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HomeMy WebLinkAbout2019-666-E Emergency Svc - Orange County Schools CBT agreement DocuSign Envelope ID:7153675D-647B-4D5F-AA47-OABA1B509205 '144ko RANGE COUNTY SCHOOLS FIRST CHOICE FOR FAMILIES Exceptional Children Department 1914 New Hope Church Road Chapel Hill, NC 27514 (919)245-4005 (919) 245-4012 (fax) COMMUNITY BASED VOCATIONAL TRAINING (CBT) AGREEMENT SCHOOL: Orange County Schools 1914 New Hope Church Road Chapel Hill, NC 27514 ADMINISTRATOR: Mary Ann Baldwin PHONE: 919-245-4006 ext. 18005 CBT TEACHERS: Pam Scism at Cedar Ridge High School aam.scism(cDorange.k12.nc.us: Lori Bartch at Orange High School lori.bartchC@orange.k12.nc.us PHONE: Pam Scism: 919-245-4000 ext 21757; Lori Bartch (919) 732-6133 ext. 20761 PERIOD OF INSTRUCTION: September 2019- May 2020 (based on school calendar) MAXIMUM NUMBER OF STUDENTS AT SITE AT ANY TIME: 2 BUSINESS/AGENCY: NAME: Orange County Emergency Services ADDRESS: 149 North Scottswood Blvd, Hillsborough, NC 27278 REPRESENTATIVE: Dinah Jeffries Emergency Services Director Phone: 919-245-6100, ext. 6123 The Orange County School System (the "Board of Education") and the business/agency(the "Business") named above have agreed to cooperate to provide community based vocational training for students, in accordance with each student's Individualized Education Plan and, if appropriate, Individualized Transition Plan. The Board of Education and the Business enter into the following agreement for providing community based vocational training. Section 1—The Business understands the following stipulations of the community-based training program. 1. The business will not receive an immediate benefit from the student trainees. 2. Although the student trainees will be under supervision of school personnel,the business may assign an employee with whom the student trainee can shadow during normal work duties as needed. 3. No employee of the business will be displaced due to the presence of student trainees nor will any employee experience a reduction in hours due to student trainees. 4. Vacancies within the business will not be filled by student trainees. 5. Student trainees will only do a part or parts of a full job description and may not perform up to full expectations of a regular employee. Orange County School does not discriminate against any person on the basis of race,color,religion,sex,national origin,age or disabling condition in any educational or employment opportunities. 6/2019,mb DocuSign Envelope ID:7153675D-647B-4D5F-AA47-OABA1B509205 RANGE COUNTY SCHOOLS FIRST CHOICE FOR FAMILIES 6. Student trainees will not be guaranteed a job within the business at the conclusion of the student training period. 7. Student trainees will not receive payment for work performed during the training period. 8. The Business may be asked to assist in the evaluation of student trainees. 9. The Business will comply with all federal, state and local health and safety standards as they apply to student trainees. 10. The Business will not discriminate against student trainees based on race, color, sex, national origin, religion or disability. 11. There is no employer-employee relationship between the business and the student trainee. 12. Student trainee will not be on the training site when school is not in session. 13. If at any time,the student will be supervised by a business employee only,that employee must have a background check and Lunsford Act check. 14. Training will be conducted during the following times: 8:00-4:00 Section II—The schools agree to: 1. Insure that all student trainees have school insurance. 2. Establish days and hours of training based on student needs and input from the business and to notify the business of any needed schedule changes. 3. Provide transportation for students to training site. 4. Conduct evaluations of student trainees with input from the business. 5. Provide information relevant to the student's job performance that would be beneficial to successful student training. 6. Provide professional and technical assistance as required or requested by the business. 7. Maintain frequent and on-going communication with the business regarding student trainees. 8. Conduct job analysis and complete a job duties form to determine the exact type of work and location of work to be performed for each student trainee. 9. Assist the business in making any necessary adaptations to accommodate a student trainee. This agreement will remain in effect during the 2019-2020 school year unless modified or terminated by either party. We the undersigned, as representatives of the parties involved agree to abide by all conditions of the agreement. We understand that this agreement may be canceled at any time by either party upon adequate notice to the other. GocuSigned by: 9/27/2019 74357ABEA4AB49E EC Program Specialist, aviary Ann 6aiawin Date OocuSigned by: PtV-4 yffiif,$ 9/27/2019 5655BC891A64473. Business Representative 0(.E!> Director Date Orange County School does not discriminate against any person on the basis of race,color,religion,sex,national origin,age or disabling condition in any educational or employment opportunities. 6/2019,mb DocuSign Envelope ID:7153675D-647B-4D5F-AA47-OABA1B509205 DATE(MMIDDIYYYYI CERTIFICATE OF LIABILITY INSURANCE 7/17/2018 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 BOLDER. IMPORTANT: It the certificate holder is an ADDITIONAL INSURED,the pollcytlesy must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: Laura Falan a AssuredPartners of North Carolina, LLC PHONE 919.645-1584 (AdCFAX, No:919 582-1999 4505 Falls of Neuse Road,Suite 350 E-MAIL Raleigh NC 27609 ADDRESS: laura.falanga@assuredpartners.com INSURER 5 AFFORDING COVERAGE NAIC B INSURER A:Peerless Insurance C ompany 24198 INSURED NCDEPTO-01 INSURER e North Carolina Department of Public Instruction INSURER C 301 North Wilmington St INSURERD: Raleigh NC 27601 INSURER E: INSURER F: _ COVERAGES CERTIFICATE NUMBER:905231489 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL SU R POLICY NUMBER MhWDO OLICY EFF MMPOLICY - LIMITS LTR A X COMMERCIAL GENERAL LIABILITY Y GL8058891 71UZO18 7/1/2019 EACH OCCURRENCE $1,00D,D00 DAMAGE TO RENTED CLAIMS-MADE FRI OCCUR PREMISES(Ea occurrence) $100A00 MED EXP Any one person $15,000 PERSONAL&ADV I NJU RY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3.000.000 x POLICY❑JE T LOC PRODUCTS-COM Plop AGG S OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Me accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Peracddent) S AUTOS NON--OWNEO PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per acciden a UMBRELLA LIAB OCCUR EACH OCCURRENCE $ E%CE85 LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS S WORKERS COMPENSATION AND EMPLOYERS'IJABILITY YIN STATUTE ER ANY PROPRIETORfPARTNEfilE CUT4 11E ❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S It yes,desrAba under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Addltlonal Remarks Schedule,may be attached If more apace Is required) Medical Professional Liability In the amount of$1,000,000 per occurrence and$3,000.000 aggregate is Included in the policy Medical Payments extend to students enrolled in the Work Farce Development Programs,In the amount of$15,000.❑renge County Schools are listed as an Additional Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Schools 200 East King Street AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD