider shall not be deemed a waiver of any essence of this contract. subsequent default or breach and shall not be construed to (i) The Contractor shall only obtain insurance from be modification of the terms of this contract unless stated companies that are authorized to provide such to be such in writing, signed by an authorized coverage and that are authorized by the Commissioner representative of the County and the Contractor and of Insurance to do business in the State of North attached to the contract. Carolina.All such insurance shall meet all laws of the State of North Carolina. Availability of Funds: The parties to this contract agree 0) The Contractor shall comply at all times with all lawful and understand that the payment of the sums specified in terms and conditions of its insurance policies and all this contract is dependent and contingent upon and subject lawful requirements of its insurer. to the appropriation, allocation, and availability of funds (k) The Contractor shall require its subcontractors to for this purpose to the County. comply with the requirements of this paragraph. (1) The Contractor shall demonstrate its compliance with Force Majeure: Neither party shall be deemed to be in the requirements of this paragraph by submitting default of its obligations hereunder if and so long as it is certificates of insurance to the County before the prevented from performing such obligations by any act of Contractor begins work under this contract. war,hostile foreign action,nuclear explosion,riot,strikes, civil insurrection,earthquake,hurricane,tornado,or other Transportation of Clients by Contractor:The contractor catastrophic natural event or act of God. will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina Utilities Survival of Promises: All promises,requirements,terms, Commission. conditions, provisions, representations, guarantees, and warranties contained herein shall survive the contract Default and Termination expiration or termination date unless specifically provided General Terms and Conditions-(06l16) Page 2 of 5 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E otherwise herein, or unless superseded by applicable that comply with all applicable federal, state and Federal or State statutes of limitation. local laws,regulations, and rules. Intellectual Property Rights (b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the Copyrights and Ownership of Deliverables: All local Department of Social Services Contract deliverable items produced pursuant to this contract are the Administrator within twenty-four(24)hours exclusive property of the County. The Contractor shall not after the breach is first discovered,provided that assert a claim of copyright or other property interest in the Contractor shall report a breach involving such deliverables. Social Security Administration data or Internal Revenue Service Data within one(1)hour after Federal Intellectual Property Bankruptcy Protection the breach is first discovered. Act: The Parties agree that the County shall be entitled to all rights and benefits of the Federal Intellectual Property (c) Cost Borne by Contractor: If any applicable Bankruptcy Protection Act,Public Law 100-506,codified federal,state,or local law,regulation or rule at 11 U.S.C. 365 (n)and any amendments thereto. requires the Contractor give written notice of a security breach to affected persons,the Contract Compliance with Applicable Laws shall bear the cost of the notice. Compliance with Laws: The Contractor shall comply Trafficking Victims Protection Act of 2000: with all laws, ordinances, codes, rules, regulations, and The Contractor will comply with the requirements of licensing requirements that are applicable to the conduct of Section 106(g)of the Trafficking Victims Protection Act its business, including those of federal, state, and local of 2000, as amended(22 U.S.C. 7104) agencies having jurisdiction and/or authority. By executing this Agreement Provider certifies that Executive Order##24: It is unlawful for any vendor, Provider has not been identified,and has not utilized contractor,subcontractor or supplier of the state to make the services of any agent or subcontractor, on the list gifts or to give favors to any state employee. For created by the State Treasurer pursuant to G.S. 147- additional information regarding the specific 86.58. requirements and exemptions,contractors are encouraged to review Executive Order 24 and G.S. Sec. Title VY,Civil Rights Compliance: In accordance with 133-32. Federal law and U.S.Department of Agriculture{USDA} and U.S. Department of Health and Human Services Confidentiality (HHS) policy, this institution is prohibited from Confidentiality: Any information, data, instruments, discriminating on the basis of race,color,national origin, documents, studies or reports given to or prepared or sex, age or disability. Under the Food Stamp Act and assembled by the Contractor under this agreement shall be USDA policy, discrimination is prohibited also on the kept as confidential and not divulged or made available to basks of religion or political beliefs. any individual or organization without the prior written Equal Employment Opportunity: The Contractor shall approval of the County.The Contractor acknowledges that comply with all federal and State laws relating to equal in receiving,storing,processing or otherwise dealing with employment opportunity. any confidential information it will safeguard and not further disclose the information except as otherwise Health Insurance Portability and Accountability Act provided in this contract. (HIPAA): The Contractor agrees that, if the County Oversight determines that some or all of the activities within the scope of this contract are subject to the Health Insurance Access to Persons and Records:The State Auditor shall Portability and Accountability Act of 1996,P.L. 104-91, have access to persons and records as a result of all as amended("HIPAA"),or its implementing regulations, contracts or grants entered into by State agencies or it will comply with the HIPAA requirements and will political subdivisions in accordance with General Statute execute such agreements and practices as the County 147-64.7. Additionally,as the State funding authority,the may require to ensure compliance. Department of Health and Human Services shall have access to persons and records as a result of all contracts or {a) Data Security: The Contractor shall adopt and grants entered into by State agencies or political apply data security standards and procedures subdivisions. General Terms and Conditions-(06/16) Page 3 of 5 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E subcontractors,complies with the requirements ofArticle 2 Record Retention: Records shall not be destroyed, of Chapter 64 of the NC General Statutes. purged or disposed of without the express written consent of the Division. State basic records retention policy Miscellaneous requires all grant records to be retained for a minimum of five years or until all audit exceptions have been resolved, Choice of Law: The validity ofthis contract and any of its whichever is longer. If the contract is subject to federal terms or provisions,as well as the rights and duties of the policy and regulations,record retention may be longer than parties to this contract,are governed by the laws of North five years since records must be retained for a period of Carolina.The Contractor,by signing this contract,agrees three years following submission of the final Federal and submits,solely for matters concerning this Contract,to Financial Status Report, if applicable, or three years the exclusive jurisdiction of the courts of North Carolina following the submission of a revised final Federal and agrees, solely for such purpose, that the exclusive Financial Status Report. Also, if any litigation, claim, venue for any legal proceedings shall be Orange County, negotiation, audit, disallowance action, or other action North Carolina. The place of this contract and all involving this Contract has been started before expiration transactions and agreements relating to it, and their situs of the five-year retention period described above, the and forum,shall be Orange County,North Carolina,where records must be retained until completion of the action and all matters,whether sounding in contract or tort,relating to resolution of all issues which arise from it,or until the end the validity,construction,interpretation,and enforcement of the regular five-year period described above,whichever shall be determined. is later. The record retention period for Temporary Assistance for Needy Families (TANF)and MEDICAID Amendment: This contract may not be amended orally or and Medical Assistance grants and programs must be by performance. Any amendment must be made in written retained for a minimum of ten years. form and executed by duly authorized representatives of the County and the Contractor. Warranties and Certifications Severability: In the event that a court of competent Date and Time Warranty: The Contractor warrants that jurisdiction holds that a provision or requirement of this the product(s) and service(s) furnished pursuant to this contract violates any applicable law,each such provision contract("product"includes,without limitation,any piece or requirement shall continue to be enforced to the extent it of equipment,hardware,firmware,middleware,custom or is not in violation of law or is not otherwise unenforceable commercial software,or internal components,subroutines, and all other provisions and requirements of this contract and interfaces therein)that perform any date and/or time shall remain in full force and effect. data recognition function, calculation,or sequencing will support a four digit year format and will provide accurate Headings: The Section and Paragraph headings in these date/time data and leap year calculations. This warranty General Terms and Conditions are not material parts ofthe shall survive the termination or expiration of this contract. agreement and should not be used to construe the meaning thereof. Certification Regarding Collection of Taxes: G.S. 143- 59.1 bars the Secretary of Administration from entering Time of the Essence: Time is of the essence in the into contracts with vendors that meet one of the conditions performance of this contract. of G.S. 105-164.8(b)and yet refuse to collect use taxes on sales of tangible personal property to purchasers in North Key Personnel: The Contractor shall not replace any of Carolina. The conditions include: (a) maintenance of a the key personnel assigned to the performance of this retail establishment or office; (b) presence of contract without the prior written approval of the County. representatives in the State that solicit sales or transact The term "key personnel" includes any and all persons business on behalf of the vendor; and (c) systematic identified as such in the contract documents and any other exploitation of the market by media-assisted, media- persons subsequently identified as key personnel by the facilitated, or media-solicited means. The Contractor written agreement of the parties. certifies that it and all of its affiliates (if any) collect all required taxes. Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property E-Verify furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, Pursuant to G.S. 143-48.5,the undersigned hereby certifies or damage to, such property. At the termination of this that the Contractor named below, and the Contractor's contract, the Contractor shall contact the County for General Terms and Conditions--(06/16) Page 4 of 5 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E instructions as to the disposition of such property and shall comply with these instructions. Orange County Living Wage: Orange County is committed to providing its employees with a living wage Travel Expenses: Reimbursement, if provided in this and encourages agencies to which it provides funding to Agreement, to the Contractor for travel mileage, meals, pursue the same goal. The County's living wage hourly lodging and other travel expenses incurred in the standard, as adopted by the Orange County Board of performance of this contract shall not exceed the rates County Commissioners annually, can be found in the established in County policy. Orange County Budget Ordinance. To the extent possible, Orange County recommends that the Contractor and all 5ales[Use Tax Refunds: If eligible,the Contractor and all subcontractors provide a living wage, as defined in this subcontractors shall: (a) ask the North Carolina section,to their employees. Department of Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, Signatures: This Agreement together with any pursuant to G.S. 105-164.14; and (b) exclude all amendments or modifications may be executed refundable sales and use taxes from all reportable electronically. All electronic signatures affixed hereto expenditures before the expenses are entered in their evidence the intent of the Parties to comply with Article reimbursement reports. 11A and Article 40 of North Carolina General Statute Chapter 66. Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising. General Terms and Conditions—(06/16) Page 5 of 5 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT B SCOPE OF WORK Orange County Department of Social Services Federal Tax Id.or SSN Contract# 68-1019 A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Chatham Transit Network 2. If dierent from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email: 3. Name of Program(s): Medicaid Transportation 4. Status: ( )Public (X)Private,Not for Profit ( )Private, For Profit 5. Contractor's Financial Reporting Year July 1,2019 through June 30,2020 B. Explanation of Services to be provided and to whom(include SIS Service Code): The Contractor will provide transportation services to client(s)identified by the County. The Contractor will transport clients to and from medical appointments.The Contractor is required to meet all goals and outcomes listed in Attachment N. C. Rate per unit of Service(define the unit): 1. If Standard Fixed Rate,Maximum Allowable,(See Rates for Services Chart) 2.Negotiated County Rate. $60.20/one way trip D.Number of units to be provided:_ E. Details of Billing Process and Time Frames: Billing and reimbursement processes will now be handled through the NC Tracks system, rather than through the County.The Contractor must submit information throw NC Tracks in order to receive reimbursement for services provided. F. Area to be served/Delivery site(s): Orange,Alamance,Durham, Wake,and Chatham Counties Dom Signed by: N �as�aw OocuSigned by: DAE1E196A83B455 1182E36ODC5F52488 � 't',s aJn, actor) Nancy Coston,Social Services Director l7/8/2019 . (Date Submitted) (Date Submitted) Contract-Scope of Work(06/04) Page Iof 1 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT C CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS AND CERTIFICATION REGARDING NONDISCRIMINATION Orange County Department of Social Services 1. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by: A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing,possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violation of such prohibition; W Establishing a drug-free awareness program to inform employees about: (1)The dangers of drug abuse in the workplace; (2)The Contractor's policy of maintaining a drug-free workplace; (3)Any available drug counseling, rehabilitation,and employee assistance programs; and (4)The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph(A); D. Notifying the employee in the statement required by paragraph(A)that,as a condition of employment under the agreement,the employee will: (1)Abide by the terms of the statement; and (2)Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction; E. Notifying the County within ten days after receiving notice under subparagraph(D)(2)from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions,within 34 days of receiving notice under subparagraph (D)(2),with respect to any employee who is so convicted: (1)Taking appropriate personnel action against such an employee,up to and including termination; or (2)Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State,or local health, law enforcement,or other appropriate agency; and Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs(A), (B),(C),(D),(E),and(F). Federal Certification-Drug-Free Workplace&Nondiscrimination rev.06-2015 Pagel of 2 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E H. The sites)for the performance of work done in connection with the specific agreement are listed below: 1. (Street address) (City,county, state,zip code) 2. (Street address) (City,county,state,zip code) Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,suspension or termination of grants,or government-wide Federal suspension or debarment 45 C.F.R.Section 82.510, Section 4 CFR Part 85,Section 85.615 and 86.620. CERTIFICATION REGARDING NONDISCRIMINATION The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)which prohibits discrimination on the basis of race, color or national origin;(b)Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps;(d)the Age Discrimination Act of 1975,as amended(42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this Agreement. DocuSignedd by: 1lrt" ` f`SaJA' Executive Director 82ESODC5F52488. Signature Title Chatham Transit Network 7/2/2019 Agency/Organization Date (Certification signature should be same as Contract signature.) Federal Certification-Drug-Free Workplace&Nondiscrimination rev.06-2015 Page 2 of 2 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ' ��.:Ll 1.�r��`:�EJ�C��tJ�■� Transit Conflict of Interest P©Iicy Definitions and Expectations Conflict of.Interest Refined: A conflict of interest is defined as an actual or perceived interest by an employee or Board member, in an action that results in, or has the appearance of resulting in,personal, organizational,or professional gain. A conflict of interest occurs when an employee/Board member has a direct or fiduciary interest in another relationship. A conflict of interest could include; Ownership with a member of the Board of Directors or an empioyee where one or the other has supervisory authority over the other or with a client who receives services. Employment of or by a member of the Board of Directors or an employee where one or the other has supervisory authority over the other or with a client who receives services. ■ Contractual relationship with a member of the Board of Directors or an employee where one or the other has supervisory authority over the other or with a client who receives services. • Creditor to debtor to a member of the Board of Directors or an employee where one or the other has supervisory authority over the other or with a client who receives services. • Consultative or consumer relationship with a member of the Board of Directors or an employee where one or the other has supervisory authority over the other or with a client who receives services. The definition of conflict of interest includes any bias or the appearance of bias in a decision- making process that would reflect a dual role played by a member of the organization or group. An example, for instance, might involve a person who is an employee and a Board member, or a person who is an employee and who hires family members as consultants. When selecting a person to join the Chatham Transit Network Board of Directors every effort will be made to ensure none of the above conditions exist. Board/Employee Expectations: ■ All board members shall avoid conflicts of interest and the appearance of impropriety. Certain board members of the Chatham Transit Network are represen tali veslernployees of various organizations that benefit from actions taken by the board. Should an instance arise when a conflict may be perceived,any individual who may benefit directly or indirectly from any action taken by the board shall abstain from participating in any decision or deliberations by the board regarding that action. ■ At all times, employees are prohibited from using their job title, the organization's name or property for private profit. 1 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E In The director,officers,or employees of Chatham Transit Network should neither, solicit or accept gifts,entertainment,favors,or other items for more than nominal value form contractors/vendors. This policy is not intended to preclude bonafide Chatham Transit Network fundraising activities. • Disclosure All conflicts of interest shaII be disclosed by the person or persons concerned. • Record of Conflict-All official minutes of the Board of Directors shall reflect any conflict of interest that was disclosed and the person(s)with conflicts of interest did not participate in discussion or vote on the matter. AFFIRMED this day,March 27,2015 For the Board of Directors,Chatham Transit Network Board President Tim Mounce 2 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract# (Contractor) NOTARIZED CONFLICT OF INTEREST POLICY State of North Carolina County of—0 M _ 1 Notary Pubilc for said County and State, certify that 1' n l—' personally appeared before me this clay and acknowledged that helshe is C C u+ Y4' L '0CjC)r- of. �t1L�# lClt4lTr?t�1�r ��[►—��f and by that authority duly given and as the act of the Organization, affirmed that the foregoing Conflict of Interest Policy was adopted by the oard ❑f Dir ctors/Trustees or other governing body in a meeting held on the ad day of�, e Sworn to and subscribed before me this l day of , JESSICA LADRONKA ic o ry siJ!` ' RtN EXPIRES O4-29-2019 My Commission expires Arv- � 20 Rev. 05-07-2015 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Transit April 23, 2019 To: County Department of Social Services/Human Services Certification: We certify that Chatham Transit Network does not have any overdue tax debts, as defined by N,C.G.S. 105-243.1, at the federal, State, or local level. We further understand that any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c)is guilty of a criminal offense punishable as provided by N.C.G.S) 143C-10-1b. Sworn Statement;: Tim Mounce and Anna Testerman being duly sworn,say that we are the Board Chair and Executive Director, respectively, of Chatham Transit Network of Pittsboro in the State of North Carolina; and that the foregoing certification is true, accurate and complete to the best of our knowledge and was made and subscribed by us. We also acknowledge and understand that any misuse of State funds will be reported to the appropriate authorities for further action. LJ Board Chair . QIj I 4A 4,j kaa, Executive Director Sworn to and subscribed before me on the day of the date of said certification. v2tMy Commission Expires' p q (Not iry SignaturNOTAN i}OBLIC LEE COUNTY,NC MY COMMISSION EXPIRES D4-29-2019 1 G.S. 105-243.1 defines: Overdue tax debt.--Any part of a tax debt that remains unpaid 90 days or more after the notice of final assessment was mailed to the taxpayer.The term does not include a tax debt, however, if the taxpayer entered into an installment agreement for the tax debt under G.S. 106-237 within 90 days after the notice of final assessment was mailed and has not failed to make any payments due under the installment agreement." 65 E. Chatham Street www.chathamtransli.org PO Box 1032, Pittsboro, NC 27312 919.542.5136 1 Fax 919.545.0672 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT J CERTIFICATION REGARDING TRANSPORTATION Orange County Department of Social Services By execution of this Agreement the Contractor certifies that it will provide safe client transportation by: l. Insuring that all drivers(including employees,contractors, contractor's employees, and volunteers)shall be at least 18 years of age; 2. Insuring that all drivers(including employees,contractors, contractor's employees, and volunteers) shall be licensed to operate the specific vehicle used in transporting clients in accordance with Chapter 20-7 of the General Statutes of North Carolina and the Division of Motor Vehicle requirements; 3. Insuring that all vehicles transporting clients shall have at least the minimum level of liability insurance appropriate for the type of vehicle as defined by Article 7,Rule R2-36 of the North Carolina Utilities Commission; 4. Insuring that the contractor shall have written policies and procedures regarding how drivers handle and report client emergencies and/or vehicle crashes involving clients to contractor and how contractor notifies the Orange County Department of Social Services; 5. Insuring that no more than one quarter of one percent of all trips be missed by the contractor during the course of the contract period; (Medicaid only) 6. Insuring that that no more than five percent(5%)of trips should be late for recipient drop off to their appointment per month; (Medicaid only) 7. Contractor will maintain records documenting the following(County may require contractor to provide): a. Valid current copies of Drivers License for all drivers; b. Current valid Vehicle Registration, for all vehicles transporting clients; c. Driving records for all drivers for the past three years and with annual updates; d. Criminal Background checks through North Carolina Law Enforcement or NCIC prior to employment and every three years thereafter; e. Alcohol and Drug Testing policy to meet the Federal Transit Authority guidelines. S. Disclosing, at the outset of the contract, upon renewal and upon request, any criminal convictions or other reasons for disqualifications from participation in Medicare, Meriinsid or Title XX programs (signature on this form confirms this.statement). OocuSigned by: W" J-fS aJn. Executive Director 1182E36ODC5' 52488. Signature Title Chatham Transit Network 7/2/2019 Agency/Organization Date (Certification signature should be same as Contract signature.) Transportation Certification(06/16) Page i of I DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT K 501(c)(3)and TAX EXEMPT STATUS Orange County Department of Social Services What is a Private Non Profit Agency? Answer: A private non profit is an organization that is incorporated under State law and whose purpose is not to make a profit,but rather to further a charitable, civic,religious, scientific, or other lawful purpose. The Secretary of State's office grants corporate status to organizations in North Carolina. What is a 501(c)(3) designation? Answer: When the agency becomes a state private non profit corporation, it can then apply for 501(c)(3)designation through the IRS. Once the IRS grants 501(c)(3) status,the organization is exempt from certain taxes and any donations to the charitable organization are tax deductible. Many individuals and organizations prefer to make donations to 501(c)(3)private non profits. Who can obtain a 501(c)(3) designation? Answer: Any organization or group can apply for 501(c)(3) status,provided their charter or mission focuses on the non profit's objective. Another option is to apply for a 509(a)(1)status which falls under the 501(c)(3)umbrella. Being a 509(a)(1)designates an organization as a tax-free public charity that receives most of its support from a governmental unit or from the general public. Becoming a 509(a)(1)provides public recognition of tax-exempt status, advance assurance to donors of deductibility of contributions, exemption from certain State and federal taxes, and non profit mailing privileges. Organizations that typically qualify are churches, educational institutions, hospitals,and governmental units. To learn more about non profits,visit www.irs.gov, or call the tax-exempt helpline at 877-829- 4933. How does a Private Non Profit obtain Tax Exempt Status? A private non profit must apply to the IRS for tax exempt status. To qualify, applicants must complete and submit to the IRS Form 1023. Once federal tax exempt status is granted,the private non profit applies for State tax exempt status by completing Form CD-435 and submitting it to the N. C. Department of Revenue. Please attach proof of 501(c)(3)or IRS tax-exempt status to this page. DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E l NT,,TNAL. REVENUE SERVICE DEPARTMENT OF THE TREASURY DIRECTOR P. 0_ BOX 2508 ' N(-.L1.1N?aT- OH 45207. Da�J�+ l 2 7 1999 :llrk-HAM TRANSIT NETWORK Contact Person: PO ROX 1032 THOMAS E O'BRIEN 10# 31187 WC 27312-1032 Contact Telephone Number: (877) 829--5500 Our Letter Dated: July 1995 Addendum Applies: No Pea-r Appl'carlt: --his ;modifies our letter of the above date in which we stated that you be treated as an organization that is not a private foundation until the -,-,P'..ra t_on of your advance ruling period_ 'oLn- exempt status under section 501(a) of the Internal. Revenue Code as an .,rxz_= zatiorz described in section 501(c) (3) is still in effect. Based on the You submitted, we have determined that you are not a private `oundation within the meaning of section 509(a) of the Code because you are an yrgar..'_.zat'ion. of the type described in section 509(a) (1) and 170(b) (1) (A) (vi) . Grantors and contributors may rely on this determination unless the i'nrc:_na'_ Revenue Service publishes notice to the contrary. However, if you voti- section 509(a) (1) status, a grantor or contributor may not rely on thin hetermination if he or she was in part responsible for, or was aware of, th-e- act or failure to act, or the substantial or material change on the part of Hie c-uganization that resulted in your loss of such status, or if he or she ae:e10.i.rod kr_ow edge that the Internal Revenue service had given notice that you r:n i r_o :anger be classified as a section 509(a) (1,) organization. re have indicated in the heading of this letter that an addendum t1-e addendum enclosed is an integral part of this letter. :3ecause th'a letter could help resolve any questionns about your private -o_-nration status, please keep it in your permanent records. you have any questions, please contact the person whose name and t e l rphone ]:umber are shown above. Sincerely yours, rg,� � n• x strict Director Letter 1050 (DO/CG) DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT M State and Local Certifications Contractor Certifications Required by North Carolina Law Orange County Department of Social Services Insti-mcdons: The person who signs this document should read the text of the statutes and Executive Order listed below and consult with counsel and other knowledgeable persons before signing.The text of each North Carolina General Statutes and of the Executive Order can be found online at: ■ Article 2 of Chapter 64: httn://www.nega.state.nc.us/Enactedl,ep-islation/Statutcs/PDFByArticle/_Chapter 64/Article_22df ■ G,S. 133-32: httn:llwww.ncga.state.ne.us/gascripts/statutes/statutelookup_pt?statute 133-32 • Executive Order No.24(Perdue,Gov.,Oct. 1,2009): http:llwww.ethiescommission.ne.povflihrarylpdfslLaws1EQ24.pdf • G.S. 105-164.8(b): http:llwww.ncga.state.ne.us/Enactedl.ep-istation/Statutes/PDFBySection/Chapter_io5/GS_105-164.8.pdf • G.S. 143-48.5: http:llwww.nc a.state.ne.usfEnactedI.egislation/Statutes/HTML/BySectionIChapier_143/GS_143-48.5.htm1 ■ G.S. 143-59.1: httpalwww.ncga.state.nc.uslEnactedl,ep-islation/Statutes/PDF/By_Section/Chapter_143/GS_143-59.I.pdf • G.S. 143-59.2: http:llwww.nc,ga.state.nc.us/EnactedLegislation/StatuteslPDF/BySegLion/C`ht ter_143/GS_143-59.2.pdf • G.S. 143-133.3: httpalwww.nega.state.nc.uslEnactedLegisIati on/Statute slHTMLIBy Sect iott/Chapter 1431GS_143-133.3.htm1 • G.S. 143B-139.6C: http://www.nc a.state.ne.us/Enactedl,egislation/StatuteslPDFIBySectionlChapter_143BIGS_143B-139.6C.pdf ■ The text of Orange County Living Wage Contractor Policy which is attached to this document. Certifications (1) Pursuant to G.S. 133-32 and Executive Order No.24 ❑Neither the Contractor nor any of its affiliates (Perdue, Gov., Oct. 1, 2009), the undersigned hereby has incorporated or reincorporated in a "tax certifies that the Contractor named below is in haven country" as set forth in G.S. 143- compliance with,and has not violated,the provisions of 59.1(c)(2)after December 31,2001; or either said statute or Executive Order. (2) Pursuant to G.S. 143-48.5 and G.S. 143-133.3, the undersigned hereby certifies that the Contractor named ® The Contractor or one of its affiliates has below, and the Contractor's subcontractors, complies incorporated or reincorporated in a "tax haven with the requirements of Article 2 of Chapter 64 of the country" as set forth in G.S. 143-59.1(c}(2} NC General Statutes, including the requirement for after December 31, 2001 but the United States each employer with more than 25 employees in North is not the principal market for the public trading Carolina to verify the work authorization of its of the stock of the corporation incorporated in employees through the federal E-Verify system." E- the tax haven country. Verify System Link: www.uscis.gov (4) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor's officers, Local government is specifically exempt from Article 2 directors, or owners (if the Contractor is an of Chapter 64 of the North Carolina General unincorporated business entity) has been convicted of Statutes. However, local government is subject to and any violation of Chapter 78A of the General Statutes or must comply with North Carolina General Statute the Securities Act of 1933 or the Securities Exchange 153A-99.1,which states in part as follows: Act of 1934 within 10 years immediately prior to the Counties Must Use E-Verify-Each county shall date of the bid solicitation. register and participate in&Verify to verify the work (5) Pursuant to G.S. 143B-139.6C, the undersigned authorization of new employees hired to work in the hereby certifies that the Contractor will not use a United States. former employee, as defined by G.S. 14313- (3) Pursuant to G.S. 143-59.1(b), the undersigned hereby 139.6C(d)(2), of the North Carolina Department of certifies that the Contractor named below is not an Health and Human Services in the administration of a "ineligible Contractor" as set forth in G.S. 143-59.1(a) contract with the Department in violation of G.S. because: 143B-139.6C and that a violation of that statute shall void the Agreement. (a) Neither the Contractor nor any of its affiliates has (6) The undersigned hereby certifies further that: refused to collect the use tax levied under Article 5 of Chapter 105 of the General Statutes on its sales (a) He or she is a duly authorized representative of the delivered to North Carolina when the sales met Contractor named below; one or more of the conditions of G.S. 105- 164.8(b);and (b) He or she is authorized to make, and does hereby (b) [check one of the following boxes] make, the foregoing certifications on behalf of the Contractor; and Contractor Certifications Required by North Carolina Law(Rev.812016) Pate 1 of 3 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E (c) He or she understands that any person who services under this contract a living wage (in knowingly submits a false certification in response Orange County currently $14.95 per/hr.) Check to the requirements of G.S. 143-59.1and -59.2 here ❑ if contractor pays employees performing shall be guilty of a Class I felony. under this contract a living wage. If Contractor does not pay employees a living wage, what is the (1) Pursuant to the Orange County Living Wage wage that employees performing services under this Contract's Policy, the undersigned certifies that contract paid? the Contractor pays the employees who perform Contractor's Name: Chatham Transit Network qq DacuSigned by:: 'A' Contractor's [�ULf11 A I`LS{� Male, 7/2/2019 Authorized Agent: signature g2EMODC5-52488. Date Anna Testerman Executive Director Printed Na DocuSigned by: Title t,SS1Ca. ,t4rbv- 7/2/2019 1Witness: Signature Date E4E483E0BB884B2 . Printed NameJessica LaDronka Title Administrative Assistant The witness should be present when the Contractor's Authorized Agent signs this certificate and should sign and date the document immediately thereafter. Contractor Certifications Required by North Carolina Law(Rev.0016) Page 2 of 3 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Section 1: General Government and Administration Policy 10.0. Living Wage Contractor Policy Reviewed by: County Attorney/County Manager Approved by: County Manager Original Effective Date: April 21,2016 Revisions: Policy Statement It is the policy of Orange County to ensure its employees,and all individuals who provide services for Orange County,are paid a living wage. Purpose To encourage all vendors and contractors to pay a living wage to all employees who perform work pursuant to a contract with Orange County. Applicability Applies to all Orange County contracts and purchases. Po� licy 10.1 Living Wage 10.1.1 Orange County is committed to providing its employees with a living wage and encourages all contractors and vendors doing business with Orange County to pursue the same goal. Orange County's living wage is$14.95 per hour. To the extent possible,Orange County recommends that contractors and vendors seeking to do business with Orange County provide a living wage to their employees. 10.1.2 Prior to final execution of a contract with Orange County all contractors and vendors seeking to do business with Orange County shall submit to the County's representative a statement indicating whether those employees who will perform work on the Orange County contract are paid at least the living wage amount set out above. If such employees do not make at least the living wage amount set out above the contractor or vendor shall indicate in the statement the actual amount paid to such employees. For bid projects this statement should be submitted as part of the bid packet. This policy may be reviewed annually and updated as needed by the Manager's Office Contractor Certifications Required by Orange County and North Carolina Law Revised 6119 Page 3 of 3 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract#68-1 U 19 Chatham Transit Network ATTACHMENT N Orange County Department of Social Services/Human Services CERTIFICATION REGARDING NONDISCRAHNATION,CLEAN AIR ACT,CLEAN WATER ACT Certification Regarding Nondiscrimination The Contractor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101- 6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L. 92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1970(P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g)Title VID of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food Stamp Act and USDA policy,which prohibit discrimination on the basis of religion and political beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this Agreement. The Contractor must comply with Executive Order 11246, entitled "Equal Employment Opportunity,"as amended by Executive Order 11375, and as supplemented by the Department of Labor Regulations (41 CFR Part 60): The Executive Order prohibits federal contractors and federally-assisted construction contractors and subcontractors who do over $10,000 in Government business in one year from discriminating in employment decisions on the basis of race, color, religion, sex, or national origin. The Executive Order also requires Government contractors to take affirmative action to ensure that equal opportunity is provided in all aspects of their employment. Meanin,&l Access for LEP Individuals: The Contractor that participate in the SNAP must take reasonable steps to ensure that LEP persons have meaningful access to programs, services, and benefits. This includes the requirement to provide bilingual program information and certification materials and interpretation services to single language minorities in certain project areas. SNAP Contractors that do not provide meaningful access for LEP individuals risk violating prohibitions against discrimination based on National Origin in the Food and Nutrition Act of 2008, as amended, Title VI of the Civil Rights Act of 1964 (Title VI)and SNAP program regulations at 7 CFR 272A(b). They also risk noncompliance with the USDA policy guidance titled, "Guidance to Federal Financial Assistance Recipients Regarding Title VI Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons", published in 79 FR 70771 -70784(November 28,2014). The Contractor should develop an implementing plan to address the language assistance needs of the LEP population served. This may include contracting for oral interpretation services, hiring bilingual staff, arranging telephone interpreters and/or language lines, coordinating community volunteers, translating vital documents, and providing written notice that language services are available in appropriate languages. Quality and accuracy of the language service is (Federal Certification-Non-Discrimination, Clean Air, Clean Water) (0 1/2018)Page 1 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract!#68-1019 Chatham Transit Network critical in order to avoid serious consequences to the LEP person and to the recipient. LEP needs should be considered in developing budgets and front Iine staff should understand how to obtain language assistance services. For additional assistance and information regarding LEP matters, please also visit http://www.lep.gov. Ensuring Equal Opportuni1y Access for Persons with Disabilities: The Contractor must also ensure equal opportunity access for persons with disabilities. This includes ensuring that communications with applicants, participants, members of the public, and companions with disabilities are as effective as communications with people without disabilities. Contractors that do not provide persons with disabilities equal opportunity access to programs may risk violating prohibitions against disability discrimination in the Rehabilitation Act of 1978, the American with Disabilities Act(ADA)of 1990,as amended,and SNAP program regulations. DOJ published revised final regulations implementing Title 11 and Title III of the ADA on September 15, 2010. These regulations are codified at 28 CFR Part 35 "Nondiscrimination on the Basis of Disability in State and Local Government Services" and at 28 CFR Part 36 "Nondiscrimination on the Basis of Disability in Public Accommodations and Commercial Facilities". In accordance with the implementing regulations,Contractors must provide auxiliary aids and services where necessary to ensure effective communication and equal opportunity access to program benefits for individuals with disabilities. The type of auxiliary aids and services required will vary, but a Contractor may not require an individual with a disability to bring another individual to interpret, and may rely on a person accompanying a disabled individual only in limited circumstances. When a Contractor communicates with applicants and beneficiaries by telephone, it must provide text telephone services (ITY) or have access to an equally effective electronic telecommunications system to communicate with individuals who are deaf, hard of hearing, or hearing impaired. Contractors must also ensure that interested persons, including persons with impaired vision or hearing, can obtain information as to the existence and location of accessible services, activities, and facilities. For more information, please visit the ADA website: http://www.ada.gov. IV.The Clean Air Act,Section 306; 42 U.S.C.§7401 et seq. (1970) a. No Federal agency may enter into any contract with any person who is convicted of any offense under section 113(c) for the procurement of goods, materials, and services to perform such contract at any facility at which the violation which gave rise to such conviction occurred if such facility is owned, leased, or supervised by such person. The prohibition in the preceding sentence shall continue until the Administrator certifies that the condition giving rise to such a conviction has been corrected. For convictions arising under section 113(c)(2), the condition giving rise to the conviction also shall be considered to include any substantive violation of this Act associated with the violation of 113(c)(2). The Administrator may extend this prohibition to other facilities owned or operated by the convicted person. b. The Administrator shall establish procedures to provide all Federal agencies with the notification necessary for the purposes of subsection(a). c. In order to implement the purposes and policy of this Act to protect and enhance the quality of the Nation's air,the President shall,not more than 180 days after enactment of the Clean Air Amendments of 1970 cause to be issued an order (1) requiring each Federal agency authorized to enter into contracts and each Federal agency which is empowered to extend Federal assistance by way of grant, loan, or contract to effectuate the purpose and policy of this Act in such contracting or assistance activities, and (2) (Federal Certification-Non-Discrimination, Clean Air, Clean Water) (0112018)Page 2 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract#68-1019 Chatham Transit Network setting forth procedures, sanctions, penalties, and such other provisions,as the President determines necessary to carry out such requirement. d. The President may exempt any contract, loan, or grant from all or part of the provisions of this section where he determines such exemption is necessary in the paramount interest of the United States and he shall notify the Congress of such exemption. e. The President shall annually report to the Congress on measures taken toward implementing the purpose and intent of this section, including but not limited to the progress and problems associated with implementation of this section. [42 U.S.C. 76061 V. The Clean Water Act;33 U.S.C.§1251 et seq.(1972) a. No Federal agency may enter into any contract with any person who has been convicted of any offense under Section 309(c) of this Act for the procurement of goods, materials, and services if such contract is to he performed at any facility at which the violation which gave rise to such conviction occurred, and if such facility is owned, leased, or supervised by such person. The prohibition in preceding sentence shall continue until the Administrator certifies that the condition giving rise to such conviction has been corrected. b. The Administrator shall establish procedures to provide all Federal agencies with the notification necessary for the purposes of subsection(a)of this section. c. In order to implement the purposes and policy of this Act to protect and enhance the quality of the Nation's water, the President shall, not more than 180 days after the enactment of this Act,cause to be issued an order: (i) requiring each Federal agency authorized to enter into contracts and each Federal agency which is empowered to extend Federal assistance by way of grant, loan; or contract to effectuate the purpose and policy of this Act in such contracting or assistance activities,and (H) setting forth procedures, sanctions, penalties, and such other provisions, as the President determines necessary to carry out such requirement. d. The President may exempt any contract, loan, or grant from all or part of the provisions of this section where he determines such exemption is necessary in the paramount interest of the United States and he shall notify the Congress of such exemption. e. The President shall annually report to the Congress on measures taken in compliance with the purpose and intent of this section, including, but not limited to,the progress and problems associated with such compliance. f. No certification by a contractor, and no contract clause, may be required in the case of a contract for the acquisition of commercial items in order to implement a prohibition or requirement of this section or a prohibition or requirement issued in the implementation of this section. g. In paragraph (1),the term"commercial item"has the meaning given such term in section 4(12)of the Office of Federal Procurement Policy Act(41 U.S.C.403(12)). (Federal Certification-Non-Discrimination, Clean Air, Clean Water) (0 1/2018)Page 3 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E Contract#68-1019 DocuSigned by: Chatham Transit Network 1K.Ut.A. J`G5{UWaJA, Executive Director 82EMODC5=52488. Signature Title Chatham Transit Network 7/2/2019 Agency/Organization Date (Certification signature should be same as Contract signature.) (Federal Certification-Non-Discrimination, Clean Air, Clean Water) (01/2015)Page 4 of 4 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E ATTACHMENT U OUTCOMES AND REPORTING Orange County Department of Social Services By signing and submitting this document,the Contractor certifies that it agrees to the following: 1.The Contractor agrees to participate in program, fiscal and administrative monitoring and/or audits, making records and staff time available to Federal, State and County staff. 