HomeMy WebLinkAbout2021-030-E Social Svc-New Destinations Inc Cardinal Managed Care performance agreement DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
CARDINAL MANAGED CARE FUNDS
PERFORMANCE AGREEMENT
THIS AGREEMENT,made and entered into the first day of July 2020, ("Effective Date")by and between
the County of Orange, a political subdivision of the State of North Carolina, Post Office Box 8181,
Hillsborough, North Carolina, 27278, ("County") and New Destinations, Inc., a not-for-profit corporation,
located at 5720 Turner Store Ln.,Raleigh,North Carolina 27603 ("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 New Destinations, Inc. agree as follows:
1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1,
2020 to June 30,2021.
2. Scope of Services.
a. Provider will provide services to the residents of Orange County, as outlined in the attached
Cardinal Managed Care Funds and Program Budget and any amendments or revision thereto
which is attached as Exhibit "A", which are incorporated by reference. The Scope of
Services and the Program Budget may be different 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.
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. Cardinal Managed Care Funding.
i. Cardinal Managed Care Funding. The County agrees to appropriate funds for the
provision of services described the"Program Services"section of Exhibit A,and
may be more particularly outlined in the"Expense Description"section of Exhibit
A,the maximum sum of$35,100.00 in Cardinal Managed Care Funds.
ii. The Provider shall be paid Cardinal Managed Care Funds in twelve equal monthly
installments in the amount of$2,925.00.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.
b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not
used for the purposes stated shall be returned to the County. Any changes in the use of funds
must be authorized in writing by the County prior to any expenditure of the funds by the
Provider. If the funds are expended not in accordance with the Work Statement, at the
discretion of the County the Provider may be required to repay the funds to the County.
(«Agencys Name»)
Orange County Cardinal Managed Care Fund Performance Agreement
Revised 112021 Page I of 9
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
c. The County's obligation to make the payments is contingent.upon receipt of Progress Reports
and requests for reimbursements as provided in Section 4 below, which show satisfactory
progress toward completion of performance measures and an accounting of expenditures as
detailed in the attached Work Statement.
d. Once Provider has satisfied its obligations as provided in Sections 3 and/or 4 payment will
be made within 21 days after receipt of the Progress Report and Request for Reimbursement.
e. The County is not obligated to provide any other support to Provider in this or in succeeding
fiscal years.
4. Agency Reporting.
a. Cardinal Managed Funds Reporting. Provider will provide Orange County a Monthly
Progress Report for Cardinal Managed Care funds that includes a fiscal report and updates
on performance measures as outlined in the Work Statement. Progress Reports are due by
the 15'of the next month following the month being reported.
b. Provider agrees to allow the County to inspect its financial books and records, which
document costs of those services,upon reasonable notice during normal working hours.
5. Termination.
a. In the event of any of the circumstances set forth below(hereinafter referred to as"default"),
the County may immediately terminate this Agreement,in whole or in part,and from time to
time.Notice of termination must be in writing,state the reason or reasons for the termination,
and specify the effective date of the termination:
i. In the event that Provider shall cease to exist as an organization or shall enter
bankruptcy proceedings,be declared insolvent, or liquidate all or substantially all of
its assets, or significantly reduce its services or accessibility to Orange County
residents during the term of this Agreement; or
ii. In the event that Provider shall fail to render a satisfactory accounting as provided
section 4 above,the County may terminate this Agreement and Provider shall return
all payments already made to it by the County for services which have not been
provided or for which no satisfactory accounting has been rendered; or
iii. In the event of any fraudulent representation by the Provider in an invoice or other
verification required to obtain payment under this Agreement or other dishonesty on
a material matter relating to the performance of services under this Agreement.
iv. Nonperformance, incomplete service or performance, or failure to satisfactorily
perform any part of the work identified in the Scope of Services or to comply with
any provision of this Agreement, as determined by the County in its sole discretion.
v. Failure to adhere to the terms of applicable county, state or federal laws,
regulations, or stated public policy.
b. In the event of default by the Provider,the county may elect to terminate this Agreement, in
whole or in part and/or require the Provider to repay the funds within ten(10)business days
from written notice of default. The County shall pay Provider that portion of the fees and
(rt�geney� Na�ne�):
Orange County Cardinal Managed Care Fund Performance Agreement Page 2 of 9
Rev. 112021
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
expenses that it has earned to the date of termination, less any costs or expenses incurred or
anticipated to be incurred by the County due to errors or omissions of the Provider. 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 parry 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.
e. Should this Agreement be terminated,the Provider shall deliver to the County within seven
(7) days, at no additional cost, all deliverables including any electronic data or files relating
to the Project.
f. Waiver. The payment of any sums by the County under this Agreement or the failure of the
County to require compliance by the Provider with any provisions of this Agreement or the
waiver by the County of any breach of this Agreement shall not constitute a waiver of any
claim for damages by the County for any breach of this Agreement or a waiver of any other
required compliance with this Agreement.