2.The Contractor agrees to take necessary steps for corrective action,as negotiated within a corrective action plan, for any items found to be out of compliance with Federal, State,and County Iaws,regulations, standards and/or terms of the Contract. 3.The Contractor agrees that continuation of and/or renewal of this Contract is contingent on meeting the following requirements. The Contractor agrees to: A. Adhere to all Federal and State transportation laws&regulations. B. Transport client(s)to and from medical appointments as requested by the County. C. Transport approved,authorized client(s)to specified destinations within and outside of Orange County upon request,on time,and in accordance with arrangements made by the County, D. Transport clients only to approved destinations.Any additional destinations cannot be provided without the expressed consent and authorization of the County. E. Provide services to enrolled participants within three days of a request. F. Provide critical services on short notice when requested. G. Coordinate maintenance with private vendors to ensure vehicles are in safe operating order. H. Discuss the specific situation, and present evidence of cause,with the County prior to termination of services for any client. I. Complete the DMA 5124 as part of the annual contract process. J. Only submit invoices for trips approved by the County. Trips included on invoices that were not pre-approved will not be reimbursed. K. Meet on-time performance standards such that no more than 5% of trips should be late for client drop-off to his appointment per month. Late is defined as past the client's appointment time. L. Not miss more than one quarter of one percent of all trips during the course of the contract year. M. Report all no-shows on a daily basis and cancellations on a monthly basis to the County. N. Record all client complaints which deal with the matters under the control of Contractor, including the date of the complaint,the nature of the complaint,and what steps were taken to resolve the complaint. ❑. Provide names of all owners,managers,management entities,and subcontractors. P. Report any changes such as insurance provider,business ownership or management. Q. Disclose,at the outset of the contract,upon renewal and upon request,any criminal convictions or other reasons for disqualifications from participation in Medicare,Medicaid or Title XX programs. DocuSigned by: ��" �f,5 � Executive Director Slgnatu K E2430 DC5 F 52488 Tiflo Chatham Transit Network 7/2/2019 Agency/Organization Date (Certification signature should be same as Contract signature.) Outcomes (06/04) Page I of I DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E X O RT,H'. n R o L [ x A x - _ Asfp[:twr.u+y or CavtrTY COfMMIs%[e]N RK RISK MANAGEMENT POOLS Coverrriy the Covatles that Cover our State LIABILITY AND PROPERTY COVERAGE CERTIFICATE COVERAGE PROVIDER: NCACC Liability and Property Pool This certificate is provided by the NCACC Liability and Property 323 West Jones St,Suite 500 Pool and is issued as a matter of information only. This Raleigh,NC 27603 certificate confers no rights upon the certificate holder other than MEMBER: those provided in the coverage document. This certificate does Chatham Transit Network not amend,extend,or alter the coverage afforded by the 480 Hillsboro Street,Suite 110 coverage documents listed herein. Pittshoro,NC 27312 COVERAGES Type of Coverage Coverage Effective Expiration Contract# Date Date Limits Liability General Liability- X Each Occurrence, No Aggregate applies LP-CH-475-19 July 1,2019 July 1,2020 X Public Officials Liability, $2,000,000 occurrence Each Wrongful Act LP-CH-475-19 July 1,2019 July 1,2020 X Law Enforcement Liability, Each Occurrence LP-CH-475-19 July 1,2019 July 1,2020 $1,000,000 aggregate Cyber Liability LP-CH-475-19 July 1,2019 July 1,2020 Claims Made Excess Liability LP-CH-475-19 July 1,2019 July 1,2020 $3,000,000 Automobile Liability X All Owned Autos, Each Accident LP-CH-475-19 July 1,2019 July 1,2020 X Hired Autos, $2,000,000 occurrence Each Accident LP-CH-475-19 July 1,2019 July 1,2020 X Excess Auto Liability far Non-Owned Autos F.-CH-475-19 July 1,2019 July 1,2020 Automobile Physical Damage X Scheduled Vehicles Actual Cash Value at the time of LP-CH-475-19 July 1,2019 Jul 1,2020 the Loss,unless otherwise Hired Autos(if coverage is not specified in the Coverage X purchased elsewhere) Document;Deductible Applies LP-CH-475-19 July 1,2019 July 1,2020 Property-Risks of Direct Physical Loss, Imit Deductible Blanket Limit LP-CH-475-19 1 July 1,2019 JWV 1,2020 $ 1,136,190 $1,000 Additional Information: Evidence of Coverage. CERTIFICATE BOLDER: Cancellation: Should any of the described Coverage documents herein be Orange County Government cancelled before the expiration date shown, the N CAC C Pools will endeavor to mail written notice to the Certificate Holder named herein,but failure to mail such 2o0 Sounth Cameron Street notice shall impose no obligation or liability of any kind upon the NCACC Pools,its Hillsboraugh,NC 27278 agents or representatives,or the issuer of this certificate. By:Willie J,Allen Jr., Underwriter far the NCACC �` fij 5130/2019 Certificate MaIled/E-Mailed or Faxed to: Orange County Government 200 Sounth Cameron Street Hillsborough,NC 27278 DocuSign Envelope ID: FB28FAE1-FFC6-4AE8-BB72-9CC28168D54E �• • iK 4 R,T Fg C A A n L i M A i] O 111 OCTATMN O}COl'NT7 C01HMS55Y[1M8P3 � y RISK MANAGEMENT POOLS cou+:Tc Cove Ong the Counties that Cd der our Va to WORKERS COMPENSATION COVERAGE CERTIFICATE COVERAGE PROVIDER: NCACC Liability and Property Pool 323 West Janes St.,Suite 500 This certificate is provided by the NCACC Workers'Compensation Pool Raleigh,NC 27603 and is Issued as a matter of Information only. This certificate confers no MEMBER: rights upon the certificate holder other than those provided In the coverage document. This certificate does not amend,extend,or alter the Chatham Transit Network coverage afforded by the coverage documents listed herein. 48a Hitlsboro Street,Suite 110 Pittsboro,NC 27312 COVERAGES Type of Coverage Coverage Effective Expiration Contract# Date Date Limits + Coverage A: WORKERS'COMPENSATION WC-CH-475-19 July 1,2019 July 1,2020 Statutory Coverage B: EMPLOYERS'LIABILITY WC-CH-475-19 July 1 2019 J uly 1 2020 12,000,000 Coverage C: OTHER STATES WC-CH-475-19 July 1,2019 July 1,2020 Statutory Additional Information: Evldemce of Coverage. CERTIFICATE HOLDER: Cancellation: Should any of the described coverage documents herein be cancelled before Orange County Government the expiration date shown, the NCACC Pools will endeavor to mall written notice to the Certificate Holder named herein,but failure to mail such notice shall Impose no obligation 200 South Cameron Street or I[abllity of any kind upon the NCACC Pools,its agents or representatives,or the Issuer of Hillsborough,NC 27278 this certificate. By: Willie J.Alien Jr., +ct� 513012fl19 Underwriter for the NCACC Certificate Mailed/E-!Nailed or Faxed to: Orange County Government 240 South Cameron Street Hillsborough,NC 27278