6. Insurance.
a. General Requirements. The Provider shall purchase and maintain, during the period of
performance of this Agreement,insurance:
i. Worker's Compensation. For protection from claims under workers' or workmen's
compensation.acts;
ii. Comprehensive General Liability Insurance covering claims arising out of or
relating to bodily injury, including bodily injury, sickness, disease or death of any
of the Consultant's employees or any other person and to real and personal property
including loss of use resulting thereof;
iii. Comprehensive Automobile Liability Insurance, including hired and non-owned
vehicles, if any, covering personal injury or death, and property damage; and
iv. Professional Liability Insurance, covering personal injury,bodily injury and
property damage and claims arising out of or related to the performance under this
Agreement by the Consultant or his agents,consultants and employees.
b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows:
INSURANCE DESCRIPTION MINIM[LT1V1 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
(t<Agencys Name»)
Orange County Cardinal Managed Care Fund Performance Agreement Page 3 of 9
Rev. 112021
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• Commercial General $1,000,000 Each Occurrence
Liability $2,000,000 Aggregate
• Automobile Liability $500,000 Combined Single Limit
• Professional Liability $1,000,000 Each Occurrence
$2,000,000 Aggregate
c. All insurance policies (with the exception of Worker's Compensation and Professional
Liability)required under this Agreement shall name the County as an additional insured
party and as a certificate holder. Evidence of such insurance and all correspondence shall
be sent to:
Orange County Risk Manager
Post Office Box 8181
Hillsborough,NC 27278
d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity
defenses.
7. Relationship of the Parties. Provider is an independent contractor of the County. Provider
represents that they have or will secure, at his own expense, all personnel required in performing
the services under this Agreement. Such personnel shall not be employees or have any contractual
relationship with the County. All personnel engaged in work under this Agreement shall be fully
qualified and shall be authorized and permitted under federal, state and local law to perform such
services.
8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws,
ordinances, orders and regulations of the federal, state or local governments, as well as their
respective departments, commissions, boards, and officers, which are in effect at the time of
execution of this Agreement or are adopted at any time following execution of this agreement.
9. Subcontract. The County and Provider deem the services provided under this Agreement to be
personal in nature and Provider may not subcontract any rights or duties under this Agreement to
any other party without prior written consent from the County.
10. Limitation and Assignment. The County and the Provider each bind themselves,their successors,
assigns and legal representatives to the terms of this Agreement. Neither the County nor the
Provider shall assign or transfer its interest in this Agreement or the rights to payment to any other
parry without the written consent of the other.
11. Indemnification. Provider agrees to defend,indemnify,and hold harmless the County,for all loss,
liability, claims or expense (including reasonable attorney's fees) arising from bodily injury,
including death or property damage, to any person or persons caused in whole or in part by the
negligence or willful misconduct of the Provider, except to the extent same are caused by the
negligence or willful misconduct of the County. It is the intent of this section to require Provider
to indemnify the County to the extent permitted under North Carolina law. Nothing in this section
is intended to affect or abrogate the County's sovereign immunity defenses.
12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the
specified services and may be terminated at any time if such funds become unavailable.
13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange
County the parties hereto for themselves,their agents, officials, employees and servants agree not
to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap,
(Mgencys Name))
Orange County Cardinal Managed Care Fund Performance Agreement Page 4 of 9
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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. Dispute Resolution.Any and all suits or actions to enforce,interpret or seek damages with respect
to any provision of, or the performance or non-performance of,this Agreement shall be brought in
the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is
agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits
or actions. Binding arbitration may not be initiated by either Party,however,the Parties may agree
to nonbinding mediation of any dispute prior to the bringing of such suit or action.
15. 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 $ 15.00 per
hour. To the extent possible, Orange County recommends that Provider provide a living wage to
its employees.
16. 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: Finance &Administrative Services Provider: Larry Lackey
Orange County New Destinations,Inc.
Post Office Box 8181 5720 Turner Store Ln.
Hillsborough,NC 27278 Raleigh,NC
27603
17. 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 farther
agree that this Agreement constitutes the complete and exclusive statement of the Agreement
between the County and Provider.
18. Severability. All clauses found herein shall act independently of each other. If a clause is found
to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It
is understood by the parties hereto that if any part,term or provision of this Agreement is by the
Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United
States,the validity of the remaining portions or provisions shall not be affected, and the rights and
obligations of the parties shall be construed and enforced as if the Agreement did not contain the
particular part,term or provision held to be invalid.
a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of
respective parties hereunder shall be governed by the laws of the State of North Carolina. By
(rfAgencys Name»�
Orange County Cardinal Managed Care Fund Performance Agreement Page 5 of 9
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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. By executing this Agreement Provider certifies that Provider has not been
identified, and has not utilized the services of any agent or subcontractor identified, on the
list created by the State Treasurer pursuant to G.S. 147-86.81.
19. Signatures. This Agreement together with any amendments or modifications may be executed
electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply
with Article 11A and Article 40 of North Carolina General Statute Chapter 66.
IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on
the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures
below.
aaPehalf of the Provider
-" -1 tA&U1 1/22/2021
Larry Lac ey,New Destinations,Inc. Date
,a&)§ehalf of Orange County Government
b61aW'(I 1/25/2021
Bonnie Hammersley, County Manager Date
((Agencys_Name»)
Orange County Cardinal Managed Care Fund Performance Agreement Page 6 of 9
Rev. 112021
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: New Destinations, Inc. Party/Vendor Contact Person: Larry Lackey Contact Phone: 919-414-
2860 Party/Vendor Address: 5720 Turner Store Ln. City Ralei State:NC Zip:27603 Department: Social Services
Amount: $35,100 Purpose: Cardinal Innovations MOE Budget Code(s): 10420020-710050 Vendor#800744 (N/A if
new vendor) Vendor is a BOCC consultant? Yes ❑ NoM Contract Type: (Check one) New ❑ Renewal M
Amendment ❑ Effective Date 7/1/2020 Approved by Board YesM No❑ Agenda Date: 6/16/2020
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
DocuSigned by:
FN" cbsw, Date: 1/22/2021
Department Director's Signature
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that
was addressed:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficient dja%av,%standards, specifications,and requirements:
VI
Office of the Risk Management Office Q�ISa Cb�nxjnR- b a Date:1/21/2021
Financial Services
This instrument has been pre-audited ' mVAR%#"quired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 06. Date:1/22/2021
Legal Services
This agreement is approved as t cficxd sufficiency:
Office of the County Attorney -'F"-""�'� _Date: 112512021
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
(aAgencys Name)
Orange County Cardinal Managed Care Fund Performance Agreement Page 7 of 9
Rev. 112021
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
Exhibit A
Cardinal Managed Care Funds Scope of Services
And Program Budget
(«Agencys Name)))
Orange County Cardinal Managed Care Fund Performance Agreement Page 8 of 9
Rev. 112021
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
ATTACHMENT "A"
Orange County Certifications—FY 2021
Cardinal Managed Care Fund Performance Agreement
Chief Contact,Administrators, Chief Executive Officer and Chief Financial Officer
I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief
financial officer for my agency with this Agreement and that I will keep it current to the County of Orange.
The list should be in writing with the name,title,residential address;phone and email address and if
possible, fax number.
Officers and Board of Directors
I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and
that we will continue to update the list as changes occur. The list should be in writing,with the name,
physical address,mailing address and if possible,phone,fax and email address.
Budget Submission
I certify that I have provided a budget for the period to be covered by funding Orange County, and that any
substantive changes made to this budget have been in advance authorized in writing by Orange County.
Annual Financial Review
I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget
adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a
separate sheet of paper.
Alignment with Organization's Mission
I certify that the programs and services for which this funding is requested align with the mission of the
organization.
Intended Purpose
I certify that the funds provided to the agency under the terms of this Agreement will be used for a public
purpose and shall only be used for the purposes intended and any money not used for those purposes will be
promptly returned to Orange County.
Certified by: Title: Date:
(Provider's Signature)
(((Agencys_Name>))
Orange County Cardinal Managed Care Fund Pei formance Agreement Page 9 of 9
Rev. 112021
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
EXHIBIT"A'
Scope of Services—FY 2020-21
Outside Agency Performance Agreement
Agency Name: New Destinations Inc(MOE Funds)
Program Name: Overlook Apartments
Funding Award:
Outline how the agency will spend Orange County's funding award.
Expense Description Amount
Apartment Manager Payroll &Benefits 26,000
Building&Vehicle Maintenance 4,000
Telephone, Internet, Program Supplies 5,100
Program Services
Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2021.
Apartment Manager will assist the(13)Adult SPMI Residents in the preparation/submission of Annual HUD
• Recertifications,collects/submits monthly rent payments
• Apartment Manager will conduct routine Apartment Inspections,coordinate necessary repairs and ensure a safe
enviroment
• Apartment Manager will ensure all Residents follow Apartment Rules and facilitate conflict resolution
Anticipated Outcomes
The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange
County,only(all Towns and municipalities).
If you use percentages,Vou must also provide the total number of participants within that measure's description or for an
earlier performance measure.
Performance Measures Anticipated
Results
Residents
Maintain their
Aparment Manger will assist the (13)Adult SPMI Residents who are at a heightened risk HUD
for homelessness in the preparaton/submission of the required Annual Hud Apartment
Recertifications in order to retain their Apartment Lease with HUD. Leases
Ensure
(13) Resident's Apartments will be inspected on a regular basis to ensure Sanitary&
they are in good order and they will be given assistance in correction any Safe Living
Conditions for
deficiencies. all Residents
Apartment Manager will conduct wellness checks on a daily basis to ensure the well being of the Ensure Residents
Residents and contact the appropriate Stake Holders(ACTT,Guardians, Medical Doctors,etc) Receive the
when issues arive which require additional involvement. Medical/Clinical
Provide Community Integraton by scheduling periodic outtings in the Community Services they
requiire.
Certified by: Title: Date:
(Provider's Electronic Signature)
"You will sign this document electronically with your performance agreement.
DocuSign Envelope ID: 1D078E61-3408-4B43-8758-39AO9lBlBE00
NEWDE-1 OP ID: C1
,acoRo CERTIFICATE OF LIABILITY INSURANCE DATE(M
09/01/20 YYY)
/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
919 467-6339 CONTACT Ed Moore&Associates, Inc.
PRODUCER NAME:
Ed Moore&Associates,Inc. PHONE 919-467-6339 FAX 919-467-6434
103-B Kilmayne Drive (Arc,No,Ext): (A/c,No):
Cary,NC 27511 E-MAIL cmoore@edmooreinsurance.com
Ed Moore&Associates,Inc. ADDRESS:
INSURERS AFFORDING COVERAGE NAIL#
INSURER A:Cincinnati Insurance Company 10677
I sur�ED INSURER B:All Risks Ltd-Oak River Ins Co
New Destinations Inc
PO Box 1239 INSURER C:
Fuquay Varina,NC 27526
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXPINSD LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE X OCCUR ETD 0388216 05/26/2020 05126/2021 DAMAGE TO RENTED 1,000,000
X PREMISES Ea occurrence $
_ MED EXP(Any one person $ 10,000
PERSONAL&ADV INJURY $ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
X POLICY PE LOC PRODUCTS-COMP/OP AGO $ 3,000,000
OTHER: $
A AUTOMOBILE LIABILITY EOa accidem SINGLE LIMIT $ 1,000,000
X ANY AUTO ETD 0388216 05/2612020 05126/2021 BODILY INJURY Perperson) $
OWNED SCHEDULED
X AUTOS ONLY X AUTOS BODILY INJURY Per accident $
X HIRED X NON-OWNED PeOPERTn(DAMAGE $
AUTOS ONLY AUTOS ONLY
A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000
EXCESS LIAR CLAIMS-MADE ETD 0388216 05/26/2020 05126/2021 AGGREGATE $ 2,000,000
DED X RETENTION$ 0
B WORKERS COMPENSATION X IPER I I OTH-
AND EMPLOYERS'LIABILITY s AT ER
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N NEWC009178 05/26/2020 05/26/2021 AC E.L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER
n NH)
EXCLUDED? [NJ NIA
E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under 1,000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
A Professional Liab ETD0388216-INCL PRIOR ACT 05/26/2020 05/2612021 Incident 1,000,000
RETROACTIVE DATE 05/26/09 Aggregate 3,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
Orange County Government is an additional insured with respect to General
Liability coverage when required by written contract.
CERTIFICATE HOLDER CANCELLATION
ORANGCO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Orange Count Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
9 Y ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Risk Manager
P.O. Box 8181
Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
Ed Moore&Associates,Inc.
ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD